Cyber Vulnerabilities in Blockchain Electronic Health Records: An In-Depth Threat Analysis

Marija Brkic, Horia-Stefan Dinu, Alida Mirkovic, Alma Sabirovic, Sajjad Khan, Davor Svetinovic

Abstract: The rapid evolution of information systems and the surge in data generation and dissemination have fostered the emergence of Electronic Health Records (EHRs). Specifically, blockchain-enabled EHRs are revolutionizing modern healthcare by centralizing patient data promoting transparency, accessibility, and interoperability. However, amidst increasing cyberattacks on healthcare institutions, the security of these EHRs is a critical concern. Existing research predominantly focuses on the advantages and disadvantages of incorporating blockchain technology into EHRs, leaving a noticeable gap in analyzing specific threats. Our study bridges this gap by leveraging a hybrid threat modeling methodology, integrating attack tree models with an exhaustive review of existing literature on threats to blockchain-based standardized EHRs. This approach has identified and organized 26 unique threats into an attack tree. Each threat is elaborated upon and discussed within the context of the Blockchain EHRs.