HL7 FHIR consent for healthcare data sharing: challenges, opportunities and integrity implications

We derive an architecture pattern that separates (a) standards-based consent representation (FHIR Consent), (b) local policy interpretation/enforcement, and (c) cross-organisational integrity verification. Cryptographic integrity anchoring is discussed as a complementary mechanism for tamper-evident verification of off-chain consent artifacts and lifecycle events, without externalizing consent semantics or personal data.