Decentralized harmony: innovating healthcare data sharing through cross-chain synchronization with fabric Ethereum and IPFS

The growing adoption of the Electronic Health Records (EHR) has revolutionized healthcare information management. However, seamless and secure interoperability between different healthcare organizations continues to be a hard challenge. Data silos, centralized trust model, and lack of scalability are common impairments of traditional systems in care delivery which limit ‘patient centric’ way of care delivery. While blockchain technology offers decentralized trust and immutability, current solutions tend to be closed on a single blockchain platform, and thus not able to provide cross network interoperability and accessing data. To address this gap, this research introduces a Cross Chain EHR Sharing Framework that may be leveraged for the secure, bi-directional synchronization of EHR between Hyperledger Fabric (private blockchain) and Ethereum Sepolia Testnet (public blockchain) via decentralized storage by IPFS with AES 256 encryption. To facilitate interoperability the research introduces a smart middleware layer that autonomously monitors the blockchain events, processes encrypted Content Identifier (CID)s, enforces real time cross chain consistency and smart contract-based access control. The experimental evaluation shows that proposed framework achieves low synchronization times (< 195 ms), efficient blockchain operations with low gas and latency costs, small encryption overhead (< 4–5 KB), robust file storage and retrieval through IPFS. It also provides scalability, security and real-world applicability for the cross-chain healthcare interoperability.