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The increasing adoption of distributed ledger technology (DLT) in healthcare promises enhanced data security, integrity, and patient control. This study evaluates the characteristics and security implications within a simulated Electronic Health Record (EHR) network, comprising 1,800 records. The analysis focuses on network access control (Access Policy), data integrity mechanisms (Record Hash), and the incidence of security risks (Malicious Node). The records show a near-even split between 'Read/Write' (50.06%) and 'Read-Only' (49.94%) access policies. Crucially, findings reveal that the presence of a Malicious Node (50.72% of records) is highly uniform across both 'Read-Only' (50.95%) and 'Read/Write' (50.5%) policies, indicating that basic access control alone is ineffective at mitigating security risks within this network. This highlights the need for dynamic, context-aware smart contracts that incorporate behavioural or clinical risk factors for enhanced security.
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Rafat Qureshi (2026) studied this question.
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