Medshard: Electronic health record sharing using blockchain sharding

Faiza Hashim, Khaled Shuaib, Farag Sallabi

Research output: Contribution to journalArticlepeer-review

20 Citations (Scopus)


Electronic health records (EHRs) are important assets of the healthcare system and should be shared among medical practitioners to improve the accuracy and efficiency of diagnosis. Block-chain technology has been investigated and adopted in healthcare as a solution for EHR sharing while preserving privacy and security. Blockchain can revolutionize the healthcare system by providing a decentralized, distributed, immutable, and secure architecture. However, scalability has always been a bottleneck in blockchain networks due to the consensus mechanism and ledger replication to all network participants. Sharding helps address this issue by artificially partitioning the network into small groups termed shards and processing transactions parallelly while running consensus within each shard with a subset of blockchain nodes. Although this technique helps resolve issues related to scalability, cross-shard communication overhead can degrade network performance. This study proposes a transaction-based sharding technique wherein shards are formed on the basis of a patient’s previously visited health entities. Simulation results show that the proposed technique outperforms standard-based healthcare blockchain techniques in terms of the number of appointments processed, consensus latency, and throughput. The proposed technique eliminates cross-shard communication by forming complete shards based on “the need to participate” nodes per patient.

Original languageEnglish
Article number5889
JournalSustainability (Switzerland)
Issue number11
Publication statusPublished - Jun 1 2021


  • Blockchain
  • Electronic health record (EHR)
  • Healthcare
  • Scalability
  • Sharding

ASJC Scopus subject areas

  • Computer Science (miscellaneous)
  • Environmental Science (miscellaneous)
  • Geography, Planning and Development
  • Energy Engineering and Power Technology
  • Hardware and Architecture
  • Management, Monitoring, Policy and Law
  • Computer Networks and Communications
  • Renewable Energy, Sustainability and the Environment


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