A Secure, Interoperable, And Energy-Aware Federated EHR: Design And Simulation With Fernet Encryption, FHIR-Like REST, And Multi-Threaded Evaluation
DOI:
https://doi.org/10.29284/z2j7nr35Keywords:
Electronic Health Record, Federated Database, Health Data Security, Python, Google Colab, Fernet Encryption, REST API, Flask, Gradio Interface, HL7, FHIR, Data Interoperability, Secure Data Exchange, Asynchronous Access, Psutil, Energy-Aware Computing,Abstract
The conducted research offer a federated and encryption-enabling FHIR-like Electronic Health Record (EHR) prototype being fully implemented in Python/Google Colab as an interoperable and low-resource conscious health data exchange system. The architecture spreads deceased patient data among virtual hospital units (JSON/dictionaries) and implements the use of Ferment symmetric research-at-rest and Transport encryption. It uses normative -aligned exchange in the form of FHIR-style REST endpoints (using FastAPI framework, Python filters with Flask), and also allows user interactions via a lightweight Gradio graphical interface, and structuring concurrency with level 2 threading/asyncio. Appearance of systems (psutil/time) tools show the latency, processor, memory, per-SQL energy. With a synthetic cohort size of 100 patients in 3 nodes (diagnosis, medications, labs/visits) mean encryption and decryption times of 47.2 ms and 43.6 ms were achieved respectively. The latency of API increased predictably with the number of users (range 121.5 ms with single-user to 289.2 ms with 20 users). CPU utilization was low (about 911% during crypto), as well as memory overhead (encryption + about 11.4MB, decryption + about 1.5MB). Energy was estimated to be = 2 J per encrypted query. The highest interoperability testers gained ≥97% success on 300 API calls, the GUI loaded in 3.5 s, retrieved in 3.2 s, decrypted in 1.0 s and received 8.8/10 satisfaction. The federated system comes with lower confidentiality, resilience, and portability improvements in exchange with small latency/memory overheads (compared to a centralized, unencrypted baseline, 128.4 ms, 225.5 MB). Accomplished surveys show congruence with the interest of the stakeholders: patients attempt to report high levels of digital preparedness and security-conditioned sharing (trust in encryption 69 percent, willingness to share if encrypted 72 percent, granular consent 61 percent), whereas staff members emphasize partial coverage of EHRs (73.3 percent), low attempt of FHIR production (16.7 percent) and format/API bottlenecks. DEID that resembles HIPAA/GDPR/India DPDP principles with a prototype that can be freely reproduced, interoperable with the cloud, and represents an extension framework of federated learning, decentralized identity/consent, and advanced cryptography.
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This work is licensed under a Creative Commons Attribution 4.0 International License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
