ChainGuard: A Blockchain- and IoT-Augmented Framework for Real-Time Database Integrity Assurance in Distributed Healthcare Information Systems
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Abstract
The integrity of distributed healthcare databases is continuously threatened by unauthorized modifications, hardware faults, software vulnerabilities, and increasingly sophisticated cyberattacks. Traditional relational and NoSQL database systems rely on centralized access-control mechanisms and periodic audit logs that cannot provide cryptographic proof of unaltered history or real-time anomaly detection. This paper presents ChainGuard, a novel middleware framework that integrates Ethereum-based smart contracts, a network of IoT integrity-sensing nodes, and an AI-powered anomaly classifier to provide end-to-end, tamper-evident integrity assurance for distributed healthcare information systems. ChainGuard records SHA-256 hash digests of critical database state snapshots onto a permissioned Ethereum ledger, while a constellation of lightweight IoT agents embedded at database server nodes continuously monitors system-level indicators—I/O throughput, memory bus activity, and cryptographic nonce validation—at ten-second intervals. Deviations from baseline behavior trigger smart-contract-enforced quarantine procedures that freeze suspect transactions and emit verifiable incident records onto the immutable ledger. A Random Forest classifier trained on 12,000 synthetic database-event logs achieves 96.4% accuracy in discriminating legitimate bulk insertions from covert data-tampering attempts. Evaluation across three clinical deployment scenarios demonstrates that ChainGuard reduces mean time to tamper detection from 47 minutes (baseline centralized audit) to 38 seconds, with a false-positive rate of 1.7%. The framework is deployable on existing PostgreSQL and MongoDB infrastructure without schema modification, making it an immediately practicable path toward regulatory compliance with HIPAA, GDPR, and the forthcoming NIS2 Directive.
