Title:	A SECURE BLOCKCHAIN DATABASE FOR STANDALONE OR INTEGRATED USE IN CLINICAL INFORMATION SYSTEMS: THE CASE OF ANTIMICROBIAL PRESCRIPTION
Author(s):	Savina Mariettou, Constantinos Koutsojannis and Vassilis Triantafyllou
ISBN:	978-989-8704-71-9
Editors:	Paula Miranda and Pedro Isaías
Year:	2025
Edition:	Single
Keywords:	Blockchain, Fuzzy Logic, e-Prescription, Cybersecurity, Antimicrobial Resistance
Type:	Full Paper
First Page:	225
Last Page:	232
Language:	English
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Paper Abstract:	Despite ongoing advancements in healthcare digitization, existing prescription systems often lack core mechanisms for clinical validation, traceability, and resistance-informed decision-making. Consequently, the misuse of antibiotics in clinical settings remains a significant public health concern, particularly in the context of increasing antimicrobial resistance (AMR). This study presents the design of a blockchain-based system that enforces prescription integrity, ensures clinician accountability, and integrates resistance-aware logic for high-risk medications. By incorporating smart contracts, cryptographic hashing, and real-time access monitoring, the proposed system ensures immutable prescription records, tamper-resistant verification, and controlled distribution of drugs. Additionally, a fuzzy logic-based artificial intelligence (AI) module monitors authentication behavior to detect early signs of suspicious activity and strengthen access security. Aligned with the principles of antimicrobial stewardship and secure data governance, the system promotes responsible prescribing and enhances transparency in clinical environments. Partial proof-of-concept implementation demonstrates the system's feasibility and responsiveness within simulated clinical workflows. The functional architecture, comprising the prescription interface, validation logic, and fuzzy-rule-based access monitoring, has been developed and tested in a standalone environment; blockchain components are planned for integration in future iterations. Compared to conventional infrastructures, this architecture addresses critical gaps in national e-prescription systems, particularly regarding the handling of controlled substances and antibiotic oversight. It facilitates future deployment as either a standalone tool or an integrated module within broader clinical information systems.
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