Table 1.

Seven principles of TEFCA and blockchain solutions

TEFCA principle	Blockchain-based HIE implementation
Standardization	Utilizes Quorum blockchain and Ethereum-based smart contracts to standardize HIE processes.
Openness and transparency	Ensures transparency through the immutable and public nature of the blockchain, as well as through dispute management smart contracts.
Cooperation and non-discrimination	Promotes cooperation among healthcare providers by providing an efficient, transparent, and secure HIE platform.
Privacy, security, and safety	Incorporates SSI mechanisms and patient tokens to protect patient privacy and ensure data security.
Access	Empowers patients to control their health data, granting or revoking access permissions to healthcare providers as needed.
Equity	The decentralized nature of the blockchain ensures data-driven accountability by allowing all stakeholders to access the transaction history.
Public health	Facilitates public health surveillance and supports biomedical research by providing a transparent, secure, and standardized platform for data exchange.