Rambabu bommisetti, K. Ushasree, P. Vidhya, G. Vaishnavi 02 7(1) Modern healthcare systems often rely on centralized storage for Electronic Health Records EHRs which introduces several critical vulnerabilities including single points of failure potential data tampering and risks to patient privacy This research proposes a decentralized EHR management framework that integrates blockchain technology with the Inter Planetary File System IPFS to securely handle doctorpatient appointment details medical reports prescriptions and patient feedback A permissioned Ethereumlike smart contract named Healthcare is utilized to immutably store user profiles appointment metadata prescription references and ratings on the blockchain Sensitive files are encrypted using AESCTR with keys derived via PBKDF2 and then pinned to a local IPFS node to ensure distributed confidential file storage Patients can register log in view a list of doctors with onchain average ratings book appointments by uploading encrypted reports and later retrieve prescriptions in decrypted form Doctors access the system to view appointments download encrypted medical reports upload encrypted prescriptions and publish relevant metadata onchain Patient feedback is also recorded as immutable blockchain transactions An inmemory Pythonbased caching layer helps improve performance by reducing the need for repeated onchain reads Experimental results demonstrate the efficiency of encryption decryption and IPFS pinning operations confirming the systems performance reliability This framework strengthens healthcare data management by ensuring transparency data integrity and fault tolerance The combination of blockchainbased metadata storage and offchain encrypted file hosting through IPFS enables secure decentralized and patientcentric healthcare services Copyright (c) Journal of Science Engineering Technology and Management Science. All rights reserved 2026