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Article : Articles dans des revues internationales ou nationales avec comité de lecture

Nowadays, healthcare takes a great attention from people and governments due to the emergence of new diseases and viruses. Health Information Exchange (HIE) allows doctors, clinicians, and healthcare facilities (HCF) to exchange and share patient records according to patient permission. Unfortunately, the HIE systems suffer from several challenges such as security, privacy, latency, throughput, and scalability. Thus, researchers proposed many techniques for efficient HIE, but they did not cover all challenges. This paper proposes an efficient architecture called ELSO that combines between public blockchain and off-chain in order to enhance the integrity and privacy of HIE systems. In this architecture, the patient information is divided into two categories: relative data containing personal information that will be stored in the public blockchain; sensitive data describing the patient situation that will be stored in the off-chain database. Furthermore, ELSO is composed of three layers: The first is called the application layer and aims to create patient profiles; the second layer is called the control layer and aims to control the specialist access, and the third layer is called the storage layer and allows to store data in blockchain and off-chain. To evaluate the performance of our framework, we used real healthcare data where the obtained results show the effectiveness of ELSO in terms of all metrics compared to other techniques.