Blockchain Audit Trails Resolve the Electronic Health Record Traceability Problem Created by Generative AI
DOI:
https://doi.org/10.5281/zenodo.20337356Keywords:
electronic health records, generative AI, blockchain, audit trail, traceability, large language models, clinical governance, provenanceAbstract
As large language models generate clinical documentation at scale, electronic health records increasingly contain AI-produced content with no verifiable provenance. The field has named this traceability gap but has not yet specified an architectural solution. Blockchain-based audit logging — append-only, cryptographically chained, and tamper-resistant — provides the answer: a lightweight layer capturing model identity, prompt hash, output fingerprint, and timestamp at generation, creating a verifiable chain of custody before text enters the clinical record. Adopting blockchain audit logging as a standard condition of institutional large language model deployment would resolve this traceability crisis before it becomes irreversible.
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Copyright (c) 2026 Thomas F Heston
This work is licensed under a Creative Commons Attribution 4.0 International License.
