The broader impact/commercial potential of this Phase I Small Business Innovation Research (SBIR) project is to address long-standing challenges with current medical image sharing practices. Despite electronic data transfer availability, healthcare institutions still rely on outdated physical media (CD/DVD) for medical image sharing due to interoperability issues, high costs, and security risks associated with digital data transfer solutions. This project’s platform mitigates these challenges through a secure, distributed network ensuring interoperability across various health systems through a hybrid blockchain and cloud architecture. Novel cryptographic protocols and smart-contracts safeguard data access and privacy, while decentralization provides transparency, immutability, and data integrity. By providing instant access to prior imaging, this project has the potential to eliminate the $30B national burden from redundant medical imaging. This project will empower patients with ownership over their medical data, catalyzing a transformation into a unified, patient-centric health ecosystem. The impact includes substantial reductions in healthcare expenditures, enhanced operational efficiencies, increased profitability for healthcare providers, enhanced patient outcomes enabled by real-time data access, facilitation of telemedicine adoption across diverse and underserved locations, and environmental sustainability by reducing physical media waste. The project will outperform existing solutions in interoperability, security, and patient-centricity, facilitating seamless data sharing.<br/> <br/>This SBIR Phase I project proposes to develop a blockchain-enabled medical image sharing platform to address the long-standing challenges associated with current medical image sharing practices. The key research objectives are to design novel security protocols and smart contracts that enable decentralized access control and data sharing across a distributed ledger, while ensuring compliance with healthcare regulations including HIPAA. The research will focus on integrating blockchain with off-chain storage to facilitate efficient and secure storage and retrieval of imaging data. Anticipated technical results include a functional prototype demonstrating seamless generation of non-fungible tokens representing medical images, with metadata references to the imaging data stored on decentralized storage networks. The platform will integrate robust access management mechanisms through smart contract rules, empowering healthcare providers to securely release medical records to patients while assigning ownership. Patients can dynamically grant and revoke data access permissions, ensuring control over sensitive health information. The platform remains vendor-neutral, ensuring compatibility and integration across various healthcare systems, with a user-friendly interface that abstracts the complexities of blockchain using gasless transactions and account abstraction. Overall, the outcomes include a functional prototype demonstrating feasibility, simulation results validating the system's performance, security, and interoperability, and a validated business model.<br/><br/>This award reflects NSF's statutory mission and has been deemed worthy of support through evaluation using the Foundation's intellectual merit and broader impacts review criteria.