In　the　realm　of　modern　healthcare,　Electronic　Health　Records　EHR　serve　as　invaluable　assets,　yet　they　also　pose　significant　security　challenges.　The　absence　of　EHR　access　auditing　mechanisms,　which　includes　the　EHR　audit　trails,　results　in　accountability　gaps　and　magnifies　security　vulnerabilities.　This　situation　effectively　paves　the　way　for　unauthorized　data　alterations　to　occur　without　detection　or　consequences.　Inadequate　EHR　compliance　auditing　procedures,　particularly　in　verifying　and　validating　access　control　policies,　expose　healthcare　organizations　to　risks　such　as　data　breaches,　and　unauthorized　data　usage.　These　vulnerabilities　result　from　unchecked　unauthorized　access　activities.　Additionally,　the　absence　of　EHR　audit　logs　complicates　investigations,　weakens　proactive　security　measures,　and　raises　concerns　to　put　healthcare　institutions　at　risk.　This　study　addresses　the　pressing　need　for　robust　EHR　auditing　systems　designed　to　scrutinize　access　to　EHR　data,　encompassing　who　accesses　it,　when,　and　for　what　purpose.　Our　research　delves　into　the　complex　field　of　EHR　auditing,　which　includes　establishing　an　immutable　audit　trail　to　enhance　data　security　through　blockchain　technology.　We　also　integrate　Purpose-Based　Access　Control　(PBAC)　alongside　smart　contracts　to　strengthen　compliance　auditing　by　validating　access　legitimacy　and　reducing　unauthorized　entries.　Our　contributions　encompass　the　creation　of　audit　trail　of　EHR　access,　compliance　auditing　via　PBAC　policy　verification,　the　generation　of　audit　logs,　and　the　derivation　of　data-driven　insights,　fortifying　EHR　access　security.　©　2024　The　Author(s)