<![CDATA[Bakcground: The rapid digital transformation of healthcare through distributed Smart Healthcare systems integrating IoMT, artificial intelligence, cloud computing, and electronic health records has significantly improved service efficiency and data accessibility. However, the increasing interconnectivity of medical devices expands the attack surface, making healthcare infrastructures vulnerable to adaptive cyberattacks and privacy breaches. Objective: This study aims to evaluate the effectiveness of blockchain-enhanced privacy protection protocols in securing distributed Smart Healthcare systems against adaptive cyber threats. Research Method: A quantitative experimental approach was employed by simulating a blockchain-integrated healthcare data architecture. The system’s performance was evaluated using security metrics including attack resistance, data integrity validation time, and privacy preservation under various adaptive attack scenarios. Results: The findings indicate that the blockchain-based system significantly reduces attack success rates and accelerates threat detection compared to conventional systems. Privacy protection is strengthened through cryptographic access control and smart contracts, minimizing unauthorized access. Although data validation latency slightly increases due to consensus mechanisms, the overhead remains within acceptable operational limits. Overall, blockchain integration enhances security resilience, data integrity, and privacy preservation in distributed Smart Healthcare environments.]]>
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