The healthcare industry has seen a radical change from version 1.0 to version 4.0. Electronic health records (EHRs) were introduced with version 2.0, while version 1.0 was primarily targeted towards doctors. One benefit of the proliferation of IoT technologies—which includes telemedicine, cloud computing, fog computing, and the Internet of Things—is the improvement in data communication and the shift toward a patient-centered approach to healthcare. Nevertheless, it has always been challenging to design a secure technique for healthcare 4.0. Email accounts, messages, and reports belonging to patients could be vulnerable to hackers if healthcare providers employ an unsecured technique. On the other hand, a safe healthcare system may make everyone happy, from patients to caregivers. In order to prevent authorized user components of E-healthcare systems from compromising data, further precautions must be taken when storing, accessing, and exchanging patient medical information on the cloud. To date, numerous cryptographic algorithms have been developed to ensure the safety of medical records whether stored, transmitted, or accessed via the cloud. However, these traditional solutions failed to meet the demands of electronic health record security in areas such as computational efficiency, service side verification, user side verifications, the absence of a trusted third party, and robust security. The capacity of blockchain-based security solutions to offer robust protection for data storage and sharing with minimal computational effort has recently garnered a lot of interest. Academics mostly focused on Bitcoin technology when they discussed the blockchain. Recently, there has been a surge in interest in using the blockchain for secure healthcare record management. This study presents a comprehensive review of existing blockchain-based solutions for medical data security, including those that utilize and do not utilize cloud computing. Several approaches based on blockchain are implemented and evaluated in this article. Results from this study that support new Healthcare 4.0 technologies include research gaps, difficulties, and a future roadmap based on the findings.