The Trustworthy Healthcare Cloud Storage Auditing Scheme (TCSHAS) represents a progressive solution for resolving trust-related issues linked to third-party auditors (TPAs) within traditional healthcare cloud storage audit systems. As the healthcare industry increasingly relies on cloud storage, concerns surrounding security and privacy have grown, motivating the development of a unique incentive mechanism. This mechanism leverages the non-tamperable and traceable features of blockchain technology to encourage TPAs to uphold honesty and reliability. By organizing TPAs as a group of nodes on the blockchain, a system of mutual surveillance is established, enabling diligent monitoring and penalization of any malicious actions. TCSHAS encompasses a comprehensive system model that incorporates smart contracts to manage transaction-related matters, including dispute resolution. Performance evaluations have confirmed its efficiency and suitability for real-world healthcare applications. Our experiments demonstrate that TCSHAS performs well in terms of gas consumption and exhibits scalability as the number of participant’s increases. Compared with other common smart contracts, TCSHAS maintains a balanced level of complexity, incorporates strong security measures, offers comprehensive auditing capabilities, and remains flexible. To further enhance our research, we can explore ways to optimize TCSHAS scalability and performance, such as through shading, as the volume of healthcare data continues to grow. In addition, we can investigate the integration of advanced privacy technologies or AI-based auditing. These advancements will reinforce the role of TCSHAS in establishing trust and security in healthcare cloud storage audits, making it highly relevant in real-world healthcare settings. Ultimately, TCSHAS contributes to improving trust and security in healthcare cloud storage auditing, ensuring responsible management of sensitive healthcare data.