Protection of the patient data against intentional attacks using a hybrid robust watermarking code.

The security of patient information is important during the transfer of medical data. A hybrid spatial domain watermarking algorithm that includes encryption, integrity protection, and steganography is proposed to strengthen the information originality based on the authentication. The proposed algorithm checks whether the patient's information has been deliberately changed or not. The created code is distributed at every pixel of the medical image and not only in the regions of non-interest pixels, while the image details are still preserved. To enhance the security of the watermarking code, SHA-1 is used to get the initial key for the Symmetric Encryption Algorithm. The target of this approach is to preserve the content of the image and the watermark simultaneously, this is achieved by synthesizing an encrypted watermark from one of the components of the original image and not by embedding a watermark in the image. To evaluate the proposed code the Least Significant Bit (LSB), Bit2SB, and Bit3SB were used. The evaluation of the proposed code showed that the LSB is of better quality but overall the Bit2SB is better in its ability against the active attacks up to a size of 2*2 pixels, and it preserves the high image quality.