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Confidentiality of Electronic Health Record (EHR) and privacy are two important security requirements for healthcare systems. Many devices on the EHR network utilize little or no encryption, which makes data in transit vulnerable to exploitative attacks, such as Man-in-the-Middle and other filtration methods. Recently, watermarking algorithms as an efficient response to these requirements is in the underline. In this paper, we present a robust watermarking method conceived as part of an Electronic Health Record platform. In this method a chaotic encryption and blind medical image watermarking technique was incorporated into the system as an authorization mechanism to ensure confidentiality and integrity of electronic health information. We present a hybrid watermarking method based on a combination of discrete wavelet transform (DWT), hessenberg Decomposition (HD), Singular value decomposition (SVD) and an original chaos crypto system based on the Arnold Transform (AT) of Singular Value Decomposition. In order to spread the robustness of our algorithm and provide additional security, an improved SVD-AT embedding and extraction procedure has been used to scramble the EHR data in the preprocessing step of the proposed method. In the process of watermark embedding, an R-level discrete wavelet transform was applied to the host image. The low frequency wavelet coefficients are selected to carry this scrambled-watermark. In extraction process, the stored used plain image is obtained from the trusted authority server to complete the verification process. The receiver should compare the unsigned watermark with the extracted watermark again. The verification can be done before clinical procedures and diagnosis. The proposed watermarking method endures entirety attacks and rightly extracts the hidden watermark without significant degradation in the image quality, thus, when the Peak Signal to Noise Ratio (PSNR) and Normalized Correlation (NC) performance of the proposed algorithm is performed.


Watermarking, Medical Image, Discrete Wavelet Transform, Singular Value Decomposition, Arnold Transform, e-Health, Chaos, Hessenberg Decomposition, EHR Modeling.
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