###### Abstract
In addition, medical multimedia (2D and 3D images, bio-signals, etc.) can be distorted when EPFs are exchanged via IoMTs [14]. Moreover, the transmission of EPFs can be unsecured, which causes a serious risk since EPFs contain confidential medical information about the patients [15]. To overcome this issue, researchers proposed the use of certain techniques to achieve integrity and tamper resistance of EPFs' content. Some of these techniques include watermarking [16; 17], zero-watermarking [18; 19], and encryption schemes [20; 21]. In general, watermarking schemes proceed in two phases: the first one is embedding secret binary information called watermarks in the original (host) signal. The second phase consists of extracting the embedded information from the host signal to confirm the originality of the copyrighted signal. However, the watermark insertion into bio-signals, especially ECGs, can lead to visual artifacts in this signal. Such artifacts can lead to misdiagnosis, and the corresponding treatment can have fatal consequences for the patient [22]. To avoid this problem, researchers are using zero-watermarking methods, which allow protection of the copyrights of bio-signals without introducing any modification of these signals. Indeed, [PERSON] et al. [18] proposed a zero-watermarking scheme to protect patient identifiers (IDs) and detected vocal cord disorders. Experimental results showed that [PERSON] et al. 's scheme could successfully assure bio-signals' imperceptibility and exhibited good reliability in ID extraction. However, since [PERSON] et al. 's algorithm is based on a spatio-temporal descriptor, namely the local bit pattern (LBP), the robustness of this algorithm is weak in noisy environments. To address this problem, [PERSON] et al. proposed in [23] a zero-watermarking scheme in the transform domain using the sine cosine algorithm (SCA) [24] and Krawtchouk-Charlier fractional-order transform. The simulation results showed that the proposed scheme provides both imperceptibility of bio-signals and high robustness against different types of signal-processing attacks, including noise attacks. [PERSON] et al. recently proposed in [19] a novel scheme for biomedical zero-watermarking using quaternion Shmaliy moments and short-time Fourier transform (STFT). This scheme could provide good robustness to different types of signal-processing attacks. Encryption schemes can also be implemented to provide a high degree of security when exchanging bio-signals via unsecured communication channels [20; 25; 26; 27; 28]. By analyzing the different bio-signal security schemes, it could be concluded that these schemes are more focused on either protecting the bio-signal copyrights or ensuring a strong security level when communicating bio-signals via unsecured communication channels such as IoMTs. However, these security schemes usually ignore the problem of protecting confidential patient information, such as personal information, identifiers, laboratory test results, medical history, radiologist reports, physical examinations, etc. This information is included with the bio-signal records in the EPFs. Then, the EPFs can be communicated between healthcare analysis service centers through unsecured communication channels such as IoMTs. This problem can have a harmful impact on patients' privacy if their confidential information is misused by unauthorized users of IoMTs. To overcome this limitation, a new security scheme is presented in the present work. The proposed scheme is used to both: (i) protect the copyrights of the bio-signals without modifying these signals during the process of watermark embedding, which ensures perfect imperceptibility, and (ii) ensure a strong security level of confidential patient information, which is stored in a plain text file. For this purpose, a new 2D chaotic system was used for encrypting the private patient plain text information. The proposed scheme involves the selection of four frames from the original bio-signal.