## 1 Introduction  
Recent technological advancements in computer science and communication support various sectors such as banking, business, education, and healthcare [1, 2]. The healthcare sector is one of the prominent domains that require significant attention from researchers for improvement to ensure a healthy society, leading to increasing the country's productivity. For the last two decades, a lot of research has been happening in the healthcare domain, which mainly focuses on designing and implementing computer-aided diagnosis systems, developing hardware devices to monitor healthcare parameters, and implementing various strategies for the secure transmission of healthcare data. This research focuses on designing and implementing an efficient and safe data transmission scheme suited for the healthcare sector. Security is a broad term used to denote the set of procedures to ensure authorized access and confidentiality of the data. A massive amount of data is transmitted in the healthcare sector every day. The healthcare data includes medical images, patient reports, discharge summaries, and diagnosis reports. A significant amount of attention is required to ensure the security of this data. Cryptography is one of the most popular approaches in practice to provide confidentiality. In a cryptography scheme, the data are converted into an unreadable form with the help of an encryption scheme by taking an encryption key as the input. An authorized receiver who has the decryption key can decrypt the contents before using them. An unauthorized person can access the encrypted information during transmission using some sophisticated techniques, but they may not view the content since it is in incomprehensible form. Several encryption schemes are in practice, and they can be broadly classified into two forms, symmetric encryption or asymmetric encryption, based on the keys used for encryption and decryption [3; 4]. A symmetric encryption system uses the same key during encryption and decryption. However, an asymmetric encryption scheme uses different keys for encryption and decryption. Most of the well-known encryption schemes, such as advanced encryption standard (AES), data encryption standard (DES), Tripple DES, Blowfish, Twofish, etc., are symmetric encryption techniques. The well-known asymmetric encryption techniques in practice are encryption schemes such as Diffie-Hellman, ElGamal, and Rivest-Shamir-Adleman (RSA) [5; 6]. The confidentiality of the digital data can be ensured using image encryption techniques. It has been proven that the recent encryption techniques such as AES, DES, RSA, etc. are hard to break by malicious people. One of the key concerns in a cryptosystem is that one can easily recognize whether digital content is in its original form or encrypted form. For example, in the case of image encryption, the encrypted image will have noise-like or texture-like patterns if it is encrypted. Considering this, recently, a new scheme called visually meaning image encryption (VMIE) has been introduced [7; 8]. In a VMIE scheme, the encrypted image looks like a natural image, and the attackers cannot distinguish a genuine image from an encrypted one. This provides some security since attackers will analyze encrypted images more often with the assumption that it consists of some crucial data. Data hiding is another key area widely studied and explored in information security [9; 10; 11]. In data hiding, the confidentiality of the data is maintained by embedding it in a cover medium. The cover medium can be digital content such as image, video, text, or audio [12; 13]. Data hiding schemes are popularly used for steganography and watermarking. Steganography is the process of concealing a secret message in a cover medium. In contrast, instead of a secret message, a digital watermark will be embedded to facilitate data authentication or copyright protection in a watermarking scheme [14; 15].