This paper describes standards which try to integrate security like authent
ication and encryption Into the domain of health care and also proposes sev
eral concepts according to these standards. There are two standards develop
ed in the USA. One of it found acceptance of software developers in Germany
. This standard called DICOM (digital imaging and communication in medicine
) [NEM96] and is a modular and often misunderstood standard. There are two
security enhancements of DICOM which are under development. Therefore a con
cept [VLM00] was proposed that uses several definitions of the standard to
construct a secure system for management of patient data. An editor was imp
lemented to integrate textual reports with images. Finally a concept was de
veloped that describes how to combine encryption and compression to make im
age processing faster.