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Currently, chaos-based cryptosystems are being proposed in the literature to provide confidentiality for digital images, since the diffusion effect in the Advance Encryption Standard (AES) algorithm is weak. Security is the most important challenge to assess in cryptosystems according to the National Institute of Standard and Technology (NIST), then cost and performance, and finally algorithm and implementation. Recent chaos-based image encryption algorithms present basic security analysis, which could make them insecure for some applications. In this paper, we suggest an integral analysis framework related to comprehensive security analysis, cost and performance, and the algorithm and implementation for chaos-based image cryptosystems. The proposed guideline based on 20 analysis points can assist new cryptographic designers to present an integral analysis of new algorithms. Future comparisons of new schemes can be more consistent in terms of security and efficiency. In addition, we present aspects regarding digital chaos implementation, chaos validation, and key definition to improve the security of the overall cryptosystem. The suggested guideline does not guarantee security, and it does not intend to limit the liberty to implement new analysis. However, it provides for the first time in the literature a solid basis about integral analysis for chaos-based image cryptosystems as an effective approach to improve security.

Recently, telemedicine offers medical services remotely via telecommunications systems and physiological monitoring devices. This scheme provides healthcare delivery services between physicians and patients conveniently, since some patients can not attend the hospital due to any reason. However, transmission of information over an insecure channel such as internet or private data storing generates a security problem. Therefore, authentication, confidentiality, and privacy are important challenges in telemedicine, where only authorized users should have access to medical or clinical records. On the other hand, chaotic systems have been implemented efficiently in cryptographic systems to provide confidential and privacy. In this work, we propose a novel symmetric encryption algorithm based on logistic map with double chaotic layer encryption (DCLE) in diffusion process and just one round of confusion-diffusion for the confidentiality and privacy of clinical information such as electrocardiograms (ECG), electroencephalograms (EEG), and blood pressure (BP) for applications in telemedicine. The clinical signals are acquired from PhysioBank data base for encryption proposes and analysis. In contrast with recent schemes in literature, we present a secure cryptographic algorithm based on chaos validated with the most complete security analysis until this time. In addition, the cryptograms are validated with the most complete pseudorandomness tests based on National Institute of Standards and Technology (NIST) 800-22 suite. All results are at MATLAB simulations and all them show the effectiveness, security, robustness, and the potential use of the proposed scheme in telemedicine.