Electronic records of a patient’s health history are often shared among healthcare providers, and patient data must be kept secure to maintain the privacy of patients. One way of doing this is through data hiding, and this paper demonstrates a scheme to achieve this. This paper proposes a capacity-raising reversible data-hiding scheme using an empirical rules table in dual images. The aim of this research is to avoid drawing awareness to the transmission of information by providing a steganographic technique capable of embedding high-capacity data into an image while maintaining the good quality of the image. To hide the secret message(s), a rules table containing 13 entries is presented. This rules table is extendable to a table of up to 262,133 entries (with each entry containing one distinct character) that are related to the 13 entries in terms of the rules. The rules of this table are used during the embedding and extraction procedures. In the proposed method, 512 × 512 images are divided into 1 × 2 blocks where adjacent pixels are represented using x and y for both embedding and extraction, respectively. Recovery of the cover image from the stego image is also achievable during the extraction process. Conducted experiments show that the proposed method has an average pixel-to-signal noise ratio of 52.65 dB, which is higher than that achieved with the methods discussed in this paper. Additionally, the proposed method can embed a wider range of characters (depending on the image size) as compared to the rest of the methods, hence its high embedding capacity of 4.25 bpp. The proposed method can also withstand security attacks such as RS, pixel value difference, entropy, and chi-square attacks. The proposed method is also undetectable under visual attack analyses such as the difference histogram, pixel difference histogram, and visual inspection. Based on the higher embedding capacity, pixel-to-signal noise ratio, the ability of this method to be undetected under visual attack analysis, and the ability of this method to withstand security attacks, it can be concluded that the proposed method is superior to the other methods.
