Secure transmission of medical images and medical data is essential in healthcare systems, both in telemedicine and AI approaches. The compromise of images and medical data could affect patient privacy and the accuracy of diagnosis. Digital watermarking embeds medical images into a non-significant image before transmission to ensure visual security. However, it is vulnerable to white-box attacks because the embedded medical image can be extracted by an attacker that knows the system’s operation and does not ensure the authenticity of image transmission. A visually secure image encryption scheme for secure fingerprint-based authenticated transmission has been proposed to solve the above issues. The proposed scheme embeds the encrypted medical image, the encrypted physician’s fingerprint, and the patient health record (EHR) into a non-significant image to ensure integrity, authenticity, and confidentiality during the medical image and medical data transmission. A chaotic encryption algorithm based on a permutation key has been used to encrypt the medical image and fingerprint feature vector. A hybrid asymmetric cryptography scheme based on Elliptic Curve Cryptography (ECC) and AES has been implemented to protect the permutation key. Simulations and comparative analysis show that the proposed scheme achieves higher visual security of the encrypted image and higher medical image reconstruction quality than other secure image encryption approaches.