Nowadays; modern Hospital Data Management Systems (HDMSs) are applied in a computer network; in addition medicinal equipments produce medical images in a digital form. HDMS must store and exchange these images in a secured environment to provide image integrity and patient privacy. The reversible watermarking techniques can be used to provide the integrity and the privacy. In this paper, a security technique based on watermarking and encryption is proposed to be used for Digital Imaging and Communications in Medicine (DICOM). It provides patient authentication, information confidentiality and integrity based on reversible watermark. To achieve integrity service at the sender side; a hash value based on encrypted MD5 is determined from the image. And to satisfy the reversible feature; R–S-Vector is determined from the image and is compressed based on a Huffman compression algorithm. After that to provide confidentiality and authentication services: the compressed R–S-Vector, the hash value and patient ID are concatenated to form a watermark then this watermark is encrypted using AES encryption technique, finally the watermark is embedded inside the medical image. Experimental results prove that the proposed technique can provide patient authentication services, image integrity service and information confidentiality service with excellent efficiency. Concluded results for all tested DICOM medical images and natural images show the following: BER equals 0, both of SNR and PSNR are consistent and have large values, and MSE has low value; the average values of SNR, PSNR and MSE are 52 dB, 57 dB and 0.12 respectively. Therefore, watermarked images have high imperceptibility, invisibility and transparency. In addition, the watermark extracted from the image at the receiver side is identical to the watermark embedded into the image in the sender side; as a result, the proposed technique is totally reversible, and the embedded watermark does not affect the quality of the original image.