The increasing need for medical information applications to handle varied multimedia data through interoperable systems is continually hindered by incompatible limited platforms, with low or non-existent security. Using the workflow of an imaging service, this chapter describes the structure and protection strategy of a secured specialized electronic patient record which allows exchanging of multimedia medical data in a secured manner. An open multimedia standard adapted to patient record requirements has been applied, combined with security tools. Prospective application scenarios are identified, and the main issues of the approach are discussed.