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Encryption and integrity protection

The .pemr bundle is designed to protect sensitive medical information.

A key part of this protection is the security of the structured medical database stored inside the bundle.

What is protected

Inside a .pemr bundle, the main structured medical record is stored in:

  • db.sqlite

This database contains information such as:

  • visits
  • growth data
  • notes
  • other structured clinical information

Because this data is sensitive, it is protected by encryption and integrity verification.

Database encryption

The db.sqlite file is encrypted.

Encryption helps protect the clinical data when the bundle is:

  • stored on a device
  • transferred between doctor and family
  • kept as a backup copy

This reduces the risk of the structured medical information being read directly outside the application.

Integrity protection

In addition to encryption, the bundle uses HMAC / SHA-256 based integrity protection.

This helps verify that the database has not been:

  • altered unexpectedly
  • corrupted during transfer
  • modified outside the application

If integrity verification fails, the application may refuse to open the bundle or may report an error.

Why integrity matters

Medical data must remain both:

  • confidential
  • trustworthy

Encryption protects confidentiality.

Integrity protection helps ensure that the record received by the doctor or family is the same record that was originally saved.

This is especially important when bundles are shared between devices.

Relationship with manual editing

Although a .pemr bundle is technically a file container, it should not be modified manually.

Opening or editing internal files outside CareFlow Kids or CareView Family may:

  • break integrity verification
  • make the bundle unreadable
  • damage the medical record

Bundles should only be changed through the application interface.

Practical meaning for users

For clinicians and families, this means:

  • the structured patient record is protected
  • the application checks that the record has not been tampered with
  • manually changing bundle contents is unsafe

For everyday use, the safest practice is simply to:

  • keep the .pemr file in a secure place
  • share it only with trusted recipients
  • use the application to read or update it