In the paper is presented one new approach for creation and management of medical image databases with multi-layer access, based on the Inverse Pyramid Decomposition (IPD). The archived visual data is compressed using the special IDP format, presented in detail in this paper. The new approach offers flexible tools for multi-layer transfer of the processed information with consecutively quality improvement, together with reliable content protection ensured by digital watermark insertion and data hiding. The IDP permits insertion of multiple watermarks in same file. Part of the visual information (specific regions of interest in the medical images) is hidden for the low access levels and could be revealed by authorized users only.