Enhanced Security: AES-256 Encryption for SSL and TLS

Business Solutions, HIPAA Compliant Email
LuxSci
December 1, 2020

SSL and TLS play critical roles in securing data transmission over the internet, and AES-256 is integral in their most secure configurations. The original standard was known as Secure Sockets Layer (SSL). Although it was replaced by Transport Layer Security (TLS), many in the industry still refer to TLS by its predecessor’s acronym. While TLS can be relied on for securing information at a high level—such as US Government TOP SECRET data—improper or outdated implementations of the standard may not provide much security.

Variations in which cipher is used in TLS impact how secure TLS ultimately is. Some ciphers are fast but insecure, while others are slower, require a greater amount of computational resources, and can provide a higher degree of security. Weaker ciphers—such as the early export-grade ciphers—still exist, but they should no longer be used.

The Advanced Encryption Standard (AES) is an encryption specification that succeeded the Data Encryption Standard (DES). AES was standardized in 2001 after a five-year review and is currently one of the most popular algorithms used in symmetric-key cryptography. It is often seen as the gold standard symmetric-key encryption technique, with many security-conscious organizations requiring employees to use AES-256 for all communications. It is also used prominently in TLS.

AES has been available in most cryptographic libraries for a long time. It became available in OpenSSL in 2002 with v0.9.7. OpenSSL is the foundation of most SSL services in UNIX and Linux environments, such as that used by LuxSci. GPG, the open source implementation of PGP, also includes an AES-256 option.

This article discusses AES, its role in TLS, which web browsers and email programs support it, and how you can ensure that you only use 256-bit AES encryption for communications that require a high level of security.

How secure are AES-256 and AES-128?

AES is Federal Information Processing Standard (FIPS) certified, and there are currently no known non-brute force attacks that work directly against AES. However, there are some side-channel timing attacks on the processing of AES. These are not feasible over a network environment and don’t apply to SSL in general. Because of this, AES is considered robust enough to protect secret government information:

The design and strength of all key lengths of the AES algorithm (i.e., 128, 192 and 256) are sufficient to protect classified information up to the SECRET level. TOP SECRET information will require use of either the 192 or 256 key lengths. The implementation of AES in products intended to protect national security systems and/or information must be reviewed and certified by NSA prior to their acquisition and use.”

Out of the three different key lengths, AES-256 offers a higher degree of security than the 128-bit and 192-bit versions of the standard.

The Beast Attack and TLS-secured websites

When TLS is used to protect website traffic (as opposed to IMAP, SMTP, encryption of files, etc.), an attack against it is known as The Beast. This attack makes it possible for people with access to a trusted location on your network to break into your TLS session and eavesdrop on your communications.

Thankfully, The Beast attack can easily be prevented. All you have to do is use TLS v1.1+ ciphers. This is why The Beast is no longer considered a critical attack vector. See also:

Mitigating The Beast attack.

Is the beast still a threat?

How long will AES-256 remain suitable for security?

The rise of quantum computing has caused a stir in the security community, with fears that it will render many of our security algorithms useless. While quantum computing looks like it will change the landscape regarding public-key algorithms, it is not believed to have significant impacts on algorithms like AES-256 soon.

The biggest quantum computing threat against AES is currently considered to be Grover’s algorithm. It is theorized to be able to perform a brute-force key search using quadratically fewer steps than required in classical computing. The implication is that an attacker with access to a quantum computer may be able to successfully attack a cipher with a key twice the length of what would generally be possible in classical computing.

However, the expense of quantum hardware and real-world complications of using Grover’s algorithm mitigate the threat of these attacks. NIST states that “… AES 128 will remain secure for decades to come. Furthermore, even if quantum computers turn out to be much less expensive than anticipated, the known difficulty of parallelizing Grover’s algorithm suggests that both AES 192 and AES 256 will still be safe for a very long time.”

Currently, there is no great rush to move away from AES to other symmetric key algorithms.

How is the cipher chosen in an SSL or TLS session?

Generally, when an SSL client, such as an email program or web browser, connects to a server and wishes to use SSL or TLS, the client sends the server a list of encryption ciphers it supports. The server then goes through the list and chooses the first match it supports. Usually, the client orders the list with the most secure methods first so that the most secure method supported by both the client and server is selected. Sometimes, the client orders the list based on other criteria to make a compromise between security and speed. This can result in a sub-optimal cipher being chosen.

Most modern web and email servers that support TLS encryption will have a wide range of different encryption techniques that they support. These can vary from 128-bit RC4, to 256-bit AES, to others. This range of options allows users with old or broken software to still take advantage of encryption, even if it is weaker than what is considered ideal in many situations.

Additionally, most companies that provide security services do not permit techniques that are deemed weak and can be broken easily. If you are connecting to a reputable service provided over TLS, the type of encryption will almost certainly be determined by your client program (i.e., email program or web browser), based on the options listed by the server.

What encryption techniques are supported by modern web browsers?

The latest versions of most modern browsers should support appropriate encryption algorithms.

You can check out whether your web browser uses up-to-date security practices by visiting:

https://www.howsmyssl.com/

If it says “Probably Okay,” it means that no security problems could be detected. If it says “Improvable” or “Bad,” your browser may be using an outdated version of TLS or have other security issues. In this case, you need to update to the latest version of your browser or switch to a browser like Firefox or Chrome that is actively being developed.

What encryption techniques were supported by legacy web browsers?

Before AES support became universal for older web browsers, we analyzed cipher support to see which ones supported AES. For posterity, we include this information here:

Web Browser	Operating System	Best Cipher	Verdict?
Native Android Browser (LG G3)	Android v4.4.2+	AES 256-bit	Good!
Chrome v39+	Android v4.4.2+	AES 256-bit	Good!
Firefox Mobile v8+	Android	AES 256-bit	Good!
Safari	iOS v8+ (iPhone/iPad/etc.)	AES 256-bit	Good
Safari	iOS v5.0.1	AES 128-bit	Good
Safari	iOS v2.2	AES 128-bit	Good
Silk	Kindle Fire	RC4 128-bit	Terrible
Firefox v35+	Windows XP & Vista, Mac OSX	AES 256-bit	Good!
Firefox v8+	Windows XP & Vista, Mac OSX	AES 256-bit	Good!
Firefox v3.0.5	Windows XP & Vista, Mac OSX	AES 256-bit	Good!
Safari v8+	Windows Vista/7, Mac OSX	AES 256-bit	Good
Safari v5.1.2	Windows Vista/7, Mac OSX	AES 128-bit	Good
Safari v3.2.1	Windows Vista, Mac OSX	AES 128-bit	Good
Safari v3.2.1	Windows XP	RC4 128-bit	Terrible
Chrome v40+	Windows Vista/7, Mac OSX	AES 256-bit	Good!
Chrome v15+	Windows Vista/7, Mac OSX	AES 256-bit	Good!
Chrome v1.x	Windows Vista	AES 128-bit	Good
Chrome v1.x	Windows XP	RC4 128-bit	Terrible
Internet Explorer v11	Windows 7	AES 256-bit	Good
Internet Explorer v9	Windows 7	AES 128-bit	Good
Internet Explorer v9	Windows Vista	RC4 128-bit	Terrible
Internet Explorer v7 & v8	Windows Vista	AES 128-bit	Good
Internet Explorer v8	Windows XP	RC4 128-bit	Terrible
Internet Explorer v7	Windows XP	RC4 128-bit	Terrible
Internet Explorer v6	Windows XP	RC4 128-bit	Terrible
Opera v26+	Mac OSX	AES 256-bit	Good!
Opera v11.10+	Windows Vista	AES 256-bit	Good!
Opera v9.62	Windows XP & Vista	AES 256-bit	Good!

So, by default, legacy browsers will take advantage of AES encryption when available. We also found that any program that uses old windows default SSL libraries will use RC4 in Windows XP and 128-bit AES in Windows Vista.

What encryption techniques are supported by modern email programs?

Asking this question about web browsers asks what is supported by the various email programs out there. If you are using a WebMail interface to access your email, the answer depends on your web browser. The latest versions of well-known email programs will use suitable encryption techniques, including AES-256. If you are using outdated/legacy email software, you should immediately update it to the latest version.

What encryption techniques were supported by legacy email programs?

We tested several popular legacy email programs on legacy operating systems to see the best encryption cipher they could use. This was done before AES usage became essentially universal. Here are the results (for posterity):

Email Program	Operating System	Verdict?	Results
Mozilla Thunderbird v2+	Windows XP & Vista	Good!	256-bit AES
Thunderbird v2+	Mac OSX v10.4.11	Good!	256-bit AES
Outlook 2010	Windows 7	Good!	256-bit AES
Outlook 2007	Windows XP	Terrible	128-bit RC4 is the best supported
Outlook 2007	Windows Vista	Good	128-bit AES chosen (though 256-bit is there, it is not listed 1st in the program and thus not used)
Outlook 2003	Windows XP	Terrible	128-bit RC4 is the best supported
Mail.app	Mac OSX v10.10	Good	256-bit AES
Mail.app	Mac OSX v10.5.5	Good	128-bit AES chosen (though 256-bit is there, it is not listed 1st in the program and thus not used)
Mail.app	Mac OSX v10.4.11	Good	128-bit AES chosen (though 256-bit is there, it is not listed 1st in the program and thus not used)
Mail.app	iPhone v2.2	Good	128-bit AES chosen (though 256-bit is there, it is not listed 1st in the program and thus not used)
Eudora v7	Windows XP	Good	256-bit AES
Eudora v8	Mac OSX v10.4	Good	256-bit AES
Entourage v12	Mac OSX v10.4	Terrible	DES

We see a similar pattern here. In most cases, the cipher used depended on the Operating System and not the program. Some programs roll their own SSL (i.e., Thunderbird/Eudora), and some use the OS built-in libraries. So, from this, we can infer that any newer version of Outlook on Vista or Windows 7+ will go for at least 128-bit AES; most things on Windows XP would use 128-bit RC4, etc.

How to force the use of AES-256 on secure web browsers and email programs

Web browsing clients like Mozilla Firefox or Opera and email clients like Thunderbird use AES-256 by default, as long as the server supports it.

However, it’s also possible to force the use of 256-bit AES encryption. This can be useful if your organization mandates that secure connections use 256-bit AES or if you do not trust that the servers you wish to connect to will have secure ciphers.

You can ensure that AES-256 is always used by following the instructions below. If the server does not support AES-256, the connection will fail.

Mozilla Firefox:

Type “about:config” in the address bar to open up the detailed list of configuration parameters.
Scroll down to “tls.version.min”, and ensure that it is set to “1” as an absolute minimum. This will turn off support for SSLv2 and SSLv3.
Search for “ssl3.”
Look for the ciphers that do not include “aes_256” in their names. If any of these say “true,” double click on them to change them to “false.” This will make them no longer available for use.
You will be left with various versions of AES-256 with TLS v1.0+.
You don’t have to restart Firefox for this to take effect.

Mozilla Thunderbird:

From Thunderbird’s home screen, click on the three horizontal lines in the top right corner.
Click Preferences, then Preferences once more in the menu that comes up.
Click Advanced, then scroll to the bottom right where it says Config Editor. Click on Config Editor.
Be aware that configuration changes can affect the program’s stability, and only proceed if you know what you are doing. Click I Accept the risk.
Scroll down to “tls.version.min”, and ensure that it is set to “1” as an absolute minimum. This will turn off support for SSLv2 and SSLv3.
Search for “ssl3 “
Look for the ciphers that do not include “aes_256” in their names. If any of these say “true,” double click on them to change them to “false.” This will make them no longer available for use.
Restart Thunderbird so that any persistent connections are broken and re-opened.
Make sure that your email accounts are all configured to use SSL or TLS (not “if available,” but “always”).
If possible, go to your email provider and disallow insecure connections to your account. This will make the connection fail even if the email program is accidentally configured to make a secure connection. (LuxSci allows this to be set on the user-level or enforced by policy account-wide).

Skype:

It’s off-topic, but Skype uses 256-bit AES encryption, so if you use it for chat or voice calls, your data is also being encrypted in this fashion.

Locking down your website (in Apache)

If you are a website owner and have TLS security on it, you can lock it down so that the only cipher your website supports is 256-bit AES. This takes the choice out of the end user’s hands. They can either use AES-256, or they won’t be able to connect to the website. However, this also means that some users may not be able to access your site unless they change to a more secure browser.

To lock your site down so that it only supports 128-bit and 256-bit AES, add the following to your Apache httpd.conf file:

SSLCipherSuite AES256-SHA:AES128-SHA

This can be added globally, in a virtual host, or even in your .htaccess file. It will ensure that any successful connection to your site will use one of these ciphers. Be sure to add it to the secure settings for your site and not just the insecure site area. More information is available at Apache.

You will generally want only to support TLS v1.2+ and NIST-recommended cipher suites. See: what level of TLS is required for HIPAA.

AES encryption is still reliable

AES encryption is still the preferred standard for TLS. Modern machines don’t noticeably affect performance, providing an adequate security level.

However, it’s important to note that TLS only protects data sent between you and the server. When you send and receive an email, the message data travels in the clear, so TLS does not protect it throughout the entire journey. The Case for Email Security explains this in more detail.

Thankfully, services like LuxSci’s SecureLine provide email encryption, which can safeguard your email the whole way. Contact our team for more information on how to protect your organization’s data.

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Why Healthcare Insurers Should Send Explanation of Benefits Statements Via Email

July 30, 2025
Pete Wermter

Explanation of Benefits statements or EOBs are mission-critical communications for health insurers because they ensure transparency, help detect billing errors or fraud, and most importantly, keep patients informed about their benefits and related payments.

However, the most conventional method of sending out EoBs, traditional mail, has several drawbacks that can prevent important information about healthcare coverage from reaching the intended recipient. This can leave policyholders in the dark about their healthcare coverage, which can lead to confusion and dissatisfaction with their insurance provider when they receive an unexpected medical bill. This can also drive up inbound calls into your claims department or contact center.

Because Explanation of Benefits statements contain the protected health information (PHI) of policyholders, insurers are bound by HIPAA (the Health Insurance Portability and Accountability Act) regulations to ensure their secure delivery. Consequently, the risks inherent to sending paper EoB statements in the mail not only have security implications but also potential consequences for non-compliance.

With all this in mind, this post discusses why healthcare insurers should send EoBs to their policyholders via secure email instead of traditional mail. We detail the various benefits of making the switch to electronic EoBs, which include enhanced security, better adherence to compliance regulations, and the opportunity to save millions of dollars per month.

Protecting Patient Privacy

The primary reason that insurance companies should shift to email EoBs as opposed to traditional mail is that it’s far more secure. Sending an EoB via email drastically decreases the risk of protected health information (PHI) getting into the wrong hands. When sent in paper form by mail, an EoB could be:

Lost, stolen or damaged in transit
Delivered to the wrong address
Not properly deposited in a letter or mailbox, then stolen
Intercepted within the intended address by another individual who lives at or has access to the residence.

As detailed later in this post, email also allows for various controls and processes, which mitigate the risks of unsuccessful message delivery.

Most importantly, secure email provides data encryption, which safeguards the sensitive patient data within EoBs during transmission and when stored by rendering it unreadable to malicious actors who might intercept it. Physical mail, in contrast, offers no such protection, as someone who intercepts a paper EoB form can simply open it and freely read its contents.

Finally, secure email delivery platforms feature identity verification and access controls that enable healthcare insurers to restrict access to PHI to authorized personnel, limiting its exposure. They also provide auditing capabilities to track access to patient data, and quickly identify the source of security breaches.

HIPAA Compliance Benefits

Because sending an Explanation of Benefits statement via email is more secure, and better protects any patient data contained within them, this also reduces the risk of HIPAA compliance violations.

First and foremost, HIPAA regulations mandate that communications containing PHI, such as EoBs, must securely reach the intended recipient. By eliminating the risk of physical interception or non-delivery, and the compliance violations from a resulting security breach, insurers can better adhere to HIPAA regulations using email for sending EOBs. On a similar note, the security features built into a HIPAA compliant email platform, such as encryption, access controls, and audit logs, help insurers to satisfy the requirements of HIPAA’s Privacy and Security Rules in their compliance efforts.

Another considerable benefit of using secure email to send policyholders their EoBs, or, in fact, any communication containing PHI, is that it’s far easier to implement breach notification protocols. Email delivery platforms provide real-time tracking, so companies can pinpoint email message failures quickly and act accordingly. Similarly, intrusion detection systems and other cybersecurity measures that support email systems can enable faster detection and containment of data breaches.

In stark contrast, physical mail is far more difficult to track – and even those limited capabilities are reserved for more expensive delivery options. Consequently, security breaches via mail could go unnoticed for days or even weeks. If you’re unaware of a data breach, or have not yet contained or mitigated it, you’re then unable to inform all affected parties, resulting in further HIPAA violations.

Increased Deliverability Rates

By greatly mitigating the security risks presented by physical mail, i.e., the various ways an EoB could fall into the wrong hands, sending an EoB by email increases your ability to get more EOBs into the hands of policyholders, more quickly. At the same time, policyholders can make faster decisions regarding their healthcare.

The ability to track secure email gives you greater control over EOB deliverability, as it allows organizations to determine the cause of delivery failure and can also make subsequent attempts. Additionally, the process of determining the reason for the message delivery failures can also reveal security issues; the same process, however, is very difficult to achieve with traditional mail.

Here’s how the typical protocol for resending a secured email goes beyond what you can do with managing traditional mail delivery:

Determine the cause of non-delivery: verify that the intended recipient information is correct and check for issues like a full email inbox or security misconfigurations.
Don’t automatically resend: to avoid exposing PHI to the wrong person, confirm the intended recipient’s email address through an alternative verified channel, e.g., phone call, secure SMS, etc.
Log the incident: document the delivery failure, steps taken to determine its cause, attempts, etc.
Reattempt message delivery: if the investigation deems it safe, attempt message redelivery with the corrected information.

In the event that subsequent delivery attempts fail, it’s best practice to contact the individual to arrange the most convenient and secure alternative to deliver their EoBs.

Cost Savings

Simply put, sending Explanation of Benefits statements via email instead of traditional mail saves health insurers money – potentially lots of it. Processing EOBs from start to finish can cost health insurers one to two dollars or more per EOB. That’s a lot. The biggest opportunity for cost reduction is tied to the money saved on printing and mailing paper EoB statements. Additionally, the cost of administering the delivery of EoB forms, ensuring their delivery, etc., is lowered when it’s done electronically. Not to mention, resending EoBs in the event of their non-delivery is much easier and cheaper via email.

In a broader sense, increasing the deliverability and the success rate of sending EoBs helps a larger number of policyholders better understand the details of their insurance coverage, i.e., how it works, which services and procedures it covers, etc. As a result of their policyholders being more informed, insurers won’t spend as much time explaining policy details and cost breakdowns to their members, allowing them to divert the otherwise required resources to other areas of the business.

Reduced Carbon Footprint

Finally, it’s difficult to highlight the benefits of sending EoBs to policyholders by email without recognizing the positive environmental impact, too. Email EoBs cut down on paper, for both the forms themselves and the envelopes they’re mailed in. Then there’s the matter of the electricity and ink involved in printing them, the emissions produced in their delivery, etc. Opting to send EoBs via email reduces all these factors, which enables healthcare organizations to lower their carbon footprint and, where applicable, meet their sustainability obligations or goals.

Deliver EoBs More Securely, Reliably, and at Lower Cost with LuxSci

LuxSci’s Secure High Volume Email Solution enables healthcare insurance companies to instantly send Explanation of Benefits statements to policyholders at a massive scale, extending into hundreds of thousands or millions per month.

Our HIPAA compliant email delivery platform features:

Dedicated IPs that isolate critical transactional messages, such as EoBs, from other email traffic, allowing LuxSci customers to reach deliverability rates of 98% or more.
Real-time tracking for determining the delivery status of EoBs, as well as troubleshooting unsuccessful delivery attempts.
Flexible encryption through LuxSci’s proprietary SecureLine Technology, which automatically adjusts encryption settings according to the recipient to better ensure the protection of sensitive data.

Know the Biggest Email Threats Facing Healthcare Right Now

July 16, 2025
Pete Wermter

Due to its near-universal adoption, speed, and cost-effectiveness, email remains one of the most common communication channels in healthcare. Consequently, it’s one of the most frequent targets for cyber attacks, as malicious actors are acutely aware of the vast amounts of sensitive data contained in messages – and standard email communication’s inherent vulnerabilities.

In light of this, healthcare organizations must remain aware of the evolving email threat landscape, and implement effective strategies to protect the electronic protected health information (ePHI) included in email messages. Failing to properly secure email communications jeopardizes patient data privacy, which can disrupt operations, result in costly HIPAA compliance violations, and, most importantly, compromise the quality of their patients’ healthcare provision.

With all this in mind, this post details the biggest email threats faced by healthcare organizations today, with the greatest potential to cause your business or practice harm by compromising patient and company data. You can also get our 2025 report on the latest email threats, which includes strategies on how to overcome them.

Ransomware Attacks

Ransomware is a type of malware that encrypts, corrupts, or deletes a healthcare organization’s data or critical systems, and enables the cybercriminals that deployed it to demand a payment (i.e., a ransom) for their restoration. Healthcare personnel can unwittingly download ransomware onto their devices by opening a malicious email attachment or clicking on a link contained in an email.

In recent years, ransomware has emerged as the email security threat with the most significant financial impact. In 2024, for instance, there were over 180 confirmed ransomware attacks with an average paid ransom of nearly $1 million.

Email Client Misconfiguration

While a healthcare organization may implement email security controls, many fail to know the security gaps of their current email service provider (ESP) or understand the value of a HIPAA compliant email platform, leaving data vulnerable to email threats, such as unauthorized access and ePHI exposure, and also, subsequently, a greater risk of compliance violations and reputation damage.

Common types of email misconfiguration include:

Lack of enforced TLS encryption: resulting in emails being transmitted in plaintext, rendering the patient data they contain readable by cybercriminals in the event of interception during transit.
Improper SPF/DKIM/DMARC setup: failure to configure or align these email authentication protocols correctly gives malicious actors greater latitude to successfully spoof trusted domains.
Disabled or lax user authentication: a lack of authentication measures, such as multi-factor authentication (MFA), increases the risk of unauthorized access and ePHI exposure.
Misconfigured secure email gateways: incorrect rules or filtering policies can allow phishing emails through or block legitimate messages.
Outdated or unsupported email client software: simply neglecting to download and apply the latest updates or patches from the email client’s vendor can leave vulnerabilities, which are well-known to cybercriminals, exposed to attack.

Social Engineering Attacks

A social engineering attack involves a malicious actor deceiving or convincing healthcare employees into granting unauthorized access or exposing patient data. Relying on psychological manipulation, social engineering attacks exploit a person’s trust, urgency, fear, or curiosity, and encompass an assortment of threats, including phishing and business email compromise (BEC) attacks, which are covered in greater depth below.

Phishing

As mentioned above, phishing is a type of social engineering attack, but they are so widespread that it warrants its own mention. Phishing sees malicious actors impersonating legitimate companies, or their employees, to trick victims into revealing sensitive patient data.

Subsequently, healthcare organizations can be subjected to several different types of phishing attacks, which include:

General phishing: otherwise known as bulk phishing or simply ‘phishing’, these are broad, generic attacks where emails are sent to large numbers of recipients, impersonating trusted entities to steal credentials or deliver malware.
Spear phishing: more targeted attacks that involve personalized phishing emails crafted for a specific healthcare organization or individual. These require more research on the part of malicious actors and typically use relevant insider details gleaned from their reconnaissance for additional credibility.
Whaling: a form of spear phishing that specifically targets healthcare executives or other high-level employees.
Clone phishing: when a cybercriminal duplicates a legitimate email that was previously received by the target, replacing links or attachments with malicious ones.
Credential phishing: also known as ‘pharming’, this involves emails that link to fake login pages designed to capture healthcare employees’ usernames and passwords under the guise of frequently used legitimate services.

Domain Impersonation and Spoofing

This category of threat revolves around making malicious messages appear legitimate, which can allow them to bypass basic email security checks. As alluded to above, these attacks exploit weaknesses in email client misconfigurations to trick the recipient, typically to expose and exfiltrate patient data, steal employee credentials, or distribute malware.

Domain spoofing email threats involve altering the “From” address in an email header to make it appear to be from a legitimate domain. If a healthcare organization fails to properly configure authentication protocols like SPF, DKIM, and DMARC, there’s a greater risk of their email servers failing to flag malicious messages and allowing them to land in users’ inboxes.

Domain impersonation, on the other hand, requires cybercriminals to register a domain that closely resembles a legitimate one. This may involve typosquatting, e.g., using “paypa1.com” instead of “paypal.com”. Alternatively, a hacker may utilize a homograph attack, which substitutes visually similar characters, e.g., from different character sets, such as Cyrillic. Malicious actors will then send emails from these fraudulent domains, which often have the ability to bypass basic email filters because they aren’t exact matches for blacklisted domains. Worse still, such emails can appear authentic to users, particularly if the attacker puts in the effort to accurately mimic the branding, formatting, and tone used by the legitimate entity they’re attempting to impersonate.

Insider Email Threats

In addition to external parties, employees within a healthcare organization can pose email threats to the security of its PHI. On one hand, insider threats can be intentional, involving disgruntled employees or third-party personnel abusing their access privileges to steal or corrupt patient data. Alternatively, they could be the result of mere human error or negligence, stemming from ignorance, or even fatigue.

What’s more, insider threats have been exacerbated by the rise of remote and flexible conditions since the onset of the COVID-19 pandemic, which has created more complex IT infrastructures that are more difficult to manage and control.

Business Email Compromise (BEC) Attacks

A BEC attack is a highly targeted type of social engineering attack in which cybercriminals gain access to, or copy, a legitimate email account to impersonate a known and trusted individual within an organization. BEC attacks typically require extensive research on the targeted healthcare company and rely less on malicious links or attachments, unlike phishing, which can make them difficult to detect.

Due to the high volume of emails transmitted within the healthcare industry, and the sensitive nature of PHI often included in communications to patients and between organizations, the healthcare industry is a consistent target of BEC attacks.

BEC attacks come in several forms, such as:

Account compromise: hijacking a real employee’s account and sending fraudulent messages.
Executive fraud: impersonating high-ranking personnel to request urgent financial transactions or access to sensitive data.
Invoice fraud: pretending to be a vendor asking for the payment of a fraudulent invoice into an account under their control.

Supply Chain Risk

Healthcare organizations increasingly rely on third-party vendors, including cloud service providers, software vendors, and billing or payment providers to serve their patients and customers. They constantly communicate with their supply chain partners via email, with some messages containing sensitive patient data; moreover, some of these organizations will have various levels of access to the PHI under their care.

Consequently, undetected vulnerabilities or lax security practices within your supply chain network could serve as entry points for email threats and malicious action. For instance, cybercriminals can compromise the email servers of a healthcare company’s third-party vendor or partner, and then send fraudulent emails from their domains to deploy malware or extract patient data.

Another, somewhat harrowing, way to understand supply chain risk is that while your organization may have a robust email security posture, in reality, it’s only as strong as that of your weakest third-party vendor’s security controls.

Download LuxSci’s Email Cyber Threat Readiness Report

To gain further insight into the biggest email threats to healthcare companies in 2025, including increasingly prevalent AI threats, download your copy of LuxSci’s Email Cyber Threat Readiness Report.

You’ll also learn about the upcoming changes to the HIPAA Security Rule and how it’s set to impact your organization going forward, and the most effective strategies for strengthening your email security posture.

Grab your copy of the report here and begin the journey to strengthening your company’s email threat readiness today.

What is the Best HIPAA Compliant Email?

July 10, 2025
Erik Kangas

The best HIPAA compliant email contains strong security features with ease of use and reasonable pricing. Top options include properly configured Google Workspace or Microsoft 365 accounts with Business Associate Agreements in place. Look at HIPAA compliant email platforms that offer encryption, access controls, audit logging, and secure mobile access while fitting their practice size, budget, and technical capabilities.

HIPAA Compliant Email Features

Healthcare professionals require email systems with particular security capabilities to protect client communications. Any HIPAA compliant email must include automatic encryption that works without requiring clients to create accounts or remember passwords. You need detailed access logs that document when messages were sent, received, and viewed. Message recall capabilities help address accidental disclosures before they become compliance issues. Calendar integration supports secure appointment scheduling and reminders. Mobile access controls ensure therapists can communicate safely from smartphones and tablets during off-hours or between office locations. Document sharing features allow secure exchange of intake forms and treatment plans. These capabilities help therapists maintain compliant communications while managing their practice efficiently.

Popular HIPAA Compliant Email Platforms

Several email providers offer solutions well-suited to mental health professionals. Hushmail for Healthcare includes features designed for therapists with web-based secure forms for client intake and customizable email templates. Paubox delivers encrypted email that works without requiring recipients to take extra steps, making it ideal for client communications. Virtru integrates with existing Gmail or Outlook accounts to add HIPAA compliant protections without changing email addresses. Google Workspace and Microsoft 365 provide affordable options when properly configured with appropriate security settings and covered by Business Associate Agreements. Smaller therapy practices often prefer these mainstream platforms for their familiarity and integration with other practice tools.

Security Considerations for Healthcare Communications

Secure healthcare communications require thoughtful security approaches due to their sensitive nature. HIPAA compliant email should include protections against phishing attacks that might target patient information. Data loss prevention tools identify and secure messages containing sensitive information even when users forget to enable encryption. Account recovery procedures must balance security with practicality for small practices. Multi-factor authentication prevents unauthorized access even if passwords are compromised.

For example, healthcare personnel handling substance use disorder information need email systems that comply with both HIPAA and 42 CFR Part 2 requirements. Solutions should accommodate supervision relationships where communications may need controlled sharing with supervisors.

Client Experience and Usability Factors

The best HIPAA compliant email solutions balance security with positive client experiences. Buyers should evaluate how encryption affects the client’s process for reading and responding to messages. Some solutions require clients to create accounts or install software, while others deliver protected messages that open with minimal friction. Mobile compatibility matters as many clients prefer communicating from smartphones. Branding options allow therapists to maintain professional appearance in all communications. Automated responses help set appropriate expectations about response timing and emergency protocols. Client-facing secure forms streamline intake processes while maintaining compliance.

HIPAA Compliant Email Implementation for Medical Practices

Implementing secure email requires planning tailored to medical practice workflows. Solo practitioners need solutions with straightforward setup and minimal ongoing maintenance. Group practices benefit from centralized administration that enforces consistent security policies across all therapists. Practice management integration connects secure email with scheduling, billing, and documentation systems.

Transition planning helps migrate existing communications to new secure platforms without disrupting client relationships. Documentation templates ensure compliance with both HIPAA and professional ethical standards for electronic communications. Training materials must address both technical operation and appropriate clinical use cases. When implementing HIPAA compliant email practice admins should create workflow procedures that incorporate secure communication into their practice routines.

Cost Considerations For Selecting Email Services

Healthcare providers must balance security requirements with budget realities when selecting HIPAA compliant email. Pricing models vary significantly, with some services charging per user while others offer flat-rate plans better suited to solo practitioners. Additional fees may apply for features like secure forms, extra storage, or advanced security controls. Implementation costs include time spent on configuration, training, and client education about new communication methods. Some platforms offer discounted rates for professional association members or multi-year commitments. Buyers should calculate the total cost of ownership beyond monthly subscription fees, including technical support and compliance documentation. Affordable HIPAA compliant email options exist for practices of all sizes, but require thoughtful evaluation of both immediate pricing and long-term value.

Integrating Email with Broader Practice Security

HIPAA compliant email represents one component of comprehensive practice security. Email solutions should complement electronic health record systems while maintaining appropriate boundaries between clinical documentation and communications. Device management policies ensure therapists access email securely across computers, tablets, and smartphones. Backup procedures preserve communications while maintaining security protections. Incident response planning prepares therapists for addressing potential security issues or breaches. Regular security reviews evaluate whether email practices continue to meet evolving compliance requirements. By integrating email security with broader practice safeguards, therapists create communication systems that protect client information throughout its lifecycle.

What Is Email Marketing For Healthcare?

July 4, 2025
Erik Kangas

Email marketing for healthcare is targeted communication strategy that medical organizations use to engage patients, promote wellness services, share health education content, and encourage preventive care while maintaining regulatory compliance and patient privacy protections. This specialized approach helps healthcare providers, payers, and suppliers build stronger relationships with their communities through informative, valuable email communications. Email marketing for healthcare differs from traditional marketing because it must balance promotional objectives with medical ethics, patient trust, and strict privacy regulations. Understanding email marketing for healthcare helps medical facilities develop communication programs that support patient engagement, improve health outcomes, and grow their practices while respecting regulatory requirements and maintaining professional standards.

The Use of Email Marketing For Healthcare

Email marketing for healthcare encompasses several communication types including patient education newsletters, appointment reminders, wellness program promotions, and health screening campaigns. Patient education emails provide valuable health information, seasonal wellness tips, and disease management guidance that helps recipients make informed healthcare decisions. These educational communications build trust and establish healthcare organizations as reliable health information sources.

Appointment and follow-up communications use email to streamline patient care coordination, reduce no-show rates, and improve treatment adherence. Wellness program promotions encourage patients to participate in health screenings, fitness classes, vaccination clinics, and other preventive care activities. Event marketing emails promote health fairs, educational seminars, and community health initiatives that benefit both patients and the broader community. Service line marketing allows healthcare organizations to promote specific departments or specialties to patients who have expressed interest in related services. Women’s health programs, cardiac care services, and orthopedic treatments can be marketed to relevant audience segments based on demographic factors and self-reported health interests rather than protected medical information.

Patient retention campaigns use email to maintain ongoing relationships with existing patients, encouraging regular check-ups, annual screenings, and continued engagement with healthcare services. These campaigns focus on long-term health maintenance rather than immediate sales objectives.

Regulatory Framework and Privacy Considerations

Email marketing for healthcare must comply with HIPAA privacy regulations that govern how protected health information can be used for communication purposes. Healthcare organizations cannot use patient medical records, diagnosis codes, or treatment histories for marketing without explicit written authorization from patients. General health education content can be sent without authorization, but targeted campaigns based on specific health conditions require proper consent procedures.

The CAN-SPAM Act applies to all commercial healthcare emails, requiring truthful subject lines, clear sender identification, valid physical addresses, and functional unsubscribe mechanisms. Healthcare organizations must honor opt-out requests promptly and maintain suppression lists to prevent future unwanted communications. State privacy laws may impose additional requirements that healthcare organizations must research and implement. Business associate agreements become necessary when healthcare organizations use third-party email platforms or service providers to handle patient information during marketing activities. These agreements ensure that vendors maintain appropriate privacy protections and comply with healthcare industry regulations. Healthcare organizations remain responsible for ensuring their email marketing practices meet all applicable regulatory requirements.

Patient consent management requires systems to track when and how patients provided authorization for different types of marketing communications. Organizations need documentation showing patient consent for targeted campaigns and procedures for updating preferences when patients change their communication choices.

Technology Platforms and Integration Requirements

Email marketing for healthcare requires specialized platforms that provide HIPAA compliance features, data encryption, audit logging, and business associate agreements. These platforms must protect patient information during campaign creation, delivery, and performance tracking while maintaining security standards appropriate for healthcare data. Standard consumer email marketing platforms may not provide adequate privacy protections for healthcare communications.

Integration capabilities allow email marketing for healthcare systems to connect with electronic health records, patient management platforms, and appointment scheduling systems. These integrations enable automated campaign triggers based on appointment dates, discharge events, or routine care intervals without exposing sensitive medical information to unauthorized personnel. Single sign-on features allow staff to access email marketing tools using existing healthcare system credentials. List management functionality should support consent tracking, preference management, and compliance reporting requirements specific to healthcare organizations. Segmentation tools need to work with demographic and behavioral data rather than protected health information to maintain privacy compliance. Automated workflows can personalize communications based on publicly available information and patient preferences.

Security monitoring and audit trails provide detailed logging of who accesses patient information, what campaigns are created and sent, and how patient data is used for marketing purposes. These features support compliance demonstrations during regulatory reviews and help organizations investigate potential privacy incidents.

Patient Engagement and Content Strategies

Email marketing for healthcare should prioritize patient value and health outcomes over purely promotional messaging to build trust and encourage long-term engagement. Educational content performs better than sales-focused communications because patients appreciate receiving useful health information that helps them make better healthcare decisions. Content should be evidence-based, medically accurate, and reviewed by qualified healthcare professionals before distribution.

Personalization strategies must balance engagement benefits with privacy requirements and regulatory constraints. Basic personalization using names, preferred languages, and geographic information can improve response rates without requiring protected health information. More detailed personalization based on health interests or conditions requires explicit patient authorization and careful data management procedures. Timing and frequency considerations help healthcare organizations maintain patient engagement without overwhelming recipients with excessive communications. Different types of healthcare emails may require different sending schedules based on urgency, content type, and patient preferences. Appointment reminders need timely delivery, while educational newsletters can follow regular monthly or quarterly schedules.

Interactive content such as health assessment questionnaires, symptom checkers, and wellness challenges can increase patient engagement while providing valuable health information. These interactive elements should collect only necessary information and maintain appropriate privacy protections throughout the user experience.

Performance Measurement and Optimization

Email marketing for healthcare should be evaluated using metrics that reflect patient engagement, health outcomes, and organizational objectives rather than purely commercial success indicators. Appointment booking rates, health screening participation, and patient satisfaction scores provide more meaningful performance measurements than traditional marketing metrics alone. These healthcare-specific metrics demonstrate how email communications support patient care and organizational mission.

Patient feedback collection through surveys, focus groups, and direct communication helps healthcare organizations understand recipient preferences and identify areas for improvement. Regular feedback collection demonstrates commitment to patient-centered communication approaches and provides insights for optimizing future campaigns. Feedback should guide content development, timing decisions, and overall communication strategy adjustments. A/B testing can improve campaign performance by comparing different subject lines, content formats, sending times, and call-to-action approaches while maintaining compliance requirements. Testing should focus on elements that affect patient engagement and health outcomes rather than manipulative tactics that might undermine patient trust.

Long-term performance analysis helps healthcare organizations understand the cumulative impact of their email marketing efforts on patient relationships, care utilization patterns, and health outcomes. This analysis supports continuous improvement initiatives and demonstrates the value of patient communication investments to organizational leadership and stakeholders.

What is a HIPAA Compliant Form?

February 19, 2025
Pete Wermter

In healthcare today, patient data is one of the most valuable assets that any provider, payer or supplier can possess. As well as being highly valuable, however, the nature of patient data also makes it highly sensitive. That’s where HIPAA compliant forms come in. A HIPAA compliant form refers to any document or electronic form used to collect, access, or store protected health information (PHI), while also meeting the privacy and security requirements outlined by the Health Insurance Portability and Accountability Act (HIPAA). HIPAA is designed to safeguard patient data and protect health information (PHI) from unauthorized access, disclosure, and use.

With the rise of digital interactions in the healthcare industry, one of the best ways to capture and manage sensitive data is through secure forms. Whether onboarding new patients, scheduling appointments, gathering patient feedback, conducting surveys, or carrying out marketing campaigns, securely collecting patient information and business intelligence via HIPAA compliant forms can provide huge opportunities for improved efficiency and a better overall patient or customer experience.

In this article, we’ll explore the essential role secure forms play in collecting patient data, why healthcare companies should use HIPAA compliant forms to capture PHI, and subsequently, how to create secure and compliant forms for use in your everyday healthcare operations.

Why HIPAA Compliant Forms are Crucial for Healthcare?

A secure form (or secure web form) is a type of online form designed to collect, transmit, and store data and business intelligence, while maintaining strict security standards, including compliance with HIPAA regulations. Secure forms typically incorporate encryption and authentication protocols to ensure data is protected from unauthorized access during submission and storage.

In the context of healthcare, secure forms are specifically designed to capture PHI, which includes a patient’s name, address, medical history, diagnoses, treatment plans and other personal details related to their health.

Healthcare organizations, such as hospitals, doctors’ offices, clinics, in-home care services, retail healthcare, testing services and laboratories, health plan administrators, insurers, and medical equipment providers all deal with patient data on a daily basis. The sensitive and important nature of this data makes it a prime target for cybercriminals, who seek to use it for financial gain or other malicious purposes, including disrupting critical infrastructure and business operations, identity theft, and more.

Accounting for this, when scheduling appointments, onboarding new patients, or conducting surveys, for example, healthcare companies must use secure forms that adhere to HIPAA guidelines to ensure patient data is properly secured.

These include:

Data is encrypted in transit, when being collected from the form and transferred to storage, and at rest, where the patient data will reside, i.e. in a database.
Only authorized users, i.e., employees with good reason to handle PHI, have access to patient data.
Authorized users are also properly authenticated, to ensure they are who they claim to be, i.e., credentials haven’t been stolen, a session hasn’t been hijacked, etc.

Conversely, using unsecured forms to collect PHI could result in the data being compromised in a breach—and your organization suffering the associated consequences. As well as the financial penalties of a security breach, such as fines and compensation paid to the affected parties, more significantly, you’ll incur a dent in your reputation of your business and a loss of patient trust.

Key Applications for Secure Forms in Healthcare

Now that we’ve covered why HIPAA compliant forms are vital for healthcare organizations, let’s look at some of the most effective ways they can be utilized.

1. New Patient Onboarding and Registration

Gathering basic information, such as their medical history, insurance details, and personal information, is a fundamental part of onboarding new patients. Secure forms allow patients to submit their sensitive data through a safe, encrypted platform, mitigating the risk of data exposure considerably and reducing or eliminating the need for human intervention in the process.

Additionally, automated form submissions, using data from electronic health record (EHR) systems and other integrated tools save time for healthcare providers and patients, offering a streamlined registration experience and improved workflows.

2. Appointment Scheduling

Secure forms offer an efficient way for patients to schedule their appointments, reducing time, effort, and administrative overhead by eliminating the need for a phone call or back-and-forth email conversation through automated scheduling. When integrated properly, the completion of a secure form can trigger appointment confirmation and reminder emails to reduce missed appointments. Allowing patients to book appointments in this way drastically reduces the amount of friction involved, making it far easier for patients to comply and making sure they don’t miss appointments.

3. Patient and Customer Surveys

Feedback from patients plays a crucial role in improving healthcare services and experiences, allowing companies to pinpoint areas for refinement. Requesting feedback is also highly beneficial for a company’s long-term relationship with a patient or customers, as it demonstrates they value their opinion and want to incorporate it into their ongoing commitment to excellent service and efficient healthcare journeys; this makes patients more inclined to trust them, strengthening their connection and overall engagement.

Whether for patient satisfaction surveys or follow-up care assessments, secure forms offer a compliant means of collecting valuable feedback without jeopardizing PHI.

4. Email Communications and Marketing Campaigns

Email marketing in healthcare can be a tricky endeavor, especially when it comes to getting patients to opt-in and for classifying and handling PHI.

By using secure forms, healthcare organizations can gather consent from patients for email communications and marketing campaigns. Secure forms ensure that any sensitive patient data (i.e., preferences for specific treatments or communications) is submitted safely and stored in compliance with privacy regulations.

End-to-End Security for Form Data

An essential requirement of secure forms used by healthcare providers, payers, and suppliers is that they provide end-to-end security, i.e., protecting form data throughout its entire lifecycle—from submission to storage to access. Here are the measures required to ensure end-to-end security for PHI captured by web forms.

1. Secure Transmission

As alluded to earlier, when a patient submits data through a form, it must be encrypted while being transmitted from the form, i.e., the place of capture, to where it will be stored. Using Secure Socket Layer (SSL) or Transport Layer Security (TLS) encryption ensures that sensitive data, such as PHI, is protected from interception by malicious actors.

2. Secure Storage

Similarly, after submission, form data must be stored securely in an encrypted database to ensure HIPAA compliance. Subsequently, in the event the database is breached and the PHI exfiltrated, it will be undecipherable to cybercriminals, protecting the data from exposure.

3. Access Control and User Authentication

Organizations must ensure that only authorized personnel can access sensitive patient data, according to their responsibilities regarding PHI. In addition to this, healthcare organizations must implement strong authentication mechanisms, such as multi-factor authentication (MFA) and robust password practices, to facilitate user authentication. These mitigation measures are interconnected as they help better secure data even if a hacker gets their hands on an authorized employee’s login details.

4. Audit Logs

Additionally, companies must maintain audit, or activity, logs to carefully track who accessed PHI, when, where they accessed it from, and why, i.e., how they acted upon the data. This helps identify suspicious or malicious behavior and, in the event of a breach, pinpoint its origin and contain its spread. Audit logs can also reveal which employees have too many access privileges, enabling healthcare organizations to tighten up their access control policies.

Best Practices for Creating Secure Forms

Finally, here are some best practices to align with when employing the use of secure forms to collect patient data.

1. Use a Secure Form Builder

Choose a solution, such as LuxSci, that specializes in secure, HIPAA compliant forms. This ensures that all data collection, transmission, and storage are adequately encrypted and that compliance standards are met.

2. Enable Encryption

Always use encryption protocols, such as SSL or TLS, to protect data in transit, as well as encrypted databases, to store data. This ensures that data, especially sensitive PHI, remains encrypted according to HIPAA regulations.

3. Implement Role-Based Access

Ensure that access to sensitive data collected from forms is restricted based on roles within your organization. Only those who need the data to perform their jobs should have access, i.e., role-based access control (RBAC).

4. Keep Forms Simple

Avoid overwhelming patients and customers with too many fields or questions and focus on collecting the essential data necessary for the task at hand. This increases the likelihood the form will be filled out correctly and you’ll capture all necessary PHI.

5. Test Your Forms

Regularly test your forms for user experience, security vulnerabilities and functionality issues. Vulnerabilities in your forms could lead to data breaches or compliance violations, so regularly probing your forms for weaknesses, and acquiring up-to-date data intelligence to discover emerging threats, ensures they remain secure.

Why LuxSci’s Secure Forms Stand Out

LuxSci offers a fully HIPAA compliant Secure Forms solution, designed specifically with the security needs of healthcare organizations in mind. This includes:

End-to-End Security: Data is protected through advanced encryption protocols during transmission and storage, ensuring patient data remains confidential.
Customization: Forms can be easily created and customized to collect a wide range of patient and customer information, including PHI, appointment details, feedback, and consent for communications.
Seamless Integration: The LuxSci Secure Forms solution integrates with existing healthcare systems that store PHI to enable streamlined workflows and centralized data management.
Audit Trails: LuxSci provides comprehensive audit logging to track every action taken on the data, offering accountability and transparency in accordance with HIPPA guidelines.

Want to learn more about how LuxSci’s Secure Forms will help you achieve HIPAA-compliant patient data collection? Contact us today to talk with our expert team.

HIPAA Compliant Forms FAQs

1. What is the difference between a secure form and a regular form?

A secure form uses encryption and security protocols to ensure that data is protected during transmission and storage. Regular forms don’t necessarily offer these risk mitigation measures, making them far more vulnerable to data breaches, especially in healthcare.

2. Is LuxSci’s Secure Forms solution HIPAA-compliant?

Yes, LuxSci’s Secure Forms are fully HIPAA-compliant, ensuring the privacy and security of Protected Health Information (PHI).

3. How does encryption work in secure forms?

Encryption transforms data into unreadable code during transmission and at rest, so only authorized recipients with the decryption key can access the original data, ensuring that sensitive information remains confidential—even in the event of a breach.

4. Can secure forms be integrated with other healthcare systems?

Yes, LuxSci Secure Forms integrate seamlessly with other healthcare systems, platforms and applications, including customer data platforms (CDPs), electronic health records (EHR) systems, and revenue cycle management (RCM) platforms, making it easier to manage collected data—and, better still, keep it secured.

5. Why is end-to-end security important for healthcare forms?

End-to-end security ensures that patient data remains protected throughout the entire process—from submission to storage to subsequent access. This reduces the risk of data breaches and ensures HIPAA compliance.

Secure Texting Apps for Healthcare: Are They Safe?

October 17, 2024
LuxSci

As today’s healthcare patients demand more personalized and efficient care, secure communication tools have become a requirement for modern multi-touch engagement. With increasingly tech-savvy patients and customers, today’s providers, payers and suppliers are turning to secure texting apps for healthcare to open up new communications channels, enhance engagement, and improve overall health outcomes.

Sounds great, right? Well, secure text must not only be efficient, but also secure and compliant with strict regulations, including HIPAA (Health Insurance Portability and Accountability Act).

In this blog post, we’ll explore how secure texting can make healthcare more efficient, adding a new and commonly used channel to better connect with your patients and customers—and we’ll provide some useful tips for companies looking to bring secure text into their healthcare engagement strategies.

The Value of Secure Texting Apps for Healthcare

Healthcare providers, payers and suppliers often face the challenge of quickly sharing critical information with patients and customers, all while maintaining data privacy and securing protected health information (PHI). Traditional texting and SMS methods are inherently insecure, leaving sensitive health information vulnerable to breaches. Text messages have a number of widely known security vulnerabilities, including issues with confidentiality, only optional encryption, and inadequate authentication.

In healthcare, a data breach isn’t just a technical issue—it can lead to severe consequences, including legal penalties and the loss of patient trust, as well as harming your brand and future business. Secure texting ensures compliance with HIPAA regulations, protecting patient data and safeguarding healthcare organizations and companies from fines.

HIPAA Compliance Considerations for Secure Texting

One of the key concerns when implementing secure texting in healthcare is HIPAA compliance. HIPAA mandates strict guidelines for the handling, transmission, and storage of Protected Health Information (PHI). Any communication containing PHI must be encrypted, auditable, and only accessible by authorized users. Here are some HIPAA compliance factors to consider:

End-to-End Encryption: Ensure that your secure texting app offers end-to-end encryption. This means that the email service provider (ESP) encrypts and transmits data using the TLS security protocol, securely stores data at rest, and data is never kept on a recipient’s device, preventing interception and access by unauthorized parties.
Audit Controls: HIPAA requires organizations to maintain an audit trail of all communications. Your secure texting solution should provide a record of when messages are sent, delivered, and read, as well as details on who accessed the information.
Access Controls: Only authorized personnel should have access to sensitive patient data or PHI. Secure texting apps for healthcare should offer user authentication features such as PINs, biometrics, or two-factor authentication to ensure the identity of the user. The safest approach is to not include PHI in your text message at all, but rather direct users to a secure communications platform via text message.
Remote Wipe Functionality: In the event that a device is lost or stolen, healthcare providers must be able to remotely wipe PHI from the device to prevent unauthorized access, if needed.

Tips for Implementing Secure Texting in Healthcare

If you’re a healthcare organization considering secure texting apps, here are some practical tips to ensure a smooth implementation:

Choose the Right Platform: Not all secure texting apps are created equal. Look for platforms that are specifically designed for healthcare, as they are more likely to include features designed for HIPAA compliance. LuxSci Secure Text, for example, is built for healthcare environments, with encryption, audit trails, and other compliance tools integrated into the solution.
Train Your Staff: Technology is only as secure as the people using it. Ensure that all staff members who will use the secure texting app are trained on best practices for handling PHI and following compliance protocols. Regular training sessions and refresher courses are a must to keep everyone up to date with the latest rules and regulations.
Encourage Patient and Customer Adoption: Secure texting is a powerful tool for patient and customer engagement. Inform patients about the benefits of secure messaging and how it protects their privacy. Offer your patients and customers—especially those less likely to respond to other channels—the option to receive text messages as part of a multi-channel or omnichannel engagement approach.
Integrate with Existing Systems: A seamless workflow is crucial for the success of any new technology. Ensure that your secure texting solution can integrate with your existing Electronic Health Records (EHR) system, CDP platform, and other healthcare engagement channels and portals, so communication between providers, payers, suppliers and patients is not siloed.
Monitor and Review: After implementing secure texting, regularly review its usage and ensure compliance protocols are being followed. Monitor audit logs and address any potential security concerns promptly. Continuous improvement is key to maintaining both security and efficiency.

Improving Personalization and Engagement with Secure Texting

Beyond compliance and data protection, secure texting apps for healthcare can significantly enhance patient engagement and improve the overall healthcare experience. In fact, personalized, timely communication has been shown to improve health outcomes and boost patient satisfaction. Here’s how:

Appointment Reminders and Care Management: Send patients personalized appointment reminders, medication prompts, or follow-up instructions, reducing no-shows and improving adherence to treatment plans. For instance, sending a patient a personalized text reminder for their diabetes check-up or alerting them to the results of medical tests can improve and accelerate care management.
Product Offers, Renewals and Upgrades: Secure messaging enables healthcare providers and suppliers to reach out to patients and customers to remind them about a prescription renewal, to upgrade or offer a new product, or to drive plan renewals and new services.
Patient Education: Use secure texting to alert patients that new educational materials, such as care instructions, post-surgery protocols, or health tips tailored to the patient’s specific condition, are available. This not only empowers patients with more information but improves outcomes with better adherence to treatment plans and ongong care needs.

How LuxSci’s Secure Text Works

LuxSci Secure Text transmits its data with TLS protection, stores its information with 256-bit AES, and data is never kept on the recipient’s device. Recipients use password-based authentication to access the information and messages are securely stored in LuxSci’s databases and dedicated secure infrastructure.

LuxSci’s Secure Text does not require the sender to install or use any new applications. Leveraging LuxSci’s SecureLine encryption service, the sender:

Writes their message in either LuxSci’s WebMail email app or their preferred email program, including Google Workspace or Microsoft 365.
In the address field, the sender enters a special email address that is based the recipient’s phone number. For example, an address of 2114367789@secure.text would send the message to a US recipient whose number is 211-436-7789. Once the sender is finished, they hit the send button.
The recipient will receive a normal SMS that tells them a secure message is waiting for them. The message contains a link, which opens up their phone’s web browser:

If they have recently viewed another Secure Text message, the new message will immediately be displayed.
If the recipient has used Secure Text to view messages at an earlier date, they will need to enter their password before they can view the message.
If this is the recipient’s first Secure Text message, they will need to set up a password before they can view the message.

With LuxSci, you do not include PHI in your text messages, helping to ensure the privacy and protection of patient and customer data at all times, and eliminating the inherent security risks of text and SMS messages.

Learn More About Secure Texting Apps for Healthcare

Today’s secure texting solutions are expanding the ways healthcare organizations communicate with patients and customers. With the right solution, you can ensure compliance with regulations like HIPAA, while enhancing personalization, engagement, and health outcomes. Secure texting can improve the end-to-end healthcare journey and create a more efficient, patient-centered healthcare experience.

Are you ready to improve your patient engagement with secure text, while maintaining HIPAA compliance and securing PHI data?

Contact us today to learn more about secure texting apps, healthcare-specific use cases, and how you can implement new secure communication channels to achieve better outcomes and grow your business.

What is a HIPAA Email API?

June 25, 2025
Ian Snipper

A HIPAA email API is a programming interface that allows healthcare applications to send secure emails containing protected health information while maintaining compliance with HIPAA regulations. These APIs provide developers with tools to integrate encrypted email functionality into healthcare software systems while automatically handling security requirements, audit logging, and PHI protection measures. Healthcare software development increasingly requires email capabilities for patient notifications, care coordination, and administrative communications. Standard email APIs lack the security controls and compliance features necessary for healthcare applications that handle sensitive patient data.

Technical Architecture and Security Framework

REST and SOAP protocols provide the foundation for most HIPAA email APIs, enabling healthcare applications to integrate email functionality through standard web service interfaces. These protocols support secure authentication and encrypted data transmission while maintaining compatibility with diverse healthcare technology environments. Message queuing systems help manage email delivery during high-volume periods while maintaining security controls throughout the transmission process. Healthcare applications can submit emails to secure queues where they receive encryption and compliance validation before delivery to recipients. Error handling mechanisms ensure that failed email transmissions do not compromise PHI security or leave sensitive data exposed in log files. HIPAA email APIs must provide detailed error information to developers while protecting patient information from unauthorized disclosure.

Authentication and Authorization Protocols

API key management provides secure access control for healthcare applications using email services. These keys must include appropriate permissions and expiration policies that prevent unauthorized access while enabling legitimate healthcare communications, allowing healthcare applications to authenticate users and obtain appropriate permissions for sending emails on their behalf. These protocols help ensure that only authorized personnel can trigger email communications containing PHI.

LuxSci supports three industry-standard authentication methods—alongside its proprietary LuxSci Secure option. These include:

OAuth 2.0 – The modern standard. Secure, flexible, and ideal for enterprise-scale integrations.
API Key – Simple and efficient. Ideal for server-to-server use when convenience matters most.
Basic Authentication – Straightforward, widely supported. Good for internal systems and quick testing.

For those who want the tightest possible control over API sessions—including HMAC signatures and session revocation—LuxSci Secure authentication remains the best option for customers.

Message Formatting, Template Management, and Security

MIME and S/MIME encoding support enables healthcare applications to send rich-text emails with attachments while maintaining encryption and security controls. These capabilities allow inclusion of medical images, test results, and formatted reports within compliant email communications. Template engines help healthcare developers create standardized email formats that include dynamic patient data while preventing inappropriate PHI disclosure. These systems can validate content against organizational policies before message transmission. Attachment handling procedures ensure that medical documents and images receive appropriate encryption and access controls when included in email communications. HIPAA email APIs must provide secure upload and transmission capabilities for healthcare file attachments.

Delivery Tracking and Status Reporting

Real-time delivery status updates help healthcare applications track email transmission progress and identify potential delivery issues. These status reports must provide actionable information without exposing PHI to unauthorized systems or personnel. Read receipt capabilities enable healthcare applications to confirm that recipients have accessed important medical communications. These features help care coordination while maintaining appropriate privacy protections for patient email interactions. Bounce management systems handle failed email deliveries appropriately while protecting PHI from exposure through error messages or automated responses. Healthcare applications need visibility into delivery problems without compromising patient privacy.

Compliance Logging and Audit Features

Automated audit trails capture detailed information about all email activities initiated through HIPAA email APIs. These logs must include sender identification, recipient information, transmission timestamps, and delivery status while protecting actual message content from unauthorized access. Compliance reporting features help healthcare organizations track their email usage patterns and identify potential policy violations. These reports can highlight unusual sending volumes, unauthorized recipient addresses, or messages that might violate PHI handling policies. Data retention controls ensure that API logs and message metadata comply with healthcare record-keeping requirements while managing storage costs and system performance. Healthcare organizations can configure retention periods based on their regulatory and operational needs.

Integration Patterns for Healthcare Applications

Electronic health record system (EHR), customer data platform (CDP), and Revenue Capture Management (RCM) platform integrations can enable automatic email messages and notifications to be sent based on clinical events like lab result availability or appointment scheduling changes. These integrations must respect minimum necessary standards while providing timely patient communications. Workflow automation allows healthcare applications to trigger email sequences based on patient care milestones or administrative requirements, tailoring communications based on user actions taken with each email. For example, healthcare organizations might send automated email reminders about upcoming appointments or medication refills. Batch processing capabilities enable healthcare organizations to send large volumes of patient communications efficiently while maintaining security controls and HIPAA compliance. These features support activities like appointment reminders, wellness newsletters, or billing notifications that affect many patients simultaneously.

Performance Optimization and Scalability

Rate limiting controls help healthcare organizations manage email volumes while preventing abuse or accidental bulk sending that might violate patient communication policies and damage your IP reputation. These controls can be customized based on organizational needs and user roles. Caching mechanisms improve API performance by storing frequently used templates and configuration data while maintaining appropriate security controls. These optimizations help reduce response times for healthcare applications without compromising PHI protection. Load balancing systems ensure reliable email delivery during peak usage periods when healthcare organizations send high volumes of patient communications. These systems must maintain security controls while distributing processing loads across multiple servers.

Testing and Development Support

Sandbox environments enable healthcare developers to test email functionality without exposing real patient data or sending communications to actual patients. These testing systems provide realistic API responses while using protected data that supports thorough integration testing. Documentation and code samples help healthcare development teams implement HIPAA email API functionality correctly while understanding security requirements and compliance obligations. These resources should include examples for common healthcare use cases and integration scenarios.

Finally, support services provide healthcare developers with technical assistance and compliance guidance during implementation and ongoing operations. API providers should offer expertise in both technical integration and healthcare regulatory requirements to ensure successful deployments.

What Is HIPAA Compliant Marketing Automation?

April 30, 2025
Erik Kangas

HIPAA compliant marketing automation uses software platforms to deliver personalized healthcare communications while protecting protected health information through automated consent management, secure data processing, and privacy controls. These systems enable healthcare organizations to scale patient engagement activities, trigger communications based on clinical events, and measure campaign effectiveness while maintaining compliance with federal privacy and security regulations. Healthcare organizations increasingly need scalable communication strategies that can deliver personalized messages to large patient populations without overwhelming staff resources. Marketing automation provides these capabilities while requiring specialized compliance features that standard commercial platforms cannot offer.

Automated Consent and Authorization Management

Permission tracking systems automatically verify patient authorization status before sending marketing communications, preventing violations by checking consent databases in real-time. These systems must update immediately when patients revoke authorization to ensure that subsequent communications do not violate consent preferences. Dynamic consent processing allows patients to specify preferences for different types of marketing communications while maintaining HIPAA compliant marketing automation of these choices. Patients might authorize wellness newsletters while declining promotional messages about elective procedures, requiring sophisticated preference management. Renewal automation helps healthcare organizations maintain current patient authorizations by sending renewal requests at appropriate intervals and processing responses automatically. These systems reduce administrative burden while ensuring that marketing communications continue to have valid patient consent.

Trigger-Based Communication Workflows

HIPAA compliant marketing automation for clinicial events enables healthcare organizations to send relevant communications based on patient care activities such as appointment scheduling, test result availability, or treatment milestones. These workflows must respect authorization requirements while providing timely patient engagement. Care coordination triggers automatically generate communications that support patient treatment plans including medication reminders, follow-up appointment notifications, and educational materials relevant to specific conditions. These communications often qualify as healthcare operations rather than marketing activities. Administrative workflows trigger communications about billing, insurance changes, or policy updates that affect patient relationships. Healthcare organizations aim to evaluate whether these communications require marketing authorization or fall under permitted healthcare operations activities.

Data Integration and Security Controls

Electronic health record connectivity enables HIPAA compliant marketing automation platforms to access clinical data for personalization while maintaining strict access controls and audit capabilities. These integrations must comply with minimum necessary standards and maintain comprehensive activity logs. Patient portal integration allows marketing automation systems to coordinate with other patient engagement tools while maintaining consistent security standards and user experience. These integrations help create seamless patient communication strategies across multiple touchpoints. Database segmentation protects patient privacy by limiting marketing automation access to only the data needed for specific campaigns while preventing broader PHI exposure. Role-based controls ensure that automated systems cannot access information beyond their authorized scope.

Personalization While Protecting Privacy

Dynamic content insertion allows HIPAA compliant marketing systems to customize communications using patient-specific information without exposing PHI to marketing personnel. These systems can personalize messages during delivery while keeping sensitive data separate from campaign development processes. Algorithmic targeting uses automated analysis to identify appropriate patient segments for specific communications while maintaining de-identification standards. These algorithms can execute sophisticated targeting strategies without revealing individual patient characteristics to human operators. Template-based personalization allows healthcare organizations to create standardized communication formats that incorporate patient-specific information automatically. Templates of this nature ensure compliance while enabling efficient campaign development and consistent messaging.

Compliance Automation and Risk Reduction

Automated audit trails capture detailed records of all marketing automation activities including campaign triggers, message delivery, patient interactions, and consent verification. These trails provide evidence of compliance efforts while supporting potential investigations or regulatory reviews. Policy enforcement automation prevents marketing communications that violate organizational policies or patient consent preferences through real-time validation of campaign parameters. These systems can block inappropriate communications before they are sent to patients. Breach detection automation monitors marketing systems for unauthorized access, unusual activity patterns, or potential security incidents involving PHI. Automated alerts allow healthcare organizations to respond quickly to potential compliance violations or security threats.

Performance Analytics and Reporting

Aggregate engagement metrics provide insights into marketing automation effectiveness without exposing individual patient response patterns. Healthcare organizations can track overall campaign performance while maintaining patient privacy through statistical reporting methods. Compliance dashboards help healthcare organizations monitor their marketing automation activities for potential violations including authorization rates, consent management effectiveness, and security incident frequency. These dashboards provide early warning indicators for compliance issues. Return on investment calculations enable healthcare organizations to evaluate marketing automation program value while maintaining appropriate data privacy protections. Financial analysis can demonstrate program benefits without requiring access to individual patient information.

Vendor Selection and Platform Management

Business associate evaluation processes help healthcare organizations select marketing vendors that can meet HIPAA compliant marketing automation requirements, and provide appropriate security capabilities. These evaluations should include security assessments, compliance audits, and contract negotiations. Platform configuration management ensures that marketing automation systems are properly configured to maintain HIPAA compliance throughout their operational lifecycle. Configuration controls should prevent unauthorized changes that could compromise security or compliance. Update and maintenance procedures ensure that marketing automation platforms receive appropriate security updates while maintaining compliance capabilities. Healthcare organizations must coordinate with vendors to ensure that system changes do not compromise PHI protection.

Integration with Healthcare Operations

Care team coordination enables marketing automation systems to support clinical workflows while maintaining appropriate boundaries between marketing activities and patient care. These integrations help ensure that automated communications enhance rather than interfere with healthcare delivery. Quality improvement integration allows marketing automation data to support healthcare quality initiatives while maintaining patient privacy protections. Aggregate communication effectiveness data can inform care improvement strategies without exposing individual patient information. Revenue cycle coordination helps healthcare organizations align marketing automation activities with billing, collections, and financial management processes. These integrations can improve patient financial experience while maintaining compliance with both marketing and billing regulations.