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 While TLS can be relied on for securing information at a high level—such as US Government TOP SECRET data—improper or outdated implementations of the standard may not provide much security.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 is High Email Deliverability Essential for Healthcare Companies?

June 30, 2025
Pete Wermter

With email communication playing a critical role in the customer engagement strategies of virtually every organization, high email deliverability rates are vital to success across all industries. In the healthcare sector, however, the stakes can be far higher. An undelivered email isn’t merely an inconvenience or a lost sales opportunity; it could mean a missed appointment, a delay in a prescription refill, or a failure to get a patient critical healthcare information. Or worse, the email could end up in the hands of an unintended recipient, including bad actors and cybercriminals.

With this in mind, this post details why high email deliverability is essential for healthcare companies, as well as how your organization benefits from reliable and rapid email delivery.

Speed and Efficiency

The primary reason that high email deliverability is crucially important to healthcare organizations is to best guarantee essential communications that directly impact an individual’s healthcare journey reach them promptly. These transactional emails can include appointment reminders, prescription renewals, product order confirmations, test results, explanation of benefits notices, payment reminders, and invoices. Administrative notifications related to software or systems that a patient might use, such as a password reset for an online portal, also fall under the category of transactional emails.

When transactional emails are delayed or fail to reach people altogether, they can compromise a patient’s ability to access care, adhere to treatment plans, stay informed on key facets of their healthcare journey, and, ultimately, achieve optimal health outcomes.

When a patient fails to receive an expected email, such as a prescription confirmation, for example, it can leave them feeling confused and unsure of what to do next. For individuals who are sick, elderly, or managing chronic conditions, this can cause unnecessary stress, anxiety, and even compromise adherence to care plans.

In contrast, high email delivery rates create the opposite effect, helping patients get the communications and information they need. This increases their trust in your company and gives them a firmer sense of control over their healthcare journey.

Compliance with HIPAA Regulations

While the above point stresses the importance of reliable email delivery for the patient’s and customer’s benefit, healthcare companies also have a vested interest in ensuring communications reach the intended recipient for regulatory and patient privacy reasons.

To comply with the Health Insurance Portability and Accountability Act (HIPAA), emails that contain sensitive patient data, i.e., electronic protected health information (ePHI), must be securely delivered to the intended recipient. If, on the other hand, a communication containing ePHI fails to reach the intended recipient patient, that represents a failure in secure communications and a potential HIPAA violation for your organization.

After all, where did the patient’s data go? Was it delivered to the wrong person? Was it blocked by a spam filter and is left sitting unencrypted on a server somewhere?

If you can’t answer these questions, you could be exposed to a data breach, and it could result in a HIPAA violation, meaning your organization incurrs the associated consequences, including financial penalties and reputational damage. Conversely, deploying a fully HIPAA compliant email solution, such as LuxSci, supported by a dedicated infrastructure and designed for high email delivery enables your organization to include patient data in communications with confidence and ensure you messages land in the recipient’s inbox.

Greater Levels of Personalization and Engagement

Finally, high email deliverability rates are essential for healthcare organizations because they help drive greater levels of engagement with patients and customers. Higher email deliverability means better inbox placement, leading to more emails being opened, more links being clicked, and more conversions for your communications and campaigns.

In the case of healthcare retailers, for example, this equates to converting more prospects into customers and, consequently, maximizing the ROI of email marketing campaigns, in some cases with up to 80% better results.

While healthcare marketers, understandably, focus most of their efforts on crafting attention-grabbing headlines, personalizing the message content, and the email’s design elements, these factors are rendered irrelevant if the message fails to reach the recipient in the first place! When you take this into account, high email deliverability is a crucial component in optimizing the ROI of email communications and campaigns, and an all too often overlooked component at that.

Get Your Copy LuxSci’s Achieving High Email Deliverability Best Practices Paper

To learn more about the importance and value of high email deliverability for healthcare companies, download your copy of LuxSci’s latest Best Practices Paper: How to Achieve High Email Deliverability in Healthcare. You’ll discover:

How to opitmize performance for the different types of healthcare emails.
Powerful strategies for increasing your company’s email deliverability rates.
How small increases in email deliverability can have considerable effects on your marketing ROI

Grab your copy of the report here, and learn how to enhance your email deliverability rates today.

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.

On-Demand Webinar: HIPAA Compliant Email Marketing – 20 Tips in 20 Minutes

June 24, 2025
Pete Wermter

Healthcare marketers and compliance professionals—this one’s for you.

LuxSci’s latest on-demand webinar, HIPAA Compliant Email Marketing: 20 Tips in 20 Minutes, delivers practical, fast-paced guidance to help you run secure, compliant, and results-driven healthcare email marketing campaigns.

Watch the Webinar

What You’ll Learn

The session is packed with actionable insights to help you safely navigate the world of HIPAA compliant email marketing, including:

How to leverage PHI safely and effectively for email personalization
Best practices for email messaging and content
Tips for segmenting and targeting audiences to boost engagement
How to stay HIPAA compliant
Automation and list-building strategies for smarter workflows
How to avoid common compliance pitfalls and reduce regulatory risk
Technical tips for email encryption, access protocols, and email retention and storage

Whether you’re leading digital strategy, building campaigns, or ensuring HIPAA compliance for your healthcare marketing efforts, this webinar provides timely and useful information on secure healthcare communications and what you need to know to keep you business safe and your patient data secure.

At LuxSci, we empower healthcare providers, payers, and suppliers to personalize their healthcare engagement efforts and better connect with patients and customers—securely, compliantly, and effectively.

Watch the Webinar

What Is a HIPAA Compliant Email API?

June 23, 2025
Ian Snipper

HIPAA compliant email API enables healthcare applications to send automated emails containing protected health information through secure programming interfaces that meet HIPAA Security Rule requirements. These APIs provide encryption, access controls, and audit logging capabilities while allowing developers to integrate email functionality into healthcare software without compromising patient privacy or regulatory compliance. Healthcare software applications increasingly need automated email capabilities for appointment reminders, test results, billing notifications, and care coordination communications. Standard email APIs lack the security features and compliance controls necessary for transmitting PHI, requiring specialized solutions designed for healthcare use cases.

API Authentication and Access Controls

HIPAA compliant email APIs implement robust authentication mechanisms that verify the identity of applications and users before allowing access to email services. These systems typically use API keys, OAuth tokens, or digital certificates to establish secure communication channels between healthcare applications and email services. Role-based access controls allow healthcare organizations to limit API functionality based on user privileges and business needs. Appointment scheduling systems might have permission to send calendar reminders while being restricted from accessing patient medical records or billing information. Rate limiting and usage tracking help prevent unauthorized bulk email sending and detect potential security threats. API providers monitor usage patterns and can automatically restrict access when they detect unusual activity that might indicate compromised credentials or malicious use.

Message Encryption and Security Features

Email messages sent through HIPAA compliant APIs receive automatic encryption during transmission and storage. These systems typically support multiple encryption standards including TLS for transport security and end-to-end encryption for message content protection. Message validation features help ensure that emails containing PHI meet compliance requirements before transmission. APIs can check for proper authorization, validate recipient addresses, and verify that message content follows organizational policies for PHI disclosure.

Secure message delivery tracking provides confirmation when recipients receive and access encrypted emails. This audit trail helps healthcare organizations demonstrate compliance with HIPAA requirements and provides documentation for potential breach investigations or regulatory audits.

Integration with Healthcare Workflows

HIPAA compliant email APIs connect seamlessly with electronic health record systems, practice management platforms, and other healthcare applications. These integrations enable automated patient communications that trigger based on clinical events, scheduling changes, or administrative milestones. Template management systems allow healthcare organizations to create standardized email formats that ensure consistent messaging while maintaining compliance controls. Templates can include dynamic content from patient records while preventing unauthorized PHI disclosure through automated formatting rules. Event-driven messaging capabilities enable real-time communications based on healthcare system activities. Laboratory systems can automatically send encrypted test results to ordering physicians immediately after completion, improving care coordination and reducing manual data entry requirements.

Audit Logging and Compliance Tracking

HIPAA compliant email APIs maintain detailed logs of all messaging activities including sender identification, recipient information, message content summaries, and delivery status. These logs provide the documentation necessary for compliance audits and breach investigations. Automated compliance reporting features help healthcare organizations track email usage patterns and identify potential policy violations. Reports can highlight unusual sending volumes, unauthorized recipient addresses, or messages that might contain inappropriate PHI disclosures.

Data retention policies ensure that API logs and message archives meet HIPAA requirements while managing storage costs and system performance. Healthcare organizations can configure retention periods based on their compliance needs and operational requirements.

Developer Tools and Documentation

API documentation provides healthcare software developers with detailed technical specifications, code samples, and integration guides for implementing HIPAA compliant email functionality. These resources help development teams understand security requirements and implement proper PHI handling procedures. Software development kits (SDKs) simplify API integration by providing pre-built libraries for common programming languages and frameworks. These tools handle encryption, authentication, and compliance features automatically, reducing the risk of implementation errors that could compromise PHI security. Testing environments allow developers to validate their integrations without exposing real patient data. Sandbox systems provide realistic API responses while using synthetic data that enables thorough testing of email functionality and error handling procedures.

Scalability and Performance Considerations

HIPAA compliant email APIs must handle varying message volumes without compromising security or compliance controls. Healthcare organizations experience different email patterns based on patient schedules, clinical activities, and administrative cycles that require flexible capacity management. Load balancing and redundancy features ensure reliable email delivery even during peak usage periods or system maintenance activities. API providers typically maintain multiple data centers and failover systems that prevent service disruptions from affecting patient communications.

Performance analytics help healthcare organizations optimize their email communications and identify potential bottlenecks in their workflows. Metrics include delivery speeds, error rates, and system response times that enable proactive performance management and capacity planning.

LuxSci Expands Executive Team to Scale Enterprise Growth and Operations

September 17, 2024
LuxSci

LuxSci, a leading provider of secure, HIPAA-compliant communications software, today announced new executive appointments as part of its strategy to drive future growth and further expansion into the enterprise market. Experienced B2B software executives Robert Sullebarger and Geneviève du Lac have joined the company as Head of Sales and Head of Finance, respectively – reporting to recently appointed CEO Mark Leonard. In addition, David Hillman has joined the company as Director of Engineering, reporting to Erik Kangas, Chief Technology Officer.

“LuxSci has proven its capabilities with some of the largest, most forward-looking companies in healthcare, including patient engagement platform, EHR systems, and payment providers, as well as healthcare retail and in-home care providers,” said Leonard. “Bob, Geneviève and David all bring deep leadership experience combined with a willingness to be hands-on in helping us optimize our operations and execute quickly for our customers and partners.”

Proven Sales Leader and Trusted Advisor

Bob’s career has focused on enterprise software sales and customer acquisition across both established and emerging technologies, including security & compliance, conversational AI and virtual assistant platforms, machine learning, and telecom & networking. Bob brings LuxSci more than two decades of experience in sales, marketing, and product management roles, serving as both a trusted business advisor and a technology expert for customers and partners. Most recently, he led the sales teams for AI solution providers ModuleQ and Interactions LLC, where he helped the company grow from $10 million to more than $100 million in annual revenue. He has also held leadership positions at contact center analytics provider CallMiner, and data security provider Vericept Corporation.

“LuxSci is the gold standard for HIPAA-compliant email and secure healthcare communications with a leadership position in the market,” said Sullebarger. “With healthcare portal adoption maxing out, we have a real opportunity to improve patient engagement and outcomes by opening up the email, SMS and marketing channels to bring more people into today’s healthcare conversation.”

Experienced CFO and Finance Leader

Geneviève joins LuxSci with more than 15 years of experience in CFO and Finance leadership roles. This includes building world-class Finance teams and organizations in the cybersecurity, consumer, and services industries at companies including Cypress Security, Astro Gaming and Wine Country Connect. Throughout her career Geneviève has established a proven track record of success in Finance leadership for ‘scale-up’ businesses, with focus on SaaS companies. Geneviève also brings LuxSci deep experience in implementing systems & processes aimed at building operational scalability, which will be a key part of her responsibilities at the company.

“I’m excited to be joining LuxSci as we build it into a world-class organization,” said Du Lac. “The company has achieved tremendous success to date, and we’re positioned better than ever to keep growing – and to help transform the healthcare industry with secure communications.”

Full Stack Software Architect and Data Scientist

David joins LuxSci with more than 20 years of experience across the entire spectrum of application development, data analysis and automated systems. This includes architect, engineer, developer, and consultant roles at innovative companies, such as Kapital Trading, Gogo, Monster, Livetext, and AT&T Bell Labs. David specializes in designing and building data-intensive applications that analyze large datasets and extract intelligence, as well as developing tools to empower users to interact with those resources. At LuxSci, David will play a key role in the future development of LuxSci technology, helping guide the company’s product direction and roadmap moving forward.

“I’m looking forward to collaborating with the outstanding team already in place at LuxSci and continuing to enhance our products to make our customers’ healthcare communications and operations both smoother and safer,” said Hillman.

In other recent news, LuxSci continues to innovate in secure healthcare communications, recently rolling out new email reporting capabilities and achieving best-in-class performance for email security.

LuxSci has been at the forefront of HIPAA-compliant communications since its inception, offering a full suite of products for secure email, marketing, text and forms. Today, LuxSci is used by nearly 2,000 customers for HIPAA-compliant communications across the healthcare industry, including athenaHealth, 1800 Contacts, Delta Dental, Lucerna Health, Hinge Health, and Rotech Healthcare.

If you’d like to learn more about how LuxSci can help you with secure healthcare communications, reach out to us today for a meeting or demo!

What are the 5 Stages of Patient Engagement Framework?

November 29, 2024
Erik Kangas

The patient engagement framework consists of five progressive stages: inform, consult, involve, collaborate, and empower. This approach helps healthcare organizations build stronger relationships with patients while improving health outcomes. The framework guides providers in developing communication strategies, technological tools, and care processes that move patients from passive recipients of care to active partners in their health management.

Patient Engagement Framework Foundations

The patient engagement framework builds upon healthcare’s evolution toward more patient-centered care models. This structured approach acknowledges that patients have varying levels of activation and readiness to participate in their healthcare decisions. The framework helps organizations assess their current engagement practices and develop strategies for improvement. Healthcare providers use these stages to map communication approaches and technology implementations that support increasing patient participation. Each stage of the patient engagement framework requires different tools, processes, and organizational capabilities. Understanding these elements helps healthcare organizations develop realistic roadmaps for advancing their engagement efforts.

Stage One: Inform

The first stage of the patient engagement framework focuses on providing patients with clear, accessible health information. At this level, communication flows primarily from provider to patient through educational materials, discharge instructions, and basic health literacy resources. Organizations develop content in multiple formats and languages to accommodate diverse patient populations. Digital patient portals typically begin at this stage with features like lab result viewing and appointment scheduling. Healthcare teams establish consistent messaging across departments to avoid confusing or contradicting information. While this stage is the beginning of the patient engagement framework, many organizations struggle to advance past informing patients about their conditions and treatments.

Stage Two: Consult

The consultation stage of the patient engagement framework opens two-way communication channels between providers and patients. Healthcare teams seek patient input about symptoms, preferences, and treatment experiences through surveys, feedback forms, and structured conversations. Providers begin recognizing patients as valuable sources of information about their own health situations. Digital tools expand to include secure messaging and symptom reporting capabilities. Care teams develop protocols for responding to patient communications within appropriate timeframes. The consultation phase of the patient engagement framework begins establishing the base for more collaborative relationships while still maintaining traditional healthcare hierarchies. Organizations generally measure success at this stage through patient satisfaction metrics and communication response rates.

Stage Three: Involve

The third stage of the patient engagement framework actively involves patients in treatment planning and health monitoring. Patients participate in goal-setting discussions and receive tools for tracking health metrics between appointments. Healthcare teams incorporate patient preferences and priorities when developing care plans. Technology platforms introduce self-management tools and educational resources tailored to individual health conditions. Care protocols expand to include regular check-ins and progress evaluations beyond scheduled appointments. The involvement stage of the patient engagement framework marks a significant shift toward recognizing patients as active participants rather than passive recipients.

Stage Four: Collaborate

Collaboration represents the fourth stage in the patient engagement framework, where patients function as true partners in their care team. Health professionals and patients make treatment decisions jointly, weighing clinical evidence alongside patient goals and preferences. Healthcare systems establish patient advisory councils to inform organizational policies and program development. Technology platforms integrate patient-generated health data with clinical systems to create comprehensive health pictures. Team-based care models include patients in case conferences and care planning sessions. The collaborative stage of the patient engagement framework requires organizational culture changes that value patient perspectives alongside clinical expertise. Healthcare systems reaching this stage often demonstrate better care coordination and reduced unnecessary utilization.

Stage Five: Empower

The final stage of the patient engagement framework focuses on empowering patients to manage their health independently when appropriate. Patients receive comprehensive tools and knowledge to make informed healthcare decisions aligned with their personal values. Organizations support patient autonomy while maintaining appropriate clinical oversight for complex conditions. Technology platforms provide personalized insights and recommendations based on individual health patterns. Care teams function as coaches and consultants rather than directing all aspects of patient care. The empowerment phase of the patient engagement framework acknowledges patients as the primary drivers of their health management with healthcare providers serving supportive roles.

Implementing the Patient Engagement Framework

Healthcare organizations implement the patient engagement framework through gradual, strategic changes to clinical processes, technology systems, and organizational culture. Leadership commitment proves essential for allocating necessary resources and championing patient-centered approaches. Staff training addresses both technical skills and communication methods appropriate for each engagement stage. Technology selection focuses on tools that can evolve alongside advancing engagement capabilities. Progress measurement includes both process indicators and outcome metrics tied to each framework stage. Organizations typically find that different service lines and patient populations may operate at different engagement levels simultaneously, requiring flexible implementation approaches. The patient engagement framework provides a roadmap while allowing organizations to adapt implementation to their unique circumstances and patient populations.

Is Google Drive HIPAA Compliant?

September 19, 2024
Erik Kangas

Google Drive can be HIPAA compliant when used with Google Workspace (formerly G Suite) under a Business Associate Agreement (BAA) and with proper configuration. Standard consumer Google Drive accounts do not meet HIPAA requirements. Healthcare organizations must implement specific security settings, access controls, and usage policies to maintain Google Drive HIPAA compliant status. These measures help ensure protected health information remains secure while benefiting from cloud storage capabilities.

Google’s Business Associate Agreement

Healthcare organizations must obtain a Business Associate Agreement from Google before storing any protected health information in Google Drive. This agreement establishes Google as a business associate under HIPAA regulations and outlines their responsibilities for protecting health data. Google offers this BAA as part of Google Workspace (formerly G Suite) business plans, but not for personal Google accounts. The agreement specifically covers Google Drive among other Google services. Organizations should review the BAA carefully to understand which Google services are covered and what responsibilities remain with the healthcare organization. This legal foundation is essential for any Google Drive HIPAA compliant implementation.

Required Security Configurations

Making Google Drive HIPAA compliant requires enabling several security features available in Google Workspace. Two-factor authentication adds an additional verification layer beyond passwords. Advanced protection program features defend against phishing and account takeover attempts. Drive access controls restrict file sharing to authorized users within the organization. Data loss prevention rules can identify documents containing patient information and apply appropriate protection policies. Audit logging must be enabled to track file access and modifications. Organizations need to configure these settings through the Google Workspace admin console rather than relying on default configurations.

File Sharing and Access Controls

Proper management of file sharing is a large aspect of Google Drive HIPAA compliant usage. Healthcare organizations should establish policies restricting how files containing protected health information can be shared. External sharing controls can prevent staff from accidentally exposing patient data outside the organization. Domain-restricted sharing limits file access to users within the organization’s Google Workspace account. Link-based sharing should be disabled for sensitive documents or carefully restricted with additional authentication requirements. Role-based access permissions ensure users can only view files necessary for their job functions. These access controls prevent both accidental exposure and unauthorized access to patient information.

Encryption and Data Protection

Google Drive HIPAA compliant implementation relies on proper encryption to protect healthcare information. Google provides encryption for data in transit between users’ devices and Google servers using TLS. Data at rest in Google Drive receives encryption with AES-256 bit keys. Organizations should use Google Workspace Client-side encryption for particularly sensitive files to maintain control of encryption keys. Staff should avoid downloading protected health information to local devices unless absolutely necessary and with appropriate security measures. Encryption serves as a fundamental protection layer that helps maintain confidentiality even if other security measures fail.

Audit and Monitoring Capabilities

HIPAA regulations require tracking who accesses protected health information. Google Workspace offers audit logging features that support HIPAA compliance. These logs record user activities including file access, sharing changes, and document modifications. Organizations should configure appropriate retention periods for these logs to support compliance verification. Security monitoring tools can analyze these logs to identify unusual access patterns or potential policy violations. Regular review of these logs helps identify potential security issues before they lead to breaches. These monitoring capabilities also provide documentation during compliance audits.

Staff Training Requirements

Technical controls alone cannot ensure compliance without proper staff education. Organizations using Google Drive HIPAA compliant configurations must train staff on appropriate usage policies. Training should cover what types of information can be stored in Google Drive, appropriate sharing practices, and security feature usage. Staff need to understand the risks of downloading sensitive information to personal devices. Regular refresher training helps maintain awareness as features and threats evolve. Documentation of this training provides evidence of compliance efforts during regulatory reviews. Even with robust technical controls, human behavior remains a critical factor in maintaining HIPAA compliance.

LuxSci vs. Paubox: How to Choose the Right HIPAA-Compliant Email Provider

January 29, 2025
LuxSci

Choosing the right HIPAA-compliant email vendor is crucial for protecting patient data and ensuring compliance with healthcare regulations, including verifying HIPAA compliance and security features, evaluating ease of use and integration capabilities, assessing deliverability and performance, and understanding pricing and scalability. You should also evaluate a vendor’s customer support and company reputation.

The Health Insurance Portability and Accountability Act (HIPAA) details strict guidelines for securing sensitive patient data, including Protected Health Information (PHI). As a result, healthcare providers, payers, and suppliers must use a HIPAA-compliant email provider to abide by regulations designed to safeguard PHI.

With this in mind, this post evaluates two of today’s most popular HIPAA-compliant email providers on the market: LuxSci and Paubox. We’ll compare the two HIPAA-compliant offerings on several criteria, helping you to decide which email provider best fits the needs of your organization.

LuxSci vs. Paubox: Evaluation Criteria

We will evaluate LuxSci vs. Paubox on the following criteria:

Data security and Compliance: how well each email provider safeguards PHI as per HIPAA’s requirements
Performance and Scalability: the platform’s ability to conduct bulk email marketing campaigns, and scale them as a company’s engagement efforts grow.
Infrastructure: if it provides the necessary technical infrastructure, processes and controls to both protect sensitive patient data and support high-volume email marketing campaigns.
Marketing Capabilities: if the platform provides tools for optimizing and refining your communication strategies.
Ease of Use: how steep the learning curve is for each platform.
Other HIPAA-Compliant Products: if the email provider offers complementary features that will aid your patient engagement efforts.

Now that we’ve explained the parameters by which we’ll be comparing the HIPAA compliant email providers, let’s see how LuxSci and Paubox stack up against each other.

LuxSci vs. Paubox: How They Compare

Data Security and Compliance

Both LuxSci and Paubox perform admirably here, with both being fully HIPAA-compliant email providers, offering automated encryption that allows you to include PHI in email communications straight away. Both providers secure email data both in transit and at rest. Additionally, both are HITRUST certified, which further demonstrates a strong commitment to data privacy and security.

When compared to Paubox, LuxSci has the edge here because it has more comprehensive encryption options. This includes highly flexible encryption: automatically setting the ideal level of security and encryption needs based on the email content, recipient and business process.

Performance and Scalability

While both email providers deliver proven solutions and enable healthcare companies to scale their email marketing campaigns accordingly, LuxSci is the better option for high-volume email marketing campaigns, including bulk sending of hundreds of thousands to millions of emails per month. This is due to the fact that LuxSci specializes in assisting large healthcare organizations with executing high volume email marketing campaigns, including companies like Athenahealth, 1800 Contacts, Eurofins, and Rotech medical equipment. Consequently, LuxSci offers enterprise-grade scalability and has developed robust solutions capable of the high throughput required for enterprise-level patient and customer engagement efforts.

Infrastructure

Additionally, when it comes to other aspects related to infrastructure, LuxSci demonstrates an advantage. Firstly, they offer secure email hosting, while Paubox does not. Additionally, though Paubox can provide some dedicated infrastructure, e.g., single-tenancy, options, as well as high availability and disaster recovery, their capabilities are not as comprehensive as LuxSci’s.

Marketing capabilities

Both email delivery platforms possess useful marketing tools, enabling more effective HIPAA-compliant email marketing. This includes automation for streamlining email marketing campaigns and, customization options, so your messages are both more compelling and align with your company’s branding.

LuxSci, however, offers more comprehensive reporting capabilities than Paubox, including real-time monitoring, detailed performance metrics (e.g., deliverability, open and click-through rates, bounced emails, spam complaints, and recipient domain reporting), as well as granular segmentation options.

Ease of use

Paubox has the edge here, being the easier of the two HIPAA-compliant email providers to deploy and for staff to get to ramp up on. Suited for more complex and sophisticated environments, LuxSci offsets this with exemplary customer support honed from decades of facilitating organizations’ HIPAA-compliant email marketing campaigns – especially for this on a large scale.

Other HIPAA-compliant Products

Lastly, when it comes to complementary features, both LuxSci and Paubox offer secure texting functionality, allowing healthcare companies to cater to their patients and customers who prefer to communicate via SMS. And while both email providers feature secure forms for HIPAA-compliant data collection, LuxSci’s forms are more advanced, capable of handling more complex workflows, including multi-step data collection, and providing better customization options.

Additionally, LuxSci offers secure file sharing, encrypting files at rest and in transit, allowing for even more granular access controls, and ensuring only those within your company who must handle PHI have the appropriate access permissions. This is yet another safeguard against the exposure of PHI, whether accidentally, through identity theft (e.g., session-hijacking by a cybercriminal), or even corporate espionage.

Get Your Copy of LuxSci’s Vendor Comparison Guide

While this post focuses on comparing LuxSci and Paubox, we have created a complete Vendor Comparison Guide, which compares 12 email providers and is packed full of essential information on HIPAA-compliant communication and how to choose the best healthcare email solution for your organization.

You can grab your copy here, and don’t hesitate to contact us to explore your options for HIPAA-compliant email further.