LuxSci

Is the Email Encrypted? How to Tell if an Email is Transmitted Using TLS

encrypted email transmission

SMTP TLS encryption is popular because it provides adequate data protection without creating a complicated user experience for email recipients. Sometimes, though, the experience is too seamless, and recipients may wonder if the message was protected at all.

Luckily, there is a way to tell if an email was encrypted using TLS. To see if a message was sent securely, we can look at the raw headers of the email. However, it requires some knowledge and experience to understand the text. It is actually easier to tell if a recipient’s server supports TLS than to tell if a particular message was securely transmitted.

To analyze a message for transmission security, we will look at an example email message sent from Hotmail to LuxSci. We will explain what to look for when decoding the message headers and how to tell if the email was transmitted using TLS encryption.

An Example Email Message

First, we must understand how an email message typically travels through several machines on its way from the sender to the recipient. Roughly speaking:

  1. The sender’s computer talks to the sender’s email or WebMail server to upload the message.
  2. The sender’s email or WebMail server then talks to the recipient’s inbound email server and transmits the message to them.
  3. Finally, the recipient downloads the message from their email server.

It is step 2 that people are most concerned about when trying to understand if their email message is transmitted securely. They usually assume or check that everything is secure and OK at the two ends. Indeed, most users who need to can take steps to ensure that they are using SSL-enabled WebMail or POP/IMAP/SMTP/Exchange services so that steps 1 and 3 are secure. The intermediate step, where the email is transmitted between two different providers, is where messages may be sent insecurely.

To determine if the message was transmitted securely between the sender’s and recipient’s servers (over TLS), we need to extract the “Received” header lines from the received email message. If you look at the source of the email message, the lines at the top start with “Received.” Let’s look at an example message from a Hotmail user below. The email addresses, IPs, and other information are obviously fake.

LuxSci:

The Outlook email was sent to a LuxSci user. The Received headers appear in reverse chronological order, starting with the server that touched the message last. Therefore, in this example, we see the LuxSci servers first.

Received: from abc.luxsci.com ([1.1.1.1])
	by def.luxsci.com (8.14.4/8.13.8) with ESMTP id r7JEfLgH003867
	(version=TLSv1/SSLv3 cipher=DHE-RSA-AES256-SHA bits=256 verify=NOT)
	for <user-xyz@def.luxsci.com>; Mon, 19 Aug 2019 10:41:21 -0400
Received: from abc.luxsci.com (localhost.localdomain [127.0.0.1])
	by abc.luxsci.com (8.14.4/8.13.8) with ESMTP id r7JEfK0Z030182
	for <user-xyz@def.luxsci.com>; Mon, 19 Aug 2019 09:41:20 -0500
Received: (from mail@localhost)
	by abc.luxsci.com (8.14.4/8.13.8/Submit) id r7JEfKXD030178
	for user-xyz@def.luxsci.com; Mon, 19 Aug 2019 09:41:20 -0500
Received: from dispatch1-us1.ppe-hosted.com (dispatch1-us1.ppe-hosted.com [2.2.2.2])
	by abc.luxsci.com (8.14.4/8.13.8) with ESMTP id r7JEfIkK030002
	(version=TLSv1/SSLv3 cipher=DHE-RSA-AES256-SHA bits=256 verify=NOT)
	for <someone@luxsci.net>; Mon, 19 Aug 2019 09:41:19 -0500

Proofpoint:

LuxSci uses an email filtering service, Proofpoint. Messages reach Proofpoint’s servers before being delivered to LuxSci. Here’s what their servers report about the email transmission:

Received: from unknown [65.54.190.216] (EHLO bay0-omc4-s14.bay0.hotmail.com)
	by dispatch1-us1.ppe-hosted.com.ppe-hosted.com
        (envelope-from <someone@hotmail.com>);
	Mon, 19 Aug 2019 08:41:18 -0600 (MDT)

Outlook:

And finally, here’s what we see from Oultook’s server.

Received: from BAY403-EAS373 ([65.54.190.199]) by bay0-omc4-s14.bay0.outlook.com
       with Microsoft SMTPSVC(6.0.3790.4675); 
       Mon, 19 Aug 2019 07:41:19 -0700

How to Use Received Message Headers to Tell if the Email is Encrypted

The message headers contain information that can help us determine if an email is encrypted. Here are a few helpful notes to help you decode the text:

  1. We said this above, but the message headers appear in reverse chronological order. The first one listed shows the last server that touched the message; the last one is the first server that touched it (typically the sending server).
  2. Each Received line documents what a server did and when.
  3. There are three sets of servers involved in this example: one machine at Hotmail, one machine at Proofpoint, where our Premium Email Filtering takes place, and some machines at LuxSci, where final acceptance of the message and subsequent delivery happened.

Presumably, the processing of email within each provider is secure. The place to be concerned about is the hand-offs between Hotmail and Proofpoint and between Proofpoint and LuxSci, as these are the big hops across the internet between providers.

In the line where LuxSci accepts the message from Proofpoint, we see:

(version=TLSv1/SSLv3 cipher=DHE-RSA-AES256-SHA bits=256 verify=NOT)

This section, typical of most email servers running “sendmail” with TLS support, indicates that the message was encrypted during transport with TLS using 256-bit AES encryption. (“Verify=not” means that LuxSci did not ask Proofpoint for a second SSL client certificate to verify itself, as that is not usually needed or required for SMTP TLS to work correctly). Also, “TLSv1/SSLv3” is a tag that means that “Some version of SSL or TLS was used;” it does not mean that it was SSL v3 or TLS v1.0. It could have been TLS v1.2 or TLS v1.3.

So, the hop between Proofpoint and LuxSci was locked down and secure. What about the hop between Hotmail and Proofpoint? The Proofpoint server’s Received line makes no note of security at all! This means that the email message was probably not encrypted during this step.

Hotmail either did not support opportunistic TLS encryption for outbound emails, or Proofpoint did not support receipt of messages over TLS, and thus, TLS could not be used. With additional context, you can know which server supports TLS and which does not.

In this case, we know that Proofpoint supports inbound TLS encryption. In fact, from another example message where LuxSci sent a message to Proofpoint, we see the Received line:

Received: from unknown [44.44.44.44] (EHLO wgh.luxsci.com)
	by dispatch1-us1.ppe-hosted.com.ppe-hosted.com
        (using TLSv1.2 with cipher ECDHE-RSA-AES256-GCM-SHA384 (256/256 bits))
	with ESMTP id b-022.p01c11m003.ppe-hosted.com
        (envelope-from <from@domain.com>);
	Mon, 02 Feb 2009 19:28:27 -0700 (MST)

The red text makes it clear that the message was indeed encrypted. Based on the additional context, we can deduce that the Hotmail sending server did not securely transmit the email using TLS.

How To Tell if an Email is Encrypted With TLS

  1. When analyzing your message headers, consider the following items to determine if the email is encrypted:
    1. The receiving server will log what kind of encryption, if any, was used in receiving the message in the headers.
    2. Different email servers use different formats and syntax to display the encryption used. Look for keywords like “SSL,” “TLS,” and “Encryption,” which will signify this information.
    3. Not all servers will record the use of encryption. While LuxSci has always logged encryption use, not every email service provider does. It is possible to use TLS encryption and not log it. Sometimes, there is no way to tell from the headers if a message is encrypted if it is not logged.
    4. Messages passed between servers at the same provider do not necessarily need TLS encryption to be secure. For example, LuxSci has back-channel private network connections between many servers so that information can be securely passed between them without SMTP TLS. So, the lack of TLS usage between two servers does not mean the transmission between them was “insecure.” You may also see multiple received lines listing the same server: the server passes the message between different processes within itself. This communication also does not need to be TLS encrypted.
    5. If you are a LuxSci customer, you can view online email delivery reports to see if TLS was used for any particular message. We record the kind of encryption in the delivery reports, so it’s easy to see which emails were encrypted.

How can you Ensure Emails Are Securely Transmitted?

With some servers not recording TLS in message headers, how can you determine if a message was transmitted securely from sender to recipient?

To answer this question accurately, you must understand the properties, servers, and networks involved. It may be easy to determine that the message was transmitted securely if included in the header information. However, the absence of information does not necessarily mean the message was insecurely transmitted. You can only know this if you know what each system’s servers record.

In our example of a message from Hotmail to LuxSci, you need to know that:

  1. Proofpoint and LuxSci will always log the use of TLS in the headers. We can infer that the Hotmail to Proofpoint transmission was not secure as nothing was recorded there.
  2. The transmission of messages within LuxSci’s infrastructure is secure due to private back channel transmissions. So, even though there is no mention of TLS in every Received line after LuxSci accepts the message from Proofpoint (in this example), transferring the messages between servers in LuxSci is as secure as using TLS. Also, the same server can add multiple received lines as it talks to itself. Generally, these hand-offs on the same server will not use TLS, as there is no need. In the LuxSci example, we see this as “abc.luxsci.com” adds several headers.
  3. We don’t know anything about Hotmail’s email servers, so we don’t know how secure the initial transmissions within their network are. However, since we know they did not securely transmit the message to Proofpoint, we are not confident that the transmissions and processing within Hotmail (which may have gone unrecorded) were secure.

Was the email message sent and received using encryption?

We skipped steps 1 and 3 and focused on step 2 – the transmission between servers. Steps 1 and 3 are equally, if not more, necessary. Why? Because eavesdropping on the internet between ISPs is less of a problem than eavesdropping near the sender and recipient (i.e., in their workplace or local wireless hotspot). So, it’s essential to ensure messages are sent securely and received securely. This means:

  • Sending: Use SMTP over SSL or TLS when sending messages from an email client or use WebMail over a secure connection (HTTPS).
  • Receiving: Ensure your POP or IMAP connection is secured via SSL or TLS. If using WebMail to read your email, be sure it is over a secure connection (HTTPS).
  • WebMail: There is generally no record in the email headers to indicate if a message sent using WebMail was transmitted from the end-user to WebMail over a secure connection (SSL/HTTPS).

You can typically control one side and ensure it is secure; you can’t control the other without taking extra steps. So, what can you do to ensure your message is secure even if it might not be transmitted with encryption or if the recipient tries to access it insecurely?

You could use end-to-end email encryption (like PGP or S/MIME, which are included in SecureLine) or a secure web portal that doesn’t require the recipient to install or set up anything to get your secure email message. These methods meet HIPAA and other regulatory compliance requirements for secure data transmission and provide complete confidence that the message will be sent and received securely.

LuxSci’s SecureLine offers flexible encryption options, including TLS, secure web portal, PGP, and S/MIME. Its dynamic capabilities can determine what types of encryption the recipient’s server supports to ensure your emails are always sent securely. Contact our team today to learn more about how to secure your emails.

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Related Posts

healthcare marketing

How Automated Workflows Boost Engagement for Healthcare Marketing Campaigns

Due to the fact that it’s simple, instantaneous, cost-effective, and nearly universally adopted, email is an essential part of all healthcare marketing engagement strategies. However, consistent, personalized email engagement – particularly at scale – can be challenging. 

 

Fortunately, Automated Workflows offer a solution, allowing healthcare companies to deliver the right messages to the appropriate individuals at the right time, based on their individual engagement with emails.. 

 

In this post, we’ll explore the concept of Automated Workflows, the considerable benefits they offer healthcare companies, and the variety of ways they can be used to increase engagement and result in greater satisfaction and better healthcare outcomes for your patients and customers.

What Are Automated Workflows?

An Automated Workflow is a sequence of actions, known as’ Steps’ in LuxSci Secure Marketing, that a Contact (i.e., a patient or customer) moves through over time, based on a series of pre-defined rules or triggers. 

 

Each Step is programmed to automatically perform a specific function, such as sending an email or updating a Contact, when certain conditions are in place. These conditions could include: 

  • A Contact opening a message.
  • A Contact clicking through on a link.
  • A specified amount of time having elapsed.. 
  • A data update via an API call

By evaluating conditions to initiate the appropriate Step, Automated Workflows facilitate more timely, consistent, and personalized communication with Contacts (patients and customers ). As a result, healthcare companies can effectively harness Automated Workflows to develop dynamic, personalized email engagement journeys that adapt according to your patients and customers’ needs and prior interactions.

What Are the Benefits of Automated Workflows?

Let’s look at the various advantages that Luxsci Automated Workflows offer. 

Reduced Administrative Workload

Arguably, the most significant benefit of Automated Workflows is the extent to which they lower the administrative burden of email engagement campaigns for healthcare organizations. 

 

First and foremost, Automated Workflows eliminate the need for an employee to manually send your Contacts messages. As well as the manual effort, it removes a great deal of thought from the process – as someone isn’t required to remember to send an email. 

 

By the same token, this reduces the scope for human error, preventing the possibility of an employee neglecting to send an important message, sending it to the wrong person, or worse, accidentally exposing patient data, i.e., electronic protected health information (ePHI). 

 

The effort that Automated Workflows reduce is typically repetitive work that staff are glad to be free of, giving them additional time to focus on tasks that provide greater value and better contribute to better patient care and/or the customer experience. 

Enhanced Scalability

The time saved by employing Automated Workflows increases with the size of your Contact List and the scale of your engagement campaigns. In fact, enterprise-scale campaigns, with volumes of hundreds of thousands to millions of emails, are only feasible through the use of automation. 

 

Similarly, Automated Workflows enable healthcare organizations to run differing, personalized email campaigns aimed at unique patient or customer segments.  As well as automatically sending each message at the appropriate time, they provide tracking capabilities to determine the outcome of each message. 

Increased Consistency in Communication

Because Automated Workflows remediate the risk of emails going unsent, they facilitate more timely and consistent communications with patients and customers. This makes healthcare providers, payers, and suppliers appear more reliable and consistent, building trust and greater levels of satisfaction from Contacts. More importantly, recipients are better able to track what’s happening with their healthcare and assume a more proactive role overall healthcare journey..

 

Finally, creating an Automated Workflow requires healthcare organizations to carefully consider how they communicate with different Contact segments. Namely, the likely journey, or communication path, different types of Contacts take, i.e., information they need to know at a particular stage in their healthcare journey, the optimal order in which information needs to be presented, etc. This allows healthcare companies to become more in-tune with their patients’ and customers’ needs, enabling them to craft more valuable email communications that boost engagement. 

Personalized Healthcare Engagement 

Perhaps the most significant benefit of Automated Workflows is that they enable adaptive, personalized engagement for healthcare marketing and communications campiagns. Instead of manually tracking where each Contact is in a given engagement sequence, or worse, merely having to guess, you know precisely where they are. Consequently, you’re acutely aware of their needs and the exact nature of the emails you need to send them next. 

 

This, in turn, enables more effective Contact nurturing, i.e, strengthening your organization’s connection with each individual. When at its most effective, this may allow you to anticipate your Contacts’ needs, enabling you to send them communications, such screening or testing recommendations, educational materials, or product and service suggestions, that support their healthcare journey and enhance their quality of care.

Automated Workflow Use Cases

Automated Workflows are a powerful tool for increasing healthcare marketing and communications engagement because they can be applied to a wide range of use cases. Let’s take a look at some of the most common and impactful ways email automation can be used by healthcare companies. 

  • New Product Announcements: keeping patients and customers in the loop on your company’s latest offerings, as well as improvements to existing products and services that are likely to be of interest, based on their data and past actions.
  • Personalized recommendations: suggesting products or services based on the recipient’s past purchases or engagement history.
  • Re-Engagement Campaigns: Automated Workflows can also be used to reconnect with Contacts with whom engagement has waned or was never completely established, sending them personalized messages to encourage specific actions or reignite interest.
  • New Member Onboarding: welcoming new patients or customers  with a structured series of emails that introduces your services, provides technical assistance (where applicable), details subsequent steps, and explains how to get the most value from your products or services. 
  • Appointment Reminers and Follow-Ups: sending reminders, care instructions, medication adherence advice, or details on how to book subsequent appointments, for instance, after a patient visit. 
  • Patient Education Campaigns: taking patients through a structured curriculum on managing their medical condition or required  lifestyle changes to improve their health..
  • Preventative Care Communications: proactively sending reminders for screenings, check-ups, vaccinations, etc., based on PHI such as a patient’s age, gender, health condition or lifestyle risk factors.
  • Milestone Communications: sending personalized messages to acknowledge birthdays, enrollment anniversaries, and other pertinent dates. These can also be combined with preventative care communications, to send recommendations or other advice, based on the contact’s age, for instance.  
  • Feedback Collection: acquiring patient and customer feedback by sending follow-up surveys a set amount of time after a visit, procedure, purchase, etc. 

How Automated Workflows Work in LuxSci Secure Marketing

To round off this post, let’s take a deeper look at how Automated Workflows work within LuxSci’s Secure Marketing solution. LuxSci’s Automated Workflows enhance your organization’s HIPAA compliant healthcare marketing and email campaigns by giving you complete control of:

 

  • When each email is sent
  • Which Contacts receive particular communications according to their behavior, needs, and other PHI-based attributes
  • Which engagement path or branch a Contact takes based on their email actions

Here’s a look at LuxSci’s Automated Workflows key capabilities in greater detail. 

Smart Event-Based Branching and Conditions

You can branch Workflows to trigger targeted messaging based on a Contact’s attributes or certain engagement events, resulting in more relevant and effective healthcare journeys  with more desirable outcomes.

  • User actions:
    • Mailing list sign-ups
    • Form completion
    • Downloading a resource.
  • Time-based triggers:
    • A set period after a visit or procedure 
    • A defined period of inactivity or lack of contact
    • Milestones, e.g., birthdays, anniversaries. 
  • Behavioral triggers:
    • Email opens
    • Clicking on links
    • Visiting particular pages on a site or 
    • A lack of engagement with previous emails.
  • Transactional triggers:
    • Purchasing a product or service
    • Signing up for an event
    • Order confirmations or shipping updates after a purchase.
  • API-triggered events
    • Lab results or similar correspondence becoming available
    • Changes to data in EHR systems, CDP platforms, or CRM systems.. 

Automated Segment Management 

Automated Workflows can be used to dynamically add Contacts to segments based on demographics, past behavior, purchase history, and similar events. This enables more precise targeting and email personalization as they progress through specific Steps in each Workflow. 

Navigation Across Steps

Automated Workflows are also capable of navigating Contacts across different Steps or completely different Workflows depending on engagement outcomes and updates to a Contact’s PHI. Better still, if a Step has already been visited, LuxSci Secure Marketing automatically prevents repetition and infinite loops.

Automate Your Healthcare Marketing and Engagement Efforts

LuxSci Secure Marketing is a HIPAA compliant healthcare marketing solution especially designed for the stringent security and regulatory requirements of the healthcare industry. Our solution enables healthcare organizations to confidently communicate with patients and customers at scale without risking compliance violations, driving increased engagement and boosting the ROI of their marketing campaigns in the process. 

 

The latest version of LuxSci’s Secure Marketing solution with Automated Workflow functionality streamlines your company’s outreach efforts, saving considerable time, reducing human effort, and facilitating intelligent Contact management. 

What’s more, LuxSci’s reporting capabilities empower you to carefully track the results of your healthcare engagement campaigns, gaining insights at every step, including:

  • Which Contacts received particular messages
  • Who engaged with email communication, and how
  • Precise points where drop-offs in engagement occur
  • The engagement achieved with each Step in the Workflow

To learn more about LuxSci’s Secure Marketing solution and how Automated Workflows boost engagement for your healthcare marketing and communications campaigns, contact us today.

 

Healthcare marketing plan

How To Create a Healthcare Marketing Plan?

A healthcare marketing plan establishes strategic promotional activities, target audience identification, budget allocation, and compliance protocols to attract new patients while adhering to HIPAA privacy regulations and state advertising laws. Medical practices develop these documents to guide their promotional efforts across digital platforms, traditional media, and community outreach programs, ensuring all patient acquisition activities comply with healthcare privacy requirements and professional advertising standards.

Medical practices compete intensely for patient attention in saturated healthcare markets. Developing promotional strategies without proper planning leads to wasted resources, compliance violations, and missed opportunities to connect with patients who need specific medical services.

Target Audience in Healthcare Marketing Plan Development

Patient demographic research identifies age groups, geographic locations, insurance coverage types, and medical conditions that align with practice specialties and service offerings. Healthcare organizations analyze existing patient data to understand referral patterns, appointment scheduling preferences, and communication channel effectiveness for different population segments.

Competitor analysis reveals promotional strategies used by similar practices, pricing structures for comparable services, and market gaps that create opportunities for differentiation. This research helps practices position their services uniquely while avoiding oversaturated promotional approaches that fail to generate meaningful patient engagement.

Budget Allocation

Financial planning allocates resources across promotional channels based on expected return on investment, patient acquisition costs, and practice revenue goals. Digital advertising usually receives 40-60% of promotional budgets due to measurable results and targeted audience capabilities, while traditional media and community events receive smaller allocations.

Compliance costs including legal reviews, authorization management, and privacy training must be factored into promotional budgets to ensure all activities meet regulatory requirements. Practices that underestimate compliance expenses often discover their promotional activities violate privacy laws or professional advertising standards.

Digital Strategy to Drive Modern Patient Acquisition

Website optimization, search engine marketing, and social media presence are the core of contemporary promotional efforts outlined in every healthcare marketing plan. Practices invest in professional website design, patient portal integration, and mobile-responsive layouts to capture patients researching medical services online.

Content creation including blog posts, educational videos, and patient resources helps establish expertise while providing valuable information to potential patients. However, all content must avoid using patient information without authorization and cannot make unsubstantiated medical claims that violate advertising regulations.

Compliance Integration Protects Promotional Activities

HIPAA authorization procedures, business associate agreements with promotional vendors, and state advertising law compliance must be woven throughout every aspect of promotional planning. Healthcare marketing plan development includes legal review processes, privacy impact assessments, and staff training protocols to prevent violations.

Documentation requirements for promotional activities include consent forms, vendor contracts, and approval workflows that demonstrate compliance with healthcare privacy laws. Practices without proper documentation face significant penalties when regulatory investigations uncover promotional activities that violate patient privacy protections.

Community Outreach Builds Local Patient Relationships

Health fairs, educational seminars, and community partnerships create opportunities for practices to connect with potential patients through face-to-face interactions. These activities require planning to ensure patient privacy protection while maximizing promotional impact through relationship building and trust development.

Referral programs with other healthcare providers, local businesses, and community organizations can generate new patient leads when structured appropriately. Any financial incentives for referrals must comply with healthcare fraud and abuse laws to avoid legal complications.

Performance Measurement Guides Strategy Optimization

Patient acquisition metrics, appointment conversion rates, and promotional channel effectiveness data help practices evaluate their promotional success and adjust strategies accordingly. Healthcare marketing plan implementation includes tracking systems for website traffic, phone inquiries, and new patient appointments generated by different promotional activities.

Return on investment calculations compare promotional spending with revenue generated from new patients to determine which activities provide the best financial results. Practices use this data to reallocate budgets toward high-performing promotional channels while eliminating ineffective strategies.

Implementation Timeline

Monthly promotional calendars coordinate campaign launches, content publication schedules, and community event participation to maximize promotional impact while avoiding resource conflicts. Healthcare marketing plan execution requires detailed project management to ensure all activities launch on schedule and within budget constraints. Seasonal considerations including flu shot campaigns, wellness check promotions, and holiday health messaging opportunities require advance planning to capitalize on increased patient interest during specific time periods. Practices that plan these campaigns well in advance may achieve better results than those that react to opportunities without preparation.

HIPAA Marketing Rule

What Does the HIPAA Marketing Rule Require?

The HIPAA marketing rule prohibits healthcare organizations from using protected health information for promotional communications without written patient authorization, defining promotional activities as communications that encourage patients to purchase products or services with financial benefit to the sender. Organizations can send treatment-related communications, appointment reminders, and health plan benefit descriptions without authorization, but any communication promoting third-party products, paid services, or revenue-generating activities requires explicit patient consent through properly executed authorization forms.

Healthcare providers regularly find themselves struggling with acceptable patient education and prohibited promotional activities. A simple newsletter about diabetes management becomes problematic when it includes advertisements for glucose monitors or pharmaceutical products that generate revenue for the practice.

The HIPAA Marketing Rule Authorization Framework

Patient authorization documents must contain sixteen specific elements including detailed descriptions of information to be disclosed, identification of recipients, expiration dates, and explanations of revocation rights. These forms cannot be combined with other consent documents and must use plain language that patients can easily understand. Healthcare organizations face penalties when authorization forms lack required elements or contain overly broad permission language.

Patients retain the right to revoke authorization at any time, forcing organizations to immediately cease all promotional activities involving that individual’s information. Organizations cannot condition treatment, payment, enrollment, or benefits eligibility on patients providing authorization for promotional purposes, creating clear separation between healthcare services and commercial activities.

Treatment Communications Bypass Marketing Restrictions

Healthcare organizations can discuss treatment alternatives, medication options, and care coordination services without obtaining separate authorization because these communications serve legitimate healthcare purposes rather than commercial interests. Appointment scheduling, test result notifications, and prescription refill reminders fall under treatment or healthcare operations exemptions from marketing regulations.

Face-to-face communications between providers and patients about treatment options is unrestricted, even when providers receive financial benefits from recommended treatments or services. Written materials distributed during these encounters may trigger authorization requirements if they promote specific products or services beyond the immediate treatment relationship.

Financial Incentive Distinctions Shape HIPAA Marketing Rule Compliance

Communications become subject to the HIPAA marketing rule when healthcare organizations receive financial remuneration from third parties for promoting their products or services. Pharmaceutical company payments for promoting medications, medical device manufacturer incentives, or referral fees from specialty services transform otherwise acceptable communications into restricted promotional activities.

Organizations must examine their financial relationships carefully to determine when communications cross from permissible healthcare operations into restricted promotional territory. Even nominal payments or gifts from third parties can trigger marketing authorization requirements for communications that mention or promote those parties’ products or services.

Business Associate Relationships Complicate Marketing Activities

Vendors creating promotional materials, managing patient outreach campaigns, or analyzing treatment data for commercial purposes need business associate agreements before accessing PHI. These relationships are difficult if the promotional vendors also provide healthcare services or when healthcare organizations share revenue from marketing activities with their business partners.

Organizations must negotiate appropriate contractual protections and ensure vendors understand their obligations under the HIPAA marketing rule before beginning any collaborative promotional activities. Liability for vendor violations remains with the covered entity, making careful partner selection and monitoring essential for maintaining compliance.

Digital Platforms & Modern Marketing Compliance Challenges

Social media advertising, email campaigns, and online retargeting involve sharing patient information with technology platforms that lack appropriate privacy protections. Healthcare organizations cannot upload patient contact lists, demographic details, or treatment information to advertising platforms without proper authorization and business associate agreements covering those platforms.

Website analytics, social media pixels, and advertising tracking technologies may inadvertently capture and transmit PHI to third-party platforms without appropriate protections. Organizations need controls to prevent accidental information sharing while still enabling effective digital marketing activities within compliance boundaries.

Enforcement Penalties Reflect Serious Violation Consequences

Recent Office for Civil Rights enforcement actions have resulted in multi-million dollar settlements for organizations that used patient information in marketing materials without authorization or shared PHI with advertising vendors without appropriate agreements. These cases highlight increasing federal scrutiny of healthcare promotional activities and willingness to impose substantial financial penalties.

Violations may stem from seemingly innocent activities like patient newsletters, social media posts, or website testimonials that inadvertently disclosed PHI without proper authorization. Organizations discover that good intentions cannot shield them from penalties when their marketing activities violate patient privacy protections under the HIPAA marketing rule.

Compliance Programs Minimize Violation Risks

Healthcare organizations benefit from establishing clear review processes for all promotional materials and patient communications before distribution. Designated privacy personnel can evaluate whether proposed communications require authorization, involve business associate relationships, or create other compliance risks under marketing regulations.

Staff training helps employees recognize the difference between permissible healthcare communications and restricted marketing activities. Education updates keep pace with new promotional channels, emerging technology platforms, and evolving interpretations of the rule’s requirements within changing healthcare and advertising landscapes.

explanation of benefits

Why Healthcare Insurers Should Send Explanation of Benefits Statements Via Email

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.

Contact us today to learn more about how your organization can begin the transition to electronic EoBs.

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What is HIPAA compliant email?

What Are HIPAA Secure Email Requirements? A Detailed Guide for Healthcare Companies

This concise guide answers the often-asked question of ‘what are HIPAA secure email requirements?’. We’ll explore the essential components of HIPAA secure email and the measures healthcare organizations must take to best protect the sensitive patient and customer data under their care. 

In healthcare, email often includes protected health information (PHI), and any transmission of PHI via email must ensure that this sensitive data is protected from unauthorized access and subsequent exposure. 

HIPAA compliant email refers to a HIPAA secure email service that meets the privacy and security standards set by the Health Insurance Portability and Accountability Act (HIPAA). In the pursuit of securing patient data and ensuring each individual’s right to privacy, HIPAA has issued a series of guidelines designed to protect sensitive patient data during email transmission. 

HIPAA Secure Email Requirements In Detail

To be classified as HIPAA secure email, an email system must meet a range of privacy and security requirements designed to protect sensitive patient data.

Let’s begin with a deeper dive into the essential requirements of a HIPAA compliant email provider:

Encryption

Encryption is the cornerstone of HIPAA compliant email. Both in-transit encryption (when the email is sent) and at-rest encryption (when the email, and, by extension, the PHI it contains, is stored on the server) are mandatory HIPAA requirements.  

End-to-end encryption safeguards PHI from being accessed by malicious actors, e.g. hackers and other cybercriminals, even if they get hold of it. Without proper encryption, in contrast, the sensitive health information contained in emails can easily be interpreted, and, consequently, has value if intercepted. 

Better still, encryption for HIPAA secure email needs to be automated and flexible. Flexibility refers to the email provider’s ability to match the type of encryption with the recipient’s security posture. Automation, meanwhile, ensures that PHI is encrypted without the need for a manual process by the email user or human intervention. These capabilities not only reduce the potential for human error but also diminish the admin overhead of securing PHI. 

Access Control

HIPAA email rules require strict access controls to ensure that only authorized personnel can access sensitive data. Not everyone at a healthcare organization, or a third party that happens to have access to their data in the course of their business relationship, should have access to patient data. With this in mind, access to PHI must be enforced through risk mitigation measures such as user authentication, multi-factor authentication (MFA), and role-based access controls (RBAC).

MFA, for instance, requires users to verify their identity beyond their login credentials. This could include something they know (a secret phase, a one-time password (OTP), something they have (a keycard or security token), or something they are (i.e., biometrics: retinal scans, fingerprints, etc.). The reason it’s called multi-factor authentication is that healthcare organizations can implement as many authentication measures as warranted by the sensitivity of the patient data. 

Audit Trails

HIPAA mandates that all access to PHI be logged for auditing purposes. This includes tracking the sender, recipient, timestamps, and any modifications to the email or its contents. Audit logs ensure that any unauthorized access or potential breach can be investigated, addressed, and, above all, contained promptly. For HIPAA secure email compliance, audit logs must be kept for a minimum of six years and must be easily accessible for compliance audits.

Business Associate Agreement (BAA)

When using third-party email providers, such as LuxSci, healthcare organizations must enter into a Business Associate Agreement (BAA). This legally binding contract ensures that the email provider, i.e., the business associate, is also held to HIPAA’s security and privacy requirements. By the same token, the BAA covers the responsibilities of the healthcare provider – or ‘covered entity’ – in safeguarding PHI and outlines penalties for non-compliance for both parties.

HIPAA Secure Email Best Practices 

To ensure your email system meets HIPAA’s compliance standards and remains secure, it’s critical to follow these best practices. If you’re unsure where to start when it comes to tightening up your compliance efforts, start with these essential principles:

  1. End-to-End Encryption: A HIPAA compliant email provider must implement end-to-end encryption: meaning that PHI is encrypted when sent and decrypted only by the intended recipient. LuxSci’s encryption protocols ensure that PHI is never exposed during the transmission process or in storage.
  2. Implement Multi-Factor Authentication (MFA): to further enhance the security of your email communications, expand your IT infrastructure to enable MFA. This ensures that unauthorized parties cannot access email accounts even if login credentials are compromised. MFA adds another layer of protection by requiring as many factors of identification as the PHI demands.
  3. Regular Audits: conduct regular audits to ensure that all actions on email communications are properly logged, tracked, and record who accessed patient data and for what purpose. As well as malicious behavior, these audits can highlight overly generous access privileges and enable security teams to tighten up their policies and protocols. 
  4. Continuous Monitoring: as well as regularly auditing PHI access logs, you need to deploy a continuous monitoring solution to remain aware of suspicious behaviors and potential attempts at data breaches. Without continuous monitoring, malicious actors have the opportunity to infiltrate your network between periodic risk assessments. 
  5. Employee Education and Training: if your staff isn’t educated on how to handle sensitive patient data, all your other efforts to safeguard PHI are likely to be undermined. In light of this, training your workforce on HIPAA regulations, how to adhere to them, and the potentially dire consequences of failing to comply with their standards, must be a top priority. 
  6. Choose a Trusted, HIPAA Compliant Email Provider: the email provider you select must offer features specifically designed to meet HIPAA standards, removing a lot of the complications from achieving compliance in the process. 

Why Choose LuxSci for Your Organization’s HIPAA Secure Email Communication Needs?

When it comes to safeguarding PHI, LuxSci offers the security of flexibility and automated end-to-end encryption, unparalleled scalability, and best-in-class deliverability to carry out effective, high-volume HIPAA-compliant email campaigns.

Whether you’re a growing practice or a large healthcare company, our solutions facilitate effective email engagement, while maintaining the highest standards of email security and compliance.

Here’s are the ways LuxSci’s leading solutions help ensure HIPAA-compliant email communication within your healthcare organization, no matter the size of your company, or the volume of emails you send:

HIPAA Secure Email Gateway for Google Workspace and Microsoft 365

LuxSci’s Secure Email Gateway is the perfect solution for smaller healthcare organizations or those already using Google Workspace or Microsoft 365. Our service enables you to make your existing email system HIPAA compliant without disrupting your current workflow and user experience. LuxSci’s Secure Email Gateway automatically applies end-to-end encryption, ensuring that all emails containing PHI are securely transmitted. The best part? The process is automated and transparent to users, requiring no extra steps and causing no interruptions.

Secure High Volume Email Solution for Large Healthcare Organizations

For larger healthcare providers and organizations that send thousands or millions of emails per month, LuxSci’s Secure High Volume Email solution provides a scalable, highly secure solution that ensures compliance without sacrificing performance. Whether you’re sending newsletters, appointment reminders, preventative care emails, or other communications to a large patient or customer base, our solution delivers best-in-class HIPAA-compliant email deliverability rates of 95% or higher. 

Flexible, Automated Encryption with SecureLine Technology

At the heart of LuxSci’s HIPAA-compliant email solutions is our SecureLine technology, our proprietary flexible and automated encryption service. SecureLine enables highly flexible, automated encryption that adapts to the security posture of your recipients’ servers, ensuring that messages reach the intended recipient. Whether you are sending individual messages or conducting a bulk email outreach campaign, SecureLine automatically handles the encryption, keeping your email communications protected, secure and private from end-to-end.

Scalability for Large Enterprises

LuxSci’s infrastructure supports some of the largest healthcare organizations in the world, providing the scalability needed to handle high volumes of sensitive communications, including sending hundreds of millions of emails per year. As your organization grows, LuxSci can scale its solutions to meet your needs, ensuring that you maintain HIPAA compliance and a seamless, secure email experience.

Contact LuxSci Today

If you have any questions or concerns about HIPAA secure email requirements or would like to learn more about how LuxSci can help secure your healthcare communications, don’t hesitate to contact us. 

We’ll be happy to discuss your unique needs and help you find the right solutions to help your organization become more secure, compliant, and better at engaging with your patients and customers.

LuxSci HIPAA Compliant Marketing FAQs

HIPAA-Compliant Email Marketing FAQs

Email is an essential channel for most healthcare marketers, but HIPAA compliance requirements can make it challenging to execute effective engagement campaigns without violating patient privacy.

HIPAA is a complicated set of regulations that while offering a lot of guidance, does not mandate the use of any specific technologies to protect patient privacy. This ambiguity causes a lot of confusion for marketers looking to integrate email into their healthcare engagement campaigns.

With this in mind, this article addresses some frequently asked questions (FAQs) about HIPAA-compliant email marketing and offers advice for securing patient data and future-proofing your marketing.

Frequently asked HIPAA compliant email marketing questions

Do Generic Newsletters Need To Be Protected?

What Is An Email API?

Does HIPAA Allow Healthcare Providers To Send Unencrypted Emails With PHI To Patients?

Can Patients Exercise Their Right Of Access By Receiving PHI via Unencrypted Email?

Is Microsoft 365 Sufficient For Marketing Emails?

What Are Common Email Marketing Use Cases For Healthcare?

How Do I Find a HIPPA-Compliant Email Marketing Vendor?

 

Do generic newsletters need to be protected?

Some marketers assume newsletters from a healthcare provider or supplier do not contain health information and, therefore, do not fall under HIPAA requirements. This assumption, however, is often incorrect, with many surprised to learn that protected health information (PHI) can be implied from seemingly innocuous information.

As a result, many generic email newsletters often indirectly contain PHI due to the very fact that they are sent to lists of current patients or customers. This is because email addresses count as individually identifiable data and when combined with the message therein, it’s pretty simple to infer that they are patients or customers.

Let’s say, for example, that you send a newsletter to the patients of a dialysis clinic. An eavesdropper could infer that the recipients receive dialysis. Consequently, as the email reveals information about an individual’s health treatment, it contains PHI and should be secured in compliance with HIPAA regulations.

For the fundamental reason that it can be difficult to determine what classifies as PHI, it’s safer to skip the ambiguity entirely and use a HIPAA-compliant email marketing solution to ensure security.

What is an email API?

An Application Programming Interface (API) is a collection of protocols, or rules, that enable different applications to communicate with each other. APIs are a crucial aspect of modern applications – as they spare developers the considerable effort of creating application features from scratch – they can just connect to the API of an existing application.

For example, how many websites have you used that utilize Google Maps? This is because they have connected their site to the Google Maps API – integrating it into their application and providing another feature for their users.

In the case of an email API, it is a way for applications, such as customer relationship management (CRM) platforms, customer data platforms (CDP) and electronic health record (EHR) systems, to connect to email service providers. This then allows marketers to send emails through the application, using the ePHI (electronic protected health information) collected and stored within the application.

Additionally, marketers can view and further utilize campaign data through the powerful dashboards and analysis tools found in CRM systems and similar applications. Trigger-based transactional or marketing emails are ideal for sending with an email API, whereby emails are sent when pre-determined conditions in the application are met. Healthcare organizations may use email APIs to send appointment reminders using electronic health records system data about a patient’s upcoming appointments, check ups or treatments.

As invaluable as email APIs are, however, especially for streamlining and automation communication workflows, they are no substitute for a comprehensive email marketing platform. Email APIs do not include the contact management systems standard in most email marketing platforms, as all the data resides within the application they connect to. Additionally, email API tools do not typically include drag-and-drop editor tools and other design features that enable you to make your emails stand out and boost patient engagement.

Does HIPAA allow healthcare providers and companies to send unencrypted emails with PHI to patients?

Encryption is an addressable standard, i.e., it must be implemented by the organization unless a risk analysis concludes that implementation is not reasonable and appropriate, under the HIPAA Security Rule. This does not mean it is optional. The HIPAA Security Rule does not explicitly forbid unencrypted email. Still, it does state that “other safeguards should be applied to protect privacy reasonably, such as limiting the amount or type of information disclosed through the unencrypted email.”

In addition, the Department of Health and Human Services also states that “covered entities are permitted to send individuals unencrypted emails if they have advised the individual of the risk, and the individual still prefers the unencrypted email.” in response to this, some organizations use waivers to inform patients of the risks and acquire permission to send unencrypted emails.

However, we do not recommend this approach for several reasons:

  1. Keeping track of waivers over time and recording status changes and updates is challenging – and increases your administrative overhead.
  2. Signed waivers do not insulate you from the consequences of a HIPAA breach.
  3. Using waivers to send unencrypted emails doesn’t absolve you of your other HIPAA obligations, such as data retention and disposal. Subsequently, using a HIPAA-compliant email solution is more manageable and eliminates ambiguity.

Can patients exercise their right of access of receiving PHI voa unencrypted email?

Yes, but they must be fully informed of the risks and sign waivers acknowledging them; the caveats detailed in the above answer apply. Consequently, it’s always best to use an encryption tool to protect patient data.

Is Microsoft 365 with encryption sufficient for sending marketing emails?

Microsoft 365 can be configured with Office Message Encryption (OME) to comply with HIPAA. However, it is not well-suited for sending marketing emails. OME primarily relies on portal pickup encryption, in which the message is stored securely on a server and requires the recipient to log in to the portal to read the email. As a result, the portal adds friction to the marketing process that prevents optimal engagement and constrains ROI.

Marketing messages containing light-PHI, i.e. low-risk data, are best sent using Transport Layer Security (TLS) encryption. TLS-encrypted messages arrive in the recipient’s inbox just like a regular email and do not require them to complete an additional step.

Additionally, Microsoft 365 is not configured to send high volumes of email. If you plan on executing large scale marketing campaigns, you could unintentionally disrupt regular business communications by sending all the messages through the same infrastructure. Instead, you should separate your business and marketing email delivery activities to protect your IP reputation, i.e., the trustworthiness of your IP addresses and how likely it is your emails end up in a spam folder, and achieve your desired sending throughput.

What are the common email marketing use cases for healthcare?

Email marketing in healthcare is not restricted to boring general practice newsletters and other communications that fail to engage patients. When you successfully harness tools that enable you to use ePHI to better target and personalize your healthcare engagement campaigns – the sky is the limit. With consumer preferences shifting toward digital communications, marketers who know how to best utilize HIPAA-compliant email marketing – and tactics like segmentation and personalization – will prove more effective at reaching patients.

Examples of ways that healthcare marketers can use email include:

  • Lead generation campaigns
  • Promotions
  • Verifications
  • Order confirmations
  • Notifications
  • Upsell & cross-sell
  • Collecting data on the patient experience

How do I find a HIPAA-compliant email vendor?

Using popular email marketing platforms, such as Mailchimp, is not recommended. Many of these platforms were designed for  businesses, but are simply not secure enough to meet HIPAA requirements. We do not recommend using a solution not specifically equipped to meet the healthcare industry’s unique security and compliance needs. To determine if your email marketing provider is compliant, they must meet three broad criteria at a minimum.

  1. The vendor must sign a Business Associate Agreement (BAA) outlining how they plan to secure your data and what they will do in the event of a breach.
  2. Encrypt data at rest when it is stored in their systems.
  3. Encrypt data, i.e., email messages, in transit as sent to the recipients.

Not all vendors will be up to the task. Carefully vet your email marketing vendors to ensure they are taking steps to secure data and protect patient privacy.

Conclusion

Admittedly, HIPAA can be difficult to understand – but choosing the right tools and adequately vetting your vendors makes it far easier to successfully execute HIPAA-compliant email marketing campaigns.

As the most experienced HIPAA-compliant email provider, LuxSci specializes in providing secure and scalable communications for companies aiming to send hundreds of thousands – or millions – of emails. In light of this, we place security, compliance and personalization considerations front and center when building our solutions.

Interested in discovering how LuxSci’s secure healthcare communications solutions can transform your healthcare marketing and engagement efforts?

Contact us to learn more today!

HIPAA Compliant Workspace

What is a HIPAA Compliant Workspace?

A HIPAA compliant workspace combines physical, technical, and administrative precautions that protect patient information in healthcare environments. These workspaces include secure physical areas, configured computers and devices, appropriate access controls, and staff trained on privacy practices. Healthcare organizations implement these measures to maintain patient confidentiality while allowing employees to perform necessary work functions in accordance with HIPAA Privacy and Security Rules.

Physical Workspace Requirements

Healthcare organizations design physical workspaces to prevent unauthorized access to patient information. Office layouts position computer screens away from public view to prevent visual exposure of records. Secure areas with badge access or keypad entry restrict unauthorized personnel from entering spaces where protected health information is handled. Document storage includes locked cabinets for paper records when not in use. Clean desk policies ensure sensitive information isn’t left visible when workstations are unattended. Privacy screens on monitors prevent visual access from side angles in shared work environments. These physical controls work together to create the foundation for information privacy.

Technical Elements of a HIPAA Compliant Workspace

Computer systems in HIPAA compliant workspaces include security measures that protect electronic health information. Workstations require secure login procedures, with multi-factor authentication for accessing patient records. Automatic screen locking activates after short periods of inactivity. Encryption protects data stored on local devices and information transmitted across networks. Software includes current security patches and antivirus protection. Printers and fax machines receiving patient information reside in secure areas with output collection procedures. Organizations should implement standardized configurations across all workstations to maintain consistent security controls.

Administrative Controls and Policies

Policies guide how staff interact with protected health information in workspace environments. Authorization procedures determine which employees can access specific types of patient information based on job responsibilities. Training programs ensure staff understand privacy requirements and proper handling of health information. Workspace monitoring may include periodic walk-throughs to identify potential privacy issues. Document disposal procedures include shredding for paper records and secure deletion for electronic files. Healthcare entities should always document these administrative controls as part of their overall HIPAA compliance program.

Remote Work Considerations

Remote workspaces require extra considerations to maintain a HIPAA compliant workspace outside of traditional office environments. Home office setups need privacy measures to prevent family members from viewing patient information. Virtual private networks (VPNs) can create secure connections to healthcare systems when working remotely. Organizations often restrict downloading patient information to personal devices. Video conferencing tools for healthcare discussions must include appropriate security features. Remote work policies typically define acceptable work locations and security requirements. These measures help maintain compliance as healthcare work extends beyond traditional facilities.

Mobile Device Management

Mobile devices in HIPAA compliant workspaces require specific security controls. Smartphones and tablets accessing health information need encryption, passcode protection, and remote wiping capabilities. Mobile device management solutions help organizations enforce security policies on both organization-owned and personal devices used for work. Application controls limit which programs can access or store patient information. Policies typically address device usage in public settings to prevent unauthorized viewing.

Workspace Compliance Documentation

Healthcare organizations maintain documentation about their workspace security measures. Facility security plans outline physical safeguards and access restrictions. System security documentation describes technical controls for workstations and networks. Training records demonstrate that staff receive appropriate privacy instructions and education. Risk assessment reports identify potential workspace vulnerabilities and mitigation strategies. These documents show HIPAA compliant workspace efforts during audits or regulatory reviews. Regular updates are critical to keep documentation current as workspace environments and security requirements evolve.

LuxSci Third Party Integrations

The Risks of Third-Party Email Integrations for Healthcare Companies

Today’s healthcare organizations heavily rely on a variety of third-party organizations for a range of services and products. This includes applications (i.e., SaaS solutions), suppliers, partners, and other companies depended upon to serve their patients and customers.

 

As the healthcare industry evolves, companies will need to increasingly collaborate with external parties, or business associates, which creates several dependencies and risks.

 

In particular, third-party email platforms are integral to the operations of healthcare companies, and the sensitive nature of protected health information (PHI) contained in email communications raises the stakes exponentially.

 

This post analyzes the main risks associated with third-party email integrations. From there, we detail the most effective measures for safeguarding your company from the dangers of an insecure integration with an email delivery platform.

What Are The Risks of Third-Party Email Integrations?

Email applications are a pillar of the modern workplace, enabling companies to communicate almost instantly and facilitating greater productivity and efficiency. Email has transformed the speed at which transactions can take place and individuals receive the product or service they’ve purchased.

 

Consequently, the importance of email communication and the vast amounts of sensitive data it encompasses, makes it a contrast target – or “attack vector” for cybercriminals. Hackers and other malicious actors know that if they can infiltrate an organization’s email system, they have the potential to steal vast amounts of private or proprietary data. Just as alarmingly, they may simply use an insecure email platform as a backdoor into a company’s wider network, assuming greater control over their systems in an effort to maximize their financial gain or inflict maximum damage to an organization.

 

For healthcare companies with ambitious patient engagement goals, sharing protected health information (PHI) with a reliable third-party email provider is mandatory. Unfortunately, this comes with a litany of risks, which include:

 

  1. Data Breaches: weak security features in third-party email providers can expose PHI. 
  2. Misconfigured Permissions: misconfigurations and a lack of oversight control can result in personnel at third parties having excessive access to PHI.
  3. HIPAA Non-Compliance – if the integration does not support encryption, audit logs and other features mandated by HIPAA, you may drift into non-compliant territory.
  4. Financial Implications: violating HIPAA regulations can result in financial penalties, including fines and compensation to affected parties. 
  5. Reputational Damage: companies that fall victim to cyber attacks, especially through negligence, become cautionary tales and case studies for cybersecurity solution vendors. Data exposure that comes from an insecure email platform integration can have disastrous effects on your company’s reputation. 

Therefore, mitigating the risks of integrating a third-party email platform into your IT infrastructure, platforms and systems is crucial. This includes customer data platforms (CDP), electronic health record systems (EHR) and revenue cycle management platforms (RCM). Let’s move on to specific strategies on how to do so and, subsequently, better safeguard your organization’s PHI. 

How To Mitigate Email Integration Risk

Now that you have a better understanding of the potential risks that come with integrating an insecure third-party email solution into your IT ecosystem, let’s look at risk prevention. Fortunately, several strategies will significantly lower the risk of malicious actors getting their hands on the sensitive patient data under your care. Let’s take a look:

Verify A Third-Party Vendor’s Security Practices

Before sharing PHI with a vendor, ensure they have a strong cybersecurity posture. This makes sure they have measures such as encryption, access control (or identity access management (IAM), and continuous monitoring solutions in place, in addition to conducting regular risk assessments.

 

Similarly, it’s crucial to research an email provider’s reputation, including how long they’ve been in operation, the companies they count among their clients, and their overall standing within the industry. 

Business Associate Agreements (BAAs)

A business associate agreement (BAA) is a legal document that’s required for HIPAA compliance, when sharing PHI with third-party vendors, such as email services. It ensures that both you and the vendor formally agree to comply with HIPAA regulations and your respective responsibilities in protecting patient data.

 

Without a BAA, the above point about verifying a vendor’s security practices is moot. If they’re not willing to sign a BAA, their security stance is irrelevant, as your organization would have violated HIPAA regulations by not signing a BAA. More to the point, a HIPAA compliant email vendor will be eager to highlight their willingness to sign a BAA, as it advertises their ability to safeguard PHI and aid companies in achieving compliance. 

Encrypting PHI

Encryption needs to be a major consideration when it comes to integrating a third-party email services provider. Adequate encryption measures ensure that sensitive data is protected even in the event of its exfiltration or interception. Sure, the hackers now have hold of the PHI, but with proper encryption policies and controls, it will be unreadable, preserving the privacy of the individuals affected by the data leak.

 

With this in mind, encryption measures that mitigate third-party email integrations include automated encryption, which ensures PHI is always encrypted without the need for manual configuration, and flexible encryption, which matches the encryption level with the security standards of your recipients. 

Threat Intelligence

Unfortunately, cybersecurity never stands still. With the ever-evolving nature of cyber threats, healthcare organizations must keep up with the latest dangers to patient data. This means creating a process for discovering, and acting upon, the latest threat intelligence.

 

This could entail signing up for a threat intelligence service, or retaining the periodic services of an external threat intelligence expert. 

Developing An Incident Response Plan For Vendor-Related Breaches

The alarming reality of securing PHI is that, even with robust safeguards in place, such as continuous monitoring, a process for acquiring the latest threat intelligence, and generally following the advice outlined in this post, data breaches are still a stark reality. Cyber criminals will always target healthcare organizations, due to the value and sensitivity of their data and systems. Worse, even as security measures grow more effective, the tools that malicious actors have at their disposal become more sophisticated. It’s an arms race, and one that’s only been exacerbated by the introduction of AI, with both security professionals and cyber criminals honing their use of it for their respective purposes.

 

Taking all this into consideration, having a comprehensive incident response plan in place ensures your organization responds quickly and effectively to cyber threats, or even suspicious activity. Your incident response plan should:

 

  • Detail what employees should do if they suspect malicious activity.
  • Outline steps for investigation and containment.
  • When and how to notify affected parties.
  • Processes for disaster recovery and retaining operational continuity.

While it’s vital to develop a general incident response plan, having a specific set of protocols for security breaches caused by third-party vendors is especially prudent.

Choose a HIPAA-Compliant Email Provider

An efficient and convenient way of mitigating the risks of third-party email integrations is to deploy a HIPAA compliant email delivery platform for communicating with patients and customers.

 

Being well-versed with the safety requirements of healthcare organizations, HIPAA compliant email software features all the security required to safeguard PHI. In deploying a HIPAA compliant email provider, you also implement several of the strategies outlined above, such as encryption and signing a BAA (as a HIPAA compliant will offer a BAA). Accounting for this, taking the time to select the right HIPAA compliant email provider for your organization’s needs and goals should be a key part of your overall cyber threat defense strategy. 

Train Staff on Secure Email Communication Practices

Your staff is a considerable part of securing third-party email communications, so they must know the best practices for email security and safeguarding PHI. Comprehensive cyber threat awareness training ensures your personnel understand the risks of HIPAA non-compliance and follow the procedures you’ve set in place. Furthermore, the more responsibility an employee has in regards to PHI, the more comprehensive and regular their training needs to be.

 

Additionally, training, or “drilling”, if you will, on their roles in the incident response process increases its efficacy considerably and optimizes your response to attempts at unauthorized access to data. 

How LuxSci Mitigates the Risks of Third-Party Integrations

At LuxSci, we specialize in providing secure, HIPAA compliant solutions that enable healthcare organizations to execute effective email communications and marketing campaigns.

 

With more than 20 years of experience, and helping close to 2000 healthcare organizations with HIPAA compliant email services, LuxSci has developed powerful, proven tools that sidestep the vulnerabilities often associated with third-party email integration. To learn more about how LuxSci can help your organization address the risks of third-party email integration, contact us today.