How do I fix the reputation of my IP address?

Business Solutions, HIPAA Compliant Email
LuxSci
May 11, 2021

It happens — you’re sending email messages without issue, and then suddenly emails are not being delivered, or they’re being flagged as spam. A little digging reveals that the problem is that your “IP reputation” is poor, and you need to fix it somehow.

What is IP Reputation?

Email service providers (e.g. AOL, Gmail, LuxSci) and email filtering systems (e.g. Barracuda, McAfee, Proofpoint, SenderScore) collaborate on and track the sending of unwanted emails to reduce the blight of email spam that continues to plague the Internet. Some of the significant factors that they track include:

Quantity of email sent from your IP address
The spam-like characteristics of these messages (based on spam filter analysis)
The number of spam complaints by recipients of these messages
The number of messages sent to invalid recipients or honey pots. Honey pots are email addresses that do not belong to real people and are traps for senders who have acquired these email addresses via web site scraping or some other illegitimate manner.

Put together, these factors end up determining the reputation of that IP address with respect to the sending of email messages. If the reputation becomes poor, then spam filters will start to quarantine or reject your email messages, resulting in poor deliverability.

What is the “bad neighborhood” effect?

If your sending server is in the same neighborhood as other sending servers, then its reputation can be affected by the others’ actions. The following are some well-known “bad neighborhoods”:

Public cloud servers (e.g. at Amazon). As these servers can be owned by anyone, they are often used for sending unwanted emails. As a result, if you use one of these servers, your IP address probably has a diminished reputation.
Big Internet Service Providers (ISPs). ISPs like Comcast always have problems with suppressing spam coming from their users’ systems (due largely to malware infecting end users and sending unsolicited emails from unsuspecting people’s machines). If you are sending messages directly from your ISP, your reputation can fluctuate wildly as a function of your neighborhood.

If you are suffering from the bad neighborhood effect, your choices are limited and simple:

You can talk to your ISP about the problem, but they may not take any action.
Instead of sending emails directly from servers in this location, you need to relay the messages through a third-party email sending service with a good reputation. This service should also scrub your messages, removing all trace of the tarnished IP of origin.

What can I do to fix IP reputation?

Assuming that you are not a victim of a bad neighborhood, you can take steps to repair the reputation of your server’s IP address. The first thing you need to do is stop sending outbound emails until you take further steps. This can be frustrating, but it is better to send no email than to continue sending problematic email.

Resolving your server reputation problem will take some work. You need to make sure that you’re only sending legitimate emails to real people, as doing this for a while will establish a track record of good sending for your server.

Review Email Lists and Message Content

To fix your IP reputation, take a look at the types of emails you are sending and who is receiving them.

Content. Review the actual content of the messages that you are sending. Make sure that it doesn’t sound like spam. Some software systems can help you analyze your message content for “spamminess.”
CAN-SPAM. Make sure that any bulk email is compliant with CAN-SPAM. Your purpose for emailing, identity, and method for unsubscribing should all be clear.
Sending Rate. Make sure that your server is not sending messages too fast to places like AOL, Yahoo, Google, etc. Pushing too many too fast is a red flag and can hurt your reputation.
Real Addresses. Sending to old or invalid email addresses does significant harm to your IP reputation. You need to review bounced emails and remove dead-end addresses from your lists.
Good Addresses. The single most important thing that you can do for your IP reputation is to send to only people who actually want and expect your email messages. This means, in particular:
1. Do not use or send to purchased lists.
2. Discard addresses obtained through scraping web pages or copied from directories or books.
3. You must get rid of all spam-trap and honey pot email addresses that you may have accumulated.
4. Eliminate all addresses that have not subscribed to your messages or with whom you do not have an existing business relationship.
5. Remove the addresses of all people that have requested to be unsubscribed or otherwise eliminated from future mailings.
6. Remove the addresses of all people that have complained that your messages are spam.

Items 1-3 relate to your message content and sending pattern and are fairly easy to address. The rest of the issues involve actively cleaning and managing your recipient lists. You need to clean all of your existing lists and then manage them going forward.

How do I clean my lists?

Cleaning mailing lists can be difficult and expensive without getting into more trouble with your IP reputation. We recommend the following steps, in the order presented. Depending on your current situation, you might not have enough information to perform them all — that will just increase the cost of the last step.

First, contact your email service provider or IT staff and:

Find a list of all of your bouncebacks and remove them
Find a list of all spam complaints and remove these recipients

Then, take your lists to FreshAddress, and use their SafeToSend email address validation service. It will take your lists, sanitize them, and then provide you with new, improved, and cleaned lists. SafeToSend will:

Validate. Ensure that email addresses are well-formatted, correspond to valid domain names that accept email, and match a working email address.
Correct. The addresses are checked for common spelling errors and typos and corrected as needed (e.g. @gmail.com instead of @gamil.com).
Protect. SafeToSend will identify and remove: spam trap email addresses, role accounts, disposable domains, fictitious and malicious email addresses, and addresses on “do not email lists” and FCC wireless domains.

After sanitizing your lists with SafeToSend and after removing people who have not opted-in to email messages, your delivery rate will skyrocket and complaints will plummet.

How long does it take to improve my IP reputation?

Sending a solid stream of messages with appropriate content to your new, safe list will reestablish your server’s IP reputation. However, it could take a number of days or even weeks to rebuild your reputation. It will depend on how much good email you are sending after repairing your content and lists. Poor IP reputation will continue to affect your email delivery rates as you rebuild that reputation.

To improve email deliverability quickly, the only other option is to relay your email out through a third-party email sending provider and having them scrub your server’s IP address. It won’t rebuild your IP reputation, though the lack of email being sent from your server can slowly improve its reputation to normal levels. However, if your reputation is due to poor lists, third-party email providers will not want your business and may terminate your account if they detect your use of bad email lists.

How do I maintain my lists?

Going forward, you need to be actively collecting bounceback and failure messages and removing these recipient addresses from your lists. Additionally, you need to be collecting spam complaints via feedback loops from the major email service providers (i.e. AOL, Yahoo, etc.) and remove these complainer addresses as well.

If you do not have the facility to capture bounces and feedback, you should use an email sending service that can take care of this for you.

List maintenance is critical. Failing to maintain your list will cause your IP reputation to gradually decline until your sending issues return.

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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.

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

June 24, 2025
Pete Wermter

How To Overcome Email Encryption Challenges in Healthcare

April 14, 2025
Pete Wermter

Encryption is a critical security measure for protecting electronic protected health information (ePHI) included within email communications, and a key technical safeguard under the HIPAA Security Rule. However, despite its efficacy in helping protect sensitive patient data from malicious actors, encryption can be difficult to successfully implement.

Technical complexity, user resistance, and compatibility issues across different email systems can emerge as persistent problems, leading to frustration, risky workarounds, and, ultimately, increased risk of ePHI exposure and compliance violations. Without thoughtful deployment and support, encryption can become a barrier to successful secure email communication in healthcare, as opposed to a measure that underpins it.

To help you ensure secure, HIPAA compliant email communication, this post discusses the main encryption challenges you’re likely to encounter, how they can diminish your email security posture, and the measures you can take to overcome them.

What Is Email Encryption?

Before we discuss the most frequent email encryption challenges faced by healthcare organizations, here’s a quick refresher on what email encryption is and why it’s so important for securing sensitive patient data.

Email encryption is the process of scrambling the content of a message to make it unreadable as it’s sent to recipients or stored in a database. Only the intended recipient, who has the encryption key, can decrypt the email and access the data within.

Consequently, in the event an encrypted message is intercepted by malicious actors in transit or exfiltrated from a data store during a security breach, they won’t be able to make sense of it. This renders any ePHI included in the message unintelligible and, therefore, worthless, adding another layer of security that preserves patient privacy – and keeps your business safe.

Common Email Encryption Challenges

Let’s move on to detailing some of the most frequent encryption challenges that must be overcome by healthcare organizations to ensure secure email communication and HIPAA compliance.

Decrypting Messages Is Too Difficult

The more difficult or drawn out it is for recipients to decrypt their email messages, the more likely they’ll simply go unread or end up deleted. If the decryption process is too cumbersome, which could include requiring a user to log into a separate site (i.e., a web portal), verify their identity multiple times, create a new account, or install additional software, it adds complexity. This can drive users to seek workarounds or cut corners, such as having information sent to them through unsecured channels, which puts your company at risk.

Similarly, email clients, browsers, and security settings may impact the decryption process, causing compatibility issues that prevent users from accessing their messages. Within a healthcare setting, where timely communication is crucial, such obstacles can disrupt workflows, slow down patient care, and lead to HIPAA compliance violations if users resort to unencrypted alternatives.

Encryption that Requires Manual Intervention

Some email encryption tools require users to manually encrypt messages. If users forget to apply encryption or misconfigure settings, sensitive patient data could be exposed, leading to compliance violations and ePHI exfiltration.

For employees who handle ePHI and need to send encrypted emails, remembering to enable encryption (vs. automated encryption) is an extra step that introduces the risk of human error into the process. To offer a related, and more relatable, example: how many times have you forgotten to include an attachment when sending an email, even when referencing the attachment in the message? It’s all too easily done. In the same way, an inexperienced, tired, or distracted user could simply neglect to turn on or correctly configure encryption before sending an email, putting patient data at risk.

Increased IT and Administrative Overhead

The two email encryption challenges outlined above contribute to a third overarching difficulty for healthcare organizations: an increased workload for its IT, security and operations teams.

First of all, IT, security and operations must establish and continuously enforce encryption policies, configuring rules that ensure sensitive patient data is encrypted while non-sensitive, business communication continues to flow unobstructed. Misconfigured policies can cause over-encryption, resulting in user inaccessibility and disruptions, or under-encryption, leading to exposure of ePHI and HIPAA compliance violations.

Second, IT support teams must troubleshoot user issues: namely employees and external recipients who are unfamiliar with encryption protocols and need support in overcoming difficulties in message decryption. These could be caused by compatibility issues between different email clients or systems, expired or missing digital certificates, incorrect key exchanges, or confusion surrounding accessing encrypted messages through portals or attachments.

Lastly, IT and governance teams must keep up-to-date with changing regulatory updates and email security threats. As compliance requirements evolve, healthcare organizations must reassess encryption standards, upgrade outdated protocols, and ensure that their workforce adheres to best practices. Without an adequate strategy and the right systems in place, managing encryption can become a constant drain on IT bandwidth, taking personnel away from other aspects of their work that contribute to patient care.

Effective Strategies For Email Encryption

Having discussed the most common encryption challenges and how they can impact a company’s email security posture, let’s look at some of the most powerful mitigation strategies, which will improve the email encryption experience for both senders and recipients.

Balance Security With Ease of Use

To overcome the challenges of user inaccessibility, human error, and excessive administrative overhead, healthcare organizations must balance the ease of use of their encryption solutions with the level of security they provide.

While opting for the most secure encryption protocols intuitively seems like the best option, extra security often comes at the expense of usability, which can render the encryption irrelevant if users decide to circumvent it altogether, as outlined earlier. Instead, it’s essential to evaluate the sensitivity of message content and select a corresponding level of encryption.

Moving onto practical technical examples, Transport Layer Security (TLS) is a widely used email encryption standard, thanks to its ease of implementation and use, i.e., once activated, no further action is required by the user to encrypt the message content. However, TLS only encrypts ePHI in transit, i.e., when being sent to recipients, which may prove insufficient for highly sensitive patient data.

In contrast, encryption protocols such as Secure/Multipurpose Internet Mail Extensions (S/MIME), AES-256 and Pretty Good Privacy (PGP) provide more comprehensive encryption, safeguarding the ePHI contained in email communications both in transit and at rest, i.e., when stored in a database. Now, while this makes them more effective at securing patient data and achieving HIPAA compliance, these standards are more complicated to implement and to use than TLS encryption.

S/MIME requires users to obtain and install digital certificates from a Certificate Authority (CA), which verifies their respective identities and provides the public key for encryption. Consequently, both the sender and recipient must have valid certificates; if either party’s certificate is revoked or expires, they won’t be able to encrypt or decrypt the message, respectively.

With PGP, meanwhile, users must manually generate and exchange public/private keys. This offers greater flexibility than S/MIME but requires careful key management, which can be confusing for non-technical users. If a recipient doesn’t have the sender’s public key, they won’t be able to decrypt the message. Additionally, both S/MIME and PGP require a public key infrastructure (PKI), which can add considerable administrative overhead, particularly in regards to the management of certificates, public keys, and user credentials.

Accounting for this, healthcare organizations can balance security with accessibility by employing a tiered encryption strategy: using TLS for lower-risk communication while opting for S/MIME or PGP for more sensitive communications.

Enable Automatic Encryption

Subsequently, the challenge of balancing security with accessibility can be remediated by deploying an email delivery platform that not only removes the need for manual user intervention but also automatically applies the appropriate encryption standard based on message content and delivery conditions. Rather than relying on users to choose the correct method—or worse, bypass encryption altogether—modern email solutions like LuxSci can intelligently enforce encryption without affecting the user experience.

Many healthcare companies rely on TLS encryption because it eliminates the need for encryption keys or certificates, additional log-ins, etc. For this reason, it’s often referred to as ‘invisible encryption’ for its lack of effect on the user experience.

However, to be most effective, both the sender’s and recipient’s email servers must support enforced TLS (i.e., TLS 1.2 and above). In the event the recipient’s email server doesn’t support TLS, the email message will be delivered unencrypted or fail to send altogether, depending on the server configurations. Additionally, once the email is delivered to the recipient’s inbox, unless the recipient’s email infrastructure encrypts messages at rest, it will be stored in an unencrypted format.

Consequently, while TLS is ideal for email messaging that doesn’t contain highly sensitive ePHI, it’s insufficient for all healthcare communication. To ensure the secure and HIPAA compliant inclusion of patient data in emails, healthcare organizations should opt for an email solution that supports automated, policy-based encryption, which can upgrade to S/MIME or PGP when necessary. This offers the combined benefits of optimal ePHI security, minimal administrative burden, and removing the need for staff intervention.

Invest in Employee Education

While a flexible encryption policy and deploying email solutions that support automation will go a long way towards overcoming email encryption challenges, these efforts can still be undermined if users aren’t sufficiently educated on their benefits and use. For this reason, it’s crucial that healthcare companies take the time to educate their employees on both the how and why of email encryption.

Even the most advanced encryption systems can fail if employees don’t understand how to use them properly, as well as what to look out for in their day-to-day email use. Some aspects of email encryption, such as recognizing secure message formats or troubleshooting delivery issues, may still require user awareness. With this in mind, employee training programs should focus on recognizing when additional encryption measures are necessary, how to ask for assistance, the dangers of unsecured channels, and how to report suspicious activity in addition to the practical aspects of using your email delivery platform.

Overcome Email Encryption Challenges with LuxSci

LuxSci is a leader in secure healthcare communication, offering HIPAA compliant solutions that empower organizations to connect with patients securely and effectively. With over 20 years of expertise, we’ve facilitated the delivery of billions of encrypted emails for healthcare providers, payers, and suppliers.

Luxsci’s proprietary SecureLine encryption technology is specially designed to help healthcare organizations overcome frequent encryption challenges and better ensure HIPAA compliance with powerful, flexible encryption capabilities. Its features include:

Comprehensive email encryption: ensuring the encryption of patient data in transit and at rest.
Automated encryption: “set it and forget it” email encryption guarantees security and HIPAA compliance – with no action required on the part of users once configured.
Flexible encryption: dynamically determining the optimal level of email encryption, as per the recipient’s security posture, job role and supported encryption methods. This makes sure messages are delivered securely while maintaining HIPAA compliance.

Ready to take your healthcare email engagement to the next level? Contact LuxSci today!

New Reporting Features Go Deeper on Email Deliverability Statistics, Trends and Analysis

May 28, 2024
LuxSci

We recently rolled out new email reporting features, taking deliverability depth and analysis to new levels. If you’re a current LuxSci customer and haven’t checked them out, now’s the time. If you’re new to LuxSci, learn more below, and don’t hesitate to reach out for more info – or a demo.

LuxSci secure communications solutions have always featured rich reporting on email deliverability, including volumes and percentages for emails:

in queue
opened
clicked
failed
secured

With our latest release, we made these powerful statistics easier to consume and analyze with an improved user interface for more efficiency and greater ease-of-use. Users can simply select the type of report they’d like and customize it using a range of filtering selections. This is great for diving deeper into your email performance to make adjustments on-the-fly, and to spot trends or opportunities for better engagement that you may have missed before.

New UI – Email Deliverability Statistics

Get more granular, ID trends in real time with Split Reporting

As part of this release, we are pleased to introduce our Split Reporting feature, which empowers users to drill down on email deliverability statistics across a range of parameters, including:

subject
from address
recipient domains
marketing ID or campaign
custom field

For example, users can analyze email deliverability statistics by subject to determine which ones are performing best, by use case to track results by campaign, or to track performance by recipient email domains. With split reporting, users also can analyze email volumes across queued, delivered, opened, failed and clicked parameters, and determine click-through rates (CTR) to measure effectiveness and ROI of campaigns.

New Feature Example – Split Reporting by Recipient Domain

If you’d like to learn more, reach out and connect with us today!

What is a HIPAA Compliant Workspace?

December 4, 2024
Erik Kangas

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.