Send Secure Emails: Alternatives to Web Portals

Business Solutions, HIPAA Compliant Email, HIPAA Email Marketing
LuxSci
December 5, 2023

Digital technologies have entirely shifted how individuals want to interact with their healthcare providers. As consumers have become used to emailing or texting with their hairstylists, mechanics, and other providers to schedule appointments, they want to have the same level of interaction with their healthcare providers.

However, many healthcare organizations find it challenging to deliver the same experience because of their compliance requirements under HIPAA. They must balance usability and access with security and patient privacy. To send secure emails, they often resort to secure web portals.

Problems with Secure Web Portals

One of the most common ways that healthcare organizations communicate securely with patients is by using the secure web portal method of email encryption. In this scenario, messages are sent to a secure web server, and a notification is sent to the recipient, who then logs into the portal to retrieve the message.

While highly secure, this method is not popular with recipients because of the friction it creates.

To maintain a high level of security, users must log in to a separate account to retrieve the message. This extra step creates a barrier, especially for individuals who are not tech-savvy. In addition to creating a new account, they must remember a different username and password to access their secure messages. If the recipient doesn’t have this information readily available, they will likely delete the message and move on with their day. Many users will never bother logging in because of the inconvenience. This creates issues for organizations that want to use email for standard business communications and patient engagement efforts.

While this method may be appropriate for sending highly sensitive information like medical records, financial documents, and other valuable information, many emails that must meet compliance requirements only infer sensitive information and do not require such a high level of security. Flu shot reminder emails are not as sensitive or potentially devastating as sending the wrong medical file to someone. Healthcare organizations need to use secure email solutions that are flexible enough to send only the most sensitive emails to the portal and less sensitive emails using other methods.

How to Meet Compliance Requirements for Sending Secure Email

So, what other options do you have for sending secure emails? The answer will depend on what specific requirements you need to meet. Healthcare organizations that must abide by HIPAA regulations will find a lot of flexibility regarding the technologies they can use to protect ePHI in transit.

In addition to a secure web portal, three other types of encryption are suitable for email sending: TLS, PGP, and S/MIME. PGP and S/MIME are more secure than a web portal. They also require advanced technological skills and coordination with the end-user to implement, which makes them impractical for most business email sending.

That leaves us with TLS, which is suitable to meet most compliance standards (including HIPAA) and delivers an email experience much like that of a “regular” email.

Send Secure Emails with TLS Encryption

TLS encryption is an excellent option for secure email sending that provides a seamless experience for the recipient. Emails sent securely with TLS appear like regular, unencrypted emails in the recipient’s inbox.

TLS encrypts the message contents as they travel between mail servers to prevent interception and eavesdropping. Once the message reaches the inbox, it is unencrypted and can be read by anyone with access to the email account. For this reason, it is less secure than a portal but secure enough to meet compliance requirements like HIPAA.

If you’re wondering why this is, HIPAA only requires covered entities and business associates to protect PHI when it is stored on their systems or as it is transmitted elsewhere. After the message reaches the recipient, it is up to the recipient to decide what they want to do to secure the information. HIPAA does not apply to individuals. Each person is entitled to share and store their health information however they see fit.

Conclusion

Balancing security and usability is a significant challenge for healthcare organizations. If the message is too secure, it may be difficult for the recipient to open and engage with it. If it’s not secure enough, it is too easy for cybercriminals and other bad actors to intercept private information as it is sent across the internet.

Choosing an email provider like LuxSci, which offers flexible email encryption options, allows users to choose the right level of encryption for each message to maximize engagement and improve health outcomes. Contact our team today to learn more about how we can support your efforts.

LuxSci

Get in touch

Find The Best Solution For Your Organization

Talk To An Expert & Get A Quote

First Name

Last Name

Work Email

Phone

Company

Type of Inquiry

Company Size

Message (optional)

Acceptance

I consent to be contacted by LuxSci for this inquiry and other relevant content, products, and services. You may unsubscribe from these communications at any time. We're committed to your privacy. For more information, check out our Privacy Policy.

A member of our staff will reach out to you

Search

Get Your Free E-Book!

LuxSci High Email Deliverability Best Practices Paper

What you’ll learn:

Is OCR Already Enforcing Email Encryption Under the New HIPAA Security Rule?

May 12, 2026
Pete Wermter

Healthcare organizations waiting for the final HIPAA Security Rule updates before improving email encryption and security may already be behind.

While the proposed changes to the HIPAA Security Rule are expected to be finalized in May, the direction from the U.S. Department of Health and Human Services Office for Civil Rights (OCR) is becoming increasingly clear. Across investigations, settlements, and enforcement actions, OCR continues emphasizing stronger technical safeguards, encryption, documented security programs, multi-factor authentication (MFA), risk analysis, and proactive cybersecurity operations.

For healthcare organizations, one area stands directly in the middle of all of these priorities: email.

Email remains a primary communication channel in healthcare — and one of the industry’s largest security vulnerabilities. From unauthorized PHI exposure to phishing attacks and ransomware delivery to account compromise, email continues to be at the center of healthcare cybersecurity incidents.

So, are the proposed HIPAA Security Rule changes hypothetical future guidance or a preview of OCR’s future enforcement expectations?

For healthcare email security, the implications are significant.

Email = Healthcare Cybersecurity Risk

Healthcare organizations rely on email for critical communications and healthcare workflows, including:

Patient communications
Care coordination
Claims and billing notifications
Marketing and engagement
Internal collaboration
Third-party vendor communications
Delivery of sensitive PHI

At the same time, attackers continue targeting email systems because they remain one of the easiest entry points into healthcare environments.

Insecure email workflows create unnecessary exposure of protected health information. Phishing campaigns are becoming more sophisticated. Credential theft attacks are bypassing traditional MFA methods. And business email compromise (BEC) attacks continue rising.

Recent OCR enforcement actions increasingly reflect these realities.

Organizations are being evaluated not simply on whether a breach occurred, but whether they implemented reasonable safeguards beforehand, including encryption, authentication controls, monitoring, access management, and documented risk mitigation processes.

For email systems specifically, that means healthcare organizations should expect increased scrutiny around:

Email encryption enforcement
MFA deployment
Audit logging and retention
Conditional access policies
Vendor security controls
Secure email delivery best practices
Segmentation and infrastructure isolation
Ongoing patch and vulnerability management

In many ways, email infrastructure is becoming a visible test of an organization’s overall cybersecurity posture.

Email Encryption Is Moving From Addressable to Required

Historically, healthcare organizations often interpreted HIPAA email encryption requirements with flexibility because encryption was technically categorized as an “addressable” safeguard under the Security Rule. But, OCR enforcement and broader cybersecurity realities are changing that interpretation rapidly.

Today, failing to encrypt sensitive healthcare communications increasingly creates both security and regulatory risk. The proposed Security Rule updates place even greater emphasis on encryption and technical safeguards. At the same time, OCR investigations continue examining whether organizations properly protected PHI in transit and at rest.

For healthcare email specifically, this creates several growing expectations:

Email encryption should be automated wherever possible
Human error should not determine whether PHI is protected
Organizations should maintain documented encryption policies
Secure delivery methods should adapt dynamically to recipient capabilities
Audit trails should demonstrate how messages were secured

At LuxSci, we have long believed that encryption should operate as a strategic layer of healthcare communications infrastructure, not as a manual user decision.

Our SecureLine email encryption technology automatically applies appropriate encryption methods based on organizational policies and delivery requirements, helping reduce the risks associated with human error while maintaining usability, deliverability and compliance. As enforcement expectations rise, this type of automated security enforcement is becoming increasingly important.

Traditional MFA May No Longer Be Enough

Another major shift emerging from both OCR enforcement trends and the proposed rule updates is the growing importance of stronger authentication models.

Healthcare organizations have historically viewed MFA deployment as sufficient protection. But attackers have adapted quickly.

MFA bypass attacks, token theft, session hijacking, and consent phishing campaigns are increasingly targeting healthcare users. As a result, regulators and cybersecurity experts are placing greater emphasis on phishing-resistant authentication approaches and contextual access controls.

For email environments, organizations should increasingly evaluate:

Whether MFA methods are resistant to phishing attacks
Conditional access policies based on device, location, and behavior
Account monitoring and anomaly detection
Administrative access protections
Session management controls
Logging and authentication auditing

The broader message is clear: healthcare organizations need authentication strategies designed for today’s threat landscape, not yesterday’s compliance checklist.

OCR Wants Proof, Not Just Policies

One of the clearest trends emerging from recent OCR activity is the increasing importance of documentation and operational evidence. Healthcare organizations must increasingly demonstrate not only that safeguards exist, but that they are consistently enforced, monitored, tested, and maintained over time.

For email systems, organizations should be prepared to demonstrate:

Email encryption policies
MFA enforcement records
Audit logs and message tracking
Vendor security documentation
Risk assessments involving email infrastructure
Patch management procedures
Employee security awareness training
Incident response procedures for email-based threats

This represents a broader shift in healthcare cybersecurity expectations.

The question is no longer: “Do you have email security controls?”

The question is increasingly: “Can you prove they are operationally effective?”

Healthcare Organizations Need a New Email Security Strategy

The healthcare industry is entering a new phase of cybersecurity enforcement.

OCR’s direction is becoming increasingly clear: organizations are expected to proactively secure systems handling PHI using modern, documented, and continuously maintained safeguards. For email security specifically, that means organizations should stop treating encryption, MFA, and secure communications as optional compliance requirements. Instead, they should view secure email infrastructure as a strategic component of enterprise cybersecurity and patient trust.

At LuxSci, we help healthcare organizations modernize secure communications with HIPAA compliant email infrastructure designed specifically for healthcare environments, including flexible encryption, secure delivery, auditability, high deliverability, access controls, and dedicated infrastructure options.

The proposed HIPAA Security Rule updates may not yet be final. But, OCR is already signaling where healthcare cybersecurity enforcement is headed next. For organizations relying on email to communicate with patients, members, customers, and partners, the time to examine your secure email infrastructure is now.

Connect with our experts to learn more using the form at the top of this page!

LuxSci Launches Enterprise-Grade HIPAA Compliant Email Security for Mid-Sized Healthcare Organizations

May 5, 2026
Pete Wermter

New right-sized offering brings advanced encryption, easy API integration, and HITRUST-certified compliance to the most underserved segment in healthcare email — with pricing starting at $99/month

CAMBRIDGE, MA — May 5, 2026 — LuxSci, a leading provider of HIPAA compliant secure healthcare communications, today announced the launch of LuxSci Secure High Volume Email for mid-sized healthcare organizations, the industry’s trusted HIPPA-compliant email solution now packaged and priced for mid-size healthcare organizations. Regional health systems, health plans, specialty group practices, urgent care networks, and multi-site regional providers can now access LuxSci’s enterprise-grade email security and encryption infrastructure at published, volume-based pricing — with no custom quote required.

LuxSci Secure High Volume Email for mid-sized healthcare organizations delivers the same HITRUST CSF r2-certified email security and flexible encryption capabilities that power communications for some of the largest healthcare organizations in the industry, including Athenahealth, 1-800 Contacts, Hinge Health and Eurofins. The new LuxSci mid-sized offer is tiered and priced for organizations with email sending volumes of between 300 and 99,000 emails per month.

LuxSci Secure High Volume Email is built on the company’s proprietary SecureLine™ encryption technology, which automatically selects the optimal email encryption method — TLS, secure portal fallback, PGP, or S/MIME — on a per-recipient basis at the time of delivery, with no action required from senders or recipients. This intelligent, adaptive encryption method goes significantly beyond TLS-only or portal fallback models offered by basic platforms, giving mid-market healthcare organizations the flexibility and cybersecurity depth they need as HIPAA regulations tighten and email threats continue to get more sophisticated.

Key capabilities include:

Automatic email encryption via SecureLine™ — encrypt every email and its content, including Protected Health Information (PHI), with per-recipient adaptive encryption across TLS, portal fallback, PGP, and S/MIME.
Advanced REST API with webhooks for dataflows into your systems — supports unlimited messages/hour with failover, queuing, plus webhooks can push email engagement data back to EHRs, CRMs, RCM and customer data platforms.
Comprehensive audit logging and reporting — message-level tracking, delivery status, engagement reporting, and downloadable reports for compliance officers.
HITRUST CSF r2 certification, BAA, GDPR-compliant, and US-EU Privacy Framework agreement all included.
Microsoft 365 and Google Workspace overlay — use LuxSci’s Secure Email Gateway add-on to integrate directly with existing M365 or Google Workspace environments, adding HIPAA-compliant encryption without migration or user retraining.
HIPAA-compliant patient engagement — secure outbound email campaigns with PHI-powered hyper-segmentation, automated workflows, and personalized emails for marketing campaigns, proactive patient communications, appointment reminders, care gap outreach, new plan enrollments, healthcare education, and more — with LuxSci Secure Marketing add-on.

New Published LuxSci Pricing

LuxSci Secure High Volume Emai for mid-sized healthcare organizations features published pricing based on monthly sending volume:

Monthly Send Volume	Monthly Price
300 to 9,999 emails/month	$99/month
10,000 – 29,999 emails/month	$199/month
30,000 – 49,999 emails/month	$299/month
50,000 – 99,999 emails/month	$399/month
100,000+ emails/month	Custom

“Mid-size healthcare organizations have been underserved for too long, forced to choose between inadequate email security tools that weren’t built for healthcare and HIPAA compliance and enterprise level solutions that felt too big or too complex,” said Mark Leanord, CEO of LuxSci. “Our new secure email packaging for mid-sized organizations changes that. We’re making the same encryption depth, ease of integration into EHRs, CRMs and other systems, and compliance rigor that powers our largest customers accessible for mid-sized organizations to easily evaluate and buy.”

Timing and Market Context

The launch comes at a critical moment for mid-size healthcare organizations. The HHS HIPAA Security Rule overhaul, expected to finalize in mid-2026, is anticipated to mandate email encryption as a required safeguard, elevating email security from addressable best practice to a regulatory requirement for thousands of organizations that have not yet upgraded their email security and compliance posture. LuxSci secure email is designed to meet these requirements, backed by HITRUST CSF r2 certification and the company’s 20-year track record in secure healthcare communications.

Availability

LuxSci Secure Email for mid-sized healthcare organizations is available immediately. Pricing and product details are published here.

Users can contact LuxSci to set up a call or DEMO.

About LuxSci

LuxSci is a leading provider of secure healthcare communications solutions for the healthcare industry. The company offers secure email, marketing, forms and hosting, delivering HIPAA‑compliant communication solutions that enable organizations to safely manage and transmit sensitive data, including protected health information (PHI). Founded in 1999 and recently merged with digital care and telehealth provider Ovia Health, LuxSci serves more than 2,000 customers across healthcare verticals, including providers, payers, suppliers, and healthcare retail, home care providers, and healthcare systems, as well as organizations operating in other highly regulated industries. LuxSci is HITRUST‑certified with current customers including Athenahealth, 1800 Contacts, Lucerna Health, Eurofins, and Rotech Healthcare, among others.

###

Media Contact:
Pete Wermter, CMO

pwermter@luxsci.com

Patient Engagement ROI: The Business Case for Secure Email in Healthcare

April 28, 2026
Pete Wermter

Every IT investment in healthcare today is being evaluated through a sharper lens.

Budgets are tighter. Expectations are higher. AI is the shiny object. Across healthcare organizations, leadership is asking the same question: how does this investment drive measurable results?

That’s where Patient Engagement ROI comes in, and where many traditional approaches fall short.

The Hidden Cost of Ineffective Communication

Patient engagement isn’t just a healthcare priority. It’s a financial one.

Missed appointments, gaps in care, and low response rates all translate directly into increased costs, operational inefficiencies, and a poor patient experience. Yet many organizations still rely on fragmented, manual, or non-personalized communication strategies.

Why?

For many, it’s because of uncertainty around HIPAA compliance, and what’s allowed and not allowed. Too often, healthcare IT and marketing teams avoid using valuable patient data to avoid security and compliance risks, especially over the email channel. The result is often generic outreach that fails to connect, and fails to deliver meaningful results, such as better health outcomes, fewer missed appointments, and increased sales.

How Secure Email Delivers ROI in Healthcare

Among all healthcare IT investments, secure email stands out for one reason: it directly impacts both patient engagement and staff and process efficiency.

With the right HIPAA-compliant marketing automation platform, secure email enables organizations to:

Deliver personalized, relevant messages using PHI data in their emails
Automate outreach at scale with triggered, engagement-driven campaigns
Improve patient response rates and adherence for better outcomes
Reduce manual workload across teams for greater productivity

This is where patient engagement ROI becomes tangible.

Instead of one-size-fits-all messaging, organizations can connect with patients based on unique needs and health conditions, such as appointments, care plans, preventative care reminders, new product needs, and more. And because it’s automated, these improvements scale without adding to workloads.

Turning Compliance into Better Outcomes and Growth

HIPAA is often viewed as a constraint. In reality, it’s an opportunity. If you have the right tools.

At LuxSci, we focus exclusively on secure healthcare communications, helping organizations safely unlock the value of their data and communications. Our solutions are designed to remove the friction between compliance and communication, so you don’t have to choose between security and growth.

With capabilities like flexible encryption, advanced segmentation, and high-volume delivery, secure email marketing becomes more than a safeguard, it becomes a growth driver.

And with industry-leading security performance and recognition, organizations can trust that their communications are protected at every level with LuxSci.

Scaling Patient Engagement ROI with Automation

The real power of secure email comes when it’s combined with automated healthcare workflows.

HIPAA compliant marketing automation allows you to build multi-step, data-driven patient journeys that run continuously in the background, taking adaptive steps based on each individual’s email engagement activity. This can include:

Appointment reminders that reduce no-shows
Follow-up communications that improve outcomes
Preventative care outreach for check-ups, annual test and care reminders
New product offers, upgrades and promotions
Educational email campaigns that drive long-term engagement and better health

Each interaction is an opportunity to improve both patient experience and your financial performance. Over time, these incremental gains compound, resulting in significantly higher patient engagement that delivers real value to your business.

Why Act Now?

Healthcare organizations can no longer afford IT investments that don’t deliver clear, measurable value. Secure email, powered by HIPAA compliant marketing automation, offers one of the most direct paths to improving engagement, efficiency, and outcomes, all while maintaining the highest standards of security.

Ready to see how LuxSci secure email can transform your patient engagement into real ROI?

Connect with us today or book a demo to explore how HITRUST-certified, HIPAA-compliant marketing automation can work for your organization.

What Is B2B Marketing in Healthcare?

April 27, 2026
Erik Kangas

B2B marketing in healthcare describes the promotion of products and services to healthcare businesses rather than to patients or the public. The audience can include provider groups, payers, laboratories, medical suppliers, health technology firms, and service companies working across the sector. The work calls for a more measured approach than many other business categories because buying decisions tend to involve several stakeholders, internal review, and close attention to data handling, workflow impact, and commercial fit. Good execution depends on clear communication, useful content, and a strong sense of how healthcare organizations evaluate change.

Why healthcare buying requires a different approach

Healthcare companies rarely move through a buying process in a straight line. One person may open the conversation, though several others can influence whether it goes any further. Finance may want a clearer commercial case. Operations may focus on staffing, efficiency, and implementation pressure. IT may look at access, system fit, and data management. Compliance teams may review privacy implications or contractual language. B2B marketing in healthcare works better when the writing reflects those realities early. Buyers are looking for material that helps them assess risk, discuss options internally, and move forward with fewer unanswered questions.

A Difference in stakeholder priorities

A single account can contain several audiences at once. That is part of what makes this area demanding. A hospital operations leader may care about throughput and day to day workflow. A payer executive may be more interested in administrative efficiency or review times. A supplier may focus on coordination, ordering processes, or communication across partner relationships. Content becomes stronger when it takes those different perspectives seriously. The message does not need to become overly technical. It needs enough accuracy and relevance for each reader to feel that the company understands the conditions attached to their role.

Why credibility matters in every channel

Healthcare buyers tend to read promotional material carefully. They notice vague claims, inflated language, and unsupported promises very quickly. That is why credibility has to be built into the writing itself. A clean explanation of a business problem can carry real weight. A grounded case example can help a reader picture how a solution would work in practice. Clear language around implementation, support, privacy, or service structure can also help keep the conversation moving. When protected health information enters the picture, HIPAA may become part of the review as well, especially for companies handling regulated data or supporting covered entities and business associates.

Content to support real decisions

The most useful assets in this space are the ones that help buyers think more clearly. An article can frame a problem in a way that supports internal discussion. An email sequence can keep a company visible while review is taking place. A service page can answer practical questions before a meeting is booked. B2B marketing in healthcare gains traction when content has a clear job and a clear reader. That focus usually produces stronger engagement than broad copy built around generic thought leadership language. Buyers respond well to material that respects their time and gives them something worth passing along.

What strong performance looks like

Success in healthcare is rarely captured by surface numbers alone. Traffic and opens may show that content has reached people, though those signals do not say much on their own about buying intent. Better indicators include repeat visits from the same organization, replies from relevant contacts, deeper engagement with security or implementation pages, and growing activity across several stakeholders in one account. Those patterns can tell commercial teams where interest is becoming more serious. B2B marketing in healthcare proves its value when it helps those teams follow up with better timing, better context, and material that fits the next stage of evaluation.

What are the Three Levels of Patient Engagement?

October 25, 2024
Erik Kangas

Patient engagement occurs across three levels: consultation, involvement, and partnership. These progressive levels describe how patients interact with healthcare systems and participate in their care decisions. Healthcare organizations design communication strategies, technologies, and care models to move patients through these engagement levels, ultimately improving health outcomes and patient satisfaction while reducing costs.

The Consultation Level of Patient Engagement

The consultation level marks the starting point for patient engagement in most healthcare settings. At this level, patients receive information about their health conditions and treatment options from healthcare providers. Communication flows primarily from provider to patient, with limited opportunity for patient input. Patients ask basic questions about their care but generally follow provider recommendations without substantial discussion. Healthcare organizations implement patient portals and educational materials to support information sharing at this level. Appointment reminders and basic health tracking tools help patients follow prescribed care plans. The consultation level of patient engagement meets minimum standards for informed consent but doesn’t fully utilize patient knowledge and capabilities in the care process.

The Involvement Level of Patient Engagement

As patients move to the involvement level of engagement, they become more active participants in their healthcare decisions. Providers seek patient input about preferences and priorities when developing treatment plans. Patients regularly track health metrics and report symptoms between appointments using digital tools and paper logs. Care teams establish two-way communication channels through secure messaging and follow-up calls. Patients receive education about their conditions that enables them to make more informed choices about treatment options. Healthcare organizations measure involvement through metrics like patient portal usage, appointment attendance, and treatment plan adherence. The involvement level of patient engagement creates more personalized care experiences while improving clinical outcomes through better treatment adherence and earlier problem identification.

The Partnership Level of Patient Engagement

The partnership level is the most advanced form of patient engagement, where patients function as true collaborators with their healthcare team. Patients and providers make decisions jointly, with providers offering medical expertise while respecting patient values and preferences. Care planning becomes a shared activity with mutually established goals and responsibilities. Patients access and contribute to their health records, adding context to clinical data. Healthcare organizations include patient advisors in program development and quality improvement initiatives. Technology platforms support robust data sharing between patients and providers, integrating patient-generated health data with clinical systems. The partnership level of patient engagement transforms the traditional healthcare hierarchy into a collaborative relationship that recognizes patients’ expertise about their own health experiences.

Factors Influencing Patient Engagement Levels

Several factors determine which level of patient engagement an individual can achieve at any given time. Health literacy affects patients’ ability to understand medical information and participate in decision-making. Cultural backgrounds influence expectations about patient-provider relationships and appropriate levels of involvement. Digital access and technology skills impact how effectively patients can use engagement tools. Chronic conditions often motivate higher engagement levels as patients develop expertise managing long-term health issues. Healthcare system design either facilitates or creates barriers to engagement through appointment scheduling, communication policies, and information accessibility. Provider communication styles and willingness to share decision-making power affect how comfortable patients feel increasing their engagement level.

Measuring Patient Engagement Across Levels

Healthcare organizations use various metrics to assess patient engagement at each level. Survey tools like the Patient Activation Measure (PAM) quantify patients’ knowledge, skills, and confidence in managing their health. Digital platform analytics track how patients interact with portals, mobile apps, and communication tools. Care plan adherence rates indicate how actively patients follow recommended treatments and lifestyle changes. Patient-reported outcome measures capture health improvements resulting from engagement activities. Healthcare utilization patterns often shift as engagement levels increase, with fewer emergency visits and more appropriate preventive care. These measurement approaches help organizations track progress in their patient engagement initiatives and identify areas needing improvement.

Strategies for Advancing Patient Engagement

Healthcare organizations implement targeted strategies to help patients advance through engagement levels. Communication training for clinical staff develops skills in shared decision-making and patient activation. Technology selection focuses on tools accessible to diverse patient populations with varying digital literacy. Care team redesign creates roles dedicated to patient education and self-management support. Process improvements reduce barriers to engagement by simplifying scheduling, communication, and information access. Population segmentation allows for personalised engagement approaches based on patient characteristics and needs. Incentive structures for both providers and patients reward activities that increase engagement levels. Through these strategic approaches, healthcare organizations create environments where patients can progress toward more active participation in their healthcare.

Benefits of Advancing Patient Engagement Levels

Moving patients to higher engagement levels creates substantial benefits for individuals and healthcare systems. Patients experience improved health outcomes as they become more knowledgeable and confident managing their conditions. Clinical quality measures improve through better treatment adherence and more effective care planning. Healthcare costs often decrease with reductions in unnecessary services and better chronic disease management. Patient satisfaction increases when care aligns more closely with individual preferences and priorities. Provider satisfaction improves through more productive interactions and shared responsibility for health outcomes. Healthcare organizations that successfully advance patient engagement across all three levels position themselves for success in value-based payment models that reward better outcomes and patient experiences.

What Is HIPAA Compliant Email Hosting?

April 5, 2025
Erik Kangas

HIPAA compliant email hosting provides secure email infrastructure that meets HIPAA Security Rule requirements for protecting electronic protected health information (ePHI). These hosting services implement administrative, physical, and technical protections while offering business associate agreements to healthcare organizations that need to transmit patient data via email communications. Healthcare providers rely heavily on email for patient communications, care coordination, and administrative tasks. Standard email hosting services lack the security controls and compliance features needed to protect PHI, making specialized HIPAA hosting solutions necessary for organizations handling sensitive health information.

Security Infrastructure Requirements

HIPAA compliant email hosting requires a security architecture that protects data at rest and in transit. Hosting providers must implement encryption protocols, access controls, and network security measures that meet or exceed HIPAA technical safeguards specifications. Data center facilities housing HIPAA compliant email servers need physical security controls including biometric access systems, surveillance cameras, and environmental protections. These facilities maintain certifications like SOC 2 Type II to show their commitment to security and operational excellence.

Network infrastructure must include firewalls, intrusion detection systems, and secure communication channels that prevent unauthorized access to email data. Hosting providers regularly implement network segmentation to isolate healthcare client data from other customers and security threats.

Business Associate Agreement Obligations

Healthcare organizations using third-party email hosting services must establish business associate agreements (BAAs) with their hosting providers. These contracts outline how the hosting company will protect PHI and comply with HIPAA regulations on behalf of the healthcare organization. Hosting providers accepting BAA responsibilities agree to implement appropriate security measures, report potential breaches, and allow healthcare organizations to audit their compliance practices. The BAA also limits how hosting companies can use or disclose PHI beyond the services specified in the agreement.

Liability provisions within BAAs help protect healthcare organizations from compliance violations caused by hosting provider security failures. Healthcare organizations remain responsible for ensuring their hosting providers maintain adequate security controls and comply with HIPAA requirements.

Data Backup and Recovery Capabilities

HIPAA compliant email hosting services must provide reliable backup and disaster recovery systems that protect against data loss while maintaining security controls. These systems ensure healthcare organizations can restore email communications and maintain business continuity after technical failures or security incidents. Backup procedures need encryption and access controls that match the security standards applied to primary email data. Hosting providers typically maintain multiple backup copies across geographically distributed facilities to protect against localized disasters or system failures.

Recovery time objectives and recovery point objectives help healthcare organizations evaluate hosting provider capabilities and ensure service levels meet their operational needs. Many providers offer guaranteed recovery times and service level agreements that include financial penalties for failing to meet performance commitments.

Email Server Administration and Maintenance

Managed email hosting services handle server administration tasks including software updates, security patches, and performance optimization. This approach helps healthcare organizations maintain HIPAA compliance without requiring internal technical expertise for email infrastructure management. Server maintenance activities must follow change control procedures that document modifications and assess potential security impacts. Hosting providers schedule maintenance during off-peak hours to minimize disruptions to healthcare operations and patient communications.

Performance tracking helps ensure email systems can handle healthcare organization communication volumes without delays that might impact patient care. Hosting providers monitor server resources, email delivery rates, and system availability to identify potential issues before they affect service quality.

Integration with Healthcare Applications

HIPAA compliant email hosting platforms often provide APIs and integration capabilities that connect with electronic health record systems, practice management software, and other healthcare applications. These integrations enable automated email communications while maintaining security and compliance controls. Directory services allow healthcare organizations to manage user accounts and access permissions centrally. Integration with existing authentication systems like Active Directory helps maintain consistent security policies across all organizational technology resources.

Email archiving features help healthcare organizations meet record retention requirements while providing search capabilities for compliance audits and legal discovery requests. These archives maintain the same security controls as active email data and provide long-term storage for regulatory compliance.

Cost Structure and Service Models

HIPAA compliant email hosting services typically use subscription-based pricing models that scale with the number of users or email volumes. Pricing often includes security features, compliance support, and administrative services that would require significant internal resources to implement independently. Hosted solutions eliminate the capital expenses associated with purchasing and maintaining email server hardware. Healthcare organizations can redirect IT budget from infrastructure costs toward other patient care priorities while ensuring email communications remain secure and compliant.

Service level agreements define hosting provider responsibilities and performance guarantees. These agreements generally include uptime commitments, support response times, and security incident response procedures that help healthcare organizations plan their operations and ensure reliable email communications.

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

March 3, 2025
Pete Wermter

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:

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.
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.
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.
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.
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.
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.

How to Secure SMTP Email Delivery with TLS

August 29, 2023
Erik Kangas

Secure email sending is a priority for organizations that communicate sensitive data externally. One of the most common ways to send secure emails is with SMTP TLS. TLS stands for Transport Layer Security and is the successor of SSL (Secure Socket Layer). TLS is one of the standard ways that computers on the internet transmit information over an encrypted channel. In general, when one computer connects to another computer and uses TLS, the following happens:

Computer A connects to Computer B (no security)
Computer B says “Hello” (no security)
Computer A says, “Let’s talk securely over TLS” (no security)
Computers A and B agree on how to do this (secure)
The rest of the conversation is encrypted (secure)

In particular:

The conversation is encrypted
Computer A can verify the identity of Computer B (by examining its SSL certificate, which is required for this dialog)
The conversation cannot be eavesdropped upon (without Computer A knowing)
A third party cannot modify the conversation
Third parties cannot inject other information into the conversation.

TLS and SSL help make the internet a more secure place. One popular way to use TLS is to secure SMTP to protect the transmission of email messages between servers.

Secure SMTP Email Delivery with TLS

The mechanism and language by which one email server transmits email messages to another email server is called Simple Mail Transport Protocol, or SMTP. For a long time, email servers have had the option of using TLS to transparently encrypt the message transmission from one server to another.

When available, using TLS with SMTP ensures the message contents are secured during transmission between the servers. Unfortunately, not all servers support TLS! Many email providers, especially free or public ones, have historically not supported TLS. Thankfully, the trend is shifting. LuxSci found that most providers now support TLS- approximately 85% of domains tested as of July 2022.

Using TLS requires that the server administrators:

purchase SSL certificates
configure the email servers to use them (and keep these configurations updated)
allocate additional computational resources on the email servers involved.

For TLS transmission to be used, the destination email server must offer support for TLS, and the sending computer or server must be configured to use TLS connections when possible.

The sending computer or server could be configured for:

No TLS: never use it.
Opportunistic TLS: use it if available; if not, send it insecurely.
Forced TLS: use TLS or do not deliver the email at all.

How Secure is Email Delivery over SMTP TLS?

TLS protects the transmission of the email message contents. It does nothing to protect the security of the message before it is sent or after it arrives at its destination. For that, other encryption mechanisms may be used, such as PGP, S/MIME, or storage in a secure portal.

For sending sensitive information to customers, transmission security is the minimum standard for compliance with healthcare and financial regulations. TLS is appropriate to meet most compliance requirements and offers an excellent alternative to more robust and less user-friendly encryption methods (like PGP and S/MIME).

There are different versions of TLS- 1.0 and 1.1 use older ciphers and are not as secure, while TLS 1.2 and 1.3 use newer ciphers and are more secure. When an email is sent, the level of TLS used is as secure as can be negotiated between the sending and receiving servers. If they both support strong encryption (like AES 256), then that will be used. If not, a weaker grade of encryption may be used. The sending and receiving servers can choose the types of encryption they will support. If there is no overlap in what they support, then TLS will fail (this is rare).

What About Replies to Secure Messages?

Let’s say you send a message to someone that is securely delivered to their inbox over TLS. Then, that person replies to you. Will that reply be secure? This may be important if you are communicating sensitive information. The reply will use TLS only if:

The recipient’s servers support TLS for outbound email (there is no way to test this externally).
The mail servers (where the “From” or “Reply” email address is hosted) support TLS for inbound email.
Both servers support overlapping TLS ciphers and protocols and can agree on a mutually acceptable means of encryption.

Unless familiar with the providers in question, it cannot be assumed that replies will use TLS. So, what should you do? Ultimately, it depends on what compliance standards you must meet, the level of risk you are willing to accept, and the types of communications you send. There are two general approaches to this question:

Conservative. If replies must be secure in all cases, assuming TLS will be used is unreasonable. In this case, a more secure method should be used to encrypt the messages in transit and store them upon arrival. The recipient must log in to a secure portal to view the message and reply securely. Alternatively, PGP or S/MIME could be used for additional security.
Aggressive. In some compliance situations like HIPAA, healthcare providers must ensure that ePHI is sent securely to patients. However, patients are not beholden to HIPAA and can send their information insecurely to anyone they want. If the patient’s reply is insecure, that could be okay. For these reasons, and because using TLS for email security is so easy, many do not worry about the security of email replies. However, this should be a risk factor you consider in an internal security audit. Consider nuanced policies that allow you to send less sensitive messages with TLS while sending more sensitive messages with higher security.

What are the Weaknesses of SMTP TLS?

As discussed, SMTP TLS has been around for a long time and has recently seen a great deal of adoption. However, it has some deficiencies compared to other types of email security:

There is no mandatory support for TLS in the email system.
A receiver’s support of the SMTP TLS option can be trivially removed by an active man-in-the-middle because TLS certificates are not actively verified.
Encryption is not used if any aspect of the TLS negotiation is undecipherable/garbled. It is very easy for a man-in-the-middle to inject garbage into the TLS handshake (which is done in clear text) and have the connection downgraded to plain text (opportunistic TLS) or have the connection fail (forced TLS).
Even when SMTP TLS is offered and accepted, the certificate presented during the TLS handshake is usually not checked to see if it is for the expected domain and unexpired. Most MTAs offer self-signed certificates as a pro forma. Thus, in many cases, one has an encrypted channel to an unauthenticated MTA, which can only prevent passive eavesdropping.

The Latest Updates to Secure SMTP TLS

Some solutions help remedy these issues—for example, SMTP Strict Transport Security. SMTP STS enables recipient servers to publish information about their SMTP TLS support in their DNS. This prevents man-in-the-middle downgrades to plain text delivery, ensures more robust TLS protocols are used, and can enable certificate validation.

In addition, users can adopt TLS 1.3. NIST recommends that government agencies develop migration plans to support TLS 1.3 by January 1, 2024. LuxSci supports both SMTP MTA-STS and TLS 1.3.

How Secure SMTP TLS Email Works with LuxSci

Inbound TLS

LuxSci’s inbound email servers support TLS for encrypted inbound email delivery from any sending email provider that also supports that. For selected organizations, LuxSci also locks down its servers to only accept email from them if delivered over TLS.

Outbound Opportunistic TLS

LuxSci’s outbound email servers will always use TLS with any server that claims to support it and with whom we can talk TLS v1.0+ using a strong cipher. The message will not be sent securely if the TLS connection to such a server fails (due to misconfiguration or no security protocols in common). Outbound opportunistic TLS encryption is automatic for all LuxSci customers, even those without SecureLine.

Forced TLS

When Forced TLS is enabled, the message is either dropped or sent with an alternate form of encryption if the recipient’s server does not support TLS. This ensures that messages will never be sent insecurely. Forced TLS is also in place for all LuxSci customers sending to banks and organizations that have requested that we globally enforce TLS to their servers.

Support for strong encryption

LuxSci’s servers will use the strongest encryption supported by the recipient’s email server. LuxSci servers will never employ an encryption cipher that uses less than 128 bits (they will fail to deliver rather than deliver via an excessively weak encryption cipher), and they will never use SSL v2 or SSL v3.

Does LuxSci Have Any Other Special TLS Features?

When using LuxSci SecureLine for outbound email encryption:

SMTP MTA STS: LuxSci’s domains support SMTP MTA STS, and LuxSci’s SecureLine encryption system leverages STS information about recipient domains to improve connection security.
Try TLS: Account administrators can have secure messages “try TLS first” and deliver that way. If TLS is unavailable, the messages would fall back and use more secure options like PGP, S/MIME, or Escrow. Email security is easy, seamless, and automatic when communicating internally or with others who support TLS.
TLS Exclusive: This is a special LuxSci-exclusive TLS sending feature. TLS Exclusive is just like Forced TLS, except that messages that can’t connect over TLS are just dropped. This is ideal for low-importance emails that must still be compliant, like email marketing messages in healthcare. In such cases, the ease of use of TLS is more important than receiving the message.
TLS Only Forwarding: Account administrators can restrict any server-side email forwarding settings in their accounts from allowing forwarding to any email addresses that do not support TLS for email delivery.
Encryption Escalation: Often, TLS is suitable for most messages, but some messages need to be encrypted using something stronger. LuxSci allows users to escalate the encryption from TLS to Escrow with a click (in WebMail) or by entering particular text in the subject line (for messages sent from email programs like Outlook).
Domain Monitoring: When TLS delivery is enabled for SecureLine accounts, messages will never be insecurely sent to domains that purport to be TLS-enabled, i.e., TLS delivery is enforced and no longer “opportunistic.” The system monitors these domains and updates their TLS-compliance status daily.
Double Encryption: Messages sent using SecureLine and PGP or S/MIME will still use Opportunistic TLS whenever possible for message delivery. In these cases, messages are often “double encrypted.” First, they are encrypted with PGP or S/MIME and may be encrypted again during transport using TLS.
No Weak TLS: Unlike many organizations, LuxSci’s TLS support for SMTP and other servers only supports those protocol levels (e.g., TLS v1.0+) and ciphers recommended by NIST for government communications and which are required for HIPAA. So, all communications with LuxSci servers will be over a compliant implementation of TLS.

For customers who can use TLS to meet security or compliance requirements, it enables seamless security and “use of email as usual.” SecureLine with Forced TLS enables clients to take advantage of this level of security whenever possible while automatically falling back to other methods when TLS is unavailable.

Of course, using Forced TLS as the sole method of encryption is optional; if your compliance needs are more substantial, you can turn off TLS-Only delivery or restrict it so that it is used only with specific recipients.

If your email use cases are complicated, LuxSci’s flexibility enables the secure sending of emails to any recipient, regardless of their email service provider’s support for TLS. Contact the LuxSci sales team to learn more about our secure SMTP TLS email sending.