LuxSci

What is HIPAA Compliant Software?

HIPAA Marketing Guidelines

HIPAA compliant software includes applications designed to protect patient information according to the requirements established in the HIPAA Security Rule. This specialized software incorporates encryption, access controls, audit logging, and other security features that safeguard electronic protected health information. While no software is inherently HIPAA compliant without proper implementation, these programs provide the necessary functionality for healthcare organizations to maintain regulatory compliance while using digital tools for patient care and administration.

HIPAA Compliant Software Security Requirements

HIPAA compliant software must incorporate several fundamental security capabilities to protect patient information. Strong encryption should secure data both at rest and during transmission between systems, preventing unauthorized access to sensitive details. Authentication systems should verify user identities through robust password requirements, and ideally incorporate multi-factor verification for additional protection. Access controls must restrict which users can view specific information based on their job responsibilities and legitimate need to know. When properly configured, these security elements establish the foundation for maintaining patient data confidentiality in digital healthcare environments.

User Authentication and Access Management

HIPAA compliant software implements sophisticated user controls that maintain accountability for patient data access. Role-based permissions allow administrators to assign appropriate access levels that match staff job functions while preventing unnecessary exposure to sensitive information. Automatic timeout features terminate sessions after periods of inactivity to prevent unauthorized access on unattended devices. Password management enforces complexity requirements, regular changes, and account lockout after failed attempts. Many healthcare applications now include single sign-on capabilities that maintain security while reducing the burden of managing multiple credentials across different systems.

Audit Trail Functionality

HIPAA regulations require maintaining detailed records of who accesses protected health information and when these interactions occur. HIPAA compliant software creates comprehensive audit trails documenting user activities, including logins, information viewing, modifications, and data exports. These logs record the user identity, timestamp, and specific actions performed on patient records. Administrators can generate reports showing access patterns and investigate unusual activities that might indicate privacy violations. The software preserves these audit logs for extended periods, typically several years, to support compliance verification during audits or investigations of potential security incidents.

Data Transmission for HIPAA Compliant Software

HIPAA compliant software safeguards patient information throughout its lifecycle using various protection mechanisms. Transport Layer Security (TLS) encrypts data during network transmission, preventing interception by unauthorized parties. Secure storage utilizes encryption algorithms that render information unreadable without proper decryption keys. Backup processes maintain data availability while preserving security protections. Many applications include data loss prevention features that identify and block potential unauthorized transfers of patient information. These protections ensure patient data remains secure whether actively used, stored in databases, or moving between healthcare systems.

Breach Notification Support

HIPAA compliant software should include tools that help organizations meet their breach notification obligations under the HIPAA Breach Notification Rule. Monitoring capabilities detect potential unauthorized access or data exfiltration attempts. Reporting features help document the scope and impact of possible breaches. Some applications incorporate risk assessment tools that evaluate whether detected incidents meet regulatory thresholds for reportable breaches. These capabilities allow healthcare organizations to respond appropriately to potential security incidents, including notifying affected individuals and regulatory authorities when required by law.

Vendor Agreement and Documentation

Beyond technical features, HIPAA compliant software vendors should provide appropriate documentation and contractual support. Business Associate Agreements establish the vendor’s responsibilities for protecting healthcare information under HIPAA regulations. Compliance documentation explains how the software meets security requirements and recommended configuration settings. Implementation guides outline proper setup procedures to maintain compliance. Support services include assistance with security-related questions and updates addressing emerging vulnerabilities. When evaluating software, healthcare organizations should consider both technical capabilities and vendor support for maintaining long-term compliance.

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How to Set Up HIPAA Compliant Email

How to Set Up HIPAA Compliant Email

Learning how to set up HIPAA compliant email involves selecting appropriate secure email platforms, configuring encryption settings, implementing access controls, and establishing proper business associate agreements with service providers. Healthcare organizations must ensure their email systems meet all HIPAA Security Rule requirements before transmitting any protected health information electronically. The setup process requires careful planning of security configurations, user authentication protocols, and audit logging capabilities that protect patient data throughout transmission and storage.

Platform Selection and Service Provider Evaluation

Choosing the right email service provider is the first step in establishing how to set up HIPAA compliant email. Healthcare organizations evaluating providers must verify their ability to sign comprehensive business associate agreements that specify exactly how patient information will be protected during transmission and storage. The provider’s data centers should maintain appropriate physical security measures, including biometric access controls, environmental monitoring, and redundant power systems that ensure continuous email availability without compromising security.

Service provider certifications provide valuable insight into their security capabilities and compliance experience. SOC 2 Type II audits demonstrate that providers maintain appropriate controls for security, availability, and confidentiality of customer data. HITRUST certification specifically addresses healthcare security requirements and indicates that the provider understands the unique compliance challenges facing healthcare organizations. These certifications should be current and available for review during the vendor selection process.

Geographic data residency requirements may influence provider selection depending on organizational policies and patient preferences. Some healthcare organizations prefer email providers that maintain all servers within United States borders to simplify compliance with various state privacy laws. International providers may offer cost advantages but require additional due diligence to ensure their data handling practices meet American healthcare privacy standards.

Scalability considerations affect long-term success when healthcare organizations experience growth or changes in email usage patterns. Email systems should accommodate increasing numbers of users, higher message volumes, and integration with additional healthcare applications without requiring complete system replacements. Healthcare organizations benefit from understanding how to set up HIPAA compliant email systems that can adapt to changing operational needs while maintaining security standards.

Security Configuration and Encryption Setup

Encryption configuration forms the cornerstone of secure healthcare email systems. Advanced Encryption Standard (AES) 256-bit encryption should activate automatically for all outgoing messages containing patient information, eliminating the risk of staff forgetting to enable security features manually. Transport Layer Security (TLS) 1.2 or higher protocols must secure all connections between email servers, preventing message interception during transmission across public internet networks.

Digital certificate management ensures that email recipients can verify sender authenticity while maintaining message integrity during transmission. Healthcare organizations learning how to set up HIPAA compliant email need certificate authorities that provide reliable identity verification services for their email communications. Certificate renewal processes should operate automatically to prevent service interruptions that could compromise email security or availability.

Key management protocols protect encryption keys from unauthorized access while ensuring legitimate users can decrypt necessary patient communications. Encryption keys should rotate automatically at predetermined intervals, with secure backup procedures that prevent data loss if primary key storage systems fail. Healthcare organizations must maintain documented procedures for key recovery that balance security requirements with operational necessity.

Message archiving configurations must preserve encrypted email communications for required retention periods while maintaining searchability for audit and legal discovery purposes. Archive systems need the same encryption protections as active email systems, with access controls that limit retrieval to authorized personnel. Backup procedures should test data recovery capabilities while ensuring archived communications remain encrypted throughout the backup and restoration process.

User Access Controls and Authentication

Multi-factor authentication provides essential protection for healthcare email accounts containing patient information. Users should provide at least two forms of identification before accessing their email accounts, typically combining passwords with mobile device verification codes, biometric scans, or hardware security tokens. Authentication systems must integrate smoothly with existing healthcare information systems to avoid creating workflow disruptions that might encourage staff to circumvent security measures.

Role-based access permissions ensure that healthcare staff can only view patient communications relevant to their job responsibilities. Physicians need different access levels compared to billing staff or administrative personnel, with granular controls that prevent unauthorized viewing of patient information outside individual care relationships. Access controls should automatically adjust when staff members change roles within the organization or transfer between departments with different patient access requirements.

Session management protocols track user activities within email systems and automatically terminate inactive sessions to prevent unauthorized access from unattended workstations. Session timeout periods should balance security requirements with operational efficiency, allowing sufficient time for healthcare staff to compose thoughtful patient communications without creating security vulnerabilities. Login attempt monitoring detects potential account compromise situations and triggers appropriate security responses.

Password policies must enforce requirements while avoiding overly burdensome rules that encourage staff to write down passwords or reuse credentials across multiple systems. Password managers can help healthcare staff maintain unique, complex passwords for their email accounts while integrating with single sign-on systems that reduce authentication friction. Organizations mastering how to set up HIPAA compliant email often implement password policies that emphasize length over complexity to improve both security and usability.

Business Associate Agreements and Legal Requirements

Comprehensive business associate agreements define the legal framework for email service provider relationships with healthcare organizations. These agreements must specify exactly how the provider will protect patient information, what uses and disclosures are permitted, and detailed procedures for reporting security incidents to the healthcare organization. Agreement terms should address data retention requirements, geographic restrictions on data storage, and procedures for returning or destroying patient information when business relationships terminate.

Liability allocation clauses protect healthcare organizations from financial exposure when email security incidents occur due to provider negligence or system failures. Insurance requirements ensure that email service providers maintain adequate cyber liability coverage to address potential damages from data breaches or privacy violations. Healthcare organizations should verify that provider insurance policies specifically cover HIPAA-related claims and regulatory penalties.

Audit rights allow healthcare organizations to verify that their email providers maintain appropriate security controls and comply with business associate agreement terms. These rights should include access to security audit reports, penetration testing results, and compliance certifications relevant to healthcare data protection. Regular audit schedules help healthcare organizations demonstrate due diligence in vendor oversight during regulatory inspections or legal proceedings.

Termination procedures specify how patient information will be handled when email service relationships end, whether due to contract expiration, service dissatisfaction, or provider business closure. Data return requirements should include specific timelines for transferring patient communications to new email systems, with verification that all copies of patient information are securely destroyed from provider systems. Those understanding how to set up HIPAA compliant email recognize that termination planning prevents patient information from remaining in unsupported systems after service relationships end.

Implementation Planning and Testing

Staff training programs must prepare healthcare workers to use secure email systems effectively while maintaining patient privacy throughout all communications. Training should cover how to recognize secure email platforms, procedures for verifying recipient identities before sending patient information, and guidelines for determining what health information is appropriate for email transmission. Healthcare staff need clear decision-making frameworks that help them choose between email communication and more secure alternatives like telephone calls or encrypted patient portals.

Pilot testing allows healthcare organizations to identify potential issues before implementing email systems organization-wide. Pilot programs should include representative users from different departments and roles to ensure the email system meets diverse operational needs. Testing scenarios should verify that encryption activates properly, access controls function as designed, and audit logging captures all necessary security events for compliance monitoring.

Integration planning addresses how secure email systems will connect with existing electronic health records, practice management software, and other healthcare applications. Data flow mapping helps identify potential security gaps where patient information might transmit between systems without appropriate encryption protection. Healthcare organizations learning how to set up HIPAA compliant email must ensure that all system integrations maintain the same security standards as the primary email platform.

Rollout schedules should phase email system implementation to minimize workflow disruptions while allowing adequate time for user adaptation and troubleshooting. Support procedures must provide healthcare staff with readily available assistance during the transition period when questions about secure email usage are most frequent. Documentation requirements include maintaining records of all configuration settings, security tests, and staff training activities that show compliance with HIPAA requirements.

Monitoring and Maintenance Procedures

When learning how to set up HIPAA compliant email, it is important to know that audit logging systems must capture detailed records of all email activities, including message sending and receiving times, user login attempts, and administrative actions within the email system. Log retention policies should maintain audit records for required periods while ensuring that log storage systems have the same security protections as the primary email platform. Healthcare organizations need procedures for reviewing audit logs to identify potential security incidents or unauthorized access attempts.

Security monitoring tools should provide real-time alerts when unusual email activities occur, such as large volumes of outbound messages, login attempts from unusual locations, or repeated authentication failures. Automated monitoring reduces the burden on healthcare IT staff while ensuring that potential security incidents receive prompt attention. Alert thresholds must balance sensitivity with operational practicality to avoid overwhelming staff with false alarms.

Performance monitoring tracks email system availability, message delivery times, and user satisfaction to ensure that security measures do not create unacceptable operational barriers. Healthcare organizations mastering how to set up HIPAA compliant email balance security requirements with usability needs, recognizing that overly complex systems may encourage staff to find workarounds that compromise patient privacy. Regular performance assessments help identify opportunities to improve both security and user experience within secure email systems.

G2 Reports

LuxSci Earns 11 Badges in G2 Fall 2025 Reports, Including Best Support and Momentum Leader

We’re happy to share that LuxSci has once again been recognized for excellence in the G2 Fall 2025 Reports! Based entirely on verified customer reviews, LuxSci earned 11 G2 badges this season, highlighting our continued commitment to providing exceptional support, driving ROI for our customers, and delivering the best products.

 

From Best Estimated ROI to Momentum Leader, our performance on G2 is a direct reflection of the trust and success of our customers. Let’s take a closer look at what these new accolades mean and why they matter.

What Is G2 and Why Does It Matter?

G2.com is a trusted platform for peer-to-peer business software reviews. G2 publishes quarterly reports that analyze software companies based on verified customer feedback and real-world performance data. For the latest G2 reports, we’re honored to have earned 11 badges for Fall 2025.

Here’s What LuxSci Earned in Fall 2025

LuxSci was awarded a total of 11 badges across multiple categories. These honors reflect customer satisfaction, platform momentum, return on investment, and the quality of support we provide.

LuxSci’s G2 Fall 2025 Badges include:

 

  • Best Support (Secure Email Gateway)
  • Easiest Admin (Email Security)
  • Best Estimated ROI (Email Security)
  • Best Meets Requirements (Secure Email Gateway)
  • Momentum Leader (Multiple Categories)
  • High Performer (Email Encryption)
  • High Performer (Secure Email Gateway)
  • High Performer (Email Security)
  • Users Most Likely to Recommend (Secure Email Gateway)
  • Easiest To Do Business With (Email Encryption)
  • Easiest Setup (Email Encryption)

Why These Badges Matter

Let’s break down a few of the key categories and why they’re worth calling out:

Best Support

This badge shows we’re not just responsive—we’re reliable, helpful, and proactive. Our support team works around the clock to ensure customers feel heard and empowered. It’s a core part of our offering and overall customer experience.

Momentum Leader

This badge is awarded to companies showing significant growth in customer satisfaction, web presence, and employee growth. It means we’re not standing still—we’re scaling smartly, with our customers and partners in mind.

Best Estimated ROI

This one’s big. It means LuxSci offers exceptional value. Customers see real results that justify the investment. This includes secure email with 98% deliverability rates that truly drive better engagement for your healthcare communications and campaigns.

Built for Security and Compliance

At LuxSci, we don’t just build HIPAA compliant, enterprise-grade secure email and marketing tools—we build trusted relationships with our customers and partners. Our focus continues to be:

 

  • Protecting sensitive data with the highest levels of security and compliance
  • Building the best products, so customers have peace of mind
  • Providing unmatched customer support, every step of the way

We’re Not Slowing Down Anytime Soon

With security threats constantly evolving and compliance demands increasing, the need for secure, HIPAA compliant email and communications has never been greater. Whether you’re in healthcare, or regulated industries like financial services, LuxSci is here to ensure your communications stay secure, high-performing, and supported.

 

We’re proud to serve a growing base of professionals who rely on LuxSci every day to keep their sensitive data secure. Want to see what the buzz is about?

 

Explore LuxSci on G2

 

Contact us today to see how we can help you!

Business Associate Agreement

Understanding Business Associate Agreements (BAAs) and Shared Responsibility

Modern-day healthcare organizations rely on a growing array of partners and vendors to provide them with the tools they need to effectively serve patients and customers. 

 

However, while new digital solutions and healthcare ecosystems often result in greater productivity and efficiency, they also increase the number of third parties a company must communicate with and share protected health information (PHI), requiring a business associate agreement (BAA). Unfortunately, this increases the risk of PHI being exposed, as it increases a healthcare organization’s supply chain network and the number of external organizations with access to their data, significantly raising the risk of a security breach. 

 

This is where the concept of shared responsibility comes in. 

 

In this article, we explore the shared responsibility model for data security, explaining the concept, the role of a BAA in shared responsibility, and why healthcare companies need to know how it works and where it factors into their HIPAA compliance efforts. 

What Is The Shared Responsibility Model? 

Shared responsibility is a core data security principle that divides the responsibility for protecting data between a company that collects the data and a vendor that supplies the infrastructure or systems used to process said data.

 

The shared responsibility model grew in prominence as more companies moved to cloud-based environments and applications. In the past, when companies kept their systems and data onsite, they had more control over who could access their data and, subsequently, a better ability to mitigate data security risks.

 

However, in adopting cloud-based infrastructure and applications, companies have to process and store their data in the cloud – often in shared infrastructure with other vendors using the same cloud – which consequently shifts some of the responsibility of information security to the cloud service provider (CSP) itself. This marked a profound shift in the way data was handled, transmitted, and stored – necessitating an evolved approach to data security. 

 

This fundamental shift in the way companies consume infrastructure and use apps ushered in the shared responsibility model: Where the cloud vendor provides the infrastructure or application, including HIPAA compliant and high secure environments, but it’s still the responsibility of the client to configure and use it securely. 

Business Associate Agreements (BAAs) and Shared Responsibility

By detailing the respective responsibilities of healthcare companies or Covered Entities (CEs) and their vendors or Business Associates (BAs) in securing PHI, a Business Associate Agreement is a prime example of shared responsibility. 

 

For example, the Business Associate shoulders the responsibility of providing the data safeguards required by HIPAA to secure patient data, such as infrastructure, encryption, audit logging, and even physical onsite security.

 

The Covered Entity, meanwhile, is responsible for conducting risk assessments, defining access control policies and processes, configuring services accordingly, workforce training, and continuous monitoring.

Additionally, both parties have the obligation to report security incidents to each other, as well as being independently accountable to the U.S. Department of Health and Human Services (HHS).

Why Shared Responsibility Is Essential for HIPAA Compliance

For healthcare companies, having a firm grasp of the shared responsibility model for safeguarding and securing PHI, and how they fit within your overall security posture is essential (for two key reasons).  

Security Gaps

Firstly, clearly understanding the shared responsibility decreases the likelihood of security gaps. If CEs are under the impression that the vendor handles all aspects of data security, they won’t be as vigilant. They’ll be less inclined to configure services, educate their staff accordingly, pay appropriate attention to vendor security alerts, etc. 

 

But the same is also true for BAs: If they assume their client does most of the heavy lifting in securing the data disclosed to them, they could be remiss in their duties to protect it. Without shared responsibility, each side simply assumes the other is covering a safeguard, opening the door for security gaps that malicious actors can exploit.

 

Fortunately, by detailing both parties’ (CEs and BAs) responsibilities and liabilities regarding data protection, a BAA removes this ambiguity and, more importantly, reduces the risk of security gaps. It’s critical to know the details and work with vendors building products for compliance versus implementing a tick-box approach to compliance that places too much burden on the CE.

Covered Entities (CEs) Are Ultimately Accountable

Subsequently, the second reason why it’s essential for CEs to understand the shared responsibility model, and increase their cybersecurity readiness accordingly, is that it’s the CE that’s ultimately held accountable for data breaches. 

 

Mistakenly thinking that a BAA automatically makes them compliant may result in healthcare companies underinvesting in training, monitoring, and incident response. Conversely, understanding that even with a BAA in place, they’re the ones primarily accountable for protecting PHI gives them a greater sense of urgency to properly implement HIPAA compliant security measures. 

The Covered Entity’s Role Within Shared Responsibility

Let’s look at the ways that healthcare companies have to hold up their end in the shared responsibility model. 

Choose Compliance-Conscious Vendors 

First and foremost, companies have to choose the right vendors to supply them with HIPAA compliant services and solutions.

 

Look for companies that market themselves as HIPAA compliant and display a detailed understanding of HIPAA requirements, particularly the HIPAA Security Rule. Do your due diligence and perform deeper dives on potential vendors, researching their stated security features, reviews from existing clients, whether they have certifications like HITRUST – and if they’ve been involved in any data breaches. 

 

Naturally, a core prerequisite of being a HIPAA compliant vendor is being willing to sign a BAA, so you can immediately rule out any vendors not willing to do so. For instance, some healthcare companies may assume they can use widely adopted solutions such as SendGrid, Mailchimp, but they don’t offer a BAA. 

 

Once you’ve confirmed a vendor offers a BAA, look through it to establish its terms and determine if it covers the services you’re interested in. 

Configuration 

Another core component of shared responsibility is comprehensive configuration management. While the BA’s responsibility is to provide a secure solution that satisfies HIPAA requirements, it’s the CE’s responsibility to configure it securely to fit within their IT ecosystem. 

Features that often require configuration include: 

 

  • Access control: Role-based access, Zero Trust, Multi-Factor Authentication (MFA).
  • Encryption settings: Enabling encryption, choosing encryption type, enforcing forced TLS, enabling storage encryption.
  • Feature restrictions: Disabling default configurations that enable integration with non-compliant tools. 
  • Audit logging: Enabling audit logging and configuring log formats.
  • Retention settings: How long to retain audit logs and who is permitted to review them.

Finally, establishing a patch management strategy, i.e., when and how your organization applies software updates, is an important element of configuration.  While the vendor must release updates to fix security vulnerabilities discovered in their solutions, it’s up to healthcare companies to deploy the patches. 

Training

Regardless of how many security features a vendor bakes into their solutions, once deployed by a healthcare company, the tool is only as secure as the practices of their least security-conscious employee. Consequently, companies must train their staff on how to properly use a solution to process protected health information and sensitive data. The more an employee is required to handle PHI, the more thorough and frequent their training should be. 

 

Key aspects of comprehensive cybersecurity training include:

 

  • Common cyber threats: what the most prevalent cyber threats are and how to recognize them.
  • Incident response: how to report a suspected security incident, i.e., who to contact and when. 
  • Specific solution training: how to securely use systems that process PHI
  • Scope awareness: knowing which services within your organization’s IT ecosystem are HIPAA-compliant and which are not

Reporting 

Although both healthcare companies and BAs have notification obligations to the HHS in the event of a data breach involving PHI, it’s the CE that bears most of the investigative burden. 

 

Firstly, while a BA may report a security incident, it’s the CE’s responsibility to conduct a risk assessment to determine the probability of compromise of PHI, assess risk, and determine whether an official notification of a breach to HHS is necessary.

 

Secondly, BAs must notify the CE without unreasonable delay and no later than 60 days after discovery. Although BAs often wait to complete internal investigations before notifying the CE, the CE’s 60-day clock starts upon the BA’s discovery, not upon the BA’s report. Therefore, BA delays can create compliance risks for the CE.

 

To prevent this, where possible, you can include stricter contractual reporting timelines in the BAAs. This constantly keeps your company in the loop, ensuring you have sufficient lead time to complete your own investigations and your HIPAA-regulated deadlines.

LuxSci – Secure Healthcare Communications

Developed specifically to fulfil the stringent regulatory and ever-evolving data security needs of the healthcare sector, LuxSci’s secure email, text, marketing and forms solutions help companies protect PHI and personalize communications.  

 

Equally as importantly, instead of leaving you to “figure it out” – pushing additional responsibility back onto your company – LuxSci has a reputation for the best customer support in the business, offering onboarding, detailed documentation, secure default configurations, and ongoing support to help navigate the murky waters of HIPAA compliance, while getting best-in-class performance out of your solution.

 

Contact LuxSci today to learn more or get a demo.

How to Send HIPAA Compliant Emails

How to Send HIPAA Compliant Emails

Learning how to send HIPAA compliant emails requires understanding encryption standards, authentication protocols, and business associate agreements that protect patient health information during electronic transmission. Healthcare providers must implement safeguards when communicating electronically about patients, ensuring that all email communications meet HIPAA Security Rule requirements for protecting electronic protected health information. Standard consumer email services like Gmail or Outlook cannot guarantee the security measures necessary for healthcare communications, making specialized secure email platforms essential for organizations handling patient data.

Encryption Requirements for Healthcare Email

End-to-end encryption is the foundation for secure healthcare email communications, protecting patient information from unauthorized access during transmission and storage. Healthcare organizations learning how to send HIPAA compliant emails need email systems that encrypt messages using Advanced Encryption Standard (AES) 256-bit encryption or equivalent security protocols before sending communications across public internet networks. The encryption process must protect both the email content and any attachments containing protected health information, ensuring that even if messages are intercepted, the patient data remains unreadable to unauthorized parties.

Message encryption should activate automatically for all healthcare communications rather than requiring manual activation by individual users. This automatic encryption prevents inadvertent transmission of unprotected patient information when staff members forget to activate security features manually. Healthcare email systems also need secure key management protocols that protect encryption keys from unauthorized access while ensuring that legitimate recipients can decrypt and read necessary patient communications.

Transport layer security protocols provide protection during email transmission, creating secure connections between email servers and preventing message interception during delivery. Healthcare organizations should verify that their email providers use TLS 1.2 or higher encryption standards for all message transmissions. Certificate-based authentication adds another security layer by verifying the identity of email recipients before allowing message delivery, preventing misdirected emails containing patient information from reaching incorrect recipients.

Authentication and Access Controls

Multi-factor authentication is a security requirement for healthcare email systems, ensuring that only authorized users can access accounts containing patient communications. Healthcare staff need to provide at least two forms of identification before accessing secure email accounts, combining passwords with mobile device codes, biometric verification, or hardware security tokens. This authentication process protects against unauthorized account access even if passwords are compromised through data breaches or social engineering attacks.

User access controls must reflect the principle of least privilege, granting healthcare staff access only to email communications necessary for their job functions. Physicians need different access levels compared to administrative staff, with role-based permissions preventing unauthorized viewing of patient information outside individual staff members’ care responsibilities. Email systems should maintain detailed audit logs tracking who accesses patient communications, when access occurs, and what actions users perform with protected health information.

Automatic session timeouts provide security by logging users out of email systems after predetermined periods of inactivity. These timeouts prevent unauthorized access when staff members step away from their workstations without properly securing their accounts. Password complexity requirements and password updates strengthen authentication security, though healthcare organizations must balance security requirements with usability to prevent staff from circumventing security measures due to overly complex requirements.

Session management protocols should track concurrent login attempts and prevent multiple simultaneous access sessions for individual user accounts. This monitoring helps detect potential account compromises when unusual access patterns occur, such as logins from multiple geographic locations within short time periods. Email systems need clear protocols for immediately revoking access when staff members leave the organization or when security breaches are detected.

Business Associate Agreements and Compliance

Healthcare organizations must establish comprehensive business associate agreements with their email service providers before transmitting any patient information through electronic communications. These legal agreements define the responsibilities and obligations of both parties regarding protected health information, specifying how the email provider will protect patient data, what uses and disclosures are permitted, and how security incidents will be reported to the healthcare organization. The agreements must cover encryption requirements, data retention policies, and procedures for returning or destroying patient information when business relationships end.

Vendor due diligence processes help healthcare organizations evaluate email service providers to ensure they understand how to send HIPAA compliant emails while meeting all regulatory requirements. This evaluation includes reviewing security certifications, examining data center facilities and security controls, and verifying the provider’s experience with healthcare industry regulations. Healthcare organizations should require proof of cyber liability insurance, incident response capabilities, and security auditing from their email service providers.

Compliance monitoring requires healthcare organizations to conduct periodic assessments of their email security measures and vendor performance. These assessments verify that encryption standards remain current, access controls function properly, and audit logging captures all necessary security events. Healthcare organizations must maintain documentation demonstrating their compliance efforts, including training records, security policies, and incident response procedures related to email communications.

Risk assessments help identify potential vulnerabilities in email security systems and guide updates to security measures as threats evolve. Healthcare organizations should review their email compliance programs annually or whenever changes occur to their operations, technology systems, or regulatory requirements. Documentation of these assessments provides evidence of due diligence in protecting patient information during regulatory audits or security investigations.

Implementation Best Practices

Staff training programs must educate healthcare workers about proper email security practices and when it is appropriate to include patient information in electronic communications. Healthcare staff learning how to send HIPAA compliant emails need clear guidelines about what patient information can be discussed via email versus what requires telephone calls or in-person meetings. Training should cover how to recognize secure email platforms, how to verify recipient identities before sending patient information, and what types of patient data require protection beyond standard email security measures.

Email policy development requires healthcare organizations to establish clear protocols governing patient communication via electronic means. These policies should specify which staff members can send patient information via email, what approval processes are required for sharing sensitive patient data, and how to handle requests from patients who want to receive their health information via email. Policies must also cover how to respond when staff accidentally send patient information to incorrect recipients or when security breaches involving email communications occur.

Testing procedures should verify that email security measures function correctly before implementing systems organization-wide. Healthcare organizations learning how to send HIPAA compliant emails need to conduct penetration testing of their email security systems, verify that encryption activates properly, and confirm that access controls prevent unauthorized viewing of patient information. Testing schedules help identify security vulnerabilities before they can be exploited by malicious actors.

Incident response planning prepares healthcare organizations to handle security breaches involving email communications containing patient information. Response plans should include procedures for containing security incidents, assessing the scope of potential patient information exposure, and notifying affected patients and regulatory authorities when breaches occur. Healthcare organizations must practice their incident response procedures to ensure staff can respond effectively during actual security emergencies.

Patient Communication Considerations

Patient consent requirements vary depending on the type of health information being transmitted and the communication method requested by patients. While healthcare providers can generally communicate with patients about treatment, payment, and healthcare operations without authorization, organizations should obtain written consent before sending detailed medical information via email. Consent forms should explain the security measures in place while acknowledging that email communication carries inherent privacy risks despite protective measures.

Email content guidelines help healthcare staff understand what patient information is appropriate for electronic transmission versus what requires more secure communication methods. Those mastering how to send HIPAA compliant emails recognize that laboratory results, medication changes, andappointment reminders may be suitable for secure email communication, while detailed psychiatric notes, HIV test results, or substance abuse treatment information may require protections or alternative communication methods. Staff need clear decision-making frameworks for evaluating the appropriateness of email communication for different types of patient information.

Alternative communication methods should remain available for patients who prefer not to receive health information via email or who lack secure email access. Understanding how to send HIPAA compliant emails includes recognizing when alternative methods like telephone calls, patient portals, and postal mail provide more appropriate secure alternatives for patient communication while ensuring that lack of email access does not create barriers to necessary healthcare information sharing. Healthcare organizations must accommodate patient preferences while maintaining appropriate security measures for all communication methods.

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How to Send HIPAA Compliant Emails

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AI-based Email Security Threats

How to Avoid AI-Based Email Security Threats

Artificial intelligence (AI) has been the hottest topic in technology for the past few years now, with a focus on how it’s transforming business and the way we work. While we’d seen glimpses of AI’s capabilities before, the release of ChatGPT (containing OpenAI’s groundbreaking GPT-3.5 AI model) put the technology’s limitless potential on full display. Soon, stakeholders in every industry looked to find ways to integrate AI into their organizations, so they could harness its huge productivity and efficiency benefits.

The problem? Hackers and bad actors are using AI too, and it’s only strengthening their ability to carry out data breaches, including AI-based email security threats. 

While AI brings considerable advantages to all types of businesses, unfortunately, its vast capabilities can be used for malicious purposes too. With their unparalleled ability to process data and generate content, cybercriminals can use a variety of AI tools to make their attacks more potent, increasing their potential to get past even the most secure safeguards. 

With all this in mind, this post discusses how AI is helping cyber criminals massively scale their efforts and carry out more sophisticated, widespread attacks. We’ll explore how malicious actors are harnessing AI tools to make AI-based email cyber attacks more personalized, potent, and harmful, and cover three of the most common threats to email security that are being made significantly more dangerous with AI. This includes phishing, business email compromise (BEC) attacks, and malware. We’ll also offer strategic insights on how healthcare organizations can best mitigate AI-enhanced email threats and continue to safeguard the electronic protected health information (ePHI) under their care. 

How Does AI Increase Threats To Email Security?

AI’s effect on email security threats warrants particular concern because it enhances them in three ways: by making email-focused attacks more scalable, sophisticated, and difficult to detect.

Scalability 

First and foremost, AI tools allow cybercriminals to scale effortlessly, enabling them to achieve exponentially more in less time, with few additional resources, if any at all. 

The most obvious example of the scalable capabilities of generative AI involves systems that can create new content from simple instructions, or prompts. In particular, large language models (LLMs), such as those found in widely used AI applications like ChatGPT, allow malicious actors to rapidly generate phishing email templates and similar content that can be used in social engineering attacks, with a level of accuracy in writing and grammar not seen before. Now, work that previously would take email cybercriminals hours can be achieved in mere seconds, with the ability to make near-instant improvements and produce countless variations.   

Similarly, should a social engineering campaign yield results, i.e., getting a potential victim to engage, malicious actors can automate the interaction through AI-powered chatbots, which are capable of extended conversations via email. This increases the risk of a cybercriminal successfully fooling an employee at a healthcare organization to grant access to sensitive patient data or reveal their login credentials so they can breach their company’s email system. 

Additionally, AI allows cybercriminals to scale their efforts by automating aspects of their actions, and gathering information about a victim, i.e., a healthcare organization before launching an attack. AI tools also can scan email systems, metadata, and publicly available information on the internet to identify vulnerable targets, and their respective security flaws. They can then use this information to pinpoint and prioritize high-value victims for future cyber attacks.

Sophistication

In addition to facilitating larger and more frequent cyber attacks, AI systems allow malicious actors to make them more convincing. As mentioned above, generative AI allows cybercriminals to create content quickly, and craft higher-quality content than they’d be capable of through their own manual efforts. 

Again, using phishing as an example, AI can refine phishing emails by eliminating grammatical errors and successfully mimicking distinct communication styles to make them increasingly indistinguishable from legitimate emails. Cybercriminals are also using AI to make their fraudulent communications more context-aware, referencing recent conversations or company events and incorporating data from a variety of sources, such as social media, to increase their perceived legitimacy.  

In the case of another common email attack vector, malware, AI can be used to create constantly evolving malware that can be attached to emails. This creates distinct versions of malware that are more difficult for anti-malware tools to stop.

More Difficult to Detect

This brings us to the third way in which AI tools enhance email threats: by making them harder to detect and helping them evade traditional security measures. 

AI-powered email threats can adapt to a healthcare organization’s cybersecurity measures, observing how its defenses, such as spam filters, flag and block malicious activity before automatically adjusting its behavior until it successfully bypasses them. 

After breaching a healthcare organization’s network, AI offers cybercriminals several new and enhanced capabilities that help them expedite the achievement of their malicious objectives, while making detection more difficult. 

These include:  

  • Content Scanning: AI tools can scan emails, both incoming and outgoing, in real-time to identify patterns pertaining to sensitive data. This allows malicious actors to identify target data in less time, making them more efficient and capable of extracting greater amounts of PHI.  
  • Context-Aware Data Extraction: similarly, AI can differentiate between regular text and sensitive data by recognizing specific formats (e.g., medical record numbers, insurance details, social security numbers, etc.)
  • Stealthy Data Exfiltration: analyzing and extracting PHI, login credentials, and other sensitive data from emails, while blending into normal network traffic. 
  • Distributed Exfiltration: instead of transferring large amounts of data at once, which is likely to trigger cyber defenses, hackers can use AI systems that slowly exfiltrate PHI in smaller payloads over time, better blending into regular network activity.

AI and Phishing

Phishing attacks involve malicious actors impersonating legitimate companies, or employees of a company, to trick victims into revealing sensitive patient data. Typical phishing attack campaigns rely on volume and trial and error. The more messages sent out by cybercriminals, the greater the chance of snaring a victim. Unfortunately, AI applications allow malicious actors to raise the efficacy of their phishing attacks in several ways.

First, AI allows scammers to craft higher-quality messaging. One of the limitations of phishing emails for healthcare companies is that they’re often easy to identify, since they are replete with mis-spelled words, poor grammar, and bad formatting. AI allows malicious actors to overcome these inadequacies and create more convincing messages that are more likely to fool healthcare employees.  

On a similar note, because healthcare is a critical industry, it’s consistently under threat from cybercriminals, which are also known as advanced persistent threats (APTs) or even cyber terrorists. By definition, such malicious actors often reside outside the US and English isn’t their first language. 

While, in the past, this may have been obvious, AI now provides machine translation capabilities, allowing cybercriminals to write messages in their native language, translating them to English, and refining them accordingly. Consequently,  scammers can craft emails with fewer tell-tale signs that healthcare organizations can train their employees to recognize. 

Additionally, as alluded to earlier, AI models can produce countless variations of phishing messages, significantly streamlining the trial-and-error aspect of phishing campaigns and allowing scammers to discover which messaging works best in far less time. 

Lastly, as well as enhancing the efficacy of conventional phishing attacks, AI helps improve spear phishing campaigns, a type of fraudulent email that targets a particular organization or employee who works there, as opposed to the indiscriminate, “scatter” approach of regular phishing.

While, traditionally, spear phishing requires a lot of research, AI can scrape data from a variety of sources, such as social media, forums, and other web pages, to automate a lot of this manual effort. This then allows cybercriminals to carry out the reconnaissance required for successful attacks faster and more effectively, increasing their frequency and, subsequently, their rate of success. 

AI and Business Email Compromise (BEC) Attacks

A business email compromise (BEC) is a type of targeted email attack that involves cybercriminals gaining access to or spoofing (i.e., copying) a legitimate email account to manipulate those who trust its owner into sharing sensitive data or executing fraudulent transactions. BEC attacks can be highly effective and, therefore, damaging to healthcare companies, but they typically require extensive research on the target organization to be carried out successfully. However, as with spear phishing, AI tools can drastically reduce the time it takes to identify potential targets and pinpoint possible attack vectors. 

For a start, cybercriminals can use AI to undertake reconnaissance tasks in a fraction of the time required previously. This includes identifying target companies and employees whose email addresses they’d like to compromise, generating lists of vendors that do business with said organization, and even researching specific individuals who are likely to interact with the target.  

Once a target is acquired, malicious actors can use AI tools in a number of terrifying ways to create more convincing messaging. By analyzing existing emails, AI solutions can quickly mimic the writing style of the owner of the compromised account, giving them a better chance of fooling the people they interact with. 

By the same token, they can use information gleaned from past emails to better contextualize fraudulent messages, i.e., adding particular information to make subsequent requests more plausible. For example, requesting data or login credentials in relation to a new project or recently launched initiative. 

Taking this a step further, cybercriminals could supplement a BEC attack with audio or video deepfakes created by AI to further convince victims of their legitimacy. Scammers can use audio deepfakes to leave voicemails or, if being especially brazen, conduct entire phone conversations to make their identity theft especially compelling.

Meanwhile, scammers can create video deepfakes that relay special instructions, such as transferring money, and attach them to emails. Believing the request came from a legitimate source, there’s a chance employees will comply with the request, boosting the efficacy of the BEC attack in the process. Furthermore, the less familiar an employee is with attacks of this kind, the more likely they are to fall victim to them.   

In short, AI models make it easier to carry out BEC attacks, which makes it all the more likely for cybercriminals to attempt them.

AI and Malware 

Malware refers to any kind of malicious software (hence, “mal(icous) (soft)ware”), such as viruses, Trojan horses, spyware, and ransomware, all of which can be enhanced by AI in several ways.

Most notable is AI’s effect on polymorphic malware, which has the ability to constantly evolve to bypass email security measures, making malicious attachments harder to detect. Malware, as with any piece of software, carries a unique digital signature that can be used to identify it and confirm its legitimacy. Anti-malware solutions traditionally use these digital signatures to flag instances of malware, but the signature of polymorphic malware changes as it evolves, allowing it to slip past email security measures. 

While polymorphic malware isn’t new, and previously relied on pre-programmed techniques such as encryption and code obfuscation, AI technology has made it far more sophisticated and difficult to detect. Now, AI-powered polymorphic malware can evolve in real-time, adapting in response to the defense measures it encounters. 

AI can also be used to discover Zero Day exploits, i.e., previously unknown security flaws, within email and network systems in less time. Malicious actors can employ AI-driven scanning tools to uncover vulnerabilities unknown to the software vendor at the time of its release and exploit them before they have the opportunity to release a patch.

How To Mitigate AI-Based Email Security Threats

While AI can be used to increase the effectiveness of email attacks, fortunately, the fundamentals of mitigating email threats remains the same; organizations must be more vigilant and diligent in following email security best practices and staying on top of the latest threats and tools used by cybercriminals. 

Let’s explore some of the key strategies for best mitigating AI-based email threats and better safeguarding the ePHI within your organization.

  • Educate Your Employees: ensure your employees are aware of how AI can enhance existing email threats. More importantly, demonstrate what this looks like in a real-world setting, showing examples of AI-generated phishing and BEC emails compared to traditional messages, what a convincing deepfake looks and sounds like, instances of polymorphic malware, and so on.

    Additionally, conduct regular simulations, involving AI-enhanced phishing, BEC attacks, etc., as part of your employees’ cyber threat awareness training. This gives them first-hand experience in identifying AI-driven email threats, so they’re not caught off-guard when they encounter them in real life. You can schedule these simulations to occur every few months, so your organization remains up-to-date on the latest email threat intelligence.
     
  • Enforce Strong Email Authentication Protocols: ensure that all incoming emails are authenticated using the following:
    • Sender Policy Framework (SPF): verifies that emails are sent from a domain’s authorized servers, helping to prevent email spoofing. 
    • DomainKeys Identified Mail (DKIM): preserves the integrity of the message’s contents by adding a cryptographic signature, mitigating compromise during transit, e.g., stealthy or distributed data exfiltration. 
    • Domain-based Message Authentication, Reporting & Conformance (DMARC): enforces email authentication policies, helping organizations detect and block unauthorized emails that fail SPF or DKIM checks.

By verifying sender legitimacy, preventing email spoofing, and blocking fraudulent messages, these authentication protocols are key defenses against AI-enhanced phishing and business email compromise (BEC) attacks.

  • Access Control: while AI increases the risk of PHI exposure and login credential compromise, the level of access that a compromised or negligent employee has to patient data is another problem entirely. Subsequently, data breaches can be mitigated by ensuring that employees only have access to the minimum amount of data required for their job roles, i.e. role-based access control (RBAC). This reduces the potential impact of a given data breach, as it lowers the chances that a malicious actor can extract large amounts of data from a sole employee.
  • Implement Multi-Factor Authentication (MFA): MFA provides an extra layer of protection by requiring users to verify their identity in multiple ways. So, even in the event that a cybercriminal gets ahold of an employee’s login credentials, they still won’t have sufficient means to prove they are who they claim to be.
  • Establish Incident Response and Recovery Plans: unfortunately, by making them more scalable, sophisticated, and harder to detect, AI increases the inevitability of security breaches. This makes it more crucial than ever to develop and maintain a comprehensive incident response plan that includes strategies for responding to AI-enhanced email security threats.

    By establishing clear protocols regarding detection, reporting, containment, and recovery, your organization can effectively mitigate, or at least minimize, the impact of email-based cyber attacks enhanced by AI. Your incident response plan should be a key aspect of your employee cyber awareness training, so your workforce knows what to do in the event of a security incident. 

Get Your Copy of LuxSci’s 2025 Email Cyber Threat Readiness Report

To learn more about healthcare’s ever-evolving email threat landscape and how to best ensure the security and privacy of your sensitive data, download your copy of LuxSci’s 2025 Email Cyber Threat Readiness Report. 

You’ll discover:

  • The latest threats to email security in 2025, including AI-based attacks
  • The most effective strategies for strengthening your email security posture
  • The upcoming changes to the HIPAA Security Rule and how it will impact healthcare organizations.

Grab your copy of the report here and start increasing your company’s email cyber threat readiness today.

hands on a keyboard sending secure email

How to Secure SMTP Email Delivery with TLS

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:

  1. Computer A connects to Computer B (no security)
  2. Computer B says “Hello” (no security)
  3. Computer A says, “Let’s talk securely over TLS” (no security)
  4. Computers A and B agree on how to do this (secure)
  5. 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:

  1. purchase SSL certificates
  2. configure the email servers to use them (and keep these configurations updated)
  3. 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:

  1. No TLS: never use it.
  2. Opportunistic TLS: use it if available; if not, send it insecurely.
  3. 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:

  1. The recipient’s servers support TLS for outbound email (there is no way to test this externally).
  2. The mail servers (where the “From” or “Reply” email address is hosted) support TLS for inbound email.
  3. 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:

  1. 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.
  2. 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:

  1. 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.
  2. 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.
  3. 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.
  4. 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.
  5. 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).
  6. 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.
  7. 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.
  8. 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.

What is HIPAA-Compliant Email Marketing?

If you are one of the 92% of Americans with an email address, you are likely familiar with email marketing. It is a tried and true marketing strategy that delivers a superior return on investment compared to other digital channels. However, when healthcare organizations want to utilize these strategies, out-of-the-box solutions are not a good fit. Healthcare organizations must utilize email marketing platforms specifically designed to meet HIPAA’s unique privacy and security requirements.

checking email on smartphone What is HIPAA-Compliant Email Marketing?

When Do You Need a HIPAA-Compliant Email Marketing Platform?

Healthcare organizations are required to use a HIPAA-compliant email for HIPAA marketing because their messages often contain electronic protected health information (ePHI). This includes information that is both individually identifiable and relates to someone’s healthcare.

Individually identifiable information includes identifiers like a patient’s name, address, birth date, email address, social security number, and more. By default, every email marketing communication includes the patient’s email address and is, therefore, individually identifiable. Not only does the definition of ePHI cover people’s past, present, and future health conditions, but it also includes treatment provisions and billing details. This information is often contained in email marketing messages.

While the law does not cover anonymous health details or individual identifiers sent by themselves, you must be careful and abide by HIPAA regulations when the two are brought together. You will need a HIPAA-compliant email marketing service whenever you send ePHI. As we will see, even if you think an email may not contain ePHI, it is still best to be cautious.

Types of HIPAA-Compliant Email Marketing Communications

An excellent example of an email blast that must comply with HIPAA is a newsletter sent to a clinic’s cancer patients. At first glance, the email doesn’t contain any specific PHI. It doesn’t mention Jane Smith’s chemotherapy treatments, other specific patients, or their medical information. However, upon closer look, it may violate HIPAA regulations.

Every email in this campaign contains a personal identifier- the patient’s email address. In this example, only cancer patients received the newsletter, which also tells you personal medical information. A hacker could infer that anyone who received this email has cancer, which is ePHI and protected under HIPAA. If you use a medical condition to create a segment of email recipients, the email campaign must comply with HIPAA.

Sometimes, it can be challenging to identify if an email contains ePHI. If you sent the same practice newsletter to a list of all current and former medical clinic patients, it may or may not contain ePHI. Even if the newsletter contained benign info about the practice’s operating hours or parking information, if the practice is centered around treating a specific condition like cancer or depression, it may be possible to infer information about the recipients regardless of the message.

There are a lot of gray areas, and it can be difficult to determine if an email contains PHI. We recommend using HIPAA-compliant email marketing for any promotional materials to reduce the risk of violations.

The Benefits of Using a HIPAA-Compliant Marketing Platform

After reading this, you may think the answer is to avoid sending PHI in email campaigns. However, by keeping your communications bland, generic, and broadly targeted, you miss out on significant opportunities to engage your patients.

Using a HIPAA-compliant email marketing solution, you can leverage ePHI to send much more effective messages. In the above example, cancer patients actively receiving treatment at your clinic are much more likely to be interested in your business updates. Targeted emails receive much higher open and click rates than those sent to a general list.

Results of leveraging PHI

Sending the right information to your patients at the right time is an effective patient engagement strategy. Think about it using an e-commerce example- when a retailer sends you product recommendations based on past purchases; they use your data to influence future purchasing decisions. By utilizing patient data to create highly relevant and personalized campaigns and offers, you receive a better return on investment in your efforts.

What is Required for HIPAA-Compliant Email Marketing?

Finding the right HIPAA-compliant email marketing platform can be challenging. Most of the common vendors aren’t HIPAA-compliant at all. Others claim compliance and will sign BAAs to protect your information at rest but still will not enable you to send PHI via email. Finding a provider that suits your business needs and protects the email messages requires careful vetting.

Generally speaking, a HIPAA-compliant email platform must meet three broad requirements:

  1. The vendor will sign a Business Associates Agreement that outlines how they will protect your data and what happens in case of a breach.
  2. The vendor protects the data at rest using appropriate storage encryption, access controls, and other security features.
  3. The vendor protects messages in transit using an appropriate level of encryption with the proper ciphers.

Thankfully, LuxSci’s Secure Marketing email platform has been designed to meet the healthcare industry’s unique needs. Our platform was built with both security and compliance at the forefront. With Secure Marketing, organizations can send fully HIPAA-compliant email marketing messages to the right patients at the right time and receive a better return on their marketing investment.