Infographic: Most Email Software Cannot Use PHI

January 12th, 2023

Email Communication is Necessary- But Introduces Risk

When it comes to receiving communications from businesses, 93% of people say that email is their preferred communication channel. In the healthcare industry, organizations must take extra care to comply with HIPAA. Only some email marketing platforms can adequately protect PHI. If not properly secured, email can introduce significant risks to sensitive data. 72% of organizations report experiencing an email cyberattack.

As the definition of PHI is ever-expanding to include information like biomarkers, organizations need to adopt a more secure posture for their personal, transactional, and marketing email. Cybercriminals seek out personal data because it is highly valued on the dark web. Data Loss Prevention (DLP) and policies preventing users from sending PHI insecurely are not enough.

Humans are prone to error and often make mistakes classifying PHI. Even DLP technology is not infallible- keywords can be misspelled, and PHI only sometimes fits cleanly into pre-determined filters. 40% of threats stem from internal actors. Many are not malicious, just mistakes! You must account for errors when humans are part of your security program.

So how can you prevent data leakage and ensure the security of sensitive data at rest and in transit? It’s simple when you choose the right solution. Resolve the tension between security risk and business engagement objectives by choosing a fully compliant email marketing solution.

infographic email phi(Click to Expand)

Two Requirements for Including PHI in Marketing Emails

Secure Application

HIPAA does not require at-rest encryption, though it is recommended to decrease risk and potential liability. When using email marketing platforms or customer relationship management systems that contain PHI, it’s essential to keep that information protected. You must ensure that all collected and stored protected health information is encrypted and can only be accessed and decrypted by people with the appropriate keys. This makes backups secure, protects data from being improperly accessed, and generally protects the data no matter what happens (unless the keys are stolen). Encryption is essential to protect private health data at rest in an application.

Transmission Encryption

If protected health information is transmitted outside of the database or application, encryption must also be used to protect the data in transmission. At a minimum, TLS encryption (with the appropriate ciphers) is secure enough to meet HIPAA guidelines. However, TLS alone may not be appropriate for your use cases. Non-compliant and quasi-compliant applications do not offer transmission encryption that is secure enough to comply with HIPAA. You should only send communications containing PHI if they are encrypted.

Types of Email Marketing Solutions

Non Compliant (1)

Many of the most popular email solutions on the market were not designed to protect the sensitive data of the healthcare industry. These vendors will not sign Business Associate Agreements and do not provide the storage or transmission encryption needed to meet HIPAA requirements. Healthcare organizations should only use these solutions if they do not send PHI- which may be impossible if you plan to email lists of patients with any information about their healthcare. 

Quasi Compliant (2)

HIPAA does not require any specific technology to meet its requirements, which allows for flexibility, but also creates uncertainty. No central government organization certifies HIPAA compliance, and as a result, many organizations advertise themselves as “HIPAA-compliant” but don’t enable you to take full advantage of their functionality. We call this “Quasi compliance.”

Quasi-compliant solutions often provide a secure application and protect patient data at rest. However, they will not permit you to send emails or transmit PHI outside the database. This can seriously limit the usefulness of the solution. Take a real-life example: one healthcare organization purchased a CRM system and set it up, uploaded their contacts, and was ready to start using it, so they enabled the “HIPAA Compliance” toggle on the backend. They quickly found that much of the functionality was no longer available and wouldn’t allow them to email or log certain data types. The solution was almost useless for their patient engagement efforts.

Other applications will permit you to use the full functionality of the solution, but when you read the terms of the Business Associate Agreement, it is clear that you are not allowed to send PHI. If signed, your organization will be responsible for any breaches caused by sending PHI insecurely, not the vendor.

Full Compliance (4)

This is why it’s crucial to vet solutions carefully and not take shortcuts regarding HIPAA compliance. Any CRM, CDP, or email marketing solution must protect data at rest in a secure application and encrypt transmitted messages. Even more importantly, it shouldn’t take any extra training or require any extra steps to use in a compliant way.

At LuxSci, (3) we provide a secure application to manage your email campaigns that encrypts transmitted messages automatically. Our Secure Marketer solution is designed to meet the unique security needs of healthcare organizations. All email transmissions are encrypted automatically, and users can choose the right type of encryption (TLS, Portal Pickup) to meet their email use cases. Automatic encryption gives your security and compliance teams peace of mind that all messages are sent securely. Data is protected throughout the lifecycle and does not require employees to decide whether a message contains PHI. Healthcare marketers can fully use PHI to personalize and customize messaging to increase patient engagement and get better ROI on their marketing campaigns.