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What is HIPAA-Compliant Email Marketing?

Tuesday, September 26th, 2023

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.

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

Healthcare organizations are required to use a HIPAA-compliant email marketing platform 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.

Tags: email marketing, email marketing platform, hipaa, hipaa compliance, HIPAA-compliant email marketing, marketing, personalization, phi, segmentation
Posted in Email Marketing, LuxSci Library: HIPAA
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HIPAA-Compliant Secure Email: Understanding Encryption

Tuesday, August 15th, 2023

Email encryption is an important topic to understand when evaluating HIPAA-compliant, secure email vendors. Encryption is an addressable standard for HIPAA compliance, but if you send sensitive information via email, encryption is the easiest way to meet the standard.

The two most common email encryption methods include SMTP TLS and Secure Portal Pick Up. This article will discuss their differences and guide users on selecting the right option for HIPAA-compliant secure email.

secure email sending

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Tags: email encryption, escrow, hipaa, hipaa compliance, hipaa-compliant email, s/mime, secure email, smtp tls, ssl, tls
Posted in LuxSci Library: HIPAA, LuxSci Library: Security and Privacy
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Patient Engagement: Why Email is an Essential Channel

Thursday, June 22nd, 2023

In today’s increasingly digital world, email is often overlooked as a channel for patient engagement. Email may not appear to be as innovative or exciting as texting, social media, or mobile applications. Nevertheless, email is a powerful tool that remains widely popular and accessible to most of the population, making it an essential channel for patient engagement.

doctor emailing patient

Email Adoption Rates

Because of its ubiquity, email should be prioritized as part of your patient engagement efforts. 92% of Americans have email accounts, and 49% check them multiple times daily. Compared to 80% who text, 72% are social media users, and 85% have a smartphone, email has one of the highest adoption rates among digital technologies. Even among older populations and disadvantaged communities, email has been widely adopted.

Best of all, email can be secured to meet HIPAA requirements and protect patient privacy, all while providing a patient-centered experience.

Patient Preferences

Communicating according to patient preferences is one of the most important ways to improve engagement. Many people prefer email communication because it’s less intrusive to their daily lives. The pandemic rapidly accelerated the demand for digital services, and healthcare was not exempt from these shifting preferences. A survey conducted by Redpoint Global found that 80% of patients said that they prefer to use digital channels to communicate with healthcare providers at least some of the time.

In today’s digital society, failing to communicate according to preferences can have significant consequences. Accenture found that 34% of people said they would switch medical providers or be less likely to access care in the future because of a poor experience.

Securing data to comply with HIPAA regulations and obtaining patient consent for marketing communications is essential to engaging patients with personalized emails. Email communications are easy to opt-in and out of- giving patients complete control over how their healthcare data is used.

The Advantages of Email for Patient Engagement

Email has several advantages, but the two most important include the ability to personalize and scale communications. Patients don’t want to receive the same generic newsletters or messaging. They expect their healthcare providers to provide information that is relevant to their health journey at the right time. The power of email lies in its ability to be customized and personalized at scale. Email APIs can pull data from your CDP, EHR, or CRM into dynamic templates. Messages can be triggered and personalized based on pre-determined actions or criteria. Organizations can create fully automated email workflows to streamline operations and meet patient needs.

By using dynamic personalization and automation, your staff can spend less time with their fingers on keyboards and more time assisting patients. Trigger-based email flows can remind patients of appointments, collect insurance information, ensure proper medication adherence, and send other relevant healthcare communications. This frees up time for staff to focus on other tasks and relieves some administrative overhead.

The Results: Improved Patient Engagement

Email is one of the most effective channels for driving customer behavior. For every $1 spent on email marketing, the average ROI is $36. Email can also provide near-instant performance analytics, so it’s possible to tell what messages are resonating and which are not. In addition, A/B testing makes it simple to test components of your message on a small scale and then send out the winning formats. Trying out different email subject lines, calls to action, imagery, and other messaging is easy. Because of these features, personalized email messaging can provide better conversion rates, patient engagement, and return on investment than other digital channels.

Conclusion

Email is a powerful channel that can benefit your medical practice. It is often preferred for one-to-one communication and can also be an effective marketing channel. Learn more about how to address clinical communication challenges with secure email technology by contacting LuxSci today.

Tags: email automation, email engagement, email marketing, hipaa compliance, patient communication, patient engagement, patient experience, patient preferences, patient retention, patient satisfaction, personalization
Posted in Email Marketing
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Tips for Improving Account Security

Thursday, December 8th, 2022

Securing access to protected health information is a crucial tenant of HIPAA compliance. Your employees may have access to sensitive information, so ensuring their accounts are secure is essential to protecting this data. While you can’t stop users from making poor choices, there are administrative actions you can take to help improve account security. We’ve created a list to help assess your security stance.

account security

What are Access Controls?

First, let’s define what we mean by access controls. In the context of HIPAA compliance, access controls refer to the technical and physical safeguards required to maintain the integrity and confidentiality of protected health information. Physical access controls include protecting the physical security of PHI located on physical servers, files, and other hardware. This is easy to understand. File cabinets are locked, rooms require passkeys or access codes to enter, and there are often sign-in and out sheets for physical files or information.

Access controls are more complicated for digital storage. In today’s world, most electronic protected health information (ePHI) is digitally stored in EHRs, databases, or the cloud. This article discusses ways to improve account security to maintain the integrity and confidentiality of digitally stored ePHI.

Account Security Checklist

Below we’ve compiled some of our tips for improving account security. Note that HIPAA does not make specific technical recommendations for how to meet its requirements. There are many ways to meet HIPAA requirements that do not dictate the use of any specific technology. However, keep in mind that the goal is to secure the sensitive data entrusted to your organization, not just check off compliance requirements.

Unique Accounts

To track who is accessing protected health information, it’s essential that account logins are not shared among staff members. When users share login credentials, it is impossible to tell who accessed information when reviewing audit logs. This can create issues when dealing with a security incident. By clearly designating logins to individuals, it’s easy to determine who is accessing PHI and to detect unusual activity. Ensure your employees understand that sharing logins is not allowed and set policies to enforce this rule.

Secure Passwords

Many people understand the importance of having a secure password, but it’s still shocking how many people use insecure or easily guessed passwords. According to a report from LastPass, 95% of IT professionals said that passwords pose security risks to their organization. They reported that employees frequently mishandle passwords, sharing them too liberally and via insecure methods. A few steps you can take to improve password security include:

  • Using unique passwords for each account
  • Requiring the use of special characters, numbers, and capitalization
  • Randomly generating passwords
  • Using password managers to store account information securely

Administrators should create policies for passwords and enforce as many of these requirements as possible by default. Don’t rely on users making the right decisions.

Multifactor Authentication

If a user’s password is weak and gets compromised, multifactor authentication can help keep accounts secure. Multifactor authentication requires a second piece of information (usually a six-digit code) to complete the login process. The code is sent to or generated by a second device. Without access to this code, a hacker cannot log in to the account, even if they have the username and password.

We recommend using an application (like DuoSecurity or Google Authenticator) to generate the second factor because a competent hacker can intercept codes sent by text/SMS.

Time and Location-Based Settings

These settings are not required for HIPAA compliance but provide an additional layer of security. Administrators can stop logins that take place from outside of pre-set geographic regions. This is useful because many cybercrimes are launched from foreign countries. For example, logins coming from countries like Russia, China, or Iran could be forbidden by administrators. In addition, admins can lock users out when it is not their regular working hours. For example, keep users from logging in between 10pm-6am (or any time of your choosing.) Many malicious actions take place outside of regular operating hours to avoid notice. Be sure to have a way to override this in case of an emergency.

IP Restricted Logins

Restrict logins even further by requiring them to come from specific IP addresses. Administrators can use VPNs to secure traffic to their applications. The user will not be able to log in if the attempt does not come from the correct IP address.

Role-Based Permissions

Another factor to keep in mind is the principle of least access. Users should only have access to the systems required to perform their job duties. Not every user should have access to every system. Reducing the number of logins available decreases the attack surface and reduces risk. This is a key tenet of the Zero Trust security philosophy.

Automatic Log Out

Finally, prevent users from staying logged into sensitive systems indefinitely. Enforce automatic logouts after a point of idleness (this could be five minutes, 30 minutes, or an hour depending on your situation). This helps prevent unauthorized access to protected information after a user has legitimately logged in.

Conclusion

These tips represent just a few ways that administrators can improve the security of their users’ accounts and protect access to PHI.

Tags: access controls, account security, automatic logout, ePHI, hipaa compliance, mfa, multifactor authentication, password manager, phi, session timeout, time-based access control, vpn
Posted in LuxSci Library: HIPAA, LuxSci Library: Security and Privacy
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Infrastructure Requirements for HIPAA Compliance

Thursday, December 1st, 2022

If you are building a new environment that must comply with HIPAA, you may be surprised to find that the infrastructure requirements for HIPAA compliance do not require the use of any specific technology. This provides a lot of flexibility for developers and architects but can also introduce risk if you are unfamiliar with the requirements. This article outlines a few considerations to keep in mind as you build a HIPAA-compliant infrastructure or application.

infrastructure hipaa requirements

Dedicated Servers and Data Isolation

Reliability and data security are two of the most important considerations when building a healthcare application. Building an infrastructure in a dedicated server environment is the best way to achieve these aims. Let’s look at both.

Reliability

Hosting your application in a dedicated environment means you never have to share server resources with anyone else, and it can be configured to meet your needs exactly. This may also include high-availability configurations to ensure you never have to deal with unexpected downtime. For many healthcare applications, unexpected downtime can have serious consequences. 

Security

A dedicated environment isolates your data from others, providing an added security layer. Segmentation and isolation are crucial components of the Zero Trust security stance, and using a dedicated environment helps keep bad actors out. Hosting your application in a public cloud could put sensitive data at risk if another customer falls victim to a cyberattack or suffers a security incident.

HIPAA does not require the use of dedicated servers. Still, any host you choose must follow the HIPAA requirements associated with access controls, documentation, physical security, backups and archival, and encryption. Review our checklist for more details about HIPAA’s security requirements.

Encryption

It’s worth spending a minute discussing encryption because it’s an often misunderstood topic. Encryption is listed as an “Addressable” standard under HIPAA. Because it is not “Required,” this leads many to think that it is optional. The Rule states: “Ensure the confidentiality, integrity, and availability of all electronic protected health information the covered entity or business associate creates, receives, maintains, or transmits.” So, while HIPAA does not state that covered entities must use encryption, it does say that they need to ensure the confidentiality of any ePHI that is created, received, maintained, or transmitted.

The confusion arises because HIPAA is technology-neutral and does not specify how exactly to protect ePHI. Encryption is unnecessary if your organization can devise another way to protect sensitive data. However, practically speaking, there aren’t many alternatives other than not storing or transmitting the data at all. Encryption is the easiest and most secure way to protect electronic data in transmission and at rest.

At-Rest Encryption

HIPAA does not require at-rest encryption, though it is recommended to decrease risk and potential liability in some situations. Suppose your risk assessment determines that storage encryption is necessary. In that case, 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 access by unauthorized people, and generally protects the data no matter what happens (unless the keys are stolen). Storage encryption is essential in any scenario where the data may be backed up or placed in locations out of your control. 

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.

  • Consider using a portal pickup method, PGP, or S/MIME encryption when transmitting highly sensitive information to end users.

Backup Infrastructure Requirements for HIPAA Compliance

Backups and archival are often an afterthought regarding HIPAA compliance, but they are essential. HIPAA requires that organizations “Create a retrievable, exact copy of electronic protected health information, when needed, before movement of equipment.” You must be sure that all ePHI stored or collected by your application is backed up and can be recovered in case of an emergency or accidental deletion. If your application sends information elsewhere (for example, via email), those messages must also be backed up or archived. HIPAA-compliant backups are robust, available, and accessible only by authorized people.

Under HIPAA Omnibus, organizations must keep electronic records of PHI disclosures for up to three years. Some states and company policies may require a longer record of disclosures; some states require up to ten years. When building a HIPAA-compliant infrastructure from scratch, it’s also essential to build backups.

Conclusion

If it is your first time dealing with infrastructure requirements for HIPAA compliance, be sure to ask the right questions and work only with vendors who thoroughly understand the risks involved. It can be overwhelming, but by selecting the right partners, you can achieve your goals without violating the law. 

Tags: at rest encryption, backup, data backups, data isolation, dedicated servers, encryption, hipaa compliance, infrastructure requirements, tls, transmission encryption, zero trust
Posted in Business Solutions, LuxSci Library: HIPAA
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