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Creating Secure Web Forms: What You Need to Know

person filling out a secure web form on a laptop

Creating secure web forms starts with creating a secure website. This process is more complex than creating web pages and adding an SSL Certificate. A certificate is a solid first step, but it only goes so far as to protect whatever sensitive data necessitates security in the first place.

Naive attempts at security can ultimately make the data less secure and more likely to be compromised by creating an appetizing target for the unscrupulous.

So, what do you do beyond hiring a developer with significant security expertise? Start with this article. Its purpose is to shed light on many of the most significant factors in creating secure web forms and how to address them. At a minimum, reading this article will help you intelligently discuss website security with the developers you hire.

person filling out a secure web form on a laptop

What Is Involved In Creating Secure Web Forms?

If you want to add a secure web form to your website, first, you must understand how to securely configure the website. Website security is a serious and complex topic; this article only discusses the high points. Check out some of our other articles and eBooks for more detailed information on website security.

Here are some of the critical issues that need to be considered:

  1. SSL – Is the website and form secured to transmit data from the end user safely? Is your website form page protected with SSL to prevent tampering with its contents?
  2. Web page content – Is the HTML content sent to the end-user protected from Cross-Site Scripting (XSS) issues, and does it avoid loading objects insecurely or from third parties?
  3. Script Security – Are the scripts or programs that process the submitted data written with security in mind? Do they have any vulnerabilities?
  4. Infrastructure – Is the website hosting provider trusted and known for good security? Are you on a shared server when you should be on a dedicated one?
  5. Data Flows – What do you do with the data once submitted? Is that data secured?
  6. Tracking – Do you track events such as data access and submission?
  7. Archival and Backup – Are there processes to make backups and permanent archives of important data?

SSL – Web Security Starts Here

SSL certificates are required for creating a secure website and form. The SSL certificate allows:

  1. The encryption of data sent to and from your web server and users to prevent eavesdropping or tampering.
  2. Your users trust that they are connecting to your website securely.

An SSL certificates on a properly configured web server encrypts your website data as it flows to and from your end users.

To get an SSL certificate, you can order one directly from a third party, or your web hosting provider will handle it for you. In either case, the web host will need to install the certificate on the server where the website is hosted, and then you will need to make changes to your site to take full advantage of the secure channel you have added.

SSL and Encryption

The most significant reason people use SSL is to encrypt the data transmitted from their website and the end-user. When an end-user visits a page protected by SSL, their web browser communicates over a secure channel with the web server so that all data transmitted is sent over this encrypted channel. This helps prevent eavesdropping and man-in-the-middle attacks on the data (more on these below).

Without SSL encryption, there is little or no protection of the data.

SSL and Trust

The most overlooked and misunderstood aspect of SSL is the establishment of trust. That is, enabling your end-users to trust and feel confident that they are connecting to your website. What else could they be connecting to, you may ask?

  1. Someone with access to the network between the end-user and website could be trying to intercept and read all the web traffic or altering your website pages themselves (e.g., changing your forms to submit the data to them instead of you). This is called a man-in-the-middle attack. Even with SSL security, a man-in-the-middle can present the end-user with an SSL Certificate for your domain name that looks legitimate, like a forged ID card.
  2. The user could be visiting another website that is pretending to be yours. This phishing website could collect information from your users for malicious purposes. Unless your users identify this site as illegitimate, they could be duped into revealing personal information. How could they end up at a phishing website like this? This can happen by clicking on a link emailed to them or by visiting a misspelled version of your URL. No site is immune from such attacks, but you can work to mitigate them.

SSL Certificates and Cybersecurity

As mentioned above, SSL certificates are not the sole website and form security solution, but they can help! To understand how it’s worth looking at how certificates are awarded. SSL certificates are signed by a third-party authority, the “Certificate Authority.” This can be:

  1. You, if you sign your certificates.
  2. A respected third-party issuing:
    1. A cheap or free certificate validating only your domain.
    2. A more expensive “Extended Validation” certificate which also validates your organization.

If you sign your own certificates, your website will generate warnings when anyone visits it. Users can choose to dismiss them, but more commonly, they will be more likely to navigate away from the website. For this reason, self-signed certificates are never recommended for a public website. Self-signed certificates provide no inherent trust that they are legitimate (anyone can generate one and pose as your site). They look amateurish and are annoying to the end user. Self-signed certificates should only be used in internal or test environments.

When ordering a certificate from a trusted third-party authority, there are various types that you can order. The cheapest ones are called domain-validated certificates. These work by emailing your domain administrator a validation link. Once verified, the certificate is awarded. These domain-validated certificates are acceptable and provide excellent security; however, as no humans are directly involved in the validation process, it may be easier for an attacker to get an illegitimate certificate by gaining control of the admin’s inbox or via other methods.

You can also order Extended Validation certificates. They cost more because real people validate the organization and your domain ownership. They make phone calls and ensure that everything looks right. If you have one of these certificates, your browser’s address bar turns green (or displays a lock symbol) when visitors come there to indicate that this site is trusted. If you want to maximize trust and make it easy for your end-users to identify your site as legitimate, you should use an Extended Validation certificate. These cost more but are well worth it in terms of security and trust. If EV certificates are outside your budget, you should still use an SSL certificate from some trusted third party.

Securing Web Forms with SSL

Once your website has an SSL certificate installed by a web host, your web pages can be accessed with addresses that start with “https://” instead of just “http://.” The “s” in “https” means “secure.” Note:

  1. When connected to a web page using a secure address like “https://yourdomain.com,” the web browser will show a lock icon to inform you that the connection is secure.
  2. Web pages that end in “.shtml” are not necessarily secure. The “s” means “server” (i.e., server-parsed page) and not “secure.” So, for example, “http://yourdomain.com/index.shtml” is not a secure page, but “https://yourdomain.com/index.html” is a secure page.
  3. With SSL enabled, you can access the same page securely and insecurely in many default web server configurations. Both “http://yourdomain.com/form.html” and “https://yourdomain.com/form.html” work and show the form — the only difference is the use of SSL or not.

So, let’s say that you have a web form located at “http://yourdomain.com/form.html.” You have an SSL certificate, and your web host has installed it. Next, you want to:

  1. Make sure people connect securely to the form page.
  2. Make sure that no one can connect to the form page insecurely.

These two goals might sound the same, but they are not.

Enforce Secure Connections to Form Pages

Since regular website pages may be insecure, you need to ensure that the links to the secure form page are absolute links starting with the prefix “https://.” This will ensure that anyone clicking these links will be taken to the form page on a secure connection.

The best solution is to use an HSTS (HTTP Strict Transport Security), which tells browsers that they should always use the secure version of your website. If you choose to have both the insecure (http) and secure (https) versions of your site running at the same time (not recommended), then you need to be careful with linking so that sensitive pages are secured:

Wrong Links: Relative links are not recommended because, if the user is on an insecure page, relative links will always take them to insecure versions of the destination page. So relative links like the following should be avoided:

Fill out my form!

Correct Links: Absolute links will ensure a secure connection by specifying that SSL must be used via the link prefix “https://.”

For example: <a href=”https://yourdomain.com/form.html”>Fill out my form!

Be sure that all links to all secure pages of the site use this secure format with the “https://” prefix.

Side Note: These days, it is recommended that you use SSL for all website pages, not just ones that process sensitive information. This is good for user trust, security, and privacy. It is also good for Search Engine Optimization (as Google will reward you for securing your site). If you set up your site so all pages are always secure, relative links are safe.

Ensure No One Can Connect to Form Pages Insecurely

Using the above suggestions, all the links on your website will take users to the secure version of the form. However, most web hosts leave the insecure version of the form there, and users can still access it if they enter the insecure address directly (or if links are directed to the insecure page). As a next step, you should ensure that accessing the form page via an insecure connection is impossible.

There are several different ways that this can be done. Some of these include:

Separate space for SSL pages: If your web host has this feature, you can configure the website to store web pages for secure (SSL) connections in a different directory from those for insecure pages. If this feature is enabled, the form page is placed in the secure directory and no copies are in the insecure directory. Thus, any insecure requests for these pages would result in a “page not found” error. You could then implement server-side redirection rules where if someone requests the insecure page, they are automatically redirected to the secure version (this can be done using .htaccess files and the “Redirect” directive). If you did this, secure and insecure requests for the page would take the user to the secure version with no errors, warnings, or issues for the end user.

Scripted pages: If the form page is generated by a server-side script (i.e., PHP, Perl, Python, or JAVA), then the script itself can determine if the request is secure or not (e.g., by looking at the server environment variables). For secure requests, it can render the form as usual. The user receives an error for insecure requests or is redirected to the proper secure location. 

Securing all pages: (Recommended) The site can be configured to automatically redirect all requests for insecure pages to the respective secure page. All pages will be secure, and any accidental/incorrect requests for the insecure pages will still get people to the right place. Security is greatly improved if you have set this up.

If my form is posted to a secure form processing script, why does it need to be secured?

This question is usually asked when a third-party manages the form processing. Is securing the form itself with SSL needed?

The answer is based on the following facts:

  1. The data sent from end-users to the server will be secure and encrypted during transmission. This is critical for creating secure websites and forms that require HIPAA compliance.
  2. Non-technical end-users will only know if their data is securely submitted once it is done. Many end-users will refrain from submitting sensitive data to an insecure form on your site.
  3. End-users cannot know if they are viewing your website or a phishing site or if eavesdropping and modification are happening. Many users will not trust the connection and will not want to submit their data through your site if it appears insecure.
  4. If your form page is insecure, it is straightforward for any malicious party to perform a man-in-the-middle attack to eavesdrop on connections, modify your form in transit to change what is collected and where the data is sent, and set up phishing sites. Your end-users can’t tell if this is going on.

If you do not secure your web form with SSL, it is vulnerable to attack. If nothing is going on, you can rely on transmission security. However, that minimal level of security is not recommended for production websites or anywhere that compliance is required.

Other Aspects of Creating Secure Web Forms

Proper use of SSL for encryption and trust is only part of creating secure website forms. You must be concerned with many other aspects to protect your users, your application, and your company’s reputation. These include (but are not limited to):

1. Cross-Site Scripting (XSS). Suppose you include dynamic content on your web pages (i.e., information submitted by other users or content submitted via form fields), and that content is not cleaned of JavaScript and HTML. In that case, bad actors could make arbitrary content appear on your website, capture user data, or worse. All data displayed should be clear of undesirable content (script tags, special characters, HTML, and other things). This is one of the most significant security issues with dynamic web pages across the internet.

2. Secure Server-Side Programming: The scripts and programs that accept and process the data from online forms must be created with security in mind. They must validate all submitted data as needed without making assumptions about its format and content. The scripts must not provide avenues for attacks like SQL Injection. Scripts must not use submitted content as actual filenames or URLs for remote loading content. They should log any strange errors or problems for later analysis. They should provide a mechanism for blocking undesirable actions or users from using the scripts.

3. Validation: Validation of all input data is part of the above two points. However, it is so essential that we will repeat it and go over some of the fundamental points:

  • If you validate submitted content, always perform your validation on the server side. Even if you use JavaScript to validate the data on the client side, you should always re-validate it on the server side. Why? Because people can get around JavaScript and submit arbitrary content directly to your scripts. The scripts should be prepared to handle that.
  • Always de-taint submitted data. What does that mean? It means never trust submitted data and take pains to ensure that the submitted data matches what you expect. For example, if you have a select list that sends your script a number as the value, do not assume you are getting a number. Instead, check that it is a numeric value or convert whatever is submitted into a number.
  • Remove disallowed content from the text submitted by users. Remove or block special characters, embedded codes, and other things that should not be there.
  • Ensure the submitted data is manageable enough to be used.
  • Do not assume anything — program defensively.

4. Preserving State with Hidden Form Fields or Cookies: If your program remembers information from one page to another by saving the data in hidden form fields, then your program must also ensure that the content of those fields was not tampered with. One good way to do this is to make a hash of all the data, together with a secret value, and include that hash in the form data. Then, when the form is submitted, you can recompute the hash and compare it with what passed from the form. If they match, you are okay; if they do not, the data has been tampered with. No one can break this scheme without knowing your secret value or breaking your hashing algorithm. This method can also be used to validate data saved in cookies. You can go further and use time stamps to prevent replay attacks.

5. Third-Party Applications: If you install programs from third parties on your website, you must ensure there are no known security issues with these programs, and you must be sure to update these programs as soon as new versions are released. If you let your website languish with an older, vulnerable version of a program, it will become a target for hackers as they constantly search the internet for such websites. Your site will likely be hacked in these cases, possibly causing loss of business, deactivation of your website, and tarnishing your website’s reputation. Using a third-party application is easy, but you need to select a good one that places the burden of keeping it updated on you. An exception is using a third-party application hosted by the third party itself. In these cases, the third party ensures that the program is continuously updated with anything needed to address any security issues. The burden is on them and not you. If you choose a good, respectable vendor, you should have no problems.

All these things, and more, are critical to developing a secure web application.

Securing the Form Data After Submission

Ensuring that users’ data is transmitted securely to your web server is critical, as is ensuring that your application is secure and will not be hacked. To secure sensitive data, you must understand what happens to that data after your program receives it. Many people forget that transmitting the data from the web server may require just as much preparation as receiving it from their users in the first place.

In the following subsections, we will look at three different ways of saving and retrieving your users’ data. In each case, we will explain what is needed to secure the data in your systems.

Send Form Data via Email 

The most common action data processing scripts do is email the submitted data to the website owner’s email address. The website owner knows when there are new submissions by checking their email and can access the data immediately. Most people running websites check their email reasonably often, which integrates well with their business operations.

However, the standard ways of sending emails are entirely insecure. So, how can you use email while ensuring the data is secure and viewable only by the intended recipient?

  1. Have your website script encrypt the data.
  2. Send this encrypted data (or a link to download the encrypted data) to the intended viewers via regular email.

As the form data is encrypted within the email message, most insecurities inherent in email are obviated. You can also use secure third-party services to have your form data emailed to you securely without programming anything yourself.

Save the Submission in a Database

Many website owners like to save the submitted form data in a database (even if it is also emailed to someone). Why?

  1. The data is saved online and potentially accessible from anywhere.
  2. If the emailed copies of the data are lost, the copies in the database are still there.
  3. The database can be accessed through a web browser with a suitable user interface.
  4. The data is typically backed up and can be restored.

If storage in an online database is for you, then you need to:

  1. Use encryption, like SSL or PGP, to ensure the data is securely stored in the database. Why? The contents of database tables are not encrypted or secure in general. Storing unencrypted data makes it available to anyone with access to the database or its backups.
  2. Provide a user interface that allows you to access the database data. It must be secure, have robust access controls, and provide a means for decrypting the data.

The database option requires much work to make a secure and usable solution. For this reason, most small organizations do not end up using secure database storage for important form data.

Save the Data in Files

The file storage option is the “quick and dirty” alternative to secure database storage. Essentially, your program will:

  1. Make a file containing the form data.
  2. Encrypt that file using PGP or SSL.
  3. Save that encrypted file in a directory on the web server that is not accessible from the website. Another option is to save it in an online file-sharing service.

Then, the website owners can log in to the web server using Secure FTP and download these files as needed. They can be decrypted locally when the data must be accessed. Other simpler data access mechanisms are available if the files are saved in an online file share.

This solution is secure and provides an excellent backup to securely emailed data.

Other Technical Tips for Creating Secure Website Forms

There are many other considerations in developing and maintaining a secure website and forms. It would be impossible to cover or even list them all. However, here are some more interesting and valuable tips.

Use Secure Cookies

If your secure site uses cookies for anything, set the “secure” cookie and the “httpOnly” flags. This will ensure that these cookies are never sent insecurely over the internet when the visitor arrives at any insecure pages of your website (they are not sent at all to insecure pages) and thus helps preserve the security of the contents of these secure cookies.

Prevent Form Spam

Form spam occurs when automated programs find your web forms and try to send spam through them. Form spam can result in hundreds or thousands of useless form posts daily. Once you start getting form spam, stopping it is a priority. There are two primary ways to help prevent spam:

  1. CAPTCHA – This method requires end-users to read text embedded in an image and type that text successfully into a form field. The back-end program then validates this. Since most spam programs cannot read text embedded in images, it will successfully block almost all automated forms spam. However, CAPTCHA requires the users to perform one more step, which can be annoying.
  2. JavaScript and Cookies – Most automated form spam programs do not process JavaScript or use cookies. If your web form requires JavaScript to submit the form successfully, bots cannot do this, and most form spam will be blocked. This method is less reliable than CAPTCHA but does not require any extra work from the end-user. Note that if you wish to use the JavaScript method, you must be sure that arbitrary submissions to the default action URL of your forms will never succeed—only submissions made after the execution of your custom JavaScript should succeed.

Minimize the Need for Trust

A good rule of thumb is to minimize the need to trust third parties and trust only the trustworthy.

  1. If you do not trust your internal IT staff, do not host your web application on your servers or give them access to the server used.
  2. If you do not trust the third-party hosting your website, encrypt the form data as soon as possible. This helps ensure that the data is not saved anywhere in plain text and is not backed up in plain text, thus minimizing your exposure to unauthorized people. Further, ensure that the private keys and passwords needed to decrypt the data are not stored on the web host’s servers.
  3. Ensure that only authorized staff can access the submitted form data. Ideally, it should always be encrypted, and only authorized people should be able to decrypt it.

These are just a few obvious points. As you evaluate your web application and data flow, ask yourself, “Who can access the raw data and how?” at each stage. Are there stages where you are trusting people who should not be trusted?

Forced use of strong encryption in SSL

The strength of encryption used by SSL is a function of both the user’s web browser and the server. Even if your web server supports excellent encryption, like AES256, the user’s browser may choose a weaker level of encryption. Older versions of Internet Explorer are notable for choosing weaker encryption in the interest of speed.

You can modify your web server configuration so that only levels of encryption you approve can be used to access your site.

Use Two-Factor Authentication

Two-factor authentication is standard on very secure sites now. You require a password and something else (a code or token) to validate their identity. With both, the user can log in. Avoid using only SMS texting as the second factor, which is no longer considered secure.

Get Started Creating Secure Web Forms

Outsourcing your form hosting and processing can be the fastest and most cost-effective way to get started. LuxSci’s Secure Form was designed for security and compliance. Contact us today to learn more about protecting sensitive information online.

Picture of Erik Kangas

Erik Kangas

With 30 years engaged in to both academic research and software architecture, Erik Kangas is the founder and Chief Technology Officer of LuxSci, playing a core role in building the company into the market leader for HIPAA compliant, secure healthcare communications solutions that it is today. An international lecturer on messaging security, Erik also advises and consults on email technology strategies and best practices, secure architectures, and HIPAA compliance. Erik holds undergraduate degrees in physics and mathematics from Case Western Reserve University, and a doctoral degree in computational biophysics from MIT. Erik Kangas — LinkedIn

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HIPAA Compliant Email

Rethinking HIPAA Compliant Email – Not Just a Checkbox

The compliance-only mentality is outdated.

Let’s be honest—when most healthcare organizations think about HIPAA compliant email, it’s usually in the context of avoiding fines or satisfying checklists. And while yes, compliance is critical, viewing it only through the lens of risk management is a missed opportunity.

In reality, HIPAA compliant email, when implemented properly, is one of the most powerful tools for patient and customer engagement. Why? Because it unlocks the ability to leverage protected health information (PHI) safely, enabling personalized, timely, and high-impact email communication that drives better engagement, satisfaction, and outcomes.

What Makes Email Truly HIPAA Compliant?

As a reminder, HIPAA compliant email requires that protected health information (PHI) is safeguarded both in transit and at rest. That means your email provider must:

  • Use encryption at all times
  • Be access-controlled
  • Include audit logs
  • Be stored and transmitted in a secure manner
  • Provide a Business Associate Agreement

Regular email services just don’t cut it. In fact, most consumer or marketing email platforms like Sendgrid or Constant Contact, while great at sending email, are not HIPAA compliant or have limitations when it comes to using PHI in your messages. Even when bolted-on encryption solutions are used, they often lack the flexibility, scalability, and automation needed for safe and effective healthcare email engagement.

LuxSci goes beyond the basics with policy-based encryption, secure TLS, PKI encryption and escrow/secure portal options. LuxSci’s SecureLine™ encryption technology dynamically selects the appropriate encryption method based on recipient capabilities and messaging context and can be configured to enforce secure delivery automatically according to organizational policies. LuxSci also provides the ability to enforce advanced multi-factor authentication. Every message is tracked with full audit trails—no guesswork, no loose ends.

The Real Opportunity – Secure, Personalized Email with PHI

Using PHI to Drive Personalized Messaging
Imagine sending a personalized reminder to a diabetic patient about an upcoming check-up. Or reaching out to new mothers with postnatal care resources tailored to their needs. Or sending automated email workflows to all your members to accelerate and increase new plan enrollments. Or email customer and prospects about a new product upgrade or new service offering. The list goes on. That’s the power of PHI-personalized email—when done securely.

Targeted Segmentation with Sensitive Data
With HIPAA compliant email solutions like LuxSci, you can segment your audience based on real health data with high levels of precision, such as chronic conditions, appointment history, insurance status, health risks, and more, without compromising patient trust or security.

Breaking the One-Size-Fits-All Approach in Healthcare Email
Generic email blasts are over. Modern patients expect personalization. With LuxSci, you can deliver highly targeted, highly secure emails with encrypted content, while staying HIPAA compliant.

Real Business Results from Secure Email

Here’s how secure, personalized email can drive improved results across a range of healthcare communications, including:

  • Increased Patient Appointments and Follow-ups – Sending encrypted, personalized appointment reminders and follow-up notices can reduce no-shows and boost overall appointment volume.
  • Boosting Preventative Care with Outreach Campaigns – Preventative campaigns (think flu shots or cancer screenings) sent securely to the right segments can lead to higher response rates, better health outcomes, and a lower cost of care.
  • Improving Health Plan Enrollments – Targeted email outreach during open enrollment, tailored by eligibility or plan type, and powered by automated workflows leads to higher enrollments and lower call center costs.
  • Driving Awareness and Sales of New Services or Products – Have a product upgrade offer, new wellness program or telehealth service? Send secure, PHI-informed HIPAA compliant email to the right audience for increased sales and faster adoption.
  • Optimize Explanation of Benefits NoticesReplace snail mail with email that’s fast, reliable and trackable, ensuring customers are informed and compliance is met.

The Healthcare Marketer’s Secret Weapon: Using PHI Responsibly

In a world moving away from third-party cookies, first-party data is more valuable than ever, and PHI is the most powerful form of it in healthcare. With secure HIPAA compliant email, PHI doesn’t have to be locked away. Marketers can safely use it to understand patient needs and send relevant, timely messages. PHI-driven segmentation lets you build hyper-targeted campaigns that speak to relevant conditions, unique needs and timely topics, increasing open rates, clicks throughs, and campaign conversions.

Meeting the Personalization Demands of Today’s Patients and Customers

HIPAA-compliant email is no longer just about checking a box. It’s about unlocking the full potential of your patient and customer data to drive better engagement, healthier outcomes, and measurable business results.

In closing, below are some final thoughts on how secure, HIPAA compliant email delivers long-term value for your organization and better connections with your patients and customers, including:

    • Future-Proofing Healthcare Engagement – Patients expect Amazon-level personalization. HIPAA-compliant tools let you meet those expectations securely.

    • Adapting to Data Privacy Regulations Beyond HIPAA – From GDPR to state-level privacy laws, secure communication is no longer optional, it’s foundational.

    • Building Trust Through Secure Communication – Each secure, personalized message sent is a trust-building moment with your patients and customers.

Why LuxSci? The Infrastructure Behind the Performance

With LuxSci’s secure email infrastructure and email marketing solutions, healthcare organizations can confidently personalize communication, reach patients more effectively, and fuel growth with PHI-safe segmentation, messaging, and email automation.

LuxSci takes data security and email performance to the next level by offering dedicated cloud infrastructure for each customer, which means your email campaigns aren’t slowed down by other vendors on shared cloud services and your attack footprint is much smaller. In short, you get higher delivery rates and throughput with proven HIPAA compliance and data security.

The future of healthcare engagement is personal, secure, and performance-driven—and it starts with HIPAA compliant email done right.

Reach out today with any questions or to learn more about LuxSci.


FAQs

1. Is HIPAA-compliant email necessary for marketing communications?
Yes—if your emails include or are based on PHI (like appointment reminders, condition-based messaging, or insurance info), you need HIPAA-compliant email and recipient consent to avoid legal risk and preserve patient trust.

2. Can PHI be used in marketing emails under HIPAA?
Yes, with proper consent and secure, HIPAA compliant infrastructure like LuxSci’s, PHI can be safely used in emails for personalized, segmented campaigns.

3. How does LuxSci ensure high email deliverability for healthcare messages?
LuxSci uses dedicated cloud servers for each customer, active email reputation monitoring, and best-practice configurations to ensure high deliverability rates for sensitive emails.

4. Is LuxSci only for marketing teams?
No—LuxSci supports marketing, clinical, operations, and IT teams by enabling secure, compliant email communication across the entire organization.

5. What types of PHI can I use to segment campaigns using LuxSci?
You can segment based on chronic conditions, visit history, insurance status, provider details, age, gender, location, and more—all while staying fully compliant.

HIPAA compliant email

Most Popular LuxSci Blog Posts of 2025

As we close out 2025, healthcare communicators, IT and compliance leaders, and digital marketers face an ever-changing landscape of security threats, regulatory updates, and technology innovations. At LuxSci, we’re committed to helping you with continuous updates and guidance on the future of secure healthcare communications.

In case you missed it, or need a refresh, below are some of our most popular blog posts from 2025. Enjoy!

1. Improve Email Engagement and Marketing Results with Automated Workflows

Automated workflows are transforming how healthcare organizations engage patients and customers — enabling dynamic, event-driven campaigns that easily scale your outreach and keep you HIPAA compliant. In this post, we introduce LuxSci’s Automated Workflows capability for our Secure Marketing healthcare solution. Learn how sequence-based journeys can personalize outreach and optimize engagement with behavior-based triggers that improve campaign performance — without sacrificing data security.

Read the full post: LuxSci Enhances Secure Marketing with Automated Workflows

2. Healthcare Email Threat Readiness Strategies

Email remains a frontline channel for healthcare communications, and a prime target for cyber threats and criminals. This deep-dive into email threat readiness strategies covers essential practices like continuous monitoring, business continuity planning, and workforce training to mitigate email-borne security risks. Whether you’re responsible for clinical systems, marketing, or enterprise IT, this post provides a strategic playbook to strengthen your defenses, while maximizing your results.

Read the full post: Healthcare Email Threat Readiness Strategies

3. HIPAA Compliant Email — 20 Tips in 20 Minutes

For practical guidance you can apply right now, this on-demand webinar distills 20 key tips for HIPAA-compliant email across technical, legal, and operational domains. Whether you’re refining your infrastructure, improving deliverability, or modernizing your data security posture in 2026, this resource is a time-efficient way to elevate your compliance and security.

Read the post and watch the webinar on demand: HIPAA Compliant Email: 20 Tips in 20 Minutes

4. Is SendGrid HIPAA-Compliant? What You Should Know

Choosing the right email provider matters, especially when Protected Health Information (PHI) is at stake. In this post, we examine SendGrid’s capabilities in the context of HIPAA compliance, outline what it takes to send PHI securely, and offer guidance on evaluating third-party services for secure healthcare email and communication needs.

Read the full post: Is SendGrid HIPAA-Compliant?

5. LuxSci Shines in G2 Winter 2026 Reports

Customer feedback matters to LuxSci. In this post, we share the most recent news about LuxSci’s performance in the G2 Winter 2026 Reports, where we earned 20 badges across categories like Email Security, Encryption, Gateway, and HIPAA-Compliant Messaging. These reviews reflect not just product excellence, but trust from real users, which we work hard to build every day!

Read the full post: LuxSci Shines in G2 Winter 2026 Reports

Looking Ahead to 2026

We look forward to providing more information and insights on secure healthcare communications in the coming year, including the latest on HIPAA compliant email, PHI security, healthcare marketing, threat readiness, and personalized engagement. In the meantime, if you’re not already, follow us on LinkedIn below, and we’ll see you here in 2026!

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HIPAA compliant email

LuxSci Welcomes Angel Mazariegos as Head of Finance

LuxSci, a leader in secure healthcare communications and HIPAA compliant email, is pleased to announce the appointment of Angel Marie Mazariegos as the company’s new Head of Finance. With over 25 years of experience in financial management, accounting, and human resources, Angel will play a central role in advancing LuxSci’s operational excellence and supporting the company’s rapid growth in 2026 and beyond.

Angel brings a wealth of expertise to LuxSci, having held senior leadership positions at organizations focused on financial services, language and access services for healthcare, and human resources. In these roles, Angel has led multi-department Finance and HR teams, spearheading critical initiatives, including ERP implementations, streamlined employee onboarding, and financial process optimization.

In her role at LuxSci, Angel will oversee all aspects of the company’s finance operations, including budgeting, forecasting and reporting. Additionally, Angel will manage the company’s HR function, ensuring that LuxSci continues to foster a strong, people-driven culture based on its Secure, Trust, Responsible and Smart company values.

“Angel’s blend of financial and HR leadership makes her an invaluable addition to the LuxSci executive team and a real asset for our people,” said Mark Leonard, CEO of LuxSci. “We look forward to working with Angel to build the high-performing teams that will be critical to our future growth and serving the evolving needs of our customers.”

Angel holds dual MBA degrees in Accounting and Human Resource Management from Cappella University, as well as dual BS degrees in Business Administration (Accounting and CIS Business Systems) from California State University, Los Angeles.

“I am honored to join the LuxSci team at such an exciting time for the company,” said Mazariegos. “I look forward to working with the team and helping build on LuxSci’s reputation for excellence and reliability in secure healthcare communications.”

HIPAA Compliant Email

LuxSci Shines in G2 Winter 2026 Reports, Underscoring Commitment to Product Leadership and Trusted Relationships

We’re pleased to announce that LuxSci has been recognized for excellence and leadership for HIPAA compliant email and messaging in the just-released G2 Winter 2026 Reports!

Based on verified customer reviews, LuxSci earned 20 G2 badges as part of the most recent G2 reports, including top honors such as Grid Leader, Highest User Adoption, Best Support, and Best Estimated ROI.

This recognition further validates what we’ve always believed: our customers don’t just choose a great product — they choose a great partner. At LuxSci, we build long-term, trusted relationships with our customers, anchored in product reliability, industry-leading email deliverability and performance, and the best customer support in the business.

Why G2 Matters

G2 is a globally trusted peer‑review platform that aggregates verified user feedback and real‑world usage data to rank software and service providers. G2’s seasonal reports like the Winter 2026 editions shine a spotlight on latest tools and vendors that deliver consistent value and satisfaction to real customers.

Earning 20 badges this quarter signals a strong vote of confidence from our customers and community, helping affirm that LuxSci is a leading, highly adopted secure email solutions provider.

What We Earned in Winter 2026

Among the 20 badges awarded to LuxSci across Email Security, Email Encryption, Email Gateway and HIPAA Compliant Messaging are:

  • Grid Leader
  • Highest User
  • Best Support
  • Best Estimated ROI

This broad range of accolades spanning leadership, adoption, support and return on investment underscores the reliability of our solutions and the trust our customers place in us.

Awards Reflect Our Commitment to Customer Success

Reliable. Winning Grid Leader and Highest User Adoption demonstrates that thousands of users are depending on LuxSci, securely delivering emails to today’s most popular platforms, including Gmail, Apple Mail, Yahoo Mail and AOL, to name a few.

Proven. With Best Estimated ROI, customers are saying that LuxSci delivers tangible results, whether in secure email delivery, regulatory compliance, or operational efficiency.

Long‑Term Trust. Best Support is perhaps the most telling because for us, success isn’t just about features, it’s about being there for our customers every step of the way.

Thank you to all of our customers. We remain committed to your success — today and in the future.

Want to learn more about LuxSci? Reach out and connect with us today!

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HIPAA Marketing Guidelines

What Are HIPAA Marketing Guidelines?

HIPAA marketing guidelines are official interpretations and best practice recommendations issued by the Department of Health and Human Services that help healthcare organizations implement Privacy Rule marketing requirements effectively. These guidelines clarify regulatory expectations, provide practical examples of compliant marketing activities, explain authorization procedures, and offer implementation strategies for common healthcare marketing scenarios. Healthcare organizations often struggle to interpret broad regulatory language and apply it to specific marketing situations. Official guidance documents and industry best practices help bridge the gap between regulatory requirements and practical implementation challenges.

Official Guidance from Health and Human Services

Privacy Rule guidance documents provide detailed explanations of marketing definitions, authorization requirements, and permitted activities that help healthcare organizations understand their obligations. These documents include examples of different communication types and analysis of when authorization is required. Enforcement guidance explains how the Office for Civil Rights evaluates marketing violations and what factors influence penalty determinations. This guidance helps healthcare organizations understand compliance expectations and prioritize their risk management efforts. Technical assistance materials offer practical implementation advice for common marketing scenarios including patient newsletters, appointment reminders, and promotional campaigns.

Best Practice Recommendations for Authorization Management

Authorization form development should follow standardized templates that include all required elements while using clear language that patients can understand. These forms explain marketing purposes in plain English and avoid legal terminology that might confuse patients. Consent tracking procedures should document authorization decisions, track expiration dates, and process revocation requests immediately to prevent unauthorized communications. Healthcare organizations are required to implement systems that update consent status across all marketing platforms simultaneously. Verification processes ensure that marketing communications only reach patients who have provided valid authorization while preventing accidental disclosure to unauthorized recipients. These processes should aim to include regular audits of recipient lists and authorization documentation.

Communication Content and Approval Procedures

Content review processes should evaluate marketing materials for HIPAA compliance before distribution including assessment of PHI usage, authorization adequacy, and regulatory exemption applicability. These reviews should involve compliance officers, legal counsel, and clinical staff as appropriate. Message development guidelines help marketing teams create compliant content that engages patients effectively while respecting privacy requirements. HIPAA marketing guidelines address PHI usage, consent language, and opt-out mechanisms for different communication types. Quality assurance procedures verify that marketing campaigns meet compliance standards before launch through systematic review of content, recipient lists, and authorization documentation.

Segmentation and Targeting Best Practices

Patient population identification should use minimum necessary principles that limit data access to information needed for specific marketing purposes. Marketing teams should receive aggregated or coded data rather than complete medical records when possible. Demographic targeting strategies can enhance marketing effectiveness while maintaining privacy protections through automated systems that apply targeting criteria without exposing individual patient characteristics. These systems enable personalization while keeping PHI separate from campaign development. Clinical data utilization requires careful evaluation of medical information usage in marketing communications to ensure compliance with authorization scope and minimum necessary standards. Healthcare organizations should develop clear criteria for when clinical data can be included in marketing materials.

Technology Implementation Guidance

Platform selection criteria should prioritize HIPAA compliance features including encryption, access controls, audit logging, and consent management capabilities. Healthcare organizations should evaluate vendors based on their ability to meet regulatory requirements rather than just marketing functionality. System configuration guidelines ensure that marketing platforms are properly set up to maintain compliance throughout their operational lifecycle. HIPAA marketing guidelines address security settings, user permissions, and integration requirements with healthcare systems. Data management procedures govern how patient information is loaded, processed, and stored within marketing platforms while maintaining appropriate security protections. These procedures should include data validation, backup requirements, and disposal protocols.

Compliance Monitoring and Assessment

Audit schedules should establish regular review intervals for marketing activities including authorization compliance, content approval, and staff adherence to established procedures. These audits should be frequent enough to identify issues before they result in regulatory violations. Performance metrics help healthcare organizations track their marketing compliance including authorization rates, consent management effectiveness, and incident frequency. These metrics should provide early warning indicators for potential compliance problems. Documentation requirements ensure that healthcare organizations maintain records demonstrating their compliance efforts including policies, training materials, audit results, and incident response activities. Well kept records support regulatory reviews and demonstrate good faith compliance efforts.

Staff Training and Education Programs

Role-based training ensures that different healthcare personnel receive appropriate education about HIPAA marketing guidelines based on their job responsibilities and PHI access levels. Marketing staff need different training than clinical personnel who might engage in face-to-face marketing activities. Competency assessment procedures verify that staff understand marketing guidelines and can apply them correctly in their daily work activities. These assessments should include scenario-based questions and practical application exercises. Update training programs ensure that staff receive current information about HIPAA marketing guidelines as regulations change or organizational policies are updated. Programs should be conducted regularly and documented for compliance purposes.

Risk Management and Incident Response

Risk identification processes help healthcare organizations recognize potential marketing compliance vulnerabilities before they result in violations. These processes should consider technology risks, procedural gaps, and staff training needs. Violation response procedures provide step-by-step guidance for addressing potential marketing violations including investigation protocols, patient notification requirements, and regulatory reporting obligations. These procedures should be tested regularly and updated based on lessons learned. Preventive measures help healthcare organizations avoid marketing violations through proactive compliance management including policy enforcement, system controls, and staff accountability measures.

Industry-Specific Implementation Considerations

Hospital marketing guidelines address unique challenges faced by large healthcare systems including multiple service lines, diverse patient populations, and complex organizational structures. HIPAA marketing guidelines should consider coordination across departments and facility locations. Medical practice recommendations focus on smaller healthcare organizations with limited compliance resources including simplified procedures, cost-effective solutions, and practical implementation strategies. These recommendations should be scalable as practices grow. Specialty provider guidance addresses marketing considerations for different healthcare specialties including behavioral health, substance abuse treatment, and other areas with enhanced privacy protections.

b2b medical marketing

What is the Meaning of Patient Engagement?

Patient engagement refers to the active participation of individuals in their healthcare through informed decision-making, self-management, and collaborative relationships with providers. This approach involves patients taking an active role in their treatment plans, communicating with healthcare teams, and managing their health between clinical visits. Patient engagement connects to improved health outcomes, higher satisfaction, and more efficient healthcare delivery by creating partnerships between patients and their care providers.

Core Components of Patient Engagement

Patient engagement encompasses several elements that work together to create meaningful healthcare participation. Knowledge and education are the base of patient engagement, providing patients information about their health conditions and treatment options. Two-way communication channels allow patients to share concerns, ask questions, and provide feedback to their healthcare team. Self-management tools help patients monitor symptoms, follow treatment plans, and make health-promoting lifestyle changes. Shared decision-making involves patients and providers discussing options and selecting treatments that align with patient values and preferences. Technology platforms often support these components through patient portals, mobile apps, and remote monitoring devices. When combined effectively, these elements create healthcare experiences where patients actively participate rather than passively receive care.

Evolution of Patient Engagement Concepts

The understanding of patient engagement has developed over decades as healthcare delivery models have changed. Traditional paternalistic approaches positioned doctors as decision-makers with minimal patient input. The informed consent movement established patients’ rights to understand treatments before agreeing to them. Consumer-directed healthcare introduced market concepts with patients viewed as consumers making choices. Patient-centered care expanded this view by recognizing patients’ unique needs, preferences, and life circumstances. Modern patient engagement builds on these previous concepts while emphasizing active participation and partnership. This evolution reflects broader societal changes in information access, consumer expectations, and understanding of what creates effective healthcare. Today’s patient engagement models acknowledge that health outcomes improve when patients participate fully in their care.

Impact on Health Outcomes

Research consistently shows that effective patient engagement leads to improved health results across numerous conditions. Engaged patients typically experience better control of chronic diseases like diabetes and hypertension through more consistent medication adherence and lifestyle management. Surgical patients who actively participate in pre-procedure education and post-operative care plans often recover faster with fewer complications. Mental health treatment shows greater effectiveness when patients actively participate in therapeutic approaches and decision-making. Prevention efforts achieve better results when individuals engage in recommended screenings and health maintenance activities. These outcome improvements stem from better treatment adherence, earlier problem identification, and care plans that align with patients’ actual lives and capabilities. Healthcare organizations increasingly focus on patient engagement as a core strategy for improving clinical quality measures.

Healthcare System Benefits

Beyond individual health improvements, patient engagement creates advantages for healthcare systems and organizations. Engaged patients typically use healthcare resources more efficiently, with fewer unnecessary emergency department visits and hospitalizations. Appointment attendance rates improve when patients actively participate in scheduling and understand the purpose of visits. Preventive care utilization increases, potentially reducing costly interventions for advanced disease. Staff satisfaction often improves through more productive patient interactions and shared responsibility for outcomes. Healthcare organizations find that focusing on patient engagement helps meet quality metrics tied to value-based payment models. Patient feedback provides valuable insights for service improvements when organizations create meaningful engagement channels. These system benefits make patient engagement a strategic priority for healthcare organizations in competitive markets.

Technology and Patient Engagement

Digital tools have transformed how patient engagement functions in modern healthcare settings. Patient portals provide secure access to medical records, test results, and communication channels with care teams. Mobile health applications help patients track symptoms, medications, and health metrics between appointments. Wearable devices gather health data that patients and providers can use for monitoring and decision-making. Telehealth platforms extend access to care beyond traditional office visits. These technologies remove barriers to engagement by making information and communication more accessible regardless of location or time constraints. While technology alone doesn’t create engagement, thoughtfully designed digital tools can facilitate greater patient participation in healthcare activities and decisions. Healthcare organizations increasingly view technology investment as essential for effective patient engagement strategies.

Implementation Challenges and Solutions

Healthcare organizations face various obstacles when trying to improve patient engagement. Health literacy varies widely, affecting patients’ ability to understand medical information and participate in decisions. Digital access and technical skills create potential disparities in who can use engagement tools. Time constraints during appointments limit opportunities for meaningful patient-provider discussion. Healthcare teams may lack training in engagement techniques like shared decision-making and motivational interviewing. Organizations address these challenges through health literacy assessment and education programs, simplified communication approaches, and multiple engagement channel options beyond digital platforms. Staff training in patient activation methods helps healthcare teams support engagement effectively. Workflows redesigned to prioritize engagement activities create space for meaningful patient participation despite busy clinical environments.

secure communication platform

What Is The Best Secure Communication Platform For Healthcare?

The best secure communication platform combines strong encryption, reliable access control, detailed audit tracking, and legal accountability under the HIPAA Privacy and Security Rules. Healthcare teams rely on these systems to exchange Protected Health Information without disruption. A secure communication platform that integrates with clinical tools, automates security standards, and provides transparent monitoring allows providers to maintain compliance while focusing on patient care.

Importance of a secure communication platform in healthcare

Healthcare depends on constant coordination between physicians, staff, and patients. Emails, messages, and shared files often include sensitive medical information that requires protection at every stage. A secure communication platform helps prevent data loss or exposure by enforcing encryption both in transit and at rest. It also preserves trust between patients and providers by ensuring confidentiality. When security controls operate automatically in the background, communication becomes smoother, and staff can work without worrying about compliance gaps that may place data at risk.

Encryption and identity protection

Encryption is the foundation of message security. Transport Layer Security establishes a private path between servers, while message-level encryption adds another layer for content that travels beyond trusted systems. Access to these communications depends on verified identity through multi-factor authentication, biometric checks, or device-based tokens. Timeout rules reduce risk on shared computers where several staff members may use the same terminal. These features work together to protect patient data from interception or misuse and give healthcare organizations tangible proof that messages remain secure.

Business Associate Agreements and legal accountability

Any organization that handles Protected Health Information must ensure its vendors meet the same compliance standards. A Business Associate Agreement defines each party’s responsibilities for data protection, breach notification, and record retention. It should reference specific safeguards listed in 45 CFR 164.308 and 164.312 to confirm that the platform follows HIPAA’s requirements. Independent audits such as SOC 2 Type II or HITRUST add assurance that these controls are active and reliable. Having clear contractual obligations supported by certifications limits ambiguity and strengthens legal protection for all involved parties.

Clinical integration and workflow compatibility

For a secure communication platform to be effective, it must fit naturally into the healthcare environment. Direct integration with electronic health records allows staff to manage messages within existing systems rather than switching between separate tools. Open APIs let hospitals customize data flow between scheduling, billing, and messaging platforms. Single sign-on simplifies authentication so clinicians can access messages quickly while maintaining compliance. Mobile access that retains encryption helps providers respond from different locations without compromising security. When communication aligns with daily routines, adoption improves and administrative burden drops.

Monitoring and audit visibility

Maintaining compliance requires visibility into system activity. An effective platform records message access, file downloads, and configuration changes through immutable logs. These records enable privacy officers to trace who viewed information and when it was accessed. Alerts for suspicious logins or unusual traffic help identify problems early. Retention settings that match policy requirements simplify discovery requests while preventing unnecessary storage costs. This combination of automation and transparency allows healthcare organizations to demonstrate compliance rather than merely claim it.

Evaluating usability and implementation

Selecting a platform should include a structured pilot across departments. Rather than focusing only on technical features, decision makers should observe how easily clinicians and staff adapt to the workflow. A useful evaluation looks at message turnaround times, administrative effort, and support responsiveness. Gathering feedback from multiple roles reveals practical issues that may not appear during demonstrations. Vendors that assist with migration, setup, and staff training tend to reduce deployment time and lower the likelihood of communication errors during transition.

Balancing cost, scalability, and compliance

Cost considerations extend well beyond subscription fees. Storage limits, archive access, and support tiers influence total expense over time. Aligning pricing with staff size and data retention policies prevents unplanned spending as the organization grows. Role-based administration and delegated access can reduce reliance on central IT teams, creating flexibility in large healthcare networks. A secure communication platform that scales smoothly maintains the same encryption, authentication, and monitoring standards as the user base expands. When compliance, usability, and affordability intersect, patient communication becomes safer, faster, and more reliable for everyone involved.

biggest email threats

Know the Biggest Email Threats Facing Healthcare Right Now

Due to its near-universal adoption, speed, and cost-effectiveness, email remains one of the most common communication channels in healthcare. Consequently, it’s one of the most frequent targets for cyber attacks, as malicious actors are acutely aware of the vast amounts of sensitive data contained in messages – and standard email communication’s inherent vulnerabilities.

In light of this, healthcare organizations must remain aware of the evolving email threat landscape, and implement effective strategies to protect the electronic protected health information (ePHI) included in email messages. Failing to properly secure email communications jeopardizes patient data privacy, which can disrupt operations, result in costly HIPAA compliance violations, and, most importantly, compromise the quality of their patients’ healthcare provision.

With all this in mind, this post details the biggest email threats faced by healthcare organizations today, with the greatest potential to cause your business or practice harm by compromising patient and company data. You can also get our 2025 report on the latest email threats, which includes strategies on how to overcome them.

Ransomware Attacks

Ransomware is a type of malware that encrypts, corrupts, or deletes a healthcare organization’s data or critical systems, and enables the cybercriminals that deployed it to demand a payment (i.e., a ransom) for their restoration. Healthcare personnel can unwittingly download ransomware onto their devices by opening a malicious email attachment or clicking on a link contained in an email.

In recent years, ransomware has emerged as the email security threat with the most significant financial impact. In 2024, for instance, there were over 180 confirmed ransomware attacks with an average paid ransom of nearly $1 million. 

Email Client Misconfiguration

While a healthcare organization may implement email security controls, many fail to know the security gaps of their current email service provider (ESP) or understand the value of a HIPAA compliant email platform, leaving data vulnerable to email threats, such as unauthorized access and ePHI exposure, and also, subsequently, a greater risk of compliance violations and reputation damage.

Common types of email misconfiguration include:

  • Lack of enforced TLS encryption: resulting in emails being transmitted in plaintext, rendering the patient data they contain readable by cybercriminals in the event of interception during transit.
  • Improper SPF/DKIM/DMARC setup: failure to configure or align these email authentication protocols correctly gives malicious actors greater latitude to successfully spoof trusted domains.
  • Disabled or lax user authentication: a lack of authentication measures, such as multi-factor authentication (MFA), increases the risk of unauthorized access and ePHI exposure.
  • Misconfigured secure email gateways: incorrect rules or filtering policies can allow phishing emails through or block legitimate messages.
  • Outdated or unsupported email client software: simply neglecting to download and apply the latest updates or patches from the email client’s vendor can leave vulnerabilities, which are well-known to cybercriminals, exposed to attack.

Social Engineering Attacks

A social engineering attack involves a malicious actor deceiving or convincing healthcare employees into granting unauthorized access or exposing patient data. Relying on psychological manipulation, social engineering attacks exploit a person’s trust, urgency, fear, or curiosity, and encompass an assortment of threats, including phishing and business email compromise (BEC) attacks, which are covered in greater depth below.

Phishing

As mentioned above, phishing is a type of social engineering attack, but they are so widespread that it warrants its own mention. Phishing sees malicious actors impersonating legitimate companies, or their employees, to trick victims into revealing sensitive patient data. 

Subsequently, healthcare organizations can be subjected to several different types of phishing attacks, which include:

  • General phishing: otherwise known as bulk phishing or simply ‘phishing’, these are broad, generic attacks where emails are sent to large numbers of recipients, impersonating trusted entities to steal credentials or deliver malware. 
  • Spear phishing: more targeted attacks that involve personalized phishing emails crafted for a specific healthcare organization or individual. These require more research on the part of malicious actors and typically use relevant insider details gleaned from their reconnaissance for additional credibility.
  • Whaling: a form of spear phishing that specifically targets healthcare executives or other high-level employees. 
  • Clone phishing:  when a cybercriminal duplicates a legitimate email that was previously received by the target, replacing links or attachments with malicious ones.
  • Credential phishing: also known as ‘pharming’, this involves emails that link to fake login pages designed to capture healthcare employees’ usernames and passwords under the guise of frequently used legitimate services.

Domain Impersonation and Spoofing

This category of threat revolves around making malicious messages appear legitimate, which can allow them to bypass basic email security checks. As alluded to above, these attacks exploit weaknesses in email client misconfigurations to trick the recipient, typically to expose and exfiltrate patient data, steal employee credentials, or distribute malware.

Domain spoofing email threats involve altering the “From” address in an email header to make it appear to be from a legitimate domain. If a healthcare organization fails to properly configure authentication protocols like SPF, DKIM, and DMARC, there’s a greater risk of their email servers failing to flag malicious messages and allowing them to land in users’ inboxes.

Domain impersonation, on the other hand, requires cybercriminals to register a domain that closely resembles a legitimate one. This may involve typosquatting, e.g., using “paypa1.com” instead of “paypal.com”. Alternatively, a hacker may utilize a homograph attack, which substitutes visually similar characters, e.g., from different character sets, such as Cyrillic. Malicious actors will then send emails from these fraudulent domains, which often have the ability to bypass basic email filters because they aren’t exact matches for blacklisted domains. Worse still, such emails can appear authentic to users, particularly if the attacker puts in the effort to accurately mimic the branding, formatting, and tone used by the legitimate entity they’re attempting to impersonate. 

Insider Email Threats

In addition to external parties, employees within a healthcare organization can pose email threats to the security of its PHI. On one hand, insider threats can be intentional, involving disgruntled employees or third-party personnel abusing their access privileges to steal or corrupt patient data. Alternatively, they could be the result of mere human error or negligence, stemming from ignorance, or even fatigue.

What’s more, insider threats have been exacerbated by the rise of remote and flexible conditions since the onset of the COVID-19 pandemic, which has created more complex IT infrastructures that are more difficult to manage and control.  

Business Email Compromise (BEC) Attacks

A BEC attack is a highly targeted type of social engineering attack in which cybercriminals gain access to, or copy, a legitimate email account to impersonate a known and trusted individual within an organization. BEC attacks typically require extensive research on the targeted healthcare company and rely less on malicious links or attachments, unlike phishing, which can make them difficult to detect.

Due to the high volume of emails transmitted within the healthcare industry, and the sensitive nature of PHI often included in communications to patients and between organizations, the healthcare industry is a consistent target of BEC attacks.

BEC attacks come in several forms, such as:

  • Account compromise: hijacking a real employee’s account and sending fraudulent messages.
  • Executive fraud: impersonating high-ranking personnel to request urgent financial transactions or access to sensitive data.
  • Invoice fraud: pretending to be a vendor asking for the payment of a fraudulent invoice into an account under their control.

Supply Chain Risk

Healthcare organizations increasingly rely on third-party vendors, including cloud service providers, software vendors, and billing or payment providers to serve their patients and customers. They constantly communicate with their supply chain partners via email, with some messages containing sensitive patient data; moreover, some of these organizations will have various levels of access to the PHI under their care.

Consequently, undetected vulnerabilities or lax security practices within your supply chain network could serve as entry points for email threats and malicious action. For instance, cybercriminals can compromise the email servers of a healthcare company’s third-party vendor or partner, and then send fraudulent emails from their domains to deploy malware or extract patient data.

Another, somewhat harrowing, way to understand supply chain risk is that while your organization may have a robust email security posture, in reality, it’s only as strong as that of your weakest third-party vendor’s security controls.

Download LuxSci’s Email Cyber Threat Readiness Report

To gain further insight into the biggest email threats to healthcare companies in 2025, including increasingly prevalent AI threats, download your copy of LuxSci’s Email Cyber Threat Readiness Report

You’ll also learn about the upcoming changes to the HIPAA Security Rule and how it’s set to impact your organization going forward, and the most effective strategies for strengthening your email security posture.

Grab your copy of the report here and begin the journey to strengthening your company’s email threat readiness today.