In today’s connected world with millions of messages bombarding people every second of the day, personalized engagement over digital channels is a requirement for any business – especially in healthcare. However, ensuring that your marketing efforts comply with the Health Insurance Portability and Accountability Act (HIPAA) can be a daunting task that never quite gives you the peace of mind you need. The good news is that you don’t have to lose sleep at night worrying about whether your marketing campaigns are secure and protected from data breaches and outside threats. With the right strategies and solutions, you can create HIPAA-compliant marketing campaigns that not only keep data protected, but also boost lead conversions, improve outcomes, and reduce costs.
Here are some simple but necessary steps to get you off and running with HIPAA-compliant marketing campaigns today:
Understand HIPAA Requirements
Before embarking on any marketing campaign, it’s crucial to have a thorough understanding of HIPAA regulations. HIPAA sets strict guidelines for keeping protected health information (PHI) safe. Ensure your marketing team is well-versed in these regulations to avoid any compliance failures. If you’re not sure, check out this recent LuxSci blog post on understanding encryption requirements for HIPAA-compliant email.
Leverage Automated Data Encryption
Safeguarding protected health information (PHI) is a requirement with HIPAA. Use advanced encryption methods – including dedicated cloud infrastructures and automation that encrypts every email sent with no user intervention required – to secure patient and customer data both in transit and at rest. This ensures that any data shared during marketing campaigns remains confidential and secure from breaches.
Implement Consent Management
Obtaining explicit consent from patients and customers before using their information in marketing campaigns is a also requirement and non-negotiable. Make sure you have a consent management system that records, stores, and manages patient and customer consent effectively and efficiently.
Personalize and Hypersegment Campaigns Using PHI Data
HIPAA does not need to hold you back. In fact, using PHI data can take your email targeting and messages to the next level. Personalized marketing can significantly improve patient and customer engagement and increase your lead conversions. Use PHI data to tailor your marketing messages to the specific needs and preferences of precise segments to ensure content is relevant and valuable – and actionable.
Utilize Encryption for All Healthcare Communications
Communicating with patients and healthcare customers through secure channels is essential for ALL communications, not just those that require HIPAA compliance. Use flexible encrypted email services, secure messaging apps, and patient portals to share sensitive information, and protect yourself from the latest cybersecurity threats at all times.
Monitor, Analyze and Improve Marketing Campaigns
Regularly test, monitor and analyze your marketing campaigns to ensure ongoing HIPAA compliance and the best results, using data on emails delivered, opened, clicked and secured. Take action in real-time to improve segmentation and results based on your latest business needs and deliverability requirements.
Improved healthcare experiences – Personalized and secure communications build trust and strengthen relationships with patients and customers.
More lead conversions – Hypersegmentation and automation drive higher conversion rates and improve patient and customer engagement.
Increased sales opportunities and revenue – Targeted, timely communications and campaigns drive the best results for growing your business.
Call to Action: ‘How-To’ Webinar on HIPAA-Compliant Marketing
Embracing HIPAA-compliant marketing is not just about avoiding penalties; it’s about delivering superior patient and customer experiences – and achieving business success. With HIPAA-compliant marketing, you can create powerful campaigns that protect PHI data, drive lead conversions, and improve patient and customer outcomes.
Are you ready to transform your healthcare marketing strategy – in a HIPAA-compliant way?
Join us for a webinar on How to Harness HIPAA-Compliant Marketing and Workflows, taking place on Tuesday, August 6 at 12:00PM Eastern Time. We’re joining forces with the experts over at Compliancy Group for an informative ‘how-to’ session on the latest best practices, success stories and easy-to-use tools for ensuring compliance across your organization – with a focus on marketing, workflows and automation. This includes:
Effectively and efficiently managing compliance across multiple standards
How to increase engagement and drive sales with HIPAA-compliant marketing
Optimizing workflows with secure forms and automation
Secure email is not the same as “email with encryption turned on.” True secure email requires enforced automated encryption, a signed BAA, access controls, audit logs, and documented processes — not just a feature toggle.
Standard email platforms like Gmail and Microsoft 365 rely on opportunistic TLS by default, which can silently fall back to unencrypted delivery if the recipient’s server doesn’t support encryption.
HIPAA’s encryption safe harbor means a misdirected but properly encrypted email is a non-event. The same email sent unencrypted is a presumed breach unless a risk assessment shows otherwise.
A signed Business Associate Agreement (BAA) with your email provider is non-negotiable — without one, you cannot legally send or store PHI through that provider.
The proposed 2025 HIPAA Security Rule update, planned for finalization in 2027, would make encryption of ePHI in transit and at rest a mandatory requirement rather than “addressable,” raising the stakes for organizations still relying on opportunistic TLS.
Best for: Healthcare IT Directors, Compliance Officers, Privacy Officers, and Marketing Managers at provider, payer, and supplier organizations that handle protected health information (PHI).
In healthcare IT, the term “secure email” gets thrown around loosely. Vendors slap the label on anything with a padlock icon, and internal teams often assume that because their provider offers TLS, they’re covered. They’re not, and the gap between what’s assumed and what’s actually required is where data breaches occur and HIPAA violations happen.
This guide breaks down exactly what secure email means from a technical and regulatory standpoint, why the email platform your staff uses every day probably isn’t compliant out of the box, and what to look for when evaluating a provider that needs to protect PHI at scale. If you want the full picture of what compliance requires beyond email specifically, our HIPAA Compliance Checklist is a useful companion read.
What Is Secure Email?
Secure email refers to an email system that protects the confidentiality, integrity, and availability of message content — specifically PHI — through a combination of technical safeguards and contractual protections. It’s not a single feature. It’s a stack of controls working together.
At minimum, secure email in a healthcare context includes:
Enforced encryption in transit, so messages can’t fall back to plaintext delivery
Encryption at rest, so stored messages remain protected on the server
Authentication protocols (SPF, DKIM, DMARC) that prevent spoofing and impersonation
Access controls and audit logs that track who accessed what, and when
A signed Business Associate Agreement (BAA) with the email provider
The distinction that trips up most organizations is this: encryption is a component of secure email, not the whole picture. A provider can offer encryption and still fail to meet HIPAA requirements if that encryption isn’t enforced, if there’s no BAA in place, or if audit logging doesn’t exist. Secure email is the combination of all these pieces functioning as a system, which is why it needs to be evaluated holistically rather than checked off feature by feature.
For healthcare provider, payer, and supplier organizations, this matters because email remains one of the highest-volume channels for PHI exposure, from clinical referrals to patient billing statements to routine staff communication. Getting the definition right is the first step toward closing the compliance gap.
Why Standard Email Is Not HIPAA-Compliant
Many healthcare organizations run on Gmail (Google Workspace) or Microsoft 365, and most assume they’re protected because encryption exists somewhere in the stack. That assumption is the single most common — and most dangerous — misconception in healthcare email security.
Here’s the problem: standard email services use opportunistic TLS by default. TLS is attempted between mail servers, but if the receiving server doesn’t support it, the message is delivered anyway — unencrypted, in plaintext. Neither the sender nor the recipient typically sees a warning. The email just goes through.
This isn’t a hypothetical edge case. IT professionals managing healthcare email infrastructure have flagged this exact issue directly: opportunistic TLS is often enabled by default and creates a false sense of security, since it offers no guarantee that a given message, including one containing PHI, won’t be transmitted in plaintext if the recipient’s mail server doesn’t support encryption. Organizations assume they’re protected simply because TLS is technically “on,” without realizing it isn’t enforced.
That gap has real consequences under HIPAA. The Security Rule currently treats transmission encryption as an “addressable” safeguard, meaning covered entities can, in theory, implement an equivalent alternative measure instead. In practice, regulators and auditors from the Office for Civil Rights (OCR) expect enforced encryption as the standard of care. “Addressable” has never meant optional — it means an organization needs a documented, defensible reason if it isn’t doing enforced encryption, and few reasons hold up under scrutiny. Finally, under OCR’s proposed changes to the HIPAA Security Rule for ePHI, scheduled for final publication in July 2027, email encryption moves from addressable to mandatory.
Beyond the encryption gap, standard consumer and even most business email plans typically lack:
A BAA that’s actually offered and signed (available on some enterprise tiers, but not automatic)
Audit logging sufficient to meet HIPAA Security Rule requirements
Built-in encryption at rest guarantees for stored messages
None of this means Gmail or Microsoft 365 are inherently insecure products. It means their default configuration is built for general business use, not for an environment where every misrouted or intercepted message carries breach notification liability. Making either platform HIPAA-appropriate requires layering on additional tools, policies, and critically, a provider relationship that includes a signed BAA covering the exact services in use.
The Technical Components of Secure Email
Secure email is built upon five technical layers. Understanding each one, and where it fails in standard email, clarifies exactly what a compliant solution needs to deliver.
Encryption in Transit (TLS)
Transport Layer Security (TLS) encrypts the connection between mail servers as a message travels from sender to recipient. There are two flavors, and the difference between them is the crux of most healthcare email compliance failures:
Opportunistic TLS attempts an encrypted connection but falls back to unencrypted delivery if the receiving server doesn’t support it. This is the default across most consumer and business email platforms.
Enforced TLS requires an encrypted connection for delivery to succeed. If encryption can’t be established, the message fails to send rather than going out in plaintext, or a link to secure portal can be sent to securely access the information.
HIPAA’s Security Rule lists encryption as addressable, but enforced TLS has become the de facto standard that auditors and OCR expect from covered entities and business associates handling PHI over email. As one healthcare IT professional put it while debating this exact tradeoff internally: the goal is to require TLS for all outbound email and then document the remaining controls around it, treating enforced TLS as the technical baseline, with policy and process built on top.
Encryption at Rest
Transit encryption only protects a message while it’s moving. Once it lands on a mail server — sender’s outbox, recipient’s inbox, backups, archives — it needs to remain encrypted in storage. This is encryption at rest, and it’s where many organizations underestimate their exposure.
Encryption in transit alone offers zero control over a message after it’s been delivered. If the destination server isn’t itself encrypting stored data, or if a backup snapshot is taken without encryption, PHI sitting in an inbox is exposed regardless of how securely it arrived. HIPAA’s Security Rule requires safeguards for ePHI both in transit and at rest, a compliant secure email provider needs to guarantee both, not just one.
End-to-End Encryption (S/MIME, PGP)
End-to-end encryption (E2EE) encrypts message content itself, not just the connection it travels over — meaning even the email provider can’t read the content. Two standards dominate here:
S/MIME uses certificate-based encryption and is common in enterprise environments, such as healthcare, particularly where organizations already manage a public key infrastructure.
PGP (Pretty Good Privacy) uses a public/private key model and is more common in technical or security-conscious communities, though it’s less frequently deployed at scale in healthcare due to key management complexity.
E2EE isn’t a baseline requirement for every PHI-containing email, enforced TLS plus encryption at rest satisfies most use cases. But it becomes necessary for especially sensitive communications, cross-organization data sharing where you don’t control the recipient’s infrastructure, or when a business associate agreement specifically requires it.
Authentication (SPF, DKIM, DMARC)
These three protocols work together to prevent domain spoofing and email impersonation, a growing attack vector against healthcare organizations specifically, given how often phishing campaigns impersonate providers, payers, or patients.
SPF (Sender Policy Framework) specifies which mail servers are authorized to send email on behalf of a domain.
DKIM (DomainKeys Identified Mail) adds a cryptographic signature verifying a message wasn’t altered in transit.
DMARC (Domain-based Message Authentication, Reporting & Conformance) tells receiving servers what to do when SPF or DKIM checks fail, and provides reporting visibility.
Without these configured correctly, an organization’s domain can be spoofed to send convincing phishing emails to patients or staff, creating a security failure that compounds the compliance risk of email interception.
Digital Signatures
Digital signatures verify sender identity and confirm a message hasn’t been tampered with between sending and receipt. Paired with encryption, they close the loop on message integrity, confirming not just that content was protected, but that it came from who it claims to have come from and arrived unaltered.
Standard Email vs. Secure Email: Feature Comparison
Feature
Standard Email
Secure Email (HIPAA-Compliant)
Encryption in Transit
Opportunistic TLS — attempted but not enforced
Enforced TLS — connection fails if encryption unavailable, can include delivery via secure portal option
Encryption at Rest
Not guaranteed; provider-dependent
Required — server-side encryption of stored messages
End-to-End Encryption
Not available
Supported via S/MIME and/or PGP
Digital Signatures
Not available
Included — verifies sender identity and message integrity
Authentication (SPF / DKIM / DMARC)
Optional, rarely enforced
Required — spoofing and impersonation protection
Business Associate Agreement (BAA)
Not provided on standard plans
Required — must be signed before sending PHI
Audit Logs
Basic or none
Full audit trail — required under HIPAA Security Rule
Access Controls
Basic password only
Role-based access, MFA, admin controls
Misdirected Email
Reportable HIPAA breach
Non-reportable if properly encrypted (safe harbor)
HIPAA Compliant by Default
No
Yes
What Makes Email HIPAA-Compliant Specifically
Technical safeguards alone don’t make email HIPAA-compliant. Compliance is a combination of technology, contracts, and documented processes — all four need to be in place simultaneously. This includes:
A signed BAA with your email provider – Any vendor that transmits, processes, or stores PHI on your behalf is a business associate under HIPAA, and business associates are legally required to sign a BAA before handling that data. Email providers have persistent access to ePHI — even end-to-end encrypted messages pass through their infrastructure at some point — which makes this requirement absolute, not situational. If a provider won’t sign a BAA, using them to send or store PHI isn’t a compliance risk you can mitigate; it’s a violation from the start.
Encryption as an addressable safeguard – Under 45 CFR §164.312(e)(2)(ii), the HIPAA Security Rule lists encryption of ePHI in transit as “addressable” rather than strictly “required.” In practice, this doesn’t mean optional, it means an organization must implement it, or document and justify an equivalent alternative safeguard. Enforced encryption has become the expected standard, and with the newly proposed HIPAA Security Rule planned for July 2027 publication, NPRM would formalize that expectation by making encryption of ePHI in transit and at rest mandatory rather than addressable. Organizations still relying on opportunistic TLS as their “equivalent alternative” should treat this as a closing window.
Access controls and audit logs – HIPAA requires the ability to track who accessed PHI, when, and what they did with it. This means role-based access permissions, multi-factor authentication, and a complete, retained audit trail — not just for compliance reporting, but for identifying and responding to incidents quickly.
The encryption safe harbor – This is one of the most consequential, and most underused, provisions in HIPAA. If PHI is sent via properly encrypted email and ends up misdirected to the wrong recipient, it is not a reportable breach under the Breach Notification Rule, because the encrypted content is considered unreadable and therefore not “unsecured PHI.” The exact same misdirection with unencrypted email is a reportable breach, triggering notification obligations to the individual and to HHS/OCR. Encryption isn’t just a security best practice here, it’s the line between a non-event and a formal breach investigation.
HITRUST certification as a trust signal – When evaluating vendors, HITRUST CSF certification is a strong external indicator that a provider’s security controls have been independently assessed against a recognized healthcare-specific framework. It’s not a HIPAA requirement in itself, but it meaningfully reduces the diligence burden on your side when vetting a provider.
Types of Healthcare Email That Must Be Secure
Not all internal debate here is about “should we secure email” — it’s about scope. Which specific email flows actually carry PHI, and therefore need to run through a compliant channel? In practice, the answer is broader than most teams initially assume.
The common thread: if a message references anything that could identify a patient in connection with health information — a name next to a diagnosis, an account number tied to a service date, an annual test reminder — it needs to move through a secure channel, regardless of whether it’s clinical, financial, or administrative in nature.
How to Evaluate a Secure Email Provider for Healthcare
Vendor evaluation in this category tends to go one of two ways: teams either take a provider’s “HIPAA-compliant” label at face value, or they get buried in RFP questions without knowing which answers actually matter. Ask these key questiosn to focus the evaluation on what’s operationally and legally significant.
“Does the provider sign a BAA? This is the first filter, not the last. If a vendor won’t sign a BAA — or offers a heavily limited one — everything else is irrelevant. Some organizations go a step further and negotiate indemnity or make-whole clauses into the BAA itself, seeking financial protection beyond the baseline liability allocation.
What encryption methods are supported? Confirm specifically whether the provider offers TLS only, or also supports S/MIME and/or PGP for end-to-end encryption where needed. TLS-only coverage is sufficient for most standard PHI communication; organizations with cross-border data sharing or especially sensitive use cases may need E2EE options available.
Is encryption enforced or opportunistic? This is the single most important technical question to ask directly, in those terms. A vendor that describes its encryption vaguely, without distinguishing enforced from opportunistic delivery, hasn’t answered the question. Push for specifics.
How are large attachments handled? Lab results, imaging files, and clinical documents often exceed standard attachment size limits. Confirm the provider has a secure, compliant method for large file transfer that doesn’t force users onto an unencrypted workaround.
What audit logging and reporting capabilities exist? You need visibility into delivery, access, and any failed encryption attempts, not just a generic sent/received log. Ask whether logs are retained for a period consistent with your organization’s HIPAA documentation requirements.
Do they support high-volume transactional email? Appointment reminders, billing notices, and patient communications at scale require infrastructure built for volume without sacrificing per-message compliance. Confirm the provider’s platform is built for this your specific pattern, not just person-to-person messaging.
Is the platform US-based with US data residency? For many healthcare organizations, where data physically resides — and under which jurisdiction — is a material factor in vendor risk assessment, particularly for payers and larger provider organizations with strict data governance policies.”
One operational factor worth weighing alongside these questions: secure email portals — the kind that require recipients to click through to a separate web page to read a message — solve the encryption problem but often create a real adoption problem. IT teams have reported a direct conflict between phishing-awareness training and portal-based workflows: staff and patients trained not to click suspicious links in emails are, understandably, reluctant to click the “secure link” a portal email contains. This is a legitimate reason many organizations increasingly prefer platforms that enforce encryption transparently in the background — like LuxSci’s SecureLine encryption technology — rather than routing every message through a separate portal experience.
Secure Email Checklist for Healthcare Organizations
Every safeguard covered in this guide comes down to a handful of concrete, verifiable actions. Use the checklist below as a working reference for what needs to be in place across your legal agreements, technical controls, and internal processes. This is not a one-time setup task, but something worth revisiting as your email volume, vendors, and regulations evolve. Share it across your compliance and IT teams as a starting point for an internal audit.
Legal and Contractual – BAA signed with email provider and all third-party vendors handling PHI.
Encryption – Forced TLS, not opportunistic only for emails in transit and all stored data encrypted with AES-256 bit encryption.
Access and Audit – Unique user IDs, role-based access, and login monitoring with advanced MFA enabled for all email accounts; audit logs active and maintained.
People and Processes – Staff trained in PHI handling, established breach response plan, annual email security policy review.
What Should I Do Now?
Secure email isn’t a single setting you switch on — it’s a combination of enforced encryption, a signed BAA, access controls, and documented process working together. Get any one piece wrong, and the rest doesn’t hold up under an OCR audit or a breach investigation.
If your organization is still relying on opportunistic TLS, an unsigned or incomplete BAA, or a patchwork of workarounds to move PHI through email, now is the time to close that gap, especially with the proposed 2025 HIPAA Security Rule update poised to make encryption a mandatory requirement rather than an addressable one in 2027.
Below are three ways you can continue your journey to securing your healthcare email:
Email can be HIPAA compliant, but only when the right safeguards are in place — enforced encryption, a signed BAA with your email provider, access controls, audit logs, and staff training on PHI handling. Standard email without these safeguards is not compliant.
2. Do I need to sign a BAA with my email provider?
Yes. Email providers have persistent access to ePHI — even encrypted messages pass through their servers — making them Business Associates under HIPAA. A signed BAA is required. If your provider won’t sign one, you cannot legally use them to send or store PHI.
3. What is the difference between opportunistic TLS and enforced TLS — and which does HIPAA require?
Opportunistic TLS attempts encryption but falls back to plaintext if the recipient’s server doesn’t support it. Enforced TLS stops delivery rather than sending unencrypted. HIPAA’s Security Rule treats transmission encryption as an addressable specification, in practice, enforced TLS is the standard auditors and OCR expect. The proposed 2025 HIPAA Security Rule NPRM would make encryption of ePHI in transit a mandatory requirement in 2027.
4. What happens if I send PHI in an unencrypted email?
It is an impermissible disclosure under HIPAA’s Privacy Rule and triggers the Breach Notification Rule, requiring you to notify the individual and HHS/OCR within 60 days. Penalties range from $100 to $50,000 per violation. Had the email been properly encrypted, the same incident would qualify for HIPAA’s encryption safe harbor, meaning no notification required.
5. Is Gmail or Microsoft 365 HIPAA compliant for sending patient emails?
Neither is compliant in their default configuration. Both use opportunistic TLS, meaning PHI can be sent in plaintext if the recipient’s server doesn’t support encryption. A signed BAA is available on enterprise plans but doesn’t close the technical gap alone. A purpose-built HIPAA-compliant email platform is the reliable solution.
If you’ve been waiting for the final word on the new HIPAA Security Rule before you touch your email encryption strategy, you now have an official reason to keep waiting.
Our advice: Don’t do it.
What is the new HIPAA Security Rule for ePHI?
The Department of Health and Human Services’ Office for Civil Rights had targeted May 2026 for a final rule implementing the most significant update to the HIPAA Security Rule in over two decades. The proposal eliminates the “addressable” standard and makes encryption of ePHI in transit and at rest mandatory for every covered entity and business associate. That deadline came and went quietly. Now we know why: an updated federal regulatory agenda shows OCR’s timeline has moved to July 2027, with the rule-making downgraded from “final rule stage” to “long-term action.” OCR is still working through more than 4,700 public comments on the January 2025 proposal.
For an industry that had been expecting a tighter deadline, a year-plus delay is the kind of news that invites a collective exhale — and a shelved project plan. At LuxSci, we think that would be a mistake, for three reasons:
The current rule already requires you to address encryption. “Addressable” was never “optional.” It has always meant you must implement the safeguard, implement an equivalent alternative, or document in writing why neither is reasonable for your organization. Most healthcare organizations have never done that documentation rigorously, and OCR’s existing enforcement authority applies today, not in 2027.
Breach costs haven’t waited for the rule.IBM’s 2025 Cost of a Data Breach Report puts the average healthcare breach at $7.42 million, still the highest of any industry. At the same time, email remains the number one attack vector into healthcare organizations. None of that risk is paused by a regulatory delay.
Delay is not withdrawal.OCR has not signaled it’s abandoning the encryption mandate, only that it’s taking longer to finalize it. Organizations that build now toward the standard already proposed will be ahead (and more secure) regardless of exactly when, or in what final form, the rule lands. Organizations that wait risk a compressed scramble once it does.
What should healthcare IT and compliance leaders actually do with this news?
Reevaluate your ePHI security posture, recalibrate its urgency, and use the extra runway to do the job right, instead of racing against a deadline. This includes:
Getting a real inventory of where ePHI moves by email today, inbound and outbound, and where encryption is inconsistent or absent.
Closing the documentation gap on “addressable” now, while you have time to do it well rather than defensively.
Pushing your email vendor for concrete answers on encryption standards, MFA enforcement, audit logging, and breach notification — the same technical controls the proposed rule would make mandatory.
Building (or updating) a written, enforcement-ready posture: policies, vendor agreements, certifications and verifications, test results, and training records that would hold up under an OCR investigation today, not just in a future compliance deadline.
Get LuxSci’s new Definitive Guide on the new HIPAA Security Rule
From Addressable to Mandatory: Email Encryption Under the New HIPAA Security Rule provides the latest update on the rule, what it means for healthcare email encryption, and what you can do now to properly prepare for what’s coming in 2027. The guide also includes an interactive scorecard that lets you evaluate your current email set up and vendor across seven security and compliance dimensions in under two minutes, no email address required.
If you want a second set of eyes on where your organization stands, our team offers a free 30-minute compliance assessment of your current email environment against the proposed rule’s requirements.
Most healthcare organizations view email as a utility, a necessary tool for sending messages between staff, communicating with patients, sending out newsletters, connecting workflows, and so on. Historically, IT teams focused on keeping it running, security teams worried about phishing, and compliance teams made sure sensitive emails were encrypted.
Today, however, that view is rapidly becoming outdated.
Email has evolved into one of healthcare’s most critical digital infrastructure components, and also one of it’s biggest security threats. It’s a core channel for patient engagement, care coordination, revenue cycle operations, digital marketing, remote monitoring, and increasingly, AI-powered communications. The organizations that recognize this shift are building communications platforms designed for security, performance, automation, and growth. With the new HIPAA Security Rule requiring email encryption on the horizon, those companies that don’t may find themselves constrained by systems that were never intended to support modern healthcare.
Email Is No Longer Just a Messaging Tool
Healthcare organizations now depend on email to support dozens of mission-critical workflows every day.
Patients receive appointment reminders, registration instructions, imaging results, billing notifications, Explanation of Benefits (EOBs), prescription updates, preventive care reminders, patient education, and post-discharge follow-up. Marketing teams deliver personalized wellness campaigns and service line promotions. Clinical systems generate transactional notifications. Revenue cycle teams rely on secure digital communications to accelerate payments and reduce paper costs.
For many organizations, mission-critical patient communications flow through email every month.
When viewed collectively, email is more than a simple communications channel. It has become operational infrastructure with high levels of security needed and increasing compliance requirements.
The Stakes Continue to Rise
As healthcare becomes more digital, every communication carries greater business and clinical importance.
A delayed billing email may postpone payment. A failed appointment reminder can increase no-show rates. An undelivered care management message may impact patient outcomes. A misconfigured security policy can expose protected health information (PHI). Poor deliverability can undermine expensive patient engagement initiatives before they ever reach the inbox.
These are no longer isolated IT issues. Email can affect revenue, patient satisfaction, operational efficiency, compliance, and organizational reputation.
Today’s healthcare leaders require email infrastructure to provide the same reliability and visibility they demand from electronic health records, identity management systems, and other core infrastructure.
AI Is Raising the Bar Even Higher
There’s little doubt that artificial intelligence (AI) promises to transform patient communications.
Healthcare organizations everywhere are exploring AI-generated patient education, personalized outreach, intelligent scheduling, multilingual communications, and automated follow-up programs.
But AI also increases the importance of the underlying communications infrastructure.
Generating more personalized emails means little if organizations cannot:
Automatically protect PHI.
Apply consistent security policies.
Maintain complete audit trails.
Deliver messages reliably.
Integrate with EHRs, RCM and CRM platforms, and customer data platforms.
Demonstrate compliance during an audits.
In many ways, AI amplifies both the opportunities and the risks. Your email platform can help determine whether AI initiatives succeed or create new compliance and operational challenges.
Infrastructure Matters More Than Features
Healthcare buyers have traditionally evaluated email platforms based on individual features such as encryption, spam filtering, or secure portals.
Those capabilities remain important, but they no longer tell the whole story.
Today’s healthcare organizations should be evaluating communications platforms the same way they evaluate any mission-critical infrastructure.
Questions increasingly include:
Can it support both transactional and marketing communications?
Does it automatically enforce security policies without relying on user decisions?
Can it integrate with EHRs, CRM systems, CDPs, and business applications?
Will it scale during peak communication periods?
Does it provide detailed audit logging and reporting?
Can it adapt as regulatory expectations evolve?
Does it maintain high deliverability at enterprise scale?
Does it support single-tenant dedicated infrastructure for high performance and increased security?
These infrastructure characteristics often determine long-term success far more than any single feature comparison.
Email and the Future Of Secure Healthcare Communications
Healthcare is steadily moving toward a world where nearly every patient interaction is digital, personalized, and data-driven.
Healthcare leaders often ask whether they need a more secure email solution. That may be the wrong question.
The better question is whether their communications infrastructure is ready for where healthcare is headed over the next decade.
If you want talk about the future of your healthcare email infrastructure, reach out today and schedule a 30-minute assessment call with our experts.
SSL and TLS play critical roles in securing data transmission over the internet, and AES-256 is integral in their most secure configurations. The original standard was known as Secure Sockets Layer (SSL). Although it was replaced by Transport Layer Security (TLS), many in the industry still refer to TLS by its predecessor’s acronym. While TLS can be relied on for securing information at a high level—such as US Government TOP SECRET data—improper or outdated implementations of the standard may not provide much security.
Variations in which cipher is used in TLS impact how secure TLS ultimately is. Some ciphers are fast but insecure, while others are slower, require a greater amount of computational resources, and can provide a higher degree of security. Weaker ciphers—such as the early export-grade ciphers—still exist, but they should no longer be used.
The Advanced Encryption Standard (AES) is an encryption specification that succeeded the Data Encryption Standard (DES). AES was standardized in 2001 after a five-year review and is currently one of the most popular algorithms used in symmetric-key cryptography. It is often seen as the gold standard symmetric-key encryption technique, with many security-conscious organizations requiring employees to use AES-256 for all communications. It is also used prominently in TLS. (more…)
Boston & Helsinki, February 12, 2026 – LuxSci, a provider of secure healthcare communications solutions in the United States, and Oiva Health, a Nordic provider of Digital Care solutions in social and healthcare services, today announced that the companies are joining forces. Backed by Main Capital Partners (“Main”), the combination brings together two complementary platforms and teams, forming a strong transatlantic software group focused on secure healthcare communications.
Founded in 1999, LuxSci is a U.S. provider of HIPAA‑compliant, secure email, marketing, and forms solutions. Its application and infrastructure software enable organizations to securely deliver personalized, sensitive data at scale to support a broad range of healthcare communications and workflows including care coordination, benefits and payments, marketing, wellness communications, after care and ongoing care. Certified by HITRUST for the highest levels of data security, LuxSci serves dozens of healthcare enterprises and hundreds of mid‑market organizations.
Founded in 2010, Oiva Health is a provider of digital care and communications solutions in the Nordics. Headquartered in Finland, with additional offices in Denmark, Norway, and Sweden, Oiva Health offers digital care and digital clinic solutions – including digital visits, secure messaging, online scheduling and appointments, and caregiver communications – serving the long-term care, especially elderly care, and occupational healthcare verticals. The company employs approximately 60 people and has recently expanded across the Nordic region, with a growing presence in Norway and Sweden.
The combination of LuxSci and Oiva Health creates a larger, cross Atlantic group with complementary solutions, serving the U.S. and European markets. Together, the companies offer healthcare providers, payers, and suppliers a comprehensive suite of tools to communicate securely and compliantly, spanning communications, workflows, and virtual care delivery.
Daan Visscher, Partner and Co-Head North America at Main, commented: “We are pleased to announce this cross Atlantic transaction, creating an internationally active secure communications player within the healthcare and home care space. The combined product suite enables healthcare organizations to drive much needed efficiency gains in healthcare provision addressing a global trend of rising costs, aging population, and increasing pressure on resources needed to provide high-quality care.”
Mark Leonard, CEO of LuxSci, said, “We are thrilled to join forces with Oiva Health and believe that together we can truly make a difference in healthcare coordination, access, and delivery. We see an exciting path forward with our customers benefiting from an end-to-end, secure and compliant approach to optimizing both healthcare communications and today’s frontline workers, which we need now more than ever.”
Juhana Ojala, CEO at Oiva Health, concluded, “We look forward to this new chapter together with LuxSci. We are very excited about the strong alignment between our solutions, which especially strongly positions us to expand our flagship Digital Care offering to the high-potential U.S. care market – from care coordination to care delivery to in-home and institutional care.”
Nothing contained in this Press Release is intended to project, predict, guarantee, or forecast the future performance of any investment. This Press Release is for information purposes only and is not investment advice or an offer to buy or sell any securities or to invest in any funds or other investment vehicles managed by Main Capital Partners or any other person.
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About LuxSci
LuxSci is a U.S.-based provider of secure healthcare communications solutions for the healthcare industry. The company offers secure email, marketing, forms and hosting, delivering HIPAA‑compliant communication solutions that enable organizations to safely manage and transmit sensitive data. Founded in 1999, LuxSci serves more than 1,900 customers across healthcare verticals, including providers, payers, suppliers, and healthcare retail, home care providers, and healthcare systems, as well as organizations operating in other highly regulated industries. LuxSci is HITRUST‑certified with example clients being Athenahealth, 1800 Contacts, Lucerna Health, Eurofins, and Rotech Healthcare, among others.
About Oiva Health
Oiva Health is a Digital Care provider in the Nordics, offering a comprehensive Digital Platform for integrated health and care services to digitalize primary healthcare, social care, hospital healthcare and long-term care services. The company was founded in 2010 and currently employs approximately 60 people in Finland, Denmark, Norway, and Sweden serving domestic municipalities, customers and partners, such as City of Helsinki, Keski-Suomi Welfare Region, Länsi-Uusimaa Welfare Region in Finland, and Viborg municipality in Denmark with its Digital Care platform. Annually over 5 million customer contacts are handled digitally through Oiva Health’s Digital Care and Digital Clinic platforms.
About Main Capital Partners
Main Capital Partners is a software investor managing private equity funds active in the Benelux, DACH, the Nordics, France, and the United States with approximately EUR 7 billion in assets under management. Main has over 20 years of experience in strengthening software companies and works closely with the management teams across its portfolio as a strategic partner to achieve profitable growth and create larger outstanding software groups. Main has approximately 95 employees operating out of its offices in The Hague, Düsseldorf, Stockholm, Antwerp, Paris, and an affiliate office in Boston. Main maintains an active portfolio of over 50 software companies. The underlying portfolio employs approximately 15,000 employees. Through its Main Social Institute, Main supports students with grants and scholarships to study IT and Computer Science at Technical Universities and Universities of Applied Sciences.
The sender of this press release is Main Capital Partners.
For more information, please contact:
Main Capital Partners Sophia Hengelbrok (PR & Communications Specialist)
Explanation of Benefits statements or EOBs are mission-critical communications for health insurers because they ensure transparency, help detect billing errors or fraud, and most importantly, keep patients informed about their benefits and related payments.
However, the most conventional method of sending out EoBs, traditional mail, has several drawbacks that can prevent important information about healthcare coverage from reaching the intended recipient. This can leave policyholders in the dark about their healthcare coverage, which can lead to confusion and dissatisfaction with their insurance provider when they receive an unexpected medical bill. This can also drive up inbound calls into your claims department or contact center.
Because Explanation of Benefits statements contain the protected health information (PHI) of policyholders, insurers are bound by HIPAA (the Health Insurance Portability and Accountability Act) regulations to ensure their secure delivery. Consequently, the risks inherent to sending paper EoB statements in the mail not only have security implications but also potential consequences for non-compliance.
With all this in mind, this post discusses why healthcare insurers should send EoBs to their policyholders via secure email instead of traditional mail. We detail the various benefits of making the switch to electronic EoBs, which include enhanced security, better adherence to compliance regulations, and the opportunity to save millions of dollars per month.
Protecting Patient Privacy
The primary reason that insurance companies should shift to email EoBs as opposed to traditional mail is that it’s far more secure. Sending an EoB via email drastically decreases the risk of protected health information (PHI) getting into the wrong hands. When sent in paper form by mail, an EoB could be:
Lost, stolen or damaged in transit
Delivered to the wrong address
Not properly deposited in a letter or mailbox, then stolen
Intercepted within the intended address by another individual who lives at or has access to the residence.
As detailed later in this post, email also allows for various controls and processes, which mitigate the risks of unsuccessful message delivery.
Most importantly, secure email provides data encryption, which safeguards the sensitive patient data within EoBs during transmission and when stored by rendering it unreadable to malicious actors who might intercept it. Physical mail, in contrast, offers no such protection, as someone who intercepts a paper EoB form can simply open it and freely read its contents.
Finally, secure email delivery platforms feature identity verification and access controls that enable healthcare insurers to restrict access to PHI to authorized personnel, limiting its exposure. They also provide auditing capabilities to track access to patient data, and quickly identify the source of security breaches.
HIPAA Compliance Benefits
Because sending an Explanation of Benefits statement via email is more secure, and better protects any patient data contained within them, this also reduces the risk of HIPAA compliance violations.
First and foremost, HIPAA regulations mandate that communications containing PHI, such as EoBs, must securely reach the intended recipient. By eliminating the risk of physical interception or non-delivery, and the compliance violations from a resulting security breach, insurers can better adhere to HIPAA regulations using email for sending EOBs. On a similar note, the security features built into a HIPAA compliant email platform, such as encryption, access controls, and audit logs, help insurers to satisfy the requirements of HIPAA’s Privacy and Security Rules in their compliance efforts.
Another considerable benefit of using secure email to send policyholders their EoBs, or, in fact, any communication containing PHI, is that it’s far easier to implement breach notification protocols. Email delivery platforms provide real-time tracking, so companies can pinpoint email message failures quickly and act accordingly. Similarly, intrusion detection systems and other cybersecurity measures that support email systems can enable faster detection and containment of data breaches.
In stark contrast, physical mail is far more difficult to track – and even those limited capabilities are reserved for more expensive delivery options. Consequently, security breaches via mail could go unnoticed for days or even weeks. If you’re unaware of a data breach, or have not yet contained or mitigated it, you’re then unable to inform all affected parties, resulting in further HIPAA violations.
Increased Deliverability Rates
By greatly mitigating the security risks presented by physical mail, i.e., the various ways an EoB could fall into the wrong hands, sending an EoB by email increases your ability to get more EOBs into the hands of policyholders, more quickly. At the same time, policyholders can make faster decisions regarding their healthcare.
The ability to track secure email gives you greater control over EOB deliverability, as it allows organizations to determine the cause of delivery failure and can also make subsequent attempts. Additionally, the process of determining the reason for the message delivery failures can also reveal security issues; the same process, however, is very difficult to achieve with traditional mail.
Here’s how the typical protocol for resending a secured email goes beyond what you can do with managing traditional mail delivery:
Determine the cause of non-delivery: verify that the intended recipient information is correct and check for issues like a full email inbox or security misconfigurations.
Don’t automatically resend: to avoid exposing PHI to the wrong person, confirm the intended recipient’s email address through an alternative verified channel, e.g., phone call, secure SMS, etc.
Log the incident: document the delivery failure, steps taken to determine its cause, attempts, etc.
Reattempt message delivery: if the investigation deems it safe, attempt message redelivery with the corrected information.
In the event that subsequent delivery attempts fail, it’s best practice to contact the individual to arrange the most convenient and secure alternative to deliver their EoBs.
Cost Savings
Simply put, sending Explanation of Benefits statements via email instead of traditional mail saves health insurers money – potentially lots of it. Processing EOBs from start to finish can cost health insurers one to two dollars or more per EOB. That’s a lot. The biggest opportunity for cost reduction is tied to the money saved on printing and mailing paper EoB statements. Additionally, the cost of administering the delivery of EoB forms, ensuring their delivery, etc., is lowered when it’s done electronically. Not to mention, resending EoBs in the event of their non-delivery is much easier and cheaper via email.
In a broader sense, increasing the deliverability and the success rate of sending EoBs helps a larger number of policyholders better understand the details of their insurance coverage, i.e., how it works, which services and procedures it covers, etc. As a result of their policyholders being more informed, insurers won’t spend as much time explaining policy details and cost breakdowns to their members, allowing them to divert the otherwise required resources to other areas of the business.
Reduced Carbon Footprint
Finally, it’s difficult to highlight the benefits of sending EoBs to policyholders by email without recognizing the positive environmental impact, too. Email EoBs cut down on paper, for both the forms themselves and the envelopes they’re mailed in. Then there’s the matter of the electricity and ink involved in printing them, the emissions produced in their delivery, etc. Opting to send EoBs via email reduces all these factors, which enables healthcare organizations to lower their carbon footprint and, where applicable, meet their sustainability obligations or goals.
Deliver EoBs More Securely, Reliably, and at Lower Cost with LuxSci
LuxSci’s Secure High Volume Email Solution enables healthcare insurance companies to instantly send Explanation of Benefits statements to policyholders at a massive scale, extending into hundreds of thousands or millions per month.
Dedicated IPs that isolate critical transactional messages, such as EoBs, from other email traffic, allowing LuxSci customers to reach deliverability rates of 98% or more.
Real-time tracking for determining the delivery status of EoBs, as well as troubleshooting unsuccessful delivery attempts.
Flexible encryption through LuxSci’s proprietary SecureLine Technology, which automatically adjusts encryption settings according to the recipient to better ensure the protection of sensitive data.
Contact us today to learn more about how your organization can begin the transition to electronic EoBs.
HIPAA emailing patient information requires healthcare organizations to implement encryption protocols, authentication controls, and business associate agreements that protect electronic protected health information during transmission and storage. Federal privacy regulations mandate that all email communications containing patient data meet stringent security standards to prevent unauthorized access, interception, or disclosure. Healthcare providers must understand which types of patient information can be transmitted via email, what security measures are necessary, and when alternative communication methods provide better protection for sensitive health data.
Permitted Uses of Email for Patient Communications
Healthcare providers can use email to communicate with patients about treatment, payment, and healthcare operations without obtaining specific authorization under HIPAA regulations. Appointment reminders, general health education materials, and prescription refill notifications fall within permitted communications that do not require patient consent. Laboratory results, medication instructions, and follow-up care guidance can be transmitted through secure email channels when proper encryption protects the information.
Treatment coordination between healthcare providers allows email communication about patient care without patient authorization when all parties are involved in the patient’s treatment. Referrals to specialists, consultation requests, and care plan discussions can occur through encrypted email platforms that meet security requirements. Payment communications including billing statements, insurance verification, and claim status updates are permissible through secure channels.
Healthcare operations activities such as quality improvement initiatives, case management, and care coordination support email communication when security measures protect patient information. Staff training scenarios using de-identified patient cases can be shared via email without violating privacy rules. Administrative functions including appointment scheduling and general practice information distribution do not require patient authorization when conducted through secure systems.
Limitations exist for certain types of sensitive health information that require extra protection beyond standard email security. Psychotherapy notes, substance abuse treatment records, and HIV test results need enhanced safeguards or alternative communication methods. Mental health information and genetic testing results may warrant more secure transmission methods than standard encrypted email provides.
Encryption Requirements for Patient Data Transmission
Message-level encryption converts email content into unreadable code before transmission, ensuring that only intended recipients can decrypt and read patient information. Advanced Encryption Standard 256-bit encryption provides strong protection that meets healthcare industry standards for securing electronic protected health information. Transport Layer Security protocols create secure connections between email servers during message delivery, preventing interception while communications travel across networks.
End-to-end encryption protects messages throughout their entire journey from sender to recipient, maintaining security even if intermediate servers are compromised. Automatic encryption activation eliminates human error by securing all outbound messages without requiring staff to remember manual encryption procedures. HIPAA emailing patient information demands consistent encryption application across all communications containing protected health information regardless of content sensitivity.
Key management systems protect the encryption keys that secure patient communications while enabling authorized recipients to decrypt necessary messages. Secure key storage prevents unauthorized access while backup procedures protect against data loss during system failures. Certificate-based authentication verifies recipient identity before allowing message delivery, reducing risks of misdirected emails containing patient information.
Digital signatures provide verification that messages originated from legitimate healthcare sources and were not altered during transmission. Integrity checks detect any unauthorized modifications to email content, alerting recipients when communications may have been tampered with during delivery. These verification mechanisms build trust in email communications while meeting regulatory requirements for data integrity.
Access Controls and User Authentication
Multi-factor authentication requires users to provide multiple forms of identification before accessing email accounts containing patient information. Password combinations with mobile verification codes, biometric scans, or hardware tokens create layered security that prevents unauthorized account access. Authentication systems should integrate smoothly with existing healthcare technology to avoid creating workflow barriers that encourage security shortcuts.
Role-based permissions ensure healthcare staff can only access patient communications relevant to their job functions and care relationships. Physicians need different access levels compared to billing specialists or administrative personnel, with granular controls preventing inappropriate information viewing. Automatic permission adjustments when staff change roles or departments maintain appropriate access restrictions as organizational structures evolve.
Session management protocols automatically log users out after inactivity periods, preventing unauthorized access from unattended workstations. Concurrent login monitoring detects unusual access patterns such as simultaneous logins from different geographic locations that might indicate account compromise. Immediate access revocation procedures ensure departing employees lose email access promptly to protect patient information.
Audit logging tracks all user activities within email systems including message viewing, sending, forwarding, and administrative actions. Detailed logs capture who accessed which patient communications, when access occurred, and what actions were performed. These records support security investigations, regulatory audits, and compliance monitoring while deterring inappropriate information access.
Business Associate Agreements and Vendor Responsibilities
Written contracts between healthcare organizations and email service providers establish clear responsibilities for protecting patient information during transmission and storage. Agreements must specify encryption standards, security measures, incident reporting timelines, and procedures for handling patient data when contracts terminate. Liability allocation clauses define financial responsibilities when security breaches result from provider system failures or negligence.
Vendor security certifications demonstrate that email providers maintain appropriate controls for protecting healthcare information. SOC 2 audits verify security measure effectiveness while HITRUST certification indicates healthcare industry experience and compliance knowledge. Current certifications provide assurance that providers maintain security standards consistently rather than just during initial implementations.
Incident response procedures outlined in agreements specify how providers will notify healthcare organizations when security breaches occur involving patient information. Notification timelines should allow organizations to meet their own breach notification obligations to patients and regulatory authorities. Provider responsibilities for breach investigation, containment, and remediation should be clearly defined in contractual terms.
Data retention and destruction procedures govern how providers handle patient information when business relationships end or retention periods expire. Secure deletion methods ensure patient data cannot be recovered after authorized destruction. Healthcare organizations conducting HIPAA emailing patient information need verification that providers completely remove all patient communications from their systems when required.
Patient Consent and Communication Preferences
Healthcare organizations should obtain written consent before emailing detailed medical information to patients, even though regulations may not require authorization for treatment communications. Consent forms should explain security measures while acknowledging inherent risks in electronic transmission despite encryption protection. Patients need clear information about how to protect their own email accounts from unauthorized access that could compromise their health information.
Communication preference documentation helps healthcare organizations understand which patients are comfortable receiving health information via email versus those preferring telephone calls or postal mail. Preference tracking systems ensure staff use appropriate communication methods for different patients based on their documented choices. Alternative communication options should remain available for patients who decline email communications or lack secure email access.
Content appropriateness guidelines help staff determine what patient information is suitable for email transmission versus what requires more secure communication methods. Routine test results and medication changes may be appropriate for encrypted email while complex diagnoses or poor prognosis discussions warrant telephone or in-person conversations. Emergency situations and urgent symptoms require immediate communication methods rather than email that patients might not check promptly.
Patient education about email security helps individuals understand their role in protecting their health information during electronic communications. Instructions about recognizing legitimate healthcare emails, maintaining strong passwords, and reporting suspicious activities empower patients to participate in securing their information. Healthcare organizations benefit from providing clear guidance about email security practices and potential risks.
Compliance Monitoring and Risk Management
Security assessments evaluate whether email systems maintain appropriate protections for patient information throughout their operational lifecycles. Penetration testing identifies vulnerabilities that could allow unauthorized access while security audits verify that controls function as intended. Assessment schedules should include testing after system updates, configuration changes, or security incident discoveries.
Policy development establishes clear guidelines about what patient information can be transmitted via email and what security measures staff must follow. Written policies should specify encryption requirements, recipient verification procedures, and content appropriateness criteria. Policy review schedules ensure guidance remains current as technology and regulations evolve.
Staff training programs educate healthcare workers about proper procedures for HIPAA emailing patient information through secure channels. Training should cover encryption activation, recipient verification, content appropriateness, and incident reporting responsibilities. Documented training records demonstrate compliance efforts during regulatory inspections while reinforcing security culture within organizations.
Incident response planning prepares healthcare organizations to handle security breaches involving email communications containing patient information. Response procedures should include immediate containment measures, breach scope assessment, affected patient notification, and regulatory reporting. Practice drills help ensure staff can execute response plans effectively during actual security emergencies that threaten patient information.
SSL and TLS play critical roles in securing data transmission over the internet, and AES-256 is integral in their most secure configurations. The original standard was known as Secure Sockets Layer (SSL). Although it was replaced by Transport Layer Security (TLS), many in the industry still refer to TLS by its predecessor’s acronym. While TLS can be relied on for securing information at a high level—such as US Government TOP SECRET data—improper or outdated implementations of the standard may not provide much security.
