Integrating HIPAA Compliant Email with EHR Systems

HIPAA Compliant Email, Patient Engagement
Pete Wermter
April 23, 2025

With digital healthcare here to stay, today’s providers, payers and suppliers are making increasing use of Electronic Health Record (EHR) systems for more connected care – and better health outcomes.

However, while EHR systems help increase the speed and efficiency at which care can be delivered to patients, healthcare companies must still consider the security of electronic protected health information (ePHI) throughout the process, especially when it comes to communicating sensitive data with patients, customers, and other organizations.

Fortunately, integrating an EHR system with a HIPAA compliant email service provider (ESP), like LuxSci, offers a secure way to engage with your patients, while leveraging – and protecting – the wealth of information within EHR systems to personalize communications.

In this post, we discuss the benefits of integrating EHR systems with a HIPAA compliant email platform, as well as several use cases made possible by bringing these two powerful solutions together.

What is an EHR System?

An EHR system is a platform used by healthcare companies to store and manage their patient’s digital data, including PHI. In providing a digital repository for a patient’s medical history, including diagnoses, prescribed medication, lab results, and other data related to their healthcare journey, EHR systems enable organizations to access, update, and share patient data more quickly and efficiently.

As EHR systems have steadily replaced paper-based records, namely, after the HITECH Act was enacted in 2009, which incentivized EHR adoption, healthcare companies are better able to access and share PHI across different environments, greatly enhancing the coordination and cooperation of providers, payers, and suppliers.

Why Should You Integrate EHR Systems with a HIPAA Compliant Email Platform?

Let’s discuss the key benefits of integrating your EHR Systems with a HIPAA compliant email platform:

Secure ePHI Transmission

When the sensitive data in EHR systems is sent out to patients and other healthcare providers and organizations, it must be encrypted, as per HIPAA regulations to safeguard it from exposure. That way, even in the event of a security breach, it will be unreadable to malicious actors, preserving the privacy of patients and customers. In light of this, HIPAA compliant email delivery platforms emphasize strong encryption capabilities to ensure sensitive patient data is always encrypted during transmission.

LuxSci’s SecureLine encryption technology employs automatic, flexible encryption, which applies the appropriate encryption standard depending on the recipient’s email security posture and infrastructure, making sure emails are always encrypted in transit.

HIPAA Compliant Patient Engagement Campaigns

Healthcare organizations are often reluctant to include the patient data stored in their EHR systems for fear of accidental exposure – and violating HIPAA regulations as a result. In addition to encryption, LuxSci provides other HIPAA-mandated security features, such as access control capabilities, to maintain precise control over who can access patient data, and audit logging, to track access to ePHI. Perhaps most importantly, LuxSci provides you with a Business Associate Agreement (BAA): a legal document, and key pre-requisite for HIPAA compliance, that clearly establishes its responsibilities in safeguarding the ePHI that originates in your EHR systems.

With these security capabilities in place, healthcare providers can confidently incorporate patient and customer data from their EHR systems into their outreach efforts, using ePHI to personalize emails accordingly to maximize engagement and improve communications.

Automated Secure EHR-Driven Communication

EHR systems facilitate automated healthcare workflows, including for clinical or administrative events that require effective communications, such as appointment scheduling, a patient diagnosis, or test results becoming available, automatically triggering follow-up actions, including updating patient care plans, generating invoices, sending outbound emails. In addition to facilitating consistency and coordination between the various companies involved in a patient’s healthcare journey, it reduces the amount of required manual work, lowering each organization’s administrative overhead.

LuxSci’s suite of HIPAA compliant, secure communications tools aid in the enhanced efficiency and productivity of EHR systems by streamlining digital communication across multiple channels. LuxSci Secure High Volume Email can automatically send personalized, HIPAA-compliant messages triggered by EHR events. Similarly, LuxSci Secure Text allows companies to notify patients via SMS, as per the situation or patient preferences. LuxSci’s Secure Forms, meanwhile, simplifies onboarding and consent processes by pre-filling web forms with EHR data, eliminating the need for manual input paperwork and manual entry.

Common Email and EHR Integration Use Cases

Integrating your EHR system with a HIPAA compliant email solution, like LuxSci, opens the door for a wide variety of enhanced patient engagement opportunities. Let’s explore some of the most valuable use cases for EHR integration below.

Appointment Confirmations and Reminders: companies can create EHR-driven workflows that send out an email confirmation as soon as an appointment is scheduled. Similarly, automated email reminders and text messages can be scheduled to go out a set number of days before the patient’s appointment, lowering the chance of a no-show.
Pre-Visit Instructions: when appropriate, tailored preparation instructions can be scheduled to be sent out by email before the appointment, according to the nature of the appointment and other relevant patient data.
Follow-Up Care Guidance: by the same token, an EHR event can be set up to send out personalized after-care advice, sourced from care plans or notes stored in the EHR system.
Test Results: an email or text can be triggered as soon as a patient’s lab results become available; this could be in the form of an alert to contact their provider to collect the results or a summary alongside a secure link to a portal for full access.
Preventive Screening Reminders: EHR data can be used to identify patients due for screenings, immunizations, or chronic care follow-ups.
Preventative Care: sending patients advice and recommendations relevant to their condition, based on ePHI stored in their healthcare provider’s EHR.
Early Detection Self-Assessments: EHR-driven emails can be used to send patients personalized risk assessments designed to detect early warning signs of conditions such as diabetes or cancer, based on ePHI like age, lifestyle factors, or family history.
Feedback Collection: healthcare organizations can schedule feedback to be collected from patients, e.g., surveys, questionnaires, etc, to measure patient satisfaction and identify key areas of improvement.

Discover the Power of EHR Integration with LuxSci

Integrating HIPAA compliant communications solutions like LuxSci with EHR systems empowers healthcare companies to craft more timely, efficient and consistent digital healthcare communications and workflows. This personalized approach to patient and customer engagement enables efficient, effective and above all, compliant communications strategies that improve individual engagement, providing better health outcomes and a higher quality of life.

Want to learn more? Contact us today!

Pete Wermter

As a marketing leader with more than 20 years of experience in enterprise software marketing, Pete's career includes a mix of corporate and field marketing roles, stretching from Silicon Valley to the EMEA and APAC regions, with a focus on data protection and optimizing engagement for regulated industries, such as healthcare and financial services. Pete Wermter — LinkedIn

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HIPAA Security Rule Email Encryption Requirements

July 8, 2026
Tom Deeb

Your Email Platform Is Becoming Critical Healthcare Infrastructure

July 1, 2026
Pete Wermter

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.

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The HIPAA Security Rule Missed Its May Deadline — Here’s What We Know

June 9, 2026
Pete Wermter

The proposed HIPAA Security Rule update has become one of the most closely watched healthcare compliance developments in recent years. Designed to strengthen cybersecurity protections for electronic protected health information (ePHI), the proposal could significantly reshape how healthcare organizations approach risk management, ePHI encryption, and mandatory email encryption requirements.

A final rule was expected as early as May 2026. However, that deadline has now passed without publication from the U.S. Department of Health and Human Services (HHS) Office for Civil Rights (OCR).

So, what happens next—and what should healthcare IT directors, CISOs, and compliance officers do now?

Where Things Stand Today

The HIPAA Security Rule Notice of Proposed Rulemaking (NPRM) was published on January 6, 2025, with the goal of strengthening cybersecurity protections for ePHI in response to escalating ransomware attacks, healthcare breaches, and growing concerns about cyber resilience across the healthcare sector.

The proposal generated thousands of public comments from healthcare providers, payers, business associates, technology vendors, and industry groups. OCR has spent much of the past year reviewing this feedback and evaluating the operational and financial impact of the proposed changes.

Although the Spring Unified Regulatory Agenda identified May 2026 as a target date for a final rule, that milestone came and went without publication. As of June 2026, the proposed HIPAA Security Rule update remains under review.

While some organizations may be tempted to take a wait-and-see approach, the missed deadline should not be interpreted as a signal that the initiative has stalled. If anything, the proposal offers valuable insight into the future direction of healthcare cybersecurity regulation.

The Growing Focus on Mandatory Email Encryption

One of the most discussed aspects of the proposed HIPAA Security Rule update is encryption.

Under the current HIPAA Security Rule, encryption is generally classified as an “addressable” implementation specification. Organizations can choose alternative safeguards if they document and justify their decisions through a risk analysis process.

The proposed changes would significantly reduce that flexibility. Instead, many security safeguards, including encryption controls, would become more prescriptive and difficult to avoid.

While the final language has not yet been released, healthcare organizations should pay close attention to the proposal’s clear message: protecting ePHI through encryption is increasingly viewed as a baseline cybersecurity requirement.

This is particularly important for email communications.

Email remains one of the most widely used communication channels in healthcare, supporting everything from patient engagement and care coordination to billing, scheduling, and marketing communications. As regulators continue to focus on reducing data breach risks, mandatory email encryption is emerging as a likely area of increased scrutiny.

What Healthcare Organizations Should Do Now

The current delay creates an opportunity, not a reason to postpone action.

Healthcare organizations can begin preparing for likely requirements today by evaluating the security controls highlighted throughout the proposed rule.

Key areas to review include:

Encryption of ePHI across systems and communications channels
Comprehensive asset inventories and ePHI data mapping
Enhanced risk analysis and risk management processes
Multifactor authentication (MFA)
Vulnerability scanning and penetration testing
Incident response planning and testing
Backup and recovery procedures
Email security and secure email encryption practices

Organizations that proactively strengthen these areas now will be better prepared regardless of the final rule’s implementation timeline.

Why Secure Email Encryption Should Be a Priority

For many healthcare organizations, email remains one of the largest compliance and security risks.

Human error, misdirected messages, phishing attacks, and inconsistent encryption practices continue to contribute to breaches involving protected health information. As a result, secure email encryption is increasingly becoming a foundational component of healthcare cybersecurity strategies.

Organizations that rely on manual encryption processes or employee judgment alone may find it difficult to meet evolving regulatory expectations.

Instead, healthcare organizations should look for solutions that automate encryption decisions, reduce user error, and provide flexibility based on the sensitivity of the communication.

At LuxSci, we have long believed that security and usability must work together. We are 100% focused on secure healthcare communications, helping healthcare providers, payers, and suppliers protect sensitive data while improving patient and customer engagement. Our proven secure email solutions, used by leading companies including Athenahealth, 1-800 Contacts, and Hinge Health, help organizations protect ePHI with automated encryption capabilities that support both compliance and operational efficiency. Our unique SecureLine encryption technology enables organizations to apply the appropriate level of protection while maintaining a seamless experience for patients, customers, and staff.

For organizations already using Microsoft 365 or Google Workspace, LuxSci Secure Email Gateway can add HIPAA-compliant email security and encryption without requiring users to change their existing workflows. This approach helps reduce risk, while preserving productivity and user adoption.

The Bottom Line

The HIPAA Security Rule final rule may have missed its anticipated May deadline, but the cybersecurity challenges driving the proposal remain very real.

The OCR is still expected to make the rule change, which could require mandatory encryption of ePHI by early 2027.

The time to prepare is now!

Healthcare organizations should view the proposed HIPAA Security Rule update as an advance warning of where regulatory expectations are heading. Stronger cybersecurity controls, enhanced risk management, ePHI encryption, and mandatory email encryption requirements are all likely to remain central themes in future compliance efforts.

The organizations that begin preparing now will not only be better positioned for future regulatory changes, but will also strengthen their ability to protect patient data, reduce risk, and build trust in an increasingly challenging threat landscape.

At LuxSci, we’re proud to support the healthcare industry’s ongoing digital transformation through secure healthcare communications. Our HIPAA-compliant solutions for secure email, email marketing, and forms empower organizations to safely use and protect PHI, while delivering better patient experiences and outcomes.

Ready to strengthen your healthcare cybersecurity strategy?

Learn more about LuxSci and our complete suite of HIPAA compliant email and marketing solutions, or schedule a consultation with one of our healthcare communication experts today.

LuxSci Awarded 20 Badges in the G2 Summer 2026 Reports

May 28, 2026
Pete Wermter

We’re excited to announce that LuxSci has again been recognized by G2 with 20 badges in its just-released Summer 2026 Reports, highlighting our continued leadership in secure healthcare communications and HIPAA compliant email solutions.

The new LuxSci G2 recognitions span several categories, including:

Best Estimated ROI
Best Support
High Performer
Leader

These latest LuxSci G2 awards reflect what matters most to our customers: delivering secure, HIPAA compliant healthcare communications backed by responsive support and measurable business results.

As one of the most trusted providers of HIPAA compliant email, marketing, and forms solutions, we’re proud to see our commitment recognized across multiple product categories and customer satisfaction metrics.

Recognition Built on Customer Experience

LuxSci’s G2 rankings are based on verified customer feedback and real-world user experiences, making these badges especially meaningful to our team.

This year’s Summer Reports recognized LuxSci for consistently delivering value to healthcare organizations looking to securely engage patients and customers while maintaining compliance with HIPAA requirements.

Among the highlights, the LuxSci G2 recognition includes:

Best Estimated ROI, reflecting the measurable value customers achieve through secure healthcare communications and personalization
Best Support, reinforcing LuxSci’s long-standing reputation for responsive, knowledgeable customer service
High Performer badges across multiple categories for customer satisfaction and product performance
Leader recognition for delivering secure, scalable communications solutions trusted by healthcare organizations

At LuxSci, we believe secure communications should also drive better engagement, stronger outcomes and operational efficiency. These recognitions reinforce our focus on helping healthcare providers, payers and suppliers personalize communications while protecting sensitive patient data.

Supporting the Future of Personalized Healthcare Engagement

LuxSci’s secure healthcare communication and patient engagement solutions empower organizations to safely communicate with patients and customers through:

HIPAA-compliant high volume email
Secure email marketing
Secure forms and data collection
Flexible encryption with SecureLine technology

Our solutions are designed to help healthcare organizations improve engagement, streamline workflows and personalize the healthcare journey while maintaining the highest standards of security and compliance.

These latest LuxSci G2 recognitions also build on LuxSci’s broader reputation for security, performance and customer success. Security and trust remain foundational to everything we do, alongside our commitment to delivering smart, responsive support for our customers.

Thank You to Our Customers

We’re grateful to our customers for their continued trust, collaboration and feedback. Their reviews and insights help shape our products and drive ongoing innovation across the LuxSci product set.

To learn more about LuxSci’s secure healthcare communications solutions, contact our team to schedule a secure email assessment or demo.

Connect with us today!

What Are HIPAA Compliant Hosting Requirements?

June 2, 2025
Erik Kangas

HIPAA compliant hosting requirements include administrative policies for workforce training and access management, physical controls for data center security and equipment protection, and information protections for data encryption, access controls, and audit logging. Healthcare organizations using hosting services must ensure providers implement appropriate business associate agreements, security measures, and compliance documentation that meet Privacy and Security Rule obligations for protecting electronic PHI. Healthcare organizations increasingly rely on cloud hosting and managed services to support their operations while reducing internal IT infrastructure costs. Outsourcing hosting responsibilities does not eliminate HIPAA compliant hosting requirements, requiring careful vendor selection and ongoing oversight.

Administrative Protection Standards

Workforce training requirements mandate that hosting providers educate their personnel about HIPAA obligations and PHI handling procedures. All staff with potential access to healthcare client data must understand privacy requirements and security protocols before gaining system access. Access management procedures ensure that hosting provider personnel receive appropriate permissions based on their job responsibilities and healthcare client needs. Role-based access controls limit employee exposure to PHI while enabling necessary system administration and support activities. Security officer designation requires hosting providers to appoint qualified individuals responsible for developing and implementing security policies that protect healthcare client data. Officers must have appropriate authority and expertise to ensure comprehensive compliance across hosting operations.

Infrastructure & HIPAA Compliant Hosting Requirements

Data center security controls must protect servers and network equipment from unauthorized physical access through multiple layers of security including perimeter controls, biometric access systems, and surveillance monitoring. These protections help prevent unauthorized individuals from accessing systems containing PHI. Equipment disposal procedures ensure that storage devices and servers containing healthcare client data receive appropriate destruction when they reach end of life. Hosting providers must implement certified data destruction methods that prevent PHI recovery from disposed equipment. Environmental protections including fire suppression, climate control, and power management help ensure that healthcare client data remains available and protected from physical threats. Systems of this nature support business continuity while maintaining data integrity and accessibility.

Control Measures for HIPAA Compliant Hosting Requirements

User authentication systems verify the identity of individuals accessing hosting infrastructure before granting permissions to view or modify healthcare client data. Multi-factor authentication provides additional security layers for privileged access to systems containing PHI. Unique user identification ensures that hosting provider activities can be traced to specific individuals through comprehensive account management and monitoring systems. These controls support accountability and enable investigation of potential security incidents involving healthcare client data. Emergency access procedures provide alternative authentication methods when normal access controls might delay urgent system maintenance or security response activities. These procedures must include enhanced monitoring and documentation requirements to maintain security while enabling necessary operations.

Audit Controls and Activity Monitoring

Comprehensive logging systems capture detailed records of all activities affecting healthcare client data including user access, system modifications, and data transfers. These logs must be protected from unauthorized modification and preserved for appropriate periods to support compliance demonstrations. Regular log analysis helps hosting providers identify unusual activity patterns that might indicate security threats or compliance violations. Automated monitoring tools can detect suspicious behavior and alert security personnel to potential incidents requiring investigation. Audit trail preservation ensures that activity records remain available for compliance reviews and incident investigations throughout required retention periods. Hosting providers must maintain secure log storage while providing healthcare clients with access to relevant audit information.

Data Integrity and Transmission Security

Encryption implementation protects healthcare client data during storage and transmission through approved cryptographic methods and key management practices. Hosting providers must maintain current encryption standards while ensuring that decryption capabilities remain available for legitimate access needs. Data validation procedures verify that healthcare client information maintains accuracy and completeness throughout processing and storage activities. These procedures help detect unauthorized modifications or corruption that could compromise data integrity or patient care. Backup and recovery systems maintain additional copies of healthcare client data while preserving security protections and access controls. Frequent testing ensures that backup systems function properly and can restore data without compromising compliance requirements.

Network Security and Communication Controls

Firewall configuration creates secure network boundaries that control traffic between healthcare client systems and external networks. These controls help prevent unauthorized access while enabling necessary communication for healthcare operations and patient care. Intrusion detection systems monitor network traffic for potential security threats and unauthorized access attempts involving healthcare client data. Automated alerting helps hosting providers respond quickly to potential incidents while maintaining comprehensive security coverage. Secure communication channels protect data transmission between healthcare clients and hosting infrastructure through encrypted connections and authenticated access methods. These channels help ensure that PHI remains protected during transfer and remote access activities.

Business Associate Agreement Obligations

Contractual requirements establish hosting provider responsibilities for PHI protection including specific security measures, incident response procedures, and compliance monitoring activities. These agreements must address all applicable HIPAA compliant hosting requirements while defining clear performance expectations. Liability allocation between healthcare organizations and hosting providers depends on their respective roles in PHI protection and which party controls different aspects of data security. Clear contractual provisions help define responsibility for various compliance obligations and potential violations. Termination procedures address how healthcare client data is handled when hosting relationships end including data return, destruction, or transfer requirements.

Compliance Monitoring and Vendor Oversight

Risk assessment procedures help healthcare organizations evaluate hosting provider security practices and identify potential vulnerabilities that could compromise PHI protection. These assessments should be conducted regularly and documented to demonstrate due diligence in vendor oversight. Performance monitoring tracks hosting provider compliance with contractual obligations and HIPAA requirements through security audits, incident reviews, and service level assessments. Healthcare organizations must maintain ongoing oversight rather than relying solely on initial vendor evaluations. Documentation requirements ensure that hosting providers maintain records demonstrating their compliance efforts including policies, training materials, audit results, and incident reports. Well kept records support healthcare client compliance demonstrations and regulatory reviews when requested.

Is the Email Encrypted? How to Tell if an Email is Transmitted Using TLS

January 9, 2024
LuxSci

SMTP TLS encryption is popular because it provides adequate data protection without creating a complicated user experience for email recipients. Sometimes, though, the experience is too seamless, and recipients may wonder if the message was protected at all.

Luckily, there is a way to tell if an email was encrypted using TLS. To see if a message was sent securely, we can look at the raw headers of the email. However, it requires some knowledge and experience to understand the text. It is actually easier to tell if a recipient’s server supports TLS than to tell if a particular message was securely transmitted.

To analyze a message for transmission security, we will look at an example email message sent from Hotmail to LuxSci. We will explain what to look for when decoding the message headers and how to tell if the email was transmitted using TLS encryption.

An Example Email Message

First, we must understand how an email message typically travels through several machines on its way from the sender to the recipient. Roughly speaking:

The sender’s computer talks to the sender’s email or WebMail server to upload the message.
The sender’s email or WebMail server then talks to the recipient’s inbound email server and transmits the message to them.
Finally, the recipient downloads the message from their email server.

It is step 2 that people are most concerned about when trying to understand if their email message is transmitted securely. They usually assume or check that everything is secure and OK at the two ends. Indeed, most users who need to can take steps to ensure that they are using SSL-enabled WebMail or POP/IMAP/SMTP/Exchange services so that steps 1 and 3 are secure. The intermediate step, where the email is transmitted between two different providers, is where messages may be sent insecurely.

To determine if the message was transmitted securely between the sender’s and recipient’s servers (over TLS), we need to extract the “Received” header lines from the received email message. If you look at the source of the email message, the lines at the top start with “Received.” Let’s look at an example message from a Hotmail user below. The email addresses, IPs, and other information are obviously fake.

LuxSci:

The Outlook email was sent to a LuxSci user. The Received headers appear in reverse chronological order, starting with the server that touched the message last. Therefore, in this example, we see the LuxSci servers first.

Received: from abc.luxsci.com ([1.1.1.1])
	by def.luxsci.com (8.14.4/8.13.8) with ESMTP id r7JEfLgH003867
	(version=TLSv1/SSLv3 cipher=DHE-RSA-AES256-SHA bits=256 verify=NOT)
	for <user-xyz@def.luxsci.com>; Mon, 19 Aug 2019 10:41:21 -0400
Received: from abc.luxsci.com (localhost.localdomain [127.0.0.1])
	by abc.luxsci.com (8.14.4/8.13.8) with ESMTP id r7JEfK0Z030182
	for <user-xyz@def.luxsci.com>; Mon, 19 Aug 2019 09:41:20 -0500
Received: (from mail@localhost)
	by abc.luxsci.com (8.14.4/8.13.8/Submit) id r7JEfKXD030178
	for user-xyz@def.luxsci.com; Mon, 19 Aug 2019 09:41:20 -0500

Received: from dispatch1-us1.ppe-hosted.com (dispatch1-us1.ppe-hosted.com [2.2.2.2])
	by abc.luxsci.com (8.14.4/8.13.8) with ESMTP id r7JEfIkK030002
	(version=TLSv1/SSLv3 cipher=DHE-RSA-AES256-SHA bits=256 verify=NOT)
	for <someone@luxsci.net>; Mon, 19 Aug 2019 09:41:19 -0500

Proofpoint:

LuxSci uses an email filtering service, Proofpoint. Messages reach Proofpoint’s servers before being delivered to LuxSci. Here’s what their servers report about the email transmission:

Received: from unknown [65.54.190.216] (EHLO bay0-omc4-s14.bay0.hotmail.com)
	by dispatch1-us1.ppe-hosted.com.ppe-hosted.com
        (envelope-from <someone@hotmail.com>);
	Mon, 19 Aug 2019 08:41:18 -0600 (MDT)

Outlook:

And finally, here’s what we see from Oultook’s server.

Received: from BAY403-EAS373 ([65.54.190.199]) by bay0-omc4-s14.bay0.outlook.com
       with Microsoft SMTPSVC(6.0.3790.4675); 
       Mon, 19 Aug 2019 07:41:19 -0700

How to Use Received Message Headers to Tell if the Email is Encrypted

The message headers contain information that can help us determine if an email is encrypted. Here are a few helpful notes to help you decode the text:

We said this above, but the message headers appear in reverse chronological order. The first one listed shows the last server that touched the message; the last one is the first server that touched it (typically the sending server).
Each Received line documents what a server did and when.
There are three sets of servers involved in this example: one machine at Hotmail, one machine at Proofpoint, where our Premium Email Filtering takes place, and some machines at LuxSci, where final acceptance of the message and subsequent delivery happened.

Presumably, the processing of email within each provider is secure. The place to be concerned about is the hand-offs between Hotmail and Proofpoint and between Proofpoint and LuxSci, as these are the big hops across the internet between providers.

In the line where LuxSci accepts the message from Proofpoint, we see:

(version=TLSv1/SSLv3 cipher=DHE-RSA-AES256-SHA bits=256 verify=NOT)

This section, typical of most email servers running “sendmail” with TLS support, indicates that the message was encrypted during transport with TLS using 256-bit AES encryption. (“Verify=not” means that LuxSci did not ask Proofpoint for a second SSL client certificate to verify itself, as that is not usually needed or required for SMTP TLS to work correctly). Also, “TLSv1/SSLv3” is a tag that means that “Some version of SSL or TLS was used;” it does not mean that it was SSL v3 or TLS v1.0. It could have been TLS v1.2 or TLS v1.3.

So, the hop between Proofpoint and LuxSci was locked down and secure. What about the hop between Hotmail and Proofpoint? The Proofpoint server’s Received line makes no note of security at all! This means that the email message was probably not encrypted during this step.

Hotmail either did not support opportunistic TLS encryption for outbound emails, or Proofpoint did not support receipt of messages over TLS, and thus, TLS could not be used. With additional context, you can know which server supports TLS and which does not.

In this case, we know that Proofpoint supports inbound TLS encryption. In fact, from another example message where LuxSci sent a message to Proofpoint, we see the Received line:

Received: from unknown [44.44.44.44] (EHLO wgh.luxsci.com)
	by dispatch1-us1.ppe-hosted.com.ppe-hosted.com
        (using TLSv1.2 with cipher ECDHE-RSA-AES256-GCM-SHA384 (256/256 bits))
	with ESMTP id b-022.p01c11m003.ppe-hosted.com
        (envelope-from <from@domain.com>);
	Mon, 02 Feb 2009 19:28:27 -0700 (MST)

The red text makes it clear that the message was indeed encrypted. Based on the additional context, we can deduce that the Hotmail sending server did not securely transmit the email using TLS.

How To Tell if an Email is Encrypted With TLS

When analyzing your message headers, consider the following items to determine if the email is encrypted:
1. The receiving server will log what kind of encryption, if any, was used in receiving the message in the headers.
2. Different email servers use different formats and syntax to display the encryption used. Look for keywords like “SSL,” “TLS,” and “Encryption,” which will signify this information.
3. Not all servers will record the use of encryption. While LuxSci has always logged encryption use, not every email service provider does. It is possible to use TLS encryption and not log it. Sometimes, there is no way to tell from the headers if a message is encrypted if it is not logged.
4. Messages passed between servers at the same provider do not necessarily need TLS encryption to be secure. For example, LuxSci has back-channel private network connections between many servers so that information can be securely passed between them without SMTP TLS. So, the lack of TLS usage between two servers does not mean the transmission between them was “insecure.” You may also see multiple received lines listing the same server: the server passes the message between different processes within itself. This communication also does not need to be TLS encrypted.
5. If you are a LuxSci customer, you can view online email delivery reports to see if TLS was used for any particular message. We record the kind of encryption in the delivery reports, so it’s easy to see which emails were encrypted.

How can you Ensure Emails Are Securely Transmitted?

With some servers not recording TLS in message headers, how can you determine if a message was transmitted securely from sender to recipient?

To answer this question accurately, you must understand the properties, servers, and networks involved. It may be easy to determine that the message was transmitted securely if included in the header information. However, the absence of information does not necessarily mean the message was insecurely transmitted. You can only know this if you know what each system’s servers record.

In our example of a message from Hotmail to LuxSci, you need to know that:

Proofpoint and LuxSci will always log the use of TLS in the headers. We can infer that the Hotmail to Proofpoint transmission was not secure as nothing was recorded there.
The transmission of messages within LuxSci’s infrastructure is secure due to private back channel transmissions. So, even though there is no mention of TLS in every Received line after LuxSci accepts the message from Proofpoint (in this example), transferring the messages between servers in LuxSci is as secure as using TLS. Also, the same server can add multiple received lines as it talks to itself. Generally, these hand-offs on the same server will not use TLS, as there is no need. In the LuxSci example, we see this as “abc.luxsci.com” adds several headers.
We don’t know anything about Hotmail’s email servers, so we don’t know how secure the initial transmissions within their network are. However, since we know they did not securely transmit the message to Proofpoint, we are not confident that the transmissions and processing within Hotmail (which may have gone unrecorded) were secure.

Was the email message sent and received using encryption?

We skipped steps 1 and 3 and focused on step 2 – the transmission between servers. Steps 1 and 3 are equally, if not more, necessary. Why? Because eavesdropping on the internet between ISPs is less of a problem than eavesdropping near the sender and recipient (i.e., in their workplace or local wireless hotspot). So, it’s essential to ensure messages are sent securely and received securely. This means:

Sending: Use SMTP over SSL or TLS when sending messages from an email client or use WebMail over a secure connection (HTTPS).
Receiving: Ensure your POP or IMAP connection is secured via SSL or TLS. If using WebMail to read your email, be sure it is over a secure connection (HTTPS).
WebMail: There is generally no record in the email headers to indicate if a message sent using WebMail was transmitted from the end-user to WebMail over a secure connection (SSL/HTTPS).

You can typically control one side and ensure it is secure; you can’t control the other without taking extra steps. So, what can you do to ensure your message is secure even if it might not be transmitted with encryption or if the recipient tries to access it insecurely?

You could use end-to-end email encryption (like PGP or S/MIME, which are included in SecureLine) or a secure web portal that doesn’t require the recipient to install or set up anything to get your secure email message. These methods meet HIPAA and other regulatory compliance requirements for secure data transmission and provide complete confidence that the message will be sent and received securely.

LuxSci’s SecureLine offers flexible encryption options, including TLS, secure web portal, PGP, and S/MIME. Its dynamic capabilities can determine what types of encryption the recipient’s server supports to ensure your emails are always sent securely. Contact our team today to learn more about how to secure your emails.

12 Key Questions to Ask Before Sending HIPAA-Compliant Marketing Emails

October 30, 2024
LuxSci

So – you’ve just been told that your email marketing program is putting your company at risk of violating HIPAA.

Ok. What now?

If you want to continue your email-based patient engagement efforts – without the risk of the financial, operational, and reputational risk that accompanies the exposure of sensitive patient data, you must implement HIPAA compliant email marketing practices.

This is comprised of two components: becoming HIPAA-compliant, setting up the required systems and procedures to ensure your PHI (PHI) and EPHI (EPHI) are protected, and your marketing objectives, who you want to reach and what to communicate.

However, you don’t have to let your marketing objectives suffer for the sake of security.

Implementing a HIPAA-compliant marketing program can actually help you achieve better marketing results.

Asking yourself these 12 questions ensures your email marketing campaigns align with your business goals and are HIPAA-compliant.

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HIPAA-Compliant Marketing Emails

1. Do you have security controls to protect access to your email marketing system?

2. Do you have a documented procedure to guide you HIPAA-compliant email marketing?

3. Can you send encrypted emails?

4. Do you have a complete understanding of your organization’s PHI and ePHI?

5. Do you have a required training process for anyone sending HIPAA-compliant marketing emails?

6. Do you have effective protection against malware?

7. Do you have valid Business Associate Agreements (BAA) in place?

8. Why am I sending this email?

9. Is my email’s subject line standing out?

10. What is the recipient’s brand and product awareness level?

11. Have I tested my message for readability?

12. Have I sent my message to a test email account?

HIPAA-Compliant Marketing Emails

If your organization requires HIPAA-compliant email, start by using these questions to inspect your email marketing for compliance. Note that while we can’t provide legal advice, the below questions will help you identify some of the most common points of vulnerability and non-compliance.

1. Do you have security controls to protect access to your email marketing system?

Email security is an essential component of being HIPAA-compliant. As a starting point, check your internal security processes for access restrictions. This includes:

A robust password policy, i.e., changed frequently (e.g., 30 days), has to contain a mixture of characters, etc.
Multi-factor authentication (MFA), i.e., users verifying their identity in multiple ways, e.g., username/password and sent number codes (text, email, key fob, etc.), biometrics, etc.
Role-based access controls, i.e., granting access to individuals based on the responsibilities of their job role.
Zero Trust Architecture (ZTA), i.e., “never trust, always verify” – where users are required to reconfirm their identity on a case-by-case basis, as opposed to once when logging on, which mitigates session hijacking and similar threats.

2. Do you have a documented procedure to guide you HIPAA-compliant email marketing?

“Winging it” simply doesn’t cut it when it comes to HIPAA-compliant email marketing; you must develop a comprehensive documented process detailing how you intend to safeguard PHI throughout your email marketing campaigns.

This should include:

Specifying the HIPAA-compliant email delivery service you’ll use to execute your marketing campaigns

The processes and controls you’ll use to encrypt data for ePHI at rest and in transit

The access and authentication controls you have in place

How you’ll implement data minimization: only using the minimum necessary PHI in communications – and not including sensitive PHI unless it’s essential.
How you’ll securely dispose of data: Implement a process for securely deleting emails containing ePHI once they’re no longer needed, to comply with retention policies.
Staff training: educating employees involved in email marketing on how to securely handle PHI and other HIPAA requirements.
Incident response plan, i.e., an additional documented plan for how you’ll respond to data breaches and other cyber attacks; this also includes notifying any affected parties as mandated by HIPAA.

If you’re starting from scratch, the information contained in the answers to the questions in this article provides a useful starting point for creating your first procedure.

3. Can you send encrypted emails?

If you are sending highly sensitive data or PHI in your emails, be aware that HIPAA requires the data to be encrypted a rest, i.e., the storage medium where it resides, and in transit, when being sent to recipients.

To the surprise of many healthcare organizations, most major email marketing providers, such as Mailchimp and Constant Contact are unable to provide encryption for data in transit and only protect data in their systems. To avoid falling foul of HIPAA regulations, ensure that the email delivery platform you use to transmit messages containing PHI offers end-to-end encryption.

4. Do you have a complete understanding of your organization’s PHI and ePHI?

Much of the time, when we, as well as healthcare providers, talk about PHI, we’re actually referring to electronic protected health information (EPHI). While PHI is a catch-all term to account for all sensitive health information, in truth, in the digital age, the vast majority is stored electronically in data centers – and the patient data handled is EPHI.

You can discover “PHI” and “ePHI” within the context of your organization’s context by identifying and categorizing the PHI and ePHI typically handled in your business. It’s an absolutely crucial tenet of data protection that you simply can’t protect what you’re not aware of.

Comprehensive PHI categorization will help your staff navigate HIPAA-compliant email requirements.

5. Do you have a required training process in place for anyone sending HIPAA-compliant marketing emails?

Your HIPAA compliance program, as with your company’s overall cybersecurity posture, is only as strong as your weakest link. In light of this, it’s essential to educate the staff within your company who are involved in your healthcare engagement campaigns on the secure use of ePHI and HIPAA-compliant marketing practices.

Additionally, this needs to be reflected in your onboarding process, so new hires are made familiar with HIPAA regulations, should their role require it.

6. Do you have effective protection against malware?

In the unlikely event you need any further encouragement to revisit your company’s anti-malware (viruses, ransomware, Trojans, etc.) measures, there are always HIPAA compliance requirements!

To better protect your sensitive customer data against a slew of increasingly sophisticated cyber threats, start with these three key considerations:

Do you have anti-malware protection running on all of your organization’s devices? Additionally, does this extend to your employee’s personal devices on which they handle PHI?
How frequently do you update your anti-malware solution?
Does your email marketing provider have sufficient protection malware mitigation measures in place, as per HIPAA requirements?

7. Do you have valid Business Associate Agreements (BAA) in place?

It’s normal to outsource activities like email marketing to a third party, but for the service they provide to be HIPAA-compliant, you must have a business associate agreement (BAA) in place.

A BAA documents how two organizations will share PHI and under what circumstances. A BAA also details the legal responsibilities of each party in the event of a serious issue. With a BAA being a core component of HIPAA compliance, failure to have one in place with your email service provider is an immediate HIPAA violation – and one that can result in serious consequences for a healthcare company.

Getting Better Results from HIPAA-Compliant Email Marketing

Now that you’ve confirmed your systems are HIPAA-compliant, let’s move on to making sure your email marketing strategy aligns with your overall business objectives.

In pursuit of this, the following questions serve as a handy “monthly review” for refining the effectiveness of your email-based patient outreach efforts .

8. Why am I sending this email?

First and foremost, for the best results, each email you send should have a single, clearly defined purpose.

I know what you’re thinking – “my customers and patients are smart, they can handle multiple points in a single message.” And while that’s true, at whatever point your email reaches a recipient, they’re already juggling several different priorities at once. While they’re capable of juggling multiple points in a message – they’re unlikely to want to; when it comes to email marketing, a single goal is the best way to go.

Similarly, it’s important to remember that your email is one of dozens – or hundreds – received by your patient that day. So, if your message is long and overly complicated, the reader will likely skip over or delete it.

9. Is my email’s subject line standing out?

Following on the above point, is your email subject line impactful enough to stand out amidst the pile of messages that will land in the patient’s inbox that day? The email subject line is the most important part of your email because it’s responsible for persuading the reader to open your message.

Despite this, many marketers still use terrible, ineffective subject lines and wonder why their emails are failing to produce results!

For the best results, write up three to ten subject lines for your next email, step away for 5-10 minutes, and then choose the headline you determine as best.

Consider these examples to check your understanding:

Ineffective Email Subject Lines

Blank (no subject): writing nothing in the subject line
Clinic Newsletter (tell them more, e.g., the subject or theme for the month)
Overusing exclamation marks!!!

Effective Email Subject Lines (examples based on a dental practice)

BRAND-NEW Dental Product Released Today
How to Cut Down on Your Health Insurance Paperwork
[Case Study] How We Helped 3 Ex-Smokers Get White Teeth

10. What is the recipient’s brand and product awareness level?

Whether promoting medical devices, new digital solutions technology, or any healthcare product or service, understanding the prospect’s awareness level is essential.

If your email is designed to introduce a brand-new product, stick to high-level features and benefits while avoiding technical jargon and granular product details. Conversely, if you’re writing an email to experienced, highly knowledgeable readers, going into greater depth makes sense.

Advanced list management and segmentation tools, as offered by Luxsci Secure Marketing, are key for ensuring the communications you send match the reader’s awareness level.

11. Have I tested my message for readability?

Do you know one of the reasons that Hemingway was popular? He was skilled at writing short phrases and phrases. Consequently, his writing was easy to understand and appealed to a wide variety of people. When in doubt, keep your writing short and free of jargon, abbreviations and “insider” terms.

When you’re deeply involved in the details of your business, it’s so easy to overlook just how much specialized jargon and language you frequently use. However, if you want your communications to engage with patients and customers, they need to be as accessible as possible.

Fortunately, there are simple solutions to this, with tools like the Text Readability Calculator that are designed to quickly enhance the readability of your emails.

12. Have I sent my message to a test email account?

Finally, if you’ve followed all of the above advice, you’re almost ready to hit SEND…there’s just one more thing you need to check.

Determine how your email will look to recipients, including its clarity, and readability by simply sending a test email to one of your own email accounts once it is received.

In particular, pay attention to how the subject line looks and test all the links in the email to ensure they take the reader through to the intended destination, such as a product or service page. A broken link will only frustrate the recipient – who was interested enough to click through, no less – and lower your conversion rate.

Better still, send the test email to a colleague somebody and ask for their opinion about the quality of the message and whether it creates the desired impression.

Demystifying HIPAA-Compliant Email Marketing

As the most experienced HIPAA-compliant email provider, LuxSci specializes in providing secure and HIPAA-compliant solutions for companies aiming to send hundreds of thousands – or millions – of emails. Our hypersegmentation tools allow you to precisely target an unlimited number of patient sub-populations to maximize the efficacy of your messaging.

Are you interested in discovering how LuxSci’s secure email marketing platform will streamline your healthcare engagement efforts?

What is a Secure Email Gateway?

April 2, 2025
Pete Wermter

Email communication is indispensable in today’s fast-paced, digitally-driven healthcare world. Unfortunately, for healthcare organizations, cyber criminals are aware of this too, which is why email-based cyber threats, such as unauthorized access, PHI exposure, phishing and ransomware, remain as prevalent as ever. A Secure Email Gateway can help, providing a security solution that sits between an organization’s email server and the outside world to monitor, filter, and control all incoming and outgoing email traffic.

As healthcare companies learn to recognize and mitigate email security threats, malicious actors grow more sophisticated, developing new ways of breaching organizations’ email security measures. In light of this, healthcare companies must find ways to better safeguard the electronic protected health information (ePHI) within their IT infrastructure, especially for email. Not only will this help maintain operational consistency, delivering high-quality and expedient service to their patients and customers, but it helps them comply with the regulatory guidelines mandated by the Health Insurance Portability and Accountability Act (HIPAA).

A secure email gateway provides an excellent solution to the problem of an evolving email cyber threat landscape, without a healthcare company having to make significant changes to their IT infrastructure. So, with this in mind, this post explores the concept of secure email gateways, how they better safeguard sensitive patient data, and how they support HIPAA compliance efforts.

What Is a Secure Email Gateway?

A secure email gateway is a security tool that filters inbound and outbound email communications to mitigate a variety of email-based cyber threats, including phishing, malware (e.g., ransomware, viruses, etc), PHI exposure, and spam mail.

Effectively providing an additional security layer for your organization’s email accounts, a secure email gateway acts as a checkpoint between its email systems and the internet, enforcing your healthcare company’s security policies and ensuring HIPAA compliance.

How Do Secure Email Gateways Work?

A secure email gateway sits between a company’s email platform (e.g., Microsoft 365, Google Workspace) and external email traffic, scanning messages for potential malicious activity and security policy violations.

When sending an outbound email, the message is encrypted before being passed onto the recipient. This prevents the exposure of any ePHI contained in the email, in the event of its interception. Without the encryption key, the email is rendered unreadable by cyber criminals, ensuring data privacy and regulatory compliance. By the same token, depending on its nature, the secure email gateway may automatically archive the email to help satisfy compliance requirements for message retention – something that will be all the more important when the updated HIPAA Security Rule comes into effect in later 2025.

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Conversely, for incoming traffic, a secure email gateway utilizes filtering tools to identify and quarantine suspicious messages. By preventing potentially malicious messages from reaching employee inboxes, a gateway reduces instances of phishing, malware installation, credential compromise – and any email cyber threat that requires human error or negligence.

When Should You Opt For a Secure Email Gateway?

The key reason to opt for a secure email gateway solution is that you want to enhance your company’s email security without replacing your existing email infrastructure.

A key advantage offered by secure email gateways is that they’re easy to install, manage, and use. This keeps the administrative burden on a company’s IT and operations departments to a minimum while still achieving the key objectives of boosting email security and aiding compliance efforts.

More specifically, installing a secure email gateway can be an easy solution for healthcare care companies looking to quickly achieve HIPAA compliance for email. By simply sitting on top of a company’s existing email service, like Microsoft 365 or Google Workspace, a secure email gateway can be easier for IT teams to install and maintain, especially for smaller companies and organizations. Additionally, employees won’t require additional training or have to make any adjustments: they can simply keep using their existing email accounts without interruption.

Enhance Your Email Security Posture With Luxsci’s Secure Email Gateway

LuxSci’s Secure Email Gateway can be easily integrated with Microsoft 365, Google Workspace, or your on-premise email client to better safeguard ePHI and ensure HIPAA compliance – with zero disruption to your current systems, employees, or your quality of service.

Using LuxSci’s proprietary SecureLine encryption technology, our Secure Email Gateway solution automatically encrypts every email, protecting sensitive patient data without the need for explicit employee intervention before sending the message.

Want to know more about how HIPAA compliant email will boost your security and compliance? Contact us to learn more and get started!