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Integrating HIPAA Compliant Email with EHR Systems

HIPAA Compliant Hosting Requirements

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!

Picture of Pete Wermter

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 Compliant Email

Rethinking HIPAA Compliant Email – Not Just a Checkbox

The compliance-only mentality is outdated.

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

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

What Makes Email Truly HIPAA Compliant?

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

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

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

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

The Real Opportunity – Secure, Personalized Email with PHI

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

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

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

Real Business Results from Secure Email

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

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

The Healthcare Marketer’s Secret Weapon: Using PHI Responsibly

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

Meeting the Personalization Demands of Today’s Patients and Customers

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

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

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

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

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

Why LuxSci? The Infrastructure Behind the Performance

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

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

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

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


FAQs

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

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

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

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

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

HIPAA compliant email

Most Popular LuxSci Blog Posts of 2025

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

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

1. Improve Email Engagement and Marketing Results with Automated Workflows

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

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

2. Healthcare Email Threat Readiness Strategies

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

Read the full post: Healthcare Email Threat Readiness Strategies

3. HIPAA Compliant Email — 20 Tips in 20 Minutes

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

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

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

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

Read the full post: Is SendGrid HIPAA-Compliant?

5. LuxSci Shines in G2 Winter 2026 Reports

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

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

Looking Ahead to 2026

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

Follow LuxSci on LinkedIn

HIPAA compliant email

LuxSci Welcomes Angel Mazariegos as Head of Finance

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

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

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

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

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

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

HIPAA Compliant Email

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

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

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

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

Why G2 Matters

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

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

What We Earned in Winter 2026

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

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

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

Awards Reflect Our Commitment to Customer Success

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

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

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

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

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

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How to Set Up HIPAA Compliant Email

How To Create a Healthcare Marketing Plan?

A healthcare marketing plan establishes strategic promotional activities, target audience identification, budget allocation, and compliance protocols to attract new patients while adhering to HIPAA privacy regulations and state advertising laws. Medical practices develop these documents to guide their promotional efforts across digital platforms, traditional media, and community outreach programs, ensuring all patient acquisition activities comply with healthcare privacy requirements and professional advertising standards.

Medical practices compete intensely for patient attention in saturated healthcare markets. Developing promotional strategies without proper planning leads to wasted resources, compliance violations, and missed opportunities to connect with patients who need specific medical services.

Target Audience in Healthcare Marketing Plan Development

Patient demographic research identifies age groups, geographic locations, insurance coverage types, and medical conditions that align with practice specialties and service offerings. Healthcare organizations analyze existing patient data to understand referral patterns, appointment scheduling preferences, and communication channel effectiveness for different population segments.

Competitor analysis reveals promotional strategies used by similar practices, pricing structures for comparable services, and market gaps that create opportunities for differentiation. This research helps practices position their services uniquely while avoiding oversaturated promotional approaches that fail to generate meaningful patient engagement.

Budget Allocation

Financial planning allocates resources across promotional channels based on expected return on investment, patient acquisition costs, and practice revenue goals. Digital advertising usually receives 40-60% of promotional budgets due to measurable results and targeted audience capabilities, while traditional media and community events receive smaller allocations.

Compliance costs including legal reviews, authorization management, and privacy training must be factored into promotional budgets to ensure all activities meet regulatory requirements. Practices that underestimate compliance expenses often discover their promotional activities violate privacy laws or professional advertising standards.

Digital Strategy to Drive Modern Patient Acquisition

Website optimization, search engine marketing, and social media presence are the core of contemporary promotional efforts outlined in every healthcare marketing plan. Practices invest in professional website design, patient portal integration, and mobile-responsive layouts to capture patients researching medical services online.

Content creation including blog posts, educational videos, and patient resources helps establish expertise while providing valuable information to potential patients. However, all content must avoid using patient information without authorization and cannot make unsubstantiated medical claims that violate advertising regulations.

Compliance Integration Protects Promotional Activities

HIPAA authorization procedures, business associate agreements with promotional vendors, and state advertising law compliance must be woven throughout every aspect of promotional planning. Healthcare marketing plan development includes legal review processes, privacy impact assessments, and staff training protocols to prevent violations.

Documentation requirements for promotional activities include consent forms, vendor contracts, and approval workflows that demonstrate compliance with healthcare privacy laws. Practices without proper documentation face significant penalties when regulatory investigations uncover promotional activities that violate patient privacy protections.

Community Outreach Builds Local Patient Relationships

Health fairs, educational seminars, and community partnerships create opportunities for practices to connect with potential patients through face-to-face interactions. These activities require planning to ensure patient privacy protection while maximizing promotional impact through relationship building and trust development.

Referral programs with other healthcare providers, local businesses, and community organizations can generate new patient leads when structured appropriately. Any financial incentives for referrals must comply with healthcare fraud and abuse laws to avoid legal complications.

Performance Measurement Guides Strategy Optimization

Patient acquisition metrics, appointment conversion rates, and promotional channel effectiveness data help practices evaluate their promotional success and adjust strategies accordingly. Healthcare marketing plan implementation includes tracking systems for website traffic, phone inquiries, and new patient appointments generated by different promotional activities.

Return on investment calculations compare promotional spending with revenue generated from new patients to determine which activities provide the best financial results. Practices use this data to reallocate budgets toward high-performing promotional channels while eliminating ineffective strategies.

Implementation Timeline

Monthly promotional calendars coordinate campaign launches, content publication schedules, and community event participation to maximize promotional impact while avoiding resource conflicts. Healthcare marketing plan execution requires detailed project management to ensure all activities launch on schedule and within budget constraints. Seasonal considerations including flu shot campaigns, wellness check promotions, and holiday health messaging opportunities require advance planning to capitalize on increased patient interest during specific time periods. Practices that plan these campaigns well in advance may achieve better results than those that react to opportunities without preparation.

encrypted email transmission

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

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:

  1. The sender’s computer talks to the sender’s email or WebMail server to upload the message.
  2. The sender’s email or WebMail server then talks to the recipient’s inbound email server and transmits the message to them.
  3. 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:

  1. 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).
  2. Each Received line documents what a server did and when.
  3. 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

  1. 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:

  1. 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.
  2. 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.
  3. 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.

Best Secure Email Provider

What is a HIPAA Compliant Email?

A HIPAA compliant email incorporates encryption, access controls, audit capabilities, and secure archiving to protect electronic protected health information during transmission and storage. Regular email services like Gmail or Yahoo Mail do not meet HIPAA requirements without enhanced security measures. Healthcare organizations must implement secure email platforms or security add-ons, establish proper usage policies, and obtain Business Associate Agreements from service providers to maintain HIPAA compliant email communications.

HIPAA Compliant Email Encryption Requirements

HIPAA compliant email services must encrypt messages containing protected health information during transmission and storage. Transport Layer Security (TLS) encryption protects messages while traveling between email servers, preventing interception by unauthorized parties. End-to-end encryption provides stronger protection by encrypting message content so only intended recipients can read it. Message-level encryption allows sending protected information to recipients who might not have secure email systems. Healthcare organizations implement gateway encryption solutions that automatically encrypt messages containing patient information. Without these encryption protocols, sensitive healthcare data remains vulnerable to access by unauthorized individuals during transmission across networks or while stored on servers.

Secure Access Control Mechanisms

Controlling who can access email accounts is an important aspect of maintaining HIPAA compliant email systems. Multi-factor authentication requires users to verify their identity through methods beyond passwords. Account lockout policies temporarily disable access after multiple failed login attempts. Password complexity requirements ensure users create strong credentials that resist guessing or cracking attempts. Session timeout features automatically log users out after periods of inactivity. Role-based access controls limit which staff members can send, receive, or view emails containing protected health information. When properly implemented, these access restrictions create multiple layers of protection that reduce the risk of unauthorized email access.

Audit and Monitoring Functions

HIPAA compliant email platforms include logging and monitoring capabilities that track message handling. Email systems record message sending, receiving, and access activities with user identification and timestamps. These logs create audit trails demonstrating who accessed what information and when these actions occurred. Email security gateways monitor outgoing messages for potential policy violations or unencrypted protected health information. Organizations review these logs to identify unusual patterns or potential security issues. Monitoring tools can alert administrators about suspicious email activities that might indicate compromised accounts. Regular auditing allows healthcare organizations to demonstrate compliance during regulatory reviews while providing essential information for investigating any potential security incidents.

HIPAA Compliant Email Retention and Archiving

Healthcare organizations must maintain HIPAA compliant email archives that preserve messages according to retention requirements. Email archiving solutions capture and securely store all messages, including those deleted from user inboxes. These archives maintain the encryption, access controls, and audit capabilities needed for protected health information. Retention policies determine how long different types of messages must be preserved based on regulatory and organizational requirements. Legal hold features prevent deletion of messages relevant to investigations or litigation. Archive search capabilities allow retrieving specific messages when needed for patient care or compliance verification. The combination of secure storage and retrieval functionality ensures healthcare communications remain available when needed while maintaining appropriate protections throughout the message lifecycle.

Business Associate Agreements

Healthcare organizations must obtain Business Associate Agreements from providers of HIPAA compliant email services. These agreements establish the email provider’s responsibilities for protecting healthcare information under HIPAA regulations. The BAA outlines security measures, breach notification procedures, and compliance documentation requirements. Organizations should verify exactly which components of the email service fall under BAA coverage, as some features might be excluded. Email providers offer standardized BAAs as part of their healthcare-focused services. Without properly executed agreements, healthcare organizations remain legally responsible for any compliance failures or data breaches occurring through their email service providers, potentially resulting in regulatory penalties.

Staff Training and Usage Policies

Technology alone cannot guarantee HIPAA compliant email without proper user behavior. Organizations must establish clear policies governing appropriate email usage for protected health information. Staff training covers what information can be included in emails, when encryption must be used, and how to verify message security before sending. Many healthcare systems implement visual indicators that help users identify when they’re composing secure versus standard emails. Regular reminders help maintain awareness as email threats and regulations evolve. Healthcare organizations require staff acknowledgment of email policies to document training completion. Even the most sophisticated email security technology can be undermined by simple human errors, making training and clear usage guidelines fundamental to maintaining compliant communications.

HIPAA Compliant Hosting

What is HIPAA Compliant Hosting?

HIPAA compliant hosting provides infrastructure for storing protected health information while meeting HIPAA Security Rule requirements. These hosting environments include physical, technical, and administrative safeguards such as encryption, access controls, audit logging, and disaster recovery. Healthcare organizations use HIPAA compliant hosting to maintain patient data security and regulatory compliance when storing electronic protected health information.

Core Requirements for HIPAA Compliant Hosting

HIPAA compliant hosting environments incorporate security measures to protect electronic health information. Data encryption safeguards information both during storage and transmission between systems. Access control systems limit data viewing to authorized personnel through user authentication and permission settings. Hosting providers maintain comprehensive audit logs that track all system access and modifications to protected information. Physical security measures protect server equipment through restricted facility access, surveillance systems, and environmental controls. These protections work to create a secure foundation for healthcare data storage and processing.

Infrastructure and Data Center Standards

HIPAA compliant hosting facilities maintain physical security standards more so than typical data centers. Providers implement layered facility access restrictions including biometric verification, security personnel, and monitored entry points. Environmental controls regulate temperature, humidity, and fire suppression to prevent data loss from environmental factors. Redundant power systems with backup generators ensure continuous operation during outages. Network infrastructure includes firewall protection, intrusion detection systems, and secure connectivity options. These facilities undergo regular security assessments and maintain documentation of all physical security measures to demonstrate compliance with HIPAA requirements.

Business Associate Agreements for Hosting

Healthcare organizations must establish Business Associate Agreements (BAAs) with their hosting providers before storing protected health information. These legally binding contracts define provider responsibilities for maintaining HIPAA compliance and protecting patient data. BAAs outline security incident response procedures, breach notification requirements, and liability terms. The agreement establishes permitted uses of health information and prohibits unauthorized disclosure. Reputable HIPAA compliant hosting providers offer standard BAAs that meet regulatory requirements without extensive negotiation. Organizations maintain copies of these agreements as part of their compliance documentation for potential regulatory audits.

Encryption and Data Protection Methods

HIPAA compliant hosting employs multiple encryption methods to protect health information throughout its lifecycle. Providers implement full-disk encryption for data storage to prevent unauthorized access even if physical drives are compromised. Transport Layer Security (TLS) protocols encrypt data during transmission between systems. Virtual Private Network (VPN) technology creates secure connections for remote access to hosted systems. Database-level encryption provides additional protection for sensitive information fields. Hosting providers maintain encryption key management systems with strict access controls. These encryption approaches protect data against various threat vectors while maintaining system performance.

Disaster Recovery and Business Continuity

HIPAA compliant hosting includes disaster recovery capabilities to prevent data loss during system failures or natural disasters. Providers maintain geographically dispersed backup systems that replicate data according to defined recovery point objectives. Regular backup verification processes ensure data integrity and restorability. Documented business continuity plans outline recovery procedures and responsible personnel. Hosting environments include redundant system components to eliminate single points of failure. Annual disaster recovery testing validates these systems under simulated emergency conditions. These measures fulfill the HIPAA contingency planning requirements while providing healthcare organizations with continuous access to patient information.

Compliance Monitoring and Documentation

HIPAA compliant hosting providers maintain documentation of their security measures and compliance activities. Regular risk assessments identify potential vulnerabilities in hosted systems and infrastructure. Security teams conduct penetration testing to validate protection effectiveness. Compliance certification reports from independent auditors demonstrate adherence to HIPAA standards and other frameworks like HITRUST or SOC 2. Providers maintain records of staff training on security procedures and HIPAA requirements. These documentation practices help healthcare organizations demonstrate due diligence in selecting appropriate hosting environments for protected health information.