How to Fix Email Not Delivered Issues?

Email Deliverability
Erik Kangas
June 13, 2025

When an email is not delivered, it triggers communication failures that can disrupt patient care, delay treatments, and create operational inefficiencies throughout healthcare systems. An email not delivered means the intended recipient never receives the message, whether due to spam filtering, server issues, authentication problems, or incorrect email addresses. Healthcare providers, payers, and suppliers experience immediate consequences when critical communications fail to reach their destinations, including missed appointments, delayed care coordination, and lost revenue opportunities. The impact of an email not delivered varies depending on the message type, recipient, and timing, but healthcare organizations consistently see negative effects on patient outcomes and operational performance.

Recovery Strategies For an Email Not Delivered

Recovery strategies after an email not delivered include implementing backup communication methods and improving email authentication protocols. Healthcare organizations can reduce the impact of delivery failures by maintaining multiple contact methods for patients and developing contingency plans for communication disruptions. Regular monitoring of email delivery metrics helps identify patterns of failed deliveries and address underlying causes. Proactive list management and sender reputation monitoring help prevent future instances of email not delivered. Healthcare organizations benefit from establishing dedicated resources for managing email communications, including staff training on delivery best practices and ongoing performance monitoring across different communication channels. These recovery strategies help minimize the long-term impact of email delivery failures on patient care and operational efficiency.

Immediate Consequences

The immediate consequences when an email is not delivered include broken communication chains and missed opportunities for patient engagement. Appointment reminders that fail to reach patients result in higher no-show rates, while lab results trapped in spam folders delay treatment decisions. Healthcare staff may not realize that an email not delivered has occurred until patients miss appointments or fail to respond to time-sensitive communications. Patient portal notifications that go undelivered prevent patients from accessing test results, prescription refills, and discharge instructions. Emergency contact attempts via email may fail when an email not delivered occurs during after-hours situations, forcing healthcare providers to rely on phone calls or postal mail as backup communication methods. These immediate failures create workflow disruptions that require additional staff time and resources to resolve.

Patient Care Disruptions When Email is Not Delivered

Patient care disruptions occur when an email not delivered prevents timely communication between healthcare providers and patients. Referral communications that never arrive can interrupt care coordination between primary physicians and specialists, delaying diagnoses and treatment plans. Pre-operative instructions sent via email may not reach patients, creating safety risks and potential surgical delays. Chronic disease management programs rely heavily on email communication for medication reminders, lifestyle coaching, and progress monitoring. When an email not delivered occurs in these programs, patients may miss medication doses, skip monitoring activities, or fail to attend follow-up appointments. Medication adherence drops significantly when patients do not receive email reminders about prescription refills or dosage changes.

Revenue Impact

Revenue impact from an email not delivered includes lost appointment fees, delayed payments, and reduced patient engagement with healthcare services. Billing statements that fail to reach patients extend collection cycles and increase accounts receivable aging. Insurance pre-authorization requests that go undelivered can delay procedures and reduce reimbursement opportunities. Healthcare organizations lose revenue when marketing emails promoting wellness programs, health screenings, and elective procedures fail to reach patient inboxes. Patient satisfaction scores may decline when communication failures occur, affecting quality bonuses and value-based care payments. The financial impact compounds over time as organizations continue investing in email communication tools that fail to deliver expected returns due to delivery failures.

Operational Inefficiencies from Email Not Delivered

Operational inefficiencies arise when an email not delivered disrupts routine workflows and communication processes. Staff members spend additional time following up on communications that may have been filtered or blocked, reducing productivity and increasing administrative costs. Supply chain communications that fail to reach vendors or suppliers can create inventory shortages and delivery delays. Electronic health record systems generate automated notifications for various clinical events, and when an email not delivered occurs, providers may miss important alerts about patient status changes or test results. Quality improvement initiatives that depend on email communication for data collection and reporting may experience delays when key stakeholders do not receive project updates or meeting notifications.

Technology System Failures

Technology system failures occur when an email not delivered prevents automated notifications from reaching their intended recipients. Practice management software relies on email alerts for appointment scheduling, billing processes, and patient communication workflows. When these notifications fail to deliver, healthcare organizations may experience system-wide communication breakdowns affecting multiple departments. Telemedicine platforms and health information exchanges depend on email notifications to alert providers about new patient data, consultation requests, and system updates. An email not delivered in these systems can prevent providers from accessing important patient information or responding to urgent consultation requests. Integration failures between healthcare applications may occur when email-based data exchange processes fail to complete successfully.

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Know the Biggest Email Threats Facing Healthcare Right Now

July 16, 2025
Pete Wermter

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

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

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

Ransomware Attacks

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

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

Email Client Misconfiguration

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

Common types of email misconfiguration include:

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

Social Engineering Attacks

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

Phishing

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

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

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

Domain Impersonation and Spoofing

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

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

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

Insider Email Threats

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

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

Business Email Compromise (BEC) Attacks

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

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

BEC attacks come in several forms, such as:

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

Supply Chain Risk

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

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

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

Download LuxSci’s Email Cyber Threat Readiness Report

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

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

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

What is the Best HIPAA Compliant Email?

July 10, 2025
Erik Kangas

The best HIPAA compliant email contains strong security features with ease of use and reasonable pricing. Top options include properly configured Google Workspace or Microsoft 365 accounts with Business Associate Agreements in place. Look at HIPAA compliant email platforms that offer encryption, access controls, audit logging, and secure mobile access while fitting their practice size, budget, and technical capabilities.

HIPAA Compliant Email Features

Healthcare professionals require email systems with particular security capabilities to protect client communications. Any HIPAA compliant email must include automatic encryption that works without requiring clients to create accounts or remember passwords. You need detailed access logs that document when messages were sent, received, and viewed. Message recall capabilities help address accidental disclosures before they become compliance issues. Calendar integration supports secure appointment scheduling and reminders. Mobile access controls ensure therapists can communicate safely from smartphones and tablets during off-hours or between office locations. Document sharing features allow secure exchange of intake forms and treatment plans. These capabilities help therapists maintain compliant communications while managing their practice efficiently.

Popular HIPAA Compliant Email Platforms

Several email providers offer solutions well-suited to mental health professionals. Hushmail for Healthcare includes features designed for therapists with web-based secure forms for client intake and customizable email templates. Paubox delivers encrypted email that works without requiring recipients to take extra steps, making it ideal for client communications. Virtru integrates with existing Gmail or Outlook accounts to add HIPAA compliant protections without changing email addresses. Google Workspace and Microsoft 365 provide affordable options when properly configured with appropriate security settings and covered by Business Associate Agreements. Smaller therapy practices often prefer these mainstream platforms for their familiarity and integration with other practice tools.

Security Considerations for Healthcare Communications

Secure healthcare communications require thoughtful security approaches due to their sensitive nature. HIPAA compliant email should include protections against phishing attacks that might target patient information. Data loss prevention tools identify and secure messages containing sensitive information even when users forget to enable encryption. Account recovery procedures must balance security with practicality for small practices. Multi-factor authentication prevents unauthorized access even if passwords are compromised.

For example, healthcare personnel handling substance use disorder information need email systems that comply with both HIPAA and 42 CFR Part 2 requirements. Solutions should accommodate supervision relationships where communications may need controlled sharing with supervisors.

Client Experience and Usability Factors

The best HIPAA compliant email solutions balance security with positive client experiences. Buyers should evaluate how encryption affects the client’s process for reading and responding to messages. Some solutions require clients to create accounts or install software, while others deliver protected messages that open with minimal friction. Mobile compatibility matters as many clients prefer communicating from smartphones. Branding options allow therapists to maintain professional appearance in all communications. Automated responses help set appropriate expectations about response timing and emergency protocols. Client-facing secure forms streamline intake processes while maintaining compliance.

HIPAA Compliant Email Implementation for Medical Practices

Implementing secure email requires planning tailored to medical practice workflows. Solo practitioners need solutions with straightforward setup and minimal ongoing maintenance. Group practices benefit from centralized administration that enforces consistent security policies across all therapists. Practice management integration connects secure email with scheduling, billing, and documentation systems.

Transition planning helps migrate existing communications to new secure platforms without disrupting client relationships. Documentation templates ensure compliance with both HIPAA and professional ethical standards for electronic communications. Training materials must address both technical operation and appropriate clinical use cases. When implementing HIPAA compliant email practice admins should create workflow procedures that incorporate secure communication into their practice routines.

Cost Considerations For Selecting Email Services

Healthcare providers must balance security requirements with budget realities when selecting HIPAA compliant email. Pricing models vary significantly, with some services charging per user while others offer flat-rate plans better suited to solo practitioners. Additional fees may apply for features like secure forms, extra storage, or advanced security controls. Implementation costs include time spent on configuration, training, and client education about new communication methods. Some platforms offer discounted rates for professional association members or multi-year commitments. Buyers should calculate the total cost of ownership beyond monthly subscription fees, including technical support and compliance documentation. Affordable HIPAA compliant email options exist for practices of all sizes, but require thoughtful evaluation of both immediate pricing and long-term value.

Integrating Email with Broader Practice Security

HIPAA compliant email represents one component of comprehensive practice security. Email solutions should complement electronic health record systems while maintaining appropriate boundaries between clinical documentation and communications. Device management policies ensure therapists access email securely across computers, tablets, and smartphones. Backup procedures preserve communications while maintaining security protections. Incident response planning prepares therapists for addressing potential security issues or breaches. Regular security reviews evaluate whether email practices continue to meet evolving compliance requirements. By integrating email security with broader practice safeguards, therapists create communication systems that protect client information throughout its lifecycle.

What Are Email HIPAA Compliance Requirements?

July 2, 2025
Erik Kangas

Email HIPAA compliance is the privacy and security standards that healthcare organizations must implement when using electronic mail to transmit, store, or discuss protected health information. These requirements include encryption protocols, access controls, audit logging, and administrative safeguards that protect patient data during email communications. Healthcare providers, payers, and suppliers must understand email HIPAA compliance obligations to avoid costly violations while maintaining effective communication with patients, business partners, and other healthcare organizations. Understanding email HIPAA compliance helps organizations select appropriate email platforms, train staff on proper procedures, and implement policies that protect patient information while supporting clinical and administrative workflows.

Privacy Rule Requirements For Email HIPAA Compliance

The Privacy Rule establishes how healthcare organizations can use and disclose protected health information in email communications without violating patient privacy rights. Email HIPAA compliance permits healthcare organizations to use patient information for treatment, payment, and healthcare operations without obtaining individual patient authorization. Clinical communications between providers, billing discussions with payers, and care coordination activities fall under these permitted uses when proper safeguards are implemented.

Healthcare organizations must provide privacy notices to patients explaining how their information may be used in email communications and their rights regarding this information. Patients have the right to request restrictions on how their information is shared via email, though organizations are not always required to agree to these limitations. Email HIPAA compliance requires organizations to honor reasonable requests and provide mechanisms for patients to file complaints about email privacy practices.

Minimum necessary standards require healthcare organizations to limit email communications to the smallest amount of protected health information needed for the specific purpose. This means that diagnosis details, treatment notes, and other sensitive information should only be included when necessary for patient care or business operations. Organizations must evaluate their email practices to ensure compliance with minimum necessary requirements across different communication types.

Security Rule Standards For Email HIPAA Compliance

The Security Rule requires healthcare organizations to implement administrative, physical, and technical safeguards to protect electronic protected health information transmitted via email. Administrative safeguards include appointing security officers responsible for email systems, conducting workforce training on email privacy requirements, and establishing procedures for granting and revoking email access. These safeguards ensure that only authorized personnel can access patient information during email communications.

Technical safeguards focus on access controls, encryption, audit logging, and transmission security for email systems. Email HIPAA compliance requires user authentication systems that verify the identity of individuals accessing email containing patient information. Encryption protects email content during transmission and storage, while audit logs track who accesses patient information and when these access events occur.

Physical safeguards protect computer systems, mobile devices, and facilities where email containing patient information is accessed or stored. Organizations must implement workstation security controls, device controls for mobile email access, and media disposal procedures for devices containing patient communications. These protections prevent unauthorized individuals from accessing patient information through physical security breaches.

Regular security assessments evaluate email systems for vulnerabilities that could lead to data breaches or unauthorized disclosures. Email HIPAA compliance requires organizations to address identified weaknesses and maintain documentation of security measures. Penetration testing and vulnerability scanning help identify potential problems before they result in privacy violations.

Business Associate Requirements For Email HIPAA Compliance

Third-party email service providers that handle protected health information on behalf of healthcare organizations must operate as business associates under HIPAA regulations. Business associate agreements must specify how email providers will protect patient information, limit data use to authorized purposes, and report security incidents or unauthorized disclosures. Email HIPAA compliance requires healthcare organizations to verify that their email providers have appropriate security measures in place.

Common email business associates include cloud email providers, managed email services, and email security vendors. Each relationship requires careful evaluation of privacy and security risks along with appropriate contractual protections. Organizations must verify that business associates maintain their own HIPAA compliance programs and provide documentation of security measures.

Business associates must implement administrative, physical, and technical safeguards for email systems and ensure that subcontractors also comply with HIPAA requirements. This includes providing security training to their workforce, maintaining audit logs, and reporting security incidents to healthcare organizations. When business associate relationships end, email providers must return or destroy patient information as specified in their agreements.

Staff Training And Policy Development

Healthcare organizations must train staff on email HIPAA compliance requirements and organizational policies for handling patient information in electronic communications. Training programs should cover identification of protected health information, appropriate use of email systems, and procedures for reporting potential privacy violations. Staff members need to understand when email communications require additional security measures and how to use secure email platforms correctly.

Policy development includes establishing procedures for email encryption, recipient verification, and incident reporting when security concerns arise. Organizations should develop different policies for various types of email communications, including patient care coordination, billing discussions, and business partner communications. Regular policy updates address changing regulations and technology developments that affect email security.

Competency assessments verify that staff understand their responsibilities when handling patient information in email communications. Organizations should document training activities and maintain records of staff compliance with email privacy policies. Regular refresher training keeps staff updated on changing requirements and reinforces proper email security practices.

Monitoring And Incident Response For Email HIPAA Compliance

Healthcare organizations need ongoing monitoring programs to ensure that email practices remain compliant with HIPAA requirements and identify potential issues before they result in violations. Regular audits should examine email content for appropriate privacy protections, verify that security safeguards function correctly, and assess whether staff follow established policies. These audits help demonstrate ongoing commitment to protecting patient information.

Incident response procedures specifically address email-related security breaches or privacy violations, including notification requirements and remediation steps. Organizations must have clear procedures for investigating potential breaches involving email communications, determining whether notification is required, and implementing corrective actions to prevent future incidents. Training on incident response helps staff recognize and respond appropriately to email security issues.

Documentation requirements include maintaining records of email policies, training activities, security assessments, and compliance monitoring efforts. This documentation helps demonstrate compliance efforts during regulatory investigations and supports continuous improvement of email practices. Organizations should retain documentation for required periods and ensure records are complete and accessible when regulatory authorities request information about email HIPAA compliance practices.

Why is High Email Deliverability Essential for Healthcare Companies?

June 30, 2025
Pete Wermter

With email communication playing a critical role in the customer engagement strategies of virtually every organization, high email deliverability rates are vital to success across all industries. In the healthcare sector, however, the stakes can be far higher. An undelivered email isn’t merely an inconvenience or a lost sales opportunity; it could mean a missed appointment, a delay in a prescription refill, or a failure to get a patient critical healthcare information. Or worse, the email could end up in the hands of an unintended recipient, including bad actors and cybercriminals.

With this in mind, this post details why high email deliverability is essential for healthcare companies, as well as how your organization benefits from reliable and rapid email delivery.

Speed and Efficiency

The primary reason that high email deliverability is crucially important to healthcare organizations is to best guarantee essential communications that directly impact an individual’s healthcare journey reach them promptly. These transactional emails can include appointment reminders, prescription renewals, product order confirmations, test results, explanation of benefits notices, payment reminders, and invoices. Administrative notifications related to software or systems that a patient might use, such as a password reset for an online portal, also fall under the category of transactional emails.

When transactional emails are delayed or fail to reach people altogether, they can compromise a patient’s ability to access care, adhere to treatment plans, stay informed on key facets of their healthcare journey, and, ultimately, achieve optimal health outcomes.

When a patient fails to receive an expected email, such as a prescription confirmation, for example, it can leave them feeling confused and unsure of what to do next. For individuals who are sick, elderly, or managing chronic conditions, this can cause unnecessary stress, anxiety, and even compromise adherence to care plans.

In contrast, high email delivery rates create the opposite effect, helping patients get the communications and information they need. This increases their trust in your company and gives them a firmer sense of control over their healthcare journey.

Compliance with HIPAA Regulations

While the above point stresses the importance of reliable email delivery for the patient’s and customer’s benefit, healthcare companies also have a vested interest in ensuring communications reach the intended recipient for regulatory and patient privacy reasons.

To comply with the Health Insurance Portability and Accountability Act (HIPAA), emails that contain sensitive patient data, i.e., electronic protected health information (ePHI), must be securely delivered to the intended recipient. If, on the other hand, a communication containing ePHI fails to reach the intended recipient patient, that represents a failure in secure communications and a potential HIPAA violation for your organization.

After all, where did the patient’s data go? Was it delivered to the wrong person? Was it blocked by a spam filter and is left sitting unencrypted on a server somewhere?

If you can’t answer these questions, you could be exposed to a data breach, and it could result in a HIPAA violation, meaning your organization incurrs the associated consequences, including financial penalties and reputational damage. Conversely, deploying a fully HIPAA compliant email solution, such as LuxSci, supported by a dedicated infrastructure and designed for high email delivery enables your organization to include patient data in communications with confidence and ensure you messages land in the recipient’s inbox.

Greater Levels of Personalization and Engagement

Finally, high email deliverability rates are essential for healthcare organizations because they help drive greater levels of engagement with patients and customers. Higher email deliverability means better inbox placement, leading to more emails being opened, more links being clicked, and more conversions for your communications and campaigns.

In the case of healthcare retailers, for example, this equates to converting more prospects into customers and, consequently, maximizing the ROI of email marketing campaigns, in some cases with up to 80% better results.

While healthcare marketers, understandably, focus most of their efforts on crafting attention-grabbing headlines, personalizing the message content, and the email’s design elements, these factors are rendered irrelevant if the message fails to reach the recipient in the first place! When you take this into account, high email deliverability is a crucial component in optimizing the ROI of email communications and campaigns, and an all too often overlooked component at that.

Get Your Copy LuxSci’s Achieving High Email Deliverability Best Practices Paper

To learn more about the importance and value of high email deliverability for healthcare companies, download your copy of LuxSci’s latest Best Practices Paper: How to Achieve High Email Deliverability in Healthcare. You’ll discover:

How to opitmize performance for the different types of healthcare emails.
Powerful strategies for increasing your company’s email deliverability rates.
How small increases in email deliverability can have considerable effects on your marketing ROI

Grab your copy of the report here, and learn how to enhance your email deliverability rates today.

What is a HIPAA Compliant Form?

January 13, 2025
Erik Kangas

A HIPAA compliant form collects protected health information while meeting security, privacy, and patient authorization requirements set by the HIPAA Privacy and Security Rules. These forms include proper disclosure statements, patient signature capabilities, data encryption, access controls, and audit tracking features. Healthcare organizations use these forms for patient intake, consent, and information exchange while safeguarding patient data throughout the collection and storage process.

Required Elements of HIPAA Compliant Forms

Healthcare forms must include specific components to maintain HIPAA compliance. HIPAA compliant forms need clear authorization language explaining how patient information will be used and disclosed. Patient signature sections document consent for information sharing and establish when that authorization expires. Forms include statements about patients’ rights to revoke authorization and receive copies of their information. Healthcare providers use plain language that patients can understand rather than technical terminology. Privacy policy information and contact details for the privacy officer help patients address concerns. Effective forms contain statements about potential redisclosure limitations after information leaves the provider’s control.

Technical Security Features for Electronic Forms

Electronic HIPAA compliant forms require robust security measures to protect patient information. Forms use encryption during data transmission and storage to prevent unauthorized access. Access controls restrict form viewing and submission processing to authorized personnel with proper credentials. Secure hosting environments provide technical protections including firewalls and intrusion detection systems. Audit logs track when information was entered, viewed, or modified, creating accountability for all data access. Well-designed forms incorporate automatic timeout features that protect information on unattended devices. Data backup systems prevent information loss, while secure storage solutions protect electronic signatures. Form builders include security configuration options that administrators can customize based on their organization’s needs.

Implementing HIPAA Compliant Forms

Healthcare organizations benefit from following structured processes when developing compliant forms. The implementation begins with a review of what patient information needs collection and how it will be used. Many organizations offer both web-based and PDF form options to accommodate different user needs. Effective form creation tools include drag-and-drop builders that simplify development while maintaining compliance standards. Healthcare providers test forms thoroughly before deployment and train staff on proper usage procedures. Implementation plans typically include integration with existing systems like electronic health records and patient portals. Organizations establish procedures for securely storing completed forms according to HIPAA retention requirements.

HIPAA Compliant Form Accessibility

Forms work best when accessible across different devices and platforms to maximize patient convenience while maintaining security. Web-based forms provide flexibility for patients to complete paperwork before appointments. Mobile-responsive designs ensure forms display properly on smartphones and tablets. Modern form systems work with secure digital signature technology to eliminate paper-based processes. Cloud storage solutions with proper security allow authorized access from multiple locations. API connectivity enables healthcare organizations to integrate form data with other systems. Accessible form design accommodates patients with disabilities or language barriers to ensure equal access to privacy protections.

Form Data Management and Integration

Healthcare organizations need systems to manage form data securely after collection. HIPAA compliant forms integrate with secure email systems for protected transmission of patient information. Data from forms flows into relevant clinical and business systems without compromising security. Integration with customer relationship management and patient journey tracking helps organizations provide cohesive care experiences. Marketing automation tools can use non-PHI form data for appropriate patient outreach while protecting sensitive information. Clear data retention policies comply with HIPAA requirements while supporting operational needs. Documented data flows from forms to downstream systems maintain compliance throughout the information lifecycle.

HIPAA Form Compliance Monitoring

Healthcare organizations maintain monitoring systems to ensure form compliance over time. Regular audits identify potential privacy violations or security weaknesses in form collection processes. Staff training covers form handling procedures and includes updates when regulations change. Form review schedules keep all documents current with changing requirements. Monitoring tracks form completion rates to identify process issues affecting patient care. Organizations maintain documentation of form versions, approval dates, and modification histories. Security teams regularly test technical protections for electronic forms to verify continued effectiveness. Compliance officers review form-related complaints to identify improvement opportunities.

Understanding HIPAA Email Retention Requirements

May 22, 2025
Erik Kangas

HIPAA email retention requirements mandate that healthcare organizations preserve electronic Protected Health Information (ePHI) contained in email communications for specific time periods based on state and federal regulations. The HIPAA Privacy Rule requires covered entities to maintain documentation and policies related to patient information for at least six years from the date of creation or when last in effect. Email messages containing patient data become part of designated record sets and must be retained according to the same standards that apply to other medical records and administrative documents.

Healthcare organizations deal with complex retention obligations that vary by state, with some requiring longer preservation periods than the federal minimum. Understanding HIPAA email retention requirements helps organizations develop compliant policies while managing storage costs and operational efficiency.

Why Do Healthcare Entities Need Email Retention Policies?

Healthcare organizations need email retention policies to comply with legal obligations and support patient care continuity. Medical record laws in most states require healthcare providers to maintain patient information for specific periods, ranging from three years to indefinitely depending on the jurisdiction and type of information. Email communications that contain treatment discussions, appointment scheduling, or billing information become part of the medical record and fall under these retention requirements.

Litigation and regulatory investigations create additional drivers for email retention. Healthcare organizations may face lawsuits, malpractice claims, or regulatory audits that require access to historical communications. Courts can impose sanctions on organizations that fail to preserve relevant electronic communications, including email messages that contain patient information. The legal hold process requires organizations to suspend normal deletion procedures when litigation is anticipated or pending.

Patient care coordination benefits from accessible historical communications between providers, patients, and care teams. Retained email messages can provide context for treatment decisions, document patient preferences, and track care transitions between different providers or facilities. Quick access to communication history helps healthcare workers make informed decisions and avoid repeating previous discussions or recommendations.

Audit and compliance verification depend on comprehensive record retention that includes email communications. Regulatory agencies like the Office for Civil Rights may request documentation during HIPAA compliance investigations. Organizations that cannot produce required communications face potential violations and penalties. Strong retention policies ensure that audit trails remain intact and compliance documentation stays accessible throughout required timeframes.

Minimum Retention Period of HIPAA Emails

Federal HIPAA requirements establish a minimum retention period of six years for policies, procedures, and documentation related to patient information protection. This timeframe applies to administrative records rather than medical records themselves. Email communications that contain ePHI may need longer retention based on state medical record laws and the type of information contained in the messages.

State regulations create varying retention requirements that healthcare organizations must navigate. Some states require medical records to be retained for seven to ten years after the last treatment date, while others mandate longer periods for specific patient populations such as minors. Email communications that become part of the medical record inherit these extended retention requirements regardless of the federal HIPAA minimum.

Patient age considerations affect retention calculations for pediatric healthcare providers. Many states require medical records for minors to be retained until the patient reaches majority age plus an additional period, potentially extending retention requirements by decades. Email communications involving pediatric patients fall under these extended requirements when they contain treatment-related information.

Specialty practice requirements may dictate longer retention periods for certain types of healthcare information. Mental health records, substance abuse treatment communications, and occupational health information often have specific retention requirements that exceed standard medical record timeframes. Healthcare organizations practicing in these areas need policies that address the longest applicable retention period for their email communications.

What Types of Email Require HIPAA Retention?

Treatment-related email communications between healthcare providers require retention when they contain patient information or clinical decision-making discussions. Messages about diagnosis, treatment plans, medication management, and care coordination become part of the medical record. Email consultations between specialists, primary care providers, and other members of the healthcare team need preservation to maintain complete treatment documentation.

Administrative email communications containing patient information also fall under retention requirements. Appointment scheduling messages, insurance verification communications, and billing inquiries that include patient identifiers become part of designated record sets. Staff discussions about patient care policies or quality improvement initiatives may require retention depending on their content and regulatory implications.

Patient communication emails need careful evaluation to determine retention requirements. Direct email exchanges between patients and providers about symptoms, treatment questions, or care instructions become part of the medical record. Portal notifications, appointment reminders, and educational materials sent to patients may also require retention based on their content and relationship to patient care.

Business partner communications involving patient information require retention consideration under Business Associate Agreement terms. Email exchanges with laboratories, imaging centers, billing companies, and other business associates may contain patient information that falls under retention requirements. Organizations need clear policies about which communications with external partners require preservation and for how long.

How to Implement HIPAA Email Retention Systems

Email archiving systems provide automated solutions for capturing and preserving healthcare communications that contain patient information. Modern archiving platforms can identify emails containing ePHI through content analysis, keyword detection, and sender/recipient patterns. The systems automatically route qualifying messages to secure storage while applying appropriate retention schedules based on content type and regulatory requirements.

Legal hold capabilities within email retention systems allow healthcare organizations to suspend normal deletion schedules when litigation or investigations require preservation of communications. The systems can place holds on specific custodians, date ranges, or keyword-identified communications while maintaining normal retention processing for other messages. Legal hold functionality helps organizations avoid spoliation sanctions while managing ongoing retention obligations.

Search and retrieval functionality enables healthcare organizations to locate specific communications quickly during audits, litigation, or patient care needs. Advanced search capabilities allow users to find messages by date ranges, participants, keywords, or patient identifiers. The systems maintain indexing that preserves search functionality even as message volumes grow over time.

Storage management features help healthcare organizations balance retention requirements with cost considerations. Tiered storage systems can move older communications to less expensive storage media while maintaining accessibility for audit or legal purposes. Compression and deduplication technologies reduce storage costs without compromising compliance or retrieval capabilities.

Challenges of HIPAA Email Retention?

Storage cost escalation creates ongoing financial pressure as email volumes grow and retention periods extend. Healthcare organizations generate substantial email volumes daily, and retaining communications for years or decades can require significant storage investments. Cloud storage costs continue to increase as data volumes expand, particularly for organizations in states with extended retention requirements.

Data classification complexity arises when determining which email communications require retention under HIPAA versus other regulatory frameworks. Healthcare organizations may need to apply different retention schedules to communications based on content, sender, recipient, and applicable regulations. Manual classification processes become impractical with large email volumes, requiring automated systems that can accurately categorize communications.

System integration challenges emerge when email retention platforms need to work with existing healthcare IT infrastructure. Electronic health record systems, practice management platforms, and communication tools may not integrate seamlessly with retention systems. Data synchronization between platforms can create gaps in retention coverage or duplicate storage requirements.

Compliance monitoring becomes complex when retention policies span multiple regulatory frameworks and state jurisdictions. Healthcare organizations operating across state lines may need to apply the most restrictive retention requirements to ensure compliance in all jurisdictions. Tracking compliance across different retention schedules, legal holds, and disposal requirements requires sophisticated policy management capabilities.

How To Optimize HIPAA Email Retention Strategies

Policy standardization helps healthcare organizations create consistent retention practices across different departments and communication types. Clear guidelines about what communications require retention, how long they must be preserved, and when disposal is appropriate reduce confusion and compliance gaps. Standardized policies also simplify training and help ensure that staff members understand their retention responsibilities.

Technology automation reduces the manual effort required to classify and retain healthcare email communications appropriately. Advanced systems can analyze message content, identify patient information, and apply retention schedules automatically. Machine learning capabilities improve classification accuracy over time while reducing the burden on IT staff and healthcare workers.

Regular policy review ensures that retention practices keep pace with changing regulations and organizational needs. Healthcare organizations examine their retention policies annually to verify compliance with current federal and state requirements. Policy updates may be necessary when organizations expand into new states, add practice specialties, or adopt new communication technologies.

Staff training programs help healthcare workers understand their roles in email retention compliance. Training covers what types of communications require retention, how to handle legal holds, and when to escalate retention questions to compliance teams. Regular refresher training ensures that staff members stay current with policy changes and retention best practices as communication patterns evolve.

Is There a HIPAA Compliant Email?

June 26, 2025
Erik Kangas

Yes, HIPAA compliant email is available through specialized platforms and services designed specifically for healthcare organizations that need to transmit protected health information securely. HIPAA compliant email solutions include encryption, access controls, audit logging, and other security features required to meet regulatory standards for protecting patient information during electronic communication. Healthcare providers, payers, and suppliers can choose from various HIPAA compliant email options that range from standalone secure messaging platforms to integrated solutions that work with existing healthcare systems. Understanding available HIPAA compliant email solutions helps organizations select appropriate tools for their communication needs while maintaining regulatory compliance and protecting patient privacy.

Types of HIPAA Compliant Email Solutions

Several categories of HIPAA compliant email solutions serve different organizational needs and technical requirements. Cloud-based secure email platforms provide hosted solutions that require minimal technical infrastructure while offering enterprise-grade security features. These platforms handle encryption, server maintenance, and security updates, allowing healthcare organizations to focus on patient care rather than email system management. On-premises HIPAA compliant email systems give organizations direct control over their email infrastructure and data storage locations. Hybrid solutions combine cloud convenience with on-premises control, allowing organizations to customize their email security approach based on specific requirements. Email encryption gateways work with existing email systems to add HIPAA compliance features without requiring complete system replacement.

Security Features in HIPAA Compliant Email Platforms

HIPAA compliant email platforms include end-to-end encryption that protects messages and attachments from unauthorized access during transmission and storage. Transport Layer Security protocols secure connections between email servers, while message-level encryption ensures that only intended recipients can read email content. Digital signatures verify sender authenticity and message integrity, preventing tampering or impersonation. Multi-factor authentication requires users to provide additional verification beyond passwords before accessing email accounts. Access controls limit which users can send emails to external recipients and which types of information can be included in different message categories. Automatic data loss prevention features scan outgoing emails for protected health information and apply appropriate security measures or block transmission of potentially sensitive content.

Business Associate Agreements and Vendor Requirements

Healthcare organizations using HIPAA compliant email services need business associate agreements with their email providers to ensure regulatory compliance. These agreements specify how email vendors will protect patient information, limit data use to authorized purposes, and report security incidents or unauthorized disclosures. Email providers operating as business associates must implement appropriate safeguards and allow healthcare organizations to audit their security practices. Vendor selection criteria should include security certifications, compliance track records, and technical capabilities that meet organizational requirements. Service level agreements define uptime expectations, support response times, and data recovery procedures. Due diligence processes help verify that email providers have appropriate security controls and compliance programs before entering into business relationships.

Implementation Challenges and Solutions

Healthcare organizations implementing HIPAA compliant email often encounter workflow disruptions as staff adapt to new security procedures and software interfaces. Training programs help users understand proper email security practices and organizational policies for handling protected health information. Change management strategies address resistance to new procedures and ensure that staff members understand the importance of email security compliance. Technical integration challenges arise when connecting HIPAA compliant email systems with existing healthcare applications and databases. Application programming interfaces enable custom integrations that streamline workflows while maintaining security standards. Migration planning addresses data transfer from legacy email systems and ensures that historical communications remain accessible when needed.

Cost Considerations for HIPAA Compliant Email

HIPAA compliant email solutions involve various cost components including software licensing, implementation services, ongoing support, and staff training expenses. Per-user subscription models allow organizations to scale email security based on their actual usage patterns. Enterprise licensing agreements may provide cost advantages for larger healthcare organizations with many email users. Hidden costs can include system integration expenses, data migration fees, and productivity losses during implementation periods. Return on investment calculations should consider potential savings from avoiding HIPAA violation penalties, reduced risk of data breaches, and improved operational efficiency from streamlined secure communication processes. Long-term cost analysis helps organizations budget appropriately for ongoing email security requirements.

Selecting the Right HIPAA Compliant Email Solution

Healthcare organizations should evaluate HIPAA compliant email options based on their specific communication patterns, technical infrastructure, and regulatory requirements. Feature comparisons help identify which platforms offer the security capabilities and integration options needed for particular use cases. Pilot testing allows organizations to evaluate user experience and system performance before making long-term commitments. Vendor demonstrations provide opportunities to assess ease of use, administrative features, and customer support quality. Reference checks with similar healthcare organizations offer insights into real-world performance and implementation experiences. Decision frameworks that consider security requirements, usability needs, and budget constraints help organizations select HIPAA compliant email solutions that will serve their long-term communication and compliance objectives effectively.

What is Email Deliverability?

June 3, 2025
Erik Kangas

Email deliverability refers to the ability of emails to reach recipients’ inboxes successfully without being filtered into spam folders or blocked entirely by email service providers. This metric involves the entire journey an email takes from sender to recipient, including authentication protocols, sender reputation, content quality, and recipient engagement patterns. For healthcare organizations managing patient communications, provider networks, and supplier relationships, understanding email deliverability is highly important given the sensitive nature of healthcare data and the need for reliable communication channels.

How Email Service Providers Filter Messages

Email service providers use sophisticated algorithms to evaluate incoming messages and determine their appropriate destination. These systems analyze multiple factors simultaneously, including sender authentication records, message content, sending patterns, and recipient behavior. The filtering process occurs in real-time, with providers like Gmail, Outlook, and Yahoo applying machine learning models trained on billions of email interactions to identify potential spam or malicious content. Authentication plays a large role in this filtering process. Providers verify sender identity through SPF (Sender Policy Framework), DKIM (DomainKeys Identified Mail), and DMARC (Domain-based Message Authentication, Reporting, and Conformance) records. Healthcare organizations without properly configured authentication often find their appointment reminders, lab results, or billing communications relegated to spam folders, disrupting patient care workflows and administrative processes.

Sender Reputation and Its Impact on Healthcare Communications

Sender reputation functions as a digital credit score for email domains and IP addresses, influencing whether healthcare organizations can reliably reach patients, providers, and business partners. Email service providers maintain reputation databases that track sending behavior, bounce rates, spam complaints, and recipient engagement over time. A single domain or IP address with poor reputation can affect email deliverability across an entire healthcare network. Healthcare entities take on reputation challenges due to the nature of their communications. Patient appointment reminders sent to outdated email addresses generate high bounce rates, while automated billing notifications may receive spam complaints from recipients who forgot they subscribed to such communications. These factors can gradually erode sender reputation, making it increasingly difficult to reach patients with time-sensitive medical information.

Protocols for Healthcare Email Deliverability Security

Modern email deliverability depends heavily on proper implementation of authentication protocols that verify sender identity and prevent email spoofing. SPF records specify which mail servers are authorized to send emails on behalf of a domain, while DKIM adds cryptographic signatures to verify message integrity. DMARC ties these protocols together by instructing receiving servers how to handle emails that fail authentication checks. Healthcare organizations must configure these protocols carefully to avoid authentication failures that could block legitimate patient communications. A misconfigured SPF record might prevent appointment confirmation emails from reaching patients, while improper DKIM setup could cause lab result notifications to be filtered as spam. These authentication failures can have serious implications for patient care, particularly when dealing with urgent medical communications or time-sensitive treatment instructions.

Content Quality and Compliance Considerations

Email content quality directly affects email deliverability, with providers using advanced algorithms to evaluate message structure, language patterns, and formatting for spam indicators. Healthcare organizations must balance informative content with deliverability requirements, ensuring that medical communications reach their intended recipients without triggering spam filters. This balance becomes particularly challenging when dealing with complex medical terminology, prescription information, or insurance-related content that may resemble spam to automated filtering systems. HIPAA compliance adds another element of complexity to healthcare email content, as organizations must protect patient information while maintaining effective communication channels. Emails containing protected health information require extra security measures and careful content formatting to avoid both compliance violations and deliverability issues. The challenge is in creating compliant, informative communications that also pass through increasingly sophisticated spam filters.

Email Deliverability Performance

Tracking email deliverability metrics provides healthcare organizations with the data needed to identify and address communication issues before they impact patient care or administrative operations. Key metrics include delivery rates, bounce rates, spam complaint rates, and inbox placement percentages across different email providers. These metrics help organizations understand how their communications perform across various platforms and identify potential problems with specific communication types or recipient segments.

Healthcare organizations should establish monitoring systems that track deliverability performance across different communication channels, including patient portal notifications, appointment reminders, billing communications, and provider-to-provider messages. This approach helps identify patterns that might indicate authentication issues, content problems, or reputation concerns that could affect the organization’s ability to communicate effectively with patients and business partners.