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

encrypted email transmission

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.

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Most Popular LuxSci Blog Posts of 2025

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

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

1. Improve Email Engagement and Marketing Results with Automated Workflows

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

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

2. Healthcare Email Threat Readiness Strategies

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

Read the full post: Healthcare Email Threat Readiness Strategies

3. HIPAA Compliant Email — 20 Tips in 20 Minutes

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

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

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

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

Read the full post: Is SendGrid HIPAA-Compliant?

5. LuxSci Shines in G2 Winter 2026 Reports

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

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

Looking Ahead to 2026

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

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HIPAA compliant email

LuxSci Welcomes Angel Mazariegos as Head of Finance

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

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

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

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

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

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

HIPAA Compliant Email

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

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

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

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

Why G2 Matters

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

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

What We Earned in Winter 2026

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

  • Grid Leader
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  • 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!

HIPAA Compliant Email

Here’s What HIPAA Compliant Email Salespeople Don’t Tell You

With email security threats continuously increasing in number and sophistication, as well as healthcare companies requiring secure solutions to communicate with patients and customers, the need for HIPAA compliant email solutions has never been greater. 

However, when looking for the right secure email services provider (ESP), healthcare organizations run the risk of making inaccurate assumptions about HIPAA compliance via what they learn from prospective vendors. This is due to the tendency for sales materials for HIPAA compliant email services, such as web pages or promotional videos, to highlight the strengths of the platform, while downplaying a healthcare company’s own role and responsibilities in securing protected health information (PHI). 

With this firmly in mind, here are six key things that HIPAA compliant email salespeople don’t tell you about securing communications and achieving compliance. 

1. The Shared Responsibility Model

Firstly, HIPAA compliant email salespeople are unlikely to emphasize the idea of shared responsibility when it comes to data security. This is the idea that two entities that share access to data, e.g., a healthcare company and their ESP, have a shared responsibility to preserve the privacy of that data.

In reality, most sales pitches explain the benefits and features of the solution, as opposed to stressing that compliance truly depends on how it’s configured and used. Now, that’s not to say that a salesperson is trying to hide this fact, as they’ll probably allude to training and configuration requirements. But, they’ll be less likely to make light of this and, more broadly, how shared responsibility factors into compliance.

2. A BAA Doesn’t Automatically Make You HIPAA Compliant

A business associate agreement (BAA) is essential for HIPAA compliance, but signing one doesn’t automatically make you compliant. Your organization still has to use the email delivery solution in a way that aligns with HIPAA regulations, which involves proper configuration, training, oversight, and reporting.

The misconception among some healthcare companies that a BAA equals compliance may be perpetuated by the term “HIPAA compliant email services provider”.  This could give some the impression that the vendor is fully HIPAA compliant and, subsequently, in signing a BAA with them, the use of their services is fully compliant.

But, it’s not that simple.

Simply signing a BAA obscures the real effort involved in achieving compliance. There’s no official HIPAA seal of approval, and HIPAA compliant means that the solution is capable of being configured for compliant use, which is a shared responsibility. HIPAA compliant email salespeople are unlikely to volunteer this nuance, especially if their email solution requires considerable configuration or has a steep learning curve to use it securely.

3. Not All Solutions or Features Are HIPAA Compliant

Another key detail often underplayed by vendor sales materials of HIPAA compliant email solutions is that some of their features, or even entire services, aren’t covered by their BAAs, so they can’t be used to handle PHI. 

These tools are referred to as “out of scope” and may include tools capable of integration with the email service, such as analytics or AI capabilities, but they don’t possess the cyber risk mitigation measures that align with HIPAA regulations. Perhaps the main reason for this is that many mass-market email delivery solutions, such as Microsoft 365 or Google Workspace, are designed for companies across all sectors. Consequently, while they can be HIPAA compliant, they weren’t developed from the ground up with the stringent regulatory demands of the healthcare industry in mind.

4. Solutions Are Not HIPAA Compliant “Out of The Box”

HIPAA compliant email salespeople may suggest that compliance is built into their platform, and healthcare organizations can use it to transmit PHI straight away, but this isn’t the case. Healthcare companies must still configure the email platform accordingly, as per the security requirements determined by their risk assessment, e.g., applying the right level of encryption. 

Also, if the email service is difficult to configure for HIPAA compliance or if the vendor’s configuration documentation lacks detail, that presents another obstacle to its compliant use. 

In addition to configuration, healthcare companies also have to implement access management controls and policies, establishing the extent to which each employee can access PHI in respect to their roles and responsibilities. From there, they will have to train their workforce on how to use the HIPAA compliant email solution securely, which may include those tools that fall outside the scope of your BAA with the vendor, and must not be used for the disclosure of patient data.

5. Essential Security Features Cost Extra 

Another more egregious version of an ESP not being HIPAA compliant out of the box is having features required for compliance, such as encryption or audit logging, as premium add-ons and not included in the solution’s base pricing. 

A vendor’s sales materials for its email service might list the necessary safeguards, but underemphasize the fact that only some versions of their platform are truly HIPAA compliant. Consequently, healthcare companies must confirm that the features required for HIPAA compliant email communications are included in the plan they’re purchasing. 

6. The Importance of Staff Training on HIPAA

HIPAA compliant email salespeople are often remiss in stressing the need for additional workforce training alongside the deployment of their platform. A healthcare company’s employees must be trained on how to securely use the email client, how to ID potential threats, and best practices for including PHI in email communications, as well as the regulations tied to HIPAA and data security.

This includes educating users on the differences between regular and secure email, and what they must do to safeguard patient and customer data. Fortunately, secure email solutions from providers like LuxSci enable automated email encryption, and users do not need to take any additional actions to ensure encryption when sending emails.

Additionally, in some cases, employees will need to be trained on which tools or features do not align with HIPAA guidelines and must not be used to process PHI.

LuxSci: Fully HIPAA Compliant – No Hidden Surprises

LuxSci specializes in solutions that enable companies to carry out secure, personalized, and HIPAA compliant email communications and campaigns. With more than 20 years of experience and billions of emails sent for companies including Athenahealth, 1 800 Contacts, Lucerna Health and Rotech Healthcare, we’ve acquired invaluable experience in helping healthcare organizations enhance their engagement efforts, all while adhering to HIPAA regulations. In addition, LuxSci’s secure high-volume and marketing email solutions feature HIPAA-required security controls, including encryption, audit logging, and multi-factor authentication (MFA) by default, not as optional, hidden extras.

Contact us today to learn more about how LuxSci’s secure email solutions can help increase the ROI on your patient and customer outreach efforts, while safeguarding PHI in line with HIPAA requirements.

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HIPAA Email Policy

What Should a HIPAA Email Policy Include?

A HIPAA email policy should include procedures for PHI handling, encryption requirements, user access controls, patient authorization processes, breach response protocols, and staff training requirements. The policy must define acceptable email usage, specify security measures for different types of communications, establish audit procedures, and outline consequences for violations to ensure comprehensive compliance with HIPAA Privacy and Security Rules. Healthcare organizations often develop email policies reactively after compliance issues arise rather than proactively addressing HIPAA requirements. HIIPAA email policy development helps prevent violations while enabling efficient email communications that support patient care and organizational operations.

Scope and Applicability Definitions

Policy coverage must clearly define which email activities fall under HIPAA requirements and which personnel must follow established procedures. HIPAA email policy should address both internal communications between staff members and external communications with patients, providers, and business partners. PHI identification guidelines help staff recognize when email messages contain protected health information that requires additional security measures. These guidelines should include examples of obvious PHI like patient names and medical record numbers as well as less obvious information that could identify patients. Exception procedures provide guidance for emergency situations when standard email security measures might delay urgent patient care communications. These procedures should balance patient safety needs with privacy protections while documenting when and why exceptions occur.

User Authentication and Access Control Procedures

Password requirements must specify minimum standards for email account security including length, complexity, and change frequency. The policy should address both initial password creation and ongoing password management to maintain account security over time. Account management procedures define how email access is granted, modified, and terminated based on employment status and job responsibilities. The policy should specify who has authority to approve access changes and how quickly modifications must be implemented. Remote access guidelines establish security requirements for accessing organizational email systems from outside locations or personal devices. These guidelines should address virtual private network usage, device security standards, and restrictions on PHI access from unsecured networks.

Email Content and Communication Standards

PHI usage guidelines specify when patient information can be included in email communications and what security measures apply to different types of content. The policy should distinguish between internal communications among healthcare team members and external communications with patients or other organizations. Subject line restrictions help prevent inadvertent PHI disclosure through email headers that might be visible to unauthorized recipients or stored in unsecured log files. Staff should understand how to reference patients and medical conditions without revealing specific identifying information. Attachment handling procedures define security requirements for medical records, test results, and other documents transmitted via email. HIPAA email policy should specify encryption standards, file naming conventions, and restrictions on certain types of sensitive information.

Encryption and Security Implementation Requirements

Encryption standards must specify which types of email communications require encryption and what methods meet organizational security requirements. The policy should address both automatic encryption for all emails and selective encryption based on content sensitivity. External communication requirements define additional security measures for emails sent outside the healthcare organization to patients, referring providers, or business partners. These requirements might include patient portal usage, secure email gateways, or alternative communication methods for highly sensitive information. Mobile device security addresses special considerations for accessing email from smartphones and tablets used for patient care activities. The policy should specify device encryption requirements, application restrictions, and procedures for lost or stolen devices.

Patient Authorization and Consent Management

Consent documentation procedures define when patient authorization is required for email communications and how these authorizations should be obtained and recorded. The policy should distinguish between treatment communications that do not require authorization and marketing or administrative communications that do. Authorization tracking systems help staff verify patient consent status before sending emails that require authorization. HIPAA email policy should specify how consent information is maintained and accessed while protecting patient privacy and supporting audit requirements. Revocation procedures establish how patients can withdraw consent for email communications and how these changes are implemented across organizational systems. Staff should understand how to process revocation requests promptly while maintaining records of authorization changes.

Incident Response and Breach Management Protocols

Violation reporting procedures define how staff should report potential HIPAA violations or security incidents involving email communications. The policy should specify who receives reports, what information must be included, and timeframes for reporting different types of incidents. Investigation processes outline how the organization will assess potential violations to determine whether they constitute HIPAA breaches requiring patient notification or regulatory reporting. These processes should include roles and responsibilities for investigation team members. Corrective action procedures establish how the organization will address confirmed violations and prevent similar incidents in the future. HIPAA email policy should include disciplinary measures for staff violations and system improvements for prevention measures.

Training and Compliance Monitoring Elements

Initial training requirements specify what HIPAA email education all staff must receive before gaining access to organizational email systems. The policy should define training content, delivery methods, and documentation requirements for compliance tracking. Refresher training schedules ensure that staff receive updated information about email security requirements and organizational policy changes. The policy should specify training frequency and procedures for tracking completion across different employee groups. Audit procedures define how the organization will monitor email usage to identify potential violations and assess policy effectiveness. The policy should specify audit frequency, scope, and reporting requirements while protecting legitimate email privacy expectations for non-PHI communications.

HIPAA Compliant Marketing Automation Tools

What Are HIPAA Compliant Marketing Automation Tools?

HIPAA compliant marketing automation tools are specialized software platforms that enable healthcare organizations to execute automated marketing campaigns while protecting Protected Health Information (PHI) according to federal privacy regulations. These platforms incorporate security controls, audit logging, and access management features required by the HIPAA Security Rule when handling patient data for marketing purposes. Healthcare organizations use these tools to improve patient communications, manage email campaigns, and track marketing performance while maintaining compliance with privacy requirements and avoiding costly violations.

Why Healthcare Organizations Need HIPAA Compliant Marketing Automation Tools

Healthcare organizations need marketing automation tools to meet federal privacy requirements while executing effective patient outreach campaigns. Standard marketing platforms lack the security controls and audit capabilities necessary to protect patient information during automated marketing processes. The HIPAA Security Rule mandates specific safeguards for systems that handle PHI, making general-purpose marketing tools inadequate for healthcare applications. Efficiency gains from marketing automation help healthcare organizations manage large patient populations and complex communication workflows without overwhelming staff resources. Automated systems can segment patient lists, personalize email content, and schedule communications based on treatment schedules or health milestones. These capabilities allow healthcare marketers to deliver relevant, timely communications while reducing manual workload and human error risks.

Risk mitigation drives adoption of compliant marketing automation as healthcare organizations face substantial penalties for privacy violations. The Office for Civil Rights can impose fines exceeding $2 million for HIPAA violations involving marketing activities. Organizations using non-compliant marketing tools expose themselves to enforcement actions, patient lawsuits, and reputation damage that can far exceed the cost of implementing appropriate technology solutions. Competitive positioning requires healthcare organizations to maintain sophisticated marketing capabilities while adhering to stricter privacy standards than other industries. Patients expect personalized, relevant communications from their healthcare providers, but organizations must achieve this personalization within HIPAA constraints. HIPAA compliant marketing automation tools enable healthcare organizations to compete effectively while maintaining patient trust through transparent privacy practices.

Security Features of HIPAA Compliant Marketing Automation Tools

Encryption capabilities protect patient information both during transmission and while stored within marketing automation platforms. HIPAA compliant marketing automation tools implement advanced encryption standards for all data at rest and in transit, ensuring that patient information remains protected throughout automated marketing processes. The platforms maintain encryption keys securely and provide key management features that meet federal security requirements. Access control mechanisms ensure that only authorized healthcare personnel can access patient information within marketing automation systems. Role-based permissions limit user access to specific patient segments, campaign types, or system functions based on job responsibilities. Multi-factor authentication adds security layers that protect against unauthorized access attempts while maintaining usability for legitimate users. Audit logging functionality tracks all system activities to create detailed compliance documentation for regulatory reviews. The platforms log user access, campaign creation, email sends, and data modifications to provide complete audit trails.

Automated reporting features help healthcare organizations monitor system usage, identify potential security incidents, and demonstrate compliance during inspections or investigations. Data backup and recovery features protect against information loss while maintaining security controls throughout the backup process. Marketing automation platforms create encrypted backups of patient information and campaign data, storing them securely with geographic redundancy. Recovery procedures ensure that patient information can be restored quickly after system failures while preserving all privacy protections and audit trails.

Implementing HIPAA Compliant Marketing Automation Tools

Vendor evaluation processes help healthcare organizations identify marketing automation providers that understand healthcare compliance requirements and can support their operational needs. Organizations examine vendor security certifications, HIPAA compliance documentation, and willingness to sign Business Associate Agreements. The evaluation includes reviewing platform architecture, data processing practices, and incident response procedures to ensure alignment with healthcare privacy requirements. Integration planning addresses how marketing automation tools will connect with existing healthcare systems such as electronic health records, patient portals, and practice management platforms. Healthcare organizations need seamless data flow between systems while maintaining security controls and audit capabilities. API compatibility and data synchronization features affect how efficiently organizations can implement automated marketing workflows. Staff training programs prepare healthcare teams to use HIPAA compliant marketing automation tools compliantly and effectively. Training covers platform functionality, privacy requirements, and workflows for creating compliant marketing campaigns. Healthcare organizations need ongoing education programs to keep marketing staff current with platform updates and evolving compliance requirements. Policy development establishes clear guidelines for using marketing automation tools within HIPAA constraints. Healthcare organizations create policies covering patient authorization requirements, data usage restrictions, and incident response procedures. The policies address when HIPA compliant marketing automation can be used, what types of patient information are permissible for different campaigns, and how to handle system security incidents or patient privacy complaints.

Implementation Challenges

Data migration complexity arises when healthcare organizations transfer existing patient lists and marketing data to new compliant automation platforms. Historical patient information must be mapped correctly to new system formats while maintaining data integrity and privacy protections. The migration process requires careful validation to ensure that all patient authorization status and communication preferences transfer accurately to the new platform. Workflow integration challenges emerge when HIPAA compliant marketing automation tools need to work seamlessly with existing healthcare operations and staff responsibilities. Healthcare organizations must redesign marketing processes to accommodate automation capabilities while ensuring that clinical staff can participate in patient communications appropriately. Change management support helps teams adapt to new workflows without disrupting patient care or administrative operations.

Performance optimization is necessary as marketing automation systems handle large volumes of patient communications and complex segmentation rules. Healthcare organizations need platforms that maintain responsiveness under peak usage while processing sophisticated targeting criteria based on patient demographics, treatment history, or health status. Monitoring tools help organizations identify performance bottlenecks and optimize system configurations for their specific usage patterns.

Is SendGrid HIPAA compliant?

Is SendGrid HIPAA-Compliant?

Twilio’s SendGrid is a cloud-based email marketing platform that contains the tools and resources that organizations need to carry out bulk email marketing campaigns. By providing companies with a robust, scalable email infrastructure, SendGrid reduces the technical and management overhead from delivering emails at scale.

SendGrid’s capabilities and benefits are undeniable – and are the reason why the popular platform is the email delivery service of choice for prominent companies like Spotify and Airbnb. For healthcare organizations, however, while reliability and scalability are essential for large-scale patient engagement campaigns and communications, security is another crucial concern. More specifically, for a healthcare company to send electronic protected health information (ePHI) through an email services platform, the service must be HIPAA-compliant.

This then begs the question, is SendGrid a HIPAA compliant email service? Subsequently, can companies use SendGrid to transmit ePHI?

The short answer is no, they are not. Let’s take a closer look

Is SendGrid HIPAA-Compliant?

SendGrid is not a HIPAA-compliant email service.  There are two key reasons for this:

  1. It lacks sufficient encryption measures
  2. SendGrid does not sign business associate agreements (BAAs)

Let’s discuss each reason in greater detail.

Basic Encryption

SendGrid only offers the basic encryption provided by the Simple Mail Transmission Protocol (SMTP), i.e., the standard mechanism used to transmit emails.

Unfortunately, this level of encryption leaves ePHI vulnerable to cyber threats such as business email compromise (BEC) attacks, ransomware, and device loss or theft. In contrast, for an email services platform to be HIPPA-compliant, it must protect ePHI in transit and at rest, using security measures like Transport Layer Security (TLS) encryption and end-to-end encryption.

Refreshingly, SendGrid is clear and upfront about this (in contrast to, Mailchimp, for example, who make you dig a little deeper to determine their non-compliance) – as Twilio’s documentation explicitly says that they do not offer HIPAA-compliant data transmission. Stating, “SendGrid does not natively support HIPAA-compliant data transmission. We do not offer any encryption or security measures surrounding message transmission beyond those included in the SMTP RFC, which was not designed with HIPAA compliancy in mind.”

In short, SendGrid wasn’t designed to withstand the increased cyber risk that accompanies handling ePHI and isn’t HIPPA-compliant as a result.

No Business Associate Agreement

Additionally, in addition to lower levels of encryption, SendGrid does not sign the business associate agreements (BAA) required to be HIPPA-compliant.

A business associate agreement (BAA) is a written contract between a covered entity (your company) and a business associate (a service provider, such as an email services or email marketing platform) that’s an essential requirement of HIPAA compliance. A BAA details how two organizations can share data and the legal responsibilities of each party.

This is again stated on Twilio’s website that says, “Twilio SendGrid does not intend uses of the Service to create obligations under The Health Insurance Portability and Accountability Act of 1996 (“HIPAA”), the Gramm-Leach-Bliley Act (“GLBA”) or similar laws and makes no representations that the Service satisfies the requirements of such laws. If You are (or become) a Covered Entity or Business Associate (as defined in HIPAA) or a Financial Institution (as defined in GLBA), You agree not to use the Service for any purpose or in any manner involving Protected Health Information (as defined in HIPAA) or Nonpublic Personal Information (as defined in GLBA).”

Here, Twilio is explicitly telling you that SendGrid does not fit the requirements of HIPPA-compliant and that you should not use their service to transmit ePHI.

HIPAA-Compliant Alternatives to SendGrid

While healthcare companies cannot rely on popular options like SendGrid if they want to utilize ePHI in their patient outreach campaigns, fortunately, there are HIPAA-compliant email platforms that are specifically designed for organizations that have to comply with the regulations.

As the most experienced HIPAA-compliant email provider, LuxSci specializes in providing secure and scalable HIPAA-compliant services for companies aiming to send hundreds of thousands – or millions – of emails. In light of this, we place security, regulatory and practical considerations front and center when building our solutions – from their early planning stages until final deployment.

Our approach results in tailor-made tools and services like HIPAA-compliant bulk email, secure text and secure marketing. This includes flexible encryption functionality, such as TLS, end-to-end, or role-based access encryption, that enable healthcare organizations to align their security with the sensitivity of the transmitted and their specific business requirements – all while remaining HIPAA compliant.

To discover how LuxSci and SendGrid stack up against each other, as well as with other HIPAA-compliant, general purpose and marketing email providers on the market, including Virtru and Mailchimp, take a look at our Vendor Comparison Guide.  The guide takes a deep dive on 12 email delivery platforms, offering insights on what to consider when selecting a provider – and how to choose the vender best suited to meet your secure healthcare communications needs.

Get your copy here, and reach out to us with any questions.

HIPAA Compliance and Email Communications

How Does HIPAA Compliance and Email Communications Work?

HIPAA compliance and email communications require healthcare organizations to implement administrative, physical, and operational safeguards that protect patient information during electronic transmission and storage. Federal regulations mandate encryption protocols, access controls, audit logging, and business associate agreements for all email systems handling protected health information. Healthcare providers must balance security requirements with operational efficiency, ensuring that email communications enhance patient care without creating compliance vulnerabilities or exposing organizations to regulatory penalties.

Safeguards for Email Security

Policy development establishes the framework for how healthcare organizations handle patient information through email channels. Written policies must specify who can send patient data via email, what types of information are appropriate for electronic transmission, and what approval processes govern sensitive communications. Documentation requirements ensure that policies reflect current regulatory standards and organizational practices.

Training programs prepare healthcare staff to use email systems securely while maintaining patient privacy throughout all communications. Education should cover encryption activation procedures, recipient verification methods, and content appropriateness criteria that prevent inadvertent disclosures. New employee training timelines ensure staff understand email security requirements before accessing patient information systems.

Access management procedures control which staff members can use email systems to communicate about patients and what information they can access. Permission structures should align with job functions, ensuring that billing staff, clinical providers, and administrative personnel each have appropriate access levels. Regular access reviews identify outdated permissions that should be revoked when staff change roles or leave organizations.

Security incident procedures outline how organizations respond when email security breaches occur or when staff discover potential vulnerabilities. Response protocols should include immediate containment steps, breach scope assessment methods, and notification procedures for affected patients and regulatory authorities. Documented incident handling demonstrates organizational preparedness during compliance audits.

Encryption Standards That Meet Regulatory Requirements

Transport-level encryption protects email messages during transmission between servers, creating secure channels that prevent interception while communications travel across public networks. TLS 1.2 or higher protocols establish encrypted connections that meet current security standards for protecting healthcare data. Server certificates verify the identity of receiving systems before allowing message transmission to prevent misdirected communications.

Message-level encryption converts email content into unreadable code before transmission, ensuring that only intended recipients with proper decryption keys can access patient information. AES 256-bit encryption provides strong protection that satisfies regulatory expectations for securing electronic protected health information. Automatic encryption removes reliance on manual activation that busy healthcare staff might forget during patient care activities.

Storage encryption protects archived email communications containing patient information while messages reside on servers or backup systems. Encryption at rest prevents unauthorized access if physical storage devices are stolen or improperly disposed. Key management protocols ensure that encryption keys receive the same protection as the data they secure.

Digital signatures add authentication layers that verify message origin and detect any unauthorized modifications during transmission. Certificate-based systems confirm sender identity before allowing message delivery, reducing risks that fraudulent communications might compromise patient information. HIPAA compliance and email communications depend on multiple encryption layers working together to protect data throughout its lifecycle.

Access Controls and Authentication Mechanisms

Multi-factor authentication strengthens account security by requiring users to provide multiple forms of identification before accessing email systems containing patient data. Passwords combined with mobile verification codes, biometric scans, or hardware tokens create barriers that prevent unauthorized access even when credentials are compromised. Authentication strength should match the sensitivity of patient information accessible through email systems.

User provisioning processes establish email accounts for new staff members while defining their access permissions based on job functions and patient care relationships. Automated provisioning systems integrated with human resources databases ensure that access aligns with employment status and role requirements. Termination procedures immediately revoke access when employment ends to prevent former staff from accessing patient communications.

Session controls automatically log users out after inactivity periods, preventing unauthorized access from unattended workstations in busy healthcare environments. Timeout durations should balance security needs with operational efficiency, allowing sufficient time for thoughtful message composition without creating excessive vulnerability windows. Concurrent session monitoring detects unusual login patterns that might indicate account compromise.

Audit capabilities track all email system activities including message transmission, viewing, forwarding, and deletion actions performed by users. Comprehensive logs capture timestamps, user identities, and specific actions taken with patient information. Log retention periods should meet regulatory requirements while supporting security investigations and compliance demonstrations.

BAA Requirements

Contractual obligations between healthcare organizations and email service providers establish responsibilities for protecting patient information during transmission and storage. Written agreements must address encryption standards, security incident notification timelines, and data handling procedures when business relationships terminate. Liability provisions allocate financial responsibilities when breaches result from provider negligence or system failures.

Vendor security assessments verify that email providers maintain appropriate safeguards before organizations entrust them with patient communications. Evaluation procedures should examine provider certifications, data center security, and incident response capabilities. Due diligence documentation demonstrates that organizations selected vendors carefully rather than accepting inadequate security measures.

Performance monitoring ensures that providers maintain contracted security standards throughout business relationships. Regular audit report reviews, security assessment updates, and compliance certification renewals verify ongoing provider commitment to protecting healthcare information. Performance issues should trigger immediate corrective action discussions to prevent security degradation.

Subcontractor management addresses situations where email providers use third-party services for hosting, backup, or support functions. Agreements should require providers to obtain equivalent security commitments from subcontractors who might access patient information. Healthcare organizations need visibility into the complete chain of entities handling their patient communications.

Documentation and Compliance Evidence

Security configuration documentation records the specific settings that organizations implement to protect email communications containing patient information. Configuration records should detail encryption algorithms, authentication requirements, access control structures, and audit logging parameters. Documentation updates track changes over time, creating histories that support compliance demonstrations.

Training records demonstrate that organizations educate staff about secure email practices and HIPAA compliance and email communications requirements. Documentation should include training dates, participant names, content covered, and assessment results verifying comprehension. Record retention periods should extend beyond individual employment to support long-term compliance evidence.

Risk assessment documentation identifies vulnerabilities in email systems and describes mitigation measures implemented to reduce security threats. Assessment reports should evaluate encryption strength, access control effectiveness, and potential failure points that could compromise patient information. Annual assessment updates track how organizations adapt security measures as threats evolve.

Incident reports document security breaches involving email communications and describe organizational responses to contain damage and prevent recurrence. Detailed breach records should include discovery methods, scope determinations, notification procedures, and corrective actions implemented. Incident documentation provides evidence of appropriate breach handling during regulatory investigations.

Operational Considerations and Best Practices

Content appropriateness guidelines help staff determine which patient information is suitable for email transmission versus what requires more secure communication methods. Routine appointment confirmations and general health education may be appropriate for encrypted email while complex diagnoses warrant telephone or in-person discussions. Emergency communications should never rely solely on email that patients might not check promptly.

Recipient verification procedures ensure staff confirm email addresses before transmitting patient information to prevent misdirected communications. Double-check processes, automated address validation, and recent communication history reviews reduce human errors that could expose patient data. Organizations should implement technological controls that flag external recipients when sending patient information.

Mobile device management addresses security challenges when staff access email from smartphones and tablets outside secure healthcare facilities. Device encryption, remote wipe capabilities, and containerization technologies separate work communications from personal data on employee devices. Bring-your-own-device policies must ensure that personal devices meet organizational security standards before allowing patient information access.

Retention management balances regulatory requirements to preserve email communications with operational needs to manage storage capacity efficiently. Automated retention policies should archive messages for required periods while deleting expired communications to minimize data exposure risks. Legal hold procedures must override automated deletion when litigation or investigations require communication preservation.

Understanding HIPAA compliance and email communications enables healthcare organizations to leverage digital communication benefits while protecting patient privacy and avoiding regulatory penalties that could result from security failures or policy violations.