LuxSci

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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Related Posts

healthcare marketing

How Automated Workflows Boost Engagement for Healthcare Marketing Campaigns

Due to the fact that it’s simple, instantaneous, cost-effective, and nearly universally adopted, email is an essential part of all healthcare marketing engagement strategies. However, consistent, personalized email engagement – particularly at scale – can be challenging. 

 

Fortunately, Automated Workflows offer a solution, allowing healthcare companies to deliver the right messages to the appropriate individuals at the right time, based on their individual engagement with emails.. 

 

In this post, we’ll explore the concept of Automated Workflows, the considerable benefits they offer healthcare companies, and the variety of ways they can be used to increase engagement and result in greater satisfaction and better healthcare outcomes for your patients and customers.

What Are Automated Workflows?

An Automated Workflow is a sequence of actions, known as’ Steps’ in LuxSci Secure Marketing, that a Contact (i.e., a patient or customer) moves through over time, based on a series of pre-defined rules or triggers. 

 

Each Step is programmed to automatically perform a specific function, such as sending an email or updating a Contact, when certain conditions are in place. These conditions could include: 

  • A Contact opening a message.
  • A Contact clicking through on a link.
  • A specified amount of time having elapsed.. 
  • A data update via an API call

By evaluating conditions to initiate the appropriate Step, Automated Workflows facilitate more timely, consistent, and personalized communication with Contacts (patients and customers ). As a result, healthcare companies can effectively harness Automated Workflows to develop dynamic, personalized email engagement journeys that adapt according to your patients and customers’ needs and prior interactions.

What Are the Benefits of Automated Workflows?

Let’s look at the various advantages that Luxsci Automated Workflows offer. 

Reduced Administrative Workload

Arguably, the most significant benefit of Automated Workflows is the extent to which they lower the administrative burden of email engagement campaigns for healthcare organizations. 

 

First and foremost, Automated Workflows eliminate the need for an employee to manually send your Contacts messages. As well as the manual effort, it removes a great deal of thought from the process – as someone isn’t required to remember to send an email. 

 

By the same token, this reduces the scope for human error, preventing the possibility of an employee neglecting to send an important message, sending it to the wrong person, or worse, accidentally exposing patient data, i.e., electronic protected health information (ePHI). 

 

The effort that Automated Workflows reduce is typically repetitive work that staff are glad to be free of, giving them additional time to focus on tasks that provide greater value and better contribute to better patient care and/or the customer experience. 

Enhanced Scalability

The time saved by employing Automated Workflows increases with the size of your Contact List and the scale of your engagement campaigns. In fact, enterprise-scale campaigns, with volumes of hundreds of thousands to millions of emails, are only feasible through the use of automation. 

 

Similarly, Automated Workflows enable healthcare organizations to run differing, personalized email campaigns aimed at unique patient or customer segments.  As well as automatically sending each message at the appropriate time, they provide tracking capabilities to determine the outcome of each message. 

Increased Consistency in Communication

Because Automated Workflows remediate the risk of emails going unsent, they facilitate more timely and consistent communications with patients and customers. This makes healthcare providers, payers, and suppliers appear more reliable and consistent, building trust and greater levels of satisfaction from Contacts. More importantly, recipients are better able to track what’s happening with their healthcare and assume a more proactive role overall healthcare journey..

 

Finally, creating an Automated Workflow requires healthcare organizations to carefully consider how they communicate with different Contact segments. Namely, the likely journey, or communication path, different types of Contacts take, i.e., information they need to know at a particular stage in their healthcare journey, the optimal order in which information needs to be presented, etc. This allows healthcare companies to become more in-tune with their patients’ and customers’ needs, enabling them to craft more valuable email communications that boost engagement. 

Personalized Healthcare Engagement 

Perhaps the most significant benefit of Automated Workflows is that they enable adaptive, personalized engagement for healthcare marketing and communications campiagns. Instead of manually tracking where each Contact is in a given engagement sequence, or worse, merely having to guess, you know precisely where they are. Consequently, you’re acutely aware of their needs and the exact nature of the emails you need to send them next. 

 

This, in turn, enables more effective Contact nurturing, i.e, strengthening your organization’s connection with each individual. When at its most effective, this may allow you to anticipate your Contacts’ needs, enabling you to send them communications, such screening or testing recommendations, educational materials, or product and service suggestions, that support their healthcare journey and enhance their quality of care.

Automated Workflow Use Cases

Automated Workflows are a powerful tool for increasing healthcare marketing and communications engagement because they can be applied to a wide range of use cases. Let’s take a look at some of the most common and impactful ways email automation can be used by healthcare companies. 

  • New Product Announcements: keeping patients and customers in the loop on your company’s latest offerings, as well as improvements to existing products and services that are likely to be of interest, based on their data and past actions.
  • Personalized recommendations: suggesting products or services based on the recipient’s past purchases or engagement history.
  • Re-Engagement Campaigns: Automated Workflows can also be used to reconnect with Contacts with whom engagement has waned or was never completely established, sending them personalized messages to encourage specific actions or reignite interest.
  • New Member Onboarding: welcoming new patients or customers  with a structured series of emails that introduces your services, provides technical assistance (where applicable), details subsequent steps, and explains how to get the most value from your products or services. 
  • Appointment Reminers and Follow-Ups: sending reminders, care instructions, medication adherence advice, or details on how to book subsequent appointments, for instance, after a patient visit. 
  • Patient Education Campaigns: taking patients through a structured curriculum on managing their medical condition or required  lifestyle changes to improve their health..
  • Preventative Care Communications: proactively sending reminders for screenings, check-ups, vaccinations, etc., based on PHI such as a patient’s age, gender, health condition or lifestyle risk factors.
  • Milestone Communications: sending personalized messages to acknowledge birthdays, enrollment anniversaries, and other pertinent dates. These can also be combined with preventative care communications, to send recommendations or other advice, based on the contact’s age, for instance.  
  • Feedback Collection: acquiring patient and customer feedback by sending follow-up surveys a set amount of time after a visit, procedure, purchase, etc. 

How Automated Workflows Work in LuxSci Secure Marketing

To round off this post, let’s take a deeper look at how Automated Workflows work within LuxSci’s Secure Marketing solution. LuxSci’s Automated Workflows enhance your organization’s HIPAA compliant healthcare marketing and email campaigns by giving you complete control of:

 

  • When each email is sent
  • Which Contacts receive particular communications according to their behavior, needs, and other PHI-based attributes
  • Which engagement path or branch a Contact takes based on their email actions

Here’s a look at LuxSci’s Automated Workflows key capabilities in greater detail. 

Smart Event-Based Branching and Conditions

You can branch Workflows to trigger targeted messaging based on a Contact’s attributes or certain engagement events, resulting in more relevant and effective healthcare journeys  with more desirable outcomes.

  • User actions:
    • Mailing list sign-ups
    • Form completion
    • Downloading a resource.
  • Time-based triggers:
    • A set period after a visit or procedure 
    • A defined period of inactivity or lack of contact
    • Milestones, e.g., birthdays, anniversaries. 
  • Behavioral triggers:
    • Email opens
    • Clicking on links
    • Visiting particular pages on a site or 
    • A lack of engagement with previous emails.
  • Transactional triggers:
    • Purchasing a product or service
    • Signing up for an event
    • Order confirmations or shipping updates after a purchase.
  • API-triggered events
    • Lab results or similar correspondence becoming available
    • Changes to data in EHR systems, CDP platforms, or CRM systems.. 

Automated Segment Management 

Automated Workflows can be used to dynamically add Contacts to segments based on demographics, past behavior, purchase history, and similar events. This enables more precise targeting and email personalization as they progress through specific Steps in each Workflow. 

Navigation Across Steps

Automated Workflows are also capable of navigating Contacts across different Steps or completely different Workflows depending on engagement outcomes and updates to a Contact’s PHI. Better still, if a Step has already been visited, LuxSci Secure Marketing automatically prevents repetition and infinite loops.

Automate Your Healthcare Marketing and Engagement Efforts

LuxSci Secure Marketing is a HIPAA compliant healthcare marketing solution especially designed for the stringent security and regulatory requirements of the healthcare industry. Our solution enables healthcare organizations to confidently communicate with patients and customers at scale without risking compliance violations, driving increased engagement and boosting the ROI of their marketing campaigns in the process. 

 

The latest version of LuxSci’s Secure Marketing solution with Automated Workflow functionality streamlines your company’s outreach efforts, saving considerable time, reducing human effort, and facilitating intelligent Contact management. 

What’s more, LuxSci’s reporting capabilities empower you to carefully track the results of your healthcare engagement campaigns, gaining insights at every step, including:

  • Which Contacts received particular messages
  • Who engaged with email communication, and how
  • Precise points where drop-offs in engagement occur
  • The engagement achieved with each Step in the Workflow

To learn more about LuxSci’s Secure Marketing solution and how Automated Workflows boost engagement for your healthcare marketing and communications campaigns, contact us today.

 

Healthcare marketing plan

How To Create a Healthcare Marketing Plan?

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

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

Target Audience in Healthcare Marketing Plan Development

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

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

Budget Allocation

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

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

Digital Strategy to Drive Modern Patient Acquisition

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

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

Compliance Integration Protects Promotional Activities

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

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

Community Outreach Builds Local Patient Relationships

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

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

Performance Measurement Guides Strategy Optimization

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

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

Implementation Timeline

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

HIPAA Marketing Rule

What Does the HIPAA Marketing Rule Require?

The HIPAA marketing rule prohibits healthcare organizations from using protected health information for promotional communications without written patient authorization, defining promotional activities as communications that encourage patients to purchase products or services with financial benefit to the sender. Organizations can send treatment-related communications, appointment reminders, and health plan benefit descriptions without authorization, but any communication promoting third-party products, paid services, or revenue-generating activities requires explicit patient consent through properly executed authorization forms.

Healthcare providers regularly find themselves struggling with acceptable patient education and prohibited promotional activities. A simple newsletter about diabetes management becomes problematic when it includes advertisements for glucose monitors or pharmaceutical products that generate revenue for the practice.

The HIPAA Marketing Rule Authorization Framework

Patient authorization documents must contain sixteen specific elements including detailed descriptions of information to be disclosed, identification of recipients, expiration dates, and explanations of revocation rights. These forms cannot be combined with other consent documents and must use plain language that patients can easily understand. Healthcare organizations face penalties when authorization forms lack required elements or contain overly broad permission language.

Patients retain the right to revoke authorization at any time, forcing organizations to immediately cease all promotional activities involving that individual’s information. Organizations cannot condition treatment, payment, enrollment, or benefits eligibility on patients providing authorization for promotional purposes, creating clear separation between healthcare services and commercial activities.

Treatment Communications Bypass Marketing Restrictions

Healthcare organizations can discuss treatment alternatives, medication options, and care coordination services without obtaining separate authorization because these communications serve legitimate healthcare purposes rather than commercial interests. Appointment scheduling, test result notifications, and prescription refill reminders fall under treatment or healthcare operations exemptions from marketing regulations.

Face-to-face communications between providers and patients about treatment options is unrestricted, even when providers receive financial benefits from recommended treatments or services. Written materials distributed during these encounters may trigger authorization requirements if they promote specific products or services beyond the immediate treatment relationship.

Financial Incentive Distinctions Shape HIPAA Marketing Rule Compliance

Communications become subject to the HIPAA marketing rule when healthcare organizations receive financial remuneration from third parties for promoting their products or services. Pharmaceutical company payments for promoting medications, medical device manufacturer incentives, or referral fees from specialty services transform otherwise acceptable communications into restricted promotional activities.

Organizations must examine their financial relationships carefully to determine when communications cross from permissible healthcare operations into restricted promotional territory. Even nominal payments or gifts from third parties can trigger marketing authorization requirements for communications that mention or promote those parties’ products or services.

Business Associate Relationships Complicate Marketing Activities

Vendors creating promotional materials, managing patient outreach campaigns, or analyzing treatment data for commercial purposes need business associate agreements before accessing PHI. These relationships are difficult if the promotional vendors also provide healthcare services or when healthcare organizations share revenue from marketing activities with their business partners.

Organizations must negotiate appropriate contractual protections and ensure vendors understand their obligations under the HIPAA marketing rule before beginning any collaborative promotional activities. Liability for vendor violations remains with the covered entity, making careful partner selection and monitoring essential for maintaining compliance.

Digital Platforms & Modern Marketing Compliance Challenges

Social media advertising, email campaigns, and online retargeting involve sharing patient information with technology platforms that lack appropriate privacy protections. Healthcare organizations cannot upload patient contact lists, demographic details, or treatment information to advertising platforms without proper authorization and business associate agreements covering those platforms.

Website analytics, social media pixels, and advertising tracking technologies may inadvertently capture and transmit PHI to third-party platforms without appropriate protections. Organizations need controls to prevent accidental information sharing while still enabling effective digital marketing activities within compliance boundaries.

Enforcement Penalties Reflect Serious Violation Consequences

Recent Office for Civil Rights enforcement actions have resulted in multi-million dollar settlements for organizations that used patient information in marketing materials without authorization or shared PHI with advertising vendors without appropriate agreements. These cases highlight increasing federal scrutiny of healthcare promotional activities and willingness to impose substantial financial penalties.

Violations may stem from seemingly innocent activities like patient newsletters, social media posts, or website testimonials that inadvertently disclosed PHI without proper authorization. Organizations discover that good intentions cannot shield them from penalties when their marketing activities violate patient privacy protections under the HIPAA marketing rule.

Compliance Programs Minimize Violation Risks

Healthcare organizations benefit from establishing clear review processes for all promotional materials and patient communications before distribution. Designated privacy personnel can evaluate whether proposed communications require authorization, involve business associate relationships, or create other compliance risks under marketing regulations.

Staff training helps employees recognize the difference between permissible healthcare communications and restricted marketing activities. Education updates keep pace with new promotional channels, emerging technology platforms, and evolving interpretations of the rule’s requirements within changing healthcare and advertising landscapes.

explanation of benefits

Why Healthcare Insurers Should Send Explanation of Benefits Statements Via Email

Explanation of Benefits statements or EOBs are mission-critical communications for health insurers because they ensure transparency, help detect billing errors or fraud, and most importantly, keep patients informed about their benefits and related payments.

 

However, the most conventional method of sending out EoBs, traditional mail, has several drawbacks that can prevent important information about healthcare coverage from reaching the intended recipient. This can leave policyholders in the dark about their healthcare coverage, which can lead to confusion and dissatisfaction with their insurance provider when they receive an unexpected medical bill. This can also drive up inbound calls into your claims department or contact center.

 

Because Explanation of Benefits statements contain the protected health information (PHI) of policyholders, insurers are bound by HIPAA (the Health Insurance Portability and Accountability Act) regulations to ensure their secure delivery. Consequently, the risks inherent to sending paper EoB statements in the mail not only have security implications but also potential consequences for non-compliance.

 

With all this in mind, this post discusses why healthcare insurers should send EoBs to their policyholders via secure email instead of traditional mail. We detail the various benefits of making the switch to electronic EoBs, which include enhanced security, better adherence to compliance regulations, and the opportunity to save millions of dollars per month.

 

Protecting Patient Privacy

The primary reason that insurance companies should shift to email EoBs as opposed to traditional mail is that it’s far more secure. Sending an EoB via email drastically decreases the risk of protected health information (PHI) getting into the wrong hands. When sent in paper form by mail, an EoB could be:

 

  • Lost, stolen or damaged in transit
  • Delivered to the wrong address
  • Not properly deposited in a letter or mailbox, then stolen
  • Intercepted within the intended address by another individual who lives at or has access to the residence. 

As detailed later in this post, email also allows for various controls and processes, which mitigate the risks of unsuccessful message delivery.

 

Most importantly, secure email provides data encryption, which safeguards the sensitive patient data within EoBs during transmission and when stored by rendering it unreadable to malicious actors who might intercept it. Physical mail, in contrast, offers no such protection, as someone who intercepts a paper EoB form can simply open it and freely read its contents.

 

Finally, secure email delivery platforms feature identity verification and access controls that enable healthcare insurers to restrict access to PHI to authorized personnel, limiting its exposure. They also provide auditing capabilities to track access to patient data, and quickly identify the source of security breaches.

HIPAA Compliance Benefits

Because sending an Explanation of Benefits statement via email is more secure, and better protects any patient data contained within them, this also reduces the risk of HIPAA compliance violations.

 

First and foremost, HIPAA regulations mandate that communications containing PHI, such as EoBs, must securely reach the intended recipient. By eliminating the risk of physical interception or non-delivery, and the compliance violations from a resulting security breach, insurers can better adhere to HIPAA regulations using email for sending EOBs. On a similar note, the security features built into a HIPAA compliant email platform, such as encryption, access controls, and audit logs, help insurers to satisfy the requirements of HIPAA’s Privacy and Security Rules in their compliance efforts.

 

Another considerable benefit of using secure email to send policyholders their EoBs, or, in fact, any communication containing PHI, is that it’s far easier to implement breach notification protocols. Email delivery platforms provide real-time tracking, so companies can pinpoint email message failures quickly and act accordingly. Similarly, intrusion detection systems and other cybersecurity measures that support email systems can enable faster detection and containment of data breaches.

 

In stark contrast, physical mail is far more difficult to track – and even those limited capabilities are reserved for more expensive delivery options. Consequently, security breaches via mail could go unnoticed for days or even weeks. If you’re unaware of a data breach, or have not yet contained or mitigated it, you’re then unable to inform all affected parties, resulting in further HIPAA violations.

Increased Deliverability Rates

By greatly mitigating the security risks presented by physical mail, i.e., the various ways an EoB could fall into the wrong hands, sending an EoB by email increases your ability to get more EOBs into the hands of policyholders, more quickly. At the same time, policyholders can make faster decisions regarding their healthcare.

The ability to track secure email gives you greater control over EOB deliverability, as it allows organizations to determine the cause of delivery failure and can also make subsequent attempts. Additionally, the process of determining the reason for the message delivery failures can also reveal security issues; the same process, however, is very difficult to achieve with traditional mail.

 

Here’s how the typical protocol for resending a secured email goes beyond what you can do with managing traditional mail delivery:

 

  • Determine the cause of non-delivery: verify that the intended recipient information is correct and check for issues like a full email inbox or security misconfigurations. 
  • Don’t automatically resend: to avoid exposing PHI to the wrong person, confirm the intended recipient’s email address through an alternative verified channel, e.g., phone call, secure SMS, etc. 
  • Log the incident: document the delivery failure, steps taken to determine its cause, attempts, etc.
  • Reattempt message delivery: if the investigation deems it safe, attempt message redelivery with the corrected information. 

In the event that subsequent delivery attempts fail, it’s best practice to contact the individual to arrange the most convenient and secure alternative to deliver their EoBs. 

Cost Savings 

Simply put, sending Explanation of Benefits statements via email instead of traditional mail saves health insurers money – potentially lots of it. Processing EOBs from start to finish can cost health insurers one to two dollars or more per EOB. That’s a lot. The biggest opportunity for cost reduction is tied to the money saved on printing and mailing paper EoB statements. Additionally, the cost of administering the delivery of EoB forms, ensuring their delivery, etc., is lowered when it’s done electronically. Not to mention, resending EoBs in the event of their non-delivery is much easier and cheaper via email.

 

In a broader sense, increasing the deliverability and the success rate of sending EoBs helps a larger number of policyholders better understand the details of their insurance coverage, i.e., how it works, which services and procedures it covers, etc. As a result of their policyholders being more informed, insurers won’t spend as much time explaining policy details and cost breakdowns to their members, allowing them to divert the otherwise required resources to other areas of the business.  

Reduced Carbon Footprint

Finally, it’s difficult to highlight the benefits of sending EoBs to policyholders by email without recognizing the positive environmental impact, too. Email EoBs cut down on paper, for both the forms themselves and the envelopes they’re mailed in. Then there’s the matter of the electricity and ink involved in printing them, the emissions produced in their delivery, etc. Opting to send EoBs via email reduces all these factors, which enables healthcare organizations to lower their carbon footprint and, where applicable, meet their sustainability obligations or goals. 

Deliver EoBs More Securely, Reliably, and at Lower Cost with LuxSci

LuxSci’s Secure High Volume Email Solution enables healthcare insurance companies to instantly send Explanation of Benefits statements to policyholders at a massive scale, extending into hundreds of thousands or millions per month.

 

Our HIPAA compliant email delivery platform features:

 

  • Dedicated IPs that isolate critical transactional messages, such as EoBs, from other email traffic, allowing LuxSci customers to reach deliverability rates of 98% or more. 
  • Real-time tracking for determining the delivery status of EoBs, as well as troubleshooting unsuccessful delivery attempts.
  • Flexible encryption through LuxSci’s proprietary SecureLine Technology, which automatically adjusts encryption settings according to the recipient to better ensure the protection of sensitive data.

Contact us today to learn more about how your organization can begin the transition to electronic EoBs.

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HIPAA Compliant

What Cloud is HIPAA Compliant?

No cloud platform is inherently HIPAA compliant without proper configuration and implementation. Major cloud providers including AWS, Microsoft Azure, Google Cloud, and Oracle Cloud can support HIPAA compliance when properly configured and covered by a Business Associate Agreement (BAA). Healthcare organizations must implement appropriate security controls, access restrictions, and monitoring regardless of which cloud they select. The HIPAA compliance of any cloud environment depends on both provider capabilities and how organizations configure their cloud resources.

Cloud Vendor Healthcare Capabilities

Leading cloud platforms offer services that support healthcare applications when properly implemented. Amazon Web Services (AWS) provides numerous HIPAA eligible services with appropriate security features and BAA coverage. Microsoft Azure includes healthcare-focused compliance frameworks and security implementations that align with HIPAA requirements. Google Cloud Platform lists HIPAA eligible services in their compliance documentation with clear guidance for healthcare implementations. Oracle Cloud offers capabilities for healthcare organizations building compliant environments. These providers maintain physical security for their data centers while providing tools for customers to implement logical security controls.

BAA Coverage and Responsibilities

Healthcare organizations must obtain a Business Associate Agreement from their cloud provider before storing protected health information in the cloud. These agreements establish the cloud provider as a business associate under HIPAA regulations. Each major provider offers standardized BAAs covering their services, though coverage varies between providers. Not all services from a provider fall under BAA coverage – organizations must verify which services qualify. The BAA establishes shared responsibility for securing protected healthcare information (PHI), with the cloud provider handling physical security and infrastructure while healthcare organizations remain responsible for application security and access management.

Implementing Cloud Security Measures

Creating a HIPAA compliant cloud environment requires several security implementations. Encryption for data at rest and in transit protects information from unauthorized access. Identity and access management controls restrict system access to authorized personnel. Network security measures include virtual private networks, firewall rules, and segmentation to isolate healthcare data. Logging and monitoring systems track user activities and system events. Backup and disaster recovery processes maintain data availability. Organizations must document these security implementations during audits or assessments to be considered fully HIPAA compliant.

Service Model Compliance Divisions

Different cloud service models affect how compliance responsibilities are divided between providers and healthcare organizations. Infrastructure as a Service (IaaS) gives organizations more control but also more responsibility for security implementation. Platform as a Service (PaaS) provides pre-configured environments with some security features built in. Software as a Service (SaaS) includes more provider-managed security but less customization. Healthcare organizations must understand where their responsibilities begin and end in each model. Documentation should clearly establish which security controls fall to the provider versus the healthcare organization based on the selected service model.

Healthcare-Optimized Cloud Solutions

Some providers offer specialized cloud environments designed for healthcare workloads. These environments include pre-configured compliance controls aligned with HIPAA requirements. Examples include AWS Healthcare, Microsoft Cloud for Healthcare, Oracle Cloud Infrastructure for Healthcare, and Google Cloud Healthcare API. These offerings often include healthcare-focused data models, integration capabilities, and security frameworks. While these environments simplify compliance efforts, organizations still must implement appropriate configurations and policies. The specialized nature of these offerings can provide advantages for healthcare-focused workflows and data handling requirements.

Maintaining Cloud Compliance

HIPAA compliance in cloud environments requires continuous management rather than one-time implementation. Organizations need processes for regular security assessments of their cloud configurations. Cloud security posture management tools help identify potential compliance gaps. Staff require training on cloud security practices and HIPAA requirements. Change management procedures should evaluate compliance impacts before implementing cloud configuration changes. Documentation must remain current as cloud environments evolve. These ongoing management practices help maintain HIPAA compliance throughout the lifecycle of cloud-based healthcare applications.

Best Secure Email Hosting

Healthcare Email Threat Readiness Strategies

Are you up to date on the latest email security threats?

 

In this post, we share details from our just-released Email Cyber Threat Readiness Report, exploring the most effective ways to strengthen your healthcare organization’s email cyber threat readiness in 2025.

 

Let’s go!

Conduct Regular Risk Assessments 

To strengthen your company’s email security posture, you must first identify vulnerabilities in your infrastructure that malicious actors could exploit. Frequent risk assessments will highlight the security gaps in your email infrastructure and allow you to implement the appropriate strategies to mitigate threats.

 

A comprehensive email risk assessment should include:

 

  • Assessment of email encryption practices.
  • Review of email authentication protocols, i.e., SPF, DKIM, DMARC.
  • Evaluation of access control policies and practices.
  • Assessment of malware detection capabilities.
  • Audit of third-party integrations.
  • Testing of employee email threat awareness through simulated attacks to determine threat readiness and training needs.
  • Review of incident response and business continuity plans, especially, in this case, in regard to email-based threats.

A risk assessment may also involve the use of vulnerability scanning tools, which scan your email infrastructure looking for conditions that match those stored in a database of known security flaws, or Common Vulnerabilities and Exposures (CVEs). Alternatively, healthcare companies often employ the services of ethical, or ‘white hat’, hackers who carry out penetration tests, in which they purposely attempt to breach your email security measures to pinpoint its flaws.

​​Implement Email Authentication Protocols

As touched on above, enabling and correctly configuring the right email authentication protocols is an essential mitigation measure against phishing and BEC attacks, domain spoofing and impersonation, and other increasingly common email threats. Just as importantly, it allows recipient email servers to verify that a message is authentic and originated from your servers, which reduces the risk of your domain being blacklisted and your emails being directed to spam folders instead of the intended recipient’s inbox.

 

The three main email authentication protocols are:

 

  • DomainKeys Identified Mail (DKIM): adds a cryptographic signature to outgoing emails, allowing the recipient’s server to verify that the email was not altered in transit. 
  • Sender Policy Framework (SPF): allows domain owners to specify which servers are authorized to send emails on their behalf, mitigating domain spoofing and other forms of impersonation.
  • Domain-based Message Authentication, Reporting & Conformance (DMARC): builds on SPF and DKIM by establishing policies for handling unauthorized emails. It instructs the recipient email server to monitor, quarantine, or reject emails that fail authentication checks. 

Establish Robust Access Control Policies

Implementing comprehensive access control policies reduces the chances of ePHI exposure by restricting its access to individuals authorized to handle it. Additionally, access privileges shouldn’t be equal and should be granted based on the employee’s job requirements, i.e., role-based access control (RBAC).

 

Zero Trust Architecture (ZTA), in contrast, is a rapidly emerging, and more secure, alternative to RBAC. ZTA’s core principles are “least privilege”, i.e., only granting the minimum necessary access rights, and “never trust, always verify”, i.e., continually asking for the user to confirm their identity as the conditions of their session change, e.g., their location, the resources they request access to, etc. 

Enable User Authentication Measures

Because a user’s login credentials can be compromised, through a phishing attack or session hijacking, for instance, access control, though vital, only protects ePHI to an extent. Subsequently, you must require a user to prove their identity, through a variety of authentication measures – with a common method being multi-factor authentication (MFA).

 

Recommended by HIPAA, MFA requires users to verify their identity in two or more ways, which could include:

 

  • Something they know (e.g., one-time password (OTP), security questions)
  • Something they have (e.g., a keycard or security token)
  • Something they are (i.e., biometrics: retinal scans, fingerprints, etc.). 

What’s more, it’s important to note that the need to enable MFA will be emphasized to a greater degree when the proposed changes to the HIPAA Security Rule go into effect in late 2025.

Identify and Manage Supply Chain Risk

While on the subject of access control, one of the most significant security concerns faced by healthcare organizations is that several third-party organizations, such as vendors and supply chain partners, have access to the patient data under their care to various degrees. As a result, cybercriminals don’t have to breach your email security measures to access ePHI – they could get their hands on your patients’ data through your vendors.

 

Consequently, third-party risk management must be a fundamental part of every healthcare organization‘s email threat mitigation strategy.  This requires you to ensure that each vendor you work with has strong email security measures in place. In light of this, a HIPAA requirement is to have a business associate agreement (BAA) in place with each third party, or business associate, so you both formally establish your responsibilities in securing ePHI. 

Set Up Encryption for Data In Transit and At Rest

Encrypting the patient data contained in email communication is a HIPAA regulation, as it prevents its exposure in the event of its interception by a cybercriminal. You should encrypt ePHI both in transit, i.e., when being included in emails, and at rest, i.e., when stored in a database.

 

Encryption standards sufficient for HIPAA compliance include:

 

  • TLS (1.2 +): a commonly-used encryption protocol that secures email in transit; popular due to being ‘invisible’, i.e., simple to use.
  • AES-256: a powerful encryption standard primarily used to safeguard stored data, e.g., emails stored in databases or archives.
  • PGP: uses public and private key pairs to encrypt and digitally sign emails for end-to-end security.
  • S/MIME: encrypts and signs emails using digital certificates issued by trusted authorities.

Develop a Patch Management Strategy

One of the most common means of infiltrating company networks, or attack vectors, is exploiting known security vulnerabilities in applications and hardware. Vendors release updates and patches to fix these vulnerabilities, so it’s crucial to establish a routine for regularly updating and patching email delivery platforms and the systems and infrastructure that underpin them.


Additionally, vendors periodically stop supporting particular versions of their applications or hardware, leaving them more susceptible to security breaches. With this in mind, you must track which elements of your IT ecosystem are nearing their end-of-support (EOS) date and replace them with suitable, HIPAA-compliant alternatives.

Implement Continuous Monitoring Protocols

Continuously monitoring your IT infrastructure is crucial for remaining aware of suspicious activity in your email traffic and potential security breaches. Without continuous monitoring, cybercriminals have a prime opportunity to infiltrate your network between periodic risk assessments. 

Worse, they can remain undetected for longer periods, allowing them to move laterally within your network and access your most critical data and systems. Conversely, continuous monitoring solutions employ anomaly detection to identify suspicious behavior, unusual login locations, etc. 

Develop Business Continuity and Disaster Recovery Plans

The unfortunate combination of organizations being so reliant upon email communication, email threats being so prevalent, and the healthcare sector being a consistent target for cyber attacks makes a data breach a near inevitability rather than a mere possibility. 

Consequently, it’s imperative to develop business continuity and disaster recovery protocols so you can resume normal operations as soon as possible in the event of a cyber attack. An essential part of a disaster recovery plan is making regular data backups, minimizing the impact on the service provided to patients and customers.

Implement Email Threat Awareness Training for Employees

Healthcare organizations must invest in email threat awareness training for their employees, so they can recognize the variety of email-based cyber attacks they’re likely to face and can play a role in their mitigation.

Email threat awareness training should include:

 

  • The different email-based cyber threats (e.g., phishing), how they work, and how to avoid them, including AI-powered threats.
  • Who to inform of suspicious activity, i.e., incident response procedures.
  • Your disaster recovery protocols.
  • Cyber attack simulations, e.g., a phishing attack or malware download.

While educating your employees will increase their email threat readiness, failing to equip them with the knowledge and skills to recognize email-based attacks could undermine your other mitigation efforts. 

Download LuxSci’s Email Cyber Threat Readiness Report

To gain further insight into the most effective email threat readiness strategies and how to better defend your healthcare organization from the ever-evolving threat landscape, download your copy of LuxSci’s Email Cyber Threat Readiness Report for 2025

 

You’ll also learn about the top email threats facing healthcare organizations in 2025, as well as how the upcoming changes to the HIPAA Security Rule may further impact your company’s cybersecurity and compliance strategies.

 

Grab your copy of the report here and reach out to us today if you want to learn more.

Why Should You Integrate CDPs and Email?

Why Should You Integrate CDPs and Email?

Growing numbers of healthcare organizations are turning to Customer Data Platforms (CDPs) to consolidate and leverage patient data (or electronic protected health information (ePHI) from electronic health record (EHR) systems, RCM platforms, CRM systems, websites, communications channels, and other various sources. 

CDPs enable healthcare providers, payers, and retailers to better understand each patient’s needs, health conditions, treatment schedules, ongoing care, and so on, enabling them to take the right actions, at the right time to improve engagement. This results in more patient participation, enhanced coordination with providers and companies, and, ultimately, improved patient outcomes.

Why Should You Integrate CDPs and Email?

Integrating the functionality of a CDP with a HIPAA compliant email platform, such as LuxSci, empowers you to put your data into action. This includes enabling you to better target your various segments using real-time communications data – such as email opens, clicks and conversions – as well as using PHI in secure messages for greater personalization – all while operating within the bounds of HIPAA (the Health Insurance Portability and Accountability Act) regulations. 

With this in mind, this post discusses the benefits of integrating your organization’s CDP solution with a HIPAA compliant email solution. We’ll explore the main benefits and how to integrate the two solutions, as well as several effective strategies for leveraging the valuable PHI stored within your CPD to increase patient and customer engagement.

Benefits of Integrating a CDP with HIPAA Compliant Email

Let’s begin by looking at the main advantages of pairing your CDP with a HIPAA compliant email platform.

Increased Protection of Customer Data

Above all, HIPAA compliant email platforms are specifically designed with the stringent data privacy and security requirements of the healthcare industry in mind. As a result, they contain a range of data security features, including encryption, access control, user authentication, and audit logging, that both better safeguard ePHI from unauthorized access and ensure HIPAA compliance. In short, HIPAA compliant email helps ensure that when valuable and sensitive CDP information is put into use, i.e. using it in patient emails and communications, it’s protected and safe both in transit and at rest.

Avoid the Consequences of HIPAA Violations

By opting for an email provider that meets the security requirements for HIPAA compliance – and better yet, HITRUST certification – your company can better mitigate the risk of data breaches, and the compliance violations that accompany them. The consequences of HIPAA compliance violations include: 

  • Financial penalties: this includes regulatory fines, legal fees and compensation to affected parties, and state-level fines (in certain cases). In the event that compliance officers can prove willful neglect, your company may even face criminal charges, incurring further damage.  
  • Operational disruptions: suffering a security breach requires healthcare organizations to spend time on containment and notifying and reassuring affected parties, as well as taking subsequent mitigation efforts – all of which take time away from running the day-to-day business.
  • Reputational damage: displaying an inability to safeguard sensitive data will cause patients and customers to lose trust in your organization and move to other providers or suppliers.

Enhanced Personalization in Engagement Efforts

With ongoing uncertainty around HIPAA regulations, healthcare companies are often reluctant to include PHI in their email communications and campaigns, missing opportunities to fully leverage your CDP to create more effective, more relevant messages, targeting highly segmented audiences. Safe in the knowledge that customer data derived from your CDP will be secured by your HIPAA compliant email provider or HIPAA compliant marketing solution, you can confidently include PHI in communications to craft more personalized – and potent – engagement opportunities.  

The data aggregated by CDPs can be used to divide, or segment, customers into smaller groups with particular commonalities, such as a health condition like diabetes, or users of a particular type of medical equipment. Healthcare marketers can use the shared needs and problems of each patient or customer segment to drive more effective and targeted campaigns that deliver more opens, clicks, and conversions.

Strategies for Leveraging Customer Data Through CDP and Email Integration

Having a better understanding of the benefits of CDP integration with your email communications, let’s move on to a few of the most effective ways to leverage your customer data through a HIPAA compliant, secure email services provider (ESP).

Segmenting Customers by Health Condition or Risk Profile

The first strategy, as alluded to above, is to use the health-oriented data stored in your CDP to group customers into segments that you can target with highly personalized messaging – using PHI to your advantage. Segmentation could be based on health conditions, such as demographics, location, or by a patient’s lifestyle risk factors, e.g., smokers. 

Having defined your segments, you can create personalized email campaigns for each, which are far more likely to drive engagement and actions versus messages designed to appeal to everyone or with limited information. Better still, you can create different email campaigns to fulfill different purposes with automated workflows based on how your patients respond, giving you a range of opportunities to reach out and connect. Using intelligence from your CDP, you can design your email campaigns to:

  • Educate: send patients and customers educational materials designed to increase their understanding of their state of health and the options available to them for creating the most favorable outcomes. 
  • Offer adherence advice: include information on how to best adhere to a prescribed care or treatment plan, resources on overcoming common challenges, where to go for support, etc. 
  • Provide preventive care tips: help patients who fit a particular risk profile, such as diabetes or heart disease, make better lifestyle choices, with the ultimate aim of avoiding the disease they’re at risk of. 

Lifecycle-Based Messaging

This is a variation on the above strategy that segments patients and customers based on how far along they are in their treatment lifecycle, for instance: 

  • Onboarding: messaging that introduces your services, explains how to access care, and covers other preliminary details; this stage is essential for setting expectations and establishing trust with your patients and customers.
  • Active Treatments: regular check-ins, medication reminders, preparation guides, and educational resources based on their condition or treatment plan; this messaging is designed to support adherence and improve healthcare outcomes.
  • Follow-Up and Recovery: personalized care instructions, satisfaction surveys, or information about next steps; this shows ongoing support and maintains consistent communication when a patient may be feeling most vulnerable. 
  • Preventive and Long-Term Care: triggering routine screening reminders, vaccine alerts, or wellness tips based on age, history, and risk factors; an integrated CDP and email system can track when patients are due for services and automate communication accordingly.
  • Re-engagement: sending patients who have been inactive for a while tailored prompts, e.g., “We haven’t seen you in a while…”; this encourages proactivity and helps highlight new services that may be of interest.

Behavior-Triggered Messaging

Integrating your CDP with a HIPAA compliant email platform enables you to automate email delivery and workflows based on a customer’s behavior and engagement patterns. This type of email is enabled by the CDP’s ability to monitor events and behaviors across multiple activities and locations, enabling you to create email campaign strategies and workflows accordingly. This approach allows for a range of timely and relevant engagement opportunities, including: 

  • Missed appointments: sending a message if a patient misses an appointment that encourages them to reschedule and assists them in how to do so. 
  • Periodic checkup reminders: similarly, if a patient is supposed to have regular checkups, follow-up appointments, a recommended health screening, etc., this data can be passed from the CDP to the email client to schedule automated emails that drive up appointment bookings.  
  • Unfilled prescriptions: if a patient hasn’t picked up their prescribed medication, you can automatically trigger an email reminder and automated workflow to get the prescription filled; this information can also be fed back to their healthcare providers if repeated reminders see the prescription remain unfilled. 
  • Patient portal inactivity: if a user hasn’t logged into a portal for a predefined time frame, this can prompt a re-engagement email encouraging them to check messages in their portal, view test results, etc. 
  • Form completion: after inputting data into a web form, an integrated CDP can help facilitate the delivery of a tailored email that offers guidance on next steps or the most relevant products or services based on given answers.

Implement Feedback Loops for Optimized Engagement

Finally, a key benefit of integrating a CDP with a HIPAA compliant email platform is that it enables you to close the loop between engagement and results. By feeding campaign performance data, such as email opens, clicks, conversions, and other key metrics, back into your CDP, you can continuously refine your email outreach strategies to enhance engagement, while developing a more complete data profile of patients and customers.

Put Your CDP into Action with LuxSci Secure Email

Integrating HIPAA compliant communications solutions like LuxSci with your healthcare organization’s CDP empowers you to securely harness your customer data in email communications for consistent, timely, and relevant engagement – for better health outcomes and better business. 

To learn more about LuxSci’s suite of secure HIPAA compliant communication solutions and how we seamlessly integrate with leading CDP solutions to improve engagement, contact us today!

Is Microsoft Outlook HIPAA compliant?

Is Microsoft Outlook HIPAA Compliant? Understanding Microsoft Email Security

Microsoft Outlook is one of the most widely used email platforms, including in healthcare, but is it truly HIPAA-compliant? The answer isn’t straightforward. While Outlook, and the entire Microsoft 365 application suite, offer security features that can support HIPAA compliance, they are not inherently compliant out of the box. 

Healthcare organizations must actually take additional measures to ensure they meet HIPAA’s stringent requirements before they can transmit electronic protected health information (ePHI) in their email communications – without risking the consequences of non-compliance. 

With this in mind, this post examines Microsoft 365 and Microsoft Outlook’s security capabilities, where and how they fall short of compliance standards, and, subsequently, how to secure each application in accordance with HIPAA regulations. 

Understanding HIPAA Compliant Email Requirements

HIPAA compliant email requires healthcare organizations to implement a series of technical, administrative, and physical safeguards to protect the sensitive patient data that they’ve amassed during the course of their operations – and are legally obliged to secure it in transit and at rest. Taking a brief look at each category in turn, these safeguards include: 

Technical

  • Encryption: converting ePHI into an unreadable format.
  • Access controls: ensuring only authorized personnel can access patient data.
  • Audit logs: tracking who has accessed ePHI and what they did with it.

Administrative

  • Risk assessments: identifying and categorizing risks to ePHI and implementing mitigation measures.
  • Workforce training: educating employees, especially those who handle ePHI, on how to identify cyber threats, e.g, phishing, and how to respond. 
  • Business Associate Agreements (BAAs): a required document for HIPAA compliance that outlines each party’s responsibility and liability in protecting patient data.

Physical safeguards: 

  • Securing servers: preventing access to the servers on which ePHI resides.
  • Restricting device access: implementing measures to keep malicious actors from accessing employee devices, should one fall into their hands.
  • Implementing screen locks: a simple, yet effective, form of device access control is setting them to lock after a few seconds of inactivity.

What Security Features Do Microsoft 365 and Microsoft Outlook Have?

Before detailing how Microsoft 365 and Microsoft Outlook do not meet HIPAA’s standards by default, let’s look at its security features:

1. Encryption and Data Protection

Microsoft 365 offers several encryption options, including:

  • TLS: Transport Layer Security (TLS) secures email in transit but does not encrypt emails at rest; if a recipient’s email server does not support TLS, messages may be sent in plaintext.
  • Office Message Encryption (OME): Office Message Encryption (OME) allows users to send encrypted messages, but it requires recipients to log in to a Microsoft account or use a one-time passcode. OME integrates with Microsoft 365’s Purview Message Encryption feature, which incorporates encryption, Do Not Forward, and rights management. 
  • BitLocker Encryption: Encrypts data at rest within Microsoft’s cloud infrastructure.
  • Azure Information Protection: a cloud-based solution that allows users to classify, label, and protect data based on its sensitivity.

While these encryption methods provide some security, they lack the flexibility and automation needed to ensure consistent HIPAA compliance, especially for high-volume email campaigns.

2. Access Controls & Authentication

Microsoft 365 and Microsoft Outlook include access controls, such as role-based permissions and device management policies, and user authentication measures such as Multi-Factor Authentication (MFA). However, organizations must actively manage and enforce these policies to prevent breaches.

3. Audit Logging & Compliance Reporting

Microsoft provides audit logging and reporting tools via the Microsoft Purview Compliance Portal. These logs help organizations track access to ePHI, but proper configuration is required to ensure that HIPAA-required retention policies are met.

4. Business Associate Agreement

One of the distinguishing features of using Microsoft 365 and Microsoft Outlook is that the company will sign a Business Associate Agreement (BAA) with healthcare organizations. However, the Microsoft BAA only applies to specific Microsoft 365 services that meet HIPAA requirements, such as Outlook, Exchange Online, and OneDrive – while apps like Skype may not be covered. 

This means healthcare organizations must carefully configure Microsoft 365 to use only HIPAA-covered services and apply security controls like encryption, access restrictions, and audit logging. 

How Microsoft Outlook and Microsoft 365 Fall Short of HIPAA Regulations

Despite Microsoft 365 and Outlook’s comprehensive security features, out of the box, they still lack a series of capabilities and configurations that prevent them from being fully HIPAA-compliant. 

  1. No End-to-End Encryption: TLS protects emails in transit, but messages may be readable on recipient servers if they don’t support TLS, exposing ePHI.
  2. Lack of Automatic Encryption: Microsoft 365 requires users to manually apply encryption settings for emails containing sensitive data, increasing the risk of human error and falling victim to data breaches.
  3. Key management issues: healthcare organizations must rely on Microsoft’s encryption key management, rather than maintaining full control over their own keys.
  4. Lack of recipient flexibility: OME requires recipients to authenticate via Microsoft accounts, which can be cumbersome for patients and other third-parties.
  5. Limited DLP Enforcement: Outlook’s default settings don’t prevent ePHI from being sent unencrypted without proper data loss prevention (DLP) rules.
  6. Audit Logging Gaps: while Microsoft 365 logs activity, they must be reviewed and retained properly to meet HIPAA guidelines.


To bridge these security gaps, healthcare organizations need an additional layer of protection.

In short, Microsoft 365 and Microsoft Outlook are not HIPAA-compliant out of the box, and healthcare companies should fully understand the implications and steps needed before using them for HIPAA compliant email communications and campaigns. However, unlike other leading email platforms, such as Mailchimp and SendGrid, they can be made HIPAA-compliant.

How LuxSci Makes Microsoft 365 and Microsoft Outlook Email HIPAA-Compliant

If your organization relies on Microsoft 365 or Microsoft Outlook for its email communications, LuxSci can streamline the process of making the platform HIPAA compliant – better-securing ePHI in the process and helping you avoid the consequences of a compliance shortfalls and a data breach.. 

LuxSci’s HIPAA compliant email features were specially designed with the security needs of healthcare organizations in mind, and include:

1. Automatic, End-to-End Email Encryption

LuxSci’s SecureLine™ encryption dynamically applies the strongest available encryption, including TLS, PGP and S/MIME,  based on the recipient’s server’s security posture and capabilities, ensuring that every email remains secure without manual intervention, and reducing human error.

2. Seamless Integration with Microsoft 365

With LuxSci’s Secure Email Gateway, organizations can continue using Microsoft 365 and Microsoft Outlook for email, while benefiting from automated encryption, outbound email filtering, and advanced compliance logging, where logs are retained per HIPAA’s strict requirements.

3. Dedicated, HIPAA-Compliant Infrastructure

LuxSci offers dedicated email servers with full control over encryption keys, ensuring compliance with HIPAA and other data privacy regulations, such as GDPR and HITRUST. This is particularly important for organizations needing high-volume email security without performance bottlenecks.

4. Secure Patient Communication & Forms

Beyond email encryption, LuxSci provides Secure Forms and Secure Text, allowing healthcare providers, payers and suppliers to safely collect sensitive patient data and improve patient engagement and workflows. 

Talk to Our Experts Today

If your organization relies on Microsoft 365 or Microsoft Outlook for email and wants to ensure full HIPAA compliance, schedule an intro call or demo with LuxSci today. Our experts will answer all your questions and help you implement a secure, high-performance email solution tailored to your needs.