LuxSci

Is Outlook a HIPAA Compliant Email?

How to Make Google Workspace HIPAA Compliant

Outlook can be HIPAA compliant email when properly configured within Microsoft 365 (formerly Office 365) and covered by a Business Associate Agreement with Microsoft. Standard consumer Outlook.com accounts do not meet HIPAA requirements for protecting patient information. Healthcare organizations must implement security settings, create robust email policies, and train staff on proper handling of patient information to maintain HIPAA compliant email communications through Outlook.

Microsoft 365 Business Associate Agreement

Healthcare organizations cannot use standard Outlook.com accounts for communicating protected health information. Only Outlook within Microsoft 365 qualifies for HIPAA compliant email usage with proper configuration. Microsoft offers Business Associate Agreements for Microsoft 365 customers, establishing Microsoft’s responsibilities for protecting healthcare information under HIPAA regulations. This agreement specifically includes Outlook among covered services. Organizations must execute this BAA before storing or transmitting any protected health information through Outlook. The agreement details security responsibilities, breach notification procedures, and other HIPAA compliance requirements. Personal “Outlook.com” accounts operate under different terms of service that don’t address healthcare data protection, making them unsuitable for clinical communications.

Required Security Configurations

Making Outlook HIPAA compliant email requires enabling several security features available in Microsoft 365 admin controls. Multi-factor authentication verifies user identities beyond password checks for stronger account protection. Message encryption settings ensure patient data stays secure during transmission. Data loss prevention rules identify emails containing health information and apply appropriate protection policies automatically. Archive and retention policies maintain records according to regulatory requirements. Audit logging tracks email access, sending, and receiving activities. Organizations configure these settings through the Microsoft 365 admin center rather than relying on default settings. When properly implemented, these security measures change standard Outlook into a platform suitable for healthcare communications.

HIPAA Compliant Email Content Protection Features

Microsoft 365 includes several Outlook features specifically designed to protect sensitive information in emails. Message encryption allows sending protected content to recipients inside or outside the organization. Information Rights Management prevents forwarding, copying, or printing of sensitive emails. Sensitivity labels classify messages based on content type and apply appropriate protections. Data loss prevention policies scan outgoing messages for patient information patterns and can block transmissions that violate security rules. S/MIME capabilities provide further encryption and digital signatures to verify message authenticity. Transport rules can apply protection automatically based on message content or recipients. Healthcare organizations use these protection features to maintain HIPAA compliant email practices while allowing necessary communications.

Mobile Access Security

Healthcare staff frequently access email through mobile devices, creating additional compliance considerations. Organizations using Outlook for HIPAA compliant email must address mobile access security. Mobile application management policies control how Outlook functions on smartphones and tablets. Conditional access rules limit email retrieval to approved devices with proper security configurations. App protection policies prevent copying patient information between Outlook and unauthorized applications. Remote wipe capabilities allow removing email data from lost or stolen devices. Organizations develop clear guidelines about which devices may access protected information through Outlook mobile apps. Balancing convenience with security requires thoughtful policies that address how modern healthcare professionals communicate.

Retention and Archive Management

HIPAA compliant email through Outlook includes proper retention and archiving of messages containing protected health information. Microsoft 365 retention policies allow organizations to preserve emails for required time periods while preventing premature deletion. Legal hold features maintain emails relevant to investigations or litigation regardless of user deletion attempts. eDiscovery tools help locate specific messages when needed for compliance verification or patient care. Archive mailboxes store older messages while maintaining appropriate security and search capabilities. Organizations establish retention schedules based on message content types and regulatory requirements. Proper archiving practices help healthcare entities demonstrate compliance while maintaining access to historical communications when needed.

HIPAA Compliant Email Staff Training

Technical controls alone cannot ensure Outlook functions as HIPAA compliant email without proper user behavior. Organizations develop comprehensive training programs covering appropriate email usage for healthcare information. Staff learn to recognize what constitutes protected health information and when it requires secure handling. Usage guidelines explain when Outlook encryption should be activated and how to verify message security before sending. Outlook configuration guides help users understand security feature operation. Organizations document that staff have completed training and understand email policies. Periodic refreshers address changing regulations and emerging security threats. With clear guidelines and regular education, healthcare staff learn to use Outlook appropriately for patient communications while maintaining compliance with HIPAA regulations.

Picture of Erik Kangas

Erik Kangas

With 30 years engaged in to both academic research and software architecture, Erik Kangas is the founder and Chief Technology Officer of LuxSci, playing a core role in building the company into the market leader for HIPAA compliant, secure healthcare communications solutions that it is today. An international lecturer on messaging security, Erik also advises and consults on email technology strategies and best practices, secure architectures, and HIPAA compliance. Erik holds undergraduate degrees in physics and mathematics from Case Western Reserve University, and a doctoral degree in computational biophysics from MIT. Erik Kangas — LinkedIn

Get in touch

Find The Best Solution For Your Organization

Talk To An Expert & Get A Quote




A member of our staff will reach out to you

Get Your Free E-Book!

LuxSci High Email Deliverability Best Practices Paper

What you’ll learn:

Related Posts

LuxSci Oiva Health

LuxSci and Oiva Health Combine to Form Transatlantic Healthcare Communications Group

Boston & Helsinki, February 12, 2026 – LuxSci, a provider of secure healthcare communications solutions in the United States, and Oiva Health, a Nordic provider of Digital Care solutions in social and healthcare services, today announced that the companies are joining forces. Backed by Main Capital Partners (“Main”), the combination brings together two complementary platforms and teams, forming a strong transatlantic software group focused on secure healthcare communications.

Founded in 1999, LuxSci is a U.S. provider of HIPAA‑compliant, secure email, marketing, and forms solutions. Its application and infrastructure software enable organizations to securely deliver personalized, sensitive data at scale to support a broad range of healthcare communications and workflows including care coordination, benefits and payments, marketing, wellness communications, after care and ongoing care. Certified by HITRUST for the highest levels of data security, LuxSci serves dozens of healthcare enterprises and hundreds of mid‑market organizations.

Founded in 2010, Oiva Health is a provider of digital care and communications solutions in the Nordics. Headquartered in Finland, with additional offices in Denmark, Norway, and Sweden, Oiva Health offers digital care and digital clinic solutions – including digital visits, secure messaging, online scheduling and appointments, and caregiver communications – serving the long-term care, especially elderly care, and occupational healthcare verticals. The company employs approximately 60 people and has recently expanded across the Nordic region, with a growing presence in Norway and Sweden.

The combination of LuxSci and Oiva Health creates a larger, cross Atlantic group with complementary solutions, serving the U.S. and European markets. Together, the companies offer healthcare providers, payers, and suppliers a comprehensive suite of tools to communicate securely and compliantly, spanning communications, workflows, and virtual care delivery.

Daan Visscher, Partner and Co-Head North America at Main, commented: “We are pleased to announce this cross Atlantic transaction, creating an internationally active secure communications player within the healthcare and home care space. The combined product suite enables healthcare organizations to drive much needed efficiency gains in healthcare provision addressing a global trend of rising costs, aging population, and increasing pressure on resources needed to provide high-quality care.”

Mark Leonard, CEO of LuxSci, said, “We are thrilled to join forces with Oiva Health and believe that together we can truly make a difference in healthcare coordination, access, and delivery. We see an exciting path forward with our customers benefiting from an end-to-end, secure and compliant approach to optimizing both healthcare communications and today’s frontline workers, which we need now more than ever.”

Juhana Ojala, CEO at Oiva Health, concluded, “We look forward to this new chapter together with LuxSci. We are very excited about the strong alignment between our solutions, which especially strongly positions us to expand our flagship Digital Care offering to the high-potential U.S. care market – from care coordination to care delivery to in-home and institutional care.”

Nothing contained in this Press Release is intended to project, predict, guarantee, or forecast the future performance of any investment. This Press Release is for information purposes only and is not investment advice or an offer to buy or sell any securities or to invest in any funds or other investment vehicles managed by Main Capital Partners or any other person.

[END OF MESSAGE]

About LuxSci

LuxSci is a U.S.-based provider of secure healthcare communications solutions for the healthcare industry. The company offers secure email, marketing, forms and hosting, delivering HIPAA‑compliant communication solutions that enable organizations to safely manage and transmit sensitive data. Founded in 1999, LuxSci serves more than 1,900 customers across healthcare verticals, including providers, payers, suppliers, and healthcare retail, home care providers, and healthcare systems, as well as organizations operating in other highly regulated industries. LuxSci is HITRUST‑certified with example clients being Athenahealth, 1800 Contacts, Lucerna Health, Eurofins, and Rotech Healthcare, among others.

About Oiva Health

Oiva Health is a Digital Care provider in the Nordics, offering a comprehensive Digital Platform for integrated health and care services to digitalize primary healthcare, social care, hospital healthcare and long-term care services. The company was founded in 2010 and currently employs approximately 60 people in Finland, Denmark, Norway, and Sweden serving domestic municipalities, customers and partners, such as City of Helsinki, Keski-Suomi Welfare Region, Länsi-Uusimaa Welfare Region in Finland, and Viborg municipality in Denmark with its Digital Care platform. Annually over 5 million customer contacts are handled digitally through Oiva Health’s Digital Care and Digital Clinic platforms.  

About Main Capital Partners

Main Capital Partners is a software investor managing private equity funds active in the Benelux, DACH, the Nordics, France, and the United States with approximately EUR 7 billion in assets under management. Main has over 20 years of experience in strengthening software companies and works closely with the management teams across its portfolio as a strategic partner to achieve profitable growth and create larger outstanding software groups. Main has approximately 95 employees operating out of its offices in The Hague, Düsseldorf, Stockholm, Antwerp, Paris, and an affiliate office in Boston. Main maintains an active portfolio of over 50 software companies. The underlying portfolio employs approximately 15,000 employees. Through its Main Social Institute, Main supports students with grants and scholarships to study IT and Computer Science at Technical Universities and Universities of Applied Sciences.

The sender of this press release is Main Capital Partners.

For more information, please contact:

Main Capital Partners
Sophia Hengelbrok (PR & Communications Specialist)

sophia.hengelbrok@main.nl

+ 31 6 53 70 76 86

HIPAA Compliant Email

Rethinking HIPAA Compliant Email – Not Just a Checkbox

The compliance-only mentality is outdated.

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

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

What Makes Email Truly HIPAA Compliant?

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

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

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

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

The Real Opportunity – Secure, Personalized Email with PHI

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

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

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

Real Business Results from Secure Email

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

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

The Healthcare Marketer’s Secret Weapon: Using PHI Responsibly

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

Meeting the Personalization Demands of Today’s Patients and Customers

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

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

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

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

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

Why LuxSci? The Infrastructure Behind the Performance

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

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

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

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


FAQs

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

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

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

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

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

HIPAA compliant email

Most Popular LuxSci Blog Posts of 2025

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

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

1. Improve Email Engagement and Marketing Results with Automated Workflows

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

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

2. Healthcare Email Threat Readiness Strategies

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

Read the full post: Healthcare Email Threat Readiness Strategies

3. HIPAA Compliant Email — 20 Tips in 20 Minutes

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

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

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

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

Read the full post: Is SendGrid HIPAA-Compliant?

5. LuxSci Shines in G2 Winter 2026 Reports

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

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

Looking Ahead to 2026

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

Follow LuxSci on LinkedIn

HIPAA compliant email

LuxSci Welcomes Angel Mazariegos as Head of Finance

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

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

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

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

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

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

You Might Also Like

LuxSci Email Deliverability

How to Fix Email Not Delivered Issues?

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

Recovery Strategies For an Email Not Delivered

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

Immediate Consequences

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

Patient Care Disruptions When Email is Not Delivered

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

Revenue Impact

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

Operational Inefficiencies from Email Not Delivered

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

Technology System Failures

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

hands on a keyboard sending secure email

How to Secure SMTP Email Delivery with TLS

Secure email sending is a priority for organizations that communicate sensitive data externally. One of the most common ways to send secure emails is with SMTP TLS. TLS stands for Transport Layer Security and is the successor of SSL (Secure Socket Layer). TLS is one of the standard ways that computers on the internet transmit information over an encrypted channel. In general, when one computer connects to another computer and uses TLS, the following happens:

  1. Computer A connects to Computer B (no security)
  2. Computer B says “Hello” (no security)
  3. Computer A says, “Let’s talk securely over TLS” (no security)
  4. Computers A and B agree on how to do this (secure)
  5. The rest of the conversation is encrypted (secure)

In particular:

  • The conversation is encrypted
  • Computer A can verify the identity of Computer B (by examining its SSL certificate, which is required for this dialog)
  • The conversation cannot be eavesdropped upon (without Computer A knowing)
  • A third party cannot modify the conversation
  • Third parties cannot inject other information into the conversation.

TLS and SSL help make the internet a more secure place. One popular way to use TLS is to secure SMTP to protect the transmission of email messages between servers.

Secure SMTP Email Delivery with TLS 

The mechanism and language by which one email server transmits email messages to another email server is called Simple Mail Transport Protocol, or SMTP. For a long time, email servers have had the option of using TLS to transparently encrypt the message transmission from one server to another.

When available, using TLS with SMTP ensures the message contents are secured during transmission between the servers. Unfortunately, not all servers support TLS! Many email providers, especially free or public ones, have historically not supported TLS. Thankfully, the trend is shifting. LuxSci found that most providers now support TLS- approximately 85% of domains tested as of July 2022.

Using TLS requires that the server administrators:

  1. purchase SSL certificates
  2. configure the email servers to use them (and keep these configurations updated)
  3. allocate additional computational resources on the email servers involved.

For TLS transmission to be used, the destination email server must offer support for TLS, and the sending computer or server must be configured to use TLS connections when possible.

The sending computer or server could be configured for:

  1. No TLS: never use it.
  2. Opportunistic TLS: use it if available; if not, send it insecurely.
  3. Forced TLS: use TLS or do not deliver the email at all.

How Secure is Email Delivery over SMTP TLS?

TLS protects the transmission of the email message contents. It does nothing to protect the security of the message before it is sent or after it arrives at its destination. For that, other encryption mechanisms may be used, such as PGP, S/MIME, or storage in a secure portal.

For sending sensitive information to customers, transmission security is the minimum standard for compliance with healthcare and financial regulations. TLS is appropriate to meet most compliance requirements and offers an excellent alternative to more robust and less user-friendly encryption methods (like PGP and S/MIME).

There are different versions of TLS- 1.0 and 1.1 use older ciphers and are not as secure, while TLS 1.2 and 1.3 use newer ciphers and are more secure. When an email is sent, the level of TLS used is as secure as can be negotiated between the sending and receiving servers. If they both support strong encryption (like AES 256), then that will be used. If not, a weaker grade of encryption may be used. The sending and receiving servers can choose the types of encryption they will support. If there is no overlap in what they support, then TLS will fail (this is rare).

What About Replies to Secure Messages?

Let’s say you send a message to someone that is securely delivered to their inbox over TLS. Then, that person replies to you. Will that reply be secure? This may be important if you are communicating sensitive information. The reply will use TLS only if:

  1. The recipient’s servers support TLS for outbound email (there is no way to test this externally).
  2. The mail servers (where the “From” or “Reply” email address is hosted) support TLS for inbound email.
  3. Both servers support overlapping TLS ciphers and protocols and can agree on a mutually acceptable means of encryption.

Unless familiar with the providers in question, it cannot be assumed that replies will use TLS. So, what should you do? Ultimately, it depends on what compliance standards you must meet, the level of risk you are willing to accept, and the types of communications you send. There are two general approaches to this question:

  1. Conservative. If replies must be secure in all cases, assuming TLS will be used is unreasonable. In this case, a more secure method should be used to encrypt the messages in transit and store them upon arrival. The recipient must log in to a secure portal to view the message and reply securely. Alternatively, PGP or S/MIME could be used for additional security.
  2. Aggressive. In some compliance situations like HIPAA, healthcare providers must ensure that ePHI is sent securely to patients. However, patients are not beholden to HIPAA and can send their information insecurely to anyone they want. If the patient’s reply is insecure, that could be okay. For these reasons, and because using TLS for email security is so easy, many do not worry about the security of email replies. However, this should be a risk factor you consider in an internal security audit. Consider nuanced policies that allow you to send less sensitive messages with TLS while sending more sensitive messages with higher security.

What are the Weaknesses of SMTP TLS?

As discussed, SMTP TLS has been around for a long time and has recently seen a great deal of adoption. However, it has some deficiencies compared to other types of email security:

  • There is no mandatory support for TLS in the email system.
  • A receiver’s support of the SMTP TLS option can be trivially removed by an active man-in-the-middle because TLS certificates are not actively verified.
  • Encryption is not used if any aspect of the TLS negotiation is undecipherable/garbled. It is very easy for a man-in-the-middle to inject garbage into the TLS handshake (which is done in clear text) and have the connection downgraded to plain text (opportunistic TLS) or have the connection fail (forced TLS).
  • Even when SMTP TLS is offered and accepted, the certificate presented during the TLS handshake is usually not checked to see if it is for the expected domain and unexpired. Most MTAs offer self-signed certificates as a pro forma. Thus, in many cases, one has an encrypted channel to an unauthenticated MTA, which can only prevent passive eavesdropping.

The Latest Updates to Secure SMTP TLS

Some solutions help remedy these issues—for example, SMTP Strict Transport Security. SMTP STS enables recipient servers to publish information about their SMTP TLS support in their DNS. This prevents man-in-the-middle downgrades to plain text delivery, ensures more robust TLS protocols are used, and can enable certificate validation.

In addition, users can adopt TLS 1.3. NIST recommends that government agencies develop migration plans to support TLS 1.3 by January 1, 2024. LuxSci supports both SMTP MTA-STS and TLS 1.3.

How Secure SMTP TLS Email Works with LuxSci

Inbound TLS

LuxSci’s inbound email servers support TLS for encrypted inbound email delivery from any sending email provider that also supports that. For selected organizations, LuxSci also locks down its servers to only accept email from them if delivered over TLS.

Outbound Opportunistic TLS

LuxSci’s outbound email servers will always use TLS with any server that claims to support it and with whom we can talk TLS v1.0+ using a strong cipher. The message will not be sent securely if the TLS connection to such a server fails (due to misconfiguration or no security protocols in common). Outbound opportunistic TLS encryption is automatic for all LuxSci customers, even those without SecureLine.

Forced TLS

When Forced TLS is enabled, the message is either dropped or sent with an alternate form of encryption if the recipient’s server does not support TLS. This ensures that messages will never be sent insecurely. Forced TLS is also in place for all LuxSci customers sending to banks and organizations that have requested that we globally enforce TLS to their servers.

Support for strong encryption

LuxSci’s servers will use the strongest encryption supported by the recipient’s email server. LuxSci servers will never employ an encryption cipher that uses less than 128 bits (they will fail to deliver rather than deliver via an excessively weak encryption cipher), and they will never use SSL v2 or SSL v3.

Does LuxSci Have Any Other Special TLS Features?

When using LuxSci SecureLine for outbound email encryption:

  1. SMTP MTA STS: LuxSci’s domains support SMTP MTA STS, and LuxSci’s SecureLine encryption system leverages STS information about recipient domains to improve connection security.
  2. Try TLS: Account administrators can have secure messages “try TLS first” and deliver that way. If TLS is unavailable, the messages would fall back and use more secure options like PGP, S/MIME, or Escrow. Email security is easy, seamless, and automatic when communicating internally or with others who support TLS.
  3. TLS Exclusive: This is a special LuxSci-exclusive TLS sending feature. TLS Exclusive is just like Forced TLS, except that messages that can’t connect over TLS are just dropped. This is ideal for low-importance emails that must still be compliant, like email marketing messages in healthcare. In such cases, the ease of use of TLS is more important than receiving the message.
  4. TLS Only Forwarding: Account administrators can restrict any server-side email forwarding settings in their accounts from allowing forwarding to any email addresses that do not support TLS for email delivery.
  5. Encryption Escalation: Often, TLS is suitable for most messages, but some messages need to be encrypted using something stronger. LuxSci allows users to escalate the encryption from TLS to Escrow with a click (in WebMail) or by entering particular text in the subject line (for messages sent from email programs like Outlook).
  6. Domain Monitoring: When TLS delivery is enabled for SecureLine accounts, messages will never be insecurely sent to domains that purport to be TLS-enabled, i.e., TLS delivery is enforced and no longer “opportunistic.” The system monitors these domains and updates their TLS-compliance status daily.
  7. Double Encryption: Messages sent using SecureLine and PGP or S/MIME will still use Opportunistic TLS whenever possible for message delivery. In these cases, messages are often “double encrypted.” First, they are encrypted with PGP or S/MIME and may be encrypted again during transport using TLS.
  8. No Weak TLS: Unlike many organizations, LuxSci’s TLS support for SMTP and other servers only supports those protocol levels (e.g., TLS v1.0+) and ciphers recommended by NIST for government communications and which are required for HIPAA. So, all communications with LuxSci servers will be over a compliant implementation of TLS.

For customers who can use TLS to meet security or compliance requirements, it enables seamless security and “use of email as usual.” SecureLine with Forced TLS enables clients to take advantage of this level of security whenever possible while automatically falling back to other methods when TLS is unavailable.

Of course, using Forced TLS as the sole method of encryption is optional; if your compliance needs are more substantial, you can turn off TLS-Only delivery or restrict it so that it is used only with specific recipients.

If your email use cases are complicated, LuxSci’s flexibility enables the secure sending of emails to any recipient, regardless of their email service provider’s support for TLS. Contact the LuxSci sales team to learn more about our secure SMTP TLS email sending.

LuxSci Secure Texting for Healthcare Apps

How Secure Texting for Healthcare Improves Patient Portals

Patient portals were once hailed as a game-changing tool for healthcare companies to engage patients throughout their healthcare journey. In theory, they offer a convenient platform where patients and customers can access their medical records, communicate with their providers or suppliers, book appointments, and even pay bills—safely and securely. But despite the optimism around patient portals, the reality is much more complex. Adoption rates remain stubbornly low, and many patients simply don’t like using them.

So, why is this the case? More importantly, how does the relatively mediocre adoption of patient portals impact patient engagement, outcomes, and overall cost?

In this post, we’ll take a closer look at the shortcomings of patient portals, share current trends in patient and customer communication preferences, and explore how text communication can improve portal adoption and patient engagement.

Why Patient Portals Aren’t Enough

At their core, patient portals are online platforms that provide access to a range of healthcare-related services. These services typically include:

  • Access to medical records
  • Secure messaging with healthcare providers
  • Appointment scheduling
  • Prescription refill requests
  • Bill payments

These portals were designed with good intentions, but as we’ll discuss, they often fall short of delivering the seamless, user-friendly experience that people expect today.

LuxSci Secure Texting for Healthcare Apps

Preferences for Healthcare Communications

Healthcare communication preferences have shifted. Today’s patients don’t just want portals—they want a range of communication options, from phone calls and emails to secure texts. According to a 2023 survey by Accenture, patients’ preferred communication channels include:

  • Phone Calls: 62% of patients still prefer phone conversations with their healthcare providers.
  • Email: 44% like receiving emails for lab results, appointment reminders, and other updates.
  • Text Messaging: 37% of patients prefer receiving healthcare communications via text, particularly for reminders and follow-ups.
  • Patient Portals: Only 28% of patients prefer using portals for routine interactions.

There are several reasons why people are reluctant to adopt patient portals, including:

  • Complexity: Many portals can be clunky, difficult to navigate, and not user-friendly. Patients and customers often find it difficult to log in, locate their information, or contact their provider or supplier through the portal.
  • Lack of Engagement: Patients are rarely encouraged to use these portals consistently, and some are unaware they even exist.
  • Concerns About Security: While patient portals are designed to be secure, many patients still harbor concerns about their personal health information being compromised.
  • Limited Access: Some portals only provide limited access to medical records, appointment scheduling, or other information, making them less useful.

Relying solely on patient portals leaves a significant portion of patients and customers under-served. By integrating secure texting apps into their engagement strategies, healthcare providers, payers and suppliers can diversify their communication methods and connect with patients and customers more effectively across the channels they prefer.

How Secure Texting Complements Patient Portals

Secure texting apps for healthcare solve many of the issues patient portals alone cannot. By offering an additional, patient-friendly communication channel, these apps improve patient engagement and streamline interactions.

Here’s how secure texting apps work:

  • Secure Access to Patient Portals: Secure texting apps allow patients to access ePHI and other sensitive information directly from mobile devices via regular SMS text messages.
  • Instant Notifications & Alerts: Patients and customers can click on a link in text messages and view information in a secure mobile web browser on their smartphones or tablets, including appointment reminders, updates, product upgrades and promotions.
  • User-friendly: Most secure texting apps are designed with usability in mind, offering an intuitive, seamless experience  – with no new applications required.

By offering secure texting as an additional communication channel, healthcare organizations can reach more patients and customers, and improve engagement by offering patients multiple channel options for communication and easier access to portals.

Security and HIPAA Compiance

It’s essential to note that not all texting apps are appropriate for healthcare use. Traditional text messaging services don’t offer the level of encryption and security required by HIPAA regulations, making them risky for exchanging protected health information (PHI).

LuxSci’s secure texting for healthcare ensures that patient and customer communications comply with HIPAA’s strict privacy and security standards. Our secure texting solution offers encryption, authentication, and data protection, ensuring that patients can directly and safely access portals for viewing health information, treatment plans, payments, promotions and more.

Benefits of Secure Texting for Healthcare

Adopting secure texting apps for healthcare, alongside other communication tools, including email and web forms, brings numerous benefits to both patients and providers, including:

  • Increased Engagement: Patients and customers are more likely to respond and engage with providers through their preferred communication method, not just a portal.
  • Improved Outcomes and Results: Engaged patients are more likely to adhere to their treatment plans, stay informed and use the right products, improving overall health outcomes.
  • Lower Costs and Greater Efficiency: Better communication leads to fewer missed appointments, more efficient processes and greater patient participation in their healthcare journeys.
  • Greater Satisfaction: Patients and customers appreciate having a choice in how they communicate with their providers and healthcare suppliers, leading to higher satisfaction, loyalty and trust.
  • Reduce Missed Appointments: Instant notifications and reminders via text can help patients stay on top of their appointments and follow-ups.

Secure Texting is Key to Modern Healthcare Communication

Patient portals alone are no longer enough to drive the kind of patient engagement needed for optimal healthcare outcomes. By integrating secure texting apps for healthcare with other communication tools like email and web forms, providers can offer a more patient-centric approach to healthcare communication.

At LuxSci, we’re committed to helping healthcare providers offer secure, HIPAA-compliant communication solutions that improve patient engagement, outcomes and results. By giving patients the flexibility to choose their preferred communication channel—whether it’s secure texting, email, phone, or a patient portal—you can increase engagement, improve outcomes, and lower costs.

Want to learn more about secure texting for healthcare? Reach out and connect with us today!

FAQs

  1. What are secure texting apps for healthcare? Secure texting apps for healthcare are HIPAA-compliant platforms that enable encrypted, secure communication between healthcare providers and patients via text message.
  2. Why are patient portals underutilized? Patient portals often have usability issues, complex login procedures, and limited functionality, making them less appealing to patients and customers.
  3. Is secure texting HIPAA-compliant? Yes, when done through solutions like LuxSci Secure Text, communications can be encrypted and meet HIPAA’s stringent security requirements.
HIPAA Compliant Marketing Automation Tools

What are the Infrastructure Requirements For HIPAA Compliant Email?

Healthcare providers, payers, and suppliers increasingly rely on email communication for a wide variety of purposes pertaining to their patients’ and customer’s healthcare journeys. However, ensuring email messaging is both effective and HIPAA compliant requires the right infrastructure, including dedicated environments, high throughput and low latency, end-to-end encryption, scalability and compliance monitoring.

The Health Insurance Portability and Accountability Act’s (HIPAA) regulations mandate a series of data security and privacy requirements to safeguard the electronic protected health information (ePHI) contained in emails, which is a good place to start. At the same time, however, healthcare organizations must also consider deliverability best practices to ensure their messages successfully reach the intended recipients. 

With all this in mind, this post discusses the infrastructure requirements for HIPAA compliant email. We’ll explore the differences between transactional and marketing emails, as well as infrastructure and compliance considerations for each. 

What Are Transactional Emails?

Transactional emails are messages that correspond to a previous interaction between a healthcare organization and an individual. A patient or customer will trigger the delivery of a transactional email by taking a specific action – with the transaction email being confirmation of the action.  

Examples of transactional emails include:

  • Explanation of Benefits
  • Billing statements
  • Invoices
  • Appointment confirmations and reminders
  • Order updates and shipping notifications
  • Password resets and security notifications
  • Plan renewal confirmation 
  • Payment failure notifications
  • In-home care communications

Healthcare companies can also use transactional emails to communicate relevant instructions, next steps, or follow-up actions.

What Are Marketing Emails?

Marketing emails contain content designed to influence the recipient into taking a particular action, usch as ordering a new product or sign up for a new service. Subsequently, they often contain informational materials intended to educate the individual so they can make a more informed decision. 

Examples of marketing emails include:

  • New product or service launches
  • Promotional offers
  • Loyalty reward notifications 
  • Customer reviews and testimonials 
  • Educational materials or campaigns 
  • Preventative care outreach
  • Event Invitations
  • Re-engagement messages (e.g., “We Miss You!..”)

With the proper data safeguards and the effective use of ePHI, marketing emails can be personalized to be made more relevant to the recipient. This then allows patients or customers to be segmented into subgroups according to particular commonalities, e.g., age, gender, lifestyle factors, medical conditions, etc.

Opt-in Rules for HIPAA-Compliant Email Communication 

One significant difference between marketing and transactional emails is that recipients must explicitly opt-in to receive marketing emails. 

HIPAA requires explicit patient consent for marketing emails if they contain ePHI, requiring individuals to opt-in to receive email marketing communications from a healthcare organization. Neglecting to allow people to opt-in to your marketing communications leaves your company open to the consequences of HIPAA non-compliance, which include financial penalties and reputational damage. 

Conversely, healthcare organizations aren’t required to obtain opt-ins to send transactional emails, but these communications are still subject to other HIPAA regulations, such as encryption and audit logging. 

Additionally, marketing emails must comply with the CAN-SPAM Act: US legislation that governs commercial email communication and protects individuals from deceptive sales and marketing practices. The CAN-SPAM Act requires healthcare organizations to provide an opt-out mechanism in the event they no longer wish to receive marketing emails. Subsequently, you must always allow individuals to opt out of marketing emails to stay compliant.

Email Infrastructure Requirements For HIPPA-Compliance

As the vast majority of healthcare organizations need to send marketing and transactional emails, they must have the appropriate infrastructure to facilitate the optimal delivery of both types of emails. Consequently, for HIPAA compliant email, they need to establish the appropriate infrastructure configurations for each, according to their differing purposes, sending patterns, and compliance considerations. 

Let’s look at the infrastructure requirements for each email type in turn, before looking at considerations that pertain to both types of email.

Key Transactional Email Infrastructure Considerations

Transactional emails are sent to a sole patient or customer, with the information therein only intended for that specific individual. Additionally, they can be highly time-sensitive: for example, a password reset or similar emails related to logins and service use must be immediate, while order confirmations need to be delivered ASAP to reassure clients of a company’s reliability and trustworthiness. 

Accounting for this, the infrastructure requirements for transactional emails include: 

  • High Speed and Low Latency: servers that are optimized  for high IOPS (input/output operations per second) and minimal processing delays to ensure near-instant delivery
  • Dedicated IPs: this helps healthcare companies maintain a strong sender reputation to avoid blacklisting, being labelled as spam, etc. This is crucial for reliable, fast delivery. 
  • High Availability and Redundancy: this includes load balancers, failover servers, and geographically distributed data centers to ensure comprehensive disaster recovery and more robust business continuity protocols.  

Key Marketing Email Infrastructure Considerations

In contrast to transactional messages, marketing emails must often be sent out in high volumes, which could be as many as hundreds of thousands or millions per month. As a result, marketing email campaigns have different computational demands, i.e., CPU and storage, than transactional messages intended for a single person. 

Subsequently, the infrastructure requirements for marketing emails include: 

  • High Volume and Scalability: marketing messages require a larger throughput to facilitate the bulk delivery of email. Additionally, servers should scale easily to accommodate increasingly larger campaigns without suffering bottlenecks.
  • Queueing and Throttling: marketing email infrastructure must prevent sending surges that could trigger spam filters or overload recipient servers, which often results in blacklisting. 
  • Dedicated vs. Shared Infrastructure: it’s important to consider whether to opt for private versus shared infrastructure, depending on the size of your organization and the scale of your campaigns. Large senders often use dedicated IPs for better control, while smaller companies or campaigns might use shared pools with strict sender reputation management.

Key Infrastructure Considerations for Both Types of Email

Lastly, there are infrastructure requirements that apply to both types of email that will help facilitate their fast and reliable delivery, respectively. These include:     

  • Separate Infrastructure: consider hosting your transactional and marketing emails on separate servers. This benefits transactional emails in particular, as there are several factors inherent to marketing email campaigns, such as bounced emails and being flagged as spam, that affect an email IP’s reputation. Separate infrastructure maintains the integrity of a healthcare company’s IP address for transactional emails, ensuring they are delivered unimpeded. 
  • Encryption: the ePHI in all email communications must be encrypted in transit, i.e., when sent to individuals, and at rest, i.e., when stored in a database. This helps safeguard the patient data within the message, regardless of its nature. 
  • HIPAA Compliance Monitoring: remaining aware of what ePHI is included in email communications. This keeps data exposure to a minimum and mitigates the unintentional inclusion of patient data in email communications. 
  • Logging and Auditing: this not only allows you to track email activity, but you also can measure the efficacy of your email communications, who accessed ePHI, and what they did with it. This is an essential part of HIPAA compliance and will be subject to tighter regulation when the updates to HIPAA’s Security Rule come into effect in late 2025. 

HIPAA-Complaint Email Solutions From LuxSci

LuxSci offers HIPAA compliant email solutions designed to optimize the reliability and deliverability of both transactional and marketing emails.

LuxSci’s Secure High Volume Email solution offers:

  • Dedicated, high-performance infrastructure to ensure fast and reliable delivery.
  • Scalable infrastructure for high-volume email campaigns, ensuring reliability even as sent emails venture into the hundreds of thousands or millions.
  • Dedicated IPs and reputation management tools to prevent blacklisting and deliverability issues.
  • Logging, tracking, and audit trails for HIPAA compliance and security monitoring.

LuxSci’s Secure Email Marketing platform provides: 

  • Hypersegmentation for personalized patient and customer engagement.
  • Detailed tracking and reporting capabilities for performance monitoring and compliance auditing.
  • Automated campaign scheduling for reduced administrative overhead.
  • Opt-in and list management tools to ensure compliance with HIPAA and CAN-SPAM.

Discover how our solutions can meet your evolving email infrastructure requirements today.