Is Outlook a HIPAA Compliant Email?

HIPAA Compliant Email
Erik Kangas
September 30, 2024

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.

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Know the Biggest Email Threats Facing Healthcare Right Now

July 16, 2025
Pete Wermter

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

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

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

Ransomware Attacks

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

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

Email Client Misconfiguration

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

Common types of email misconfiguration include:

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

Social Engineering Attacks

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

Phishing

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

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

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

Domain Impersonation and Spoofing

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

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

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

Insider Email Threats

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

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

Business Email Compromise (BEC) Attacks

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

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

BEC attacks come in several forms, such as:

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

Supply Chain Risk

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

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

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

Download LuxSci’s Email Cyber Threat Readiness Report

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

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

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

What is the Best HIPAA Compliant Email?

July 10, 2025
Erik Kangas

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

HIPAA Compliant Email Features

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

Popular HIPAA Compliant Email Platforms

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

Security Considerations for Healthcare Communications

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

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

Client Experience and Usability Factors

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

HIPAA Compliant Email Implementation for Medical Practices

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

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

Cost Considerations For Selecting Email Services

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

Integrating Email with Broader Practice Security

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

Why is High Email Deliverability Essential for Healthcare Companies?

June 30, 2025
Pete Wermter

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

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

Speed and Efficiency

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

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

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

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

Compliance with HIPAA Regulations

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

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

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

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

Greater Levels of Personalization and Engagement

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

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

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

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

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

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

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

Is There a HIPAA Compliant Email?

June 26, 2025
Erik Kangas

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

Types of HIPAA Compliant Email Solutions

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

Security Features in HIPAA Compliant Email Platforms

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

Business Associate Agreements and Vendor Requirements

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

Implementation Challenges and Solutions

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

Cost Considerations for HIPAA Compliant Email

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

Selecting the Right HIPAA Compliant Email Solution

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

Is Microsoft Forms HIPAA Compliant?

December 9, 2024
Erik Kangas

Microsoft Forms is considered HIPAA compliant only when properly configured within a Microsoft 365 Enterprise or Business environment with an executed Business Associate Agreement (BAA). Unlike various competing products, Microsoft includes Forms among its covered services in its BAA, allowing healthcare organizations to collect protected health information when implemented with proper security controls and organizational policies.

Microsoft Business Associate Agreement Coverage

Microsoft offers a BAA that covers Microsoft Forms when used within a properly licensed Microsoft 365 environment. This agreement establishes Microsoft as a business associate under HIPAA regulations and defines responsibilities for protecting healthcare information. The BAA covers Microsoft Forms along with other Microsoft 365 services such as Exchange Online, SharePoint Online, and Teams. Healthcare organizations must execute this agreement before using Microsoft Forms to collect protected health information. The BAA establishes contractual protections beyond standard terms of service and the requirements of becoming HIPAA compliant.

Required Configuration for HIPAA Compliance

Making Microsoft Forms HIPAA compliant requires specific configuration beyond simply signing a BAA. Organizations must implement appropriate access controls using Microsoft 365 administrative settings to restrict form creation and data access to authorized personnel. Enabling audit logging through the Microsoft 365 Compliance Center helps track who creates, modifies, and accesses form data. Organizations need to configure retention policies that align with HIPAA record-keeping requirements. Multi-factor authentication adds an essential security layer for employees accessing protected health information. These technical controls work together to create a compliant environment for collecting patient information.

Security Features in Microsoft Forms

Microsoft Forms includes several security capabilities that support HIPAA compliance requirements. The platform encrypts data both during transmission and storage within Microsoft’s infrastructure. Access controls integrate with Microsoft 365 identity management to restrict form data visibility. Audit capabilities track form creation, modification, and response activities. Microsoft’s cloud infrastructure meets various compliance certifications beyond HIPAA, including FedRAMP, ISO 27001, and SOC standards. These underlying security measures provide the technical foundation for compliant form implementation when properly configured.

Limitations and Compliance Considerations

While Microsoft Forms can be HIPAA compliant, certain limitations require attention from healthcare organizations. The standard form templates do not include healthcare-specific authorization language required by the HIPAA Privacy Rule. Organizations must customize forms to include appropriate patient consent statements and privacy notices. Certain advanced features like form branching may create complexity in tracking what information appears to which respondents. Organizations need policies governing form creation and approval to ensure all necessary compliance elements appear consistently. These limitations require procedural controls beyond technical configuration.

Implementation Best Practices

Healthcare organizations implementing Microsoft Forms for collecting protected health information can benefit from following established best practices. Creating standardized form templates with pre-approved compliance language helps maintain consistency. Limiting form creation permissions to trained staff members reduces compliance risks. Regular privacy and security training for all employees who handle form data improves organizational awareness. Conducting periodic audits of form content and access patterns identifies potential compliance issues. Integrating forms with secure document storage in SharePoint improves information governance. These practices can enhance the security of patient information collected through electronic forms.

Alternative Form Solutions and Considerations

Microsoft Forms can be considered HIPAA compliant, but organizations should evaluate whether it provides the optimal solution for their needs. Specialized healthcare form platforms may offer additional features like electronic signature capture, direct EHR or CDP integration, or healthcare-specific templates. Microsoft Forms works best for organizations already invested in the Microsoft 365 ecosystem who need integrated form capabilities. The decision between Microsoft Forms and alternatives like LuxSci depends on factors including existing technology investments, integration requirements, complexity of form needs, and organizational resources for configuration and maintenance.

Is Google Drive HIPAA Compliant?

September 19, 2024
Erik Kangas

Google Drive can be HIPAA compliant when used with Google Workspace (formerly G Suite) under a Business Associate Agreement (BAA) and with proper configuration. Standard consumer Google Drive accounts do not meet HIPAA requirements. Healthcare organizations must implement specific security settings, access controls, and usage policies to maintain Google Drive HIPAA compliant status. These measures help ensure protected health information remains secure while benefiting from cloud storage capabilities.

Google’s Business Associate Agreement

Healthcare organizations must obtain a Business Associate Agreement from Google before storing any protected health information in Google Drive. This agreement establishes Google as a business associate under HIPAA regulations and outlines their responsibilities for protecting health data. Google offers this BAA as part of Google Workspace (formerly G Suite) business plans, but not for personal Google accounts. The agreement specifically covers Google Drive among other Google services. Organizations should review the BAA carefully to understand which Google services are covered and what responsibilities remain with the healthcare organization. This legal foundation is essential for any Google Drive HIPAA compliant implementation.

Required Security Configurations

Making Google Drive HIPAA compliant requires enabling several security features available in Google Workspace. Two-factor authentication adds an additional verification layer beyond passwords. Advanced protection program features defend against phishing and account takeover attempts. Drive access controls restrict file sharing to authorized users within the organization. Data loss prevention rules can identify documents containing patient information and apply appropriate protection policies. Audit logging must be enabled to track file access and modifications. Organizations need to configure these settings through the Google Workspace admin console rather than relying on default configurations.

File Sharing and Access Controls

Proper management of file sharing is a large aspect of Google Drive HIPAA compliant usage. Healthcare organizations should establish policies restricting how files containing protected health information can be shared. External sharing controls can prevent staff from accidentally exposing patient data outside the organization. Domain-restricted sharing limits file access to users within the organization’s Google Workspace account. Link-based sharing should be disabled for sensitive documents or carefully restricted with additional authentication requirements. Role-based access permissions ensure users can only view files necessary for their job functions. These access controls prevent both accidental exposure and unauthorized access to patient information.

Encryption and Data Protection

Google Drive HIPAA compliant implementation relies on proper encryption to protect healthcare information. Google provides encryption for data in transit between users’ devices and Google servers using TLS. Data at rest in Google Drive receives encryption with AES-256 bit keys. Organizations should use Google Workspace Client-side encryption for particularly sensitive files to maintain control of encryption keys. Staff should avoid downloading protected health information to local devices unless absolutely necessary and with appropriate security measures. Encryption serves as a fundamental protection layer that helps maintain confidentiality even if other security measures fail.

Audit and Monitoring Capabilities

HIPAA regulations require tracking who accesses protected health information. Google Workspace offers audit logging features that support HIPAA compliance. These logs record user activities including file access, sharing changes, and document modifications. Organizations should configure appropriate retention periods for these logs to support compliance verification. Security monitoring tools can analyze these logs to identify unusual access patterns or potential policy violations. Regular review of these logs helps identify potential security issues before they lead to breaches. These monitoring capabilities also provide documentation during compliance audits.

Staff Training Requirements

Technical controls alone cannot ensure compliance without proper staff education. Organizations using Google Drive HIPAA compliant configurations must train staff on appropriate usage policies. Training should cover what types of information can be stored in Google Drive, appropriate sharing practices, and security feature usage. Staff need to understand the risks of downloading sensitive information to personal devices. Regular refresher training helps maintain awareness as features and threats evolve. Documentation of this training provides evidence of compliance efforts during regulatory reviews. Even with robust technical controls, human behavior remains a critical factor in maintaining HIPAA compliance.

How to Improve Patient Engagement with Secure Communications

October 29, 2024
LuxSci

As people demand more personalized experiences from their healthcare companies and providers, patient engagement is increasingly emerging as a top priority. With increasing demands for digital-first interactions and more connected healthcare journeys from their patients and customers, healthcare organizations must evolve their communication strategies to meet these new expectations. In fact, more than ever, today’s healthcare patients and customer expect the same efficient and personalized experiences that they have with other businesses, including retail and financial services.

In this article, we explore two key strategies for improving patient and customer engagement: employing a multi-channel approach and personalization. We’ll show you how each concept improves your communication strategy, while ensuring HIPAA compliance at the same time.

The Growing Importance of Patient Engagement

Today’s healthcare industry is undergoing significant changes – some might even call it outright disruption. With new and varied services like Telehealth, Remote Care, In-Home Care, Connected Care, Value-Based Care, and more, clear and targeted communication has never been more vital for effectively improving patient engagement and driving greater levels of participation in an individual’s healthcare journey.

Another key thing to bear in mind is that today’s patients and customers already have increasing expectations for convenient, personalized, and secure interactions with their healthcare providers. According to a report from McKinsey & Company, over 70% of patients prioritize the ability to communicate with their healthcare providers, payers and suppliers through their preferred channels. However, these preferences vary significantly across age groups, highlighting the importance of a multi-channel communication strategy; let’s explore those preferences now.

Patient Engagement Preferences by Age Group

The chart below, compiled from recent research findings, highlights the varying communication channel preferences by age group, helping healthcare companies craft their engagement strategies accordingly:

Channel	Gen Z (18-25)	Millennials (26-40)	Baby Boomers (57-75)
Phone	10%	35%	55%
Email	20%	35%	45%
Text	40%	45%	15%
Patient Portals	30%	45%	25%
Face-to-Face	15%	25%	60%

By understanding these differences, healthcare organizations can implement and continually refine multi-channel marketing strategies that cater to the unique preferences of each demographic group. Key takeaways include:

Baby Boomers (57 – 75 years old) still prefer phone calls (55%) and face-to-face interactions (60%), though there is preference in email (45%) for certain types of communication, such as appointment reminders and post-care instructions.
Millennials (26 – 40 years old) tend to favor asynchronous methods that fit into their busy schedules, i.e., phone, text, and email. This age group is tech-savvy, with half also using patient portals for managing their healthcare options.
As digital natives, Gen Z patients lean heavily toward digital channels, with text messaging (40%) and patient portals (30%) as top choices. They, more than any other group, expect fast, responsive communication, which makes secure, real-time digital options essential.

Catering to patients’ communication channel preferences ensures they feel better heard and, as a result, more valued. This will result in them becoming more involved in their healthcare journey, leading to higher rates of satisfaction, being more receptive to new services or products, and, most importantly, better health outcomes.

Multi-Channel Communication: Meeting Patients Where They Are

Healthcare providers, payers and suppliers need a multi-channel strategy, that incorporates email, text, patient portals, and phone calls to match the different communication preferences of their diverse patient and customer bases.

A single-channel, or siloed, approach is far less effective, as each demographic interacts with healthcare providers in unique ways. In light of this, offering communication options across multiple channels makes it easier to reach patients – and for them to participate in their healthcare journeys on their preferred terms.

Benefits of multi-channel communication include:

Increased Engagement: Patients and customer are more likely to respond and engage through their preferred communication method, whether that’s by text, email, portal or over the phone.
Improved Satisfaction: receiving timely, personalized updates makes patients feel more connected and satisfied with care.
Better Adherence to Care Plans: patients who receive reminders or follow-ups through their preferred channels are more likely to adhere to care plans, attend appointments, and follow medical advice.
Upselling and Cross-Selling Opportunities: when healthcare providers and suppliers connect with patients and customers over the channel of their choice they are more likely to reach their target audience and attract qualified prospects for new services and products, as well as upgrades to existing ones.

Take Personalization Further by Using PHI in Communications

After unprecedented numbers of people were forced to adapt to digital solutions during the COVID-19 pandemic, personalization is no longer optional or “a nice to have” – but an expectation among patients and customers. The healthcare industry is no exception to this with personalized communications greatly enhancing efficiency and driving favorable outcomes.

Securely harnessing protected health information (PHI) is critical to effective personalization across a broad range of use cases, including care management, marketing and preventative care. It’s important to appreciate, however, that personalization in healthcare engagement goes beyond merely addressing patients by their names; it includes tailoring messages, reminders, renewals, recommendations, and offers based on their medical history, treatment plans, personal characteristics (age, gender, etc.), and ongoing health needs.

Examples of PHI-driven personalization include:

Appointment Reminders: personalized reminders based on the patient’s treatment plan can reduce no-show rates.
Post-Procedure Follow-Ups: securely sending follow-up instructions and health updates specific to the patient’s condition leads to better adherence and recovery rates.
Targeted Preventative Care Campaigns: using patient data to create campaigns around vaccinations, screenings, annual tests, or chronic disease management helps address individual health needs.
Marketing campaigns: delivering targeted campaigns to highly segmented groups of patients and customers, e.g., offers for the latest in-home blood pressure monitor for patients suffering from hypertension.

However, using PHI in communications requires strict adherence to HIPAA regulations and a broad set of data security safeguards and best practices. LuxSci’s Secure Healthcare Communications Suite enables healthcare organizations to safely use PHI in digital communications, ensuring compliance for email, text, marketing and data collection forms, while providing all the required functionality for personalizing your communications to create the desired impact.

Why Secure Healthcare Communication is Crucial

Data breaches in the healthcare industry are consistently on the rise, and, unfortunately, they show no signs of abating. In fact, between 2009 and 2023, healthcare data breaches resulted in the exposure of more than a half billion patient records. Healthcare companies are prime targets for cyberattacks, because of the sensitivity of the data they possess and the critical importance of their services.

Consequently, the fines for healthcare companies that fail to sufficiently protect PHI and fall victim to data breaches can extend into the millions. The reputation damage, however, can be far more costly, with it often being beyond repair.

LuxSci is the most experienced provider of HIPAA-compliant email and secure healthcare communication solutions, working with organizations of all sizes: from local and regional practices to large healthcare systems, providers and suppliers, including Athenahealth, Delta Dental, 1800 Contacts, and Rotech Healthcare.

Our comprehensive HIPAA-compliant communications platform includes:

HIPAA-Compliant Email: send millions of secure emails every month with our Secure High Volume Email solution, or make your Google Workspace or Microsoft 365 email HIPAA-compliant with our Secure Gateway Product
Secure Text Messaging: reach patients quickly and securely with appointment reminders, health updates, and other communications via text. Connect them directly into their patient portals via their desktop or mobile device —with no application installation required.
Secure Marketing: proactively connect with your customers with HIPAA-compliant email marketing campaigns for increased engagement, lead generation and sales.
Secure Forms: safely collect, store, access and analyze PHI data from patients to optimize workflows and generate insights that allow you to refine your long-term strategies.

If you’d like to learn more about how to take your patient and customer engagement to the next level, all while remaining compliant with HIPAA regulations, contact us today!

12 Key Questions to Ask Before Sending HIPAA-Compliant Marketing Emails

October 30, 2024
LuxSci

So – you’ve just been told that your email marketing program is putting your company at risk of violating HIPAA.

Ok. What now?

If you want to continue your email-based patient engagement efforts – without the risk of the financial, operational, and reputational risk that accompanies the exposure of sensitive patient data, you must implement HIPAA compliant email marketing practices.

This is comprised of two components: becoming HIPAA-compliant, setting up the required systems and procedures to ensure your PHI (PHI) and EPHI (EPHI) are protected, and your marketing objectives, who you want to reach and what to communicate.

However, you don’t have to let your marketing objectives suffer for the sake of security.

Implementing a HIPAA-compliant marketing program can actually help you achieve better marketing results.

Asking yourself these 12 questions ensures your email marketing campaigns align with your business goals and are HIPAA-compliant.

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HIPAA-Compliant Marketing Emails

1. Do you have security controls to protect access to your email marketing system?

2. Do you have a documented procedure to guide you HIPAA-compliant email marketing?

3. Can you send encrypted emails?

4. Do you have a complete understanding of your organization’s PHI and ePHI?

5. Do you have a required training process for anyone sending HIPAA-compliant marketing emails?

6. Do you have effective protection against malware?

7. Do you have valid Business Associate Agreements (BAA) in place?

8. Why am I sending this email?

9. Is my email’s subject line standing out?

10. What is the recipient’s brand and product awareness level?

11. Have I tested my message for readability?

12. Have I sent my message to a test email account?

HIPAA-Compliant Marketing Emails

If your organization requires HIPAA-compliant email, start by using these questions to inspect your email marketing for compliance. Note that while we can’t provide legal advice, the below questions will help you identify some of the most common points of vulnerability and non-compliance.

1. Do you have security controls to protect access to your email marketing system?

Email security is an essential component of being HIPAA-compliant. As a starting point, check your internal security processes for access restrictions. This includes:

A robust password policy, i.e., changed frequently (e.g., 30 days), has to contain a mixture of characters, etc.
Multi-factor authentication (MFA), i.e., users verifying their identity in multiple ways, e.g., username/password and sent number codes (text, email, key fob, etc.), biometrics, etc.
Role-based access controls, i.e., granting access to individuals based on the responsibilities of their job role.
Zero Trust Architecture (ZTA), i.e., “never trust, always verify” – where users are required to reconfirm their identity on a case-by-case basis, as opposed to once when logging on, which mitigates session hijacking and similar threats.

2. Do you have a documented procedure to guide you HIPAA-compliant email marketing?

“Winging it” simply doesn’t cut it when it comes to HIPAA-compliant email marketing; you must develop a comprehensive documented process detailing how you intend to safeguard PHI throughout your email marketing campaigns.

This should include:

Specifying the HIPAA-compliant email delivery service you’ll use to execute your marketing campaigns

The processes and controls you’ll use to encrypt data for ePHI at rest and in transit

The access and authentication controls you have in place

How you’ll implement data minimization: only using the minimum necessary PHI in communications – and not including sensitive PHI unless it’s essential.
How you’ll securely dispose of data: Implement a process for securely deleting emails containing ePHI once they’re no longer needed, to comply with retention policies.
Staff training: educating employees involved in email marketing on how to securely handle PHI and other HIPAA requirements.
Incident response plan, i.e., an additional documented plan for how you’ll respond to data breaches and other cyber attacks; this also includes notifying any affected parties as mandated by HIPAA.

If you’re starting from scratch, the information contained in the answers to the questions in this article provides a useful starting point for creating your first procedure.

3. Can you send encrypted emails?

If you are sending highly sensitive data or PHI in your emails, be aware that HIPAA requires the data to be encrypted a rest, i.e., the storage medium where it resides, and in transit, when being sent to recipients.

To the surprise of many healthcare organizations, most major email marketing providers, such as Mailchimp and Constant Contact are unable to provide encryption for data in transit and only protect data in their systems. To avoid falling foul of HIPAA regulations, ensure that the email delivery platform you use to transmit messages containing PHI offers end-to-end encryption.

4. Do you have a complete understanding of your organization’s PHI and ePHI?

Much of the time, when we, as well as healthcare providers, talk about PHI, we’re actually referring to electronic protected health information (EPHI). While PHI is a catch-all term to account for all sensitive health information, in truth, in the digital age, the vast majority is stored electronically in data centers – and the patient data handled is EPHI.

You can discover “PHI” and “ePHI” within the context of your organization’s context by identifying and categorizing the PHI and ePHI typically handled in your business. It’s an absolutely crucial tenet of data protection that you simply can’t protect what you’re not aware of.

Comprehensive PHI categorization will help your staff navigate HIPAA-compliant email requirements.

5. Do you have a required training process in place for anyone sending HIPAA-compliant marketing emails?

Your HIPAA compliance program, as with your company’s overall cybersecurity posture, is only as strong as your weakest link. In light of this, it’s essential to educate the staff within your company who are involved in your healthcare engagement campaigns on the secure use of ePHI and HIPAA-compliant marketing practices.

Additionally, this needs to be reflected in your onboarding process, so new hires are made familiar with HIPAA regulations, should their role require it.

6. Do you have effective protection against malware?

In the unlikely event you need any further encouragement to revisit your company’s anti-malware (viruses, ransomware, Trojans, etc.) measures, there are always HIPAA compliance requirements!

To better protect your sensitive customer data against a slew of increasingly sophisticated cyber threats, start with these three key considerations:

Do you have anti-malware protection running on all of your organization’s devices? Additionally, does this extend to your employee’s personal devices on which they handle PHI?
How frequently do you update your anti-malware solution?
Does your email marketing provider have sufficient protection malware mitigation measures in place, as per HIPAA requirements?

7. Do you have valid Business Associate Agreements (BAA) in place?

It’s normal to outsource activities like email marketing to a third party, but for the service they provide to be HIPAA-compliant, you must have a business associate agreement (BAA) in place.

A BAA documents how two organizations will share PHI and under what circumstances. A BAA also details the legal responsibilities of each party in the event of a serious issue. With a BAA being a core component of HIPAA compliance, failure to have one in place with your email service provider is an immediate HIPAA violation – and one that can result in serious consequences for a healthcare company.

Getting Better Results from HIPAA-Compliant Email Marketing

Now that you’ve confirmed your systems are HIPAA-compliant, let’s move on to making sure your email marketing strategy aligns with your overall business objectives.

In pursuit of this, the following questions serve as a handy “monthly review” for refining the effectiveness of your email-based patient outreach efforts .

8. Why am I sending this email?

First and foremost, for the best results, each email you send should have a single, clearly defined purpose.

I know what you’re thinking – “my customers and patients are smart, they can handle multiple points in a single message.” And while that’s true, at whatever point your email reaches a recipient, they’re already juggling several different priorities at once. While they’re capable of juggling multiple points in a message – they’re unlikely to want to; when it comes to email marketing, a single goal is the best way to go.

Similarly, it’s important to remember that your email is one of dozens – or hundreds – received by your patient that day. So, if your message is long and overly complicated, the reader will likely skip over or delete it.

9. Is my email’s subject line standing out?

Following on the above point, is your email subject line impactful enough to stand out amidst the pile of messages that will land in the patient’s inbox that day? The email subject line is the most important part of your email because it’s responsible for persuading the reader to open your message.

Despite this, many marketers still use terrible, ineffective subject lines and wonder why their emails are failing to produce results!

For the best results, write up three to ten subject lines for your next email, step away for 5-10 minutes, and then choose the headline you determine as best.

Consider these examples to check your understanding:

Ineffective Email Subject Lines

Blank (no subject): writing nothing in the subject line
Clinic Newsletter (tell them more, e.g., the subject or theme for the month)
Overusing exclamation marks!!!

Effective Email Subject Lines (examples based on a dental practice)

BRAND-NEW Dental Product Released Today
How to Cut Down on Your Health Insurance Paperwork
[Case Study] How We Helped 3 Ex-Smokers Get White Teeth

10. What is the recipient’s brand and product awareness level?

Whether promoting medical devices, new digital solutions technology, or any healthcare product or service, understanding the prospect’s awareness level is essential.

If your email is designed to introduce a brand-new product, stick to high-level features and benefits while avoiding technical jargon and granular product details. Conversely, if you’re writing an email to experienced, highly knowledgeable readers, going into greater depth makes sense.

Advanced list management and segmentation tools, as offered by Luxsci Secure Marketing, are key for ensuring the communications you send match the reader’s awareness level.

11. Have I tested my message for readability?

Do you know one of the reasons that Hemingway was popular? He was skilled at writing short phrases and phrases. Consequently, his writing was easy to understand and appealed to a wide variety of people. When in doubt, keep your writing short and free of jargon, abbreviations and “insider” terms.

When you’re deeply involved in the details of your business, it’s so easy to overlook just how much specialized jargon and language you frequently use. However, if you want your communications to engage with patients and customers, they need to be as accessible as possible.

Fortunately, there are simple solutions to this, with tools like the Text Readability Calculator that are designed to quickly enhance the readability of your emails.

12. Have I sent my message to a test email account?

Finally, if you’ve followed all of the above advice, you’re almost ready to hit SEND…there’s just one more thing you need to check.

Determine how your email will look to recipients, including its clarity, and readability by simply sending a test email to one of your own email accounts once it is received.

In particular, pay attention to how the subject line looks and test all the links in the email to ensure they take the reader through to the intended destination, such as a product or service page. A broken link will only frustrate the recipient – who was interested enough to click through, no less – and lower your conversion rate.

Better still, send the test email to a colleague somebody and ask for their opinion about the quality of the message and whether it creates the desired impression.

Demystifying HIPAA-Compliant Email Marketing

As the most experienced HIPAA-compliant email provider, LuxSci specializes in providing secure and HIPAA-compliant solutions for companies aiming to send hundreds of thousands – or millions – of emails. Our hypersegmentation tools allow you to precisely target an unlimited number of patient sub-populations to maximize the efficacy of your messaging.

Are you interested in discovering how LuxSci’s secure email marketing platform will streamline your healthcare engagement efforts?