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Sending HIPAA Compliant Email the Right Way

Sending HIPAA Compliant Email

Maintaining HIPAA compliance is a critical requirement for healthcare providers, payers and suppliers dealing with protected health information (PHI). Ensuring your email communications align with those standards can be, well… tricky. With fines reaching into the millions, non-compliance isn’t something you want to risk. We’ve seen it time and time again when engaging with our customers and prospects. Unfortunately, many organizations fall into the trap of believing they’re sending HIPAA compliant emails because they’ve applied what we call “self-certification” strategies—without fully understanding what’s required to be compliant.

Are you 100% sure that you’re sending HIPAA compliant emails?

In this blog post, we’ll delve into the risks of being non-compliant, explain why self-certification strategies often lead to problems, and provide a HIPAA-compliant email checklist to help ensure your organization avoids the pitfalls self-compliance.

The Importance of Sending HIPAA Compliant Emails

HIPAA (Health Insurance Portability and Accountability Act) was established to ensure the protection and privacy of patients’ PHI. This law mandates that any entity handling PHI must implement strict safeguards to prevent unauthorized access, breaches, and exposure of sensitive patient data.

In today’s digital world, where healthcare communications often take place over email and other digital platforms, maintaining HIPAA compliance becomes even more complex. It’s not enough to merely think you’re compliant; you must be able to prove it beyond a doubt.

What Is PHI and Why Does It Need to Be Protected?

As a quick reminder, PHI refers to any data that can be used to identify an individual and that relates to their past, present, or future health condition. This can include anything from personal identification information to medical records and billing information to email exchanges that reference patient care.

Examples of PHI include:

  • Names
  • Addresses
  • Birth dates
  • Social Security numbers
  • Medical history and diagnoses
  • Treatment plans & prescriptions
  • Medical device usage and services
  • Appointment information
  • Billing, payments and insurance information

The Risks of Not Being 100% Sure About HIPAA Compliance

In addition to losing sleep at night, the consequences of sending non-compliant emails can be significant. Non-compliance can result in hefty penalties, ranging from $100 to $50,000 per violation, depending on the severity and intent. In some cases, these fines can even surpass $1.5 million annually.

But it’s not just the fines—PHI exposure opens the door to a variety of serious risks, including the reputational damage that can stem from breaches of patient data that can impact peoples’ lives and the future of your business. Patients place immense trust in healthcare providers and organizations to safeguard their sensitive information, which stretches beyond HIPAA-compliance to overall data security and privacy. The loss of patient trust is difficult—if not impossible—to regain once compromised.

Sending HIPAA Compliant Email

The Problem with DIY HIPAA Compliance

Simply put, self-certifying HIPAA compliance is a recipe for disaster. Many companies and healthcare organizations falsely believe that if they conduct an internal review or have implemented basic security measures, they’re fully compliant. But without the right expertise and the right technology in place, especially encryption, it’s easy to overlook crucial details.

Even if you have encryption in place or think your emails are safe, these minimal steps can create a false sense of security. True HIPAA compliance requires continuous monitoring, updating of policies, and regular training to address potential risks.

A Checklist for Sending HIPAA Compliant Email

Sending HIPAA compliant email means ensuring you’ve implemented the following safeguards:

1. Encryption Standards for HIPAA Compliance

All emails containing PHI must be encrypted both at rest and in transit—end-to-end. Ensure your email service provider offers high-grade encryption protocols, like TLS (Transport Layer Security), for sending and receiving messages, and flexible options, including dedicated cloud infrastuctures for the highest levels of data protection.

2. Secure Access and Authentication

Set up multi-factor authentication (MFA) and role-based access controls to limit who can access emails containing PHI.

3. Business Associate Agreements (BAA)

If you’re using a third-party email provider, you must have a signed BAA. This agreement ensures that the provider will uphold HIPAA’s security standards.

4. Data Backup and Recovery

Make sure your email system has a secure backup and recovery solution. Data breaches can happen, but having a recovery plan will minimize damage and maintain compliance.

5. Employee Training and Awareness

Ensure your employees are regularly trained on HIPAA guidelines. Human error is one of the leading causes of HIPAA violations, so proper education is key.

6. Regularly Audit Your HIPAA Compliance Strategy & Practices

HIPAA regulations evolve as technology advances. Conducting regular compliance audits ensures your security protocols are up to date with the latest best practices.

7. Avoiding Overconfidence in Your Own Processes

No matter how confident you are in your HIPAA strategy, bringing in an external auditor can provide an unbiased view of your compliance status and help identify overlooked vulnerabilities.

Don’t Let HIPAA Self-Certification Fool You!

HIPAA compliance is not something you can afford to be unsure about. The risks—both financially and reputationally—are too great. While it may be tempting to “self-certify” or assume your current measures are sufficient, doing so can leave your organization—and your patients and customers—vulnerable. Instead, ensure that you follow a comprehensive strategy that includes best-in-class email encryption, secure access, regular audits, employee training, and support from external experts.

Don’t take shortcuts when it comes to protecting sensitive health information and ensuring HIPAA compliance—get it right from the start.

If you’d like to get your questions on sending HIPAA compliant email answered, don’t hesitate to reach out to talk with one of our experts—and learn more about the healthcare industry’s leading HIPAA-compliant email, text and marketing solutions from LuxSci.

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Most Popular LuxSci Blog Posts of 2025

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

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

1. Improve Email Engagement and Marketing Results with Automated Workflows

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

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

2. Healthcare Email Threat Readiness Strategies

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

Read the full post: Healthcare Email Threat Readiness Strategies

3. HIPAA Compliant Email — 20 Tips in 20 Minutes

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

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

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

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

Read the full post: Is SendGrid HIPAA-Compliant?

5. LuxSci Shines in G2 Winter 2026 Reports

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

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

Looking Ahead to 2026

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

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HIPAA compliant email

LuxSci Welcomes Angel Mazariegos as Head of Finance

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

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

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

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

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

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

HIPAA Compliant Email

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

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

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

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

Why G2 Matters

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

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

What We Earned in Winter 2026

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

  • Grid Leader
  • Highest User
  • Best Support
  • Best Estimated ROI

This broad range of accolades spanning leadership, adoption, support and return on investment underscores the reliability of our solutions and the trust our customers place in us.

Awards Reflect Our Commitment to Customer Success

Reliable. Winning Grid Leader and Highest User Adoption demonstrates that thousands of users are depending on LuxSci, securely delivering emails to today’s most popular platforms, including Gmail, Apple Mail, Yahoo Mail and AOL, to name a few.

Proven. With Best Estimated ROI, customers are saying that LuxSci delivers tangible results, whether in secure email delivery, regulatory compliance, or operational efficiency.

Long‑Term Trust. Best Support is perhaps the most telling because for us, success isn’t just about features, it’s about being there for our customers every step of the way.

Thank you to all of our customers. We remain committed to your success — today and in the future.

Want to learn more about LuxSci? Reach out and connect with us today!

HIPAA Compliant Email

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

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

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

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

1. The Shared Responsibility Model

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

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

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

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

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

But, it’s not that simple.

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

3. Not All Solutions or Features Are HIPAA Compliant

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

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

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

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

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

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

5. Essential Security Features Cost Extra 

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

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

6. The Importance of Staff Training on HIPAA

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

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

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

LuxSci: Fully HIPAA Compliant – No Hidden Surprises

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

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

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LuxSci Email Tracking Features

New Email Tracking Features Deliver More Accurate Engagement Insights

Today, we’re excited to announce two new reporting features designed to help healthcare organizations improve reporting accuracy and the overall effectiveness of their email campaigns. The new features offer deeper insights into Apple Mail and Google email performance by distinguishing between opens and clicks performed by human actions and automated events — and by giving users control over how these events are reflected in LuxSci email campaign reporting.

Let’s dive into what these features are and how they can help you get more precise data from your healthcare email marketing and communications efforts.

Feature 1: Enhanced Open and Click Tracking – Human vs. Automated

One of the biggest challenges in email tracking today is the rise of automated systems that pre-load images and scan links in emails. Automated systems can trigger open or click events without the recipient actually interacting with the email, leading to inflated and misleading open/click rates.

With LuxSci’s new enhanced open and click tracking, you can now tell whether Apple Mail and Google emails (Gmail and Google Workspace) were opened or a link was clicked by a human or by an automated system. This crucial distinction allows you to have a much clearer picture of actual user engagement.

Here’s how it works:

  • When emails are sent with open tracking enabled, a small tracking image (also known as a pixel) is embedded in the email. When that image is loaded, the system tracks the email as “opened.”
  • Similarly, links in the email are encoded to track clicks. If a recipient clicks a link, it triggers a “clicked” event, but these events can also be triggered by automated systems.
  • LuxSci’s enhanced open and click tracking feature analyzes these events and reports whether the actions were performed by a human or an automated system, helping you sift through false positives.

Feature 2: Suppressing Automated Events in Your Reporting

In addition to tracking the source of open and click events, LuxSci’s second new feature gives you the option to exclude automated events from Apple Mail and Google email from your email engagement statistics altogether. This setting, available in account-wide outbound email settings, is a powerful tool for ensuring the accuracy of your reports and understanding true user engagement.

Here’s how it works:

  • Automated opens and clicks can be removed from email reporting for better accuracy. For example, if a security bot clicks a link, that event will be logged, but it won’t mark the email as “clicked” in your statistics.
  • Your open, click, and click-through rates can be set to only reflect real human actions, making these metrics much more reliable for evaluating campaign performance and actual patient engagement.

Why These Features Matter for Healthcare Email Marketing

For healthcare organizations, reliable metrics are essential. Emails often carry critical information related to patient care, transactions, or marketing, and understanding who is engaging with your content is critical to ongoing improvement and long-term success. At the same time, automated actions can inflate your open and click rates, leading to inaccurate conclusions about your email performance.

LuxSci’s new features give you the power to:

  • Track email engagement with precision: Know the difference between human engagement and automated actions, so your metrics reflect reality.
  • Customize your reporting: Decide whether you want to include or suppress automated events in your reports.
  • Improve deliverability strategies: By analyzing which emails are genuinely opened or clicked by real people, you can fine-tune your email campaigns to maximize their effectiveness.

Ready to Enhance Your Email Tracking?

Take control of your email deliverability insights with LuxSci’s newest email tracking tools. Whether you want to gain deeper insights into recipient behavior or eliminate noise from automated systems, these features are designed to help you improve your email reporting, performance and engagement.

For current LuxSci customers, you can learn more about these features in the Support Library, under Support, when you are logged into your account.

If you’re new to LuxSci, reach out today and we’d be happy show you the power of our secure, HIPAA-complaint healthcare communications solutions, including high volume email, text, forms and marketing solutions. Contact us here.

HIPAA Compliant

Can a Website Be HIPAA Compliant?

A website can be HIPAA compliant when it incorporates security measures, privacy protections, and data handling practices that meet HIPAA regulatory requirements. Healthcare organizations must implement encryption, access controls, audit logging, and secure data storage for websites that collect, store, or transmit protected health information. A well configured HIPAA compliant website helps healthcare providers maintain patient privacy while offering online services.

HIPAA Website Requirements

Websites handling protected health information must meet the standards established in the HIPAA Security Rule. These requirements include encryption for data transmission using protocols like TLS 1.2 or higher. Access controls limit website data viewing to authorized personnel with appropriate login credentials. Audit logging tracks all user activities and data access attempts across the website. Session timeouts automatically log out inactive users to prevent unauthorized access. Regular security testing identifies and addresses potential vulnerabilities. These measures work together to protect patient information from unauthorized access or disclosure.

Website Hosting and Infrastructure

HIPAA compliant hosting provides the foundation for a secure healthcare website. When selecting a hosting provider, healthcare organizations look for companies willing to sign a Business Associate Agreement (BAA). This legal document establishes the hosting provider’s responsibilities for protecting health information. The physical location of servers matters, with many HIPAA compliant services using data centers with restricted access, environmental controls, and monitoring systems. Network protection typically includes firewalls, intrusion detection, and regular security updates. Organizations often choose dedicated hosting environments rather than shared servers to maintain data separation.

Patient Data Collection and Forms

Most healthcare websites collect information through online forms. HIPAA compliant websites include appropriate authorization language on these forms before gathering protected health information. Well-designed websites explain how patient data will be used in clear, accessible language. Form data requires protection both during transmission and after submission. Many websites use secure database connections and encryption for stored information. Healthcare organizations determine what information they actually need to collect, following the minimum necessary standard from HIPAA regulations. User-friendly form design can improve completion rates while maintaining compliance.

Secure Patient Portals and Interaction

Patient portals on HIPAA compliant websites allow secure access to medical records, appointment scheduling, and provider communications. These portals employ authentication measures like password requirements and account recovery processes. Many implement automatic timeout features that log out inactive users after a set period. Secure messaging features enable patient-provider communication without using standard email. The best patient portals maintain detailed logs of all system access and actions. Healthcare organizations integrate these portals with their electronic health record systems for data consistency and accuracy.

Mobile Responsiveness and App Integration

Modern HIPAA compliant websites function across various devices while maintaining security protections. Mobile responsive design allows patients to access information securely from smartphones and tablets. When healthcare organizations develop companion mobile apps, these applications need the same HIPAA compliance measures as their websites. Integration between websites and mobile applications requires secure API connections and consistent authentication methods. Many healthcare providers test their digital platforms across multiple devices to ensure both functionality and security. The mobile experience influences patient satisfaction with digital healthcare services.

Compliance Maintenance

Healthcare websites require regular updates and monitoring to maintain HIPAA compliance over time. Technology changes quickly, and security measures that worked previously may become outdated. Website administrators perform regular security scans and vulnerability testing. Organizations document these maintenance activities as evidence of compliance efforts. Staff training helps ensure everyone handling website data understands privacy requirements. As regulations evolve, websites need corresponding updates to privacy notices and security features. Many healthcare organizations work with compliance consultants who specialize in digital healthcare requirements.

Best HIPAA Compliant Email Providers

What Makes PHI Email Compliant with HIPAA Requirements?

PHI email becomes compliant through end-to-end encryption, access controls, audit trails, and secure transmission protocols. Healthcare organizations must implement email solutions that encrypt protected health information both in transit and at rest, maintain detailed logs of all communications, and restrict access to authorized personnel only. Medical practices encounter the challenges of patient information travelling through digital communication channels, as each message contains names, medical record numbers, or treatment details. Patient communications flow through healthcare systems constantly, creating numerous opportunities for data exposure. Email messages containing appointment confirmations, lab results, or billing inquiries must receive the same protection level as paper records stored in locked cabinets. The difficulty increases when metadata reveals patient-provider relationships without obvious identifying information appearing in message content itself.

Email Encryption Methods Protect Patient Data

Healthcare email platforms deploy Advanced Encryption Standard protocols with 256-bit keys to render intercepted messages unreadable without proper decryption credentials. Transport Layer Security protocols shield communications during transmission between mail servers, while storage encryption protects messages residing in email systems. These protection layers work to secure PHI email whether traveling across networks or sitting in user mailboxes.

Identity-based encryption provides an alternative where recipients authenticate through secure web portals instead of managing encrypted attachments with complex passwords. Patients log into portal systems once and access their messages without downloading files or remembering multiple authentication credentials for different healthcare providers.

User Access Controls Prevent Information Breaches

Multi-factor authentication requires users to provide passwords, mobile verification codes, and sometimes biometric data before accessing PHI email systems. Staff members receive permissions aligned with their job responsibilities, preventing billing personnel from reading clinical notes while restricting nurses from accessing financial communications. These permission structures eliminate accidental information exposure between healthcare departments.

Session timeouts automatically disconnect users after inactivity periods, and systems monitor failed login attempts to detect potential unauthorized access. Organizations document access permissions and conduct monthly reviews to ensure appropriate information boundaries. Employee departures trigger immediate email access revocation to prevent data exposure after employment ends.

Monitoring Systems Track Message Activities

Modern PHI email platforms record message creation, transmission, delivery, viewing, forwarding, and deletion activities. These logs include timestamps, user identifications, and recipient information that create detailed records for compliance reviews and incident investigations. Healthcare organizations must preserve these records for six years and provide them during HIPAA audits.

Behavioral analysis systems detect unusual patterns like mass message downloads during off-hours or attempts to redirect communications to personal email accounts. Security teams receive immediate notifications when suspicious activities occur, enabling rapid investigation of potential breaches or unauthorized access attempts.

Vendor Contracts Define Compliance Obligations

Email service providers handling patient information must execute business associate agreements outlining their compliance responsibilities. These contracts address data protection standards, breach notification timelines, and audit cooperation requirements. Cloud email providers must prove their systems meet HIPAA standards through independent security assessments.

Healthcare organizations bear liability for vendor compliance failures, making thorough evaluation processes necessary before selecting email platforms. Assessment procedures examine data storage locations, infrastructure security measures, and incident response capabilities to ensure adequate protection throughout the technology supply chain.

Employee Education Prevents Security Violations

Training programs teach staff to identify phishing attempts, follow acceptable use policies, and handle PHI email appropriately. Organizations conduct simulated phishing exercises to evaluate employee responses to suspicious messages and provide additional education for those requiring improvement. Policies clarify when staff should use secure messaging platforms instead of traditional email systems.

Content filtering systems scan outgoing messages for Social Security numbers, medical record numbers, and other patient identifiers. When these systems detect sensitive information, they automatically apply encryption or prevent message transmission until users implement appropriate security measures.

Performance Tracking Ensures Program Effectiveness

Healthcare organizations monitor encryption usage rates, policy compliance scores, and incident response times to evaluate their PHI email programs. Monthly assessments examine compliance trends and identify areas where system improvements or additional training could strengthen protection. Risk evaluations examine emerging threats and technology changes that might affect email security.

Compliance teams review email policies quarterly and update procedures based on regulatory developments or security incidents. System testing verifies that encryption, access controls, and monitoring functions operate correctly under various usage conditions, ensuring patient communications receive consistent protection through all organizational email activities.

encrypted email transmission

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

SMTP TLS encryption is popular because it provides adequate data protection without creating a complicated user experience for email recipients. Sometimes, though, the experience is too seamless, and recipients may wonder if the message was protected at all.

Luckily, there is a way to tell if an email was encrypted using TLS. To see if a message was sent securely, we can look at the raw headers of the email. However, it requires some knowledge and experience to understand the text. It is actually easier to tell if a recipient’s server supports TLS than to tell if a particular message was securely transmitted.

To analyze a message for transmission security, we will look at an example email message sent from Hotmail to LuxSci. We will explain what to look for when decoding the message headers and how to tell if the email was transmitted using TLS encryption.

An Example Email Message

First, we must understand how an email message typically travels through several machines on its way from the sender to the recipient. Roughly speaking:

  1. The sender’s computer talks to the sender’s email or WebMail server to upload the message.
  2. The sender’s email or WebMail server then talks to the recipient’s inbound email server and transmits the message to them.
  3. Finally, the recipient downloads the message from their email server.

It is step 2 that people are most concerned about when trying to understand if their email message is transmitted securely. They usually assume or check that everything is secure and OK at the two ends. Indeed, most users who need to can take steps to ensure that they are using SSL-enabled WebMail or POP/IMAP/SMTP/Exchange services so that steps 1 and 3 are secure. The intermediate step, where the email is transmitted between two different providers, is where messages may be sent insecurely.

To determine if the message was transmitted securely between the sender’s and recipient’s servers (over TLS), we need to extract the “Received” header lines from the received email message. If you look at the source of the email message, the lines at the top start with “Received.” Let’s look at an example message from a Hotmail user below. The email addresses, IPs, and other information are obviously fake.

LuxSci:

The Outlook email was sent to a LuxSci user. The Received headers appear in reverse chronological order, starting with the server that touched the message last. Therefore, in this example, we see the LuxSci servers first.

Received: from abc.luxsci.com ([1.1.1.1])
	by def.luxsci.com (8.14.4/8.13.8) with ESMTP id r7JEfLgH003867
	(version=TLSv1/SSLv3 cipher=DHE-RSA-AES256-SHA bits=256 verify=NOT)
	for <user-xyz@def.luxsci.com>; Mon, 19 Aug 2019 10:41:21 -0400
Received: from abc.luxsci.com (localhost.localdomain [127.0.0.1])
	by abc.luxsci.com (8.14.4/8.13.8) with ESMTP id r7JEfK0Z030182
	for <user-xyz@def.luxsci.com>; Mon, 19 Aug 2019 09:41:20 -0500
Received: (from mail@localhost)
	by abc.luxsci.com (8.14.4/8.13.8/Submit) id r7JEfKXD030178
	for user-xyz@def.luxsci.com; Mon, 19 Aug 2019 09:41:20 -0500
Received: from dispatch1-us1.ppe-hosted.com (dispatch1-us1.ppe-hosted.com [2.2.2.2])
	by abc.luxsci.com (8.14.4/8.13.8) with ESMTP id r7JEfIkK030002
	(version=TLSv1/SSLv3 cipher=DHE-RSA-AES256-SHA bits=256 verify=NOT)
	for <someone@luxsci.net>; Mon, 19 Aug 2019 09:41:19 -0500

Proofpoint:

LuxSci uses an email filtering service, Proofpoint. Messages reach Proofpoint’s servers before being delivered to LuxSci. Here’s what their servers report about the email transmission:

Received: from unknown [65.54.190.216] (EHLO bay0-omc4-s14.bay0.hotmail.com)
	by dispatch1-us1.ppe-hosted.com.ppe-hosted.com
        (envelope-from <someone@hotmail.com>);
	Mon, 19 Aug 2019 08:41:18 -0600 (MDT)

Outlook:

And finally, here’s what we see from Oultook’s server.

Received: from BAY403-EAS373 ([65.54.190.199]) by bay0-omc4-s14.bay0.outlook.com
       with Microsoft SMTPSVC(6.0.3790.4675); 
       Mon, 19 Aug 2019 07:41:19 -0700

How to Use Received Message Headers to Tell if the Email is Encrypted

The message headers contain information that can help us determine if an email is encrypted. Here are a few helpful notes to help you decode the text:

  1. We said this above, but the message headers appear in reverse chronological order. The first one listed shows the last server that touched the message; the last one is the first server that touched it (typically the sending server).
  2. Each Received line documents what a server did and when.
  3. There are three sets of servers involved in this example: one machine at Hotmail, one machine at Proofpoint, where our Premium Email Filtering takes place, and some machines at LuxSci, where final acceptance of the message and subsequent delivery happened.

Presumably, the processing of email within each provider is secure. The place to be concerned about is the hand-offs between Hotmail and Proofpoint and between Proofpoint and LuxSci, as these are the big hops across the internet between providers.

In the line where LuxSci accepts the message from Proofpoint, we see:

(version=TLSv1/SSLv3 cipher=DHE-RSA-AES256-SHA bits=256 verify=NOT)

This section, typical of most email servers running “sendmail” with TLS support, indicates that the message was encrypted during transport with TLS using 256-bit AES encryption. (“Verify=not” means that LuxSci did not ask Proofpoint for a second SSL client certificate to verify itself, as that is not usually needed or required for SMTP TLS to work correctly). Also, “TLSv1/SSLv3” is a tag that means that “Some version of SSL or TLS was used;” it does not mean that it was SSL v3 or TLS v1.0. It could have been TLS v1.2 or TLS v1.3.

So, the hop between Proofpoint and LuxSci was locked down and secure. What about the hop between Hotmail and Proofpoint? The Proofpoint server’s Received line makes no note of security at all! This means that the email message was probably not encrypted during this step.

Hotmail either did not support opportunistic TLS encryption for outbound emails, or Proofpoint did not support receipt of messages over TLS, and thus, TLS could not be used. With additional context, you can know which server supports TLS and which does not.

In this case, we know that Proofpoint supports inbound TLS encryption. In fact, from another example message where LuxSci sent a message to Proofpoint, we see the Received line:

Received: from unknown [44.44.44.44] (EHLO wgh.luxsci.com)
	by dispatch1-us1.ppe-hosted.com.ppe-hosted.com
        (using TLSv1.2 with cipher ECDHE-RSA-AES256-GCM-SHA384 (256/256 bits))
	with ESMTP id b-022.p01c11m003.ppe-hosted.com
        (envelope-from <from@domain.com>);
	Mon, 02 Feb 2009 19:28:27 -0700 (MST)

The red text makes it clear that the message was indeed encrypted. Based on the additional context, we can deduce that the Hotmail sending server did not securely transmit the email using TLS.

How To Tell if an Email is Encrypted With TLS

  1. When analyzing your message headers, consider the following items to determine if the email is encrypted:
    1. The receiving server will log what kind of encryption, if any, was used in receiving the message in the headers.
    2. Different email servers use different formats and syntax to display the encryption used. Look for keywords like “SSL,” “TLS,” and “Encryption,” which will signify this information.
    3. Not all servers will record the use of encryption. While LuxSci has always logged encryption use, not every email service provider does. It is possible to use TLS encryption and not log it. Sometimes, there is no way to tell from the headers if a message is encrypted if it is not logged.
    4. Messages passed between servers at the same provider do not necessarily need TLS encryption to be secure. For example, LuxSci has back-channel private network connections between many servers so that information can be securely passed between them without SMTP TLS. So, the lack of TLS usage between two servers does not mean the transmission between them was “insecure.” You may also see multiple received lines listing the same server: the server passes the message between different processes within itself. This communication also does not need to be TLS encrypted.
    5. If you are a LuxSci customer, you can view online email delivery reports to see if TLS was used for any particular message. We record the kind of encryption in the delivery reports, so it’s easy to see which emails were encrypted.

How can you Ensure Emails Are Securely Transmitted?

With some servers not recording TLS in message headers, how can you determine if a message was transmitted securely from sender to recipient?

To answer this question accurately, you must understand the properties, servers, and networks involved. It may be easy to determine that the message was transmitted securely if included in the header information. However, the absence of information does not necessarily mean the message was insecurely transmitted. You can only know this if you know what each system’s servers record.

In our example of a message from Hotmail to LuxSci, you need to know that:

  1. Proofpoint and LuxSci will always log the use of TLS in the headers. We can infer that the Hotmail to Proofpoint transmission was not secure as nothing was recorded there.
  2. The transmission of messages within LuxSci’s infrastructure is secure due to private back channel transmissions. So, even though there is no mention of TLS in every Received line after LuxSci accepts the message from Proofpoint (in this example), transferring the messages between servers in LuxSci is as secure as using TLS. Also, the same server can add multiple received lines as it talks to itself. Generally, these hand-offs on the same server will not use TLS, as there is no need. In the LuxSci example, we see this as “abc.luxsci.com” adds several headers.
  3. We don’t know anything about Hotmail’s email servers, so we don’t know how secure the initial transmissions within their network are. However, since we know they did not securely transmit the message to Proofpoint, we are not confident that the transmissions and processing within Hotmail (which may have gone unrecorded) were secure.

Was the email message sent and received using encryption?

We skipped steps 1 and 3 and focused on step 2 – the transmission between servers. Steps 1 and 3 are equally, if not more, necessary. Why? Because eavesdropping on the internet between ISPs is less of a problem than eavesdropping near the sender and recipient (i.e., in their workplace or local wireless hotspot). So, it’s essential to ensure messages are sent securely and received securely. This means:

  • Sending: Use SMTP over SSL or TLS when sending messages from an email client or use WebMail over a secure connection (HTTPS).
  • Receiving: Ensure your POP or IMAP connection is secured via SSL or TLS. If using WebMail to read your email, be sure it is over a secure connection (HTTPS).
  • WebMail: There is generally no record in the email headers to indicate if a message sent using WebMail was transmitted from the end-user to WebMail over a secure connection (SSL/HTTPS).

You can typically control one side and ensure it is secure; you can’t control the other without taking extra steps. So, what can you do to ensure your message is secure even if it might not be transmitted with encryption or if the recipient tries to access it insecurely?

You could use end-to-end email encryption (like PGP or S/MIME, which are included in SecureLine) or a secure web portal that doesn’t require the recipient to install or set up anything to get your secure email message. These methods meet HIPAA and other regulatory compliance requirements for secure data transmission and provide complete confidence that the message will be sent and received securely.

LuxSci’s SecureLine offers flexible encryption options, including TLS, secure web portal, PGP, and S/MIME. Its dynamic capabilities can determine what types of encryption the recipient’s server supports to ensure your emails are always sent securely. Contact our team today to learn more about how to secure your emails.