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The Risks of Third-Party Email Integrations for Healthcare Companies

LuxSci Third Party Integrations

Today’s healthcare organizations heavily rely on a variety of third-party organizations for a range of services and products. This includes applications (i.e., SaaS solutions), suppliers, partners, and other companies depended upon to serve their patients and customers.

 

As the healthcare industry evolves, companies will need to increasingly collaborate with external parties, or business associates, which creates several dependencies and risks.

 

In particular, third-party email platforms are integral to the operations of healthcare companies, and the sensitive nature of protected health information (PHI) contained in email communications raises the stakes exponentially.

 

This post analyzes the main risks associated with third-party email integrations. From there, we detail the most effective measures for safeguarding your company from the dangers of an insecure integration with an email delivery platform.

What Are The Risks of Third-Party Email Integrations?

Email applications are a pillar of the modern workplace, enabling companies to communicate almost instantly and facilitating greater productivity and efficiency. Email has transformed the speed at which transactions can take place and individuals receive the product or service they’ve purchased.

 

Consequently, the importance of email communication and the vast amounts of sensitive data it encompasses, makes it a contrast target – or “attack vector” for cybercriminals. Hackers and other malicious actors know that if they can infiltrate an organization’s email system, they have the potential to steal vast amounts of private or proprietary data. Just as alarmingly, they may simply use an insecure email platform as a backdoor into a company’s wider network, assuming greater control over their systems in an effort to maximize their financial gain or inflict maximum damage to an organization.

 

For healthcare companies with ambitious patient engagement goals, sharing protected health information (PHI) with a reliable third-party email provider is mandatory. Unfortunately, this comes with a litany of risks, which include:

 

  1. Data Breaches: weak security features in third-party email providers can expose PHI. 
  2. Misconfigured Permissions: misconfigurations and a lack of oversight control can result in personnel at third parties having excessive access to PHI.
  3. HIPAA Non-Compliance – if the integration does not support encryption, audit logs and other features mandated by HIPAA, you may drift into non-compliant territory.
  4. Financial Implications: violating HIPAA regulations can result in financial penalties, including fines and compensation to affected parties. 
  5. Reputational Damage: companies that fall victim to cyber attacks, especially through negligence, become cautionary tales and case studies for cybersecurity solution vendors. Data exposure that comes from an insecure email platform integration can have disastrous effects on your company’s reputation. 

Therefore, mitigating the risks of integrating a third-party email platform into your IT infrastructure, platforms and systems is crucial. This includes customer data platforms (CDP), electronic health record systems (EHR) and revenue cycle management platforms (RCM). Let’s move on to specific strategies on how to do so and, subsequently, better safeguard your organization’s PHI. 

How To Mitigate Email Integration Risk

Now that you have a better understanding of the potential risks that come with integrating an insecure third-party email solution into your IT ecosystem, let’s look at risk prevention. Fortunately, several strategies will significantly lower the risk of malicious actors getting their hands on the sensitive patient data under your care. Let’s take a look:

Verify A Third-Party Vendor’s Security Practices

Before sharing PHI with a vendor, ensure they have a strong cybersecurity posture. This makes sure they have measures such as encryption, access control (or identity access management (IAM), and continuous monitoring solutions in place, in addition to conducting regular risk assessments.

 

Similarly, it’s crucial to research an email provider’s reputation, including how long they’ve been in operation, the companies they count among their clients, and their overall standing within the industry. 

Business Associate Agreements (BAAs)

A business associate agreement (BAA) is a legal document that’s required for HIPAA compliance, when sharing PHI with third-party vendors, such as email services. It ensures that both you and the vendor formally agree to comply with HIPAA regulations and your respective responsibilities in protecting patient data.

 

Without a BAA, the above point about verifying a vendor’s security practices is moot. If they’re not willing to sign a BAA, their security stance is irrelevant, as your organization would have violated HIPAA regulations by not signing a BAA. More to the point, a HIPAA compliant email vendor will be eager to highlight their willingness to sign a BAA, as it advertises their ability to safeguard PHI and aid companies in achieving compliance. 

Encrypting PHI

Encryption needs to be a major consideration when it comes to integrating a third-party email services provider. Adequate encryption measures ensure that sensitive data is protected even in the event of its exfiltration or interception. Sure, the hackers now have hold of the PHI, but with proper encryption policies and controls, it will be unreadable, preserving the privacy of the individuals affected by the data leak.

 

With this in mind, encryption measures that mitigate third-party email integrations include automated encryption, which ensures PHI is always encrypted without the need for manual configuration, and flexible encryption, which matches the encryption level with the security standards of your recipients. 

Threat Intelligence

Unfortunately, cybersecurity never stands still. With the ever-evolving nature of cyber threats, healthcare organizations must keep up with the latest dangers to patient data. This means creating a process for discovering, and acting upon, the latest threat intelligence.

 

This could entail signing up for a threat intelligence service, or retaining the periodic services of an external threat intelligence expert. 

Developing An Incident Response Plan For Vendor-Related Breaches

The alarming reality of securing PHI is that, even with robust safeguards in place, such as continuous monitoring, a process for acquiring the latest threat intelligence, and generally following the advice outlined in this post, data breaches are still a stark reality. Cyber criminals will always target healthcare organizations, due to the value and sensitivity of their data and systems. Worse, even as security measures grow more effective, the tools that malicious actors have at their disposal become more sophisticated. It’s an arms race, and one that’s only been exacerbated by the introduction of AI, with both security professionals and cyber criminals honing their use of it for their respective purposes.

 

Taking all this into consideration, having a comprehensive incident response plan in place ensures your organization responds quickly and effectively to cyber threats, or even suspicious activity. Your incident response plan should:

 

  • Detail what employees should do if they suspect malicious activity.
  • Outline steps for investigation and containment.
  • When and how to notify affected parties.
  • Processes for disaster recovery and retaining operational continuity.

While it’s vital to develop a general incident response plan, having a specific set of protocols for security breaches caused by third-party vendors is especially prudent.

Choose a HIPAA-Compliant Email Provider

An efficient and convenient way of mitigating the risks of third-party email integrations is to deploy a HIPAA compliant email delivery platform for communicating with patients and customers.

 

Being well-versed with the safety requirements of healthcare organizations, HIPAA compliant email software features all the security required to safeguard PHI. In deploying a HIPAA compliant email provider, you also implement several of the strategies outlined above, such as encryption and signing a BAA (as a HIPAA compliant will offer a BAA). Accounting for this, taking the time to select the right HIPAA compliant email provider for your organization’s needs and goals should be a key part of your overall cyber threat defense strategy. 

Train Staff on Secure Email Communication Practices

Your staff is a considerable part of securing third-party email communications, so they must know the best practices for email security and safeguarding PHI. Comprehensive cyber threat awareness training ensures your personnel understand the risks of HIPAA non-compliance and follow the procedures you’ve set in place. Furthermore, the more responsibility an employee has in regards to PHI, the more comprehensive and regular their training needs to be.

 

Additionally, training, or “drilling”, if you will, on their roles in the incident response process increases its efficacy considerably and optimizes your response to attempts at unauthorized access to data. 

How LuxSci Mitigates the Risks of Third-Party Integrations

At LuxSci, we specialize in providing secure, HIPAA compliant solutions that enable healthcare organizations to execute effective email communications and marketing campaigns.

 

With more than 20 years of experience, and helping close to 2000 healthcare organizations with HIPAA compliant email services, LuxSci has developed powerful, proven tools that sidestep the vulnerabilities often associated with third-party email integration. To learn more about how LuxSci can help your organization address the risks of third-party email integration, contact us today.

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Email Deliverability

Why is High Email Deliverability Essential for Healthcare Companies?

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.

HIPAA Email API

What is a HIPAA Email API?

A HIPAA email API is a programming interface that allows healthcare applications to send secure emails containing protected health information while maintaining compliance with HIPAA regulations. These APIs provide developers with tools to integrate encrypted email functionality into healthcare software systems while automatically handling security requirements, audit logging, and PHI protection measures. Healthcare software development increasingly requires email capabilities for patient notifications, care coordination, and administrative communications. Standard email APIs lack the security controls and compliance features necessary for healthcare applications that handle sensitive patient data.

Technical Architecture and Security Framework

REST and SOAP protocols provide the foundation for most HIPAA email APIs, enabling healthcare applications to integrate email functionality through standard web service interfaces. These protocols support secure authentication and encrypted data transmission while maintaining compatibility with diverse healthcare technology environments. Message queuing systems help manage email delivery during high-volume periods while maintaining security controls throughout the transmission process. Healthcare applications can submit emails to secure queues where they receive encryption and compliance validation before delivery to recipients. Error handling mechanisms ensure that failed email transmissions do not compromise PHI security or leave sensitive data exposed in log files. HIPAA email APIs must provide detailed error information to developers while protecting patient information from unauthorized disclosure.

Authentication and Authorization Protocols

API key management provides secure access control for healthcare applications using email services. These keys must include appropriate permissions and expiration policies that prevent unauthorized access while enabling legitimate healthcare communications, allowing healthcare applications to authenticate users and obtain appropriate permissions for sending emails on their behalf. These protocols help ensure that only authorized personnel can trigger email communications containing PHI.

LuxSci supports three industry-standard authentication methods—alongside its proprietary LuxSci Secure option. These include:

  1. OAuth 2.0 – The modern standard. Secure, flexible, and ideal for enterprise-scale integrations.
  2. API Key – Simple and efficient. Ideal for server-to-server use when convenience matters most.
  3. Basic Authentication – Straightforward, widely supported. Good for internal systems and quick testing.

For those who want the tightest possible control over API sessions—including HMAC signatures and session revocation—LuxSci Secure authentication remains the best option for customers.

Message Formatting, Template Management, and Security

MIME and S/MIME encoding support enables healthcare applications to send rich-text emails with attachments while maintaining encryption and security controls. These capabilities allow inclusion of medical images, test results, and formatted reports within compliant email communications. Template engines help healthcare developers create standardized email formats that include dynamic patient data while preventing inappropriate PHI disclosure. These systems can validate content against organizational policies before message transmission. Attachment handling procedures ensure that medical documents and images receive appropriate encryption and access controls when included in email communications. HIPAA email APIs must provide secure upload and transmission capabilities for healthcare file attachments.

Delivery Tracking and Status Reporting

Real-time delivery status updates help healthcare applications track email transmission progress and identify potential delivery issues. These status reports must provide actionable information without exposing PHI to unauthorized systems or personnel. Read receipt capabilities enable healthcare applications to confirm that recipients have accessed important medical communications. These features help care coordination while maintaining appropriate privacy protections for patient email interactions. Bounce management systems handle failed email deliveries appropriately while protecting PHI from exposure through error messages or automated responses. Healthcare applications need visibility into delivery problems without compromising patient privacy.

Compliance Logging and Audit Features

Automated audit trails capture detailed information about all email activities initiated through HIPAA email APIs. These logs must include sender identification, recipient information, transmission timestamps, and delivery status while protecting actual message content from unauthorized access. Compliance reporting features help healthcare organizations track their email usage patterns and identify potential policy violations. These reports can highlight unusual sending volumes, unauthorized recipient addresses, or messages that might violate PHI handling policies. Data retention controls ensure that API logs and message metadata comply with healthcare record-keeping requirements while managing storage costs and system performance. Healthcare organizations can configure retention periods based on their regulatory and operational needs.

Integration Patterns for Healthcare Applications

Electronic health record system (EHR), customer data platform (CDP), and Revenue Capture Management (RCM) platform integrations can enable automatic email messages and notifications to be sent based on clinical events like lab result availability or appointment scheduling changes. These integrations must respect minimum necessary standards while providing timely patient communications. Workflow automation allows healthcare applications to trigger email sequences based on patient care milestones or administrative requirements, tailoring communications based on user actions taken with each email. For example, healthcare organizations might send automated email reminders about upcoming appointments or medication refills. Batch processing capabilities enable healthcare organizations to send large volumes of patient communications efficiently while maintaining security controls and HIPAA compliance. These features support activities like appointment reminders, wellness newsletters, or billing notifications that affect many patients simultaneously.

Performance Optimization and Scalability

Rate limiting controls help healthcare organizations manage email volumes while preventing abuse or accidental bulk sending that might violate patient communication policies and damage your IP reputation. These controls can be customized based on organizational needs and user roles. Caching mechanisms improve API performance by storing frequently used templates and configuration data while maintaining appropriate security controls. These optimizations help reduce response times for healthcare applications without compromising PHI protection. Load balancing systems ensure reliable email delivery during peak usage periods when healthcare organizations send high volumes of patient communications. These systems must maintain security controls while distributing processing loads across multiple servers.

Testing and Development Support

Sandbox environments enable healthcare developers to test email functionality without exposing real patient data or sending communications to actual patients. These testing systems provide realistic API responses while using protected data that supports thorough integration testing. Documentation and code samples help healthcare development teams implement HIPAA email API functionality correctly while understanding security requirements and compliance obligations. These resources should include examples for common healthcare use cases and integration scenarios.

Finally, support services provide healthcare developers with technical assistance and compliance guidance during implementation and ongoing operations. API providers should offer expertise in both technical integration and healthcare regulatory requirements to ensure successful deployments.

LuxSci Webinar HIPAA Compliant Marketing

On-Demand Webinar: HIPAA Compliant Email Marketing – 20 Tips in 20 Minutes

Healthcare marketers and compliance professionals—this one’s for you.

LuxSci’s latest on-demand webinar, HIPAA Compliant Email Marketing: 20 Tips in 20 Minutes, delivers practical, fast-paced guidance to help you run secure, compliant, and results-driven healthcare email marketing campaigns.

Watch the Webinar

What You’ll Learn

The session is packed with actionable insights to help you safely navigate the world of HIPAA compliant email marketing, including:

  • How to leverage PHI safely and effectively for email personalization
  • Best practices for email messaging and content
  • Tips for segmenting and targeting audiences to boost engagement
  • How to stay HIPAA compliant
  • Automation and list-building strategies for smarter workflows
  • How to avoid common compliance pitfalls and reduce regulatory risk
  • Technical tips for email encryption, access protocols, and email retention and storage

Whether you’re leading digital strategy, building campaigns, or ensuring HIPAA compliance for your healthcare marketing efforts, this webinar provides timely and useful information on secure healthcare communications and what you need to know to keep you business safe and your patient data secure.

At LuxSci, we empower healthcare providers, payers, and suppliers to personalize their healthcare engagement efforts and better connect with patients and customers—securely, compliantly, and effectively.

Watch the Webinar

HIPAA Compliant Email Marketing Software

What Is a HIPAA Compliant Email API?

HIPAA compliant email API enables healthcare applications to send automated emails containing protected health information through secure programming interfaces that meet HIPAA Security Rule requirements. These APIs provide encryption, access controls, and audit logging capabilities while allowing developers to integrate email functionality into healthcare software without compromising patient privacy or regulatory compliance. Healthcare software applications increasingly need automated email capabilities for appointment reminders, test results, billing notifications, and care coordination communications. Standard email APIs lack the security features and compliance controls necessary for transmitting PHI, requiring specialized solutions designed for healthcare use cases.

API Authentication and Access Controls

HIPAA compliant email APIs implement robust authentication mechanisms that verify the identity of applications and users before allowing access to email services. These systems typically use API keys, OAuth tokens, or digital certificates to establish secure communication channels between healthcare applications and email services. Role-based access controls allow healthcare organizations to limit API functionality based on user privileges and business needs. Appointment scheduling systems might have permission to send calendar reminders while being restricted from accessing patient medical records or billing information. Rate limiting and usage tracking help prevent unauthorized bulk email sending and detect potential security threats. API providers monitor usage patterns and can automatically restrict access when they detect unusual activity that might indicate compromised credentials or malicious use.

Message Encryption and Security Features

Email messages sent through HIPAA compliant APIs receive automatic encryption during transmission and storage. These systems typically support multiple encryption standards including TLS for transport security and end-to-end encryption for message content protection. Message validation features help ensure that emails containing PHI meet compliance requirements before transmission. APIs can check for proper authorization, validate recipient addresses, and verify that message content follows organizational policies for PHI disclosure.

Secure message delivery tracking provides confirmation when recipients receive and access encrypted emails. This audit trail helps healthcare organizations demonstrate compliance with HIPAA requirements and provides documentation for potential breach investigations or regulatory audits.

Integration with Healthcare Workflows

HIPAA compliant email APIs connect seamlessly with electronic health record systems, practice management platforms, and other healthcare applications. These integrations enable automated patient communications that trigger based on clinical events, scheduling changes, or administrative milestones. Template management systems allow healthcare organizations to create standardized email formats that ensure consistent messaging while maintaining compliance controls. Templates can include dynamic content from patient records while preventing unauthorized PHI disclosure through automated formatting rules. Event-driven messaging capabilities enable real-time communications based on healthcare system activities. Laboratory systems can automatically send encrypted test results to ordering physicians immediately after completion, improving care coordination and reducing manual data entry requirements.

Audit Logging and Compliance Tracking

HIPAA compliant email APIs maintain detailed logs of all messaging activities including sender identification, recipient information, message content summaries, and delivery status. These logs provide the documentation necessary for compliance audits and breach investigations. Automated compliance reporting features help healthcare organizations track email usage patterns and identify potential policy violations. Reports can highlight unusual sending volumes, unauthorized recipient addresses, or messages that might contain inappropriate PHI disclosures.

Data retention policies ensure that API logs and message archives meet HIPAA requirements while managing storage costs and system performance. Healthcare organizations can configure retention periods based on their compliance needs and operational requirements.

Developer Tools and Documentation

API documentation provides healthcare software developers with detailed technical specifications, code samples, and integration guides for implementing HIPAA compliant email functionality. These resources help development teams understand security requirements and implement proper PHI handling procedures. Software development kits (SDKs) simplify API integration by providing pre-built libraries for common programming languages and frameworks. These tools handle encryption, authentication, and compliance features automatically, reducing the risk of implementation errors that could compromise PHI security. Testing environments allow developers to validate their integrations without exposing real patient data. Sandbox systems provide realistic API responses while using synthetic data that enables thorough testing of email functionality and error handling procedures.

Scalability and Performance Considerations

HIPAA compliant email APIs must handle varying message volumes without compromising security or compliance controls. Healthcare organizations experience different email patterns based on patient schedules, clinical activities, and administrative cycles that require flexible capacity management. Load balancing and redundancy features ensure reliable email delivery even during peak usage periods or system maintenance activities. API providers typically maintain multiple data centers and failover systems that prevent service disruptions from affecting patient communications.

Performance analytics help healthcare organizations optimize their email communications and identify potential bottlenecks in their workflows. Metrics include delivery speeds, error rates, and system response times that enable proactive performance management and capacity planning.

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Send Secure Emails: Alternatives to Web Portals

Digital technologies have entirely shifted how individuals want to interact with their healthcare providers. As consumers have become used to emailing or texting with their hairstylists, mechanics, and other providers to schedule appointments, they want to have the same level of interaction with their healthcare providers.

However, many healthcare organizations find it challenging to deliver the same experience because of their compliance requirements under HIPAA. They must balance usability and access with security and patient privacy. To send secure emails, they often resort to secure web portals. 

mail sending from phone Send Secure Emails: Alternatives to Web Portals

Problems with Secure Web Portals

One of the most common ways that healthcare organizations communicate securely with patients is by using the secure web portal method of email encryption. In this scenario, messages are sent to a secure web server, and a notification is sent to the recipient, who then logs into the portal to retrieve the message.

While highly secure, this method is not popular with recipients because of the friction it creates.

To maintain a high level of security, users must log in to a separate account to retrieve the message. This extra step creates a barrier, especially for individuals who are not tech-savvy. In addition to creating a new account, they must remember a different username and password to access their secure messages. If the recipient doesn’t have this information readily available, they will likely delete the message and move on with their day. Many users will never bother logging in because of the inconvenience. This creates issues for organizations that want to use email for standard business communications and patient engagement efforts. 

While this method may be appropriate for sending highly sensitive information like medical records, financial documents, and other valuable information, many emails that must meet compliance requirements only infer sensitive information and do not require such a high level of security. Flu shot reminder emails are not as sensitive or potentially devastating as sending the wrong medical file to someone. Healthcare organizations need to use secure email solutions that are flexible enough to send only the most sensitive emails to the portal and less sensitive emails using other methods.

How to Meet Compliance Requirements for Sending Secure Email

So, what other options do you have for sending secure emails? The answer will depend on what specific requirements you need to meet. Healthcare organizations that must abide by HIPAA regulations will find a lot of flexibility regarding the technologies they can use to protect ePHI in transit.

In addition to a secure web portal, three other types of encryption are suitable for email sending: TLS, PGP, and S/MIME. PGP and S/MIME are more secure than a web portal. They also require advanced technological skills and coordination with the end-user to implement, which makes them impractical for most business email sending.

That leaves us with TLS, which is suitable to meet most compliance standards (including HIPAA) and delivers an email experience much like that of a “regular” email.

Send Secure Emails with TLS Encryption

TLS encryption is an excellent option for secure email sending that provides a seamless experience for the recipient. Emails sent securely with TLS appear like regular, unencrypted emails in the recipient’s inbox.

TLS encrypts the message contents as they travel between mail servers to prevent interception and eavesdropping. Once the message reaches the inbox, it is unencrypted and can be read by anyone with access to the email account. For this reason, it is less secure than a portal but secure enough to meet compliance requirements like HIPAA.

If you’re wondering why this is, HIPAA only requires covered entities and business associates to protect PHI when it is stored on their systems or as it is transmitted elsewhere. After the message reaches the recipient, it is up to the recipient to decide what they want to do to secure the information. HIPAA does not apply to individuals. Each person is entitled to share and store their health information however they see fit.

Conclusion

Balancing security and usability is a significant challenge for healthcare organizations. If the message is too secure, it may be difficult for the recipient to open and engage with it. If it’s not secure enough, it is too easy for cybercriminals and other bad actors to intercept private information as it is sent across the internet. 

Choosing an email provider like LuxSci, which offers flexible email encryption options, allows users to choose the right level of encryption for each message to maximize engagement and improve health outcomes. Contact our team today to learn more about how we can support your efforts.

AI-based Email Security Threats

How to Avoid AI-Based Email Security Threats

Artificial intelligence (AI) has been the hottest topic in technology for the past few years now, with a focus on how it’s transforming business and the way we work. While we’d seen glimpses of AI’s capabilities before, the release of ChatGPT (containing OpenAI’s groundbreaking GPT-3.5 AI model) put the technology’s limitless potential on full display. Soon, stakeholders in every industry looked to find ways to integrate AI into their organizations, so they could harness its huge productivity and efficiency benefits.

The problem? Hackers and bad actors are using AI too, and it’s only strengthening their ability to carry out data breaches, including AI-based email security threats. 

While AI brings considerable advantages to all types of businesses, unfortunately, its vast capabilities can be used for malicious purposes too. With their unparalleled ability to process data and generate content, cybercriminals can use a variety of AI tools to make their attacks more potent, increasing their potential to get past even the most secure safeguards. 

With all this in mind, this post discusses how AI is helping cyber criminals massively scale their efforts and carry out more sophisticated, widespread attacks. We’ll explore how malicious actors are harnessing AI tools to make AI-based email cyber attacks more personalized, potent, and harmful, and cover three of the most common threats to email security that are being made significantly more dangerous with AI. This includes phishing, business email compromise (BEC) attacks, and malware. We’ll also offer strategic insights on how healthcare organizations can best mitigate AI-enhanced email threats and continue to safeguard the electronic protected health information (ePHI) under their care. 

How Does AI Increase Threats To Email Security?

AI’s effect on email security threats warrants particular concern because it enhances them in three ways: by making email-focused attacks more scalable, sophisticated, and difficult to detect.

Scalability 

First and foremost, AI tools allow cybercriminals to scale effortlessly, enabling them to achieve exponentially more in less time, with few additional resources, if any at all. 

The most obvious example of the scalable capabilities of generative AI involves systems that can create new content from simple instructions, or prompts. In particular, large language models (LLMs), such as those found in widely used AI applications like ChatGPT, allow malicious actors to rapidly generate phishing email templates and similar content that can be used in social engineering attacks, with a level of accuracy in writing and grammar not seen before. Now, work that previously would take email cybercriminals hours can be achieved in mere seconds, with the ability to make near-instant improvements and produce countless variations.   

Similarly, should a social engineering campaign yield results, i.e., getting a potential victim to engage, malicious actors can automate the interaction through AI-powered chatbots, which are capable of extended conversations via email. This increases the risk of a cybercriminal successfully fooling an employee at a healthcare organization to grant access to sensitive patient data or reveal their login credentials so they can breach their company’s email system. 

Additionally, AI allows cybercriminals to scale their efforts by automating aspects of their actions, and gathering information about a victim, i.e., a healthcare organization before launching an attack. AI tools also can scan email systems, metadata, and publicly available information on the internet to identify vulnerable targets, and their respective security flaws. They can then use this information to pinpoint and prioritize high-value victims for future cyber attacks.

Sophistication

In addition to facilitating larger and more frequent cyber attacks, AI systems allow malicious actors to make them more convincing. As mentioned above, generative AI allows cybercriminals to create content quickly, and craft higher-quality content than they’d be capable of through their own manual efforts. 

Again, using phishing as an example, AI can refine phishing emails by eliminating grammatical errors and successfully mimicking distinct communication styles to make them increasingly indistinguishable from legitimate emails. Cybercriminals are also using AI to make their fraudulent communications more context-aware, referencing recent conversations or company events and incorporating data from a variety of sources, such as social media, to increase their perceived legitimacy.  

In the case of another common email attack vector, malware, AI can be used to create constantly evolving malware that can be attached to emails. This creates distinct versions of malware that are more difficult for anti-malware tools to stop.

More Difficult to Detect

This brings us to the third way in which AI tools enhance email threats: by making them harder to detect and helping them evade traditional security measures. 

AI-powered email threats can adapt to a healthcare organization’s cybersecurity measures, observing how its defenses, such as spam filters, flag and block malicious activity before automatically adjusting its behavior until it successfully bypasses them. 

After breaching a healthcare organization’s network, AI offers cybercriminals several new and enhanced capabilities that help them expedite the achievement of their malicious objectives, while making detection more difficult. 

These include:  

  • Content Scanning: AI tools can scan emails, both incoming and outgoing, in real-time to identify patterns pertaining to sensitive data. This allows malicious actors to identify target data in less time, making them more efficient and capable of extracting greater amounts of PHI.  
  • Context-Aware Data Extraction: similarly, AI can differentiate between regular text and sensitive data by recognizing specific formats (e.g., medical record numbers, insurance details, social security numbers, etc.)
  • Stealthy Data Exfiltration: analyzing and extracting PHI, login credentials, and other sensitive data from emails, while blending into normal network traffic. 
  • Distributed Exfiltration: instead of transferring large amounts of data at once, which is likely to trigger cyber defenses, hackers can use AI systems that slowly exfiltrate PHI in smaller payloads over time, better blending into regular network activity.

AI and Phishing

Phishing attacks involve malicious actors impersonating legitimate companies, or employees of a company, to trick victims into revealing sensitive patient data. Typical phishing attack campaigns rely on volume and trial and error. The more messages sent out by cybercriminals, the greater the chance of snaring a victim. Unfortunately, AI applications allow malicious actors to raise the efficacy of their phishing attacks in several ways.

First, AI allows scammers to craft higher-quality messaging. One of the limitations of phishing emails for healthcare companies is that they’re often easy to identify, since they are replete with mis-spelled words, poor grammar, and bad formatting. AI allows malicious actors to overcome these inadequacies and create more convincing messages that are more likely to fool healthcare employees.  

On a similar note, because healthcare is a critical industry, it’s consistently under threat from cybercriminals, which are also known as advanced persistent threats (APTs) or even cyber terrorists. By definition, such malicious actors often reside outside the US and English isn’t their first language. 

While, in the past, this may have been obvious, AI now provides machine translation capabilities, allowing cybercriminals to write messages in their native language, translating them to English, and refining them accordingly. Consequently,  scammers can craft emails with fewer tell-tale signs that healthcare organizations can train their employees to recognize. 

Additionally, as alluded to earlier, AI models can produce countless variations of phishing messages, significantly streamlining the trial-and-error aspect of phishing campaigns and allowing scammers to discover which messaging works best in far less time. 

Lastly, as well as enhancing the efficacy of conventional phishing attacks, AI helps improve spear phishing campaigns, a type of fraudulent email that targets a particular organization or employee who works there, as opposed to the indiscriminate, “scatter” approach of regular phishing.

While, traditionally, spear phishing requires a lot of research, AI can scrape data from a variety of sources, such as social media, forums, and other web pages, to automate a lot of this manual effort. This then allows cybercriminals to carry out the reconnaissance required for successful attacks faster and more effectively, increasing their frequency and, subsequently, their rate of success. 

AI and Business Email Compromise (BEC) Attacks

A business email compromise (BEC) is a type of targeted email attack that involves cybercriminals gaining access to or spoofing (i.e., copying) a legitimate email account to manipulate those who trust its owner into sharing sensitive data or executing fraudulent transactions. BEC attacks can be highly effective and, therefore, damaging to healthcare companies, but they typically require extensive research on the target organization to be carried out successfully. However, as with spear phishing, AI tools can drastically reduce the time it takes to identify potential targets and pinpoint possible attack vectors. 

For a start, cybercriminals can use AI to undertake reconnaissance tasks in a fraction of the time required previously. This includes identifying target companies and employees whose email addresses they’d like to compromise, generating lists of vendors that do business with said organization, and even researching specific individuals who are likely to interact with the target.  

Once a target is acquired, malicious actors can use AI tools in a number of terrifying ways to create more convincing messaging. By analyzing existing emails, AI solutions can quickly mimic the writing style of the owner of the compromised account, giving them a better chance of fooling the people they interact with. 

By the same token, they can use information gleaned from past emails to better contextualize fraudulent messages, i.e., adding particular information to make subsequent requests more plausible. For example, requesting data or login credentials in relation to a new project or recently launched initiative. 

Taking this a step further, cybercriminals could supplement a BEC attack with audio or video deepfakes created by AI to further convince victims of their legitimacy. Scammers can use audio deepfakes to leave voicemails or, if being especially brazen, conduct entire phone conversations to make their identity theft especially compelling.

Meanwhile, scammers can create video deepfakes that relay special instructions, such as transferring money, and attach them to emails. Believing the request came from a legitimate source, there’s a chance employees will comply with the request, boosting the efficacy of the BEC attack in the process. Furthermore, the less familiar an employee is with attacks of this kind, the more likely they are to fall victim to them.   

In short, AI models make it easier to carry out BEC attacks, which makes it all the more likely for cybercriminals to attempt them.

AI and Malware 

Malware refers to any kind of malicious software (hence, “mal(icous) (soft)ware”), such as viruses, Trojan horses, spyware, and ransomware, all of which can be enhanced by AI in several ways.

Most notable is AI’s effect on polymorphic malware, which has the ability to constantly evolve to bypass email security measures, making malicious attachments harder to detect. Malware, as with any piece of software, carries a unique digital signature that can be used to identify it and confirm its legitimacy. Anti-malware solutions traditionally use these digital signatures to flag instances of malware, but the signature of polymorphic malware changes as it evolves, allowing it to slip past email security measures. 

While polymorphic malware isn’t new, and previously relied on pre-programmed techniques such as encryption and code obfuscation, AI technology has made it far more sophisticated and difficult to detect. Now, AI-powered polymorphic malware can evolve in real-time, adapting in response to the defense measures it encounters. 

AI can also be used to discover Zero Day exploits, i.e., previously unknown security flaws, within email and network systems in less time. Malicious actors can employ AI-driven scanning tools to uncover vulnerabilities unknown to the software vendor at the time of its release and exploit them before they have the opportunity to release a patch.

How To Mitigate AI-Based Email Security Threats

While AI can be used to increase the effectiveness of email attacks, fortunately, the fundamentals of mitigating email threats remains the same; organizations must be more vigilant and diligent in following email security best practices and staying on top of the latest threats and tools used by cybercriminals. 

Let’s explore some of the key strategies for best mitigating AI-based email threats and better safeguarding the ePHI within your organization.

  • Educate Your Employees: ensure your employees are aware of how AI can enhance existing email threats. More importantly, demonstrate what this looks like in a real-world setting, showing examples of AI-generated phishing and BEC emails compared to traditional messages, what a convincing deepfake looks and sounds like, instances of polymorphic malware, and so on.

    Additionally, conduct regular simulations, involving AI-enhanced phishing, BEC attacks, etc., as part of your employees’ cyber threat awareness training. This gives them first-hand experience in identifying AI-driven email threats, so they’re not caught off-guard when they encounter them in real life. You can schedule these simulations to occur every few months, so your organization remains up-to-date on the latest email threat intelligence.
     
  • Enforce Strong Email Authentication Protocols: ensure that all incoming emails are authenticated using the following:
    • Sender Policy Framework (SPF): verifies that emails are sent from a domain’s authorized servers, helping to prevent email spoofing. 
    • DomainKeys Identified Mail (DKIM): preserves the integrity of the message’s contents by adding a cryptographic signature, mitigating compromise during transit, e.g., stealthy or distributed data exfiltration. 
    • Domain-based Message Authentication, Reporting & Conformance (DMARC): enforces email authentication policies, helping organizations detect and block unauthorized emails that fail SPF or DKIM checks.

By verifying sender legitimacy, preventing email spoofing, and blocking fraudulent messages, these authentication protocols are key defenses against AI-enhanced phishing and business email compromise (BEC) attacks.

  • Access Control: while AI increases the risk of PHI exposure and login credential compromise, the level of access that a compromised or negligent employee has to patient data is another problem entirely. Subsequently, data breaches can be mitigated by ensuring that employees only have access to the minimum amount of data required for their job roles, i.e. role-based access control (RBAC). This reduces the potential impact of a given data breach, as it lowers the chances that a malicious actor can extract large amounts of data from a sole employee.
  • Implement Multi-Factor Authentication (MFA): MFA provides an extra layer of protection by requiring users to verify their identity in multiple ways. So, even in the event that a cybercriminal gets ahold of an employee’s login credentials, they still won’t have sufficient means to prove they are who they claim to be.
  • Establish Incident Response and Recovery Plans: unfortunately, by making them more scalable, sophisticated, and harder to detect, AI increases the inevitability of security breaches. This makes it more crucial than ever to develop and maintain a comprehensive incident response plan that includes strategies for responding to AI-enhanced email security threats.

    By establishing clear protocols regarding detection, reporting, containment, and recovery, your organization can effectively mitigate, or at least minimize, the impact of email-based cyber attacks enhanced by AI. Your incident response plan should be a key aspect of your employee cyber awareness training, so your workforce knows what to do in the event of a security incident. 

Get Your Copy of LuxSci’s 2025 Email Cyber Threat Readiness Report

To learn more about healthcare’s ever-evolving email threat landscape and how to best ensure the security and privacy of your sensitive data, download your copy of LuxSci’s 2025 Email Cyber Threat Readiness Report. 

You’ll discover:

  • The latest threats to email security in 2025, including AI-based attacks
  • The most effective strategies for strengthening your email security posture
  • The upcoming changes to the HIPAA Security Rule and how it will impact healthcare organizations.

Grab your copy of the report here and start increasing your company’s email cyber threat readiness today.

Healthcare Marketing Trends

Healthcare Marketing Trends

Let’s take a look at key healthcare marketing trends to be aware of and how they can impact your results.

Email Deliverability 

Thanks to Google and Yahoo, significant changes happened for email marketers in 2024. As we’ve previously written about, Google and Yahoo are implementing new requirements for bulk email senders that will involve a lot of coordination and effort for marketers. Beyond the initial implementation of technical requirements like SPF, DKIM, and DMARC records, marketers must pay close attention to their spam rates in the future. Keeping your spam reports below 0.3% will be essential to ensure that Google and Yahoo aren’t blacklisting your emails. Marketers must keep their email lists clean, craft relevant campaigns, and use technology to remove unengaged contacts promptly. Over two billion people use Google or Yahoo as their email provider, so adopting these standards is not optional.

Artificial Intelligence

Healthcare marketers are also looking at ways to use artificial intelligence to save time and automate processes with tools like ChatGPT, DALL-E, and Midjourney. Now, marketers are seriously evaluating tools that can assist with business processes like copywriting, graphic design, data analysis, and other functions.

However, it’s essential to carefully vet any artificial intelligence tool if you plan to use it in your marketing efforts. What data sets is it trained on? Are they biased? Is the information accurate? Some tools introduce legal compliance risks, and it’s essential to understand the risks thoroughly.

Trust is essential in healthcare marketing, and relying too heavily on AI tools can create a negative patient experience. AI tools should not replace marketers. At best, these tools can help marketers complete their work. Guardrails are required when it comes to AI tools, and healthcare marketers should be cautious to ensure their brands are well-represented by the output of these tools.

Automation and APIs

Another way to save time and measure results is using APIs and automation. Many marketers are turning to automation tactics to streamline operations in the face of increasing budgetary pressure. Advanced email marketers can use email APIs to trigger email campaigns and automated workflows when specific criteria are met, including user engagement with emails, and use dynamic content to personalize the healthcare journey. These tactics make email marketing scalable and ensure your audience receives the proper communications at the right time. 

APIs can also be used to organize the results of your marketing efforts. Email APIs can deliver data about your campaigns (delivery status, open and clicks, unsubscribes, number secured, etc.) back into your marketing dashboards and databases. This is a way to help you make informed decisions and improve your marketing results. Expect to see more marketers embrace automation alongside AI tools this year. 

Personalization

Personalization continues to be extremely important to successful healthcare marketing efforts. This is a challenge for healthcare providers because they must comply with HIPAA regulations in their email communications. Luckily, with the right tools and patient permission, it’s possible to personalize emails to create relevant campaigns, including using PHI in emails and messaging. When healthcare marketers have access to zero-party patient data and the right tools to execute, they can go beyond practice newsletters to create email campaigns that deliver results.

Proving Impact and Delivering ROI

Healthcare providers continue to face a challenging economic situation and may be forced to cut marketing budgets. Although some advertising channels may be forced to take a hiatus, email marketing should not be one of them. Not only do patients want to receive marketing communications via email, but email marketing also delivers one of the best returns on investment compared to other channels.

However, the way we track and measure the impact of marketing campaigns must also change. In 2024, open rates started becoming less reliable indicators of marketing success. Apple Mail’s privacy features and the increasing prevalence of email filtering and spam tools mean that marketers will need to rely on different metrics to judge the success of their campaigns. Tracking the clicks and what actions users take in other channels after receiving the email is crucial to understanding the effectiveness of your campaigns – and making adjustments to improve results. Also, keeping email lists clean and removing unsubscribed and inactive users is more important than ever to keep your IP addresses from being throttled.

Contact us today if you want to go deeper in any of these aread and how they can impact your business.

What are the 5 Stages of Patient Engagement Framework?

The patient engagement framework consists of five progressive stages: inform, consult, involve, collaborate, and empower. This approach helps healthcare organizations build stronger relationships with patients while improving health outcomes. The framework guides providers in developing communication strategies, technological tools, and care processes that move patients from passive recipients of care to active partners in their health management.

Patient Engagement Framework Foundations

The patient engagement framework builds upon healthcare’s evolution toward more patient-centered care models. This structured approach acknowledges that patients have varying levels of activation and readiness to participate in their healthcare decisions. The framework helps organizations assess their current engagement practices and develop strategies for improvement. Healthcare providers use these stages to map communication approaches and technology implementations that support increasing patient participation. Each stage of the patient engagement framework requires different tools, processes, and organizational capabilities. Understanding these elements helps healthcare organizations develop realistic roadmaps for advancing their engagement efforts.

Stage One: Inform

The first stage of the patient engagement framework focuses on providing patients with clear, accessible health information. At this level, communication flows primarily from provider to patient through educational materials, discharge instructions, and basic health literacy resources. Organizations develop content in multiple formats and languages to accommodate diverse patient populations. Digital patient portals typically begin at this stage with features like lab result viewing and appointment scheduling. Healthcare teams establish consistent messaging across departments to avoid confusing or contradicting information. While this stage is the beginning of the patient engagement framework, many organizations struggle to advance past informing patients about their conditions and treatments.

Stage Two: Consult

The consultation stage of the patient engagement framework opens two-way communication channels between providers and patients. Healthcare teams seek patient input about symptoms, preferences, and treatment experiences through surveys, feedback forms, and structured conversations. Providers begin recognizing patients as valuable sources of information about their own health situations. Digital tools expand to include secure messaging and symptom reporting capabilities. Care teams develop protocols for responding to patient communications within appropriate timeframes. The consultation phase of the patient engagement framework begins establishing the base for more collaborative relationships while still maintaining traditional healthcare hierarchies. Organizations generally measure success at this stage through patient satisfaction metrics and communication response rates.

Stage Three: Involve

The third stage of the patient engagement framework actively involves patients in treatment planning and health monitoring. Patients participate in goal-setting discussions and receive tools for tracking health metrics between appointments. Healthcare teams incorporate patient preferences and priorities when developing care plans. Technology platforms introduce self-management tools and educational resources tailored to individual health conditions. Care protocols expand to include regular check-ins and progress evaluations beyond scheduled appointments. The involvement stage of the patient engagement framework marks a significant shift toward recognizing patients as active participants rather than passive recipients.

Stage Four: Collaborate

Collaboration represents the fourth stage in the patient engagement framework, where patients function as true partners in their care team. Health professionals and patients make treatment decisions jointly, weighing clinical evidence alongside patient goals and preferences. Healthcare systems establish patient advisory councils to inform organizational policies and program development. Technology platforms integrate patient-generated health data with clinical systems to create comprehensive health pictures. Team-based care models include patients in case conferences and care planning sessions. The collaborative stage of the patient engagement framework requires organizational culture changes that value patient perspectives alongside clinical expertise. Healthcare systems reaching this stage often demonstrate better care coordination and reduced unnecessary utilization.

Stage Five: Empower

The final stage of the patient engagement framework focuses on empowering patients to manage their health independently when appropriate. Patients receive comprehensive tools and knowledge to make informed healthcare decisions aligned with their personal values. Organizations support patient autonomy while maintaining appropriate clinical oversight for complex conditions. Technology platforms provide personalized insights and recommendations based on individual health patterns. Care teams function as coaches and consultants rather than directing all aspects of patient care. The empowerment phase of the patient engagement framework acknowledges patients as the primary drivers of their health management with healthcare providers serving supportive roles.

Implementing the Patient Engagement Framework

Healthcare organizations implement the patient engagement framework through gradual, strategic changes to clinical processes, technology systems, and organizational culture. Leadership commitment proves essential for allocating necessary resources and championing patient-centered approaches. Staff training addresses both technical skills and communication methods appropriate for each engagement stage. Technology selection focuses on tools that can evolve alongside advancing engagement capabilities. Progress measurement includes both process indicators and outcome metrics tied to each framework stage. Organizations typically find that different service lines and patient populations may operate at different engagement levels simultaneously, requiring flexible implementation approaches. The patient engagement framework provides a roadmap while allowing organizations to adapt implementation to their unique circumstances and patient populations.