What Are the 4 Ps of Healthcare Marketing

Healthcare Email Marketing, Healthcare Marketing
Erik Kangas
October 4, 2024

Successful healthcare marketing combines four key elements – Product, Price, Place, and Promotion – to effectively reach patients, customers and healthcare partners. These marketing principles guide product and service development, pricing, delivery methods, campaign strategies and promotional activities. Marketing teams should apply these concepts, while meeting healthcare regulations and patient privacy standards.

Product Development in Healthcare

Medical services, products and treatments are core offerings in healthcare marketing. Organizations develop product and service lines based on community health needs and market opportunities. Product planning includes new medical technologies, treatment protocols, and patient care programs. Marketing teams should work with clinical departments to define features and benefits. Patient needs and competitor offerings must be researched to identify product and service gaps in your own offerings. Product development also should consider insurance coverage requirements and reimbursement rates. Teams should then create product and service descriptions and marketing content and materials that accurately represent your capabilities and benefits.

Healthcare Pricing Strategies

Price planning in healthcare marketing balances product and service costs, market rates, and patient accessibility. Organizations should analyze insurance reimbursement levels, operating expenses, and competitive pricing. Marketing teams should also develop pricing communications that help patients understand their financial responsibilities, working with billing departments to create clear cost explanations and payment options. Effective pricing strategies include considerations for different insurance plans and self-pay patients. Teams must regularly monitor market pricing trends and adjust rates based on product and service costs and competition.

Healthcare Service Delivery and Access Points

Healthcare organizations should plan new products, services and delivery methods to maximize patient access. Marketing teams analyze geographic coverage, facility capabilities, and effective communications practices to ensure they are connecting with patients at the right time, over the right channel. They promote various access points including medical offices, outpatient centers, and telehealth options. Location planning considers population density, competition, and healthcare demand patterns. Evaluations including facility requirements for different services and patient volumes are necessary here. Marketing materials and content should display convenient access points and service availability, and/or easy access to new products. Organizations should track utilization rates across different channels and locations to optimize engagement and deliver the best outcomes.

Marketing Communications and Promotion

Healthcare marketing teams develop promotional strategies to reach patients and customers, as well as healthcare providers, payers and suppliers. They should create educational content about medical services and treatment benefits, new products, preventative care, as well as promotional plans that include advertising schedules, content distribution, and community outreach communications. The teams select marketing channels based on target audience preferences and message requirements, such as email or social media platforms. A main team goal should be to maintain consistent branding across all marketing materials and platforms, and to follow healthcare advertising guidelines and regulatory requirements for all communications, especially HIPAA. Organizations can measure campaign effectiveness through patient response rates, conversions, service utilization and new product sales.

Integration of Marketing Elements

Marketing plans should combine all four elements to create effective healthcare programs. Teams should ensure that product offerings are aligned with pricing strategies, patient needs and channel preferences. From there, promotional messages and campaigns should be developed to accurately represent services and products. Marketing activities should be coordinated between different departments to ensure consistent experiences, branding and outcomes. Organizations can track how changes in one area affect other marketing elements. Teams should adjust their marketing and channel mix based on performance data and market changes. Integration planning helps maintain efficient marketing operations and resource use.

Measurement and Performance Review

Healthcare organizations should establish metrics to evaluate their marketing program results at all times. Performance is tracked across all four marketing elements through regular reporting, in addition to analysis of patient volume, engagement, revenue generation, and satisfaction scores. Marketing departments should measure return on investment for different activities and campaigns to determine what programs and working and those that need to be updated or stopped. Performance reviews help teams identify successful strategies and improvement areas. Organizations should use this data to refine their marketing approaches and resource allocation as conditions change. Regular assessments ensure marketing programs meet organizational goals, as well as patient and customer needs.

Erik Kangas

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

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LuxSci Welcomes Angel Mazariegos as Head of Finance

December 9, 2025
Pete Wermter

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.”

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

December 4, 2025
Pete Wermter

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!

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

November 18, 2025
Pete Wermter

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.

What Does b2b Medical Marketing Help Healthcare Vendors Accomplish?

November 4, 2025
Erik Kangas

B2b medical marketing helps healthcare vendors to explain the practical value of a product to clinical and administrative buyers by presenting clear information that supports decision making across operational and regulatory domains. Buyers respond to communication that describes how a tool fits into routine workflows and how it handles information, and the process depends on steady explanations rather than promotional language.

Early Movement in the Buyer Relationship

The first stage of communication gives prospective buyers a clear sense of what the service does and why it belongs in their setting. Healthcare groups rely on predictable routines and they look for products that support those routines without creating unnecessary strain on staff. When an introduction explains how a tool fits into patient movement, documentation demands, or coordination between departments, readers can place the service into a familiar context. This lowers the cognitive effort required to evaluate whether further consideration is worthwhile and creates a smoother path for later discussions, which is why many vendors treat early stage explanations as the base of effective b2b medical marketing in this environment.

The Influence of Operational Structure

Clinical and administrative environments are shaped by long standing systems, varied software tools, and staff roles that have developed around known constraints. Vendors using b2b medical marketing describe how a product enters this environment so that the buyer can picture the transition from interest to adoption. Extended explanations of onboarding steps, data migration choices, and staff training routines help readers understand how daily operations shift when a new tool is introduced. These explanations allow decision makers to forecast workload changes rather than relying on assumptions, and they reflect the broader goal of b2b medical marketing which is to reduce uncertainty.

Regulatory Considerations in Vendor Communication

Healthcare buyers place great weight on regulatory matters, which is why clear descriptions of data handling are central to this type of communication. Readers look for information about access management, retention practices, audit preparation, and the path information takes through each component of a system. When vendors describe these areas in detail, compliance teams can perform early assessments and avoid long chains of clarification requests. This approach supports efficient internal review because the buyer gains confidence that the vendor maintains structured processes rather than improvised arrangements, and this clarity strengthens the overall impact of b2b medical marketing.

Reliability Expectations Within Clinical Settings

Healthcare settings cannot tolerate uncertainty in the systems that support patient care. B2b medical marketing provides insight into how a vendor manages service interruptions, planned updates, backup routines, and recovery efforts. A description of past events or internal procedures gives readers a sense of how the vendor behaves when conditions are difficult. Buyers place great value on this type of detail because it helps them differentiate between systems that hold up under stress and systems that falter when routine performance is disrupted, and these reliability discussions form a core thread in b2b medical marketing for clinical tools.

Perspectives That Influence Internal Decision Making

Each participant in the purchasing process evaluates a product through a different lens. Financial leaders consider long term spending patterns, clinical managers look for ease of use and effects on staff time, and compliance teams examine information practices. Communication that attends to these perspectives without shifting tone allows the reader to share information across departments with minimal friction. This prevents internal delays because each group can assess the service using information that relates to its role in the organisation, and thoughtful navigation of these viewpoints reinforces the strength of b2b medical marketing across healthcare markets.

The Role of Educational Content in Vendor Outreach

Healthcare groups respond well to educational material that speaks to challenges in clinical settings. Articles and guides that explain regulatory shifts, workflow bottlenecks, or mistakes observed in comparable organisations allow readers to examine their own processes. This form of communication helps buyers understand the vendor’s approach to problem solving and creates familiarity before any formal evaluation begins. Educational content performs well in this field because it demonstrates practical awareness rather than relying on abstract claims, making it a central component of many b2b medical marketing programs.

Use After Adoption

Decision makers frequently look beyond the moment of purchase and seek a clear view of the daily relationship that follows implementation. Communication describing staff support, update patterns, training formats, and communication channels helps buyers picture how the tool will fit into routine operations. Long paragraphs that describe the lived experience of using the service allow internal champions to advocate for the product with fewer unknowns, which supports faster movement through approval stages. This expectation of clarity after adoption aligns with the wider goals of b2b medical marketing which encourage predictable cooperation between vendor and buyer.

Documentation Supporting Review Processes

Healthcare organisations rely heavily on documentation during evaluation. Guides, records, administrative instructions, and explanations of data controls enable teams to examine the product without repeated requests for further detail. B2b medical marketing that introduces these documents early in the conversation reduces internal delays because reviewers can move through their procedures with all necessary information available at the outset. This transparent approach helps build trust between the vendor and the buyer and underscores the value of documentation as a recurring theme within b2b medical marketing.

B2b medical marketing works most effectively when vendors show an accurate grasp of clinical pressures and administrative realities. When communication reflects these conditions and acknowledges the challenges that healthcare groups experience during busy periods, readers gain confidence that the vendor understands the world they operate in. This supports deeper conversations about integration, performance, and long term cooperation across the organisation.

What is a HIPAA Secure Email?

June 20, 2025
Erik Kangas

A HIPAA secure email is a specialized communication system that protects protected health information during electronic transmission through encryption, access controls, audit logging, and other security features required for regulatory compliance. HIPAA secure email platforms enable healthcare organizations to send sensitive patient information while meeting privacy and security standards established by federal healthcare regulations. Healthcare providers, payers, and suppliers use HIPAA secure email to communicate with patients, business partners, and other healthcare organizations without risking privacy violations or security breaches. Understanding what makes HIPAA secure email different from standard email helps organizations select appropriate communication tools and maintain compliance with healthcare privacy regulations.

Core Security Features of HIPAA Secure Email

HIPAA secure email systems include end-to-end encryption that transforms readable messages into coded format during transmission and storage. This encryption ensures that only authorized recipients with proper decryption keys can access message content and attachments. Transport Layer Security protocols protect email communications during transmission between servers, while message-level encryption secures content even when stored on email servers. Multi-factor authentication verifies user identities before granting access to email systems, requiring additional verification beyond standard passwords. Access controls limit which users can send emails to external recipients and specify what types of information can be included in different message categories. Automatic session timeouts prevent unauthorized access when users leave workstations unattended, while secure password requirements protect user accounts from unauthorized access.

Administrative Controls and User Management

HIPAA secure email platforms provide centralized administration tools that allow IT teams to manage user accounts, configure security policies, and monitor compliance across the organization. Role-based permissions ensure that staff members can only access email functions appropriate to their job responsibilities and organizational roles. User provisioning and deprovisioning processes control access to email systems when staff members join or leave the organization. Policy enforcement mechanisms automatically apply security settings based on message content, recipient types, and organizational rules. Administrative dashboards provide real-time visibility into email security metrics, user activity patterns, and potential policy violations. Centralized logging captures all administrative activities, creating audit trails that demonstrate compliance with regulatory requirements and organizational policies.

Audit and Compliance Tracking Capabilities

Comprehensive audit logging tracks all activities within HIPAA secure email systems, creating detailed records of message transmission, recipient access, and user behavior patterns. These logs include information about who sent messages, when they were transmitted, what attachments were included, and how recipients accessed the content. Audit trails help organizations demonstrate compliance during regulatory reviews and investigate potential security incidents. Log retention policies ensure that audit information remains available for required periods while protecting stored data from unauthorized modification or deletion. Automated reporting features generate compliance reports and alert administrators to unusual email patterns or potential security concerns. Regular audit log reviews help identify training needs and process improvements for email security practices across the organization.

Integration with Healthcare Systems and Workflows

HIPAA secure email solutions integrate with electronic health record systems, practice management platforms, and other healthcare applications to streamline communication workflows. These integrations allow users to send secure messages directly from patient records or billing systems without switching between multiple applications. Automated triggers generate secure email notifications for appointment reminders, lab results, billing communications, and other routine patient interactions. Application programming interfaces enable custom integrations with specialized healthcare software used by different types of organizations. Single sign-on capabilities allow users to access email functions using their existing healthcare system credentials, reducing password management burden and improving user experience. Integration features help maintain productivity while ensuring that all communications involving protected health information remain secure.

Patient Communication and External Messaging

HIPAA secure email platforms include patient portal functionality that enables secure two-way communication between healthcare organizations and their patients. Patients can access secure portals to read messages, respond to communications, and download documents without requiring special software installations. Portal notifications alert patients when new messages arrive while maintaining privacy protections throughout the communication process. External messaging capabilities allow secure communication with business partners, referring physicians, and other healthcare organizations that may use different email systems. Message delivery confirmation and read receipts provide verification that important communications reached intended recipients and were accessed appropriately. Secure message forwarding ensures that communications can be shared with authorized parties while maintaining encryption and audit trail integrity.

Implementation and Deployment Considerations

Healthcare organizations implementing HIPAA secure email need to consider data migration from existing email systems, staff training requirements, and integration with current technology infrastructure. Planning processes should include security risk assessments, workflow analysis, and stakeholder input to ensure selected solutions meet organizational communication needs. Pilot deployments allow organizations to test functionality and identify potential issues before full implementation across all departments. Change management strategies help staff adapt to new email security procedures and software interfaces while maintaining productivity and patient care quality. Technical support during implementation ensures that integration challenges are resolved quickly and security configurations meet organizational requirements. Post-deployment monitoring verifies that HIPAA secure email systems perform as expected and continue meeting compliance obligations as organizational needs change over time.

Healthcare Email Threat Readiness Strategies

May 14, 2025
Pete Wermter

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

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

Let’s go!

Conduct Regular Risk Assessments

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

A comprehensive email risk assessment should include:

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

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

Implement Email Authentication Protocols

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

The three main email authentication protocols are:

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

Establish Robust Access Control Policies

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

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

Enable User Authentication Measures

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

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

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

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

Identify and Manage Supply Chain Risk

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

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

Set Up Encryption for Data In Transit and At Rest

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

Encryption standards sufficient for HIPAA compliance include:

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

Develop a Patch Management Strategy

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

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

Implement Continuous Monitoring Protocols

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

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

Develop Business Continuity and Disaster Recovery Plans

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

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

Implement Email Threat Awareness Training for Employees

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

Email threat awareness training should include:

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

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

Download LuxSci’s Email Cyber Threat Readiness Report

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

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

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

What is the Cheapest HIPAA Compliant Email?

November 11, 2024
Pete Wermter

The cheapest HIPAA compliant email options include budget-friendly plans from Paubox, Virtru, and Google Workspace when properly configured with security add-ons. Healthcare organizations should consider total costs including implementation, training, and ongoing management expenses. While consumer email services cost less, they lack the security features and Business Associate Agreements necessary for HIPAA compliant email communications with patients.

Entry-Level HIPAA Compliant Email Services

Several providers offer affordable HIPAA compliant email options for smaller healthcare practices and organizations with limited budgets. LuxSci and Paubox provide encrypted HIPAA compliant email with a Business Associate Agreement included, including support for securing Google Workspace and Microsoft 365. Virtru also offers email encryption for small teams. ProtonMail Professional includes encryption, though healthcare organizations must verify BAA availability. Google Workspace and Microsoft 365 Business provide foundational platforms, but require additional security configurations and add-ons to achieve full HIPAA compliance. These baseline services provide encryption and security features while keeping monthly costs manageable for smaller healthcare entities.

Non Subscription Fee Budget Considerations

The true cost of HIPAA compliant email extends beyond monthly subscription prices. Implementation expenses include configuration time, security testing, and integration with existing systems. Staff training introduces both direct costs and productivity impacts during the learning period. Ongoing management requires dedicated IT resources or outsourced support services. Audit preparations and compliance documentation demand administrative attention. Organizations also face potential costs from security incidents if they choose inadequately protected budget options to save money. Many healthcare providers discover that selecting email services based solely on subscription prices leads to higher overall expenses. A thorough cost analysis should include all implementation and operational factors rather than focusing exclusively on monthly fees, and also should consider the vendor’s customer support practices and reputation.

Security Features and Compliance Trade-offs

Less expensive HIPAA compliant email services may offer fewer security features than premium alternatives. Basic plans typically provide essential encryption during transmission but might lack advanced access controls or comprehensive audit logging. Less costly options often exclude data loss prevention tools that automatically detect and secure messages containing patient information. Mobile device security features may be limited in budget-friendly plans. Archive and retention capabilities might require additional paid add-ons. Password management and multi-factor authentication options vary considerably between providers. Healthcare organizations must carefully evaluate whether security limitations in less expensive services align with their risk management requirements. Finding the right balance between cost and protection depends on each organization’s specific patient communication needs.

Provider Reliability and Support Quality

Lower-priced HIPAA compliant email providers differ substantially in reliability and customer support quality. Some lower cost services experience more frequent outages or performance issues than premium alternatives. Customer support availability ranges from 24/7 assistance to limited business hours only. Support channels vary from direct phone access to email-only communications. Implementation assistance might be comprehensive or nearly non-existent depending on the provider. Security update frequency and speed of vulnerability patching also differs between services. Healthcare organizations should investigate reliability statistics and read customer reviews about support experiences before selecting a provider. The operational impact of service disruptions or delayed support responses can quickly outweigh small differences in monthly subscription costs.

Cost-Effective HIPAA Compliant Email Implementation

Healthcare organizations can reduce HIPAA compliant email expenses through strategic implementation approaches. Tiered and role-based access limits higher-cost security features to staff who routinely handle protected health information while providing basic service to other employees. Negotiating multi-year contracts often yields substantial discounts compared to month-to-month arrangements. Starting with pilot projects allows testing services before full organizational commitment. Exploring whether existing IT infrastructure can support secure email reduces the need for completely new systems. Selecting services that integrate with existing systems minimizes implementation costs and training requirements. These practical approaches help organizations achieve HIPAA compliance while controlling email expenses.

Long-Term Value Assessment

Evaluating HIPAA compliant email options requires looking beyond initial price tags to assess long-term value. Less expensive services may lack scalability for organizational growth, necessitating costly migrations later. Budget options sometimes require more staff time for management and security monitoring, creating hidden operational costs. Cheaper services might provide fewer automation features that could otherwise reduce administrative burdens. Integration capabilities with electronic health records and practice management systems vary considerably between providers. Forward-looking healthcare organizations consider how email solutions will adapt to changing regulations and emerging security threats. While immediate budget constraints matter, the most cost-effective HIPAA compliant email solution often depends on an organization’s growth trajectory and long-term communication strategy. If you’d like to explore the different options for HIPAA compliant email, contact us today.

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

January 9, 2024
LuxSci

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:

The sender’s computer talks to the sender’s email or WebMail server to upload the message.
The sender’s email or WebMail server then talks to the recipient’s inbound email server and transmits the message to them.
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:

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).
Each Received line documents what a server did and when.
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

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:

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.
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.
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.