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What are the Infrastructure Requirements For HIPAA Compliant Email?

HIPAA Compliant Marketing Automation Tools

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

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

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

What Are Transactional Emails?

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

Examples of transactional emails include:

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

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

What Are Marketing Emails?

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

Examples of marketing emails include:

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

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

Opt-in Rules for HIPAA-Compliant Email Communication 

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

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

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

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

Email Infrastructure Requirements For HIPPA-Compliance

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

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

Key Transactional Email Infrastructure Considerations

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

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

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

Key Marketing Email Infrastructure Considerations

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

Subsequently, the infrastructure requirements for marketing emails include: 

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

Key Infrastructure Considerations for Both Types of Email

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

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

HIPAA-Complaint Email Solutions From LuxSci

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

LuxSci’s Secure High Volume Email solution offers:

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

LuxSci’s Secure Email Marketing platform provides: 

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

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

Picture of Pete Wermter

Pete Wermter

As a marketing leader with more than 20 years of experience in enterprise software marketing, Pete's career includes a mix of corporate and field marketing roles, stretching from Silicon Valley to the EMEA and APAC regions, with a focus on data protection and optimizing engagement for regulated industries, such as healthcare and financial services. Pete Wermter — LinkedIn

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HIPAA Compliant Email

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

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

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

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

1. The Shared Responsibility Model

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

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

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

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

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

But, it’s not that simple.

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

3. Not All Solutions or Features Are HIPAA Compliant

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

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

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

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

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

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

5. Essential Security Features Cost Extra 

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

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

6. The Importance of Staff Training on HIPAA

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

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

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

LuxSci: Fully HIPAA Compliant – No Hidden Surprises

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

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

b2b medical marketing

What Does b2b Medical Marketing Help Healthcare Vendors Accomplish?

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.

MailHippo HIPAA compliant

Is Mailhippo HIPAA Compliant?

MailHippo is considered HIPAA compliant when healthcare providers use a paid plan or 30-day free trial, sign a BAA, and enable the required security settings. As a result, MailHippo HIPAA compliant usage is only possible when all of these conditions are met. The cloud-based encrypted email service provides secure messaging for healthcare providers handling PHI, though considerations should be made in areas such as administrative controls, audit logging, and integration options. Healthcare providers considering MailHippo for patient communications should examine its security capabilities alongside potential workflow capabilities before making a decision on implementation.

Email Security Requirements Under HIPAA

Healthcare email systems handling PHI must satisfy federal privacy regulations through encryption, access controls, and audit capabilities. Data encryption during transmission prevents unauthorized interception of patient information traveling across public networks. Storage encryption protects archived messages containing health data while they reside on email servers. Access restrictions ensure that only authorized personnel can view patient communications relevant to their job responsibilities.

Audit controls track who accesses email systems, what messages they view, and when these activities occur. Integrity safeguards prevent unauthorized modification or deletion of patient communications that might compromise medical records or compliance evidence. Business associate agreements create legal frameworks defining how email service providers protect patient information and respond when security incidents occur.

Consumer email platforms lack typically these protections in their standard configurations, creating compliance vulnerabilities when healthcare providers use them for patient communications. For example, Gmail, Outlook, and Yahoo Mail were designed for general business use rather than regulated healthcare environments. To summarize, healthcare organizations benefit from email services that implement HIPAA security requirements by design rather than requiring complex manual configurations that might be implemented incorrectly.

The MailHippo Service Model

MailHippo positions itself as a straightforward encrypted email solution for professionals in regulated industries including healthcare, legal, and financial services. The cloud-based platform eliminates time-consuming software installation requirements, allowing users to send secure messages through web browsers without downloading applications. This simplicity appeals to solo practitioners and small medical practices that lack dedicated IT support staff.

Independent healthcare providers, small medical offices, mental health professionals, and insurance consultants represent the service’s primary user base. These smaller operations value ease of use over advanced features, preferring solutions that deliver basic security without complicated setup and user procedures. It’s important to note that MailHippo delivers encrypted messages to recipients through secure web portals rather than standard email clients, creating protected communication channels that don’t require recipients to install special software.

The MailHippo service model focuses on one-to-one secure messaging rather than bulk communications or automated workflows. Healthcare providers send individual messages to patients or colleagues through encrypted channels that protect information during transmission and storage. Recipients receive notifications that secure messages await them in web portals where they can view content after authentication. This approach works for routine patient communications but may not support more complex healthcare communication needs. For larger organizations that prefer users staying within a dedicated email application or need high volume sending, several HIPAA compliant alternatives exist, including LuxSci.

MailHippo’s HIPAA Compliant Encryption and Security Features

MailHippo features transport encryption using TLS protocols, protecting messages during transmission between email servers, and preventing interception while communications travel across networks. AES-256 encryption secures stored messages, ensuring that archived communications remain protected if servers are compromised. The combination of transmission and storage encryption addresses HIPAA requirements for protecting ePHI throughout its lifecycle.

Recipient access through secure web portals eliminates the vulnerabilities associated with delivering encrypted content through standard email clients. Patients and healthcare providers authenticate themselves before viewing message content, creating additional security layers beyond basic encryption. Using a portal-based approach reduces exposure through compromised email accounts or insecure devices that might not maintain proper security configurations.

Authentication requirements mandate that users log in before sending or receiving messages, preventing unauthorized access to patient communications. MailHippo supports two-factor authentication (2FA), but the company’s documentation doesn’t clearly spell out which MFA methods are available or whether organizations can enforce MFA for all users. Healthcare entities that require strong authentication factors, such as hardware tokens or biometrics should confirm these details directly with the vendor.

Delivery and read receipts provide tracking information about message transmission and recipient access. These receipts confirm that messages reached intended recipients and document when recipients viewed content. The tracking capabilities, while useful for confirming communication delivery, lack the detailed audit logging that larger healthcare organizations likely need for compliance and security investigations.

Third-Party Email Provider Contract Requirements

Federal regulations classify email service providers handling PHI as business associates subject to HIPAA compliance obligations. Healthcare entities must execute written agreements with these providers defining responsibilities for protecting patient data and responding to security incidents. Without signed BAAs, email communications containing patient information violate HIPAA regardless of encryption or other security measures implemented.

MailHippo HIPAA compliant email requires executed business associate agreements between the service provider and healthcare organizations. The company offers these agreements to paying and free trial customers who specifically request them. However, long-term free subscription plan users cannot obtain business associate agreements, making those accounts unsuitable for transmitting protected health information even when encryption features are enabled.

Business associate agreements specify encryption standards, incident notification timelines, and procedures for handling patient data when service relationships terminate. These contracts allocate liability between healthcare organizations and email providers, protecting organizations from financial exposure when security breaches that result from provider negligence. Agreement terms should address data retention requirements, geographic restrictions on information storage, and secure deletion methods when retention periods expire.

Healthcare organizations implementing MailHippo HIPAA compliant solutions must verify that executed agreements cover all anticipated uses of the platform. Agreements should explicitly permit transmission and storage of PHI while defining what security measures the provider maintains. Without proper agreements in place, healthcare organizations assume full liability for any security incidents involving patient communications transmitted through the platform.

Administrative Control & Potential Limitations

User management capabilities determine how healthcare organizations control access to email systems and enforce security policies across multiple staff members. Role-based permissions enable organizations to grant different access levels to physicians, nurses, administrative staff, and billing personnel based on their job functions. Centralized administration consoles allow IT staff or practice managers to oversee all user accounts, modify permissions, and review security concerns from a single interface.

MailHippo HIPAA compliant implementations may lack the administrative tools that larger healthcare organizations require, including managing large numbers of users. The platform does not provide role-based permission structures that restrict access based on job functions or patient care relationships. Centralized dashboards for overseeing user activities across organizations are absent, making it more difficult for administrators to monitor security compliance or identify potential policy violations.

Integration & Workflow Considerations

Healthcare communication workflows rely heavily on integration between email systems, electronic health records, practice management software, and patient engagement platforms. Automated workflows reduce administrative burden while ensuring consistent security practices across all patient communications. API connectivity enables different healthcare applications to exchange information seamlessly without requiring manual data transfer, which increases the risk of human error.

While MailHippo publishes an email API, it does not offer ‘out-of-the-box’ integration capabilities with electronic health record systems or practice management platforms. As a result, healthcare organizations cannot automatically populate patient communications with appointment information, test results, or treatment updates from their clinical systems without technical integration work.

Marketing automation and bulk communication capabilities do not exist within the MailHippo service model, which is designed for individual message transmission. Healthcare organizations conducting patient outreach, appointment reminders, or health education campaigns need alternative solutions for these activities. The focus on one-to-one messaging limits the platform’s utility for organizations with diverse communication requirements high-volume sending needs beyond routine secure messaging.

Appropriate Use Cases and Organizational Fit

Solo practitioners and small medical practices with straightforward communication needs represent ideal candidates for MailHippo HIPAA compliant email. These organizations likely value simplicity over advanced features, preferring solutions that deliver basic security without requiring technical expertise to configure and maintain. Single physicians or therapists communicating with individual patients benefit from the portal-based secure messaging that protects patient information without complicated setup procedures.

Healthcare providers requiring only basic one-to-one secure messaging without forms, complex integrations, or user management can operate effectively within the platform’s capabilities. For example. mental health professionals conducting therapy practices, independent consultants providing healthcare advice, and small specialty clinics with limited communication volumes fit the service model well.

Larger healthcare organizations, multi-location practices, and operations with complex communication requirements and workflows will find the platform’s limitations constraining. Organizations needing multiple user tiers, departmental segregation, or centralized administration lack the tools necessary for managing these structures. Healthcare systems requiring electronic health record integration, automated workflows, or bulk communication capabilities often need more comprehensive email security platforms than MailHippo HIPAA compliant setups can provide.

Implementation and Compliance Verification

Now, it’s important to note that healthcare organizations implementing secure email must verify that all HIPAA requirements are satisfied before transmitting PHI. Proper configuration helps ensure that encryption activates properly, access controls function as intended, and audit logging captures necessary security events. In addition, business associate agreement execution creates legal frameworks before any patient data flows through email systems.

As with any ESP for healthcare, organizations adopting MailHippo HIPAA compliant email should document their compliance measures, including executed agreements, security configurations, and staff training records. Documentation demonstrates due diligence during regulatory audits while providing evidence that organizations took appropriate steps to protect patient information. Policy development establishes guidelines about what information can be transmitted via email and what alternative communication methods should be used for particularly sensitive content.

Staff training prepares healthcare workers to use secure email systems properly while maintaining patient privacy throughout communications. Training should cover portal access procedures, recipient verification methods, and appropriate content guidelines that prevent inadvertent disclosures. Documented training records prove that organizations educated staff about security requirements before granting email system access.

Finally, periodic security assessments verify that email systems continue meeting compliance requirements as technology and threats evolve. Assessment schedules should include configuration reviews, access control testing, and verification that business associate agreements remain current. Healthcare organizations relying on MailHippo HIPAA compliant workflows must treat email security as an active process rather than a one-time setup, maintaining vigilance about vulnerabilities and regulatory changes.

If you’d like to learn more, reach out to us today!

HIPAA compliant email

HIPAA Compliant Email Use Cases for Healthcare Retailers

Today’s digital-first consumers expect the same convenience and personalization from their healthcare providers that they get from their favorite retailers and service providers. However, unlike companies in other sectors, there’s far less room for error for healthcare organizations, especially when it comes to privacy and data security. 

Whether a local pharmacy, online provider of glasses, a wellness store, or a nationwide retail health clinic, the key to building long-term loyalty and ensuring trust with your customers lies in trusted, meaningful communication that’s timely, relevant – and, above all, secure.

As a result, HIPAA compliant email is a strategic component for reliable and effective communication with your customers.

But, what about HIPAA?

Far from being a roadblock, HIPAA compliance is actually an enabler for retail healthcare brands that want to deliver more personalized, more targeted messaging without putting customer trust, or their sensitive personal data, at risk.

In this post, we dive into the most impactful email use cases for retail healthcare providers, as well as how deploying a secure email delivery platform like LuxSci can unlock more meaningful engagement, greater loyalty, and accelerated growth for your company.

Why Email Remains a Top Channel for Retail Healthcare

Email Is Everywhere – Because It Works

Email isn’t just for work or spam folders. It’s the preferred communication channel for tens of millions of health-conscious consumers across all demographics. People are accustomed to receiving alerts from their pharmacies, reminders from clinics, and promotions from their preferred wellness brands – all in one convenient place – and email is an important part of the mix.

When deployed securely, email becomes a powerful, personal, and persistent touchpoint for healthcare engagement.

HIPAA Compliance Enables Trust and Transparency

While your customers crave convenience, they also demand privacy – especially when it comes to their health. HIPAA compliant email ensures that personal health data and protected health information (PHI) stays precisely that – protected – while enabling retail healthcare brands to deliver personalized communications that build trust and loyalty.

HIPAA Compliance Helps Ensure Secure Healthcare Marketing

HIPAA doesn’t restrict your ability to communicate; conversely, it defines how you can do it securely and best perform, while protecting the sensitive data under your care. When emails contain PHI, you need to ensure:

  • Email content encryption
  • Access controls
  • Secure storage and transmission
  • A signed Business Associate Agreement (BAA) with your email provider

With the key HIPAA requirements in place, retail healthcare organizations can send high-impact, personalized, and, with some platforms, such as LuxSci, automated emails to engage and educate their customers – all while adhering to HIPAA compliance regulations.

How HIPAA Compliant Email Improves Retail Results

HIPAA compliant email doesn’t just check a box – it opens the door for personalized, proactive, and performance-driven customer and patient engagement. With the right strategy and the right HIPAA compliant email services provider, healthcare retailers can:

  • Deliver marketing messages that include PHI with confidence
  • Develop trust and customer loyalty through secure, reliable, and frequent communication
  • Increase new and repeat purchases and average order value (AOV)
  • Lower operational costs in comparison to phone and physical mail-based engagement campaigns

HIPAA Compliant Email Use Cases for Healthcare Retailers

Now, let’s look at six essential use cases that healthcare retailers can employ for more effective customer and patient engagement.  

Use Case #1: New Product Announcements

Why It Matters: Drive sales and keep customers informed

Whether it’s a new allergy medication, wellness supplements, or a wearable device, product launch email campaigns allow customers and targets to stay in the loop regarding new offerings that could benefit their health. This empowers individuals to take a more active role in their healthcare journey, while helping you meet your organization’s growth objectives.

HIPAA Compliant Email Advantage

  • Announce product launches tailored to individual customer needs, such as health conditions or specific health needs
  • Use PHI-related content deliver highly targeted, highly segmented campaigns – while staying compliant
  • Build trust by ensuring messages are private and secure

Use Case #2: Promotional Offers and Discounts

Why It Matters: Boost loyalty and repeat business

Both retail healthcare providers and customers benefit from promotions, such as 2-4-1 supplement deals, seasonal flu shot discounts, or loyalty reward bonuses. HIPAA compliant email allows you to securely execute promotional campaigns even when they’re linked to health data or prior purchasing behavior.

HIPAA Compliant Email Advantage

  • Target based on previous purchases, prescriptions, or any other PHI data points
  • Comply with privacy laws while increasing engagement
  • Deliver offers directly to inboxes – no portals or logins

Use Case #3: Reminders for Refills, Appointments, and Screenings

Why It Matters: drive adherence to health plans and improve outcomes

Forgetful customers don’t refill prescriptions, miss wellness exams, and ignore follow-up visits. HIPAA-compliant email reminders help tactfully nudge them towards taking favorable action. 

HIPAA Compliant Email Advantage

  • Automate refill and screening reminders based on PHI
  • Avoid manual call-outs or printed letters
  • Boost adherence and improve overall satisfaction

Use Case #4: Order Confirmations and Delivery Notifications

Why It Matters: Create a seamless shopping experience

Consumers want to know that their orders are being processed, shipped, or ready for pickup; in other words, that they’re being taken care of and not taken for granted. For prescriptions, OTC medication, or wellness products, email is the perfect way to keep them updated.

HIPAA Compliant Email Advantage

  • Include product names, refill details, and other customer data securely in emails 
  • Track opens and clicks to ensure delivery – re-target as needed 
  • Reduce support call volumes with proactive, regular email updates

Use Case #5: Educational Health Content & Resources

Why It Matters: Position your brand as a trusted health partner

From seasonal wellness tips to chronic condition education, sending valuable health education and awareness content helps position your brand as a go-to source for relevant, credible advice – and a contributor to keep people healthier.

HIPAA Compliant Email Advantage

  • Personalize content based on past purchases or health concerns
  • Build deeper engagement and trust with relevant, timely topics
  • Share sensitive health content without privacy risk

Use Case #6: Customer Satisfaction and Loyalty Surveys

Why It Matters: Collect feedback to improve products and services

Post-purchase or post-visit surveys enable retail healthcare providers to measure customer satisfaction, while identifying key areas for improvement. This not only gives you an edge over competitors who are less diligent in collecting feedback, but you also make your customer feel heard, further strengthening their brand loyalty. 

HIPAA Compliant Email Advantage

  • Send personalized surveys securely
  • Include PHI-related context without fear of violation
  • Collect better data to inform future campaigns and services

LuxSci Helps Healthcare Marketers Send Secure Email at Scale

Retail healthcare is evolving rapidly – and your customers expect communication that’s personal, secure, and immediate. With HIPAA-compliant email, you can deliver all of that, and more.

From promotions and product launches to order updates and educational content, secure email helps you build stronger relationships, improve customer outcomes, and grow your business, all while maintaining the privacy and trust that healthcare demands.

With retail healthcare leaders like 1-800 Contacts as customers, LuxSci specializes in secure, HIPAA compliant communication solutions for healthcare organizations, including retail health brands, consumer wellness providers, and medical equipment providers. 

Whether you’re a national pharmacy chain, a growing telehealth brand, or a local wellness shop, LuxSci provides you with the secure infrastructure and capabilities to scale personalized email engagement with confidence. This includes:

  • Automated email encryption (TLS, PGP, S/MIME)
  • Email marketing tools specifically designed to align with HIPAA compliance requirements
  • 98%+ deliverability and high performance throughput
  • APIs and SMTP options for seamless data integration and automation
  • Support for marketing, transactional, and operational messages
  • A signed Business Associate Agreement (BAA) – with no loopholes or “out-of-scope” services that compromise your compliance posture 

Is it time to make us switch from your current provider? 

Contact us today to find out more. 

Retail Healthcare Secure Email Use Cases FAQs

Can retail Healthcare brands send promotional emails under HIPAA?

Yes, with proper consent and a fully HIPAA-compliant platform like LuxSci, you can send targeted promotional emails that include PHI.

What kind of PHI can I include in a secure email?

You can include health conditions, medication details, order info, service history, and a large array of other PHI data points in your messaging – provided the email is encrypted and sent through a compliant platform.

Are delivery and refill reminders considered PHI?

Yes, if the email content relates to a specific patient and their health, then it contains PHI. That’s precisely why it’s so vital that secure email is used to send out such reminders, or any communication containing sensitive customer or paitent data.

How do I ensure HIPAA compliance with my marketing emails?

Deploying a platform like LuxSci that signs a BAA, provides email encryption, including its content, and all the required PHI safeguards is the best way to ensure HIPAA compliance when executing your marketing campaigns. Better yet, LuxSci also features automation and hypersegmentation to enhance the efficacy of your customer engagement campaigns, as well as ensuring they align with HIPAA requirements.

Can I send secure email campaigns in bulk or high volumes?

Most definitely! In fact, LuxSci’s high-volume secure email solution is ideal for large-scale outreach, whether it’s marketing, educational, or transactional emails. We have designed our infrastructure to facilitate the consistent delivery of hundreds of thousands, if not millions, of emails in accordance with your company’s engagement needs and HIPAA compliance.

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Sending HIPAA Compliant Email

Sending HIPAA Compliant Email the Right Way

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

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

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

The Importance of Sending HIPAA Compliant Emails

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

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

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

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

Examples of PHI include:

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

The Risks of Not Being 100% Sure About HIPAA Compliance

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

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

Sending HIPAA Compliant Email

The Problem with DIY HIPAA Compliance

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

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

A Checklist for Sending HIPAA Compliant Email

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

1. Encryption Standards for HIPAA Compliance

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

2. Secure Access and Authentication

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

3. Business Associate Agreements (BAA)

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

4. Data Backup and Recovery

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

5. Employee Training and Awareness

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

6. Regularly Audit Your HIPAA Compliance Strategy & Practices

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

7. Avoiding Overconfidence in Your Own Processes

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

Don’t Let HIPAA Self-Certification Fool You!

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

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

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

Contact us here!

HIPAA compliant Email

HIPAA Compliant Email Use Cases for Health Plan Administrators and Insurance Providers

Email is still one of the most pervasive and trusted digital communication channels in use today — and it’s not going anywhere. For health insurance providers and health plan system administrators, email presents a major opportunity: the ability to communicate reliably, more personally, and more effectively with members and customers.

Despite this, some health insurers and plan providers are wary of utilizing email to its full potential for fear of running afoul of HIPAA regulations. Or worse, they think they’re HIPAA compliant when they may not be, or they don’t think they need to be compliant when it comes to certain communications.

When email is encrypted properly, it becomes a direct, compliant channel for everything from new plan enrollments and policy changes to Explanation of Benefits (EOBs) and reimbursements. With the right encryption methods and best practices in place, you can deliver the kind of personalized, efficient experiences that today’s members and customers expect, while meeting the highest standards for privacy and security.

With this in mind, let’s explore the most impactful HIPAA compliant email use cases for health plan administrators and health insurance providers – and how enabling secure, fully encrypted email with LuxSci can improve member engagement, drive more efficient processes, speed payment, and deliver better results and outcomes.

Email: A Highly Trusted Healthcare Communication Channel

Everyone uses email. It’s a daily habit for billions of people – including your members and customers. Email is also a top channel for baby boomers, and it will continue to be for years to come.

Simply put, people are familiar and comfortable with how email works, they trust it, and email doesn’t require the installation and use of another app or logging into a separate portal. For health plans and insurers, this means you can meet members and customers directly where they already are, through a highly used method of communication.

A Private and Preferred Option for Key Healthcare Conversations

When designed with security in mind, email is perfectly suited for delivering sensitive healthcare information, i.e., protected health information (PHI) and conversations about an individual’s health condition, related treatment, and insurance coverage. Just as importantly, it’s can be less invasive than SMS, and more effective – not to mention cheaper – than printed mail, making it an ideal choice for critical, high-touch communications, such as member benefits, policy updates, and billing.

HIPAA Compliance: Securing Better Digital Engagement

HIPAA compliance often gets framed as a limitation; in reality, however, it provides the framework for secure, scalable communications in healthcare.

With the right HIPAA compliant email solution, health plan administrators and health insurers can:

  • Deliver personalized content directly to members and customers – securely
  • Automate secure communications and related workflows
  • Avoid the additional friction of portals – and capture non-portal users
  • Ensure privacy and legal protection for sensitive data

Rather than avoiding email for sensitive communications, more and more organizations are now embracing secure email to improve engagement, click-throughs and conversions. This translates to more timely plan enrollments, more policy renewals and faster payments.

Compliance Enables Engagement, Not the Other Way Around

When you build compliance into your communications strategy, you unlock more ways to engage with members effectively. Confident in the safeguards you have in place to protect sensitive member and customer data, you can personalize your email communications, segmenting members according to their healthcare needs, their status within your organization, or their individual situation (recently joined, long-time member, disengaged, etc).

Consequently, HIPAA compliance doesn’t have to slow you down, as it’s persistently perceived to, it actually enables you to harness the possibilities of personalization to drive better engagement and better results.

HIPAA Compliant Email Use Cases for Health Plan Administrators and Insurers 

Let’s turn our attention to five highly applicable use cases for HIPAA compliant email for health plans and insuers, and how they can benefit your company, as well as your members or customers. 

Use Case #1: Sending Explanation of Benefits (EOBs)

Why It Matters: Reliable delivery, faster payments

In most cases, EOBs are still sent via physical mail, which is slow, costly, often misunderstood, and may never reach the intended recipient for myriad reasons. Conversely, with HIPAA compliant email, you can deliver digital EOBs directly to members in a format they can understand and trust is secure – at a much lower cost.

Benefits

  • Increased deliverability
  • Reduce printing and mailing costs
  • Reduced carbon footprint
  • The ability to track message activity, i.e., if delivered, opened, etc.

Try the LuxSci EOB ROI calculator here, and see how you can save millions of dollars per month with HIPAA compliant email EOBs.

Use Case #2: New Plan Enrollments

Why It Matters: Secure enrollments, faster and on time

Enrollment is a crucial moment on the member journey. With secure email, you can onboard new members more quickly by reaching them directly via their inbox, providing them with their enrollment instructions, required logins, delivering their plan details, and supplying coverage summaries. All of which can be achieved without them having to wait for the mail or chase portal logins.

Benefits

  • Real-time delivery of enrollment and onboarding materials
  • Immediate coverage confirmation
  • Easier to troubleshoot potential issues
  • Enhanced support with secure reply options

Use Case #3: Policy Change and Renewal Notifications

Why It Matters: Transparency and speed build trust

Policy updates, such as changes to deductibles, coverage, or provider networks, must be communicated clearly and as soon as possible. HIPAA compliant email makes it simple to notify members and deliver legally required communications reliably and securely.

Benefits

  • Keep members better informed and more empowered to make healthcare decisions
  • Meet regulatory deadlines
  • Align with compliance requirements
  • Reduce call center volume from confused policyholders 

Use Case #4: Payments, Reimbursements and Financial Communications

Why It Matters: Payment and coverage clarity drives satisfaction, business continuity

From payment confirmations to out-of-pocket estimates, secure email gives members clear, timely financial updates, allowing them to plan accordingly. This makes them feel their healthcare providers are being open with them and transparent in communications for payments.

In contrast, confusion about benefits, coverage, and costs diminishes trust, which strains communication and makes effective engagement difficult. Financial clarity also accelerates your organization’s internal processes, enhancing efficiency and your ability to provide the best possible service to members. 

Benefits

  • Increased member trust and satisfaction
  • Speed up reimbursement cycles
  • Reduce payment confusion
  • Enable secure document submission (e.g., receipts, claims)

Use Case #5: Education and Preventive Health Campaigns

Why It Matters: Proactive education supports better health outcomes

Use HIPAA compliant email to send targeted content, including preventive screening reminders, wellness resources, and seasonal health tips, while effectively securing PHI. Members benefit by taking a more active role in their healthcare journeys and committing to better health, which reduces healthcare costs and improves outcomes.

Benefits

  • Educated members are more involved in their healthcare journey
  • Personalized health education based on member history
  • Secure mass communication that meets HIPAA standards
  • Improved health outcomes and engagement

LuxSci for Health Plan Administrators and Insurers

HIPAA compliance isn’t the end of the conversation – it’s really the beginning of smarter and more secure engagement that has a real impact on business results, as well as member and customer satisfaction.

LuxSci is a trusted provider of secure email solutions tailored for healthcare organizations. With over 20 years of experience supporting HIPAA compliance and HITRUST certification, LuxSci enables compliance, marketing, operations, and IT teams to send high-volume, secure, personalized email – all without compromising privacy or performance.

Key Features

  • Automated encryption (TLS, PGP, S/MIME), which sets encryption according to message sensitivity and the recipient’s email security posture
  • Secure SMTP and API-based sending
  • Real-time tracking and delivery reporting
  • Automated workflows
  • Configurable access controls and user management
  • Full BAA coverage and dedicated infrastructure

Whether you’re sending thousands of onboarding emails or automating payment updates, LuxSci helps you do it securely, seamlessly, and at scale.

Ready to unlock the full potential of HIPAA compliant email?

Contact LuxSci today to discover more about how our solutions can enable more effective, more personalized healthcare communication. 

Health Plan Administrator and Insurance Provider Secure Email Use Cases FAQs

How Does HIPAA Enable Better Email Communications for Health Plans?

HIPAA provides the framework for secure, HIPAA compliant communication of electronic protected health information (ePHI), allowing health plans and insurers to safely send personalized, high-impact emails to members.

Can We Use Email for Mass Communications Involving PHI?

Indeed, you can. LuxSci provides the infrastructure to send thousands, or even millions, of encrypted email communications containing PHI –  securely, compliantly, and with fully encrypted content.

Is Secure Email More Effective Than Traditional Member Portals?

In many cases, yes: Secure email bypasses portal fatigue, created by the friction of your members having to log into a separate platform to receive key communications. Conversely, secure email platforms, like LuxSci, deliver  messages directly to the inbox where members are more likely to read and respond.

What Makes Luxsci Different from Other Secure Email Providers?

LuxSci’s solutions have been built from the ground up with the stringent compliance and secuirty needs of healthcare organizations in mind. This translated into providing HIPAA-compliant email communication without sacrificing usability, supporting high-volume sending, flexible encryption options, and seamless integration into your existing systems.

hands on a keyboard sending secure email

How to Secure SMTP Email Delivery with TLS

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

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

In particular:

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

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

Secure SMTP Email Delivery with TLS 

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

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

Using TLS requires that the server administrators:

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

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

The sending computer or server could be configured for:

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

How Secure is Email Delivery over SMTP TLS?

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

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

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

What About Replies to Secure Messages?

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

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

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

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

What are the Weaknesses of SMTP TLS?

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

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

The Latest Updates to Secure SMTP TLS

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

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

How Secure SMTP TLS Email Works with LuxSci

Inbound TLS

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

Outbound Opportunistic TLS

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

Forced TLS

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

Support for strong encryption

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

Does LuxSci Have Any Other Special TLS Features?

When using LuxSci SecureLine for outbound email encryption:

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

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

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

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

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.