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What Are the Benefits of Email Communication in Healthcare?

Benefits of Email Communication in Healthcare

The benefits of email communication in healthcare include improved patient outcomes, reduced administrative costs, enhanced care coordination, and increased patient satisfaction through convenient, secure digital messaging platforms. Healthcare organizations implementing secure email systems experience improvements in medication adherence, appointment attendance, and chronic disease management while reducing telephone call volumes and administrative workload for clinical staff. These digital communication tools enable healthcare providers to maintain continuous contact with patients between visits, provide timely responses to health concerns, and deliver personalized education and support that strengthens patient engagement in their care management.

Relationship Building

Secure email platforms enable healthcare providers to establish deeper, more meaningful relationships with their patients through consistent, documented communication that extends beyond brief office visits. Patients can express their health concerns thoughtfully in writing, providing healthcare teams with detailed symptom descriptions and treatment questions that might be forgotten or rushed during in-person appointments. The benefits of email communication in healthcare become evident when patients feel more comfortable discussing sensitive health topics through written messages rather than verbal conversations, leading to more open and honest dialogue between providers and patients.

Response time flexibility allows healthcare providers to consider patient questions carefully and provide comprehensive, thoughtful answers without the time pressures associated with telephone conversations or office visits. Providers can research complex medical questions, consult with colleagues, and provide evidence-based responses that include educational resources and detailed explanations. This measured approach to communication enables healthcare teams to deliver higher-quality information and guidance compared to quick verbal exchanges that may lack depth or clarity.

Documentation benefits create permanent records of all patient communications that can be referenced during future appointments, shared with consulting specialists, or reviewed by other healthcare team members involved in patient care. These written records eliminate miscommunication issues that can occur with telephone conversations and provide clear evidence of medical advice, treatment instructions, and patient responses to interventions. Healthcare providers can track communication patterns over time to identify patient concerns, monitor treatment adherence, and adjust care plans based on documented patient feedback and questions.

Continuity of care improves when healthcare providers can maintain consistent contact with patients regardless of schedule conflicts, geographic distance, or other barriers that might prevent in-person visits. Email communication enables providers to follow up on treatment responses, check on patient recovery progress, and provide support for chronic disease management without requiring patients to schedule separate appointments for routine check-ins.

Operational Efficiency from the Benefits of Email Communication in Healthcare

Administrative workflow optimization occurs when routine patient inquiries can be handled through secure email rather than time-consuming telephone calls that interrupt clinical activities and require immediate staff attention. Reception staff experience reduced call volumes when patients can submit prescription refill requests, appointment scheduling inquiries, and general health questions through email systems that allow for batched processing during designated times. The benefits of email communication in healthcare extend to scheduling efficiency, as patients can request appointments, receive confirmations, and make changes through automated systems that operate beyond standard business hours.

Cost savings accumulate through reduced staff time spent on telephone communications, decreased appointment scheduling overhead, and improved resource allocation for patient care activities. Healthcare organizations report time savings when routine patient communications shift from telephone calls to secure email systems. These time savings translate to increased availability for patient care activities, reduced overtime costs, and improved staff productivity across administrative and clinical functions.

Revenue optimization results from improved appointment attendance rates when patients receive email reminders and have convenient options for rescheduling conflicts before they become no-shows. Billing efficiency improves when patients can receive statements, ask billing questions, and submit payment information through secure email channels that reduce administrative processing time. Insurance verification and prior authorization communications become more streamlined when documentation can be shared electronically rather than through time-consuming telephone calls and fax transmissions.

Practice scalability benefits emerge as email communication systems can handle increasing patient volumes without proportional increases in administrative staff or telephone infrastructure. Healthcare organizations can serve larger patient populations more efficiently while maintaining high-quality communication standards through automated systems that provide consistent, documented interactions with all patients regardless of practice size or growth patterns.

Clinical Quality Improvements and Patient Safety Benefits

Care coordination enhancement enables healthcare teams to share important patient information quickly and securely between providers, specialists, and other healthcare professionals involved in patient treatment. Email communication facilitates rapid consultation between primary care providers and specialists, enabling timely treatment decisions without delays associated with telephone tag or appointment scheduling. The benefits of email communication in healthcare include improved care transitions when patients move between different providers or healthcare settings, as complete communication histories can be shared electronically to ensure continuity and prevent important information from being lost.

Medication adherence monitoring becomes more effective when patients can report side effects, ask questions about their prescriptions, and receive guidance about proper medication administration through secure email channels. Healthcare providers can identify medication compliance issues early through patient communications and provide immediate support or adjustments before problems escalate to require emergency interventions. Prescription management improves when patients can submit refill requests electronically and receive confirmations or medication changes through documented channels that create clear records of all prescription-related communications.

Patient safety enhancements result from improved communication accuracy when important medical information is documented in writing rather than communicated verbally where misunderstandings can occur. Email systems enable healthcare providers to include detailed instructions, medication dosages, and follow-up requirements that patients can reference repeatedly to ensure proper compliance with treatment plans. Laboratory results and diagnostic test findings can be communicated through secure email with accompanying explanations that help patients understand their results and next steps in their care.

Preventive care compliance increases when healthcare providers can send personalized reminders about screenings, vaccinations, and wellness visits through email systems that track patient responses and follow-up requirements. Population health management becomes more effective when healthcare organizations can communicate with entire patient groups about health promotion activities, disease prevention strategies, and community health initiatives through targeted email campaigns.

Patient Empowerment from the Benefits of Email Communication in Healthcare

Convenient communication access eliminates many barriers that prevent patients from seeking timely healthcare guidance, particularly for working adults who cannot easily make telephone calls during business hours or patients with mobility limitations that make office visits challenging. Email communication enables patients to ask health questions, report concerning symptoms, and seek medical advice when they need it most rather than waiting for appointment availability or business hours. The benefits of email communication in healthcare become particularly valuable for patients managing chronic conditions who need frequent communication with their healthcare teams but cannot visit offices regularly.

Health education delivery through email platforms enables healthcare providers to share personalized educational materials, treatment instructions, and wellness resources that patients can access repeatedly and share with family members or caregivers. Educational content can be customized based on individual patient needs, diagnoses, and health literacy levels to ensure understanding and retention. Interactive educational resources sent through email can include videos, articles, and self-assessment tools that engage patients actively in learning about their health conditions and treatment options.

Decision-making support improves when patients have time to review treatment options, research their conditions, and formulate questions through email communication rather than making quick decisions during brief office visits. Healthcare providers can share decision aids, risk assessments, and treatment comparisons through secure email that enable patients to make informed choices about their care. Family involvement becomes easier when patients can share healthcare communications with family members or caregivers who help with decision-making and treatment management.

Self-advocacy skills develop when patients learn to communicate effectively about their health concerns, ask appropriate questions, and take active roles in their healthcare management through regular email interactions with their providers. These communication skills transfer to in-person appointments where patients become more prepared, engaged, and effective advocates for their health needs.

Technology Integration and Future Healthcare Innovation

Electronic health record integration ensures that all email communications become part of comprehensive patient medical records that support clinical decision-making and care coordination across multiple providers and healthcare settings. Automated documentation capabilities eliminate manual data entry requirements while maintaining complete communication histories that meet regulatory requirements and support quality improvement initiatives. The benefits of email communication in healthcare expand when integration capabilities enable providers to access complete patient communication histories during appointments, emergency situations, or care transitions.

Artificial intelligence applications can analyze email communication patterns to identify patients at risk for non-adherence, deteriorating health conditions, or care gaps that require proactive intervention. Natural language processing technologies can help prioritize urgent patient messages, identify concerning symptoms that require immediate attention, and route communications to appropriate healthcare team members based on content analysis. Machine learning algorithms can identify communication preferences and optimize message timing and content to improve patient engagement and response rates.

Telemedicine integration creates seamless communication workflows where email consultations can transition to video appointments when interaction becomes necessary for assessment or treatment. Secure messaging platforms can schedule and coordinate virtual visits, share pre-appointment questionnaires, and provide post-visit follow-up communications that support comprehensive telehealth experiences. Remote monitoring data from wearable devices and home health equipment can be communicated through integrated email systems that alert healthcare providers to concerning changes requiring intervention.

Population health analytics utilize email communication data to identify trends, measure intervention effectiveness, and guide public health initiatives across large patient populations. Healthcare organizations can analyze communication volumes, response rates, and patient engagement patterns to optimize their outreach strategies and resource allocation for population health impact. Quality improvement programs can use email communication data to measure patient satisfaction, identify areas for service enhancement, and demonstrate the benefits of email communication in healthcare to stakeholders and accrediting organizations.

Implementation Success Factors and Best Practices

Staff training programs ensure that healthcare teams understand how to use secure email systems effectively while maintaining professional communication standards and regulatory compliance requirements. Training should cover appropriate email etiquette, privacy protection measures, and workflows for managing patient communications efficiently without compromising quality or safety. Healthcare organizations must establish clear policies about response time expectations, appropriate content for email communication, and escalation procedures for urgent patient concerns that require immediate attention rather than email responses.

Patient education initiatives help individuals understand how to use secure email systems effectively, what types of health concerns are appropriate for email communication, and what security measures protect their private health information during electronic transmission. Educational materials should cover email security practices, account protection measures, and instructions for accessing and navigating patient portal systems. Healthcare organizations implementing secure email should provide multiple training formats including written instructions, video tutorials, and in-person assistance to accommodate different learning preferences and technology comfort levels.

Security protocols must be rigorously maintained to protect patient privacy and comply with healthcare regulations governing electronic communication of protected health information. Multi-factor authentication, encryption standards, and access controls ensure that only authorized individuals can view patient communications while audit trails track all system usage for compliance monitoring. Security assessments, staff training updates, and technology upgrades maintain protection against evolving cybersecurity threats that could compromise patient information or system integrity.

Quality monitoring procedures track email communication effectiveness through patient satisfaction surveys, provider feedback, and outcome measurements that demonstrate the benefits of email communication in healthcare across different patient populations and clinical scenarios. Healthcare organizations should establish metrics for response times, patient engagement rates, and clinical outcomes associated with email communication programs to guide improvement efforts and demonstrate return on investment to organizational leadership and regulatory bodies.

Picture of Erik Kangas

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 Oiva Health

LuxSci and Oiva Health Combine to Form Transatlantic Healthcare Communications Group

Boston & Helsinki, February 12, 2026 – LuxSci, a provider of secure healthcare communications solutions in the United States, and Oiva Health, a Nordic provider of Digital Care solutions in social and healthcare services, today announced that the companies are joining forces. Backed by Main Capital Partners (“Main”), the combination brings together two complementary platforms and teams, forming a strong transatlantic software group focused on secure healthcare communications.

Founded in 1999, LuxSci is a U.S. provider of HIPAA‑compliant, secure email, marketing, and forms solutions. Its application and infrastructure software enable organizations to securely deliver personalized, sensitive data at scale to support a broad range of healthcare communications and workflows including care coordination, benefits and payments, marketing, wellness communications, after care and ongoing care. Certified by HITRUST for the highest levels of data security, LuxSci serves dozens of healthcare enterprises and hundreds of mid‑market organizations.

Founded in 2010, Oiva Health is a provider of digital care and communications solutions in the Nordics. Headquartered in Finland, with additional offices in Denmark, Norway, and Sweden, Oiva Health offers digital care and digital clinic solutions – including digital visits, secure messaging, online scheduling and appointments, and caregiver communications – serving the long-term care, especially elderly care, and occupational healthcare verticals. The company employs approximately 60 people and has recently expanded across the Nordic region, with a growing presence in Norway and Sweden.

The combination of LuxSci and Oiva Health creates a larger, cross Atlantic group with complementary solutions, serving the U.S. and European markets. Together, the companies offer healthcare providers, payers, and suppliers a comprehensive suite of tools to communicate securely and compliantly, spanning communications, workflows, and virtual care delivery.

Daan Visscher, Partner and Co-Head North America at Main, commented: “We are pleased to announce this cross Atlantic transaction, creating an internationally active secure communications player within the healthcare and home care space. The combined product suite enables healthcare organizations to drive much needed efficiency gains in healthcare provision addressing a global trend of rising costs, aging population, and increasing pressure on resources needed to provide high-quality care.”

Mark Leonard, CEO of LuxSci, said, “We are thrilled to join forces with Oiva Health and believe that together we can truly make a difference in healthcare coordination, access, and delivery. We see an exciting path forward with our customers benefiting from an end-to-end, secure and compliant approach to optimizing both healthcare communications and today’s frontline workers, which we need now more than ever.”

Juhana Ojala, CEO at Oiva Health, concluded, “We look forward to this new chapter together with LuxSci. We are very excited about the strong alignment between our solutions, which especially strongly positions us to expand our flagship Digital Care offering to the high-potential U.S. care market – from care coordination to care delivery to in-home and institutional care.”

Nothing contained in this Press Release is intended to project, predict, guarantee, or forecast the future performance of any investment. This Press Release is for information purposes only and is not investment advice or an offer to buy or sell any securities or to invest in any funds or other investment vehicles managed by Main Capital Partners or any other person.

[END OF MESSAGE]

About LuxSci

LuxSci is a U.S.-based provider of secure healthcare communications solutions for the healthcare industry. The company offers secure email, marketing, forms and hosting, delivering HIPAA‑compliant communication solutions that enable organizations to safely manage and transmit sensitive data. Founded in 1999, LuxSci serves more than 1,900 customers across healthcare verticals, including providers, payers, suppliers, and healthcare retail, home care providers, and healthcare systems, as well as organizations operating in other highly regulated industries. LuxSci is HITRUST‑certified with example clients being Athenahealth, 1800 Contacts, Lucerna Health, Eurofins, and Rotech Healthcare, among others.

About Oiva Health

Oiva Health is a Digital Care provider in the Nordics, offering a comprehensive Digital Platform for integrated health and care services to digitalize primary healthcare, social care, hospital healthcare and long-term care services. The company was founded in 2010 and currently employs approximately 60 people in Finland, Denmark, Norway, and Sweden serving domestic municipalities, customers and partners, such as City of Helsinki, Keski-Suomi Welfare Region, Länsi-Uusimaa Welfare Region in Finland, and Viborg municipality in Denmark with its Digital Care platform. Annually over 5 million customer contacts are handled digitally through Oiva Health’s Digital Care and Digital Clinic platforms.  

About Main Capital Partners

Main Capital Partners is a software investor managing private equity funds active in the Benelux, DACH, the Nordics, France, and the United States with approximately EUR 7 billion in assets under management. Main has over 20 years of experience in strengthening software companies and works closely with the management teams across its portfolio as a strategic partner to achieve profitable growth and create larger outstanding software groups. Main has approximately 95 employees operating out of its offices in The Hague, Düsseldorf, Stockholm, Antwerp, Paris, and an affiliate office in Boston. Main maintains an active portfolio of over 50 software companies. The underlying portfolio employs approximately 15,000 employees. Through its Main Social Institute, Main supports students with grants and scholarships to study IT and Computer Science at Technical Universities and Universities of Applied Sciences.

The sender of this press release is Main Capital Partners.

For more information, please contact:

Main Capital Partners
Sophia Hengelbrok (PR & Communications Specialist)

sophia.hengelbrok@main.nl

+ 31 6 53 70 76 86

HIPAA Compliant Email

Rethinking HIPAA Compliant Email – Not Just a Checkbox

The compliance-only mentality is outdated.

Let’s be honest—when most healthcare organizations think about HIPAA compliant email, it’s usually in the context of avoiding fines or satisfying checklists. And while yes, compliance is critical, viewing it only through the lens of risk management is a missed opportunity.

In reality, HIPAA compliant email, when implemented properly, is one of the most powerful tools for patient and customer engagement. Why? Because it unlocks the ability to leverage protected health information (PHI) safely, enabling personalized, timely, and high-impact email communication that drives better engagement, satisfaction, and outcomes.

What Makes Email Truly HIPAA Compliant?

As a reminder, HIPAA compliant email requires that protected health information (PHI) is safeguarded both in transit and at rest. That means your email provider must:

  • Use encryption at all times
  • Be access-controlled
  • Include audit logs
  • Be stored and transmitted in a secure manner
  • Provide a Business Associate Agreement

Regular email services just don’t cut it. In fact, most consumer or marketing email platforms like Sendgrid or Constant Contact, while great at sending email, are not HIPAA compliant or have limitations when it comes to using PHI in your messages. Even when bolted-on encryption solutions are used, they often lack the flexibility, scalability, and automation needed for safe and effective healthcare email engagement.

LuxSci goes beyond the basics with policy-based encryption, secure TLS, PKI encryption and escrow/secure portal options. LuxSci’s SecureLine™ encryption technology dynamically selects the appropriate encryption method based on recipient capabilities and messaging context and can be configured to enforce secure delivery automatically according to organizational policies. LuxSci also provides the ability to enforce advanced multi-factor authentication. Every message is tracked with full audit trails—no guesswork, no loose ends.

The Real Opportunity – Secure, Personalized Email with PHI

Using PHI to Drive Personalized Messaging
Imagine sending a personalized reminder to a diabetic patient about an upcoming check-up. Or reaching out to new mothers with postnatal care resources tailored to their needs. Or sending automated email workflows to all your members to accelerate and increase new plan enrollments. Or email customer and prospects about a new product upgrade or new service offering. The list goes on. That’s the power of PHI-personalized email—when done securely.

Targeted Segmentation with Sensitive Data
With HIPAA compliant email solutions like LuxSci, you can segment your audience based on real health data with high levels of precision, such as chronic conditions, appointment history, insurance status, health risks, and more, without compromising patient trust or security.

Breaking the One-Size-Fits-All Approach in Healthcare Email
Generic email blasts are over. Modern patients expect personalization. With LuxSci, you can deliver highly targeted, highly secure emails with encrypted content, while staying HIPAA compliant.

Real Business Results from Secure Email

Here’s how secure, personalized email can drive improved results across a range of healthcare communications, including:

  • Increased Patient Appointments and Follow-ups – Sending encrypted, personalized appointment reminders and follow-up notices can reduce no-shows and boost overall appointment volume.
  • Boosting Preventative Care with Outreach Campaigns – Preventative campaigns (think flu shots or cancer screenings) sent securely to the right segments can lead to higher response rates, better health outcomes, and a lower cost of care.
  • Improving Health Plan Enrollments – Targeted email outreach during open enrollment, tailored by eligibility or plan type, and powered by automated workflows leads to higher enrollments and lower call center costs.
  • Driving Awareness and Sales of New Services or Products – Have a product upgrade offer, new wellness program or telehealth service? Send secure, PHI-informed HIPAA compliant email to the right audience for increased sales and faster adoption.
  • Optimize Explanation of Benefits NoticesReplace snail mail with email that’s fast, reliable and trackable, ensuring customers are informed and compliance is met.

The Healthcare Marketer’s Secret Weapon: Using PHI Responsibly

In a world moving away from third-party cookies, first-party data is more valuable than ever, and PHI is the most powerful form of it in healthcare. With secure HIPAA compliant email, PHI doesn’t have to be locked away. Marketers can safely use it to understand patient needs and send relevant, timely messages. PHI-driven segmentation lets you build hyper-targeted campaigns that speak to relevant conditions, unique needs and timely topics, increasing open rates, clicks throughs, and campaign conversions.

Meeting the Personalization Demands of Today’s Patients and Customers

HIPAA-compliant email is no longer just about checking a box. It’s about unlocking the full potential of your patient and customer data to drive better engagement, healthier outcomes, and measurable business results.

In closing, below are some final thoughts on how secure, HIPAA compliant email delivers long-term value for your organization and better connections with your patients and customers, including:

    • Future-Proofing Healthcare Engagement – Patients expect Amazon-level personalization. HIPAA-compliant tools let you meet those expectations securely.

    • Adapting to Data Privacy Regulations Beyond HIPAA – From GDPR to state-level privacy laws, secure communication is no longer optional, it’s foundational.

    • Building Trust Through Secure Communication – Each secure, personalized message sent is a trust-building moment with your patients and customers.

Why LuxSci? The Infrastructure Behind the Performance

With LuxSci’s secure email infrastructure and email marketing solutions, healthcare organizations can confidently personalize communication, reach patients more effectively, and fuel growth with PHI-safe segmentation, messaging, and email automation.

LuxSci takes data security and email performance to the next level by offering dedicated cloud infrastructure for each customer, which means your email campaigns aren’t slowed down by other vendors on shared cloud services and your attack footprint is much smaller. In short, you get higher delivery rates and throughput with proven HIPAA compliance and data security.

The future of healthcare engagement is personal, secure, and performance-driven—and it starts with HIPAA compliant email done right.

Reach out today with any questions or to learn more about LuxSci.


FAQs

1. Is HIPAA-compliant email necessary for marketing communications?
Yes—if your emails include or are based on PHI (like appointment reminders, condition-based messaging, or insurance info), you need HIPAA-compliant email and recipient consent to avoid legal risk and preserve patient trust.

2. Can PHI be used in marketing emails under HIPAA?
Yes, with proper consent and secure, HIPAA compliant infrastructure like LuxSci’s, PHI can be safely used in emails for personalized, segmented campaigns.

3. How does LuxSci ensure high email deliverability for healthcare messages?
LuxSci uses dedicated cloud servers for each customer, active email reputation monitoring, and best-practice configurations to ensure high deliverability rates for sensitive emails.

4. Is LuxSci only for marketing teams?
No—LuxSci supports marketing, clinical, operations, and IT teams by enabling secure, compliant email communication across the entire organization.

5. What types of PHI can I use to segment campaigns using LuxSci?
You can segment based on chronic conditions, visit history, insurance status, provider details, age, gender, location, and more—all while staying fully compliant.

HIPAA compliant email

Most Popular LuxSci Blog Posts of 2025

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

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

1. Improve Email Engagement and Marketing Results with Automated Workflows

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

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

2. Healthcare Email Threat Readiness Strategies

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

Read the full post: Healthcare Email Threat Readiness Strategies

3. HIPAA Compliant Email — 20 Tips in 20 Minutes

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

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

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

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

Read the full post: Is SendGrid HIPAA-Compliant?

5. LuxSci Shines in G2 Winter 2026 Reports

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

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

Looking Ahead to 2026

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

Follow LuxSci on LinkedIn

HIPAA compliant email

LuxSci Welcomes Angel Mazariegos as Head of Finance

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

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

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

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

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

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

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What is a cyber risk assessment?

What Is a Cyber Risk Assessment?

As cyber threats become both more frequent and sophisticated, it’s essential for healthcare companies to strengthen their cybersecurity posture and safeguard the electronic protected health information (ePHI) within their IT ecosystems and communications. This begins with a comprehensive cyber risk assessment that spans infrastructure, applications and communications. 

A cyber risk assessment enables healthcare companies to focus their attention on the IT areas that need the most improvement, allowing them to be more effective in their threat mitigation efforts. This not only reduces the chances of cyber attacks but helps them align with HIPAA’s guidelines and maintain the operational integrity required to best serve their patients and customers.

Let’s discuss why it’s vital that healthcare companies conduct thorough cyber threat risk assessments and the steps your organization can take to carry one out effectively.

Why Are Cyber Risk Assessments Crucial for Healthcare Organizations?

In an increasingly digitized healthcare landscape, conducting regular risk assessments is essential for companies of all sizes, in every industry. For healthcare companies, charged with protecting patient data, it’s especially critical and often a compliance requirement. Electronic PHI, which contains details of an individual’s health history, including current conditions, past illnesses and procedures, prescribed medicine, etc., is very sensitive in nature, so healthcare companies must go the extra mile to ensure its protection in transit and at rest. 

Performing a cyber threat risk assessment is the first step to achieving this critical requirement. A risk assessment allows you to identify all of the ePHI within your business, understand the threats it faces, determine gaps in your cybersecurity posture, and, most importantly, mitigate them.  

Additionally, from a compliance perspective, conducting regular risk assessments is a key requirement of HIPAA’s Security Rule. Consequently, healthcare companies must carry out periodic risk assessments if they want to comply with HIPAA regulations, and avoid the consequences of non-compliance. A risk assessment provides documented evidence, to auditors, supply-chain partners, and others, that you are conscious of security concerns and have taken the proper steps to mitigate them. 

How Do You Conduct A Cyber Risk Assessment? 

Now that we’ve discussed their importance, let’s turn our attention to how healthcare organizations can conduct effective cyber risk assessments. 

Identify Assets

The first, and, arguably, most important step of a risk assessment is identifying your organization’s digital assets, which include: 

  • Hardware: endpoint devices (desktops, laptops, smartphones, etc.), servers, network equipment, medical equipment, etc. 
  • Systems, infrastructure and applications: operating systems, cloud services, etc. 
  • Data, i.e., ePHI

Now, the reason asset identification could be considered the most crucial part of a risk assessment is that a healthcare organization‘s security teams can’t protect what they aren’t aware of! 

Consequently, weeding out instances of “shadow IT”, i.e., the use of applications and/or systems without the approval of a company’s IT department is essential. Otherwise, you could have cases in which ePHI is used in applications, resides on databases, and so on – without it being adequately safeguarded. 

Once you’ve identified your assets, you need to classify them: based on their sensitivity and potential impact if a security incident were to occur.

Identify Vulnerabilities and Threats

Having successfully catalogued your assets, you must now establish the factors most likely to compromise their security. This first means pinpointing the vulnerabilities in your IT ecosystem, which could include:

  • A lack of encryption, or weak standards
  • Lax access controls
  • Weak password policies 
  • Lack of monitoring and logging 
  • Outdated software (with some no longer being supported by its vendor) 
  • End-of-life hardware
  • Infrequent back-ups
  • Unverified or insecure third-party vendors

When you have a better understanding of these vulnerabilities, which are called attack vectors, you can then determine the most likely threats to ePHI based on the gaps in your security posture. These include:

  • Data breaches or exposure
  • Malware, e.g., ransomware, viruses, spyware, etc. 
  • Social engineering phishing
  • Insider threats (whether through malice or human error)
  • Distributed Denial of Service (DDoS) attacks

Fortunately, there is an array of scanning tools that will help you find your cybersecurity vulnerabilities. As far as understanding the main threats to your sensitive patient and customer data, you need to keep up with the latest in threat intelligence. Cybercriminals are always devising new ways to infiltrate healthcare organizations’ networks, so your security teams must remain aware of emerging cyber threats. 

Risk Prioritization

So, now you have catalogued your assets, determined their vulnerabilities, and identified the threats. However, implementing cyber threat mitigation measures requires resources – namely time and money – so you must prioritize which risks to mitigate first, based on their likelihood and impact.

First, how likely is a threat to exploit a vulnerability? Healthcare organizations typically determine this through existing threat databases, such as MITRE, as well as keeping up-to-date on the latest threat intelligence and determining how it pertains to your company. 

Secondly, evaluate the potential impact, or consequences, of a threat actually manifesting, i.e., a an email breach or a malicious actor successfully pulling off a cyber attack and infiltrating your network. When analyzing the potential impact, consider the financial, operational, reputational, and compliance implications. 

Report Findings

At this point, you should report the findings of the risk assessments to your company’s key stakeholders, e.g., upper management, compliance officers, IT management and security, etc. This ensures that decision-makers understand the nature of the top threats facing your organization, their potential business impact, and the urgency of implementing mitigation controls. 

This also helps security teams secure the resources they need to bolster their cybersecurity posture accordingly. An additional benefit of this reporting is that it provides an audit trail for compliance efforts, as it demonstrates your efforts to better protect patient and customer data. 

Implement Mitigation Measures

Now, we’ve come to the point in the risk assessment process where you act on your due diligence and implement the policies and controls that will better protect patient data and comply with HIPAA guidelines.  

Mitigation measures broadly fall into three categories: 

  • Preventive: e.g., encryption, access control, user authentication (e.g., multi-factor authentication (MFA))
  • Detective: e.g., vulnerability scanning, continuous monitoring
  • Corrective: e.g., incident response, backups and disaster recovery

A robust cybersecurity posture requires a combination of all three. Your risk assessment may reveal that your organization is strong in one aspect but less so in others, or you may need to bolster your efforts across the board. 

Document Your Risk Mitigation Measures

Create a risk mitigation implementation report that details how your organization executed its cyber threat mitigation strategies. This should include: 

  • Affected assets: the parts of your IT infrastructure (servers, databases, etc.) and applications you identified as vulnerable and the severity of their corresponding threats. 
  • Mitigation actions: the specific action(s) undertaken to mitigate cyber threats against the asset, e.g., enhancing encryption standards, strengthening password policies, conducting cyber threat awareness training, etc. 
  • Technical details: where applicable, such as a particular update applied to an application, how a system has been configured, which new software solution has been deployed, and so on.
  • Post-mitigation risk assessment: re-evaluate the risk level of each asset after the implementation of new security measures. 
  • Monitoring and compliance: detail how the organization will monitor the efficacy of the implemented measures, as well as how your enhanced controls and policies align with compliance standards (e.g., HIPAA, NIST, HITRUST, etc).

As with the report for stakeholders after the initial stages of the assessment, the risk mitigation implementation report also leaves a compliance audit trail, which will become all the more important when the proposed changes to the HIPAA Security Rule come into effect.

Continuous Monitoring and Review

As detailed in your risk mitigation implementation report, you must continuously monitor your IT infrastructure to assess the effectiveness of your newly implemented policies and controls. This process also mitigates cyber risk, in and of itself, as it provides fewer opportunities for malicious actors to breach your network: you’ll have systems in place to alert you of suspicious activity. 

Additionally, you must regularly reassess your organization’s cyber risks as new threats emerge, your IT ecosystem evolves, or if you succumb to a cyber attack. 

How Often Should You Conduct Cyber Risk Assessments? 

Healthcare organizations should carry out a cyber risk assessment at least once a year, with respect to time, or when they make changes to their IT infrastructure. With the proposed changes to the HIPAA Security Rule on the horizon, now is an opportune time to conduct a risk assessment and measure your cyber threat readiness against the new stipulations of the soon-to-be-updated Security Rule.

Also, as alluded to above, if you suffer a security incident, you must conduct a post-breach assessment, once the threat is contained, to establish how a malicious actor breached your network – and how to prevent it from happening again. 

How LuxSci Helps Mitigate Cyber Risk in the Healthcare Industry

With more than 20 years of experience, LuxSci has developed the required expertise to make secure communication solutions tailored to meet the stringent cyber risk mitigation needs of the healthcare industry.

LuxSci’s suite of HIPAA-compliant communication solutions includes:

  • Secure Email: HIPAA compliant email solutions for executing highly scalable, high volume email campaigns that include PHI – millions of emails per month.
  • Secure Forms: Securely and efficiently collect and store ePHI without compromising security or compliance – for onboarding new patients and customers and gathering intelligence for personalization.
  • Secure Marketing: proactively reach your patients and customers with HIPAA marketing campaigns for increased engagement, lead generation and sales.
  • Secure Text Messaging: enable access to ePHI and other sensitive information directly to mobile devices via regular SMS text messages.

Interested in discovering more about how LuxSci can help you protect your patient’s ePHI, mitigate cyber risk, and ensure HIPAA compliance for your email and communications? Contact us today!

encrypted email transmission

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

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

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

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

An Example Email Message

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

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

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

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

LuxSci:

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

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

Proofpoint:

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

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

Outlook:

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

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

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

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

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

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

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

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

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

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

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

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

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

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

How To Tell if an Email is Encrypted With TLS

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

How can you Ensure Emails Are Securely Transmitted?

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

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

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

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

Was the email message sent and received using encryption?

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

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

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

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

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

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.

HIPAA email laws

What Are HIPAA Compliant Hosting Services?

HIPAA compliant hosting services provide secure infrastructure for healthcare applications and data storage while meeting regulatory requirements for protecting electronic protected health information. These services include cloud hosting, dedicated servers, managed services, and hybrid solutions that implement encryption, access controls, audit logging, and business associate agreements to support healthcare organizations’ compliance obligations. Healthcare organizations need reliable hosting solutions that can handle the security and compliance requirements of medical applications while providing scalability and cost-effectiveness. Standard hosting services lack the features necessary for healthcare applications involving protected health information.

Cloud Infrastructure and Platform Services

Infrastructure as a Service (IaaS) platforms provide virtualized computing resources including servers, storage, and networking that healthcare organizations can configure for their specific applications while maintaining HIPAA compliant hosting. These platforms offer scalability and flexibility while implementing appropriate security controls. Platform as a Service (PaaS) solutions provide development and deployment environments for healthcare applications with built-in compliance features including encryption, access controls, and audit capabilities. These platforms enable healthcare organizations to focus on application development while leveraging provider expertise in compliance management. Software as a Service (SaaS) applications designed for healthcare provide complete solutions including electronic health records, practice management systems, and patient engagement tools with integrated HIPAA compliance features. These applications reduce internal IT requirements while maintaining regulatory adherence.

Private Cloud Options for HIPAA Compliant Hosting Services

Single-tenant environments provide healthcare organizations with dedicated computing resources that are not shared with other clients, offering enhanced security and performance isolation. These environments help address concerns about data co-location while providing predictable performance characteristics. Private cloud deployments combine the scalability benefits of cloud computing with the security advantages of dedicated infrastructure through isolated virtual environments. Healthcare organizations can achieve cloud flexibility while maintaining greater control over their computing environment. Hybrid cloud solutions enable healthcare organizations to combine on-premises infrastructure with cloud services based on specific application requirements and compliance needs. Architectures provide flexibility for different workloads while maintaining appropriate security controls.

Support Options for HIPAA Compliant Hosting Services

HIPAA compliant hosting services provide specialized expertise for healthcare data storage including backup, recovery, performance optimization, and security monitoring. These services help healthcare organizations maintain database security while reducing internal administrative burden. Application hosting services manage the complete technology stack for healthcare applications including operating systems, middleware, and application software while maintaining HIPAA compliance. These services enable healthcare organizations to focus on patient care rather than infrastructure management. Security monitoring services provide oversight of hosting infrastructure including threat detection, incident response, and compliance monitoring.

Data Protection and Backup Solutions

Encryption services protect healthcare data during storage and transmission through automated key management and policy enforcement. These services ensure that PHI receives appropriate protection without requiring healthcare organizations to develop internal encryption expertise. Backup and disaster recovery services maintain additional copies of healthcare data while preserving security protections and enabling rapid restoration after system failures or security incidents. These services help ensure business continuity while maintaining compliance obligations. Data loss prevention tools monitor healthcare data movement and usage to identify potential unauthorized disclosures or policy violations. Data tools help hosting providers and healthcare clients maintain awareness of data handling activities while preventing compliance incidents.

Network Security and Access Management

Virtual private network services provide secure communication channels between healthcare organizations and hosting infrastructure while protecting data transmission from interception or modification. These HIPAA compliant hosting services enable remote access while maintaining appropriate security controls. Identity and access management services help healthcare organizations control user permissions and authentication for hosted applications while maintaining audit trails and compliance documentation. These services integrate with existing healthcare systems while providing centralized access control. Network segmentation services isolate healthcare applications and data from other hosted services while maintaining necessary connectivity for operations and patient care. These services help reduce security risks while enabling efficient resource utilization.

Compliance and Audit Support Services

Risk assessment services help healthcare organizations evaluate their hosting environment for potential vulnerabilities and compliance gaps while providing recommendations for improvement. HIPAA compliant hosting services use specialized expertise in healthcare security and regulatory requirements. Audit preparation services assist healthcare organizations in responding to regulatory reviews or compliance assessments by organizing documentation and providing evidence of security controls. These services help reduce the burden of compliance demonstrations while ensuring thoroughness. Compliance monitoring services provide ongoing oversight of hosting environment security and regulatory adherence through automated tools and expert analysis. HIPAA compliant hosting services help healthcare organizations maintain awareness of their compliance status while identifying potential issues before they become violations.

Vendor Selection and Evaluation Criteria

Security certification assessment helps healthcare organizations evaluate hosting providers based on their compliance with industry standards including SOC 2, HITRUST, and ISO 27001. These certifications provide objective evidence of provider security capabilities and commitment to best practices. Business associate agreement evaluation ensures that hosting providers accept appropriate liability and compliance obligations when handling PHI on behalf of healthcare organizations. These agreements must include specific provisions about data protection, breach notification, and audit rights. Service level agreement analysis helps healthcare organizations understand hosting provider performance commitments including uptime guarantees, response times, and support availability.

Subscription-based pricing provides predictable monthly or annual costs for HIPAA compliant hosting services while including compliance features and support services. Healthcare organizations can budget effectively while ensuring that compliance capabilities are included in base pricing rather than additional fees. Usage-based billing scales hosting costs with actual resource consumption while maintaining compliance features regardless of utilization levels. This pricing model helps healthcare organizations manage costs during growth or seasonal variations while preserving security protections. Implementation and migration services help healthcare organizations transition to compliant hosting solutions while minimizing disruption to patient care and business operations. Services do well to include project management, data transfer, and staff training to ensure successful deployment.