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What is a Secure Email Gateway?

HIPAA Compliant Marketing

Email communication is indispensable in today’s fast-paced, digitally-driven healthcare world. Unfortunately, for healthcare organizations, cyber criminals are aware of this too, which is why email-based cyber threats, such as unauthorized access, PHI exposure, phishing and ransomware, remain as prevalent as ever. A Secure Email Gateway can help, providing a security solution that sits between an organization’s email server and the outside world to monitor, filter, and control all incoming and outgoing email traffic.

As healthcare companies learn to recognize and mitigate email security threats, malicious actors grow more sophisticated, developing new ways of breaching organizations’ email security measures. In light of this, healthcare companies must find ways to better safeguard the electronic protected health information (ePHI) within their IT infrastructure, especially for email. Not only will this help maintain operational consistency, delivering high-quality and expedient service to their patients and customers, but it helps them comply with the regulatory guidelines mandated by the Health Insurance Portability and Accountability Act (HIPAA).  

A secure email gateway provides an excellent solution to the problem of an evolving email cyber threat landscape, without a healthcare company having to make significant changes to their IT infrastructure. So, with this in mind, this post explores the concept of secure email gateways, how they better safeguard sensitive patient data, and how they support HIPAA compliance efforts. 

What Is a Secure Email Gateway?

A secure email gateway is a security tool that filters inbound and outbound email communications to mitigate a variety of email-based cyber threats, including phishing, malware (e.g., ransomware, viruses, etc), PHI exposure, and spam mail. 

Effectively providing an additional security layer for your organization’s email accounts, a secure email gateway acts as a checkpoint between its email systems and the internet, enforcing your healthcare company’s security policies and ensuring HIPAA compliance.

How Do Secure Email Gateways Work?

A secure email gateway sits between a company’s email platform (e.g., Microsoft 365, Google Workspace) and external email traffic, scanning messages for potential malicious activity and security policy violations.

When sending an outbound email, the message is encrypted before being passed onto the recipient. This prevents the exposure of any ePHI contained in the email, in the event of its interception. Without the encryption key, the email is rendered unreadable by cyber criminals, ensuring data privacy and regulatory compliance. By the same token, depending on its nature, the secure email gateway may automatically archive the email to help satisfy compliance requirements for message retention – something that will be all the more important when the updated HIPAA Security Rule comes into effect in later 2025.

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Conversely, for incoming traffic, a secure email gateway utilizes filtering tools to identify and quarantine suspicious messages. By preventing potentially malicious messages from reaching employee inboxes, a gateway reduces instances of phishing, malware installation, credential compromise – and any email cyber threat that requires human error or negligence.  

When Should You Opt For a Secure Email Gateway?

The key reason to opt for a secure email gateway solution is that you want to enhance your company’s email security without replacing your existing email infrastructure.

A key advantage offered by secure email gateways is that they’re easy to install, manage, and use. This keeps the administrative burden on a company’s IT and operations departments to a minimum while still achieving the key objectives of boosting email security and aiding compliance efforts. 

More specifically, installing a secure email gateway can be an easy solution for healthcare care companies looking to quickly achieve HIPAA compliance for email. By simply sitting on top of a company’s existing email service, like Microsoft 365 or Google Workspace, a secure email gateway can be easier for IT teams to install and maintain, especially for smaller companies and organizations. Additionally, employees won’t require additional training or have to make any adjustments: they can simply keep using their existing email accounts without interruption.

Enhance Your Email Security Posture With Luxsci’s Secure Email Gateway

LuxSci’s Secure Email Gateway can be easily integrated with Microsoft 365, Google Workspace, or your on-premise email client to better safeguard ePHI and ensure HIPAA compliance – with zero disruption to your current systems, employees, or your quality of service.   

Using LuxSci’s proprietary SecureLine encryption technology, our Secure Email Gateway solution automatically encrypts every email, protecting sensitive patient data without the need for explicit employee intervention before sending the message.  

Want to know more about how HIPAA compliant email will boost your security and compliance? Contact us to learn more and get started!

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biggest email threats

Know the Biggest Email Threats Facing Healthcare Right Now

Due to its near-universal adoption, speed, and cost-effectiveness, email remains one of the most common communication channels in healthcare. Consequently, it’s one of the most frequent targets for cyber attacks, as malicious actors are acutely aware of the vast amounts of sensitive data contained in messages – and standard email communication’s inherent vulnerabilities.

 

In light of this, healthcare organizations must remain aware of the evolving email threat landscape, and implement effective strategies to protect the electronic protected health information (ePHI) included in email messages. Failing to properly secure email communications jeopardizes patient data privacy, which can disrupt operations, result in costly HIPAA compliance violations, and, most importantly, compromise the quality of their patients’ healthcare provision.

 

With all this in mind, this post details the biggest email threats faced by healthcare organizations today, with the greatest potential to cause your business or practice harm by compromising patient and company data. You can also get our 2025 report on the latest email threats, which includes strategies on how to overcome them.

Ransomware Attacks

Ransomware is a type of malware that encrypts, corrupts, or deletes a healthcare organization’s data or critical systems, and enables the cybercriminals that deployed it to demand a payment (i.e., a ransom) for their restoration. Healthcare personnel can unwittingly download ransomware onto their devices by opening a malicious email attachment or clicking on a link contained in an email.

In recent years, ransomware has emerged as the email security threat with the most significant financial impact. In 2024, for instance, there were over 180 confirmed ransomware attacks with an average paid ransom of nearly $1 million. 

Email Client Misconfiguration

While a healthcare organization may implement email security controls, many fail to know the security gaps of their current email service provider (ESP) or understand the value of a HIPAA compliant email platform, leaving data vulnerable to email threats, such as unauthorized access and ePHI exposure, and also, subsequently, a greater risk of compliance violations and reputation damage.


 

Common types of email misconfiguration include:

 

  • Lack of enforced TLS encryption: resulting in emails being transmitted in plaintext, rendering the patient data they contain readable by cybercriminals in the event of interception during transit.
  • Improper SPF/DKIM/DMARC setup: failure to configure or align these email authentication protocols correctly gives malicious actors greater latitude to successfully spoof trusted domains.
  • Disabled or lax user authentication: a lack of authentication measures, such as multi-factor authentication (MFA), increases the risk of unauthorized access and ePHI exposure.
  • Misconfigured secure email gateways: incorrect rules or filtering policies can allow phishing emails through or block legitimate messages.
  • Outdated or unsupported email client software: simply neglecting to download and apply the latest updates or patches from the email client’s vendor can leave vulnerabilities, which are well-known to cybercriminals, exposed to attack.

Social Engineering Attacks

A social engineering attack involves a malicious actor deceiving or convincing healthcare employees into granting unauthorized access or exposing patient data. Relying on psychological manipulation, social engineering attacks exploit a person’s trust, urgency, fear, or curiosity, and encompass an assortment of threats, including phishing and business email compromise (BEC) attacks, which are covered in greater depth below.

Phishing

As mentioned above, phishing is a type of social engineering attack, but they are so widespread that it warrants its own mention. Phishing sees malicious actors impersonating legitimate companies, or their employees, to trick victims into revealing sensitive patient data. 

Subsequently, healthcare organizations can be subjected to several different types of phishing attacks, which include:

 

  • General phishing: otherwise known as bulk phishing or simply ‘phishing’, these are broad, generic attacks where emails are sent to large numbers of recipients, impersonating trusted entities to steal credentials or deliver malware. 
  • Spear phishing: more targeted attacks that involve personalized phishing emails crafted for a specific healthcare organization or individual. These require more research on the part of malicious actors and typically use relevant insider details gleaned from their reconnaissance for additional credibility.
  • Whaling: a form of spear phishing that specifically targets healthcare executives or other high-level employees. 
  • Clone phishing:  when a cybercriminal duplicates a legitimate email that was previously received by the target, replacing links or attachments with malicious ones.
  • Credential phishing: also known as ‘pharming’, this involves emails that link to fake login pages designed to capture healthcare employees’ usernames and passwords under the guise of frequently used legitimate services.

Domain Impersonation and Spoofing

This category of threat revolves around making malicious messages appear legitimate, which can allow them to bypass basic email security checks. As alluded to above, these attacks exploit weaknesses in email client misconfigurations to trick the recipient, typically to expose and exfiltrate patient data, steal employee credentials, or distribute malware.

 

Domain spoofing email threats involve altering the “From” address in an email header to make it appear to be from a legitimate domain. If a healthcare organization fails to properly configure authentication protocols like SPF, DKIM, and DMARC, there’s a greater risk of their email servers failing to flag malicious messages and allowing them to land in users’ inboxes.

 

Domain impersonation, on the other hand, requires cybercriminals to register a domain that closely resembles a legitimate one. This may involve typosquatting, e.g., using “paypa1.com” instead of “paypal.com”. Alternatively, a hacker may utilize a homograph attack, which substitutes visually similar characters, e.g., from different character sets, such as Cyrillic. Malicious actors will then send emails from these fraudulent domains, which often have the ability to bypass basic email filters because they aren’t exact matches for blacklisted domains. Worse still, such emails can appear authentic to users, particularly if the attacker puts in the effort to accurately mimic the branding, formatting, and tone used by the legitimate entity they’re attempting to impersonate. 

Insider Email Threats

In addition to external parties, employees within a healthcare organization can pose email threats to the security of its PHI. On one hand, insider threats can be intentional, involving disgruntled employees or third-party personnel abusing their access privileges to steal or corrupt patient data. Alternatively, they could be the result of mere human error or negligence, stemming from ignorance, or even fatigue.

 

What’s more, insider threats have been exacerbated by the rise of remote and flexible conditions since the onset of the COVID-19 pandemic, which has created more complex IT infrastructures that are more difficult to manage and control.  

Business Email Compromise (BEC) Attacks

A BEC attack is a highly targeted type of social engineering attack in which cybercriminals gain access to, or copy, a legitimate email account to impersonate a known and trusted individual within an organization. BEC attacks typically require extensive research on the targeted healthcare company and rely less on malicious links or attachments, unlike phishing, which can make them difficult to detect.

 

Due to the high volume of emails transmitted within the healthcare industry, and the sensitive nature of PHI often included in communications to patients and between organizations, the healthcare industry is a consistent target of BEC attacks.

 

BEC attacks come in several forms, such as:

 

  • Account compromise: hijacking a real employee’s account and sending fraudulent messages.
  • Executive fraud: impersonating high-ranking personnel to request urgent financial transactions or access to sensitive data.
  • Invoice fraud: pretending to be a vendor asking for the payment of a fraudulent invoice into an account under their control.

Supply Chain Risk

Healthcare organizations increasingly rely on third-party vendors, including cloud service providers, software vendors, and billing or payment providers to serve their patients and customers. They constantly communicate with their supply chain partners via email, with some messages containing sensitive patient data; moreover, some of these organizations will have various levels of access to the PHI under their care.

 

Consequently, undetected vulnerabilities or lax security practices within your supply chain network could serve as entry points for email threats and malicious action. For instance, cybercriminals can compromise the email servers of a healthcare company’s third-party vendor or partner, and then send fraudulent emails from their domains to deploy malware or extract patient data.

 

Another, somewhat harrowing, way to understand supply chain risk is that while your organization may have a robust email security posture, in reality, it’s only as strong as that of your weakest third-party vendor’s security controls.

Download LuxSci’s Email Cyber Threat Readiness Report

To gain further insight into the biggest email threats to healthcare companies in 2025, including increasingly prevalent AI threats, download your copy of LuxSci’s Email Cyber Threat Readiness Report

 

You’ll also learn about the upcoming changes to the HIPAA Security Rule and how it’s set to impact your organization going forward, and the most effective strategies for strengthening your email security posture.

 

Grab your copy of the report here and begin the journey to strengthening your company’s email threat readiness today.

HIPAA compliant email for Therapists

What is the Best HIPAA Compliant Email?

The best HIPAA compliant email contains strong security features with ease of use and reasonable pricing. Top options include properly configured Google Workspace or Microsoft 365 accounts with Business Associate Agreements in place. Look at HIPAA compliant email platforms that offer encryption, access controls, audit logging, and secure mobile access while fitting their practice size, budget, and technical capabilities.

HIPAA Compliant Email Features

Healthcare professionals require email systems with particular security capabilities to protect client communications. Any HIPAA compliant email must include automatic encryption that works without requiring clients to create accounts or remember passwords. You need detailed access logs that document when messages were sent, received, and viewed. Message recall capabilities help address accidental disclosures before they become compliance issues. Calendar integration supports secure appointment scheduling and reminders. Mobile access controls ensure therapists can communicate safely from smartphones and tablets during off-hours or between office locations. Document sharing features allow secure exchange of intake forms and treatment plans. These capabilities help therapists maintain compliant communications while managing their practice efficiently.

Popular HIPAA Compliant Email Platforms

Several email providers offer solutions well-suited to mental health professionals. Hushmail for Healthcare includes features designed for therapists with web-based secure forms for client intake and customizable email templates. Paubox delivers encrypted email that works without requiring recipients to take extra steps, making it ideal for client communications. Virtru integrates with existing Gmail or Outlook accounts to add HIPAA compliant protections without changing email addresses. Google Workspace and Microsoft 365 provide affordable options when properly configured with appropriate security settings and covered by Business Associate Agreements. Smaller therapy practices often prefer these mainstream platforms for their familiarity and integration with other practice tools.

Security Considerations for Healthcare Communications

Secure healthcare communications require thoughtful security approaches due to their sensitive nature. HIPAA compliant email should include protections against phishing attacks that might target patient information. Data loss prevention tools identify and secure messages containing sensitive information even when users forget to enable encryption. Account recovery procedures must balance security with practicality for small practices. Multi-factor authentication prevents unauthorized access even if passwords are compromised.

For example, healthcare personnel handling substance use disorder information need email systems that comply with both HIPAA and 42 CFR Part 2 requirements. Solutions should accommodate supervision relationships where communications may need controlled sharing with supervisors.

Client Experience and Usability Factors

The best HIPAA compliant email solutions balance security with positive client experiences. Buyers should evaluate how encryption affects the client’s process for reading and responding to messages. Some solutions require clients to create accounts or install software, while others deliver protected messages that open with minimal friction. Mobile compatibility matters as many clients prefer communicating from smartphones. Branding options allow therapists to maintain professional appearance in all communications. Automated responses help set appropriate expectations about response timing and emergency protocols. Client-facing secure forms streamline intake processes while maintaining compliance.

HIPAA Compliant Email Implementation for Medical Practices

Implementing secure email requires planning tailored to medical practice workflows. Solo practitioners need solutions with straightforward setup and minimal ongoing maintenance. Group practices benefit from centralized administration that enforces consistent security policies across all therapists. Practice management integration connects secure email with scheduling, billing, and documentation systems.

Transition planning helps migrate existing communications to new secure platforms without disrupting client relationships. Documentation templates ensure compliance with both HIPAA and professional ethical standards for electronic communications. Training materials must address both technical operation and appropriate clinical use cases. When implementing HIPAA compliant email practice admins should create workflow procedures that incorporate secure communication into their practice routines.

Cost Considerations For Selecting Email Services

Healthcare providers must balance security requirements with budget realities when selecting HIPAA compliant email. Pricing models vary significantly, with some services charging per user while others offer flat-rate plans better suited to solo practitioners. Additional fees may apply for features like secure forms, extra storage, or advanced security controls. Implementation costs include time spent on configuration, training, and client education about new communication methods. Some platforms offer discounted rates for professional association members or multi-year commitments. Buyers should calculate the total cost of ownership beyond monthly subscription fees, including technical support and compliance documentation. Affordable HIPAA compliant email options exist for practices of all sizes, but require thoughtful evaluation of both immediate pricing and long-term value.

Integrating Email with Broader Practice Security

HIPAA compliant email represents one component of comprehensive practice security. Email solutions should complement electronic health record systems while maintaining appropriate boundaries between clinical documentation and communications. Device management policies ensure therapists access email securely across computers, tablets, and smartphones. Backup procedures preserve communications while maintaining security protections. Incident response planning prepares therapists for addressing potential security issues or breaches. Regular security reviews evaluate whether email practices continue to meet evolving compliance requirements. By integrating email security with broader practice safeguards, therapists create communication systems that protect client information throughout its lifecycle.

Email HIPAA Compliance

What Are Email HIPAA Compliance Requirements?

Email HIPAA compliance is the privacy and security standards that healthcare organizations must implement when using electronic mail to transmit, store, or discuss protected health information. These requirements include encryption protocols, access controls, audit logging, and administrative safeguards that protect patient data during email communications. Healthcare providers, payers, and suppliers must understand email HIPAA compliance obligations to avoid costly violations while maintaining effective communication with patients, business partners, and other healthcare organizations. Understanding email HIPAA compliance helps organizations select appropriate email platforms, train staff on proper procedures, and implement policies that protect patient information while supporting clinical and administrative workflows.

Privacy Rule Requirements For Email HIPAA Compliance

The Privacy Rule establishes how healthcare organizations can use and disclose protected health information in email communications without violating patient privacy rights. Email HIPAA compliance permits healthcare organizations to use patient information for treatment, payment, and healthcare operations without obtaining individual patient authorization. Clinical communications between providers, billing discussions with payers, and care coordination activities fall under these permitted uses when proper safeguards are implemented.

Healthcare organizations must provide privacy notices to patients explaining how their information may be used in email communications and their rights regarding this information. Patients have the right to request restrictions on how their information is shared via email, though organizations are not always required to agree to these limitations. Email HIPAA compliance requires organizations to honor reasonable requests and provide mechanisms for patients to file complaints about email privacy practices.

Minimum necessary standards require healthcare organizations to limit email communications to the smallest amount of protected health information needed for the specific purpose. This means that diagnosis details, treatment notes, and other sensitive information should only be included when necessary for patient care or business operations. Organizations must evaluate their email practices to ensure compliance with minimum necessary requirements across different communication types.

Security Rule Standards For Email HIPAA Compliance

The Security Rule requires healthcare organizations to implement administrative, physical, and technical safeguards to protect electronic protected health information transmitted via email. Administrative safeguards include appointing security officers responsible for email systems, conducting workforce training on email privacy requirements, and establishing procedures for granting and revoking email access. These safeguards ensure that only authorized personnel can access patient information during email communications.

Technical safeguards focus on access controls, encryption, audit logging, and transmission security for email systems. Email HIPAA compliance requires user authentication systems that verify the identity of individuals accessing email containing patient information. Encryption protects email content during transmission and storage, while audit logs track who accesses patient information and when these access events occur.

Physical safeguards protect computer systems, mobile devices, and facilities where email containing patient information is accessed or stored. Organizations must implement workstation security controls, device controls for mobile email access, and media disposal procedures for devices containing patient communications. These protections prevent unauthorized individuals from accessing patient information through physical security breaches.

Regular security assessments evaluate email systems for vulnerabilities that could lead to data breaches or unauthorized disclosures. Email HIPAA compliance requires organizations to address identified weaknesses and maintain documentation of security measures. Penetration testing and vulnerability scanning help identify potential problems before they result in privacy violations.

Business Associate Requirements For Email HIPAA Compliance

Third-party email service providers that handle protected health information on behalf of healthcare organizations must operate as business associates under HIPAA regulations. Business associate agreements must specify how email providers will protect patient information, limit data use to authorized purposes, and report security incidents or unauthorized disclosures. Email HIPAA compliance requires healthcare organizations to verify that their email providers have appropriate security measures in place.

Common email business associates include cloud email providers, managed email services, and email security vendors. Each relationship requires careful evaluation of privacy and security risks along with appropriate contractual protections. Organizations must verify that business associates maintain their own HIPAA compliance programs and provide documentation of security measures.

Business associates must implement administrative, physical, and technical safeguards for email systems and ensure that subcontractors also comply with HIPAA requirements. This includes providing security training to their workforce, maintaining audit logs, and reporting security incidents to healthcare organizations. When business associate relationships end, email providers must return or destroy patient information as specified in their agreements.

Staff Training And Policy Development

Healthcare organizations must train staff on email HIPAA compliance requirements and organizational policies for handling patient information in electronic communications. Training programs should cover identification of protected health information, appropriate use of email systems, and procedures for reporting potential privacy violations. Staff members need to understand when email communications require additional security measures and how to use secure email platforms correctly.

Policy development includes establishing procedures for email encryption, recipient verification, and incident reporting when security concerns arise. Organizations should develop different policies for various types of email communications, including patient care coordination, billing discussions, and business partner communications. Regular policy updates address changing regulations and technology developments that affect email security.

Competency assessments verify that staff understand their responsibilities when handling patient information in email communications. Organizations should document training activities and maintain records of staff compliance with email privacy policies. Regular refresher training keeps staff updated on changing requirements and reinforces proper email security practices.

Monitoring And Incident Response For Email HIPAA Compliance

Healthcare organizations need ongoing monitoring programs to ensure that email practices remain compliant with HIPAA requirements and identify potential issues before they result in violations. Regular audits should examine email content for appropriate privacy protections, verify that security safeguards function correctly, and assess whether staff follow established policies. These audits help demonstrate ongoing commitment to protecting patient information.

Incident response procedures specifically address email-related security breaches or privacy violations, including notification requirements and remediation steps. Organizations must have clear procedures for investigating potential breaches involving email communications, determining whether notification is required, and implementing corrective actions to prevent future incidents. Training on incident response helps staff recognize and respond appropriately to email security issues.

Documentation requirements include maintaining records of email policies, training activities, security assessments, and compliance monitoring efforts. This documentation helps demonstrate compliance efforts during regulatory investigations and supports continuous improvement of email practices. Organizations should retain documentation for required periods and ensure records are complete and accessible when regulatory authorities request information about email HIPAA compliance practices.

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.

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HIPAA Compliant

What Cloud is HIPAA Compliant?

No cloud platform is inherently HIPAA compliant without proper configuration and implementation. Major cloud providers including AWS, Microsoft Azure, Google Cloud, and Oracle Cloud can support HIPAA compliance when properly configured and covered by a Business Associate Agreement (BAA). Healthcare organizations must implement appropriate security controls, access restrictions, and monitoring regardless of which cloud they select. The HIPAA compliance of any cloud environment depends on both provider capabilities and how organizations configure their cloud resources.

Cloud Vendor Healthcare Capabilities

Leading cloud platforms offer services that support healthcare applications when properly implemented. Amazon Web Services (AWS) provides numerous HIPAA eligible services with appropriate security features and BAA coverage. Microsoft Azure includes healthcare-focused compliance frameworks and security implementations that align with HIPAA requirements. Google Cloud Platform lists HIPAA eligible services in their compliance documentation with clear guidance for healthcare implementations. Oracle Cloud offers capabilities for healthcare organizations building compliant environments. These providers maintain physical security for their data centers while providing tools for customers to implement logical security controls.

BAA Coverage and Responsibilities

Healthcare organizations must obtain a Business Associate Agreement from their cloud provider before storing protected health information in the cloud. These agreements establish the cloud provider as a business associate under HIPAA regulations. Each major provider offers standardized BAAs covering their services, though coverage varies between providers. Not all services from a provider fall under BAA coverage – organizations must verify which services qualify. The BAA establishes shared responsibility for securing protected healthcare information (PHI), with the cloud provider handling physical security and infrastructure while healthcare organizations remain responsible for application security and access management.

Implementing Cloud Security Measures

Creating a HIPAA compliant cloud environment requires several security implementations. Encryption for data at rest and in transit protects information from unauthorized access. Identity and access management controls restrict system access to authorized personnel. Network security measures include virtual private networks, firewall rules, and segmentation to isolate healthcare data. Logging and monitoring systems track user activities and system events. Backup and disaster recovery processes maintain data availability. Organizations must document these security implementations during audits or assessments to be considered fully HIPAA compliant.

Service Model Compliance Divisions

Different cloud service models affect how compliance responsibilities are divided between providers and healthcare organizations. Infrastructure as a Service (IaaS) gives organizations more control but also more responsibility for security implementation. Platform as a Service (PaaS) provides pre-configured environments with some security features built in. Software as a Service (SaaS) includes more provider-managed security but less customization. Healthcare organizations must understand where their responsibilities begin and end in each model. Documentation should clearly establish which security controls fall to the provider versus the healthcare organization based on the selected service model.

Healthcare-Optimized Cloud Solutions

Some providers offer specialized cloud environments designed for healthcare workloads. These environments include pre-configured compliance controls aligned with HIPAA requirements. Examples include AWS Healthcare, Microsoft Cloud for Healthcare, Oracle Cloud Infrastructure for Healthcare, and Google Cloud Healthcare API. These offerings often include healthcare-focused data models, integration capabilities, and security frameworks. While these environments simplify compliance efforts, organizations still must implement appropriate configurations and policies. The specialized nature of these offerings can provide advantages for healthcare-focused workflows and data handling requirements.

Maintaining Cloud Compliance

HIPAA compliance in cloud environments requires continuous management rather than one-time implementation. Organizations need processes for regular security assessments of their cloud configurations. Cloud security posture management tools help identify potential compliance gaps. Staff require training on cloud security practices and HIPAA requirements. Change management procedures should evaluate compliance impacts before implementing cloud configuration changes. Documentation must remain current as cloud environments evolve. These ongoing management practices help maintain HIPAA compliance throughout the lifecycle of cloud-based healthcare applications.

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!

Email HIPAA Compliance

Is ActiveCampaign HIPAA Compliant?

ActiveCampaign is a cloud-based marketing automation platform that helps organizations manage their email marketing, customer relationships, and sales automation, and it can be HIPAA compliant for enterprise deployments. The platform’s automation capabilities enable organizations to streamline their workflows and carry out marketing campaigns with less administrative overhead, saving both time and money. Additionally, ActiveCampaign’s advanced segmentation tools allow companies to personalize campaigns according to demographics, behavior, and past interactions.

 

While these capabilities are highly sought after by healthcare organizations who want to enhance their engagement with patients and customers, they require one characteristic above all in their marketing platform of choice: HIPAA compliance.

 

More specifically, for a company to send electronic protected health information (ePHI) through an email marketing platform, it must comply with the Health Insurance Portability and Accountability Act (HIPAA).

 

Let’s take a closer look

Is ActiveCampaign HIPAA Compliant?

Firstly, to address the question directly – is ActiveCampaign HIPAA compliant? – it is not HIPAA-compliant by default. Healthcare organizations can only conduct HIPAA compliant marketing campaigns if they are signed up for the Enterprise version of the solution.

 

Our findings revealed that companies are required to configure ActiveCampaign accordingly to ensure HIPAA compliance. Again, that healthcare organizations need to ensure compliance themselves – and how they do so – isn’t made 100% clear in any of the company’s literature.

 

ActiveCampaign’s Security Features

 

ActiveCampaign does not provide email encryption, which prevents the safe usage of PHI data in emails. This limits your ability to engage patients with personalized and relevant messages that result in more opens, clicks and conversions.

 

ActiveCampaign’s sole mention of HIPAA compliance is on their security features page, on which they state:

ActiveCampaign is heavily focused on GDPR, SOC 2, and HIPAA compliance. We constantly improve our security to go above and beyond compliance standards.”

 

Now, while they don’t go into further detail, ActiveCampaign does indeed feature some security controls that lend themselves towards HIPAA compliance. These include:

 

  • Single Sign-On (SSO): users can sign into ActiveCampaign through an existing identity provider, such as Google, without requiring a separate set of credentials. This helps protect data through stronger access control and allows for simpler user authentication.
  • Multi-Factor Authentication (MFA): ActiveCampaign supports MFA, requiring users to verify their identity through text or time-based one-time password (TOTP) authentication. This adds another layer of security, in line with HIPAA regulations, and is something that could be more emphasized when changes to the Security Rule come into effect later this year. 
  • Automatic Session Timeouts: idle sessions are automatically logged out after a short amount of time: protecting them from session hijacking and related cyber threats. 

Additionally, users are responsible for setting up the proper email authentication protocols themselves, including:

 

  • SPF (Sender Policy Framework): Specifies authorized mail servers for your domain.

  • DKIM (DomainKeys Identified Mail): Adds a digital signature to your emails, verifying their authenticity.

  • DMARC (Domain-based Message Authentication, Reporting & Conformance): Provides instructions to email providers on handling messages that fail SPF or DKIM checks.

Setting up these protocols helps fight against email spoofing and phishing attacks, ensuring that your emails are recognized as legitimate by recipients’ mail servers.

 

Will ActiveCampaign Sign a BAA?

 

Now, even with some security features and stating they are focused on compliance, a marketing platform can’t truly comply with HIPAA regulations unless they sign a Business Associate Agreement (BAA).

 

Subsequently, ActiveCampaign is willing to sign a BAA, but only for their enterprise customers; this can be arranged by talking to a dedicated account manager who accompanies this version of their solution. 

Discover HIPAA Compliant Alternatives to ActiveCampaign

As this post illustrates, while it is possible to make ActiveCampaign HIPAA-compliant, it’s not straightforward. Fortunately, there are alternative email and marketing solutions that are fully HIPAA-compliant – out-of-the-box – removing the guesswork and ambiguity from securing your digital communications and allowing you to focus on engaging with your patients and customers. This includes LuxSci Secure Marketing, which enables healthcare organizations to proactively reach patients and customers with HIPAA compliant email marketing campaigns that can securely include PHI for increased engagement, lead generation and sales.

 

Discover how LuxSci can elevate your secure healthcare engagement efforts with PHI data, resulting in better health outcomes for your patients, in addition to enhancing your brand identity and achieving your company’s growth objectives. Reach out today for a call or demo.

AES-256 Maximal Security

Enhanced Security: AES-256 Encryption for SSL and TLS

AES-256 EncryptionSSL and TLS play critical roles in securing data transmission over the internet, and AES-256 is integral in their most secure configurations. The original standard was known as Secure Sockets Layer (SSL). Although it was replaced by Transport Layer Security (TLS), many in the industry still refer to TLS by its predecessor’s acronym. While TLS can be relied on for securing information at a high level—such as US Government TOP SECRET data—improper or outdated implementations of the standard may not provide much security.

Variations in which cipher is used in TLS impact how secure TLS ultimately is. Some ciphers are fast but insecure, while others are slower, require a greater amount of computational resources, and can provide a higher degree of security. Weaker ciphers—such as the early export-grade ciphers—still exist, but they should no longer be used.

The Advanced Encryption Standard (AES) is an encryption specification that succeeded the Data Encryption Standard (DES). AES was standardized in 2001 after a five-year review and is currently one of the most popular algorithms used in symmetric-key cryptography. It is often seen as the gold standard symmetric-key encryption technique, with many security-conscious organizations requiring employees to use AES-256 for all communications. It is also used prominently in TLS. (more…)