What is Email Deliverability?

Email Deliverability
Erik Kangas
June 3, 2025

Email deliverability refers to the ability of emails to reach recipients’ inboxes successfully without being filtered into spam folders or blocked entirely by email service providers. This metric involves the entire journey an email takes from sender to recipient, including authentication protocols, sender reputation, content quality, and recipient engagement patterns. For healthcare organizations managing patient communications, provider networks, and supplier relationships, understanding email deliverability is highly important given the sensitive nature of healthcare data and the need for reliable communication channels.

How Email Service Providers Filter Messages

Email service providers use sophisticated algorithms to evaluate incoming messages and determine their appropriate destination. These systems analyze multiple factors simultaneously, including sender authentication records, message content, sending patterns, and recipient behavior. The filtering process occurs in real-time, with providers like Gmail, Outlook, and Yahoo applying machine learning models trained on billions of email interactions to identify potential spam or malicious content. Authentication plays a large role in this filtering process. Providers verify sender identity through SPF (Sender Policy Framework), DKIM (DomainKeys Identified Mail), and DMARC (Domain-based Message Authentication, Reporting, and Conformance) records. Healthcare organizations without properly configured authentication often find their appointment reminders, lab results, or billing communications relegated to spam folders, disrupting patient care workflows and administrative processes.

Sender Reputation and Its Impact on Healthcare Communications

Sender reputation functions as a digital credit score for email domains and IP addresses, influencing whether healthcare organizations can reliably reach patients, providers, and business partners. Email service providers maintain reputation databases that track sending behavior, bounce rates, spam complaints, and recipient engagement over time. A single domain or IP address with poor reputation can affect email deliverability across an entire healthcare network. Healthcare entities take on reputation challenges due to the nature of their communications. Patient appointment reminders sent to outdated email addresses generate high bounce rates, while automated billing notifications may receive spam complaints from recipients who forgot they subscribed to such communications. These factors can gradually erode sender reputation, making it increasingly difficult to reach patients with time-sensitive medical information.

Protocols for Healthcare Email Deliverability Security

Modern email deliverability depends heavily on proper implementation of authentication protocols that verify sender identity and prevent email spoofing. SPF records specify which mail servers are authorized to send emails on behalf of a domain, while DKIM adds cryptographic signatures to verify message integrity. DMARC ties these protocols together by instructing receiving servers how to handle emails that fail authentication checks. Healthcare organizations must configure these protocols carefully to avoid authentication failures that could block legitimate patient communications. A misconfigured SPF record might prevent appointment confirmation emails from reaching patients, while improper DKIM setup could cause lab result notifications to be filtered as spam. These authentication failures can have serious implications for patient care, particularly when dealing with urgent medical communications or time-sensitive treatment instructions.

Content Quality and Compliance Considerations

Email content quality directly affects email deliverability, with providers using advanced algorithms to evaluate message structure, language patterns, and formatting for spam indicators. Healthcare organizations must balance informative content with deliverability requirements, ensuring that medical communications reach their intended recipients without triggering spam filters. This balance becomes particularly challenging when dealing with complex medical terminology, prescription information, or insurance-related content that may resemble spam to automated filtering systems. HIPAA compliance adds another element of complexity to healthcare email content, as organizations must protect patient information while maintaining effective communication channels. Emails containing protected health information require extra security measures and careful content formatting to avoid both compliance violations and deliverability issues. The challenge is in creating compliant, informative communications that also pass through increasingly sophisticated spam filters.

Email Deliverability Performance

Tracking email deliverability metrics provides healthcare organizations with the data needed to identify and address communication issues before they impact patient care or administrative operations. Key metrics include delivery rates, bounce rates, spam complaint rates, and inbox placement percentages across different email providers. These metrics help organizations understand how their communications perform across various platforms and identify potential problems with specific communication types or recipient segments.

Healthcare organizations should establish monitoring systems that track deliverability performance across different communication channels, including patient portal notifications, appointment reminders, billing communications, and provider-to-provider messages. This approach helps identify patterns that might indicate authentication issues, content problems, or reputation concerns that could affect the organization’s ability to communicate effectively with patients and business partners.

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Why is High Email Deliverability Essential for Healthcare Companies?

June 30, 2025
Pete Wermter

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.

What is a HIPAA Email API?

June 25, 2025
Ian Snipper

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

Technical Architecture and Security Framework

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

Authentication and Authorization Protocols

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

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

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

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

Message Formatting, Template Management, and Security

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

Delivery Tracking and Status Reporting

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

Compliance Logging and Audit Features

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

Integration Patterns for Healthcare Applications

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

Performance Optimization and Scalability

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

Testing and Development Support

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

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

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

June 24, 2025
Pete Wermter

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

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

Watch the Webinar

What You’ll Learn

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

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

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

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

Watch the Webinar

What Is a HIPAA Compliant Email API?

June 23, 2025
Ian Snipper

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

API Authentication and Access Controls

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

Message Encryption and Security Features

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

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

Integration with Healthcare Workflows

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

Audit Logging and Compliance Tracking

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

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

Developer Tools and Documentation

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

Scalability and Performance Considerations

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

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

How Can I Prove an Email was Sent to Me?

January 16, 2024
LuxSci

Almost everyone has been in this situation: someone claims to have sent you an email message, but you look in your inbox and don’t see it. As far as you know, you never got it. How can you prove an email was sent?

How to Prove That an Email was Sent

So, where do you start? As the purported recipient of an email message, the easiest way to prove that a message was sent to you is to have a copy of that message. It could be:

In your inbox or another email folder
A copy in your permanent email archives

Sometimes, missing emails are caused by simple user errors. The obvious place to start the search is in your inbox and email folders. It’s also a good idea to check your email filtering and archival services. It’s possible that your email filtering system accidentally flagged the message as spam or sent it to quarantine. If it’s not there, check your email archival system. That should capture a copy of all sent and received messages.

Hopefully, that will solve the issue. If it doesn’t, it’s worth stepping back to understand where the email could have gone and where you should turn next to solve the problem.

What happened to the email?

In reality, there are only a few things that could have happened:

The recipient never sent the message.
The recipient did send the message, but it did not reach you.
The message did make it to you, but it was accidentally or inadvertently deleted (or overlooked).

Let’s begin with what you can check and investigate. Start your search soon. The more time that elapses, the less evidence you may have, as logs and backups get deleted over time.

Did the recipient actually send the message?

First, you should know that the sender could have put tracking on the message so that they were informed if you opened or read it (even if you are unaware of the tracking). In such cases, the sender can disprove false claims of “I didn’t get it!” If you are concerned about an email being ignored, use read recipients or tracking pixels to confirm email delivery.

If you never saw the message, do what we discussed above and start searching your email folders for it. It could have been accidentally moved to the wrong folder or sent to the Trash folder. If you have a folder that keeps copies of all inbound emails (like LuxSci’s “BACKUP” folder), check there too. Check your spam folder and spam-filtering system. Your spam-filtering system may also have logs that you can search for evidence of this message passing through it. Finally, check any custom email filters you may have set up with your email service provider or in your email programs. If you have filters that auto-delete or auto-reject some messages, see if that may have happened to the message in question.

The searches above are straightforward; you can do many of them yourself. Often, they will yield evidence of the missing message or explain why you might not have received it.

Maybe the email was sent but didn’t make it to you?

Email messages leave a trail as they travel from the sender to the recipient. This trail is visible in the “Received” email headers of the message (if you have it) and in the server logs at the sender’s email provider and your email provider. If you know some aspects of the message in question (i.e., the subject, sender, recipient, and date/time sent), you can ask your email service provider to search their logs to see if there is any evidence of such a message arriving in their systems. This will tell you if such a message reached your email provider. However, email providers can typically only search the most recent one to two weeks of logs. So, if the message in question was from a while ago, your email service provider may be unable to help you (or may charge you a lot of money to manually extract and search archived log files if they have them).

If your email provider has no record of the message or cannot search their logs, you (or the sender) can ask the same question of the sender’s email provider. If they can provide records of such an email being sent through their system, that will prove the email was sent.

The log file analysis provided by the email providers could also explain why you didn’t get the message. Your email address might have been spelled wrong, there could have been a server glitch or issue, etc. However, if the message was sent long ago, the chance of learning anything useful from the email provider is small. Also, if you use a commodity email provider such as AOL, Yahoo, Outlook, Gmail, etc., you may find it impossible to contact a technical support person and have them perform an accurate and helpful log search. Premium providers, like LuxSci, are more likely to support your requests.

The last thing you can do is have the sender review their sent email folders for a copy of that message. If they have it, that can indicate that they sent it and can reveal why you didn’t get it (i.e., wrong email address, content that would have triggered your filters, etc.). However, be wary. It is easy to forge a message in a sent email folder, so it should not be considered definitive proof that the message was sent. And, even so, just because the message was sent, it does not prove it ever made it to your email provider or inbox.

The recipient never actually sent the email message

If the sending event was recent, then the data from your email service provider can prove that the message did not reach you, but that doesn’t prove that it was not sent. The sender may claim that they do not have a record of sent messages and that their email provider will not do log searching, and that may also be true. At this point, you are stuck without a resolution.

While email is a reliable delivery system, there are many ways for messages not to make it to the intended recipient. Whether it was not sent or was sent and never arrived, the result is the same- no message for you. As a result, it’s best not to send legal notices or other important documents only by email. Using read receipts and other technologies when sending important messages can help increase confidence that an email was sent and received. Still, there is no foolproof way to guarantee email delivery.

How Do I Prove the Email Sender’s Identity?

A separate but related question is, how can I be sure the sender is who they say they are? Social engineering is rising, and cybercriminals can use technology to impersonate individuals and companies. If you are questioning whether the sender actually sent the message to your inbox (or if it is from a spammer or cybercriminal), it is necessary to perform a forensic analysis of the email headers (particularly the Received lines, DKIM signatures, etc.) and possibly get the sender’s email provider involved to corroborate the evidence. To learn more about how to conduct this analysis, please read: How Spammers and Hackers Can Send Forged Email.

What Is HIPAA Email Archiving?

May 7, 2025
Erik Kangas

HIPAA email archiving is the systematic process of capturing, storing, and preserving electronic communications containing Protected Health Information (ePHI) in compliance with federal privacy and security regulations. Healthcare organizations use archiving systems to automatically collect email messages that contain patient data, maintain them in secure storage environments, and provide controlled access for authorized users. The archiving process ensures that patient communications remain available for clinical care, regulatory compliance, and legal discovery while protecting the confidentiality and integrity of health information throughout extended retention periods.

Medical practices and healthcare systems rely on email archiving to meet documentation requirements while managing the growing volume of electronic communications. Strong archiving strategies help organizations balance operational efficiency with regulatory obligations and risk management needs.

Why HIPAA Email Archiving is Required

Healthcare organizations require HIPAA email archiving to meet federal documentation standards and state medical record preservation laws. The HIPAA Privacy Rule establishes requirements for maintaining records related to patient information management, while state regulations often mandate specific retention periods for medical communications. Email messages containing treatment discussions, care coordination details, or patient scheduling, are all part of the medical record and must be preserved according to applicable legal timeframes.

Risk mitigation drives archiving implementation as healthcare organizations face increasing litigation and regulatory scrutiny. Medical malpractice cases frequently involve examination of communication records between providers, patients, and care teams. Organizations without proper archiving systems may face discovery sanctions or inability to defend against claims when relevant communications cannot be retrieved. Email archiving provides defensible documentation that supports clinical decision-making and protects against liability exposure.

Operational continuity benefits from archived communication access when healthcare providers need historical context for patient care decisions. Archived emails can reveal previous treatment discussions, specialist recommendations, or patient preferences that inform current care plans. Quick retrieval of communication history helps avoid duplicating previous conversations and ensures care teams have complete information when making treatment decisions.

Audit preparedness is achievable through systematic email archiving that preserves communication documentation for regulatory reviews. The Office for Civil Rights and other oversight agencies may request access to communication records during HIPAA compliance investigations. Organizations with properly implemented archiving systems can respond quickly to audit requests and demonstrate their commitment to patient information protection.

How Does HIPAA Email Archiving Differ From Standard Email Backup?

Security controls within HIPAA email archiving systems exceed those found in standard backup solutions. Archiving platforms implement encryption for data at rest and in transit, role-based access controls that limit user permissions, and audit logging that tracks all system interactions. Standard email backups may lack these specialized security features needed to protect patient information according to HIPAA Security Rule requirements.

Data organization in healthcare archiving systems focuses on patient-centric indexing and retrieval capabilities. The systems can organize archived communications by patient identifiers, treatment episodes, or healthcare provider relationships. Standard backup systems store emails chronologically or by user account without the specialized indexing needed for clinical or legal searches involving patient information.

Retention management features in HIPAA archiving platforms accommodate complex healthcare documentation requirements. The systems can apply different retention schedules based on message content, patient age, or state regulations while maintaining legal hold capabilities for litigation. Standard backup solutions lack the policy management tools needed to handle varied retention requirements across different types of healthcare communications.

Search functionality in healthcare archiving systems includes patient privacy protections and access controls that prevent unauthorized information disclosure. Users can search for communications related to specific patients or clinical topics while the system maintains audit trails of all search activities. Standard backup search tools do not include the privacy controls and audit capabilities required for handling patient information.

Components Supporting HIPAA Email Archiving Systems

Capture mechanisms within archiving systems automatically identify and collect email communications containing patient information as they flow through healthcare email infrastructure. Journal-based capture methods create copies of all email messages at the server level, ensuring complete collection without relying on user actions. Content analysis tools can identify messages containing ePHI through keyword detection, pattern recognition, and sender/recipient analysis to ensure appropriate archiving coverage.

Storage architecture for HIPAA email archiving incorporates multiple layers of data protection and redundancy. Primary storage systems maintain active archives with fast access capabilities for recent communications, while secondary storage tiers provide cost-effective long-term preservation for older messages. Geographic replication protects against data loss from natural disasters or facility damage while maintaining compliance with data residency requirements.

Access control systems manage user permissions and authentication requirements for archived email access. Role-based permissions ensure that healthcare workers can only access communications relevant to their job functions and patient care responsibilities. Multi-factor authentication adds security layers that protect against unauthorized access attempts while maintaining usability for legitimate users.

Audit and monitoring capabilities track all interactions with archived email communications to create compliance documentation. The systems log user access attempts, search queries, message exports, and administrative actions to provide complete audit trails. Automated reporting features help healthcare organizations monitor archiving system usage and identify potential security incidents or policy violations.

How to Select HIPAA Email Archiving Solutions

Compliance certification evaluation helps healthcare organizations identify archiving vendors that understand healthcare regulatory requirements. Vendors with HITRUST CSF certification, SOC 2 Type II reports, or similar security validations demonstrate their commitment to protecting healthcare information. Business Associate Agreement willingness and terms indicate vendor readiness to accept HIPAA compliance responsibilities for archived patient data.

Scalability assessment ensures that archiving solutions can accommodate current email volumes and future growth projections. Healthcare organizations examine storage capacity, user licensing models, and system performance under peak usage conditions. The evaluation includes reviewing vendor infrastructure capabilities and support for geographic expansion or practice acquisitions that may increase archiving requirements.

Integration requirements vary based on existing healthcare IT infrastructure and workflow needs. Archiving solutions need compatibility with current email platforms, electronic health record systems, and practice management applications. API availability and integration support affect how seamlessly archived communications can be accessed from within existing clinical workflows.

Total cost analysis encompasses software licensing, implementation services, ongoing maintenance, and storage expenses over the expected system lifespan. Healthcare organizations compare subscription models, per-user pricing, and storage-based fees while considering long-term retention requirements. The analysis includes potential cost savings from reduced legal discovery expenses and improved compliance management efficiency.

Implementation Challenges

Historical data migration requires careful planning to transfer existing email communications into new archiving systems while maintaining data integrity and compliance protections. Healthcare organizations need strategies for handling legacy email formats, preserving original timestamps and metadata, and ensuring complete transfer of patient communications. The migration process must maintain security controls throughout the transition period.

User training programs need development to help healthcare staff understand archiving system functionality and their responsibilities for communication compliance. Training covers proper email practices, archiving system search capabilities, and procedures for handling legal holds or audit requests. Change management support helps staff adapt to new workflows and archiving requirements without disrupting patient care operations.

Performance optimization is highly important as archiving systems handle increasing volumes of healthcare communications. Email traffic in large healthcare systems can be substantial, requiring archiving platforms that maintain capture rates and search responsiveness under heavy loads. Organizations need monitoring tools and vendor support to optimize system configurations for their specific usage patterns.

Policy development and enforcement require clear guidelines about archived communication access, retention schedules, and disposal procedures. Healthcare organizations need policies that address who can access archived communications, under what circumstances searches are permitted, and how to handle requests for patient communication records. Enforcement mechanisms ensure that archiving policies are followed consistently across the organization.

How to Maximize Email Archiving Investment

Workflow integration maximizes archiving value by making historical communications easily accessible within existing clinical applications. Healthcare organizations can implement single sign-on authentication and embed archiving search capabilities within electronic health record systems. Integration reduces the time healthcare workers spend switching between systems while maintaining security controls for patient information access.

Advanced search capabilities help healthcare organizations extract maximum value from archived communications through sophisticated query tools and analytics. Machine learning features can identify communication patterns, flag potential compliance issues, or surface relevant historical context for current patient care decisions. Analytics capabilities provide insights into communication volumes, response times, and collaboration patterns that support quality improvement initiatives.

Legal discovery preparation benefits from archiving systems that streamline the identification and production of relevant communications during litigation. Healthcare organizations can use search and filtering tools to quickly locate communications related to specific patients, time periods, or clinical events. Export capabilities and legal hold management reduce the time and cost associated with responding to discovery requests.

Compliance monitoring automation helps healthcare organizations maintain ongoing oversight of their email archiving practices and identify potential issues before they become violations. Automated reports can track archiving coverage, identify gaps in communication capture, and monitor user access patterns for unusual activity. Proactive monitoring supports continuous improvement in archiving practices and compliance management

12 Key Questions to Ask Before Sending HIPAA-Compliant Marketing Emails

October 30, 2024
LuxSci

So – you’ve just been told that your email marketing program is putting your company at risk of violating HIPAA.

Ok. What now?

If you want to continue your email-based patient engagement efforts – without the risk of the financial, operational, and reputational risk that accompanies the exposure of sensitive patient data, you must implement HIPAA compliant email marketing practices.

This is comprised of two components: becoming HIPAA-compliant, setting up the required systems and procedures to ensure your PHI (PHI) and EPHI (EPHI) are protected, and your marketing objectives, who you want to reach and what to communicate.

However, you don’t have to let your marketing objectives suffer for the sake of security.

Implementing a HIPAA-compliant marketing program can actually help you achieve better marketing results.

Asking yourself these 12 questions ensures your email marketing campaigns align with your business goals and are HIPAA-compliant.

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HIPAA-Compliant Marketing Emails

1. Do you have security controls to protect access to your email marketing system?

2. Do you have a documented procedure to guide you HIPAA-compliant email marketing?

3. Can you send encrypted emails?

4. Do you have a complete understanding of your organization’s PHI and ePHI?

5. Do you have a required training process for anyone sending HIPAA-compliant marketing emails?

6. Do you have effective protection against malware?

7. Do you have valid Business Associate Agreements (BAA) in place?

8. Why am I sending this email?

9. Is my email’s subject line standing out?

10. What is the recipient’s brand and product awareness level?

11. Have I tested my message for readability?

12. Have I sent my message to a test email account?

HIPAA-Compliant Marketing Emails

If your organization requires HIPAA-compliant email, start by using these questions to inspect your email marketing for compliance. Note that while we can’t provide legal advice, the below questions will help you identify some of the most common points of vulnerability and non-compliance.

1. Do you have security controls to protect access to your email marketing system?

Email security is an essential component of being HIPAA-compliant. As a starting point, check your internal security processes for access restrictions. This includes:

A robust password policy, i.e., changed frequently (e.g., 30 days), has to contain a mixture of characters, etc.
Multi-factor authentication (MFA), i.e., users verifying their identity in multiple ways, e.g., username/password and sent number codes (text, email, key fob, etc.), biometrics, etc.
Role-based access controls, i.e., granting access to individuals based on the responsibilities of their job role.
Zero Trust Architecture (ZTA), i.e., “never trust, always verify” – where users are required to reconfirm their identity on a case-by-case basis, as opposed to once when logging on, which mitigates session hijacking and similar threats.

2. Do you have a documented procedure to guide you HIPAA-compliant email marketing?

“Winging it” simply doesn’t cut it when it comes to HIPAA-compliant email marketing; you must develop a comprehensive documented process detailing how you intend to safeguard PHI throughout your email marketing campaigns.

This should include:

Specifying the HIPAA-compliant email delivery service you’ll use to execute your marketing campaigns

The processes and controls you’ll use to encrypt data for ePHI at rest and in transit

The access and authentication controls you have in place

How you’ll implement data minimization: only using the minimum necessary PHI in communications – and not including sensitive PHI unless it’s essential.
How you’ll securely dispose of data: Implement a process for securely deleting emails containing ePHI once they’re no longer needed, to comply with retention policies.
Staff training: educating employees involved in email marketing on how to securely handle PHI and other HIPAA requirements.
Incident response plan, i.e., an additional documented plan for how you’ll respond to data breaches and other cyber attacks; this also includes notifying any affected parties as mandated by HIPAA.

If you’re starting from scratch, the information contained in the answers to the questions in this article provides a useful starting point for creating your first procedure.

3. Can you send encrypted emails?

If you are sending highly sensitive data or PHI in your emails, be aware that HIPAA requires the data to be encrypted a rest, i.e., the storage medium where it resides, and in transit, when being sent to recipients.

To the surprise of many healthcare organizations, most major email marketing providers, such as Mailchimp and Constant Contact are unable to provide encryption for data in transit and only protect data in their systems. To avoid falling foul of HIPAA regulations, ensure that the email delivery platform you use to transmit messages containing PHI offers end-to-end encryption.

4. Do you have a complete understanding of your organization’s PHI and ePHI?

Much of the time, when we, as well as healthcare providers, talk about PHI, we’re actually referring to electronic protected health information (EPHI). While PHI is a catch-all term to account for all sensitive health information, in truth, in the digital age, the vast majority is stored electronically in data centers – and the patient data handled is EPHI.

You can discover “PHI” and “ePHI” within the context of your organization’s context by identifying and categorizing the PHI and ePHI typically handled in your business. It’s an absolutely crucial tenet of data protection that you simply can’t protect what you’re not aware of.

Comprehensive PHI categorization will help your staff navigate HIPAA-compliant email requirements.

5. Do you have a required training process in place for anyone sending HIPAA-compliant marketing emails?

Your HIPAA compliance program, as with your company’s overall cybersecurity posture, is only as strong as your weakest link. In light of this, it’s essential to educate the staff within your company who are involved in your healthcare engagement campaigns on the secure use of ePHI and HIPAA-compliant marketing practices.

Additionally, this needs to be reflected in your onboarding process, so new hires are made familiar with HIPAA regulations, should their role require it.

6. Do you have effective protection against malware?

In the unlikely event you need any further encouragement to revisit your company’s anti-malware (viruses, ransomware, Trojans, etc.) measures, there are always HIPAA compliance requirements!

To better protect your sensitive customer data against a slew of increasingly sophisticated cyber threats, start with these three key considerations:

Do you have anti-malware protection running on all of your organization’s devices? Additionally, does this extend to your employee’s personal devices on which they handle PHI?
How frequently do you update your anti-malware solution?
Does your email marketing provider have sufficient protection malware mitigation measures in place, as per HIPAA requirements?

7. Do you have valid Business Associate Agreements (BAA) in place?

It’s normal to outsource activities like email marketing to a third party, but for the service they provide to be HIPAA-compliant, you must have a business associate agreement (BAA) in place.

A BAA documents how two organizations will share PHI and under what circumstances. A BAA also details the legal responsibilities of each party in the event of a serious issue. With a BAA being a core component of HIPAA compliance, failure to have one in place with your email service provider is an immediate HIPAA violation – and one that can result in serious consequences for a healthcare company.

Getting Better Results from HIPAA-Compliant Email Marketing

Now that you’ve confirmed your systems are HIPAA-compliant, let’s move on to making sure your email marketing strategy aligns with your overall business objectives.

In pursuit of this, the following questions serve as a handy “monthly review” for refining the effectiveness of your email-based patient outreach efforts .

8. Why am I sending this email?

First and foremost, for the best results, each email you send should have a single, clearly defined purpose.

I know what you’re thinking – “my customers and patients are smart, they can handle multiple points in a single message.” And while that’s true, at whatever point your email reaches a recipient, they’re already juggling several different priorities at once. While they’re capable of juggling multiple points in a message – they’re unlikely to want to; when it comes to email marketing, a single goal is the best way to go.

Similarly, it’s important to remember that your email is one of dozens – or hundreds – received by your patient that day. So, if your message is long and overly complicated, the reader will likely skip over or delete it.

9. Is my email’s subject line standing out?

Following on the above point, is your email subject line impactful enough to stand out amidst the pile of messages that will land in the patient’s inbox that day? The email subject line is the most important part of your email because it’s responsible for persuading the reader to open your message.

Despite this, many marketers still use terrible, ineffective subject lines and wonder why their emails are failing to produce results!

For the best results, write up three to ten subject lines for your next email, step away for 5-10 minutes, and then choose the headline you determine as best.

Consider these examples to check your understanding:

Ineffective Email Subject Lines

Blank (no subject): writing nothing in the subject line
Clinic Newsletter (tell them more, e.g., the subject or theme for the month)
Overusing exclamation marks!!!

Effective Email Subject Lines (examples based on a dental practice)

BRAND-NEW Dental Product Released Today
How to Cut Down on Your Health Insurance Paperwork
[Case Study] How We Helped 3 Ex-Smokers Get White Teeth

10. What is the recipient’s brand and product awareness level?

Whether promoting medical devices, new digital solutions technology, or any healthcare product or service, understanding the prospect’s awareness level is essential.

If your email is designed to introduce a brand-new product, stick to high-level features and benefits while avoiding technical jargon and granular product details. Conversely, if you’re writing an email to experienced, highly knowledgeable readers, going into greater depth makes sense.

Advanced list management and segmentation tools, as offered by Luxsci Secure Marketing, are key for ensuring the communications you send match the reader’s awareness level.

11. Have I tested my message for readability?

Do you know one of the reasons that Hemingway was popular? He was skilled at writing short phrases and phrases. Consequently, his writing was easy to understand and appealed to a wide variety of people. When in doubt, keep your writing short and free of jargon, abbreviations and “insider” terms.

When you’re deeply involved in the details of your business, it’s so easy to overlook just how much specialized jargon and language you frequently use. However, if you want your communications to engage with patients and customers, they need to be as accessible as possible.

Fortunately, there are simple solutions to this, with tools like the Text Readability Calculator that are designed to quickly enhance the readability of your emails.

12. Have I sent my message to a test email account?

Finally, if you’ve followed all of the above advice, you’re almost ready to hit SEND…there’s just one more thing you need to check.

Determine how your email will look to recipients, including its clarity, and readability by simply sending a test email to one of your own email accounts once it is received.

In particular, pay attention to how the subject line looks and test all the links in the email to ensure they take the reader through to the intended destination, such as a product or service page. A broken link will only frustrate the recipient – who was interested enough to click through, no less – and lower your conversion rate.

Better still, send the test email to a colleague somebody and ask for their opinion about the quality of the message and whether it creates the desired impression.

Demystifying HIPAA-Compliant Email Marketing

As the most experienced HIPAA-compliant email provider, LuxSci specializes in providing secure and HIPAA-compliant solutions for companies aiming to send hundreds of thousands – or millions – of emails. Our hypersegmentation tools allow you to precisely target an unlimited number of patient sub-populations to maximize the efficacy of your messaging.

Are you interested in discovering how LuxSci’s secure email marketing platform will streamline your healthcare engagement efforts?

How Insurers Can Save Millions Per Month with Secure Email EOBs

June 10, 2025
Pete Wermter

Have you looked into what it’s costing your company to snail mail EOBs these days?

EOBs give an individual an increased understanding of their insurance coverage, the cost of care, and their out of pocket expenses. As a result, it’s absolutely critical that health insurers deliver EOBs quickly and effectively.

However, the most commonly used method for sending out EOBs, traditional mail or snail mail, has several drawbacks that can prevent important information about healthcare coverage from reaching people in a timely manner – not to mention the high cost insurers take on to send them. This can leave policyholders in the dark about their healthcare coverage, which can lead to confusion and dissatisfaction with their insurance provider when they receive an unexpected medical bill.

Furthermore, because EOBs contain the protected health information (PHI) of policyholders or members, insurers are bound by HIPAA (the Health Insurance Portability and Accountability Act) regulations to ensure their secure delivery. Consequently, the risks inherent to sending paper EOB statements in the mail not only have security implications but also potential consequences for non-compliance.

With all this in mind, this post discusses why healthcare insurers should send EOBs to their policyholders via secure email instead of traditional mail. We detail the various benefits of making the switch to email EOBs, which include enhanced security, better adherence to compliance regulations, higher deliverability rates, and significant cost savings.

Security Benefits

Insurance companies that send out EOBs via email as opposed to traditional mail are less likely to be at risk for a data breach or leak of PHI. Firstly, sending an EOB via email drastically decreases the risk of interception. When sent in paper form, an EOB could be:

Lost, stolen or damaged in transit
Delivered to the wrong address
Not properly deposited in a letter or mailbox, then stolen
Intercepted within the intended address by another individual who lives at or has access to the residence.

Conversely, as detailed later in this post, email allows for various controls and processes, which mitigate the risks of unsuccessful message delivery.

Additionally, secure, HIPAA compliant email provides data encryption, which safeguards the sensitive patient data within EOBs during transmission and at rest by rendering it unreadable to malicious actors who might intercept it or gain access to it. Physical mail, in contrast, offers no such protection, as someone who intercepts a paper EOB notice can simply open it and freely read its contents.

Finally, secure email delivery platforms, such as LuxSci, feature identity verification and access controls that enable healthcare insurers to restrict access to PHI, limiting its exposure. Similarly, HIPAA compliant email also provides auditing logging capabilities to track access to patient data, to quickly identify the source of security breaches.

Increased Delivery

Once a person opts-in, sending an EOB by email greatly increases its deliverability, up to 98% or more – almost instantly. By better ensuring a policyholder receives their EOBs, healthcare insurers increase the chance of successfully communicating the intended information they contain, namely, the cost of a service and how much they’re required to cover.

Additionally, the ability to track secure email in near real-time also enhances its deliverability, as it allows organizations to determine the cause of delivery failure and make subsequent attempts to get the EOB delivered. At the same time, the process of determining the reason for the message failure may also reveal security concerns; a process that is very difficult, if not impossible, to achieve with traditional physical mail.

Radical Cost Savings

Simply put, sending EOBs via email instead of traditional mail can save health insurers massive amounts of money. By saving a dollar or more per EOB, the cost savings can quickly add up to millions of dollars per month in savings.

If you’re curious about just how much you can save with email EOBs, try our just-released email EOB ROI calculator. You can see how much your company can save with just a 30 percent shift from physical mail EOBs to email, in a few seconds.

Try the EOB Calculator here

The most significant cost reduction is the money saved on printing and mailing paper EOB statements. Additionally, the cost of administering the delivery of EOB notices is lowered when it’s done electronically. Resending EOBs in the event of their non-delivery also is much easier, faster and cheaper via email.

Compliance Benefits

Because sending an EOB via email requires HIPAA compliance, your communications are encrypted by default, protecting patient privacy and keeping PHI out of the hands of malicious actors, all while reducing the risk of HIPAA compliance violations. The security features built into HIPAA compliant email platforms, such as encryption, access control, and audit logs, help insurers satisfy the requirements of HIPAA’s Privacy and Security Rules in their compliance efforts.

Another considerable benefit of using secure email to send policyholders their EoBs, or, in fact, any communication containing PHI, is that it’s far easier to implement breach notification protocols. HIPAA compliant email delivery platforms provide real-time tracking, so companies can pinpoint email message failures quickly and act accordingly. Similarly, intrusion detection systems and other cybersecurity measures that support email systems enable the faster detection and containment of data breaches.

In stark contrast, physical mail is far more difficult to track. Consequently, security breaches via mail could go unnoticed for days or even weeks. If you’re unaware of a data breach, let alone have not yet contained or mitigated it, you’re unable to inform all affected parties, resulting in further HIPAA violations and a loss of customer trust.

Reduced Carbon Footprint

It’s difficult to highlight the cost benefits of sending EOBs to policyholders by email without recognizing the positive environmental impact, too. Email EOBs cuts down on paper usage, for both the notices themselves and the envelopes they’re mailed in. Then there’s the matter of the electricity and ink involved in printing them, the emissions produced in their delivery, etc. Opting to send EOBs via email reduces all these factors, which enables healthcare organizations to lower their carbon footprint and, where applicable, meet their sustainability obligations.

Now’s the Time to Move to Email EOBs

LuxSci’s HIPAA compliant Secure High Volume Email solution enables healthcare insurers to instantly send EOBs to policyholders securely and at scale, extending into hundreds of thousands and millions of messages a month.

Our HIPAA compliant email delivery platform features:

Dedicated IPs that isolate critical transactional messages, such as EOBs, from other email traffic, allowing our clients to reach deliverability rates of 98% or more.
Real-time tracking for determining the delivery status of EOBs, as well as troubleshooting unsuccessful delivery attempts.
Flexible encryption through LuxSci’s proprietary SecureLine Technology, which automatically adjusts encryption according to the recipient to better ensure the protection of sensitive data, including for EOBs or any sensitive healthcare communication.

Contact us today to learn more about how your organization can begin the transition to electronic EoBs, reducing costs and improving the customer experience.