LuxSci

What Makes PHI Email Compliant with HIPAA Requirements?

Best HIPAA Compliant Email Providers

PHI email becomes compliant through end-to-end encryption, access controls, audit trails, and secure transmission protocols. Healthcare organizations must implement email solutions that encrypt protected health information both in transit and at rest, maintain detailed logs of all communications, and restrict access to authorized personnel only. Medical practices encounter the challenges of patient information travelling through digital communication channels, as each message contains names, medical record numbers, or treatment details. Patient communications flow through healthcare systems constantly, creating numerous opportunities for data exposure. Email messages containing appointment confirmations, lab results, or billing inquiries must receive the same protection level as paper records stored in locked cabinets. The difficulty increases when metadata reveals patient-provider relationships without obvious identifying information appearing in message content itself.

Email Encryption Methods Protect Patient Data

Healthcare email platforms deploy Advanced Encryption Standard protocols with 256-bit keys to render intercepted messages unreadable without proper decryption credentials. Transport Layer Security protocols shield communications during transmission between mail servers, while storage encryption protects messages residing in email systems. These protection layers work to secure PHI email whether traveling across networks or sitting in user mailboxes.

Identity-based encryption provides an alternative where recipients authenticate through secure web portals instead of managing encrypted attachments with complex passwords. Patients log into portal systems once and access their messages without downloading files or remembering multiple authentication credentials for different healthcare providers.

User Access Controls Prevent Information Breaches

Multi-factor authentication requires users to provide passwords, mobile verification codes, and sometimes biometric data before accessing PHI email systems. Staff members receive permissions aligned with their job responsibilities, preventing billing personnel from reading clinical notes while restricting nurses from accessing financial communications. These permission structures eliminate accidental information exposure between healthcare departments.

Session timeouts automatically disconnect users after inactivity periods, and systems monitor failed login attempts to detect potential unauthorized access. Organizations document access permissions and conduct monthly reviews to ensure appropriate information boundaries. Employee departures trigger immediate email access revocation to prevent data exposure after employment ends.

Monitoring Systems Track Message Activities

Modern PHI email platforms record message creation, transmission, delivery, viewing, forwarding, and deletion activities. These logs include timestamps, user identifications, and recipient information that create detailed records for compliance reviews and incident investigations. Healthcare organizations must preserve these records for six years and provide them during HIPAA audits.

Behavioral analysis systems detect unusual patterns like mass message downloads during off-hours or attempts to redirect communications to personal email accounts. Security teams receive immediate notifications when suspicious activities occur, enabling rapid investigation of potential breaches or unauthorized access attempts.

Vendor Contracts Define Compliance Obligations

Email service providers handling patient information must execute business associate agreements outlining their compliance responsibilities. These contracts address data protection standards, breach notification timelines, and audit cooperation requirements. Cloud email providers must prove their systems meet HIPAA standards through independent security assessments.

Healthcare organizations bear liability for vendor compliance failures, making thorough evaluation processes necessary before selecting email platforms. Assessment procedures examine data storage locations, infrastructure security measures, and incident response capabilities to ensure adequate protection throughout the technology supply chain.

Employee Education Prevents Security Violations

Training programs teach staff to identify phishing attempts, follow acceptable use policies, and handle PHI email appropriately. Organizations conduct simulated phishing exercises to evaluate employee responses to suspicious messages and provide additional education for those requiring improvement. Policies clarify when staff should use secure messaging platforms instead of traditional email systems.

Content filtering systems scan outgoing messages for Social Security numbers, medical record numbers, and other patient identifiers. When these systems detect sensitive information, they automatically apply encryption or prevent message transmission until users implement appropriate security measures.

Performance Tracking Ensures Program Effectiveness

Healthcare organizations monitor encryption usage rates, policy compliance scores, and incident response times to evaluate their PHI email programs. Monthly assessments examine compliance trends and identify areas where system improvements or additional training could strengthen protection. Risk evaluations examine emerging threats and technology changes that might affect email security.

Compliance teams review email policies quarterly and update procedures based on regulatory developments or security incidents. System testing verifies that encryption, access controls, and monitoring functions operate correctly under various usage conditions, ensuring patient communications receive consistent protection through all organizational email activities.

Picture of Erik Kangas

Erik Kangas

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

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HIPAA Compliant Email

Rethinking HIPAA Compliant Email – Not Just a Checkbox

The compliance-only mentality is outdated.

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

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

What Makes Email Truly HIPAA Compliant?

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

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

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

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

The Real Opportunity – Secure, Personalized Email with PHI

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

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

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

Real Business Results from Secure Email

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

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

The Healthcare Marketer’s Secret Weapon: Using PHI Responsibly

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

Meeting the Personalization Demands of Today’s Patients and Customers

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

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

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

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

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

Why LuxSci? The Infrastructure Behind the Performance

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

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

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

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


FAQs

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

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

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

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

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

HIPAA compliant email

Most Popular LuxSci Blog Posts of 2025

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

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

1. Improve Email Engagement and Marketing Results with Automated Workflows

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

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

2. Healthcare Email Threat Readiness Strategies

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

Read the full post: Healthcare Email Threat Readiness Strategies

3. HIPAA Compliant Email — 20 Tips in 20 Minutes

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

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

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

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

Read the full post: Is SendGrid HIPAA-Compliant?

5. LuxSci Shines in G2 Winter 2026 Reports

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

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

Looking Ahead to 2026

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

Follow LuxSci on LinkedIn

HIPAA compliant email

LuxSci Welcomes Angel Mazariegos as Head of Finance

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

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

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

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

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

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

HIPAA Compliant Email

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

We’re pleased to announce that LuxSci has been recognized for excellence and leadership for HIPAA compliant email and messaging in the just-released G2 Winter 2026 Reports!

Based on verified customer reviews, LuxSci earned 20 G2 badges as part of the most recent G2 reports, including top honors such as Grid Leader, Highest User Adoption, Best Support, and Best Estimated ROI.

This recognition further validates what we’ve always believed: our customers don’t just choose a great product — they choose a great partner. At LuxSci, we build long-term, trusted relationships with our customers, anchored in product reliability, industry-leading email deliverability and performance, and the best customer support in the business.

Why G2 Matters

G2 is a globally trusted peer‑review platform that aggregates verified user feedback and real‑world usage data to rank software and service providers. G2’s seasonal reports like the Winter 2026 editions shine a spotlight on latest tools and vendors that deliver consistent value and satisfaction to real customers.

Earning 20 badges this quarter signals a strong vote of confidence from our customers and community, helping affirm that LuxSci is a leading, highly adopted secure email solutions provider.

What We Earned in Winter 2026

Among the 20 badges awarded to LuxSci across Email Security, Email Encryption, Email Gateway and HIPAA Compliant Messaging are:

  • Grid Leader
  • Highest User
  • Best Support
  • Best Estimated ROI

This broad range of accolades spanning leadership, adoption, support and return on investment underscores the reliability of our solutions and the trust our customers place in us.

Awards Reflect Our Commitment to Customer Success

Reliable. Winning Grid Leader and Highest User Adoption demonstrates that thousands of users are depending on LuxSci, securely delivering emails to today’s most popular platforms, including Gmail, Apple Mail, Yahoo Mail and AOL, to name a few.

Proven. With Best Estimated ROI, customers are saying that LuxSci delivers tangible results, whether in secure email delivery, regulatory compliance, or operational efficiency.

Long‑Term Trust. Best Support is perhaps the most telling because for us, success isn’t just about features, it’s about being there for our customers every step of the way.

Thank you to all of our customers. We remain committed to your success — today and in the future.

Want to learn more about LuxSci? Reach out and connect with us today!

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phi in patient communications

The Benefits of Using PHI in Patient Communications

Some healthcare organizations do not allow PHI to be sent outside the patient’s health record. However, by allowing your marketing and administrative teams to use PHI in patient communication, you can streamline operations, improve the patient experience, and increase revenue with HIPAA marketing.

Although the healthcare industry is traditionally slow to adopt new technologies, the past few years have rapidly accelerated the shift to digital communications. The reasons for these shifts are varied and will be explored in detail below. No matter the reason, one thing is certain- organizations adapting to the modern digital age are thriving, while those resisting change are falling behind in meeting patient expectations.  

Changing Technology Preferences

Rapid technological innovation has made it possible to communicate securely at scale. As broadband access has increased, people are incorporating it into their daily lives. In 2022, 92% of Americans reported using email, and 49% checked it every few hours. Many people now prefer to receive business communications via email because it is asynchronous and can be engaged with when it fits into their schedules.

healthcare technology preferences stats

Healthcare organizations that utilize email for external communication are experiencing better response rates and fewer patient no-shows. Email already fits into the daily lives of many patients and doesn’t require them to take extra steps to receive information about their healthcare journey.

The Rise of Healthcare Consumerism

Healthcare consumerism refers to patients’ personal choices and responsibility in paying for and managing their health. Patients are no longer stuck with one provider or practice. They have more choices than ever and will shop around for new providers if unsatisfied with their experience. 

If healthcare providers are not delivering a digital experience that meets patient expectations, they could risk losing patients and revenue.

reasons to change providers

In addition, as younger generations are taking control of their healthcare, they are used to digital-first experiences that are personalized to their needs. If organizations are unwilling to invest into personalized digital patient experiences, they will not adequately serve the next generation of healthcare consumers. 

Staffing Challenges

The healthcare industry is not immune to recent staffing challenges. Staffing shortages have left fewer employees available to do more tasks, including patient care. Introducing digital technology into your patient communication strategy can help automate and streamline common communication workflows like:

  • Appointment reminders
  • Pre- and post-procedure instructions
  • Health education messages
  • Vaccine reminders
  • Medication adherence reminders
  • Billing

Automating common workflows frees up time for staff to focus on urgent patient needs and improves the patient experience. 

How to Safely Use PHI in Patient Communications

Patients are already communicating with their healthcare providers one-on-one via email. The question is, how can you protect this data while communicating at scale for marketing and educational purposes? There are tools (like LuxSci’s Secure Marketing and Secure High Volume Email solutions) that are designed to support the unique security needs of the healthcare industry while providing the personalized digital experience that patients desire.

Protecting PHI in Patient Communications

PHI needs to be protected in emails with advanced encryption technology. TLS encryption should be used as often as possible because it provides a user experience like regular email without requiring a portal login. For marketing and patient education emails, TLS is sufficient to protect data and allows patients to readily engage with the email content. By properly vetting and choosing the right vendors, marketing and administrative teams can communicate with patients via email without violating HIPAA. 

Personalization at Scale

The power of PHI is undeniable. When healthcare marketers can harness healthcare data to create ultra-personalized campaigns, it increases their relevance and the likelihood that the content will be engaged with, delivering a better ROI. Our solutions integrate via API to securely personalize messages and trigger emails when specific conditions are met. This allows marketers to send relevant messages at the right time when it is relevant to the patient’s healthcare journey.

personalization stats 

Modern technology is needed to serve today’s patients. Meeting patients where they are with the information they need on the channels they prefer is vital to improving healthcare outcomes for the most vulnerable populations. Using PHI in patient communications gives your organization a comparative advantage by providing a better patient experience. 

HIPAA secure email

What Are the HIPAA Emailing Rules Healthcare Organizations Must Follow?

HIPAA emailing rules require healthcare organizations to protect patient information through encryption, access controls, and business associate agreements when transmitting protected health information electronically. The HIPAA Security Rule mandates that covered entities implement administrative, physical, and operational safeguards to ensure the confidentiality, integrity, and availability of electronic protected health information during email transmission. These regulations apply to all healthcare providers, health plans, and healthcare clearinghouses that use email to communicate about patients, making compliance with HIPAA emailing rules essential for avoiding regulatory penalties and protecting patient privacy.

Encryption Requirements and Data Protection Standards

Protected health information transmitted via email must be encrypted using current industry standards that render the information unreadable to unauthorized recipients. The Department of Health and Human Services does not specify particular encryption algorithms, but most healthcare organizations implement Advanced Encryption Standard (AES) 256-bit encryption to meet regulatory expectations. Transport Layer Security (TLS) protocols create secure connections between email servers during message transmission, preventing interception of patient data while communications travel across public internet networks. Message-level encryption protects email content even if transport security fails or messages are stored on intermediate servers during transmission delays. End-to-end encryption ensures that only intended recipients can decrypt and read patient communications, maintaining privacy protection throughout the entire communication process.

Digital signatures provide additional security by verifying sender authenticity and detecting any unauthorized modifications to email content during transmission. These authentication measures help recipients confirm that patient communications originated from legitimate healthcare sources and have not been tampered with by malicious actors. Certificate-based authentication systems ensure that only verified healthcare providers and authorized recipients can access encrypted patient information sent through email channels. Key management protocols protect the encryption keys that safeguard patient information while ensuring that legitimate healthcare providers can access necessary communications without delays that might interfere with patient care. Secure key storage systems prevent unauthorized access to encryption keys while maintaining backup procedures that prevent data loss if primary key storage systems experience failures. Healthcare organizations following HIPAA emailing rules must maintain documented procedures for key management that balance security requirements with operational necessity.

Access Control Implementation and User Authentication

Multi-factor authentication serves as the primary defense against unauthorized access to healthcare email systems containing patient information. Users must provide multiple forms of verification before accessing their email accounts, typically combining passwords with mobile device verification codes, hardware tokens, or biometric identification. Role-based permissions ensure that healthcare staff can only access patient communications relevant to their job responsibilities and patient care relationships. Physicians need different access levels compared to billing specialists or administrative staff, with granular controls preventing unauthorized viewing of patient information outside legitimate care activities. Access permissions should automatically adjust when staff members change positions within healthcare organizations or when their patient care responsibilities shift to different departments or specialties.

Session management controls protect against unauthorized access from unattended workstations by automatically logging users out of email systems after predetermined periods of inactivity. Session timeout configurations must balance security requirements with operational efficiency, allowing sufficient time for healthcare providers to compose thoughtful patient communications without creating security vulnerabilities. Login monitoring systems detect unusual access patterns and trigger security responses when potential account compromises occur. Password policies must enforce strong authentication credentials without creating excessive burden that encourages staff to write down passwords or reuse credentials across multiple healthcare systems. Healthcare organizations implementing HIPAA emailing rules benefit from password managers that help staff maintain unique, complex passwords while integrating with single sign-on systems that reduce authentication friction during busy clinical workflows.

BAA Requirements for HIPAA Emailing Rules

Business associate agreements establish the legal framework governing relationships between healthcare organizations and their email service providers. These contracts must specify exactly how providers will protect patient information, what security measures they will maintain, and detailed procedures for reporting security incidents to healthcare organizations. Agreement terms should cover data retention requirements, geographic restrictions on information storage, and procedures for returning or destroying patient data when business relationships terminate. Vendor security assessments verify that email service providers maintain appropriate technical safeguards and compliance programs before healthcare organizations entrust them with patient information. Due diligence evaluations should include reviewing provider security certifications, examining their data center facilities, and verifying their experience with healthcare compliance requirements. Insurance verification ensures that email providers maintain adequate cyber liability coverage to protect healthcare organizations from financial exposure during security incidents.

Audit rights enable healthcare organizations to verify that their email providers comply with business associate agreement terms and maintain appropriate security controls. These contractual rights should include access to security audit reports, penetration testing results, and compliance documentation relevant to patient data protection. Liability allocation clauses protect healthcare organizations from financial responsibility when email security incidents result from provider negligence or system failures. Contract terms should clearly define each party’s responsibilities for maintaining security controls and specify how costs will be allocated when security breaches require patient notification, credit monitoring, or regulatory penalties. Those mastering HIPAA emailing rules recognize that business associate agreements are the foundation for compliant email communication with third-party service providers.

Workflow Integration for HIPAA Emailing Rules

Staff training programs must educate healthcare workers about appropriate use of email for patient communications and help them understand when alternative communication methods are more appropriate than electronic messaging. Training should cover recipient verification procedures, encryption activation requirements, and any other HIPAA Emailing Rules for determining what health information is suitable for email transmission versus what requires telephone calls or secure patient portals. Healthcare staff need decision-making frameworks that help them evaluate the appropriateness of email communication for different types of patient information and clinical situations. Incident response procedures prepare healthcare organizations to handle security breaches involving patient information transmitted through email systems. Response protocols should include immediate containment measures, assessment of potential patient impact, and notification procedures for affected individuals and regulatory authorities. Documentation requirements ensure that incident response activities demonstrate compliance with breach notification requirements and provide evidence of appropriate remediation efforts.

Backup and disaster recovery procedures protect patient communications from data loss while maintaining the same encryption and access control standards as primary email systems. Recovery procedures should be tested regularly to verify that patient information can be restored quickly without compromising security protections. Archive systems must preserve encrypted email communications for required retention periods while maintaining searchability for clinical and legal purposes. Quality assurance monitoring verifies that email security measures function correctly and staff follow established procedures for protecting patient information. Audit procedures should review email usage patterns, verify encryption activation, and assess compliance with access control requirements. Entities implementing HIPAA emailing rules receive help from automated monitoring systems that detect potential security issues and generate alerts when unusual email activities occur that might indicate security incidents or policy violations.

Consent Procedures for HIPAA Emailing Rules

Patient consent requirements vary depending on the type of health information being transmitted and the communication preferences expressed by individual patients. While healthcare providers can generally communicate with patients about treatment, payment, and healthcare operations without specific authorization, organizations should obtain written consent before sending detailed medical information through email channels. Consent documentation should explain security measures while acknowledging that email communication carries inherent privacy risks despite protective technologies. Communication content guidelines help healthcare staff determine what patient information is appropriate for email transmission versus what requires more secure communication methods. Appointment reminders, general health education, and routine test results may be suitable for encrypted email communication, while psychiatric evaluations, substance abuse treatment records, or genetic testing results may require additional protections or alternative communication approaches. Staff need clear criteria for evaluating the sensitivity of patient information and selecting appropriate communication channels.

encrypted email transmission

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

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

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

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

An Example Email Message

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

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

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

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

LuxSci:

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

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

Proofpoint:

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

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

Outlook:

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

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

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

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

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

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

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

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

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

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

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

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

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

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

How To Tell if an Email is Encrypted With TLS

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

How can you Ensure Emails Are Securely Transmitted?

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

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

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

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

Was the email message sent and received using encryption?

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

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

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

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

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

HIPAA compliant email

Most Popular LuxSci Blog Posts of 2025

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

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

1. Improve Email Engagement and Marketing Results with Automated Workflows

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

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

2. Healthcare Email Threat Readiness Strategies

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

Read the full post: Healthcare Email Threat Readiness Strategies

3. HIPAA Compliant Email — 20 Tips in 20 Minutes

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

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

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

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

Read the full post: Is SendGrid HIPAA-Compliant?

5. LuxSci Shines in G2 Winter 2026 Reports

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

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

Looking Ahead to 2026

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

Follow LuxSci on LinkedIn