Why Is Email Deliverability Important?

Email Deliverability
Erik Kangas
June 11, 2025

Email deliverability is important as it directly determines whether healthcare organizations can successfully communicate with patients, providers, and business partners when it matters most. Poor email deliverability can result in missed appointments, delayed care coordination, lost revenue, and compliance violations that put both patient safety and organizational reputation at risk. For healthcare providers, payers, and suppliers, maintaining high email deliverability rates means ensuring that appointment reminders reach patients, lab results arrive on time, and billing communications are received without delay. When deliverability fails, the entire healthcare communication chain breaks down, creating gaps in the patient journey and administrative efficiency.

Email Deliverability Affects Patient Care Coordination

Patient care coordination depends heavily on timely, reliable email communication between healthcare providers, specialists, and patients themselves. When email deliverability rates drop, appointment reminders fail to reach patients, leading to increased no-show rates and delayed care. Lab results that end up in spam folders can delay treatment decisions, while referral communications that never arrive can disrupt the continuity of care between primary physicians and specialists. Healthcare organizations with poor email deliverability face cascading effects throughout their patient care processes. A single missed communication can lead to delayed diagnoses, postponed treatments, and frustrated patients who feel disconnected from their care team. Emergency departments may not receive timely notifications about incoming patients, while discharge instructions delivered via email may never reach patients who need them most. The ripple effects of poor email deliverability extend far beyond simple communication failures, directly impacting patient outcomes and satisfaction scores.

Poor Email Deliverability Creates Revenue Loss

Revenue loss from poor email deliverability affects missed appointments, delayed payments, failed billing communications, and reduced patient engagement with healthcare services. When billing statements and payment reminders fail to reach patients due to deliverability issues, healthcare organizations experience increased accounts receivable aging and higher collection costs. Insurance claim notifications and EOBs that end up in spam folders can delay reimbursement processes, affecting cash flow and financial stability. Healthcare organizations also lose revenue through reduced patient engagement with preventive care services and elective procedures. Email campaigns promoting wellness programs, health screenings, and specialized services generate lower response rates when deliverability problems prevent messages from reaching patient inboxes. The financial impact compounds over time, as organizations invest in email marketing and patient communication tools that fail to deliver expected returns due to underlying email deliverability challenges.

Compliance Risks When Deliverability Fails

Healthcare organizations face large compliance risks when email deliverability problems prevent timely delivery of required communications. HIPAA regulations require covered entities to implement reasonable safeguards for protecting patient information, and failed email delivery can create documentation gaps that expose organizations to regulatory scrutiny. When patient communications fail to reach their intended recipients, or worse, reach an unintended recipient, healthcare organizations compliance lapses and data breaches can occurr. Failed email deliverability can also create audit trail problems, as organizations may not realize that required communications never reached patients or business partners. This lack of visibility into delivery failures can lead to compliance violations that result in fines, penalties, and increased regulatory oversight. Healthcare organizations operating under value-based care contracts face additional risks when poor email deliverability prevents timely communication of quality metrics and performance data to payers and regulatory bodies.

Email Deliverability Impacts Operational Efficiency

Operational efficiency in healthcare depends on smooth communication flows between departments, providers, external partners, and patients and customers. When email deliverability issues disrupt these communication channels, healthcare organizations experience increased administrative burden, duplicated efforts, and workflow interruptions. Staff members spend additional time following up on communications that may have been filtered into spam folders or blocked entirely, reducing productivity and increasing operational costs. Poor email deliverability also affects supply chain management, as communications with vendors, suppliers, and business partners may fail to reach their intended recipients. Order confirmations, shipping notifications, and inventory updates that end up in spam folders can lead to supply shortages, delivery delays, and increased procurement costs. Healthcare organizations may need to implement alternative communication methods, such as phone calls or postal mail, which are more expensive and time-consuming than email.

Technology Integration Challenges

Healthcare organizations rely on integrated technology systems that depend on reliable email deliverability for automated notifications, alerts, and data exchanges. Electronic health record systems, customer data platforms, and patient portal platforms all generate email communications that can be affected by deliverability issues. When these automated systems cannot reliably deliver messages, healthcare organizations may experience system-wide communication breakdowns that affect multiple departments and workflows. Poor email deliverability can also disrupt integration with third-party healthcare applications, telemedicine platforms, and health information exchanges. These systems rely on email notifications to alert providers about new patient data, test results, or system updates. When deliverability problems prevent these notifications from reaching their intended recipients, healthcare organizations may miss important information that affects patient care decisions and operational planning.

Building Sustainable Practices

Healthcare organizations can build sustainable email deliverability practices by implementing authentication protocols, monitoring sender reputation, and maintaining clean recipient lists. Regular audits of email deliverability performance help identify problems before they affect patient care, customer communications, or operational efficiency. Organizations benefit from establishing dedicated resources for managing email deliverability, including staff training on best practices and ongoing monitoring of delivery metrics across different communication channels.

Sustainable email deliverability practices also include developing contingency plans for communication failures, such as alternative contact methods and backup notification systems. Healthcare organizations can reduce their vulnerability to email deliverability issues by diversifying their communication channels while maintaining primary reliance on email for routine communications. This balanced approach helps ensure that patient care and operational efficiency remain intact even when challenges arise.

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Know the Biggest Email Threats Facing Healthcare Right Now

July 16, 2025
Pete Wermter

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

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

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

Ransomware Attacks

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

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

Email Client Misconfiguration

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

Common types of email misconfiguration include:

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

Social Engineering Attacks

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

Phishing

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

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

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

Domain Impersonation and Spoofing

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

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

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

Insider Email Threats

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

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

Business Email Compromise (BEC) Attacks

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

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

BEC attacks come in several forms, such as:

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

Supply Chain Risk

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

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

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

Download LuxSci’s Email Cyber Threat Readiness Report

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

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

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

What is the Best HIPAA Compliant Email?

July 10, 2025
Erik Kangas

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

HIPAA Compliant Email Features

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

Popular HIPAA Compliant Email Platforms

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

Security Considerations for Healthcare Communications

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

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

Client Experience and Usability Factors

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

HIPAA Compliant Email Implementation for Medical Practices

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

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

Cost Considerations For Selecting Email Services

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

Integrating Email with Broader Practice Security

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

What Are Email HIPAA Compliance Requirements?

July 2, 2025
Erik Kangas

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

Privacy Rule Requirements For Email HIPAA Compliance

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

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

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

Security Rule Standards For Email HIPAA Compliance

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

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

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

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

Business Associate Requirements For Email HIPAA Compliance

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

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

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

Staff Training And Policy Development

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

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

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

Monitoring And Incident Response For Email HIPAA Compliance

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

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

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

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 Makes a Device HIPAA Compliant?

October 22, 2024
Erik Kangas

No single feature makes a device HIPAA compliant, as compliance derives from a combination of security controls, administrative policies, and appropriate usage practices. Healthcare organizations must implement encryption, access restrictions, and monitoring capabilities to ensure devices handling protected health information meet regulatory requirements. While manufacturers may advertise “HIPAA compliant” products, the responsibility for maintaining HIPAA compliant status ultimately rests with the healthcare organization through proper configuration, management, and usage in clinical environments.

Physical Security Requirements

Healthcare technology requires physical protections to prevent unauthorized access to patient information. Organizations aiming to render a device HIPAA compliant should consider location restrictions that limit where equipment can be used or stored. Physical safeguards include screen privacy filters that prevent visual access from unauthorized viewers, device locks securing equipment to fixed objects, and controlled access to areas containing sensitive technology. For portable devices, theft prevention features like tracking software and remote wiping capabilities provide additional protection. These physical controls complement other measures to create more complete security for healthcare devices.

Data Encryption Implementation

Encryption is a requirement for becoming fully HIPAA compliant in healthcare settings. Organizations should implement full-disk encryption that protects all information stored on device hard drives or solid-state storage. For devices transmitting data across networks, communications encryption using current protocols prevents interception during transmission. Mobile devices particularly benefit from encryption since they face higher risks of loss or theft. Many healthcare organizations establish minimum encryption standards that all devices must meet before connecting to clinical systems or accessing patient information. Proper encryption key management ensures data remains accessible to authorized users while maintaining protection from unauthorized access.

Access Control Systems

Controlling who can use devices and access the information they contain forms an essential part of compliance. Healthcare organizations typically establish access policies supporting HIPAA compliant operations requiring unique identification for each user. Authentication methods range from passwords or PINs to biometric verification like fingerprint scanning or facial recognition. Automatic timeout features terminate sessions after periods without activity. Role-based permissions restrict what information different users can view based on their job functions. These layered access controls help prevent both external threats and inappropriate internal access to sensitive patient data.

Mobile Device Management

Mobile technology presents unique compliance challenges due to portability and varied usage contexts. An approach to HIPAA compliant management includes mobile device management (MDM) solutions that enforce security policies across smartphones, tablets, and laptops. These management systems can remotely configure security settings, install updates, and even wipe devices if lost or stolen. Application controls limit which programs can be installed or access protected health information. Many organizations implement container solutions that separate personal and clinical applications on the same device. These management capabilities provide consistency across diverse mobile platforms while adapting to healthcare workflows.

Audit and Monitoring Capabilities

HIPAA regulations require tracking access to protected health information, making monitoring important for device HIPAA compliant certification. Devices handling patient data should maintain logs recording user activities, data access, and system events. Security monitoring tools analyze these logs to identify unusual patterns that might indicate unauthorized access. Vulnerability scanning helps identify security weaknesses before they lead to data breaches. These monitoring capabilities not only help detect potential security incidents but also provide documentation of compliance efforts during regulatory reviews or audits.

Maintenance and Update Procedures

Maintaining device HIPAA compliant status requires ongoing attention to emerging security threats and vulnerabilities. Organizations should establish procedures for promptly applying security patches and updates to all devices accessing protected health information. Asset management systems track which devices need updates and verify completion. End-of-life policies ensure obsolete devices that can no longer receive security updates are removed from clinical use. Lifecycle planning addresses hardware and software obsolescence before it creates security gaps. These maintenance procedures help ensure that devices remain compliant throughout their operational lifespan in healthcare environments.

Can You Send HIPAA Through Email?

June 19, 2025
Erik Kangas

Yes, you can send protected health information (PHI) under HIPAA through email when using appropriate security measures and compliant email systems designed to protect protected health information during electronic transmission. Sending PHI through email requires encryption, access controls, audit logging, and other safeguards that meet regulatory standards for protecting patient information in digital communications. Healthcare providers, payers, and suppliers can transmit protected health information via email when they implement proper security protocols and use compliant email platforms. Understanding how to send HIPAA through email safely helps organizations maintain regulatory compliance while conducting routine business communications and patient care coordination activities.

Security Requirements for Sending HIPAA Through Email

Sending PHI through email requires end-to-end encryption that protects messages and attachments from unauthorized access during transmission and storage. Healthcare organizations cannot use standard email platforms like Gmail, Yahoo, or Outlook for transmitting protected health information without additional security measures. Encryption protocols transform readable text into coded format that only authorized recipients can decrypt and access. uthentication mechanisms verify the identity of both senders and recipients before allowing access to encrypted email content. Digital certificates provide additional verification that messages originated from legitimate healthcare organizations and have not been tampered with during transmission. Secure transmission protocols protect email communications from interception by unauthorized parties during delivery to intended recipients.

Permitted Uses When Sending HIPAA Through Email

Healthcare organizations can send HIPAA through email for treatment, payment, and healthcare operations without obtaining patient authorization. Treatment communications include sharing patient information between healthcare providers involved in care coordination, referrals, and consultation activities. Payment-related emails may include billing information, insurance claims, and financial communications with patients or payers. Healthcare operations encompass quality improvement activities, staff training materials, and administrative communications that support patient care delivery. Patient communications via secure email may include appointment reminders, lab results, and discharge instructions when appropriate safeguards are implemented. Business associate communications can include HIPAA through email when vendors have signed appropriate agreements and maintain compliant systems.

Prohibited Practices When Sending HIPAA Through Email

Regular email platforms without encryption cannot be used for sending HIPAA through email due to inadequate security protections. Healthcare organizations cannot send protected health information via text message, social media platforms, or other unsecured digital communication channels. Forwarding encrypted emails to non-compliant systems compromises security and violates HIPAA requirements. Sending protected health information to unauthorized recipients constitutes a privacy violation regardless of the security measures used. Healthcare staff cannot use personal email accounts for work-related communications involving patient information. Storing protected health information in unsecured cloud storage systems or sharing login credentials for secure email accounts creates compliance risks and potential security breaches.

Technical Implementation for HIPAA Through Email

Healthcare organizations implementing systems for sending PHI through email need secure email gateways that integrate with existing IT infrastructure. These systems automatically encrypt outgoing messages containing protected health information and provide secure delivery mechanisms for recipients. Message encryption occurs before transmission, ensuring that sensitive content remains protected throughout the delivery process. Recipient verification systems confirm that emails reach intended recipients and prevent unauthorized access to protected health information. Secure message retrieval processes may require recipients to authenticate their identity before accessing encrypted content. Audit logging capabilities track all email activities, including message transmission, recipient access, and any forwarding or reply activities involving protected health information.

Staff Training for HIPAA Through Email Compliance

Healthcare organizations must train staff on proper procedures for sending HIPAA through email and recognizing when additional security measures are needed. Training programs cover identification of protected health information, appropriate use of secure email systems, and policies for handling patient communications. Staff members learn to distinguish between communications that require encryption and those that can use standard email platforms. Policy education includes guidelines for password management, secure login procedures, and incident reporting requirements when security concerns arise. Regular refresher training keeps staff updated on changing regulations and organizational policies for email security. Competency assessments verify that staff members understand their responsibilities when handling protected health information in email communications.

Compliance Monitoring and Risk Management

Healthcare organizations need ongoing monitoring programs to ensure that practices for sending HIPAA through email remain compliant with regulatory requirements. Regular audits review email security configurations, user access controls, and compliance with organizational policies. Risk assessments identify potential vulnerabilities in email systems and communication processes that could lead to privacy violations. Incident response procedures address potential security breaches or unauthorized disclosures involving email communications. Documentation requirements include maintaining records of security training, policy updates, and compliance monitoring activities. Organizations benefit from establishing clear accountability structures and regular review processes that demonstrate ongoing commitment to protecting patient privacy in all email communications involving protected health information.

What You Need to Know About PHI Identifiers

November 5, 2024
Erik Kangas

It’s hard to understate the benefits of using protected health information (PHI) in your patient engagement efforts. By effectively leveraging PHI, you can create highly-targeted and personalized email marketing campaigns, which have greater potential to connect with your patients and customers – and drive your desired outcomes.

However, before diving in, it’s essential to be aware of HIPAA’s complex compliance requirements and how they govern healthcare organizations’ marketing communications. Chief among these considerations is the concept of PHI identifiers and the role they play in classifying and protecting sensitive patient data. With this in mind, let’s explore HIPAA’s 18 PHI identifiers

What is a PHI Identifier?

Before we detail the 18 different PHI identifiers, it’s crucial to first distinguish between what counts as PHI and what, in reality, is personally identifiable information (PII).

PHI (as well as its digital equivalent or electronic protected health information (ePHI)), is defined as “individually identifiable protected health information” and specifically refers to three classes of data:

An individual’s past, present, or future physical or mental health or condition.
The past, present, or future provisioning of health care to an individual.
The past, present, or future payment-related information for the provisioning of health care to an individual.

In short, for an individual’s PII to be classed as protected health information it must be related to a health condition, their healthcare provision, or the payment of that provision. So, a patient’s email address in isolation, for example, isn’t necessarily PHI. However when combined with any information about their healthcare – such as in a patient engagement email campaign – it would constitute PHI.

Put another way, as HIPAA is designed to enforce standards and best practices in the healthcare industry, it’s concerned with protecting health-related information. While the protection of general PII is of the utmost importance, that’s a significantly larger remit – and, consequently, one that’s shared by a variety of data privacy regulations covering different industries and regions (PCI-DSS, GDPR, etc.).

What are the 18 PHI Identifiers?

With the above background in mind, we now have a clearer understanding of what is classed as PHI and, as a result, what data needs to be de-identified. The HIPAA Privacy Rule provides two methods for the de-identification of PHI: the Expert Determination and Safe Harbour methods.

Expert Determination requires a statistical or scientific expert to assess the PHI and conclude that the risk of it being able to identify a particular patient is very low. Safe Harbour, meanwhile, involves systematically removing or securing specific data types to mitigate the risk of patient identification. It’s from the Safe Harbour method that we get the following 18 PHI identifiers:

Patient Names

Geographical Elements: street address, city, and all other subdivisions lower than the state.

Dates Related to Patient’s ID or Health History: eD.O.B, D.O.D, admission and discharge dates, etc.

Telephone Numbers

Fax Numbers

Email Addresses

Social Security Numbers

Medical Record Numbers

Health Insurance Beneficiary Numbers

Account Numbers

Certificate or License Numbers: as these can confirm an individual’s professional qualifications or credentials, and when combined with PHI, are exploitable by malicious actors.

Vehicle Identifiers: i.e., license plate and serial numbers

Device Identifiers and Serial Numbers: those belonging to smartphones, tablets, or medical devices, because they communicate with healthcare companies during provision and can be linked back to the patient

Digital Identifiers: namely website addresses used by healthcare companies that patients may visit (for healthcare education, event registration, etc.)

Internet Protocol (IP) Addresses: the digital location from where a patient’s device accesses the internet; this can be used to acquire subsequent PHI

Biometric Identifiers: e.g., fingerprints, voice samples, etc.

Full Face Photographs: in additional to other comparable images

Other Unique Numbers, Codes, or Characteristics: not covered by the prior 17 categories

As illustrated by the above list, HIPAA’s list of PHI identifiers is comprehensive, covering all aspects of an individual’s identity and digital footprint. In light of this, when handling patient data it’s crucial to use platforms and digital solutions that have been designed with the secure transmission and storage of PHI in mind.

Harness the Benefits of Using PHI for Better Patient Engagement

As the most experienced provider of HIPAA-compliant communications, LuxSci specializes in secure email, text, marketing and forms for healthcare providers, payers and suppliers. LuxSci’s Secure Healthcare Communications suite offers flexible encryption, customizable security policies, and automated features to ensure HIPAA compliance and the protection of PHI data.

Interested in discovering how LuxSci’s solutions can help you securely engage with your patients and customers?

Is iCloud Email HIPAA Compliant?

August 5, 2024
Erik Kangas

An iCloud email is not HIPAA compliant without added security measures, and Apple does not offer Business Associate Agreements for standard iCloud services. Healthcare organizations cannot legally use iCloud email to transmit protected health information as it lacks required encryption, access controls, and audit capabilities. Medical providers seeking HIPAA compliant communication must select email platforms designed for healthcare data protection instead of consumer-oriented services like iCloud.

Apple’s Position on HIPAA Compliant Services

Apple does not position iCloud email as a HIPAA compliant service for healthcare organizations. The company does not offer Business Associate Agreements for standard iCloud accounts, which healthcare providers must obtain before using any service for protected health information. Apple’s terms of service and privacy policies make no mention of healthcare compliance or regulatory requirements. While Apple emphasizes privacy in its marketing, these protections focus on consumer privacy rather than healthcare regulatory compliance. The company’s enterprise offerings like Apple Business Manager address some business security needs but lack the documentation and features required for HIPAA compliance. Without a BAA and proper security features, using iCloud email for patient information violates HIPAA regulations regardless of any additional measures implemented.

Missing Security Features for HIPAA Compliant Status

iCloud email lacks several features necessary for HIPAA compliant communications. The service provides basic encryption during transmission but does not offer end-to-end encryption for email content. User authentication relies primarily on passwords without required multi-factor verification. Access controls lack the granularity needed for healthcare environments where different staff members require varying levels of information access. Audit logging capabilities fall short of HIPAA requirements for tracking who accessed what information and when. Data loss prevention tools to identify and protect messages containing health information are absent. Archive and retention features do not meet healthcare regulatory requirements. These limitations make iCloud email unsuitable for handling protected health information in medical settings.

Alternative Email Solutions with HIPAA Compliant Capabilities

Healthcare organizations requiring HIPAA compliant email must select appropriately designed platforms instead of iCloud. Microsoft 365 and Google Workspace offer email services with Business Associate Agreements and healthcare-focused security features when properly configured. Dedicated secure email providers like Paubox, Virtru, and Zix specialize in HIPAA compliant communications with built-in encryption and security controls. These alternatives include features like message encryption, detailed access logging, and security controls designed for healthcare environments. Many provide seamless encryption that works automatically without requiring recipients to create accounts or remember passwords. Organizations selecting these platforms gain both regulatory compliance and practical security benefits unavailable with consumer email services.

Risk Factors in Consumer Email Platforms

Using consumer email services like iCloud creates substantial risks for healthcare organizations. Without proper security controls, patient information may be exposed to unauthorized access during transmission or storage. The lack of detailed audit logs makes it impossible to track potential breaches or inappropriate access. Limited administrative controls prevent organizations from enforcing consistent security policies across all users. Consumer terms of service often allow the provider to analyze email content for advertising purposes, creating additional compliance concerns. Organizations face potential financial penalties from regulatory authorities if protected health information is handled through non-compliant channels. These risks extend to both direct financial penalties and reputation damage from potential breaches or compliance failures.

HIPAA Compliant Communication Strategies

Healthcare organizations develop comprehensive communication strategies that account for email platform limitations. Many implement a layered approach using HIPAA compliant email platforms for healthcare communications while maintaining separate personal accounts for non-patient information. Secure messaging through patient portals often provides a more controlled alternative to email for patient communications. Staff training focuses on which communication channels are appropriate for different types of information. Clear policies establish what information can never be transmitted via email regardless of the platform. Organizations implement technical controls to prevent accidental transmission of protected information through unauthorized channels, which helps maintain compliant communications while working within the constraints of available technology.

Evaluating Email Services for Healthcare Use

When evaluating potential email services, healthcare organizations should apply comprehensive assessment criteria. Availability of Business Associate Agreements forms a non-negotiable starting point for any healthcare email solution. Security features must align with HIPAA Security Rule requirements for access controls, encryption, and audit logging. Administrative tools should enable consistent policy enforcement across all users. Integration capabilities with existing systems affect both security and workflow efficiency. Mobile access security deserves particular attention as healthcare staff increasingly use smartphones and tablets. Support for compliance documentation helps organizations demonstrate due diligence during regulatory reviews. A thorough evaluation process helps healthcare entities select email platforms that balance security, usability, and regulatory compliance.