---
title: "Compliance and Email Security: Navigating HIPAA Regulations in Healthcare | DuoCircle"
description: "60% of consumers want to receive promotional content via email."
image: "https://www.duocircle.com/images/og-default.png"
canonical: "https://www.duocircle.com/blog/email-security/navigating-hipaa-compliance-in-email-security/"
---

Quick Answer

HIPAA does not prescribe specific email rules, but it requires that protected health information (PHI) be encrypted in transit and at rest and protected with appropriate safeguards. A HIPAA-compliant email setup combines: encryption (TLS or S/MIME, end-to-end where possible, plus password-protected attachments shared over a separate channel), data loss prevention to scan outbound mail for PHI, audit trails of who sent, received, accessed, or modified messages, access controls including MFA and role-based permissions, and a Business Associate Agreement (BAA) with any email service provider that touches ePHI. Organizations also need a written email policy, staff training, archiving for at least six years, patient consent before email PHI exchange, and a documented backup and disaster recovery plan. In March 2022 alone, 30 healthcare breaches affected 1.4 million people, which is why these controls are non-negotiable.

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![Email Security](https://media.mailhop.org/duocircle/images/2024/05/what-is-dkim-selector-7543.jpg) 

[60% of consumers](https://squareup.com/us/en/the-bottom-line/series/foc/future-of-commerce) want to receive promotional content via email. This is promising news for businesses looking to engage in **email marketing**, including those in the healthcare industry.

But in a regulation-heavy industry like healthcare, organizations must take email security very seriously. In March 2022, there were [30 reported healthcare breaches](https://www.hhs.gov/sites/default/files/insider-threats-in-healthcare.pdf). And they **impacted 1.4 million people**.

Healthcare emails often contain protected health information (PHI). If this information gets into the wrong hands, it could spell trouble for your organization.

_This could include legal penalties, reputational damage, and loss of patient trust._

Let’s dive into **HIPAA-compliant emails** and how to make sure you’re not in violation of these regulations when communicating with patients.

## What Is a HIPAA-Compliant Email?

HIPAA doesn’t really have a specific set of rules governing email. However, it does require healthcare providers and organizations to **encrypt all electronic communication** of PHI.

Emails that adhere to HIPAA regulations have a few things in common:

- They have **data loss prevention (DLP)** measures in place to prevent [unauthorized disclosures of PHI](https://www.techtarget.com/searchhealthit/definition/PHI-breach-protected-health-information-breach) (e.g., scanning outgoing emails for sensitive information, and enforcing policies to ensure unauthorized sharing).
- They have **audit trails**, which include records of who sent, received, accessed, or modified the information.
- They implement access controls, such as password protection, [multi-factor authentication (MFA)](/email-security/multi-factor-authentication-mfa-and-its-impact-on-email-security/), and **user permissions**.
- They’re encrypted to prevent [unauthorized access](https://www.healthcareitnews.com/news/himss24-perspective-safeguarding-ephi-and-restricting-unauthorized-access).

The ultimate goal of HIPAA is to protect patients and their sensitive healthcare information. _So, **health care providers are responsible** for keeping this information safe_.

Nowadays, they use emails for many purposes, such as:

- Patient satisfaction surveys and feedback requests
- **Follow-up care** and post-discharge instructions
- Clinical communication and collaboration
- Healthcare marketing and promotions
- Medication reminders and refills
- Billing and financial information
- **Disease prevention campaigns**
- Test results and lab reports
- Appointment reminders
- [Telehealth](https://telehealth.hhs.gov/patients/why-use-telehealth) visits
- Newsletters
- Updates

With so many emails going out, healthcare professionals must be **extra careful** when following HIPAA rules about email security. 

[We Level Up Treatment Centers](https://welevelup.com/) is a good example. While using emails for various purposes, the organization makes sure it **adheres to HIPAA rules**. 

The screenshot below shows the fine print under an email We Level Up Treatment Centers sent out. The disclosure highlights that We Level Up follows the HIPAA and **HITECH Act** to ensure patient information is safe while they receive the services they need.

[![HIPAA Regulations](https://media.mailhop.org/duocircle/images/2024/05/smtp-service-1.jpg)](https://media.mailhop.org/duocircle/images/2024/05/smtp-service-1.jpg)

([Image Source](https://welevelup.com/privacy-policy/))

Consider another example. [Travel nursing](https://www.fusionmedstaff.com/traveler/nursing/) is a job that involves a unique set of circumstances. For instance, travel nurses often have to access patient information on the go. _This means that a **big part of their job** requires them to communicate with patients and other healthcare providers via email._ 

As they move toward new, unknown facilities, the risk increases. That’s why it’s important to implement [HIPAA-compliant email systems](https://www.hipaajournal.com/make-your-email-hipaa-compliant/), as well as **encrypted messaging platforms**. 

**Safeguarding patient privacy** is also important when prescribing medications, oral semaglutide for weight management or other diabetes treatments. 

Health care providers must exercise caution when emailing details about this type of patient’s prescription or treatment plan. To maintain HIPAA compliance, electronic communications containing protected health information (like the provision of health care) should **always be encrypted** and transmitted through a [secure messaging platform](https://www.pcmag.com/picks/best-secure-messaging-apps).

Failure to secure emails discussing a patient’s medication regimen, dosage of oral semaglutide, or potential side effects could result in a **breach of confidentiality** and significant fines under HIPAA regulations.

Robust email security protocols and [staff training on handling PHI](https://www.compliancehome.com/hipaa-training/) are essential for healthcare organizations to protect patient privacy while facilitating **coordinated care**.

## How to Send Healthcare Emails That Meet HIPAA Regulations

Follow these **tried-and-true tips** to help you secure every email you send. 

### Encrypt Everything

As we mentioned above, [encryption](/email-security/the-evolution-of-email-security-over-time-a-deep-dive-into-eight-modern-email-encryption-protocols/) is key to ensuring HIPAA-compliant emails. How does encryption work? It **masks sensitive data** so that only the user containing a decryption key can access it.

This is where [end-to-end (E2EE) encryption](https://www.techtarget.com/searchsecurity/definition/end-to-end-encryption-E2EE) comes into play, which encrypts emails at rest and in transit. This means that whether an email is in your inbox or it’s an email you sent, they’re **equally secure** no matter what. 

So, how do you encrypt your healthcare emails? _Choose an email service provider that offers **built-in encryption features** or supports email protocols like Transport Layer Security or [Secure/Multipurpose Internet Mail Extensions (S/MIME)](https://www.zoho.com/mail/glossary/what-is-s-mime.html)_.

Also, consider password-protecting sensitive email attachments or use a **secure file-sharing service** to share large files containing PHI.

Send these password-protected attachments **separately from the email** body. And only share passwords through a separate channel, such as phone call, text message, secure messaging app, or in person.

Let’s look at an example of how a healthcare organization can use encryption in its emails to keep PHI safe.

Form Health sends its patients emails about their **online prescriptions** for [medications like Mounjaro](https://www.formhealth.co/mounjaro-weight-loss) for weight loss. 

The telehealth platform can protect this sensitive information using secure platforms, such as a mobile app. The brand specially designed the Form Health app to encrypt communication between patients and dieticians, often without the need for email. Working with a [telehealth app development company](https://flatirons.com/services/telehealth-software-development/) can ensure such platforms are built with end-to-end encryption, **HIPAA compliance**, and user-friendly interfaces tailored to both patients and healthcare providers.

[![telehealth platform](https://media.mailhop.org/duocircle/images/2024/05/hosted-email-server-2.jpg)](https://media.mailhop.org/duocircle/images/2024/05/hosted-email-server-2.jpg)

([Image Source](https://www.formhealth.co/))

### Form a Business Associate Agreement (BAA) With Your Email Provider

Anytime you use a third-party application or platform, such as an email service provider (ESP), that will be **handling ePHI**, be sure to prepare a [business associate agreement (BAA)](https://healthitsecurity.com/features/what-is-a-hipaa-business-associate-agreement-baa).

This will ensure they follow HIPAA regulations, too. That way, you can safeguard patient data at all touchpoints. 

If an ESP doesn’t want to enter into this agreement with you, keep looking. _A **BAA should always be a dealbreaker** when searching for an ESP that handles ePHI._

### Implement Access & Audit Controls

Limit access to PHI within your email to authorized individuals only. Use **secure authentication methods**, such as strong passwords or MFA.

Require patients to create strong, unique passwords to protect their email accounts from unauthorized access.

This involves using [password complexity requirements](https://cybernews.com/best-password-managers/how-to-create-a-strong-password/), such as **minimum length**, special characters, and numbers.

Implement **audit control procedures** to monitor and record access to sensitive ePHI. This involves tracking and logging access to email systems that handle ePHI. Monitor user logins, email send and receive activities, or any changes or access to email content containing PHI. 

With audit controls, you can record detailed information about email activity, including the date, time, sender, recipient, subject, and content of healthcare emails. These audit logs allow you to **track the flow of PHI** and identify any unauthorized or [suspicious activity](https://www.10news.com/news/local-news/palomar-health-medical-group-finds-suspicious-activity-on-some-computers-in-network).

[![secure authentication methods](https://media.mailhop.org/duocircle/images/2024/05/dkim-selector-7544.jpg)](https://media.mailhop.org/duocircle/images/2024/05/dkim-selector-7544.jpg)

### Develop Email Policies Within Your Organization & Train Staff

**Put a policy in place** that outlines how stakeholders within your healthcare organization should handle emails containing PHI.

Your policy should **specify the responsibilities** of employees, contractors, and partners regarding how they should handle PHI.

Include requirements for safeguarding PHI, including encryption, access controls, and [data breach](https://www.bbc.com/news/articles/cglvpnpxx87o) reporting.

_Don’t forget to add procedures for HIPAA training, risk analysis, incident response, and auditing._ Establish protocols for how your organization should **respond to incidents**, breaches, and potential violations of HIPAA regulations.

Last but not least, **consult with legal counsel** to make sure your email policy adheres to HIPAA regulations.

### Archive Your Emails According to Standards

To maintain HIPAA compliance, you must archive and retain all emails containing protected health information for a **minimum of six years**.

After this period, you should dispose of the information. You can **automate** this process with an [email archiving](/content/email-archiving/) solution.

### Inform Patients About the Risks of ePHI Communication

Regularly **update your privacy policy** so that patients know about the type of data you collect and how you protect and use their information.

_Zocdoc regularly updates its privacy policy and Terms of Use._

[![Zocdoc](https://media.mailhop.org/duocircle/images/2024/05/email-sending-services-2.jpg)](https://media.mailhop.org/duocircle/images/2024/05/email-sending-services-2.jpg)

_Screenshot provided by the author_

**Always get consent from patients** before communicating with them via email. In most states, consent isn’t necessary.

But it’s still a good idea to ask for consent to make sure patients **understand the risks** of communicating PHI by email. These risks include unauthorized access, interception, and data breaches.

Knowing the risks involved, patients can **make informed decisions** regarding how they want to communicate about their PHI electronically.

### Put Data Backup & Disaster Recovery Measures in Place

Have a **disaster recovery plan** in place so that if a [cyberattack](/data-privacy/rising-cyberattacks-and-emerging-risks-impacting-the-cyber-world/), system outage, or natural disaster occurs, you can quickly recover PHI.

_A good HIPAA-encrypted email solution should include a data backup and disaster recovery plan._

### Use an Email Security Solution

Invest in an [email security](/) solution that can **stop malicious emails** before they harm your healthcare organization.

An email security solution offers an additional layer of protection. It works by delivering threat prevention across emails that handle sensitive PHI. 

Look for email security software that offers:

- Outbound Simple Mail Transfer Protocol (SMTP)
- Hosted phishing and [ransomware protection](/resources/locky-ransomware)
- [Email backup MX](/email/email-backup-mx) (mail exchange)
- Phishing protection
- [Email forwarding](/email/email-forwarding)

## Maintaining HIPAA Compliance in Patient Communication

The **national standards** for keeping PHI safe in healthcare emails involve encryption, access and audit controls, and strong [data loss prevention (DLP)](https://www.ibm.com/topics/data-loss-prevention) strategies.

Once you take care of these tasks, you’ve made a great first step to making sure your emails follow HIPAA regulations and **protect your patients medical records**.

The next step? Using an email security solution that protects email communications between your organization, providers, and patients.

You can also take things a step further with secure [email hosting](/email/hosted-email) services. That way, you’ll have access to **strong email security** measures and a [HIPAA-compliant email service provider](https://cybersecuritynews.com/hippa-compliance-service/).

By following these steps and implementing robust email security measures, healthcare organizations can ensure the security policy and privacy of their communications, complying with the **Privacy Rule** and protecting identifiable health information and electronic health records. 

Ensuring that [healthcare clearinghouses](https://sdata.us/2020/09/09/what-is-a-healthcare-clearinghouse/) and covered entities take reasonable steps to safeguard patient records is essential to **avoid criminal penalties** and protect against unauthorized disclosures of PHI for personal gain or commercial advantage.

What **technical safeguards** will you implement as a health care professional to provide the best medical care and protect your health care operations?

---

[![Author](https://media.mailhop.org/duocircle/images/2024/05/Jeremy.jpg)](https://media.mailhop.org/duocircle/images/2024/05/Jeremy.jpg)

_Jeremy is co-founder & CEO at_ [_uSERP_](https://userp.io/)_, a digital PR and SEO agency working with brands like Monday, ActiveCampaign, Hotjar, and more. He also buys and builds SaaS companies like_ [_Wordable.io_](https://wordable.io/) _and writes for publications like Entrepreneur and Search Engine Journal._

## Topics

email securityUpdates 

![Brad Slavin](https://media.mailhop.org/dmarcreport/images/team/brad-slavin.jpg) 

Brad Slavin 

General Manager

General Manager at DuoCircle. Product strategy and commercial lead across the email security portfolio.

## Secure your email infrastructure

Protect, authenticate, and deliver. Contact our team to find the right solution.

[Contact Sales](/contact/) [Explore Products](/products/) 

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