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How to Secure SMTP Email Delivery with TLS

hands on a keyboard sending secure email

Secure email sending is a priority for organizations that communicate sensitive data externally. One of the most common ways to send secure emails is with SMTP TLS. TLS stands for Transport Layer Security and is the successor of SSL (Secure Socket Layer). TLS is one of the standard ways that computers on the internet transmit information over an encrypted channel. In general, when one computer connects to another computer and uses TLS, the following happens:

  1. Computer A connects to Computer B (no security)
  2. Computer B says “Hello” (no security)
  3. Computer A says, “Let’s talk securely over TLS” (no security)
  4. Computers A and B agree on how to do this (secure)
  5. The rest of the conversation is encrypted (secure)

In particular:

  • The conversation is encrypted
  • Computer A can verify the identity of Computer B (by examining its SSL certificate, which is required for this dialog)
  • The conversation cannot be eavesdropped upon (without Computer A knowing)
  • A third party cannot modify the conversation
  • Third parties cannot inject other information into the conversation.

TLS and SSL help make the internet a more secure place. One popular way to use TLS is to secure SMTP to protect the transmission of email messages between servers.

hands on a keyboard sending secure email

Securing SMTP Email Delivery with TLS 

The mechanism and language by which one email server transmits email messages to another email server is called Simple Mail Transport Protocol, or SMTP. For a long time, email servers have had the option of using TLS to transparently encrypt the message transmission from one server to another.

When available, using TLS with SMTP ensures the message contents are secured during transmission between the servers. Unfortunately, not all servers support TLS! Many email providers, especially free or public ones, have historically not supported TLS. Thankfully, the trend is shifting. LuxSci found that most providers now support TLS- approximately 85% of domains tested as of July 2022.

Using TLS requires that the server administrators:

  1. purchase SSL certificates
  2. configure the email servers to use them (and keep these configurations updated)
  3. allocate additional computational resources on the email servers involved.

For TLS transmission to be used, the destination email server must offer support for TLS, and the sending computer or server must be configured to use TLS connections when possible.

The sending computer or server could be configured for:

  1. No TLS: never use it.
  2. Opportunistic TLS: use it if available; if not, send it insecurely.
  3. Forced TLS: use TLS or do not deliver the email at all.

How Secure is Email Delivery over SMTP TLS?

TLS protects the transmission of the email message contents. It does nothing to protect the security of the message before it is sent or after it arrives at its destination. For that, other encryption mechanisms may be used, such as PGP, S/MIME, or storage in a secure portal.

For sending sensitive information to customers, transmission security is the minimum standard for compliance with healthcare and financial regulations. TLS is appropriate to meet most compliance requirements and offers an excellent alternative to more robust and less user-friendly encryption methods (like PGP and S/MIME).

There are different versions of TLS- 1.0 and 1.1 use older ciphers and are not as secure, while TLS 1.2 and 1.3 use newer ciphers and are more secure. When an email is sent, the level of TLS used is as secure as can be negotiated between the sending and receiving servers. If they both support strong encryption (like AES 256), then that will be used. If not, a weaker grade of encryption may be used. The sending and receiving servers can choose the types of encryption they will support. If there is no overlap in what they support, then TLS will fail (this is rare).

What about Replies to Secure Messages?

Let’s say you send a message to someone that is securely delivered to their inbox over TLS. Then, that person replies to you. Will that reply be secure? This may be important if you are communicating sensitive information. The reply will use TLS only if:

  1. The recipient’s servers support TLS for outbound email (there is no way to test this externally).
  2. The mail servers (where the “From” or “Reply” email address is hosted) support TLS for inbound email.
  3. Both servers support overlapping TLS ciphers and protocols and can agree on a mutually acceptable means of encryption.

Unless familiar with the providers in question, it cannot be assumed that replies will use TLS. So, what should you do? Ultimately, it depends on what compliance standards you must meet, the level of risk you are willing to accept, and the types of communications you send. There are two general approaches to this question:

  1. Conservative. If replies must be secure in all cases, assuming TLS will be used is unreasonable. In this case, a more secure method should be used to encrypt the messages in transit and store them upon arrival. The recipient must log in to a secure portal to view the message and reply securely. Alternatively, PGP or S/MIME could be used for additional security.
  2. Aggressive. In some compliance situations like HIPAA, healthcare providers must ensure that ePHI is sent securely to patients. However, patients are not beholden to HIPAA and can send their information insecurely to anyone they want. If the patient’s reply is insecure, that could be okay. For these reasons, and because using TLS for email security is so easy, many do not worry about the security of email replies. However, this should be a risk factor you consider in an internal security audit. Consider nuanced policies that allow you to send less sensitive messages with TLS while sending more sensitive messages with higher security.

What are the Weaknesses of SMTP TLS?

As discussed, SMTP TLS has been around for a long time and has recently seen a great deal of adoption. However, it has some deficiencies compared to other types of email security:

  • There is no mandatory support for TLS in the email system.
  • A receiver’s support of the SMTP TLS option can be trivially removed by an active man-in-the-middle because TLS certificates are not actively verified.
  • Encryption is not used if any aspect of the TLS negotiation is undecipherable/garbled. It is very easy for a man-in-the-middle to inject garbage into the TLS handshake (which is done in clear text) and have the connection downgraded to plain text (opportunistic TLS) or have the connection fail (forced TLS).
  • Even when SMTP TLS is offered and accepted, the certificate presented during the TLS handshake is usually not checked to see if it is for the expected domain and unexpired. Most MTAs offer self-signed certificates as a pro forma. Thus, in many cases, one has an encrypted channel to an unauthenticated MTA, which can only prevent passive eavesdropping.

The Latest Updates to Secure SMTP TLS

Some solutions help remedy these issues—for example, SMTP Strict Transport Security. SMTP STS enables recipient servers to publish information about their SMTP TLS support in their DNS. This prevents man-in-the-middle downgrades to plain text delivery, ensures more robust TLS protocols are used, and can enable certificate validation.

In addition, users can adopt TLS 1.3. NIST recommends that government agencies develop migration plans to support TLS 1.3 by January 1, 2024. LuxSci supports both SMTP MTA-STS and TLS 1.3.

What about Secure SMTP TLS Email Delivery at LuxSci?

Inbound TLS

LuxSci’s inbound email servers support TLS for encrypted inbound email delivery from any sending email provider that also supports that. For selected organizations, LuxSci also locks down its servers to only accept email from them if delivered over TLS.

Outbound Opportunistic TLS

LuxSci’s outbound email servers will always use TLS with any server that claims to support it and with whom we can talk TLS v1.0+ using a strong cipher. The message will not be sent securely if the TLS connection to such a server fails (due to misconfiguration or no security protocols in common). Outbound opportunistic TLS encryption is automatic for all LuxSci customers, even those without SecureLine.

Forced TLS

When Forced TLS is enabled, the message is either dropped or sent with an alternate form of encryption if the recipient’s server does not support TLS. This ensures that messages will never be sent insecurely. Forced TLS is also in place for all LuxSci customers sending to banks and organizations that have requested that we globally enforce TLS to their servers.

Support for strong encryption

LuxSci’s servers will use the strongest encryption supported by the recipient’s email server. LuxSci servers will never employ an encryption cipher that uses less than 128 bits (they will fail to deliver rather than deliver via an excessively weak encryption cipher), and they will never use SSL v2 or SSL v3.

Does LuxSci have any other Special TLS Features?

When using SecureLine for outbound email encryption:

  1. SMTP MTA STS: LuxSci’s domains support SMTP MTA STS, and LuxSci’s SecureLine encryption system leverages STS information about recipient domains to improve connection security.
  2. Try TLS: Account administrators can have secure messages “try TLS first” and deliver that way. If TLS is unavailable, the messages would fall back and use more secure options like PGP, S/MIME, or Escrow. Email security is easy, seamless, and automatic when communicating internally or with others who support TLS.
  3. TLS Exclusive: This is a special LuxSci-exclusive TLS sending feature. TLS Exclusive is just like Forced TLS, except that messages that can’t connect over TLS are just dropped. This is ideal for low-importance emails that must still be compliant, like email marketing messages in healthcare. In such cases, the ease of use of TLS is more important than receiving the message.
  4. TLS Only Forwarding: Account administrators can restrict any server-side email forwarding settings in their accounts from allowing forwarding to any email addresses that do not support TLS for email delivery.
  5. Encryption Escalation: Often, TLS is suitable for most messages, but some messages need to be encrypted using something stronger. LuxSci allows users to escalate the encryption from TLS to Escrow with a click (in WebMail) or by entering particular text in the subject line (for messages sent from email programs like Outlook).
  6. When TLS delivery is enabled for SecureLine accounts, messages will never be insecurely sent to domains that purport to be TLS-enabled. I.e., TLS delivery is enforced and no longer “opportunistic.” The system monitors these domains and updates their TLS-compliance status daily.
  7. Double Encryption: Messages sent using SecureLine and PGP or S/MIME will still use Opportunistic TLS whenever possible for message delivery. In these cases, messages are often “double encrypted.” First, they are encrypted with PGP or S/MIME and may be encrypted again during transport using TLS.
  8. No Weak TLS: Unlike many organizations, LuxSci’s TLS support for SMTP and other servers only supports those protocol levels (e.g., TLS v1.0+) and ciphers recommended by NIST for government communications and which are required for HIPAA. So, all communications with LuxSci servers will be over a compliant implementation of TLS.

For customers who can use TLS to meet security or compliance requirements, it enables seamless security and “use of email as usual.” SecureLine with Forced TLS enables clients to take advantage of this level of security whenever possible while automatically falling back to other methods when TLS is unavailable.

Of course, using Forced TLS as the sole method of encryption is optional; if your compliance needs are more substantial, you can turn off TLS-Only delivery or restrict it so that it is used only with specific recipients.

If your email use cases are complicated, LuxSci’s flexibility enables the secure sending of emails to any recipient, regardless of their email service provider’s support for TLS. Contact the LuxSci sales team to learn more about our secure SMTP TLS email sending.

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What is a cyber risk assessment?

What Is a Cyber Risk Assessment?

As cyber threats become both more frequent and sophisticated, it’s essential for healthcare companies to strengthen their cybersecurity posture and safeguard the electronic protected health information (ePHI) within their IT ecosystems and communications. This begins with a comprehensive cyber risk assessment that spans infrastructure, applications and communications. 

A cyber risk assessment enables healthcare companies to focus their attention on the IT areas that need the most improvement, allowing them to be more effective in their threat mitigation efforts. This not only reduces the chances of cyber attacks but helps them align with HIPAA’s guidelines and maintain the operational integrity required to best serve their patients and customers.

Let’s discuss why it’s vital that healthcare companies conduct thorough cyber threat risk assessments and the steps your organization can take to carry one out effectively.

Why Are Cyber Risk Assessments Crucial for Healthcare Organizations?

In an increasingly digitized healthcare landscape, conducting regular risk assessments is essential for companies of all sizes, in every industry. For healthcare companies, charged with protecting patient data, it’s especially critical and often a compliance requirement. Electronic PHI, which contains details of an individual’s health history, including current conditions, past illnesses and procedures, prescribed medicine, etc., is very sensitive in nature, so healthcare companies must go the extra mile to ensure its protection in transit and at rest. 

Performing a cyber threat risk assessment is the first step to achieving this critical requirement. A risk assessment allows you to identify all of the ePHI within your business, understand the threats it faces, determine gaps in your cybersecurity posture, and, most importantly, mitigate them.  

Additionally, from a compliance perspective, conducting regular risk assessments is a key requirement of HIPAA’s Security Rule. Consequently, healthcare companies must carry out periodic risk assessments if they want to comply with HIPAA regulations, and avoid the consequences of non-compliance. A risk assessment provides documented evidence, to auditors, supply-chain partners, and others, that you are conscious of security concerns and have taken the proper steps to mitigate them. 

How Do You Conduct A Cyber Risk Assessment? 

Now that we’ve discussed their importance, let’s turn our attention to how healthcare organizations can conduct effective cyber risk assessments. 

Identify Assets

The first, and, arguably, most important step of a risk assessment is identifying your organization’s digital assets, which include: 

  • Hardware: endpoint devices (desktops, laptops, smartphones, etc.), servers, network equipment, medical equipment, etc. 
  • Systems, infrastructure and applications: operating systems, cloud services, etc. 
  • Data, i.e., ePHI

Now, the reason asset identification could be considered the most crucial part of a risk assessment is that a healthcare organization‘s security teams can’t protect what they aren’t aware of! 

Consequently, weeding out instances of “shadow IT”, i.e., the use of applications and/or systems without the approval of a company’s IT department is essential. Otherwise, you could have cases in which ePHI is used in applications, resides on databases, and so on – without it being adequately safeguarded. 

Once you’ve identified your assets, you need to classify them: based on their sensitivity and potential impact if a security incident were to occur.

Identify Vulnerabilities and Threats

Having successfully catalogued your assets, you must now establish the factors most likely to compromise their security. This first means pinpointing the vulnerabilities in your IT ecosystem, which could include:

  • A lack of encryption, or weak standards
  • Lax access controls
  • Weak password policies 
  • Lack of monitoring and logging 
  • Outdated software (with some no longer being supported by its vendor) 
  • End-of-life hardware
  • Infrequent back-ups
  • Unverified or insecure third-party vendors

When you have a better understanding of these vulnerabilities, which are called attack vectors, you can then determine the most likely threats to ePHI based on the gaps in your security posture. These include:

  • Data breaches or exposure
  • Malware, e.g., ransomware, viruses, spyware, etc. 
  • Social engineering phishing
  • Insider threats (whether through malice or human error)
  • Distributed Denial of Service (DDoS) attacks

Fortunately, there is an array of scanning tools that will help you find your cybersecurity vulnerabilities. As far as understanding the main threats to your sensitive patient and customer data, you need to keep up with the latest in threat intelligence. Cybercriminals are always devising new ways to infiltrate healthcare organizations’ networks, so your security teams must remain aware of emerging cyber threats. 

Risk Prioritization

So, now you have catalogued your assets, determined their vulnerabilities, and identified the threats. However, implementing cyber threat mitigation measures requires resources – namely time and money – so you must prioritize which risks to mitigate first, based on their likelihood and impact.

First, how likely is a threat to exploit a vulnerability? Healthcare organizations typically determine this through existing threat databases, such as MITRE, as well as keeping up-to-date on the latest threat intelligence and determining how it pertains to your company. 

Secondly, evaluate the potential impact, or consequences, of a threat actually manifesting, i.e., a an email breach or a malicious actor successfully pulling off a cyber attack and infiltrating your network. When analyzing the potential impact, consider the financial, operational, reputational, and compliance implications. 

Report Findings

At this point, you should report the findings of the risk assessments to your company’s key stakeholders, e.g., upper management, compliance officers, IT management and security, etc. This ensures that decision-makers understand the nature of the top threats facing your organization, their potential business impact, and the urgency of implementing mitigation controls. 

This also helps security teams secure the resources they need to bolster their cybersecurity posture accordingly. An additional benefit of this reporting is that it provides an audit trail for compliance efforts, as it demonstrates your efforts to better protect patient and customer data. 

Implement Mitigation Measures

Now, we’ve come to the point in the risk assessment process where you act on your due diligence and implement the policies and controls that will better protect patient data and comply with HIPAA guidelines.  

Mitigation measures broadly fall into three categories: 

  • Preventive: e.g., encryption, access control, user authentication (e.g., multi-factor authentication (MFA))
  • Detective: e.g., vulnerability scanning, continuous monitoring
  • Corrective: e.g., incident response, backups and disaster recovery

A robust cybersecurity posture requires a combination of all three. Your risk assessment may reveal that your organization is strong in one aspect but less so in others, or you may need to bolster your efforts across the board. 

Document Your Risk Mitigation Measures

Create a risk mitigation implementation report that details how your organization executed its cyber threat mitigation strategies. This should include: 

  • Affected assets: the parts of your IT infrastructure (servers, databases, etc.) and applications you identified as vulnerable and the severity of their corresponding threats. 
  • Mitigation actions: the specific action(s) undertaken to mitigate cyber threats against the asset, e.g., enhancing encryption standards, strengthening password policies, conducting cyber threat awareness training, etc. 
  • Technical details: where applicable, such as a particular update applied to an application, how a system has been configured, which new software solution has been deployed, and so on.
  • Post-mitigation risk assessment: re-evaluate the risk level of each asset after the implementation of new security measures. 
  • Monitoring and compliance: detail how the organization will monitor the efficacy of the implemented measures, as well as how your enhanced controls and policies align with compliance standards (e.g., HIPAA, NIST, HITRUST, etc).

As with the report for stakeholders after the initial stages of the assessment, the risk mitigation implementation report also leaves a compliance audit trail, which will become all the more important when the proposed changes to the HIPAA Security Rule come into effect.

Continuous Monitoring and Review

As detailed in your risk mitigation implementation report, you must continuously monitor your IT infrastructure to assess the effectiveness of your newly implemented policies and controls. This process also mitigates cyber risk, in and of itself, as it provides fewer opportunities for malicious actors to breach your network: you’ll have systems in place to alert you of suspicious activity. 

Additionally, you must regularly reassess your organization’s cyber risks as new threats emerge, your IT ecosystem evolves, or if you succumb to a cyber attack. 

How Often Should You Conduct Cyber Risk Assessments? 

Healthcare organizations should carry out a cyber risk assessment at least once a year, with respect to time, or when they make changes to their IT infrastructure. With the proposed changes to the HIPAA Security Rule on the horizon, now is an opportune time to conduct a risk assessment and measure your cyber threat readiness against the new stipulations of the soon-to-be-updated Security Rule.

Also, as alluded to above, if you suffer a security incident, you must conduct a post-breach assessment, once the threat is contained, to establish how a malicious actor breached your network – and how to prevent it from happening again. 

How LuxSci Helps Mitigate Cyber Risk in the Healthcare Industry

With more than 20 years of experience, LuxSci has developed the required expertise to make secure communication solutions tailored to meet the stringent cyber risk mitigation needs of the healthcare industry.

LuxSci’s suite of HIPAA-compliant communication solutions includes:

  • Secure Email: HIPAA-compliant email solutions for executing highly scalable, high volume email campaigns that include PHI – millions of emails per month.
  • Secure Forms: Securely and efficiently collect and store ePHI without compromising security or compliance – for onboarding new patients and customers and gathering intelligence for personalization.
  • Secure Marketing: proactively reach your patients and customers with HIPAA compliant email marketing campaigns for increased engagement, lead generation and sales.
  • Secure Text Messaging: enable access to ePHI and other sensitive information directly to mobile devices via regular SMS text messages.

Interested in discovering more about how LuxSci can help you protect your patient’s ePHI, mitigate cyber risk, and ensure HIPAA compliance for your email and communications? Contact us today!

HIPAA Compliant Email

What Are the Implications of the Proposed Changes to the HIPAA Security Rule?

With the recent announcement of proposed changes to the HIPAA Security Rule, by the Office for Civil Rights (OCR), healthcare providers, payers, suppliers, and organizations of all sizes will have to tighten up their cybersecurity practices. In some cases, considerably. 

However, with the announcement being so recent (and there not even yet being a clear timeline for when companies will have to implement the changes), it’s all too easy for organizations to view the proposed amendments as a challenge that’s far off in the future.

However, even at this early stage, the proposed changes to the Security Rule require careful consideration and important conversations. Soon, healthcare companies will have to implement or improve a series of cybersecurity controls designed to better safeguard electronic protected health information (ePHI). 

In light of this, in this post, we’ll discuss some of the most important practical considerations that healthcare organizations will have to contend with to maintain HIPAA compliance when the proposed changes to the Security Rule go through. 

What are the Key Proposed Changes to the HIPAA Security Rule?

First, a refresher on what the proposed changes to the Security Rule are:

  1. More Comprehensive Risk Management: healthcare organizations must conduct more frequent risk assessments to identify, categorize, and mitigate threats to sensitive patient data. 
  2. Stricter Documentation and Evidence Retention Policies: similarly, stronger documentation and record-keeping practices to ensure organizations can demonstrate compliance with security requirements.

    This includes:
  • Maintaining detailed records of how they assess threats and implement safeguard security controls (e.g., encryption policies, access controls, etc).
  • Retaining detailed audit logs of system access, data modifications, and security events, as well as reports from security solutions, such as firewalls and intrusion detection systems all must be securely stored, retained for a defined period, and made available for audits and compliance reviews.
  • By the same token, the proposed updates to the Security Rule may extend how long healthcare organizations must retain logs and other security documentation, allowing auditors to review historical compliance efforts in the event of an investigation.
  1. Mandatory Encryption for All ePHI Transmission: healthcare companies will require end-to-end encryption for emails, messages, and data transfers involving ePHI. Like today, this means that patient data must be encrypted in transit, i.e., from one place to another (when collected in a secure form, sent in an email, etc.), and in storage, i.e., where it will reside.
  2. Stronger User Authentication and Identity Verification Requirements: healthcare providers must implement stronger identity access management IAM safeguards, such as Multi-Factor Authentication (MFA), for employees with access to patient data.
  3. Tighter Third-Party Security Controls: stricter security controls for business associates who have access to the healthcare company’s ePHI. One of the proposed changes to the HIPAA Security Rule is that vendor security audits will be mandatory instead of optional.
  4. Updated Incident Response (IR) and Data Breach Reporting Rules: mandating stricter breach notification timelines for healthcare entities and their business associates, with them being obligated to inform parties affected by a security breach as soon as possible. 

What Are The Practical Implications for Healthcare Companies?

So, what will healthcare companies have to do to comply with HIPAA regulations when the proposed changes to the Security Rule go through? Let’s look at the main practical considerations.

Cybersecurity Solution Deployment and Infrastructure Upgrades 

Many healthcare companies will have to install (and subsequently, maintain) new IT infrastructure and deploy new cybersecurity tools to strengthen their authentication safeguards (e.g., MFA, Zero Trust, etc.) to meet new HIPAA’s heightened cybersecurity standards.

Expanded Vendor and Third-Party Management

As well as having to deploy new cybersecurity solutions, such as HIPAA compliant email services and continuous monitoring tools, healthcare organizations will have to be more diligent in their oversight of their third-party vendors.  

Stricter Auditing and Documentation Requirements

In having to provide more details of their risk management practices and maintain real-time logs, healthcare organizations will have to develop processes, policies, and supporting documentation. 

Staff Training 

Healthcare companies will have to train their staff on the updates of the Security Rule, their implications, how to use the new applications and hardware deployed to harden their security posture, etc. 

Increased Management and Administrative Burden 

Dealing with proposed changes to the Security Rule is going to require all hands on deck. 

Managers and stakeholders are going to make several important strategic decisions; procurement and product managers are going to have to research and purchase new solutions; IT will have to deploy the solutions; and everyone will need to learn how to use them. 

With all this in mind, more will be required from everyone within your organization. Employees will be taken away from their work, which could affect the quality of the service provided to patients and customers. 

That’s why it’s crucial to be prepared…

How Can You Prepare For the Proposed Changes to the Security Rule?

  • Conduct risk assessments: pinpoint vulnerabilities within your IT network and the ePHI contained therein. You should conduct risk assessments annually at the very least – or you upgrade your IT infrastructure. In light of the proposed amendments to the Security Rule, conducting a risk assessment to identify the security gaps in your network against the proposed rule changes is essential.
  • Evaluate your existing email and communication platforms: to accommodate the upcoming changes to the Security Rule, many healthcare companies will need to upgrade to HIPAA compliant email communication solutions, as well as encrypted databases for securely storing ePHI at rest. Deploying an email services solution designed for the healthcare industry, like LuxSci, best ensures compliance with encryption and the other new requirements of the Security Rule.
  • Improve your organization’s incident response planning and documentation processes: develop all the required documentation to track the movement of patient data, and refine your processes for handling security events. This also encompasses training your staff on your new security policies and procedures.
  • Improve your organization’s cybersecurity posture: by implementing end-to-end encryption, network segmentation, zero-trust security infrastructure, data loss protection (DLP) protocols, and other measures that will better protect patient data.
  • Perform vendor due diligence: ensure your third-party service providers meet HIPAA compliance standards and that you have a Business Associate Agreement (BAA) in place with each vendor that can access your ePHI. 

How Luxsci Can Help You Navigate the Proposed Changes to the HIPAA Security Rule

With more than 20 years of experience in delivering best-in-class secure healthcare communication solutions, LuxSci is a trusted partner for healthcare organizations looking to secure their email and digital communications in line with regulatory standards and the industry’s highest security standards.

LuxSci’s suite of HIPAA-compliant solutions includes:

  • Secure Email: HIPAA-compliant email solutions executing highly scalable email campaigns that include PHI – send millions of emails per month.
  • Secure Forms: Securely and efficiently collect and store ePHI without compromising security or compliance – for onboarding new patients and customers and gathering intelligence for personalization.
  • Secure Marketing – proactively reach your patients and customers with HIPAA compliant email marketing campaigns for increased engagement, lead generation and sales.
  • Secure Text Messaging – enable access to ePHI and other sensitive information directly to mobile devices via regular SMS text messages. 

Interested in discovering more about LuxSci can help you get a head start on upgrading your cybersecurity stance to ensure future HIPAA compliance? Contact us today!

healthcare marketing

What is a SMART Objective in Healthcare Marketing?

Healthcare marketing objectives typically follow the SMART framework: Specific, Measurable, Achievable, Relevant, and Time-bound goals that guide marketing campaigns and patient outreach programs. These structured objectives help healthcare organizations track progress, measure success, and adapt strategies to meet defined targets within budget and regulatory requirements. Clear, well-defined objectives lead to effective resource allocation and higher returns on marketing investments. As a result, marketing teams use this framework to develop campaigns that deliver quantifiable results while maintaining healthcare industry standards and compliance requirements.

SMART Marketing Requirements

The SMART framework provides healthcare organizations with a structured method to develop marketing plans that deliver measurable results. Marketing teams design objectives that meet specific criteria for success, including detailed action plans and performance metrics. Each objective links to broader organizational goals while maintaining healthcare compliance standards. Teams consider market conditions, resource availability, and patient needs when setting these objectives. The framework ensures marketing plans remain focused on achievable outcomes rather than vague aspirations. To track results, organizations review their healthcare marketing objectives quarterly to validate alignment with business goals and adjust targets based on market changes. Marketing teams document their objectives in detail, including baseline metrics, target improvements, and measurement methods to track progress accurately.

  • SMART objectives help healthcare marketers directly connect marketing activities to measurable patient acquisition outcomes.
  • Cross-departmental collaboration improves when marketing and relevant teams set out clearly defined objectives.
  • Healthcare organizations using structured objectives can better demonstrate marketing value to leadership and stakeholders.
  • Well-documented SMART objectives create marketing accountability while supporting compliance with healthcare regulations.
  • The framework encourages more efficient resource allocation by requiring measurable outcomes for all marketing investments.

Target Markets and Patient Segments

Marketing teams use demographic data and healthcare utilization patterns to identify target patient populations. They analyze factors like age groups, insurance coverage, medical needs, and geographic location to create focused marketing objectives. This research shapes campaign messaging and channel selection for different patient segments. Teams track response rates across various demographics to refine their targeting strategies. Market segmentation helps organizations allocate marketing resources to the most promising patient groups and service lines. Research includes analyzing patient data from electronic health records, insurance claims, and market surveys to understand healthcare needs and preferences. Teams develop patient personas to guide marketing efforts and create relevant messaging for each segment. They study healthcare consumption patterns, referral sources, and patient journey maps to identify marketing opportunities within each segment.

Budget Planning and Resource Management

Healthcare marketing objectives should include detailed budget planning and resource allocation strategies. This means that teams develop cost projections for different marketing channels and campaign types. They track spending against expected patient acquisition costs and revenue generation. These financial objectives help organizations maintain profitable marketing operations while meeting growth targets. Budget planning includes staff time, technology costs, advertising and lead generation expenses, and marketing content production. Regular financial reviews ensure marketing activities stay within planned spending limits while delivering expected results. Marketing departments calculate return on investment for each campaign type and channel to optimize resource allocation. They maintain detailed cost tracking systems to monitor expenses across all marketing activities. Teams develop contingency plans for budget adjustments based on campaign performance and market changes.

Technology Integration and Digital Marketing

Marketing objectives dictate technology requirements for campaign execution and performance tracking. Teams set goals for website optimization, email deliverability and conversions, social media engagement, and digital ad campaign results. They also plan implementation schedules for new marketing technologies and patient communication tools. These objectives include metrics for online appointment scheduling, patient portal usage, email engagement, and digital content engagement. Organizations track technology adoption rates and return on digital marketing investments. Marketing teams continuously evaluate new healthcare marketing technologies and platforms to improve campaign effectiveness. For example, email marketing platforms that securely transmit protected health information (PHI) can enable greater personalization with more targeted and customized messages. Integration plans are developed for marketing automation tools, email marketing and campaign tools, customer relationship management systems, and analytics platforms. The technical requirements include the necessary data security measures, such as end-to-end encryption, to protect patient information and maintain HIPAA compliance across all digital marketing channels.

Marketing departments can also create automation objectives to nurture leads and improve operational efficiency. Email communication campaigns are created with targeted messages based on patient attributes, health conditions, interests and product needs. Marketing teams must establish protocols for using PHI to personalize patient outreach while maintaining compliance standards. Marketing automation tools help track patient interactions across multiple touchpoints and trigger appropriate follow-up communications. Organizations measure email engagement rates, deliverability, and conversion metrics to evaluate effectiveness. Their teams develop workflow automation systems that reduce manual tasks and improve campaign conversions and ongoing engagement. These automated processes help marketing departments manage larger email volumes while maintaining personalized patient and customer communications.

Campaign Execution and Timeline Management

Healthcare marketing teams create detailed implementation schedules for their objectives. They set specific dates for campaign launches, content creation, and performance reviews. Marketing calendars account for seasonal healthcare needs, annual testing, procedures and plan enrollments, and organizational updates. Teams coordinate marketing activities with other departments, including clinical departments, customer experience teams, operations, IT infrastructure and security, and administrative staff. Project management tools help track progress toward marketing objectives and maintain accountability. Regular timeline reviews allow teams to adjust schedules based on results and changing priorities. Campaign execution plans should also include content development schedules, media placement timelines, and coordination with external marketing vendors. The teams create workflow systems to manage multiple campaigns across different channels and patient segments, and an approval processes is established for marketing campaigns and materials to ensure compliance with healthcare regulations and brand standards.

Performance Analysis and Strategy Refinement

Successful healthcare marketing teams establish systems to measure marketing objective achievements, with their teams tracking key performance indicators through analytics platforms and robust reporting tools. They analyze patient acquisition data, lead generation and conversions, opportunities and revenue growth. This information helps marketing departments identify successful strategies and areas for improvement. Performance analysis includes comparing results against industry benchmarks and competitor performance, as well as their own historical performance. Regular strategy reviews ensure marketing objectives remain aligned with organizational goals and market conditions. Marketing teams should create monthly performance reports, tracking progress toward SMART objectives. The teams should also conduct quarterly reviews of marketing strategies to assess effectiveness and make necessary adjustments. Analysis includes patient satisfaction and engagement metrics, service and product line revenue growth rates, and marketing campaign response rates. Teams use this data to refine future marketing objectives and improve campaign performance.

LuxSci Third Party Integrations

The Risks of Third-Party Email Integrations for Healthcare Companies

Today’s healthcare organizations heavily rely on a variety of third-party organizations for a range of services and products. This includes applications (i.e., SaaS solutions), suppliers, partners, and other companies depended upon to serve their patients and customers. 

As the healthcare industry evolves, companies will need to increasingly collaborate with external parties, or business associates, which creates several dependencies and risks. 

In particular, third-party email platforms are integral to the operations of healthcare companies, and the sensitive nature of protected health information (PHI) contained in email communications raises the stakes exponentially. 

This post analyzes the main risks associated with third-party email integrations. From there, we detail the most effective measures for safeguarding your company from the dangers of an insecure integration with an email delivery platform.

What Are The Risks of Third-Party Email Integrations?

Email applications are a pillar of the modern workplace, enabling companies to communicate almost instantly and facilitating greater productivity and efficiency. Email has transformed the speed at which transactions can take place and individuals receive the product or service they’ve purchased. 

Consequently, the importance of email communication and the vast amounts of sensitive data it encompasses, makes it a contrast target – or “attack vector” for cybercriminals. Hackers and other malicious actors know that if they can infiltrate an organization’s email system, they have the potential to steal vast amounts of private or proprietary data. Just as alarmingly, they may simply use an insecure email platform as a backdoor into a company’s wider network, assuming greater control over their systems in an effort to maximize their financial gain or inflict maximum damage to an organization.

For healthcare companies with ambitious patient engagement goals, sharing protected health information (PHI) with a reliable third-party email provider is mandatory. Unfortunately, this comes with a litany of risks, which include:

  1. Data Breaches: weak security features in third-party email providers can expose PHI. 
  2. Misconfigured Permissions: misconfigurations and a lack of oversight control can result in personnel at third parties having excessive access to PHI.
  3. HIPAA Non-Compliance – if the integration does not support encryption, audit logs and other features mandated by HIPAA, you may drift into non-compliant territory.
  4. Financial Implications: violating HIPAA regulations can result in financial penalties, including fines and compensation to affected parties. 
  5. Reputational Damage: companies that fall victim to cyber attacks, especially through negligence, become cautionary tales and case studies for cybersecurity solution vendors. Data exposure that comes from an insecure email platform integration can have disastrous effects on your company’s reputation. 

Therefore, mitigating the risks of integrating a third-party email platform into your IT infrastructure, platforms and systems is crucial. This includes customer data platforms (CDP), electronic health record systems (EHR) and revenue cycle management platforms (RCM). Let’s move on to specific strategies on how to do so and, subsequently, better safeguard your organization’s PHI. 

How To Mitigate Email Integration Risk

Now that you have a better understanding of the potential risks that come with integrating an insecure third-party email solution into your IT ecosystem, let’s look at risk prevention. Fortunately, several strategies will significantly lower the risk of malicious actors getting their hands on the sensitive patient data under your care. Let’s take a look:

Verify A Third-Party Vendor’s Security Practices

Before sharing PHI with a vendor, ensure they have a strong cybersecurity posture. This makes sure they have measures such as encryption, access control (or identity access management (IAM), and continuous monitoring solutions in place, in addition to conducting regular risk assessments. 

Similarly, it’s crucial to research an email provider’s reputation, including how long they’ve been in operation, the companies they count among their clients, and their overall standing within the industry. 

Business Associate Agreements (BAAs)

A business associate agreement (BAA) is a legal document that’s required for HIPAA compliance, when sharing PHI with third-party vendors, such as email services. It ensures that both you and the vendor formally agree to comply with HIPAA regulations and your respective responsibilities in protecting patient data. 

Without a BAA, the above point about verifying a vendor’s security practices is moot. If they’re not willing to sign a BAA, their security stance is irrelevant, as your organization would have violated HIPAA regulations by not signing a BAA. More to the point, a HIPAA compliant email vendor will be eager to highlight their willingness to sign a BAA, as it advertises their ability to safeguard PHI and aid companies in achieving compliance. 

Encrypting PHI

Encryption needs to be a major consideration when it comes to integrating a third-party email services provider. Adequate encryption measures ensure that sensitive data is protected even in the event of its exfiltration or interception. Sure, the hackers now have hold of the PHI, but with proper encryption policies and controls, it will be unreadable, preserving the privacy of the individuals affected by the data leak. 

With this in mind, encryption measures that mitigate third-party email integrations include automated encryption, which ensures PHI is always encrypted without the need for manual configuration, and flexible encryption, which matches the encryption level with the security standards of your recipients. 

Threat Intelligence

Unfortunately, cybersecurity never stands still. With the ever-evolving nature of cyber threats, healthcare organizations must keep up with the latest dangers to patient data. This means creating a process for discovering, and acting upon, the latest threat intelligence.

This could entail signing up for a threat intelligence service, or retaining the periodic services of an external threat intelligence expert. 

Developing An Incident Response Plan For Vendor-Related Breaches

The alarming reality of securing PHI is that, even with robust safeguards in place, such as continuous monitoring, a process for acquiring the latest threat intelligence, and generally following the advice outlined in this post, data breaches are still a stark reality. Cyber criminals will always target healthcare organizations, due to the value and sensitivity of their data and systems. Worse, even as security measures grow more effective, the tools that malicious actors have at their disposal become more sophisticated. It’s an arms race, and one that’s only been exacerbated by the introduction of AI, with both security professionals and cyber criminals honing their use of it for their respective purposes.

Taking all this into consideration, having a comprehensive incident response plan in place ensures your organization responds quickly and effectively to cyber threats, or even suspicious activity. Your incident response plan should:

  • Detail what employees should do if they suspect malicious activity.
  • Outline steps for investigation and containment.
  • When and how to notify affected parties.
  • Processes for disaster recovery and retaining operational continuity.

While it’s vital to develop a general incident response plan, having a specific set of protocols for security breaches caused by third-party vendors is especially prudent.

Choose a HIPAA-Compliant Email Provider

An efficient and convenient way of mitigating the risks of third-party email integrations is to deploy a HIPAA compliant email delivery platform for communicating with patients and customers. 

Being well-versed with the safety requirements of healthcare organizations, HIPAA compliant email software features all the security required to safeguard PHI. In deploying a HIPAA compliant email provider, you also implement several of the strategies outlined above, such as encryption and signing a BAA (as a HIPAA compliant will offer a BAA). Accounting for this, taking the time to select the right HIPAA compliant email provider for your organization’s needs and goals should be a key part of your overall cyber threat defense strategy. 

Train Staff on Secure Email Communication Practices

Your staff is a considerable part of securing third-party email communications, so they must know the best practices for email security and safeguarding PHI. Comprehensive cyber threat awareness training ensures your personnel understand the risks of HIPAA non-compliance and follow the procedures you’ve set in place. Furthermore, the more responsibility an employee has in regards to PHI, the more comprehensive and regular their training needs to be.  

Additionally, training, or “drilling”, if you will, on their roles in the incident response process increases its efficacy considerably and optimizes your response to attempts at unauthorized access to data. 

How LuxSci Mitigates the Risks of Third-Party Integrations

At LuxSci, we specialize in providing secure, HIPAA compliant solutions that enable healthcare organizations to execute effective email communications and marketing campaigns.  

With more than 20 years of experience, and helping close to 2000 healthcare organizations with HIPAA compliant email services, LuxSci has developed powerful, proven tools that sidestep the vulnerabilities often associated with third-party email integration. To learn more about how LuxSci can help your organization address the risks of third-party email integration, contact us today.

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How To Send HIPAA Compliant Emails

Knowing how to send HIPAA Compliant Emails is a critical requirement for healthcare providers, payers and suppliers dealing with protected health information (PHI). With fines reaching into the millions, non-compliance isn’t something you want to risk when engaging with our customers and prospects. Unfortunately, many organizations fall into the trap of believing they’re sending HIPAA compliant email because they’ve applied what we call “self-certification” strategies—without fully understanding what’s required to be compliant.

Are you 100% sure that you’re sending HIPAA compliant emails and understand HIPAA email rules?

In this blog post, we’ll delve into the risks of being non-compliant, explain why self-certification strategies often lead to problems, and provide a HIPAA-compliant email checklist to help ensure your organization avoids the pitfalls self-compliance.

The Importance of Sending HIPAA Compliant Emails

HIPAA (Health Insurance Portability and Accountability Act) was established to ensure the protection and privacy of patients’ PHI. This law mandates that any entity handling PHI must implement strict safeguards to prevent unauthorized access, breaches, and exposure of sensitive patient data.

In today’s digital world, where healthcare communications often take place over email and other digital platforms, maintaining HIPAA compliance becomes even more complex. It’s not enough to merely think you’re compliant; you must be able to prove it beyond a doubt.

What Is PHI and Why Does It Need to Be Protected?

As a quick reminder, PHI refers to any data that can be used to identify an individual and that relates to their past, present, or future health condition. This can include anything from personal identification information to medical records and billing information to email exchanges that reference patient care.

Examples of PHI include:

  • Names
  • Addresses
  • Birth dates
  • Social Security numbers
  • Medical history and diagnoses
  • Treatment plans & prescriptions
  • Medical device usage and services
  • Appointment information
  • Billing, payments and insurance information

The Risks of Not Being 100% Sure About HIPAA Compliance

In addition to losing sleep at night, the consequences of sending non-compliant emails can be significant. Non-compliance can result in hefty penalties, ranging from $100 to $50,000 per violation, depending on the severity and intent. In some cases, these fines can even surpass $1.5 million annually.

But it’s not just the fines—PHI exposure opens the door to a variety of serious risks, including the reputational damage that can stem from breaches of patient data that can impact peoples’ lives and the future of your business. Patients place immense trust in healthcare providers and organizations to safeguard their sensitive information, which stretches beyond HIPAA-compliance to overall data security and privacy. The loss of patient trust is difficult—if not impossible—to regain once compromised.

The Problem with DIY HIPAA Compliance

Simply put, self-certifying HIPAA compliance is a recipe for disaster. Many companies and healthcare organizations falsely believe that if they conduct an internal review or have implemented basic security measures, they’re fully compliant. But without the right expertise and the right HIPAA compliant infrastructure in place, especially encryption, it’s easy to overlook crucial details.

Even if you have encryption in place or think your emails are safe, these minimal steps can create a false sense of security. True HIPAA compliance requires continuous monitoring, updating of policies, and regular training to address potential risks.

A Checklist for Sending HIPAA Compliant Email

Sending HIPAA compliant email means ensuring you’ve implemented the following safeguards:

1. Encryption Standards for HIPAA Compliance

All emails containing PHI must be encrypted both at rest and in transit—end-to-end. Ensure your email service provider offers high-grade encryption protocols, like TLS (Transport Layer Security), for sending and receiving messages, and flexible options, including dedicated cloud infrastuctures for the highest levels of data protection.

2. Secure Access and Authentication

Set up multi-factor authentication (MFA) and role-based access controls to limit who can access emails containing PHI.

3. Business Associate Agreements (BAA)

If you’re using a third-party email provider, you must have a signed BAA. This agreement ensures that the provider will uphold HIPAA’s security standards.

4. Data Backup and Recovery

Make sure your email system has a secure backup and recovery solution. Data breaches can happen, but having a recovery plan will minimize damage and maintain compliance.

5. Employee Training and Awareness

Ensure your employees are regularly trained on HIPAA guidelines. Human error is one of the leading causes of HIPAA violations, so proper education is key.

6. Regularly Audit Your HIPAA Compliance Strategy & Practices

HIPAA regulations evolve as technology advances. Conducting regular compliance audits ensures your security protocols are up to date with the latest best practices.

7. Avoiding Overconfidence in Your Own Processes

No matter how confident you are in your HIPAA strategy, bringing in an external auditor can provide an unbiased view of your compliance status and help identify overlooked vulnerabilities.

Don’t Let HIPAA Self-Certification Fool You!

HIPAA compliance is not something you can afford to be unsure about. The risks—both financially and reputationally—are too great. While it may be tempting to “self-certify” or assume your current measures are sufficient, doing so can leave your organization—and your patients and customers—vulnerable. Instead, ensure that you follow a comprehensive strategy that includes best-in-class email encryption, secure access, regular audits, employee training, and support from external experts.

Don’t take shortcuts when it comes to protecting sensitive health information and ensuring HIPAA compliance—get it right from the start.

If you’d like to get your questions on sending HIPAA compliant email answered, don’t hesitate to reach out to talk with one of our experts—and learn more about the healthcare industry’s leading HIPAA-compliant email, text and marketing solutions from LuxSci.

LuxSci Email Tracking Features

New Email Tracking Features Deliver More Accurate Engagement Insights

Today, we’re excited to announce two new reporting features designed to help healthcare organizations improve reporting accuracy and the overall effectiveness of their email campaigns. The new features offer deeper insights into Apple Mail and Google email performance by distinguishing between opens and clicks performed by human actions and automated events — and by giving users control over how these events are reflected in LuxSci email campaign reporting.

Let’s dive into what these features are and how they can help you get more precise data from your healthcare email marketing and communications efforts.

Feature 1: Enhanced Open and Click Tracking – Human vs. Automated

One of the biggest challenges in email tracking today is the rise of automated systems that pre-load images and scan links in emails. Automated systems can trigger open or click events without the recipient actually interacting with the email, leading to inflated and misleading open/click rates.

With LuxSci’s new enhanced open and click tracking, you can now tell whether Apple Mail and Google emails (Gmail and Google Workspace) were opened or a link was clicked by a human or by an automated system. This crucial distinction allows you to have a much clearer picture of actual user engagement.

Here’s how it works:

  • When emails are sent with open tracking enabled, a small tracking image (also known as a pixel) is embedded in the email. When that image is loaded, the system tracks the email as “opened.”
  • Similarly, links in the email are encoded to track clicks. If a recipient clicks a link, it triggers a “clicked” event, but these events can also be triggered by automated systems.
  • LuxSci’s enhanced open and click tracking feature analyzes these events and reports whether the actions were performed by a human or an automated system, helping you sift through false positives.

Feature 2: Suppressing Automated Events in Your Reporting

In addition to tracking the source of open and click events, LuxSci’s second new feature gives you the option to exclude automated events from Apple Mail and Google email from your email engagement statistics altogether. This setting, available in account-wide outbound email settings, is a powerful tool for ensuring the accuracy of your reports and understanding true user engagement.

Here’s how it works:

  • Automated opens and clicks can be removed from email reporting for better accuracy. For example, if a security bot clicks a link, that event will be logged, but it won’t mark the email as “clicked” in your statistics.
  • Your open, click, and click-through rates can be set to only reflect real human actions, making these metrics much more reliable for evaluating campaign performance and actual patient engagement.

Why These Features Matter for Healthcare Email Marketing

For healthcare organizations, reliable metrics are essential. Emails often carry critical information related to patient care, transactions, or marketing, and understanding who is engaging with your content is critical to ongoing improvement and long-term success. At the same time, automated actions can inflate your open and click rates, leading to inaccurate conclusions about your email performance.

LuxSci’s new features give you the power to:

  • Track email engagement with precision: Know the difference between human engagement and automated actions, so your metrics reflect reality.
  • Customize your reporting: Decide whether you want to include or suppress automated events in your reports.
  • Improve deliverability strategies: By analyzing which emails are genuinely opened or clicked by real people, you can fine-tune your email campaigns to maximize their effectiveness.

Ready to Enhance Your Email Tracking?

Take control of your email deliverability insights with LuxSci’s newest email tracking tools. Whether you want to gain deeper insights into recipient behavior or eliminate noise from automated systems, these features are designed to help you improve your email reporting, performance and engagement.

For current LuxSci customers, you can learn more about these features in the Support Library, under Support, when you are logged into your account.

If you’re new to LuxSci, reach out today and we’d be happy show you the power of our secure, HIPAA-complaint healthcare communications solutions, including high volume email, text, forms and marketing solutions. Contact us here.

Send Secure Emails: Alternatives to Web Portals

Digital technologies have entirely shifted how individuals want to interact with their healthcare providers. As consumers have become used to emailing or texting with their hairstylists, mechanics, and other providers to schedule appointments, they want to have the same level of interaction with their healthcare providers.

However, many healthcare organizations find it challenging to deliver the same experience because of their compliance requirements under HIPAA. They must balance usability and access with security and patient privacy. To send secure emails, they often resort to secure web portals. 

Problems with Secure Web Portals

One of the most common ways that healthcare organizations communicate securely with patients is by using the secure web portal method of email encryption. In this scenario, messages are sent to a secure web server, and a notification is sent to the recipient, who then logs into the portal to retrieve the message.

While highly secure, this method is not popular with recipients because of the friction it creates.

To maintain a high level of security, users must log in to a separate account to retrieve the message. This extra step creates a barrier, especially for individuals who are not tech-savvy. In addition to creating a new account, they must remember a different username and password to access their secure messages. If the recipient doesn’t have this information readily available, they will likely delete the message and move on with their day. Many users will never bother logging in because of the inconvenience. This creates issues for organizations that want to use email for standard business communications and patient engagement efforts. 

While this method may be appropriate for sending highly sensitive information like medical records, financial documents, and other valuable information, many emails that must meet compliance requirements only infer sensitive information and do not require such a high level of security. Flu shot reminder emails are not as sensitive or potentially devastating as sending the wrong medical file to someone. Healthcare organizations need to use secure email solutions that are flexible enough to send only the most sensitive emails to the portal and less sensitive emails using other methods.

How to Meet Compliance Requirements for Sending Secure Email

So, what other options do you have for sending secure emails? The answer will depend on what specific requirements you need to meet. Healthcare organizations that must abide by HIPAA regulations will find a lot of flexibility regarding the technologies they can use to protect ePHI in transit.

In addition to a secure web portal, three other types of encryption are suitable for email sending: TLS, PGP, and S/MIME. PGP and S/MIME are more secure than a web portal. They also require advanced technological skills and coordination with the end-user to implement, which makes them impractical for most business email sending.

That leaves us with TLS, which is suitable to meet most compliance standards (including HIPAA) and delivers an email experience much like that of a “regular” email.

Send Secure Emails with TLS Encryption

TLS encryption is an excellent option for secure email sending that provides a seamless experience for the recipient. Emails sent securely with TLS appear like regular, unencrypted emails in the recipient’s inbox.

TLS encrypts the message contents as they travel between mail servers to prevent interception and eavesdropping. Once the message reaches the inbox, it is unencrypted and can be read by anyone with access to the email account. For this reason, it is less secure than a portal but secure enough to meet compliance requirements like HIPAA.

If you’re wondering why this is, HIPAA only requires covered entities and business associates to protect PHI when it is stored on their systems or as it is transmitted elsewhere. After the message reaches the recipient, it is up to the recipient to decide what they want to do to secure the information. HIPAA does not apply to individuals. Each person is entitled to share and store their health information however they see fit.

Conclusion

Balancing security and usability is a significant challenge for healthcare organizations. If the message is too secure, it may be difficult for the recipient to open and engage with it. If it’s not secure enough, it is too easy for cybercriminals and other bad actors to intercept private information as it is sent across the internet. 

Choosing an email provider like LuxSci, which offers flexible email encryption options, allows users to choose the right level of encryption for each message to maximize engagement and improve health outcomes. Contact our team today to learn more about how we can support your efforts.

searching for an email

How Can I Prove an Email was Sent to Me?

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

searching for an email

How to Prove That an Email was Sent

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

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

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

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

What happened to the email?

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

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

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

Did the recipient actually send the message?

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

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

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

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

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

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

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

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

The recipient never actually sent the email message

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

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

How Do I Prove the Email Sender’s Identity?

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