Enhanced Security: AES-256 Encryption for SSL and TLS

Business Solutions, HIPAA Compliant Email
LuxSci
December 1, 2020

SSL and TLS play critical roles in securing data transmission over the internet, and AES-256 is integral in their most secure configurations. The original standard was known as Secure Sockets Layer (SSL). Although it was replaced by Transport Layer Security (TLS), many in the industry still refer to TLS by its predecessor’s acronym. While TLS can be relied on for securing information at a high level—such as US Government TOP SECRET data—improper or outdated implementations of the standard may not provide much security.

Variations in which cipher is used in TLS impact how secure TLS ultimately is. Some ciphers are fast but insecure, while others are slower, require a greater amount of computational resources, and can provide a higher degree of security. Weaker ciphers—such as the early export-grade ciphers—still exist, but they should no longer be used.

The Advanced Encryption Standard (AES) is an encryption specification that succeeded the Data Encryption Standard (DES). AES was standardized in 2001 after a five-year review and is currently one of the most popular algorithms used in symmetric-key cryptography. It is often seen as the gold standard symmetric-key encryption technique, with many security-conscious organizations requiring employees to use AES-256 for all communications. It is also used prominently in TLS.

AES has been available in most cryptographic libraries for a long time. It became available in OpenSSL in 2002 with v0.9.7. OpenSSL is the foundation of most SSL services in UNIX and Linux environments, such as that used by LuxSci. GPG, the open source implementation of PGP, also includes an AES-256 option.

This article discusses AES, its role in TLS, which web browsers and email programs support it, and how you can ensure that you only use 256-bit AES encryption for communications that require a high level of security.

How secure are AES-256 and AES-128?

AES is Federal Information Processing Standard (FIPS) certified, and there are currently no known non-brute force attacks that work directly against AES. However, there are some side-channel timing attacks on the processing of AES. These are not feasible over a network environment and don’t apply to SSL in general. Because of this, AES is considered robust enough to protect secret government information:

The design and strength of all key lengths of the AES algorithm (i.e., 128, 192 and 256) are sufficient to protect classified information up to the SECRET level. TOP SECRET information will require use of either the 192 or 256 key lengths. The implementation of AES in products intended to protect national security systems and/or information must be reviewed and certified by NSA prior to their acquisition and use.”

Out of the three different key lengths, AES-256 offers a higher degree of security than the 128-bit and 192-bit versions of the standard.

The Beast Attack and TLS-secured websites

When TLS is used to protect website traffic (as opposed to IMAP, SMTP, encryption of files, etc.), an attack against it is known as The Beast. This attack makes it possible for people with access to a trusted location on your network to break into your TLS session and eavesdrop on your communications.

Thankfully, The Beast attack can easily be prevented. All you have to do is use TLS v1.1+ ciphers. This is why The Beast is no longer considered a critical attack vector. See also:

Mitigating The Beast attack.

Is the beast still a threat?

How long will AES-256 remain suitable for security?

The rise of quantum computing has caused a stir in the security community, with fears that it will render many of our security algorithms useless. While quantum computing looks like it will change the landscape regarding public-key algorithms, it is not believed to have significant impacts on algorithms like AES-256 soon.

The biggest quantum computing threat against AES is currently considered to be Grover’s algorithm. It is theorized to be able to perform a brute-force key search using quadratically fewer steps than required in classical computing. The implication is that an attacker with access to a quantum computer may be able to successfully attack a cipher with a key twice the length of what would generally be possible in classical computing.

However, the expense of quantum hardware and real-world complications of using Grover’s algorithm mitigate the threat of these attacks. NIST states that “… AES 128 will remain secure for decades to come. Furthermore, even if quantum computers turn out to be much less expensive than anticipated, the known difficulty of parallelizing Grover’s algorithm suggests that both AES 192 and AES 256 will still be safe for a very long time.”

Currently, there is no great rush to move away from AES to other symmetric key algorithms.

How is the cipher chosen in an SSL or TLS session?

Generally, when an SSL client, such as an email program or web browser, connects to a server and wishes to use SSL or TLS, the client sends the server a list of encryption ciphers it supports. The server then goes through the list and chooses the first match it supports. Usually, the client orders the list with the most secure methods first so that the most secure method supported by both the client and server is selected. Sometimes, the client orders the list based on other criteria to make a compromise between security and speed. This can result in a sub-optimal cipher being chosen.

Most modern web and email servers that support TLS encryption will have a wide range of different encryption techniques that they support. These can vary from 128-bit RC4, to 256-bit AES, to others. This range of options allows users with old or broken software to still take advantage of encryption, even if it is weaker than what is considered ideal in many situations.

Additionally, most companies that provide security services do not permit techniques that are deemed weak and can be broken easily. If you are connecting to a reputable service provided over TLS, the type of encryption will almost certainly be determined by your client program (i.e., email program or web browser), based on the options listed by the server.

What encryption techniques are supported by modern web browsers?

The latest versions of most modern browsers should support appropriate encryption algorithms.

You can check out whether your web browser uses up-to-date security practices by visiting:

https://www.howsmyssl.com/

If it says “Probably Okay,” it means that no security problems could be detected. If it says “Improvable” or “Bad,” your browser may be using an outdated version of TLS or have other security issues. In this case, you need to update to the latest version of your browser or switch to a browser like Firefox or Chrome that is actively being developed.

What encryption techniques were supported by legacy web browsers?

Before AES support became universal for older web browsers, we analyzed cipher support to see which ones supported AES. For posterity, we include this information here:

Web Browser	Operating System	Best Cipher	Verdict?
Native Android Browser (LG G3)	Android v4.4.2+	AES 256-bit	Good!
Chrome v39+	Android v4.4.2+	AES 256-bit	Good!
Firefox Mobile v8+	Android	AES 256-bit	Good!
Safari	iOS v8+ (iPhone/iPad/etc.)	AES 256-bit	Good
Safari	iOS v5.0.1	AES 128-bit	Good
Safari	iOS v2.2	AES 128-bit	Good
Silk	Kindle Fire	RC4 128-bit	Terrible
Firefox v35+	Windows XP & Vista, Mac OSX	AES 256-bit	Good!
Firefox v8+	Windows XP & Vista, Mac OSX	AES 256-bit	Good!
Firefox v3.0.5	Windows XP & Vista, Mac OSX	AES 256-bit	Good!
Safari v8+	Windows Vista/7, Mac OSX	AES 256-bit	Good
Safari v5.1.2	Windows Vista/7, Mac OSX	AES 128-bit	Good
Safari v3.2.1	Windows Vista, Mac OSX	AES 128-bit	Good
Safari v3.2.1	Windows XP	RC4 128-bit	Terrible
Chrome v40+	Windows Vista/7, Mac OSX	AES 256-bit	Good!
Chrome v15+	Windows Vista/7, Mac OSX	AES 256-bit	Good!
Chrome v1.x	Windows Vista	AES 128-bit	Good
Chrome v1.x	Windows XP	RC4 128-bit	Terrible
Internet Explorer v11	Windows 7	AES 256-bit	Good
Internet Explorer v9	Windows 7	AES 128-bit	Good
Internet Explorer v9	Windows Vista	RC4 128-bit	Terrible
Internet Explorer v7 & v8	Windows Vista	AES 128-bit	Good
Internet Explorer v8	Windows XP	RC4 128-bit	Terrible
Internet Explorer v7	Windows XP	RC4 128-bit	Terrible
Internet Explorer v6	Windows XP	RC4 128-bit	Terrible
Opera v26+	Mac OSX	AES 256-bit	Good!
Opera v11.10+	Windows Vista	AES 256-bit	Good!
Opera v9.62	Windows XP & Vista	AES 256-bit	Good!

So, by default, legacy browsers will take advantage of AES encryption when available. We also found that any program that uses old windows default SSL libraries will use RC4 in Windows XP and 128-bit AES in Windows Vista.

What encryption techniques are supported by modern email programs?

Asking this question about web browsers asks what is supported by the various email programs out there. If you are using a WebMail interface to access your email, the answer depends on your web browser. The latest versions of well-known email programs will use suitable encryption techniques, including AES-256. If you are using outdated/legacy email software, you should immediately update it to the latest version.

What encryption techniques were supported by legacy email programs?

We tested several popular legacy email programs on legacy operating systems to see the best encryption cipher they could use. This was done before AES usage became essentially universal. Here are the results (for posterity):

Email Program	Operating System	Verdict?	Results
Mozilla Thunderbird v2+	Windows XP & Vista	Good!	256-bit AES
Thunderbird v2+	Mac OSX v10.4.11	Good!	256-bit AES
Outlook 2010	Windows 7	Good!	256-bit AES
Outlook 2007	Windows XP	Terrible	128-bit RC4 is the best supported
Outlook 2007	Windows Vista	Good	128-bit AES chosen (though 256-bit is there, it is not listed 1st in the program and thus not used)
Outlook 2003	Windows XP	Terrible	128-bit RC4 is the best supported
Mail.app	Mac OSX v10.10	Good	256-bit AES
Mail.app	Mac OSX v10.5.5	Good	128-bit AES chosen (though 256-bit is there, it is not listed 1st in the program and thus not used)
Mail.app	Mac OSX v10.4.11	Good	128-bit AES chosen (though 256-bit is there, it is not listed 1st in the program and thus not used)
Mail.app	iPhone v2.2	Good	128-bit AES chosen (though 256-bit is there, it is not listed 1st in the program and thus not used)
Eudora v7	Windows XP	Good	256-bit AES
Eudora v8	Mac OSX v10.4	Good	256-bit AES
Entourage v12	Mac OSX v10.4	Terrible	DES

We see a similar pattern here. In most cases, the cipher used depended on the Operating System and not the program. Some programs roll their own SSL (i.e., Thunderbird/Eudora), and some use the OS built-in libraries. So, from this, we can infer that any newer version of Outlook on Vista or Windows 7+ will go for at least 128-bit AES; most things on Windows XP would use 128-bit RC4, etc.

How to force the use of AES-256 on secure web browsers and email programs

Web browsing clients like Mozilla Firefox or Opera and email clients like Thunderbird use AES-256 by default, as long as the server supports it.

However, it’s also possible to force the use of 256-bit AES encryption. This can be useful if your organization mandates that secure connections use 256-bit AES or if you do not trust that the servers you wish to connect to will have secure ciphers.

You can ensure that AES-256 is always used by following the instructions below. If the server does not support AES-256, the connection will fail.

Mozilla Firefox:

Type “about:config” in the address bar to open up the detailed list of configuration parameters.
Scroll down to “tls.version.min”, and ensure that it is set to “1” as an absolute minimum. This will turn off support for SSLv2 and SSLv3.
Search for “ssl3.”
Look for the ciphers that do not include “aes_256” in their names. If any of these say “true,” double click on them to change them to “false.” This will make them no longer available for use.
You will be left with various versions of AES-256 with TLS v1.0+.
You don’t have to restart Firefox for this to take effect.

Mozilla Thunderbird:

From Thunderbird’s home screen, click on the three horizontal lines in the top right corner.
Click Preferences, then Preferences once more in the menu that comes up.
Click Advanced, then scroll to the bottom right where it says Config Editor. Click on Config Editor.
Be aware that configuration changes can affect the program’s stability, and only proceed if you know what you are doing. Click I Accept the risk.
Scroll down to “tls.version.min”, and ensure that it is set to “1” as an absolute minimum. This will turn off support for SSLv2 and SSLv3.
Search for “ssl3 “
Look for the ciphers that do not include “aes_256” in their names. If any of these say “true,” double click on them to change them to “false.” This will make them no longer available for use.
Restart Thunderbird so that any persistent connections are broken and re-opened.
Make sure that your email accounts are all configured to use SSL or TLS (not “if available,” but “always”).
If possible, go to your email provider and disallow insecure connections to your account. This will make the connection fail even if the email program is accidentally configured to make a secure connection. (LuxSci allows this to be set on the user-level or enforced by policy account-wide).

Skype:

It’s off-topic, but Skype uses 256-bit AES encryption, so if you use it for chat or voice calls, your data is also being encrypted in this fashion.

Locking down your website (in Apache)

If you are a website owner and have TLS security on it, you can lock it down so that the only cipher your website supports is 256-bit AES. This takes the choice out of the end user’s hands. They can either use AES-256, or they won’t be able to connect to the website. However, this also means that some users may not be able to access your site unless they change to a more secure browser.

To lock your site down so that it only supports 128-bit and 256-bit AES, add the following to your Apache httpd.conf file:

SSLCipherSuite AES256-SHA:AES128-SHA

This can be added globally, in a virtual host, or even in your .htaccess file. It will ensure that any successful connection to your site will use one of these ciphers. Be sure to add it to the secure settings for your site and not just the insecure site area. More information is available at Apache.

You will generally want only to support TLS v1.2+ and NIST-recommended cipher suites. See: what level of TLS is required for HIPAA.

AES encryption is still reliable

AES encryption is still the preferred standard for TLS. Modern machines don’t noticeably affect performance, providing an adequate security level.

However, it’s important to note that TLS only protects data sent between you and the server. When you send and receive an email, the message data travels in the clear, so TLS does not protect it throughout the entire journey. The Case for Email Security explains this in more detail.

Thankfully, services like LuxSci’s SecureLine provide email encryption, which can safeguard your email the whole way. Contact our team for more information on how to protect your organization’s data.

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What Is a Cyber Risk Assessment?

March 19, 2025
Pete Wermter

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!

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

March 14, 2025
Pete Wermter

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:

More Comprehensive Risk Management: healthcare organizations must conduct more frequent risk assessments to identify, categorize, and mitigate threats to sensitive patient data.
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.

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.
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.
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.
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!

What is a SMART Objective in Healthcare Marketing?

March 13, 2025
Erik Kangas

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.

The Risks of Third-Party Email Integrations for Healthcare Companies

March 10, 2025
Pete Wermter

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:

Data Breaches: weak security features in third-party email providers can expose PHI.
Misconfigured Permissions: misconfigurations and a lack of oversight control can result in personnel at third parties having excessive access to PHI.
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.
Financial Implications: violating HIPAA regulations can result in financial penalties, including fines and compensation to affected parties.
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.

What Is a Cyber Risk Assessment?

March 19, 2025
Pete Wermter

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

March 14, 2025
Pete Wermter

What is a SMART Objective in Healthcare Marketing?

March 13, 2025
Erik Kangas

The Risks of Third-Party Email Integrations for Healthcare Companies

March 10, 2025
Pete Wermter

Webinar: How to Harness HIPAA-Compliant Marketing & Workflows

July 24, 2024
LuxSci

In today’s connected world with millions of messages bombarding people every second of the day, personalized engagement over digital channels is a requirement for any business – especially in healthcare. However, ensuring that your marketing efforts comply with the Health Insurance Portability and Accountability Act (HIPAA) can be a daunting task that never quite gives you the peace of mind you need. The good news is that you don’t have to lose sleep at night worrying about whether your marketing campaigns are secure and protected from data breaches and outside threats. With the right strategies and solutions, you can create HIPAA-compliant marketing campaigns that not only keep data protected, but also boost lead conversions, improve outcomes, and reduce costs.

Here are some simple but necessary steps to get you off and running with HIPAA-compliant marketing campaigns today:

Understand HIPAA Requirements

Before embarking on any marketing campaign, it’s crucial to have a thorough understanding of HIPAA regulations. HIPAA sets strict guidelines for keeping protected health information (PHI) safe. Ensure your marketing team is well-versed in these regulations to avoid any compliance failures. If you’re not sure, check out this recent LuxSci blog post on understanding encryption requirements for HIPAA-compliant email.

Leverage Automated Data Encryption

Safeguarding protected health information (PHI) is a requirement with HIPAA. Use advanced encryption methods – including dedicated cloud infrastructures and automation that encrypts every email sent with no user intervention required – to secure patient and customer data both in transit and at rest. This ensures that any data shared during marketing campaigns remains confidential and secure from breaches.

Implement Consent Management

Obtaining explicit consent from patients and customers before using their information in marketing campaigns is a also requirement and non-negotiable. Make sure you have a consent management system that records, stores, and manages patient and customer consent effectively and efficiently.

Personalize and Hypersegment Campaigns Using PHI Data

HIPAA does not need to hold you back. In fact, using PHI data can take your email targeting and messages to the next level. Personalized marketing can significantly improve patient and customer engagement and increase your lead conversions. Use PHI data to tailor your marketing messages to the specific needs and preferences of precise segments to ensure content is relevant and valuable – and actionable.

Utilize Encryption for All Healthcare Communications

Communicating with patients and healthcare customers through secure channels is essential for ALL communications, not just those that require HIPAA compliance. Use flexible encrypted email services, secure messaging apps, and patient portals to share sensitive information, and protect yourself from the latest cybersecurity threats at all times.

Monitor, Analyze and Improve Marketing Campaigns

Regularly test, monitor and analyze your marketing campaigns to ensure ongoing HIPAA compliance and the best results, using data on emails delivered, opened, clicked and secured. Take action in real-time to improve segmentation and results based on your latest business needs and deliverability requirements.

Benefits of HIPAA-Compliant Marketing

Implementing HIPAA-compliant marketing strategies offers numerous benefits, including:

Improved healthcare experiences – Personalized and secure communications build trust and strengthen relationships with patients and customers.

More lead conversions – Hypersegmentation and automation drive higher conversion rates and improve patient and customer engagement.

Increased sales opportunities and revenue – Targeted, timely communications and campaigns drive the best results for growing your business.

Call to Action: ‘How-To’ Webinar on HIPAA-Compliant Marketing

Embracing HIPAA-compliant marketing is not just about avoiding penalties; it’s about delivering superior patient and customer experiences – and achieving business success. With HIPAA-compliant marketing, you can create powerful campaigns that protect PHI data, drive lead conversions, and improve patient and customer outcomes.

Are you ready to transform your healthcare marketing strategy – in a HIPAA-compliant way?

Join us for a webinar on How to Harness HIPAA-Compliant Marketing and Workflows, taking place on Tuesday, August 6 at 12:00PM Eastern Time. We’re joining forces with the experts over at Compliancy Group for an informative ‘how-to’ session on the latest best practices, success stories and easy-to-use tools for ensuring compliance across your organization – with a focus on marketing, workflows and automation. This includes:

Effectively and efficiently managing compliance across multiple standards
How to increase engagement and drive sales with HIPAA-compliant marketing
Optimizing workflows with secure forms and automation
Includes 2 live demos

Don’t miss it. Sign up today!

LuxSci Provides Oracle Cloud Infrastructure Customers Secure High Volume Email Solution to Protect Healthcare Data

April 18, 2023
LuxSci

LuxSci Secure High Volume Email Sending is Powered by Oracle Cloud and Available on Oracle Cloud Marketplace

BOSTON, MA– LuxSci, a HIPAA-compliant and HITRUST certified email service provider, and member of Oracle PartnerNetwork (OPN), is pleased to announce its Secure High Volume Email Sending solution has achieved Powered by Oracle Cloud Expertise and is now available on Oracle Cloud Marketplace, offering added value to Oracle Cloud customers.

Protected health information is highly valued by cybercriminals, which puts healthcare organizations at serious risk of ransomware and other cyberattacks. In 2020, 60% of all ransomware attacks targeted the healthcare industry. Oracle Cloud Infrastructure (OCI) is a deep and broad platform of public cloud services that enables customers to build and run a wide range of applications in a scalable, secure, highly available, and high-performance environment. OCI’s security-first design, encryption by default, and computing model proactively addresses common cybersecurity threats posed to the healthcare industry. Powered by Oracle Cloud, LuxSci provides highly secure and custom healthcare communications solutions for customers of all sizes.

“Our mission is to protect healthcare communications through highly secure solutions that are also highly flexible. OCI’s configuration options allow us to architect custom deployments for our customers that meet their unique security and compliance needs,” said Erik Kangas, CEO of LuxSci.

Before working with OCI, LuxSci used several public and private cloud providers, but they needed many customizations and upgrades to meet LuxSci’s stringent security standards. Combining OCI’s best-in-class cloud infrastructure with LuxSci’s best-in-class security solutions for healthcare communications creates a highly secure environment for any compliance need.

In addition to the security advantages of OCI, LuxSci has recorded measurable performance improvements to its systems, including memory that is 10 to 20 times faster than other public clouds and markedly improved CPU performance. These benefits are delivered directly to its customers, whose email and web services are speedier and more responsive.

“The cloud represents a huge opportunity for our partner community,” said David Hicks, vice-president, Worldwide ISV Cloud Business Development, Oracle. “LuxSci’s commitment to innovation and security with Oracle Cloud Infrastructure can help our mutual customers with cloud-enabled encrypted communications solutions designed for healthcare and compliance and ready to meet critical business needs.”

As ransomware threats increase, so does the demand for digital patient communication. Healthcare organizations must invest in the patient experience to keep patients satisfied and engaged in their healthcare journey. 60% of consumers expect their digital healthcare experience to mirror the consumer experience of retail. Healthcare organizations must adopt digital communication technology that is secure enough to send PHI and can engage patients at scale.

Together, Oracle and LuxSci are providing their customers with the highly secure environment needed for healthcare data. LuxSci Powered by Oracle Cloud enables secure, scalable, and reliable communications designed to meet the healthcare industry’s unique needs.

The Oracle Cloud Marketplace is a one-stop shop for Oracle customers seeking trusted business applications offering unique business solutions, including ones that extend Oracle Cloud Applications. Powered by Oracle Cloud Expertise recognizes OPN members with solutions that run on Oracle Cloud. For partners earning the Powered by Oracle Cloud Expertise, this achievement offers customers confidence that the partner’s application is supported by the Oracle Cloud Infrastructure SLA, enabling full access and control over their cloud infrastructure services as well as consistent performance.

About Oracle PartnerNetwork

Oracle PartnerNetwork (OPN) is Oracle’s partner program designed to enable partners to accelerate the transition to cloud and drive superior customer business outcomes. The OPN program allows partners to engage with Oracle through track(s) aligned to how they go to market: Cloud Build for partners that provide products or services built on or integrated with Oracle Cloud; Cloud Sell for partners that resell Oracle Cloud technology; Cloud Service for partners that implement, deploy and manage Oracle Cloud Services; and License & Hardware for partners that build, service or sell Oracle software licenses or hardware products. Customers can expedite their business objectives with OPN partners who have achieved Expertise in a product family or cloud service. To learn more visit: http://www.oracle.com/partnernetwork.

Trademarks

Oracle, Java, MySQL, and NetSuite are registered trademarks of Oracle Corporation. NetSuite was the first cloud company–ushering in the new era of cloud computing.

HIPAA Email Rules: What You Need to Know

October 16, 2024
LuxSci

The Health Insurance Portability and Accountability Act (HIPAA) is a complicated law that defines the standards for the secure collection, transmission, and storage of protected health information (PHI). When information is stored or exchanged electronically, the HIPAA Security and Privacy Rules require covered entities, i.e., organizations that handle PHI, to safeguard its integrity and confidentiality.

One of the most common ways that PHI is shared electronically is via email, so understanding HIPAA email rules is essential for achieving compliance and protecting sensitive data.

The HIPAA Email Security Rule

It’s important to note that HIPAA does not require the use of any specific technology or vendor to meet its requirements. Generally speaking, the Security Rule requirements for email fall into four categories:

Organizational requirements state the specific functions a covered entity must perform, including implementing policies, procedures and obligations concerning business associate agreements (BAAs).
Administrative requirements relate to employee training, professional development, and management of PHI.
Physical safeguards encompass the security of computer systems, servers, and networks, access to the facility and workstations, data backup and storage, and the destruction of obsolete data.
Technical safeguards ensure the security of email data transmitted over an open electronic network and the storage of that data.

Let’s move on to discussing some of the main requirements that apply to email and the steps you need to take to secure email accounts that transmit and store PHI.

HIPAA Email Rules: Compliance Checklist

While encryption gets most of the spotlight during discussions on email security, the HIPAA email rules, in contrast, cover a range of behaviors, controls, and services that work together to address eight key areas:

Access
Encryption
Backups and Archival
Defense
Authorization
Reporting
Reviews and Policies
Vendor Management

Let’s look at each aspect of HIPPA’s email rules in greater detail.

1. Access

Access controls help safeguard access to your email accounts and messages. Implementing access controls is essential to keep out unauthorized users and secure your data, with key steps including:

Using strong passwords that cannot be easily guessed or memorized – and changing them frequently, e.g. every 30 days.
Creating different passwords for different sites and applications.
Enabling multi-factor authentication (MFA).
Securing connections to your email service provider using TLS and a VPN.
Blocking unencrypted connections.
Pre-emptively installing software that remotely wipes sensitive email off your mobile device when it is stolen or misplaced.
Logging off from your system when it is not in use and when employees are away from workstations.
Emphasizing opt-out email encryption to minimize breaches resulting from human error.

2. Encryption

Email is inherently insecure and at risk of being read, stolen, intercepted, modified, and forged (repudiated). Covered entities should go beyond the technical safeguards of the HIPAA Security Rule and take steps that exceed what is required to futureproof their communications. Email encryption features to adopt include the following:

The ability to send secure messages to anyone with any email address.
The ability to receive secure messages from anyone.
Implementing measures to prevent the insecure transmission of sensitive data via email.
Exploring message retraction features to retrieve email messages sent to the wrong address.
Avoiding opt-in encryption to satisfy HIPAA Omnibus Rule.

3. Backups and Archival

HIPAA email rules require copies of messages containing PHI to be retained for at least six years. In light of this, organizations must consider the following:

How are email folders backed up?
Are there at least two different backups at two different geographical locations? Additionally, the processes updating these backups should be independent of each other as a measure against backup system failures.
Have you maintained separate, permanent, and searchable archives? While the emails should be tamper-proof, with no way to delete or edit them, they should be easily retrievable to facilitate discovery, comply with audit requests, and support business-critical scenarios.

4. Defense

Cyber threats against healthcare organizations are continually on the increase. Some may be surprised to learn that HIPAA compliant email rules mandate that organizations take steps to defend against possible malicious actors. With this in mind, consider implementing the following technologies:

Server-side inbound email malware and anti-virus scanning to detect phishing messages and malicious links.
Showing the sender’s email address by default on received messages.
Email filtering software to detect fraudulent messages and ensure it uses Sender Policy Framework (SPF), DomainKeys Identified Mail (DKIM), and Domain-based Message Authentication, Reporting and Conformance (DMARC) information to classify messages.
Scanning outbound email.
Scanning workstations for malware, i.e., viruses, ransomware, etc.
Using plain text previews of your messages.

5. Authorization

A critical aspect of HIPAA’s email rules is ensuring that cybercriminals cannot impersonate your company or employees. Configuring your domains with SPF and DKIM is essential to verify your identity as an authorized sender of mail from your domains. Also, ensure that users cannot send messages through your email servers without authentication and encryption.

6. Reporting

Setting accountability standards for email security is essential to establishing and strengthening your HIPAA compliance posture. Important steps to take include:

Creating login audit trails.
Receiving login failure and success alerts.
Auto-blocking known attackers.
Maintaining a log of all sent messages.

7. Reviews and Policies

Humans are the greatest vulnerability to any security and compliance plan, so creating policies and procedures that focus on plugging vulnerabilities and preventing human errors is essential. Strategies for reducing risk include:

Inviting independent third parties to review your email policies and user settings. Fresh, unbiased eyes can discover existing issues quickly.
Preventing devices that connect to sensitive email accounts from connecting to public WiFi networks.
Creating email policies prohibiting users from clicking on links or opening attachments that are not expected or requested.

8. Vendor Management

Most companies do not manage their email in-house, so it’s crucial to thoroughly research and vet whoever will be responsible for your email services. Perform an annual review of your email security and stay on top of emerging cybersecurity threats to take proactive action and for continued compliance with HIPAA email rules.

LuxSci’s secure high-volume email and marketing solutions are designed to help healthcare organizations tackle complicated HIPAA email rules and automate the compliance process. Contact us today to learn more about how our industry-leading HIPAA complaint email services can help you better secure your customer PHI and keep you in compliance.

The Benefits of Using PHI in Patient Communications

March 15, 2023
LuxSci

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

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

Changing Technology Preferences

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

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

The Rise of Healthcare Consumerism

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

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

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

Staffing Challenges

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

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

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

How to Safely Use PHI in Patient Communications

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

Protecting PHI in Patient Communications

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

Personalization at Scale

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

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