Emailing Patients? Here’s How to Stay HIPAA-Compliant and Secure

In the healthcare sector, just like across industries, email is still a vital communication tool, even though social media are very influential, too. However, when you deal with protected health information (PHI), it is very important to ensure email communications comply with the Health Insurance Portability and Accountability Act (HIPAA). Non-compliance can lead to severe penalties, including fines and, what can be even more harmful, reputational damage. 

First, what is protected health information? According to the Berkeley Human Research Program at the University of California, Berkeley, protected health information is any information in the medical record or designated record set that can be used to identify an individual and that was created, used, or disclosed in the course of providing a health care service such as diagnosis or treatment. There are 18 official identifiers, such as names, contact info, medical record numbers, account numbers, photo images, biometric data, and others, that qualify information as PHI. This means that any health information by itself, without these 18 identifiers, is not considered PHI.

Use our guide as a healthcare professional responsible for maintaining or acquiring a HIPAA-compliant email solution. It will help you handle the complexities of communication when emailing patients. To safely navigate these waters, the #1 thing is to understand the HIPAA principles comprehensively.

What Is HIPAA, and Who Needs to Comply?

HIPAA is a U.S. federal law enacted in 1996 by the 104th Congress during the Clinton era to protect sensitive health information from being disclosed without the patient’s consent or knowledge. Let’s see what entities must comply with HIPAA:

• Covered entities: These are health plans, healthcare clearinghouses, and healthcare providers who transmit health information electronically.
• Business associates: These are organizations or individuals that perform services involving the use or disclosure of PHI on behalf of a covered entity.

HIPAA provides that compliance is mandatory for both groups to ensure the confidentiality, integrity, and availability of protected health information (PHI). Simply put, the HIPAA meaning is to protect your personal information as a patient from being disclosed to third parties. By the way, HIPAA violations happen each year, the problem is real.

For instance, in 2024 alone, there were 22 HIPAA confirmed violation cases, resolved with civil monetary penalties or settlements, according to the HIPAA Journal. Breaching HIPAA information is very serious, it can really hurt! The maximum penalty, in case of neglect not rectified within 30 days, can reach $2,134,851 annually, so you must be very attentive to comply with the HIPAA rules. Among the most recent HIPAA violation cases as of 2025 are Guam Memorial Hospital Authority and Oregon Health & Science University.

Core Requirements for HIPAA-Compliant Email

What is a HIPAA-compliant email, and how can it be developed? No law will work without efficient tools to implement it. To ensure your email communication with patients is HIPAA-compliant, make sure the following six cyber safeguards are put into effect:

✅ Encryption: Your emails containing protected health information must be encrypted during transmission and storage to prevent unauthorized access. So get a good IT person to ensure this provision—and everything else in this section! 

✅ Access controls: Another important point is implementing effective access controls, including unique patient IDs and passwords, to restrict access to PHI. 

✅ Audit controls: You must also maintain logs of email access and activity to monitor for unauthorized access or breaches—and not let it happen. Ever. 

✅ Integrity controls: That’s rather simple. You must ensure that PHI is not improperly altered or destroyed.

✅ Authentication: Again, you must verify that the person or organization seeking access to PHI is who they claim to be.

✅ Business associate agreements (BAAs): Make sure you enter into BAAs with any third-party service providers that handle PHI on your behalf.

The HIPAA Security Rule by the U.S. Department of Health and Human Services (HHS) officially outlines these requirements. They establish strict standards for protecting electronic protected health information (ePHI). So, providing cybersecurity for your email operations leads to a sustainable HIPAA-compliant policy. Apart from digital protection, please also consider providing strong physical security to your servers. 

HIPAA-Compliant Email Service Providers

Keeping the HIPAA email rules will be much easier with reliable email service providers. We strongly advise you to choose the right email service provider, which is critical for maintaining HIPAA compliance. Let’s look at this list of providers that are known for their HIPAA-compliant email solutions:

• Proton Mail. The free and secure email service provides OpenPGP end-to-end encryption and zero-access architecture, ensuring that only authorized personnel in your organization can read the emails with PHI. Proton Mail also offers business accounts with BAAs to business users. You can find more information in their Proton Mail HIPAA guide. 
• MailHippo. This agent offers encrypted email services featuring 256-bit AES encryption and their signature SendSafe® address for secure communication. Also, BAAs are included during signup by default. Please see the MailHippo HIPAA compliance to learn more about their policy.
• Paubox. This email service platform delivers seamless encryption without needing portals or passwords, making it user-friendly while ensuring compliance. The provider also offers various HIPAA-compliant email marketing solutions, like Paubox Email Suite, Paubox Testing, and Paubox Forms. Visit the Paubox HIPAA-Compliant Email guide to obtain more info. 
• Hushmail. This email service provider offers a nice blend of secure email, web forms, and e-signatures in a HIPAA-compliant package, making it a viable option for healthcare organizations. A private message center feature is also available. For more details, go to Hushmail for Healthcare.

Please note: when choosing a provider, ensure they offer the necessary security features and are willing to sign a BAA. If available, such information is usually easy to spot on HIPAA-related pages.

Best Practices for Email Marketers Working Under HIPAA

If you are wondering how to send a HIPAA-compliant email, let’s look at the best practices in this area. Email marketing in healthcare requires careful planning to avoid HIPAA violations and consecutive penalties. Let’s look at the six best, legally safe practices to follow:

1️⃣ Obtain explicit consent. Now, that’s important: before sending marketing emails, you must get written authorization from patients. This written permission must have a clear statement regarding the purpose of the communication. Our tip is to avoid pre-checked boxes and use opt-in methods that require active consent. Patients express their precise intention and grant you their explicit authorization in this case. 

2️⃣ Use HIPAA-compliant platforms. Utilize email marketing platforms specifically designed for healthcare that provide encryption, access controls, audit trails, and BAAs. Look up to the previous section to choose from reliable email service platforms.

3️⃣ Limit PHI in emails. We advise you to avoid including sensitive patient information in emails unless absolutely necessary. Just be PHI-conscious. If you still have to include it in your email, make sure it’s encrypted, which is the core requirement for HIPAA-compliant communication.

4️⃣ Include unsubscribe options. This is about respecting your patients and their freedom to choose. Provide clear options for recipients to opt out of future communications, complying with the CAN-SPAM Act. It may look weird, but this feature can actually increase customer trust in your organization.  

5️⃣ Segment your audience. We advise you to group your email list based on non-sensitive criteria to send targeted messages without exposing protected health information. In this case, you will avoid sending sensitive content to those who simply don’t need it. 

6️⃣ Train personnel regularly. You can be a 100% HIPAA-conscious person; however, it is always better to be confident about your staff. Educate your team on HIPAA regulations and the importance of maintaining patient privacy in all forms of communication, including emails.

Email Campaign Types That Can Be HIPAA-Safe

As email and HIPAA compliance go hand in hand, let’s look at the safest side of the story. There are four types of email campaigns that you can conduct without risk of violating HIPAA regulations:

• Educational newsletters. You can share general health tips, wellness advice, or updates about your practice without including protected health information. You can also inform your recipients about the latest state-of-the-art diagnostic equipment that your company has acquired. 
• Appointment reminders. If you send reminders for upcoming appointments, ensuring the content is limited to necessary information is a great way to launch a HIPAA-safe email campaign.
• Health program announcements. Another safe option for your organization would be informing patients about new programs or services. Again, this way, you will avoid the inclusion of PHI.
• Patient satisfaction surveys. Getting patient feedback is essential because it is vital to customer care. You can collect info regarding what your patients think of the services provided. The trick is to ensure that their responses are stored securely and confidentially.

Launching these email campaigns will get you on the HIPAA-safe content side. We strongly recommend always assessing the content of your emails to ensure they do not inadvertently disclose protected health information.

To Sum Up

Congrats on concluding our HIPAA-compliance guide! In this final part, let’s summarize the most crucial takeaways.

First, HIPAA email compliance is not something out of your reach or too complicated to follow. We hope you’ve learned simple rules and best practices to take you on the safe side regarding HIPAA communication. 

Second, maintaining HIPAA compliance in email communications is crucial for safeguarding patient privacy and avoiding potential legal issues for your organization. We recommend moving step-by-step, according to the structure of the article. Start by understanding HIPAA requirements, choosing the right service providers, and not forgetting to implement best practices. This way, your healthcare organization can effectively use email as a communication and marketing tool without compromising security. Just take your time to review all the above-mentioned info.

After that, you have the green light to launch strong, patient-centric, HIPAA-compliant communication for your company!