Wellness newsletters and HIPAA compliance

Wellness newsletters are a good way for healthcare providers and wellness programs to engage patients, share valuable health information, and strengthen the patient-provider relationship. They provide a convenient and effortless way for recipients to receive helpful advice on topics like nutrition, stress management, and reminders for preventative screenings.

Benefits of wellness newsletters

Wellness newsletters can be used to:

• Educate patients about healthy lifestyles and disease prevention.
• Encourage adherence to treatment plans and recommended screenings.
• Help reduce barriers to care by sharing tips on navigating the healthcare system.
• Support behavioral change via regular engagement and reminders.

As noted in the study, Designing Educational Newsletter Interventions: An Example That Supported Grandfamilies’ Physical Wellness Needs, “Printed mail may be one of the most effective community-level methods with which to reach certain populations with at-home education. Reading newsletters over time, with no other intervention component, has led various populations to improve their awareness, knowledge, attitudes, motivation, and behaviors regarding gardening, healthful eating, marital enrichment, parenting, physical activity, and protection against sun exposure/sunburns.”

HIPAA and email communication

According to the U.S. Department of Health and Human Services (HHS), “The Privacy Rule allows covered health care providers to communicate electronically, such as through e-mail, with their patients, provided they apply reasonable safeguards when doing so… For example, certain precautions may need to be taken when using e-mail to avoid unintentional disclosures, such as checking the e-mail address for accuracy before sending, or sending an e-mail alert to the patient for address confirmation prior to sending the message.”

For wellness newsletters, HIPAA compliance requirements depend on the content. A general newsletter that contains educational content such as nutrition tips or stress management strategies, without identifying a patient or referencing their care, may not involve protected health information (PHI) at all. However, once a newsletter includes personalized information, appointment details, or references to a patient’s condition, it becomes subject to HIPAA’s safeguards.

HIPAA safeguards for wellness emails

When a wellness email contains PHI, it is considered electronic protected health information (ePHI). At this point, the communication is no longer just a general marketing or educational message; it is now subject to HIPAA’s Security Rule.

The HIPAA Security Rule requires covered entities and business associates to implement administrative, physical, and technical safeguards to protect ePHI from unauthorized access, disclosure, alteration, or destruction. In wellness newsletters or email campaigns, these safeguards are important because email remains one of the most common sources of healthcare data breaches. As Paubox has reported, 180 healthcare organizations reported email-related security breaches to the HHS Office for Civil Rights (OCR) between January 1, 2024, and January 31, 2025.

Administrative safeguards

Administrative safeguards, as defined by HIPAA’s Security Rule, are “administrative actions, and policies and procedures, to manage the selection, development, implementation, and maintenance of security measures to protect electronic protected health information and to manage the conduct of the covered entity’s workforce in relation to the protection of that information.” In the development of wellness newsletters, this means establishing comprehensive policies that outline how email communications containing ePHI are created, reviewed, and distributed. It also involves educating staff on what qualifies as PHI and how to avoid accidental disclosures, conducting regular risk assessments to identify vulnerabilities in email systems, and ensuring appropriate oversight of third-party vendors who may handle newsletter subscriber data or transmit emails on the organization’s behalf.

Additionally, the administrative safeguards require that if a marketing or email platform handles PHI, the provider must sign a business associate agreement (BAA) with that vendor. Without a BAA, using the service to transmit PHI would violate HIPAA.

Physical safeguards

Physical safeguards are “physical measures, policies, and procedures to protect a covered entity’s electronic information systems and related buildings and equipment, from natural and

environmental hazards, and unauthorized intrusion.” They protect the hardware and environments where ePHI is accessed or stored. In practice, this looks like:

• Securing workstations that access email systems
• Implementing automatic logouts
• Restricting physical access to servers or devices containing ePHI

While these measures may seem separate from newsletters, they are crucial if staff members access subscriber lists or send PHI-containing emails from shared or unsecured devices.

Technical safeguards

Technical safeguards are, as defined by HIPAA, “the technology and the policy and procedures for its use that protect electronic protected health information and control access to it.” Technical safeguards are particularly relevant to email communication. They include access control measures, such as encryption, which “provide users with rights and/or privileges to access

and perform functions using information systems, applications, programs, or files.” Encryption specifically, converts “an original message of regular text into encoded text. The text is encrypted by means of an algorithm.”

Why HIPAA matters for wellness newsletters

HIPAA matters for wellness newsletters because it governs how patient information can be used in communications that promote products or services. Under HIPAA, wellness newsletters can be considered marketing, which is defined as “a communication about a product or service that encourages recipients of the communication to purchase or use the product or service.” Under this definition, if a wellness newsletter promotes a product, program, or service in a way that encourages patients to buy or use it, the communication may qualify as marketing, particularly if it goes beyond treatment, care coordination, or healthcare operations.

HIPAA goes even further. It also defines marketing as “An arrangement between a covered entity and any other entity whereby the covered entity discloses protected health information to the other entity, in exchange for direct or indirect remuneration, for the other entity or its affiliate to make a communication about its own product or service that encourages recipients of the communication to purchase or use that product or service.” This portion of the definition has significant implications for newsletters. If healthcare organizations shares PHI with third parties, such as a pharmaceutical company, wellness brand, or medical device manufacturer, in exchange for payment or any form of compensation, and that third party uses the information to promote its own product, that communication is considered marketing. In such cases, written patient authorization is required. Using HIPAA compliant email providers like Paubox can ease the burden of achieving and maintaining HIPAA compliance in such cases.

See also: HIPAA compliant email marketing: What you need to know

When educational content becomes marketing under HIPAA

Wellness newsletters can lead to HIPAA issues when they:

• Promote third-party health products or services
• Include sponsored wellness content tied to patient data
• Segment mailing lists based on diagnoses and use that information for promotional messaging
• Involve paid partnerships where PHI is disclosed

For example, sending a general article about heart health is typically permissible. But sending that same newsletter to patients with documented cardiac conditions, while promoting a specific device from a paid partner, could trigger HIPAA’s marketing provisions if PHI is used in the arrangement.

Why this matters

Wellness newsletters are meant to inform and support patients. However, if they are structured in a way that encourages purchases or involves compensated third-party promotions tied to PHI, they may legally qualify as marketing, requiring authorization and strict compliance controls.

Failing to recognize this boundary can result in:

• HIPAA violations
• Financial penalties
• Breach notifications
• Loss of patient trust

See also: The very basics of HIPAA compliant newsletters

FAQS

Can I include patient names in a newsletter?

Including a patient’s name alone is not a HIPAA violation unless it is combined with health-related information.

Are wellness newsletters considered treatment communications?

If a newsletter provides information related to treatment, case management, or care coordination, it may fall under HIPAA’s permitted uses for treatment and healthcare operations. However, if it promotes products or services unrelated to treatment, it may qualify as marketing.