According to a 2022 CDC publication, QuickStats: Percentage* of Office-Based Physicians Who Had Telephone or Internet/Email Consults with Patients† — National Ambulatory Medical Care Survey, United States, 2018 and 2020§, physicians who reported having Internet/email consults with patients increased from 13.9% in 2018 to 26.8% in 2020. Furthermore, according to the 2022 Annual Report to Congress on Breaches of Unsecured Protected Health Information, 22% of reported breaches affecting 500 or more individuals were attributed to email-based incidents. These numbers show that while email remains one of the most widely used communication tools in healthcare, it also presents one of the greatest risks for data breaches.
To address this, organizations covered by the Health Insurance Portability and Accountability Act (HIPAA) must use secure email solutions that protect electronic protected health information (ePHI). Choosing the right HIPAA compliant email API can help you streamline secure communication while ensuring regulatory compliance.
An email application programming interface (API) allows organizations to integrate secure email functions directly into their software systems, such as electronic health records (EHRs), telehealth platforms, and patient portals. This eliminates reliance on third-party portals or manual processes, enabling healthcare providers to send and receive encrypted emails seamlessly.
By focusing on key features like encryption, audit trails, and BAAs, organizations can select an API that meets HIPAA’s stringent requirements and helps them streamline secure communication within their organizations.
An email application programming interface (API) allows developers to integrate email functionality directly into software applications. In healthcare, platforms like electronic health records, scheduling systems, or mobile health apps can send and receive encrypted emails without requiring users to log into separate portals.
For example:
By using an API, providers gain more control, streamline workflows, and reduce the risk of human error compared to manual email handling.
When evaluating an email API for HIPAA compliance, here are some essential features to consider:
Although encryption was previously considered an “addressable specification,” as of 2025, all HIPAA addressable specifications have been changed to mandatory. Encryption ensures that any data shared between parties is unreadable to unauthorized individuals.
When evaluating an API, confirm it supports encryption of data in transit and at rest.
According to the HIPAA Security Rule, “A regulated entity must implement procedures to verify that a person seeking access to ePHI is who they say they are.” Strong user authentication prevents unauthorized access to sensitive information. HIPAA-regulated entities must choose an API that offers features like two-factor authentication (2FA) or multi-factor authentication (MFA) to ensure that only authorized users can access email systems and sensitive patient data.
According to the HIPAA Security Rule, specifically 45 C.F.R. § 164.312(b), covered healthcare organizations and their business associates must “implement hardware, software, and/or procedural mechanisms that record and examine activity in information systems that contain or use electronic protected health information.” An API should provide detailed audit trails that log:
Data loss can occur due to human error, technical issues, or cyberattacks. Organizations must ensure that the email API offers robust data backup and recovery solutions to preserve important communications in case of a system failure or breach.
A business associate agreement (BAA) is a legally binding contract between a healthcare provider and a third-party service provider (like an email API provider) that ensures the service provider will comply with HIPAA regulations. “The business associate contract also serves to clarify and limit, as appropriate, the permissible uses and disclosures of protected health information by the business associate, based on the relationship between the parties and the activities or services being performed by the business associate,” writes the HHS. Organizations must make sure the email API provider offers a signed BAA before they begin using their service.
HIPAA mandates that health data be kept for a specified period but also requires secure deletion when it is no longer needed. A good email API should allow you to manage data retention and offer secure deletion options that comply with HIPAA guidelines.
Read also: What is a HIPAA retention policy?
For healthcare organizations, the email API must integrate with existing software such as electronic health records (EHR), practice management systems, and other healthcare software. This ensures smooth workflows without compromising security.
A good email API will allow for granular access control. This means administrators can restrict access to sensitive email content based on roles, ensuring only those who need access to patient data can view it. HIPAA’s access control requirement states that covered entities must “Implement technical policies and procedures for electronic information systems that maintain electronic protected health information to allow access only to those persons or software programs that have been granted access rights as specified in § 164.308(a)(4)[Information Access Management].”
Paubox offers a HIPAA compliant email API designed for healthcare organizations. Key features include:
Pros:
Yes, using a HIPAA compliant email API for internal communications is often a good practice, especially when discussing or sharing PHI among healthcare staff.
HIPAA applies specifically to emails containing PHI. If emails are purely administrative and do not include PHI, they may not require HIPAA compliance. However, if there’s any chance an email could contain sensitive information, it’s best to treat it as if HIPAA applies to ensure compliance and data security.