Content management systems that integrate with external SMTP services for sending emails

Secure and reliable communication in healthcare is a compliance requirement. Whether it's appointment confirmations, prescription refill alerts, patient portal notifications, or internal updates, cmail continues to be a vital channel for engaging both patients and healthcare providers.  But using basic, server-based email functions can lead to poor deliverability, increased risk of data breaches, and violations of regulations like HIPAA.

That’s why integrating your healthcare content management system (CMS) with a secure, external Simple Mail Transfer Protocol (SMTP) service is essential. These services improve email deliverability and support encryption, authentication, and audit logs - features that help protect patient data and support compliance efforts. 

Let’s explore popular CMSs that support SMTP, how they integrate with it, and what tools are available to help you configure this essential functionality.

WordPress (with HIPAA compliant hosting)

Overview: WordPress is the world’s most popular content management system (CMS), powering more than 40% of all websites globally. According to W3Techs, as of 2025, WordPress holds a market share of over 63% among CMS-powered sites. Its open-source nature and vibrant plugin ecosystem make SMTP integration extremely straightforward.

Why it’s popular:

• Flexible and user-friendly.
• Huge plugin ecosystem (including for SEO, email, and forms).
• Can be made HIPAA compliant with secure, specialized hosting.

SMTP integration: Easy via plugins like WP Mail SMTP.

Configuration: After installing a plugin like WP Mail SMTP, you can enter your SMTP credentials in the plugin settings, including:

• SMTP Host and Port
• Encryption method (SSL/TLS)
• SMTP Username and Password

Use case: Ideal for blogs, small businesses, and e-commerce (with WooCommerce) that need consistent and trackable email delivery.

See also: Using Paubox SMTP API with WordPress

Drupal

Overview: Drupal is a highly customizable, secure CMS used primarily for complex and large-scale web projects. Drupal has a usage of 0.8% and a market share of 1.2%. Drupal offers 53,382 modules (plugins/extensions) and 3,200 themes, enabling deep customization. Its headless/decoupled architecture also allows integration with front-end frameworks. 

Use case: Hospitals, academic medical centers, public health agencies.

Popular Modules:

• SMTP Authentication Support
• PHPMailer

These modules allow you to enter SMTP credentials and select your mailer service. You can also test emails and check logs.

Why it’s popular:

• Extremely customizable and secure.
• Strong support for access control, multi-site, and multilingual needs.
• Used by major health institutions (e.g., NIH, Cleveland Clinic).

SMTP integration: Yes, via modules like SMTP Authentication Support.

Sitecore

Overview: Sitecore is a powerful, HIPAA compliant enterprise-level content management system (CMS) and digital experience platform (DXP) that enables over 25,000 organizations to create, manage, and personalize content across websites, apps, and email campaigns. Known for its scalability and flexibility, Sitecore is widely used in highly regulated industries like healthcare and insurance.

Use case: Enterprise-level healthcare organizations, insurance providers, and healthcare marketing teams.

Why it’s popular:

• Robust personalization and marketing automation tools.
• Enterprise-grade security and compliance capabilities.
• Integrates well with CRM and patient journey mapping tools.

SMTP integration: Yes, as part of its integrated marketing suite.

Joomla

Overview: Joomla is an open-source CMS known for its flexibility and ease of use. Joomla offers more than ten thousand extensions and templates and over two million websites worldwide and is supported by an active developer community. It supports multilingual content out of the box and offers strong access control levels, which can benefit healthcare teams managing diverse user roles.

Use case: Regional clinics, specialist practices, or healthcare nonprofits that require multilingual support or strong user role management.

Why it’s popular:

• Native multilingual support.
• Strong user and access control system.
• Large extension ecosystem with over 6,000 verified extensions.

SMTP integration: Yes, SMTP can be configured directly in Joomla’s Global Configuration panel.

TYPO3

Overview: TYPO3 is an open-source CMS primarily used in Europe and often favored for complex enterprise-grade websites. It is “backed by the more than 1000 members of the TYPO3 Association” and is known for stability, scalability, and multilingual content handling. Though less common in North America, it’s a reliable choice for organizations needing robust content workflows.

Use case: Large healthcare networks, research institutions, or international NGOs.

Why it’s popular:

• Enterprise-ready features.
• Native support for multilingual and multisite setups.
• Fine-grained permissions and security tools.

SMTP integration: Yes, via its built-in mail configuration settings or through third-party extensions like SwiftMailer or MailerLite Integration.

Configuration: SMTP settings are defined in the LocalConfiguration.php file or through the admin interface under Mail Settings.

Security note: TYPO3 offers encryption options and supports custom email logging, which can be adapted to meet HIPAA auditing needs.

Craft CMS

Overview: Having created more than 150,000 websites, Craft CMS is a flexible, developer-centric CMS used for building custom digital experiences. While it doesn’t have the plugin bloat of some larger platforms, it offers clean architecture and powerful templating, making it an excellent choice for healthcare developers who want granular control over content and email behavior.

Use case: Custom patient portals, appointment scheduling platforms, or HIPAA compliant marketing microsites.

Why it’s popular:

• Developer-friendly and secure by default.
• Granular control over every content element.
• Headless CMS features are available out of the box.

SMTP integration: Yes, Craft CMS supports SMTP configuration directly in its config/app.php or via environment variables.

Umbraco (for .NET environments)

Overview: Umbraco is a popular open-source CMS built on the .NET framework. It’s often used in organizations already running Microsoft environments. Healthcare systems using Azure or Windows-based infrastructure often find Umbraco to be a natural fit.

Use case: Hospitals or clinics operating within Microsoft ecosystems or Azure-hosted environments.

Why it’s popular:

• Built on Microsoft’s trusted tech stack.
• Easy integration with .NET applications.
• Strong developer support and customizability.

SMTP integration: Yes, SMTP can be configured via the web.config file.

Integrating with Paubox SMTP

Integrating your CMS with Paubox SMTP provides a simple yet powerful way to send secure, HIPAA compliant emails without burdening patients or users with extra steps. For healthcare teams prioritizing privacy, usability, and compliance, Paubox is a trusted partner.

Overview: Paubox is a HIPAA compliant email provider that offers secure, encrypted email delivery without the need for portals or extra logins. The Paubox SMTP solution is particularly useful for healthcare organizations that want to send transactional or system-generated emails (e.g., appointment reminders, lab results notifications, or password resets) directly from their CMS while maintaining HIPAA compliance.

Why Paubox SMTP?

• HIPAA compliance with BAA: Paubox signs business associate agreements, a must-have for covered entities and business associates handling protected health information (PHI).
• Zero-step encryption: Emails sent via Paubox SMTP are automatically encrypted and delivered directly to the recipient’s inbox without requiring them to log into a portal.
• High deliverability: Paubox routes messages through trusted servers, reducing the chances of emails being marked as spam or rejected.
• Audit-friendly: Detailed logs and analytics help track delivery status and maintain audit trails.

Integration Basics

Paubox SMTP can be integrated with any CMS that allows SMTP configuration, including WordPress.

Configuration settings typically include:

• SMTP Host: smtp.paubox.com
• SMTP Port: 587 (recommended for TLS)
• Encryption: STARTTLS
• SMTP Username: Your Paubox email address
• SMTP Password: The SMTP password set in your Paubox Admin Console

Ideal for

• Appointment reminders
• System alerts and user notifications
• Form submissions (e.g., patient intake, contact forms)
• Password resets and account verification

Go deeper: Paubox SMTP API: Everything you need to know

FAQS

What is an SMTP service, and why should I use one with my CMS?

An SMTP (Simple Mail Transfer Protocol) service handles the sending of emails from your website or application. Using an external SMTP service improves email deliverability, ensures proper authentication, and provides tracking and logging, important for security and regulatory compliance in healthcare environments.

What makes an SMTP service HIPAA compliant?

A HIPAA compliant SMTP provider must:

• Offer encryption (e.g., TLS/SSL).
• Provide access logs and user activity auditing.
• Implement identity verification and user authentication.
• Be willing to sign a BAA with your organization.