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Healthcare providers must adhere to HIPAA standards to ensure the security of protected health information (PHI). One of the most common ways that PHI is shared is through email. However, email is also one of the most vulnerable channels for data breaches. To remain HIPAA compliant, healthcare organizations must follow specific guidelines to ensure secure email communication.


HIPAA compliant email basics

The HIPAA Security Rule sets out specific requirements for safeguarding electronic PHI, including email. Here are some of the central guidelines for HIPAA compliant email communication:


1. Encryption and authentication

HIPAA requires that all ePHI transmitted over an electronic network, including email, be encrypted. Encryption is the process of encoding information so that only authorized parties can read it. Authentication is the process of verifying the identity of the sender and receiver of the message. Encrypted email can be sent using secure email providers or email encryption software.


2. Minimum necessary information 

HIPAA's Privacy Rule requires that healthcare providers and other covered entities use and disclose only the minimum necessary PHI needed to accomplish their intended purpose. Email messages should contain only the information essential for the recipient to perform their job. For example, a physician should not include a patient's complete medical history in an email to a nurse.


3. Access controls

HIPAA requires that access to ePHI be restricted to authorized individuals. Healthcare organizations should implement access controls, such as password protection, to ensure that only authorized individuals can access electronic PHI. Passwords should be complex, changed regularly, and stored securely.


4. Disposal of printed emails

HIPAA requires that all PHI, including printed emails, be disposed of securely. Printed emails should be shredded or otherwise destroyed to prevent unauthorized access.


Best Practices for Email Communication under HIPAA

In addition to following the HIPAA guidelines for email, healthcare organizations should implement best practices to ensure the privacy and security of email communication with patients and other covered entities.

Here are some best practices for email communication under HIPAA:


1. Use secure email providers

One way to ensure HIPAA compliance is to use secure email providers. HIPAA compliant email providers use encryption and authentication to protect email messages and attachments. For example, Paubox Email Suite encrypts all email communication by default, removing the risk of violating HIPAA when emailing PHI. 


2. Train employees on HIPAA guidelines

Healthcare organizations should regularly train employees on HIPAA guidelines for email communication. The training should be focussed on the proper use of email, including how to create secure passwords, avoid phishing scams, and identify potential security threats.


3. Implement two-factor authentication

Two-factor authentication is a security measure that requires users to provide two forms of identification, such as a password and a security token, to access their email accounts. Two-factor authentication adds an extra layer of security to email communication and can help prevent unauthorized access to ePHI.


4. Conduct regular risk assessments 

Healthcare organizations should conduct regular risk assessments to identify potential security vulnerabilities and take steps to address them. Risk assessments should be conducted at least annually or whenever significant changes to the organization's technology or processes occur.


Common HIPAA violations related to email

Despite the guidelines and best practices for email communication under HIPAA, violations can still occur. Here are some common mistakes that can lead to HIPAA violations related to email:


1. Sending unencrypted emails

Sending unencrypted emails that contain PHI is a HIPAA violation. Unencrypted emails can be intercepted and read by unauthorized individuals, putting patients' sensitive information at risk.


2. Sending emails to the wrong recipient

Sending emails to the wrong recipient can also lead to HIPAA violations. This can happen if the sender accidentally selects the incorrect email address or if the email is forwarded to the wrong person. In either case, the recipient may have access to ePHI that they should not have.


3. Including too much information in emails

Email messages should contain only the minimum necessary information to accomplish their intended purpose.

RelatedWhat violates HIPAA in email?


Steps to take in case of a HIPAA violation related to email

If a HIPAA violation related to email occurs, healthcare organizations should take immediate action to address the issue. Here are some steps to take in case of a HIPAA violation related to email:


1. Report the incident 

HIPAA requires that all breaches of PHI be reported to the affected individuals, the Department of Health and Human Services (HHS), and, in some cases, the media. Healthcare organizations should have a breach notification policy to ensure that all breaches are reported promptly.


2. Investigate the incident

Once a breach has been reported, healthcare organizations should investigate the incident to determine the cause and extent of the violation. 


3. Take corrective action

Healthcare organizations should take corrective action to prevent future breaches. This may include implementing new security measures, providing additional employee training, or updating policies and procedures.


Email is a convenient and efficient way to communicate in the healthcare industry. However, it also poses a significant risk to the privacy and security of ePHI. By following the HIPAA guidelines for email and implementing best practices for secure email communication, healthcare organizations can reduce the risk of breaches and ensure HIPAA compliance. 


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