HIPAA compliant email for patient follow-up after treatment

A 2016 study by Holly Jeffers and Maureen Baker, Continuity of care: still important in modern-day general practice, wrote that “Continuity of care has always been at the heart of general practice. Patients who receive continuity have better healthcare outcomes, higher satisfaction rates, and the health care they receive is more cost-effective.” Furthermore, from a patient perspective, the study Importance of continuity of care from a patient perspective – a cross-sectional study in Swedish health care by Ebba Cohen and Iba Lindman, found that “the majority of patients value CoC [continuity of care] in terms of importance of having an RGP [regular general practitioner].”

To support this vital continuity, especially in the period following treatment, healthcare organizations can leverage HIPAA compliant email as a secure and effective communication tool. This allows healthcare organizations to ensure continuity of care while maintaining patient privacy and confidentiality. They can securely offer valuable post-treatment support, guidance, and follow-up appointments by obtaining patient consent, selecting a HIPAA compliant email service provider, and implementing secure communication practices. 

HIPAA and email communication in patient follow-ups

HIPAA regulations govern how healthcare providers handle protected health information (PHI), including communication with patients. According to the HHS, "The Security Rule requires covered entities to maintain reasonable and appropriate administrative, technical, and physical safeguards for protecting e-PHI." This may include encryption, access controls, and audit trails. These measures ensure that patient information remains secure throughout the communication process, reducing the risk of unauthorized access or breaches. Compliance with these regulations helps healthcare organizations maintain patient trust and confidentiality while enabling effective follow-up care.

Patients often forget a significant portion of medical consultation information, with only 49% remembering decisions and recommendations, according to AARP. However, follow-up may provide a solution to patients forgetting information relayed by their healthcare provider. The study Email consultations in health care: 1—scope and effectiveness, found that email communication can enhance patient understanding, memory, and involvement in their care by offering a written record of medical guidance that patients can review as needed. Sending follow-up emails with key points, helpful resources, or responses to common questions allows healthcare providers to reinforce critical information and support better patient comprehension.

HIPAA requirements for email communication

The U.S. Department of Health and Human Services (HHS) states that “the Security Rule does not expressly prohibit the use of email for sending e-PHI.”  However, covered entities and their business associates are required to establish policies and procedures in line with HIPAA standards for access control, integrity, and transmission security of ePHI. These measures must ensure the protection of ePHI's integrity and prevent unauthorized access.

Healthcare providers must choose email service providers offering features compliant with these HIPAA requirements to ensure secure PHI exchange and regulatory adherence.

Features of a HIPAA compliant email provider

The HIPAA requirements for email communication involving PHI include:

• Risk analysis and risk management: Covered entities must conduct a risk assessment to evaluate how email systems handle PHI and implement measures to reduce potential vulnerabilities.
• Encryption during transit and at rest: Emails containing PHI should be encrypted both when they are stored and when they are being transmitted.
• Patient consent: Before initiating email communications, organizations must obtain explicit, documented consent from the patient. This ensures patients understand the risks and voluntarily agree to receive communications electronically.
• Minimum necessary rule: Healthcare providers must limit the information shared via email to the minimum necessary to accomplish the intended purpose.
• Business associate agreement (BAA): If the email platform is managed by a third party, the healthcare provider must have a signed BAA with the email vendor. This legally binds the vendor to protect PHI and comply with HIPAA.

Choosing an email service provider that meets these helps ensure a secure communication. Non-compliance can lead to steep penalties, which can range from $141 to $71,146 per violation, depending on the level of negligence.

Read more: 

• Rules for HIPAA compliant email communications
• Higher HIPAA penalties announced

Ensuring HIPAA compliant email communication for patient follow-up

• Obtaining patient consent: Healthcare organizations must obtain documented patient consent for email communication to ensure HIPAA compliance. This can be achieved through a clear opt-in process during treatment or discharge, ensuring patients understand and agree to electronic communication. It’s best practice to:
  • Provide a clear explanation of the risks and benefits of email communication.
  • Offer an opt-in option rather than assuming implied consent.
  • Include the consent in written form and retain it in the patient’s medical records.
  • Allow patients to withdraw their consent at any time.
• Selecting a HIPAA compliant email service provider: Choosing a HIPAA compliant email service provider ensures secure patient follow-up. Go with providers who offer security features such as encryption, access controls, and audit trails, like Paubox. Look for email service providers that offer:
  • Automatic encryption without requiring patients to log into a portal.
  • Access controls and identity verification features.
  • Automatic email logging and audit trails.
  • Seamless integration with EHR systems and mobile devices.

These safeguard patient information and ensure compliance with HIPAA regulations, maintaining the privacy and confidentiality of patient data.

• Implementing secure communication practices: Healthcare organizations should implement secure communication practices when using email for patient follow-up. This includes adhering to the minimum necessary standard, educating staff on email security best practices, and regularly updating security protocols to address emerging threats. 

Using Paubox for follow-up emails

Paubox Email Suite offers a secure, user-friendly solution designed specifically for healthcare providers. Unlike traditional encrypted email services that require patients to log into a separate portal, Paubox delivers encrypted messages directly to the patient’s inbox. This frictionless experience improves patient engagement and ensures that important follow-up information is read and acted upon.

Paubox offers seamless encryption, robust access controls, and automatic email logging to protect sensitive health information while simplifying compliance with HIPAA’s Privacy and Security Rules. For follow-up care, this means providers can confidently send appointment reminders, medication instructions, post-treatment guidance, or educational resources, knowing that the communication is both secure and accessible.

Additionally, Paubox integrates with existing email platforms like Gmail and Microsoft 365, making it easy for healthcare providers to adopt without changing their workflow. With features like email tracking, audit trails, and customizable templates, providers can streamline follow-up processes and maintain a reliable communication record.

FAQS

Are there additional considerations for patient follow-up communication with minors?

When communicating with minors, healthcare providers should obtain consent from the minor's parent or legal guardian and ensure that any communication adheres to HIPAA regulations regarding minors' privacy rights.

Can patients opt out of communication for follow-up with their healthcare provider?

Patients generally have the right to opt out of using HIPAA compliant communication channels for follow-up with their healthcare provider. However, healthcare organizations may need to provide alternative communication options to ensure continuity of care.

Can healthcare providers use social media for patient follow-up communication if privacy settings are in place?

While social media platforms may offer communication capabilities, they are generally not considered HIPAA compliant channels for patient follow-up. Healthcare providers should rather use dedicated HIPAA compliant communication platforms to ensure patient privacy and compliance with regulations.