How HIPAA's 2025 updates are transforming healthcare communication

Healthcare communication in 2025 requires healthcare organizations to modernize their systems to meet rising cybersecurity threats. Electronic health records (EHRs), telehealth, and cloud-based tools have changed how providers interact with patients and each other, making care more accessible and coordinated. But these advancements also expose vulnerabilities in communication systems. 

Many healthcare systems still rely on outdated communication infrastructure that lacks the security, flexibility, and integration capabilities needed in today’s digital-first environment. The recent HIPAA Security Rule updates place new emphasis on encryption, multifactor authentication (MFA), and incident response planning.

“Recent HIPAA updates signal an urgent need to modernize outdated communication systems and fortify cybersecurity defenses,” says David Chou, Founder of Chou Group Healthcare Technology Advisory Services. “The challenge lies in upgrading 24/7 operational systems without disruption, making it critical for leaders to prioritize multifactor authentication and proactive incident response planning.”

Chou’s observation reflects the reality facing many healthcare organizations: they must navigate a complex web of legacy technology and constant cyber threats.

Why healthcare communication needs an upgrade

In just the first half of 2025, U.S. healthcare organizations reported 311 data breaches to the HHS OCR involving 500 or more individuals. These incidents affected approximately 23.1 million individuals, and most of these breaches were caused by hacking and IT incidents.

Modern communication tools ensure efficiency and continuity of care but also safeguard sensitive patient information. This is proven in the study Methods and Effectiveness of Communication Between Hospital Allied Health and Primary Care Practitioners: A Systematic Narrative Review which states that “advances in health IT may offer a promising solution to the inconsistency of healthcare communication.”

Furthermore, as regulatory standards like HIPAA are updated to reflect today’s digital realities, healthcare organizations must prioritize modernization in their communication methods. 

Read also: Technology in healthcare

The risk of relying on outdated systems

Healthcare organizations typically operate around the clock, depending on infrastructure that needs to be continuously accessible. However, many of these systems were designed before cybersecurity became a concern.

Legacy systems create several problems, such as:

• Security vulnerabilities: Older software may not support encryption, multifactor authentication (MFA), or regular patches.
• Inefficiency: Manual processes like faxing or mailing documents slow down care delivery.
• Non-compliance: Outdated systems may not meet modern HIPAA standards, exposing the organization to penalties.
• Poor integration: Legacy tools often don’t integrate with newer EHRs or communication platforms, leading to data silos and duplication.

These risks are especially seen during transitions from one platform to another. As David Chou points out, "The challenge lies in upgrading 24/7 operational systems without disruption, making it critical for leaders to prioritize multifactor authentication and proactive incident response planning."

Read also: How legacy systems disrupt patient care

What the recent HIPAA Security Rule updates require

In December 2024, the U.S. Department of Health and Human Services (HHS) Office for Civil Rights (OCR) issued a Notice of Proposed Rulemaking (NPRM) aimed at modernizing the HIPAA Security Rule, marking the first substantial update since 2013. These updates include: 

Elimination of “Addressable” vs. “Required” standards

Previously, “addressable” standards allowed entities to decide whether to implement certain safeguards, often overlooked as optional. The new proposal removes this distinction, making all implementation specifications mandatory, with only limited exceptions.

Mandatory encryption of ePHI

Encryption is now required for ePHI both at rest and in transit, ensuring that even if data is intercepted or stolen, it remains unreadable and protected.

Compulsory multi-factor authentication (MFA)

MFA is no longer “strongly recommended” but mandatory for access to all ePHI systems, with narrow exceptions for very specific legacy medical devices.

Detailed risk analysis, asset inventory and mapping

Organizations must now:

• Maintain an up-to-date written inventory of all technology assets handling ePHI.
• Create a network map tracing how ePHI flows through systems.
• Conduct formal risk analyses before implementing system changes and update them annually.

Enhanced administrative requirements

The proposed changes also add explicit mandates for:

• Written policies and procedures covering patch management, workforce access, sanctions, and contingency planning.
• Annual compliance reviews, penetration testing, and vulnerability scans.
• Implement strict workforce access and termination protocols to ensure prompt deprovisioning and effective cross-entity notifications.

Formalized incident response and contingency planning

The proposal requires documented and tested incident response procedures, including:

• Incident detection, reporting, and remediation workflows.
• A 72-hour recovery mandate for critical health systems.
• Business associate notification protocols: for example, alerting covered entities within 24 hours of contingency plan activations.

Stronger oversight of business associates

Businesses handling ePHI must:

• Verify annually that technical safeguards are in place.
• Notify covered entities within 24 hours of initiating contingency procedures.

Go deeper: HHS proposes updated HIPAA security rule

How these updates affect communication 

The updates to the HIPAA Security Rule in 2025 reshape healthcare communication by enhancing security standards, strengthening accountability measures, and addressing longstanding compliance gaps. Here's how communication is expected to change:

Secure communication is no longer optional, it’s mandatory

All digital communication, whether email, patient portals, messaging apps, or document exchanges, must use automatic encryption. This forces organizations to upgrade from legacy systems (e.g., unencrypted email, fax machines) to HIPAA compliant platforms like secure email providers, encrypted messaging apps, and telehealth tools.

Mandatory multi-factor authentication (MFA)

This sets higher standards for user verification in messaging systems, EHR portals, and collaboration tools. Providers must now integrate MFA into all communication endpoints, adding a layer of defense against phishing, credential theft, and unauthorized access.

Asset inventory and network mapping are now required

Healthcare organizations must now formally track every communication tool in use (e.g., email platforms, texting apps, file-sharing services). 

Testing and policies for communication systems

Ongoing penetration tests, vulnerability scans, and staff training are now required. This creates a more resilient and proactive communication environment.

Business associates face stricter oversight

Healthcare organizations must re-evaluate their vendor relationships to ensure that all email, telehealth, and messaging providers offer full HIPAA compliance, rapid breach response protocols, and technical safeguards.

Incident response integration with communication tools

Healthcare communication tools must now support incident response, including breach notifications, system lockdowns, audit logs, and secure backup channels. Real-time alerts and traceability become standard requirements.

The HIPAA compliant solution: Paubox

As healthcare providers face new HIPAA mandates in 2025, Paubox Email Suite is seen as a leading solution that already meets or exceeds many of the proposed standards. Its all-in-one, HIPAA compliant email platform simplifies secure communication without sacrificing usability, helping organizations transition smoothly into this new regulatory landscape.

Seamless and automatic email encryption 

With the updated HIPAA Security Rule making  encryption of ePHI mandatory, both in transit and at rest, Paubox encrypts every email by default, without requiring patient portals, login credentials, or message retrieval links. This encryption ensures compliance while maintaining provider-patient communication flow, whether on desktop or mobile.

Built-in multi-factor authentication (MFA)

With MFA now required for system access, Paubox supports two-factor authentication (2FA) and integrates seamlessly with identity management systems like Google Workspace and Microsoft 365. This provides an extra layer of protection against credential theft and phishing.

Comprehensive audit trails and access logging

To meet HIPAA’s enhanced requirements for activity monitoring, Paubox provides detailed audit logs of sent, received, and encrypted emails. These logs support internal reviews, compliance reporting, and incident response investigations.

Proactive threat detection and spam protection

Paubox Email Suite includes inbound threat protection, scanning emails for malware, ransomware, and phishing attempts. This aligns with the 2025 requirement for formalized risk management and early incident detection.

Business associate agreement (BAA) and vendor accountability

Paubox signs a business associate agreement (BAA) with all its customers, demonstrating full commitment to HIPAA compliance. This contract ensures shared accountability for data protection.

Incident response support

Should a breach occur, Paubox is equipped to support your incident response plan with:

• Rapid log access for breach analysis.
• Secure, encrypted outbound messaging for breach notifications.
• 24/7 customer support to assist in incident mitigation.

Learn more: Features of Paubox Email Suite

FAQS

What types of communication need to be HIPAA compliant?

Any communication that involves protected health information (PHI), including emails, text messages, telehealth platforms, EHR messaging, and cloud file sharing, must meet HIPAA compliance standards, including encryption, access control, and audit logging.

Who needs to comply with these updates?

HIPAA applies to all covered entities and business associates.

Are healthcare vendors also affected by the HIPAA updates?

Yes. Business associates, like email providers, cloud platforms, and IT support, must now meet stricter requirements, including encryption, security assessments, and breach notification protocols within 24 hours of an incident.