Paubox blog: HIPAA compliant email - easy setup, no portals or passcodes

How secure emails safeguard privacy in digital healthcare

Written by Caitlin Anthoney | October 31, 2025

The digitisation of healthcare has changed how providers store, share, and analyze patient data.

According to Sage Journals’ research article on Security and Privacy in Digital Healthcare Systems: Challenges and Mitigation Strategies, “The rapid digitisation of healthcare systems has ushered in a new era of possibilities, transforming the way medical information is managed and healthcare services are delivered.” 

Email is one of the most widely used communication tools in this transformation, but it also presents risks. These risks can lead to exposure of individuals’ protected health information (PHI), resulting in potential HIPAA violations and reputational harm.

Consequently, healthcare providers must use HIPAA compliant emails to protect PHI during transmission and at rest. HIPAA compliant emails also maintain efficiency, accessibility, and improved patient care.

 

Why HIPAA compliant email matters

“Security breaches, unauthorised access, cyber threats and privacy breaches pose significant risks to the confidentiality, integrity and availability of patient information,” the research article explains.

More specifically, email, if unsecured, can be an easy entry point for these risks. HIPAA compliant email addresses these challenges with advanced encryption, secure storage, access controls, and transparent consent mechanisms.

 

Risks of non-compliant email in healthcare

Digital communication without HIPAA compliance exposes patients and providers to harm:

  • Data breaches: “Data breaches can occur due to various factors, including vulnerabilities in software systems, weak authentication mechanisms, or inadequate security protocols.” In terms of email, unencrypted PHI could be intercepted in transit, leading to a data breach.
  • Cyberattacks: “Digital healthcare systems are susceptible to a wide range of cybersecurity threats and attacks… ransomware, malware infections, phishing attempts.” Email is a common delivery vector for such attacks.
  • Insider threats: Employees may access or misuse patient data. The researcher stresses that “Insider threats, such as employees accessing or misusing patient data for personal gain or malicious intent, pose a significant challenge.”
  • IoT and device integration: Medical devices increasingly generate data shared via email reports. Without secure channels, attackers can easily expose PHI on wearables and implants.

 

Email as the frontline of healthcare cybersecurity

Email remains one of the most common entry points for cyberattacks in healthcare. While electronic health records (EHRs) and patient portals attract attention in security conversations, inboxes often serve as the gateway for threats like ransomware, phishing, and social engineering. 

According to the research study, “Digital healthcare systems are susceptible to a wide range of cybersecurity threats and attacks. These include malicious activities such as ransomware attacks, malware infections, phishing attempts, and Distributed Denial of Service attacks.”

 

Why email is a prime target

Healthcare providers exchange thousands of emails daily when sharing lab reports, billing information, referrals, and internal updates. These emails can be exposed to external and internal risks. 

As the researchers state, “Insider threats, [like] employees accessing or misusing patient data for personal gain or malicious intent, pose a significant challenge in digital healthcare.” 

A compromised email account can expose sensitive PHI, resulting in identity theft, fraud, or blackmail. The high value of PHI on the dark web makes healthcare email particularly attractive to attackers. While credit card numbers can be canceled quickly, PHI includes long-term identifiers like medical histories, Social Security numbers, and insurance details. Once stolen, this data can be exploited for years.

 

Phishing and ransomware in healthcare

Phishing is the most widespread email-based threat. Attackers craft convincing emails that appear to come from trusted colleagues or institutions. If a healthcare employee clicks on a malicious link or downloads an infected attachment, attackers can gain access to login credentials or deploy ransomware. 

Moreover, “Such attacks can disrupt healthcare services, compromise the confidentiality and integrity of patient data, and even impact patient safety.” In these cases, hospitals have been forced to delay surgeries, shut down systems, and divert patients due to ransomware infections initiated by a single malicious email.

 

HIPAA compliant email as a defense

A HIPAA compliant email system reduces these risks significantly by combining technical safeguards with compliance frameworks. Encryption ensures that even if email data is intercepted, it remains unusable. Multi-factor authentication (MFA) prevents unauthorized access to accounts, even if credentials are stolen. 

“Strong authentication methods, such as two-factor authentication or biometric verification, can help ensure that only authorised individuals have access to patient data.”

Additionally, HIPAA compliant platforms offer advanced threat protection, scanning incoming and outgoing emails for suspicious links, attachments, or patterns of misuse. With data loss prevention (DLP) tools, organizations can automatically flag or block emails that contain PHI being sent outside authorized channels.

HIPAA compliant email solutions, like Paubox, mitigate these risks with multiple defenses:

 

Encryption

“Encryption ensures that even if unauthorised individuals gain access to the data, these remain indecipherable without the appropriate decryption key,” according to the research study.

For example, whether a provider emails lab results, prescriptions, or billing statements, only the intended recipient can read them. With platforms like Paubox, outgoing emails are automatically encryption happens automatically without requiring additional portals or patient logins.

 

Strong authentication and access controls

HIPAA compliance also demands verifying that only the right people access PHI. As the authors explain, “Strong authentication methods, such as two-factor authentication or biometric verification, can help ensure that only authorised individuals have access to patient data.”

HIPAA compliant emails allow healthcare organizations to implement role-based access controls and monitor for suspicious activity. For example, a nurse may only have access to patient information relevant to their care, while an administrator may have broader access for billing purposes. This helps keep sensitive patient data protected, so only authorized personnel can access it.

 

Secure communication channels

Email is only as secure as the infrastructure behind it. According to Sage Journals, “Robust authentication and access controls are crucial for mitigating security and privacy concerns in digital healthcare.” 

More specifically, providers cannot use standard Gmail or Outlook, as these services do not meet the necessary requirements under HIPAA Rules. Using these platforms puts patient information at risk of being compromised, as they do not provide the necessary encryption and security measures required for protecting sensitive data. 

Healthcare providers must instead utilize secure communication channels that are compliant with HIPAA regulations to maintain the privacy and security of patient information.

 

Compliance and regulatory alignment

“Adhering to privacy regulations and standards is vital for building trust in digital healthcare systems. Organisations should ensure compliance with relevant regulations such as the Health Insurance Portability and Accountability Act.”

Therefore, using a HIPAA compliant email solution reduces regulatory risk and demonstrates a provider’s commitment to ethical data handling. It also ensures readiness for audits, patient complaints, or legal challenges.

 

Building trust through transparency

Patients need to know their information is safe. The researchers point out that “Transparent and easily understandable consent management processes should be implemented, ensuring that patients have full awareness of how their data will be utilised and shared.”

HIPAA compliant emails directly support this, offering audit trails, consent options, and the ability for patients to revoke consent. When patients trust digital communication, they are more likely to engage actively in their care.

For example, patients may be more willing to share important health information or follow up on treatment recommendations if they feel confident in the security of their data. This can ultimately lead to better health outcomes and more effective communication between patients and healthcare providers.

 

Ongoing training and awareness

Staff must understand secure email practices. Therefore, “Continuous training and awareness programmes are crucial for healthcare professionals and staff to understand security and privacy best practices.” 

Staff must know how to spot phishing emails, safeguard login credentials, and handle PHI responsibly. 

For example, if an email seems suspicious or requests sensitive information, staff should report it to the appropriate IT department for further investigation. Additionally, regular training on cybersecurity best practices can help ensure that staff are equipped to protect patient data effectively.

 

Privacy by design in email systems

“Privacy by design involves considering privacy requirements and implementing privacy controls from the inception of system design.” HIPAA compliant email embodies this principle with default encryption, strict access policies, and secure transmission baked into the system.

As the researchers conclude, “…implementing robust security measures, adhering to privacy regulations, fostering trust through transparency and user empowerment, and upholding ethical principles, the potential of digital healthcare can be realised while safeguarding patient privacy and security.”

 

What to look for in a HIPAA compliant email

A reliable HIPAA compliant email must offer:

  • Default TLS encryption on every message.
  • HITRUST CSF certification for regulatory alignment.
  • No extra logins, portals, or passwords for patients.
  • Email DLP (data loss prevention) and advanced threat protection.
  • Easy integration with existing workflows.

For providers looking to balance compliance, security, and usability, Paubox is the most straightforward way to achieve HIPAA compliant communication.

 

FAQs

Why can’t providers use Gmail or Outlook for patient communication?

Standard Gmail, Outlook, or Yahoo accounts don’t meet HIPAA requirements since they lack default advanced encryption, audit trails, and business associate agreements (BAAs). Therefore, providers who use them for PHI put themselves at risk of regulatory violations and fines.

Read also: How to set up HIPAA compliant emails on Google

 

Do HIPAA compliant emails improve patient care?

Yes, HIPAA compliant emails improve the accuracy, security, and reliability of patient communication, helping providers deliver better and safer patient care.

 

Can AI be integrated into HIPAA compliant emails?

Yes, AI-powered features can be integrated with HIPAA compliant emailing platforms, like Paubox, to send personalized emails while maintaining HIPAA compliance.