Improving patient trust using HIPAA compliant email

A 2016 study titled Trust, Health Care Relationships, and Chronic Illness: A Theoretical Coalescence found that trust in healthcare providers and institutions is essential for achieving positive health outcomes. It affects the willingness of individuals to seek necessary medical treatments, undergo preventive screenings, and access mental health care services. When patients trust that their personal information is safe and confidential, they are more likely to engage proactively in their healthcare journey.

The use of HIPAA compliant email demonstrates a provider's commitment to maintaining trust by ensuring that sensitive patient information is communicated securely and privately. When patients receive encrypted messages protecting their personal health information (PHI), they are more likely to feel respected and secure. As noted in the study Patient Perspectives of Medical Confidentiality, “Medical confidentiality, despite its diminished state, remains important to doctors and patients. Effective treatment requires accurate information. Patients are most likely to provide this information when they are not worried about public exposure.” This reassurance encourages patients to engage more openly with their providers, reduces anxiety around data misuse, and fosters long-term transparency in the care relationship.

Why patient trust is fragile

Trust is essential in the patient-provider relationship, especially when dealing with serious conditions like cancer. However, as shown in the study The fragility of trust between patients and oncologists: A multiple case study published in Palliative and Supportive Care, trust is not always as solid as it appears. Even when patients seem cooperative and deferential, their trust can be fragile: easily disrupted by inconsistent care, poor communication, or subtle interpersonal cues. Understanding what undermines trust can help healthcare professionals take steps to preserve it.

Factors that make patient trust fragile

• Superficial trust can mask confusion or doubt: The study notes that patients often “appear to trust their oncologist” even while internally struggling with confusion or doubt. Many feel too intimidated or emotionally overwhelmed to ask clarifying questions during consultations, leading to unspoken misunderstandings that quietly erode trust over time.
• Lack of continuity in care: Trust is most stable when relationships are built over time. However, frequent changes in providers or exposure to multiple team members with differing communication styles can fracture that sense of stability. As one patient in the study remarked, “I’ve seen a lot of different doctors. I don’t really know who is who anymore.”
• Perceived lack of clinician confidence: Patients are highly attuned to a provider’s demeanor. The study found that when clinicians, especially junior staff, appeared uncertain or hesitant, patients questioned their competence. One participant explained, “He didn’t seem sure... it made me nervous.” This perceived lack of confidence can quickly damage even well-established trust.
• Patient personality and emotional readiness: The ability to trust is influenced by each patient’s emotional state, past experiences, and coping style. Some participants described themselves as inherently cautious or mistrustful due to past traumas or difficult diagnoses, making them more sensitive to subtle relational shifts. As the authors observed, “Trust was not only about the clinician but also about the patient’s own psychological readiness.”
• Communication gaps and unspoken tensions: Avoidance of emotionally charged topics, such as prognosis or end-of-life decisions, can quietly undermine the therapeutic relationship. In many cases, both clinicians and patients sidestepped difficult conversations, leading to a buildup of “emotional undercurrents” that, while unvoiced, made the trust feel uncertain and easily shaken.

The study concluded that trust is not a fixed state but “an ongoing achievement that can be threatened by even subtle disruptions.” Recognizing and addressing these fragile points can help providers maintain more resilient, transparent relationships with patients, especially in emotionally complex care settings like oncology.

What is HIPAA compliant email?

HIPAA compliant email refers to email services and practices that meet the security and privacy requirements of the Health Insurance Portability and Accountability Act (HIPAA). These requirements include:

• Encryption of emails in transit and at rest.
• Access controls, like role-based permissions and login monitoring.
• Audit controls to track who accessed what and when.
• Business associate agreements (BAAs) with third-party email providers.

When providers use such platforms, they are sending a clear message: “We value your privacy and are taking steps to protect it.”

How HIPAA compliant email builds patient trust

It signals compliance and transparency

The HIPAA Privacy Rule requires healthcare organizations to be transparent about “how protected health information can be used and disclosed” and be accountable for any breaches or violations. Using HIPAA compliant email demonstrates that a provider has taken the necessary steps to meet these regulatory obligations. It assures patients that their protected health information (PHI) is transmitted through secure, encrypted channels in accordance with federal law. 

It encourages open communication

HIPAA compliant email enables patients to reach out with questions or concerns without fear of data exposure. Patients who know their messages are protected are more likely to:

• Ask follow-up questions
• Share symptoms or concerns in detail
• Engage in ongoing care coordination
• This fosters better provider-patient engagement and improves health outcomes.

It reduces the risk of data breaches

“The Security Rule establishes a national set of security standards to protect certain health information that is maintained or transmitted in electronic form. The Security Rule sets forth the administrative, physical, and technical safeguards that covered entities and business associates (collectively, “regulated entities”) must put in place to secure individuals’ electronic protected health information,” writes the HHS. Implementation of these safeguards can minimize common risks like phishing, misdirected messages, and unauthorized access.

It offers reassurance during a data breach

Even if a breach occurs elsewhere (e.g., through a vendor or unrelated system), having secure email as a standard practice helps maintain trust. Providers can communicate transparently and securely with affected patients, offering updates and support without exposing more information.

Read also: How HIPAA compliance improves patient trust

Best practices for using HIPAA compliant email to build trust

Choose a reputable provider

Use email services that:

• Provide BAAs
• Encrypt all emails automatically
• Offer two-factor authentication (2FA)

See also: Top 12 HIPAA compliant email services

Train staff on email etiquette and compliance

Your secure email system is only as strong as the people using it. Ensure staff:

• Understand PHI and what not to send via regular email
• Use templated, professional responses
• Avoid forwarding or copying unnecessary parties

Read more: How staff training ensures HIPAA compliant email

Let patients know you’re using secure email

Proactively explain your communication methods:

“To protect your privacy, all of our emails are encrypted and sent via a HIPAA compliant platform.” This increases transparency and reassures patients.

Related: Do disclaimers make emails HIPAA compliant?

Using Paubox to build trust through secure email

Paubox is a HIPAA compliant email platform that integrates seamlessly with existing systems like Gmail and Outlook. Unlike patient portals that require logins and separate credentials, Paubox enables direct, encrypted email delivery to patients’ inboxes without extra steps.

With Paubox, providers can:

• Send PHI securely without requiring patient logins
• Automate appointment reminders and test results
• Track email delivery and read status
• Offer patients a familiar, convenient way to engage

This combination of security and simplicity helps providers retain patients, improve communication, and meet compliance standards, all while earning patient trust.

Learn more: Features of Paubox Email Suite

FAQS

Can I use Gmail or Outlook to send HIPAA compliant email?

Not without additional security layers and a signed BAA. Services like Paubox make these platforms HIPAA compliant.

Do patients need to log into a portal to read secure messages?

With certain providers like Paubox, no. Patients can read encrypted messages directly in their inbox.