At our March Zoom social mixer, the conversation focused on new Paubox features, AI implementation strategies for HIPAA compliance, and practical solutions for managing email security workloads.
What happened:
The March social mixer was an unmoderated discussion among healthcare IT professionals. We covered product updates, including subject line triggers and DLP Observer mode, AI tools with BAA agreements, direct-to-spam filtering to reduce IT burden, shadow AI usage concerns, ExecProtect configuration for former employees, and phishing training approaches.
Go deeper: 2026 healthcare email security report
Our takeaways:
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Several new features launched based on customer feedback, including subject line triggers for Secure Message Center, 150MB attachment limits for Paubox Forms, and Observe and Report mode for Paubox DLP that allows monitoring without blocking emails.
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Direct-to-spam filtering can significantly reduce IT workload by automatically delivering gray/spam emails to user spam folders instead of quarantine. One attendee confirmed this approach eliminated support calls since users find emails in their junk folders themselves.
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Multiple customers are successfully implementing AI solutions using Claude with BAA agreements while maintaining HIPAA compliance.
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One attendee built an isolated OpenClaw server in Azure and uses the Paubox Email API to receive AI-generated content via HIPAA-compliant email.
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Another automated EHR testing by replacing manual spreadsheet validation with Claude.
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Shadow AI usage is widespread, with research showing 85% of healthcare IT leaders suspect unauthorized AI tool usage but only 26% have visibility.
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Several attendees recommended providing sanctioned AI tools with clear guidelines rather than prohibition, as employees will use these tools regardless of restrictions.
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ExecProtect should retain former employees indefinitely to prevent email spoofing attacks. One attendee reported blocking a VP Engineering spoof one year after departure, and another uses former employee accounts as spam honeypots to identify patterns and populate deny lists.
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Microsoft 365 users face a direct send vulnerability where attackers bypass MX records to deliver malicious emails. A mail flow rule can prevent these attacks, which often appear as self-sent emails with malicious QR codes in PDFs.
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One participant uses Microsoft Attack Simulator with AI-generated custom HTML emails for realistic phishing training scenarios, while another collects real-world phishing examples from staff personal experiences to humanize training.
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Workflow optimization should precede AI implementation. Attendees emphasized augmentation over replacement, with operational use cases serving as safer starting points than clinical applications.
The bottom line: Customers count on Paubox to help keep their emails HIPAA compliant and save time managing inbound email security challenges.
See also: Our playbook for Zoom social mixers
See also: HIPAA Compliant Email: The Definitive Guide
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Dean Levitt
