The very basics of HIPAA compliant newsletters

Healthcare organizations use email newsletters to educate patients, share wellness information, and communicate practice updates. Newsletters are an effective engagement tool; however, they also carry compliance risks if not handled correctly. Healthcare organizations must ensure their email newsletters comply with HIPAA by obtaining patient consent, using HIPAA compliant email platforms with encryption and a business associate agreement (BAA), and providing clear opt-out options. Newsletters should focus on general health tips, avoid PHI in subject lines, and follow HIPAA’s minimum necessary rule.

What are HIPAA compliant newsletters?

HIPAA compliant newsletters are marketing materials that may contain personalized information or PHI to help encourage patients to receive care or education. The HHS defines PHI as “all 'individually identifiable health information’ held or transmitted by a covered entity or its business associate, in any form or media, whether electronic, paper, or oral.” HIPAA sets strict rules about how PHI can be used, shared, and stored. If newsletters include PHI, they must follow these rules to ensure the privacy and security of patient data.

Read more: HIPAA compliant email marketing: What you need to know

HIPAA guidelines for newsletters

When creating healthcare newsletters, avoid including PHI unless you have specific patient authorization. As the HHS states, “The HIPAA Privacy Rule gives individuals important controls over whether and how their protected health information is used and disclosed for marketing purposes. With limited exceptions, the Rule requires an individual’s written authorization before a use or disclosure of his or her protected health information can be made for marketing.”

Furthermore, the HIPAA minimum necessary rule requires healthcare organizations to share only the least amount of information needed to achieve the communication’s purpose.

Obtaining patient consent

HHS states that “if the communication is “marketing,” then the communication can occur only if the covered entity first obtains an individual’s “authorization.” Therefore, before sending any marketing communication, you must obtain written authorization from the patient. HIPAA requires authorization to be explicit and to detail the type of information being shared, the purpose, and the recipient.

For example, if your clinic wants to send a patient-specific health reminder about their upcoming treatment or follow-up, you will need the patient’s permission.

Read more: How to get consent for texting and emailing patients

Using HIPAA compliant email marketing platforms

Not all email marketing platforms are suitable for sending HIPAA compliant newsletters. You must choose a platform that provides encryption and offers a business associate agreement (BAA). A BAA is a contract between the healthcare organization and the HIPAA compliant email marketing service provider, ensuring that the provider will handle any PHI in compliance with HIPAA regulations. Without a BAA, using a third-party platform that can access PHI would be a violation. Consider using Paubox email marketing for secure, reliable, and user-friendly marketing.

Related: The consequences of not having a BAA with an email service provider

Ensuring email security and encryption

Even when you avoid PHI, you still need to ensure the security of your newsletters. All email communications should be encrypted, protecting them from unauthorized access or interception. While HIPAA’s “final Security Rule made the use of encryption an addressable implementation specification,” HIPAA recognizes encryption to prevent patient information from being compromised. If you must include sensitive information in your emails, encryption ensures that only the intended recipient can view it.

Providing clear opt-out options

CAN-SPAM notes that “Your [marketing] message must include a clear and conspicuous explanation of how the recipient can opt out of getting marketing email from you in the future.” The explanation must be “easy for an ordinary person to recognize, read, and understand.” The CAN-SPAM Act aligns with HIPAA in that both give the patient the right to opt in or opt out of receiving marketing emails at any time they wish.

Read more: Opt-out mechanisms in healthcare marketing

Keeping PHI out of subject lines

Subject lines are often visible even without opening the email. Therefore, including PHI in the subject line can result in an unintended disclosure, as anyone with access to the device or email account could see sensitive details at a glance. For this reason, subject lines should always remain neutral and non-identifying.

As a best practice, healthcare organizations should use broad, generic subject lines such as “Health Updates,” “Wellness Newsletter,” or “Clinic News.” Subject lines should never reference a patient’s diagnosis, treatment, appointment, or ongoing care, nor should they imply that the recipient is receiving medical services.

Read also: Writing a HIPAA compliant subject line

Common mistakes to avoid

More than 50% of healthcare professionals violate HIPAA requirements, leading to costly fines, loss of reputation, and breaches. Therefore, like any email, healthcare professionals must remain HIPAA compliant when using email marketing.

When healthcare organizations use email marketing or newsletters, direct marketing principles indicated in the article Direct marketing in health and medicine: using direct mail, email marketing, and related communicative methods to engage patients help us identify several common pitfalls to avoid. These include:

Sending emails without permission (spamming recipients)

The article explains that direct marketing efforts that do not follow a “permission marketing” approach, where recipients explicitly opt in before being contacted, can generate negative feelings and damage the organization’s reputation. In healthcare, sending emails without consent can make recipients feel intruded upon and may reduce trust. Additionally, it also is a HIPAA violation.

Being intrusive or disrespectful of privacy

Direct marketing can easily become intrusive if emails are sent too frequently or without respect for recipients’ preferences. The article notes that analogies like spam in email inboxes indicate how irritating unsolicited or irrelevant communications can be. Healthcare marketers must respect patients’ boundaries by avoiding sending constant promotional emails, making sure messages are relevant, and respecting privacy.

Poor database management

According to the article, direct marketing success depends on maintaining a high-quality database that includes accurate contact details, up-to-date permissions, and communication preferences. Failing to update opt-ins or not tracking who wants educational versus promotional emails can lead to sending the wrong type of message to the wrong person, which harms engagement and trust.

Lack of relevant or valuable content

Another pitfall is sending emails that lack real value. The article states that content must be meaningful and relevant to recipients. In the context of healthcare, newsletters that feel generic, overly promotional, or unrelated to recipients’ interests are less likely to be opened or appreciated. Emails should educate, inform, or support patient needs, not just promote services.

Failing to respect communication preferences

Failure to honor how and how often recipients want to be contacted is another mistake. The article emphasizes that preferences, such as email versus paper mail and the type of content desired, should be tracked and respected. Ignoring these preferences can make recipients feel misunderstood or harassed, reducing the effectiveness of email communications.

See also: HIPAA compliant email marketing: What you need to know

FAQs

Can healthcare organizations send newsletters to non-patients?

Yes, healthcare organizations can send newsletters to non-patients as long as no PHI is shared and proper opt-in consent has been obtained from the recipients.

Is using images of patients in newsletters a HIPAA violation?

Using patient images without written consent is a HIPAA violation, even if the image alone doesn’t seem to reveal personal health information.

Are internal staff newsletters subject to HIPAA?

Internal staff newsletters must comply with HIPAA if they contain any PHI or patient-related information, even when circulated only among employees.