Notification Compliances

How Do The Top 113 Healthcare Companies Remain HIPPA Compliant With Their Email Notifications?

Nikita Navral
March 24, 2023
TABLE OF CONTENTS

Introduction

As a healthcare provider, you know the importance of protecting patient privacy and ensuring compliance with HIPAA regulations. But realistically, keeping track of all those email notifications and ensuring they're secure can be an uphill battle.

That's where the top 113 healthcare companies come in. These industry giants have mastered the art of sending HIPAA-compliant email notifications without breaking a sweat (or breaking the bank with expensive security measures). 

Jeffrey Vinson, the current CISO at Harry Health Systems, did an excellent podcast with John Vecchi about security in the healthcare system. He said, “Everybody is fully aware that healthcare is a number one attacked industry. In healthcare, once your medical record is compromised, you can’t get a new medical record.” He talks about HIPPA compliance and safety measures that healthcare business providers, including the sending of email notifications, can adopt.

On a similar note, Scott Scehfe, CIO of OnePlaceSafe, says, “With HIPPA, PCI, and Dodd-Frank compliance, email security is a growing concern for every client.” 


This article will explore 4 easy ways to ensure that your business email notifications are HIPAA-compliant. 

Legal Requirements for HIPAA Compliance with Email Notifications

Proactive measures are often deemed more effective than reactive ones, and in the realm of HIPAA compliant email notifications, healthcare organizations are prioritizing preventative measures to ensure compliance.

What is HIPPA Compliance?

The Health Insurance Portability and Accountability Act (HIPAA) is a set of federal regulations (Public Law 104-191) that protect the privacy of individuals' personal health information. It is essential for businesses and organizations that handle this type of information to stay compliant with HIPAA regulations, including when sending email notifications.

Some of the important rules which form the base when sending HIPPA email notifications are as follows:

  1. HIPPA Privacy Rule: The HIPAA Privacy Rule, located at 45 CFR Part 160, is a regulation that establishes national standards for the protection of individuals' medical records, including personal health information. It also gives patients the right to access and control their health information.
  2. The HIPAA Security Rule: HIPAA SR, located at 45 CFR Part 160, 162, and 164, is a regulation that sets out standards for the security of electronically protected health information (ePHI). It requires businesses to implement physical, technical, and administrative safeguards to protect the confidentiality, integrity, and availability of ePHI.
  3. HIPPA Breach Notification Rule: It requires businesses to notify individuals and the Department of Health and Human Services (HHS) in case of a breach of unsecured PHI. The HIPAA Enforcement Rule outlines the penalties for HIPAA violations.

Check out what the top 113 healthcare businesses, including Anthem Inc., CVS Health Corp, UnitedHealth Group, and Cardinal Health Inc. do to remain HIPAA compliant.

Types of Email Notifications Healthcare Businesses Send

Healthcare businesses are required to notify their users about various events and remain HIPAA compliant, such as about:

  • Appointment reminders and confirmations
  • Test results
  • Prescription refill requests
  • Health information updates
  • Treatment and care plan updates
  • Billing and payment notifications
  • Patient education materials
  • Surveys and research studies

And last but not least, engagement and marketing materials. (if patient consent has been obtained).

HIPAA Compliant Email Notifications Non - HIPAA Compliant Email Notifications
Use Secure email servers that encrypt transmitted information May not use secure servers or sufficient encryption
Require authentication before granting access to emails May not have authentication requirements
Use access controls to ensure that only authorized individuals can access medical information May not have proper access controls
Regularly monitor and update the system to address potential security vulnerabilities May not have proper processes in place for monitoring and updating
May require a Business Associate Agreement(BAA) to be signed before sending emails containing ePHI May not require a BAA to be signed
Examples of HIPAA-compliant email systems include Secure-mail, TigerConnect, and MedCrypt Examples of non-HIPAA compliant email providers include Yahoo and AOL

With the next section, you can save your healthcare business from non-compliance penalties of up to $250,000. You’ll know the top 4 how-to-do ways to remain HIPPA-compliant with business email notifications.

1. Obtain Prior Consent from Patients

According to a 2021 survey titled ‘Patient Perspective’ by PatientPop, 85% of patients prefer to receive appointment reminders and service notifications via email. 

Asked about their single most preferred communication way to clear their questions, and this was the response. 

How do users prefer to get answers to their queries?


Obtaining prior consent from patients before sending them email notifications is an essential aspect of HIPAA compliance for businesses. According to Page 6 of the HIPAA Privacy Rule Book, businesses can use email to communicate with patients as long as appropriate safeguards are in place, including obtaining patient consent.

How To Obtain Consent From Patients With SuprSend To Remain HIPPA-Compliant

Obtaining consent from patients can be orchestrated in various ways, such as:

Communicate in clear language:

Using clear, concise language when communicating with the user is essential to obtain patient consent. It can help ensure that patients understand the email notifications' purpose and their rights to use their personal health information.

Obtain consent electronically:

Electronic consent forms are an efficient way to obtain users’ consent, but it is important to ensure that the consent process is secure and meets HIPAA requirements. 

You can use software like Jotform, Google G Suite, Updox, or Microsoft 365 to take consent easily. These forms also enable users to interact with the business by asking questions and clarifying their queries.

Allow patients to opt out:

HIPAA requires businesses to allow patients to opt out of receiving email notifications at any time. Businesses can provide patients with an easy way to opt out of all notifications or some notifications, such as through a link in the email or through settings on their website. Check this guide to put opt-out preferences intuitively on your website using SuprSend.

2. Use Centralized Email Notification Systems

Centralized email notification systems like SuprSend lets organizations manage and monitor the use of email for PHI through audit logs, API uptime, and delivery rate.

SuprSend's integrated email providers use advanced encryption technology to protect the confidentiality of ePHI in email communications, helping businesses meet the technical requirements of the HIPAA Security Rule.

How To Use Centralized Email Service To Stay HIPPA-Compliant

Follow these tips to choose a secure email service using the SuprSend email notification system.

Evaluate the encryption options offered:

Choosing a secure email provider that uses strong encryption algorithms to protect the confidentiality of electronically protected health information (ePHI) in email communications is important.

Email providers integrated with SuprSend, like Mailgun or SendGrid, use advanced encryption technology, such as AES-256, and volume level, to protect the confidentiality of ePHI in email communications.

Review the data privacy policies:

When choosing a secure email service, it is important to review the data privacy policies of the service to ensure that they align with HIPAA requirements and protect the privacy of patient data. SuprSend has a comprehensive data privacy policy that outlines how it handles and protects the privacy of users' data. For other email providers, you can access their privacy policy here:

Train Employees On Email Systems:

Businesses should provide employees with training on HIPAA requirements and best practices. This may include information on the proper handling of PHI in email communications, the use of encrypted email servers and email addresses, the proper setup and use of access controls for email servers and systems, and tips on creating strong passwords and detecting and reporting potential security breaches.

Email Analytics With Audit Logs:

Monitoring email activity is important in implementing email access controls to ensure that email notifications containing PHI are sent and received HIPAA compliantly. SuprSend makes it easy with these analytic features in place:

  • Real-time email monitoring using SuprSend & vendor webhooks can be translated into your systems.
  • Identify potential vulnerabilities by identifying behavior patterns during email activity, such as delays and server downtimes.

You also get additional features like sending personalized and scheduled emails, running CRON scripts, and taking customer responses via emails.

3. Implement Organization-wide Email access controls

Email access controls refer to the policies and procedures to ensure that only authorized individuals can access email accounts and send and receive emails containing PHI.

One key requirement per the 45 CFR Part 160 of the HIPPA Security Rule is the need to implement appropriate safeguards to protect the confidentiality, integrity, and availability of PHI. This includes using unique usernames and passwords for each employee or user with PHI access.

How To Implement Access Controls To Remain HIPPA-Compliant

Following are some tips to implement access controls in your organization to keep confidential email data from unauthorized access. 

Use Email Encryption

End-to-end data encryption is important to remain HIPPA compliant for therapists and others, as it can help reduce unauthorized access to the ePHI. Businesses can use systems such as SSL/ TLC or PGP (Gpg4win for Windows or GPGTools for Mac). 

Free email providers like Gmail, AOL, and Yahoo are generally not suitable for sending confidential ePHI emails. To use them, a Business Associate Agreement (BAA) should be signed. Check out this model BAA by HHS.

Use Unique Passwords And Implement Security Measures

According to the U.S. Department of HHS, the most common causes of data breaches in the healthcare industry are unauthorized access/disclosure, theft, and improper disposal of records. 

Businesses should use unique passwords for their email accounts and implement other security measures to protect against unauthorized access to their email accounts. This may include using multi-factor authentication and Role Based Access Controls (RBACs), implementing access controls for their email servers, regularly changing passwords, and implementing security protocols such as firewalls and antivirus software.

4. Email Risk Assessments & Data Breach Measures

By conducting regular email risk assessments, businesses can help ensure the privacy and security of patient health information and avoid potential fines and penalties for HIPAA violations.

From 2005 to 2019, a total of 249.09 million people were impacted by healthcare data breaches, according to a study by Privacy Rights.

How To Conduct Email Risk Assessments To Send HIPPA Compliant Emails

Here are some tips for conducting risk assessments to remain HIPAA compliant for businesses that provide email notification services.

Use risk assessment for email systems:

Businesses should conduct a risk assessment to evaluate the types of email communications sent and received, the sensitivity of the information in the emails, and the potential risks associated with sending and receiving email notifications containing PHI. You can use this risk assessment template by UNCO. Regularly review and update the risk assessments by considering all external threats on email servers and end-users.

Involve all relevant stakeholders in communication:

Involving all relevant stakeholders can help ensure that all potential vulnerabilities are identified and addressed and can also help build consensus and support for risk management efforts.

The concept of the 4 Ps’ in healthcare outlines the main stakeholders. It includes Patients, Providers (professionals and institutions), Payors, and Policymakers.

Mapping Stakeholders involved in Healthcare email communication


Depending on the extent of the data breach, there may be legal requirements for notification and reporting. You can use automatically triggered workflows using SuprSend to send emails and other notifications to all the affected parties, including others mandated by HIPPA policy. 

For example, in a breach affecting more than 500 individuals, companies are mandated to inform the health department secretary without delay (and in no case after 60 days).

Identifying And Mitigating Data Breach Cause:

In case of a HIPAA violation, it is important for businesses to have clear communication protocols in place and to take steps to identify and mitigate the cause of the data breach.

Some communication protocols may include:

  • establishing a chain of command,
  • setting up a central point of contact, and
  • establishing internal and external communication protocols.

Some steps to identify and mitigate data breaches include: 

  • isolating affected systems,
  • conducting a forensic analysis, and
  • implementing additional security measures.

Key Takeaways

It is essential for businesses that serve healthcare stakeholders to remain HIPAA compliant to protect the privacy and security of user health information. There are several easy ways to send HIPAA compliant email notifications, including 

  • Obtain patient consent before using email to communicate with them.
  • Train employees on HIPAA requirements and best practices for email notifications.
  • Use a centralized email notification system to manage and track patient consent.
  • Regularly review and update email notification policies and procedures.
  • Implement safety measures to protect against unauthorized access to email accounts and servers, including audit logs.

By remaining HIPAA compliant, businesses can protect the trust of their clients and avoid the risk of fines and penalties for HIPAA violations.

FAQs

  1. What are HIPPA violation reporting requirements?
    Covered entities must report HIPAA violations to the OCR within 60 days and notify affected individuals. If the breach affects 500 or more individuals, the media must also be notified. If the breach affects fewer than 500 individuals, a record of the breach must be kept and provided to the OCR upon request.
  1. Can medical records be emailed under HIPPA guidelines?
    Under HIPAA, medical records can be emailed with secure email servers that encrypt transmitted information and require authentication for access.
  1. Why is my business email not HIPAA compliant?
    It can happen due to insufficient security measures on the email server, lack of authentication requirements, inadequate access controls, or lack of regular monitoring and updates to address security vulnerabilities.
  1. Can HIPPA-compliant email be free?
    HIPPA-compliant emails can be free. However, it is important to note that while the email service itself may be free, costs may be associated with other necessary security measures such as authentication, access controls, and BAA considerations.
  1. How much does it cost to create HIPPA-compliant emails?
    The cost of a HIPPA compliant email server can be as low as $10 per month. A complete email notification stack like SuprSend may be preferred for larger scale or multiple stakeholders, starting at $0 per month.
  1. Is free internet-based email providers like Gmail and Outlook HIPPA compliant?
    For individuals like therapists or doctors, Gmail and Outlook can act as HIPPA-compliant email systems only if you have signed a BAA. However, at business levels, it is recommended to use secure email servers designed for HIPAA compliance.

HIPPA-Compliant Healthcare Email Notification Templates

In case of a Data Breach.

Sample HIPPA-compliant email template businesses could use to notify the stakeholders regarding any breach of PHI.

Subject: Important Information About a Breach of Your Protected Health Information

In the case of sharing Privacy Policies as per HIPPA guidelines.

Here is a sample HIPAA-compliant email template that a healthcare business could use to provide individuals with a notice of their privacy practices:

Subject: Notice of Privacy Practices

In case someone is requesting access to their personal data.

Here is a sample HIPAA-compliant email template that a healthcare business could use to respond to an individual's request for access to their protected health information (PHI):

Subject: Request for Access to Protected Health Information

In case of providing an accounting of disclosure to user requests.

Here is a sample HIPAA-compliant email template that a healthcare business could use to provide an accounting of disclosures of an individual's protected health information (PHI) upon request:

Subject: Request for Accounting of Disclosures of Protected Health Information

Written by:
Nikita Navral
Co-Founder, SuprSend
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