As healthcare companies increasingly adopt electronic records and digital services, the risk of cyber attacks and data breaches also increases. Cybercriminals have already exposed the private medical information of millions of patients, and the number of hacking incidents at healthcare firms has risen dramatically in the past five years.

From 2010 to 2022, healthcare breaches exposed 385 million patient records, according to federal records. These cybercriminals often demand ransoms in exchange for restoring access to sensitive medical data.

HIPAA, the federal law safeguarding sensitive patient information, sets the bar for privacy and security standards. For close to three decades, email has been a staple tool for businesses and individuals, woven seamlessly into daily life.

Many providers rely on email to communicate with patients, necessitating the consideration of HIPAA compliance requirements to protect PHI from unauthorized exposure. HIPAA regulations mandate covered entities to adopt various security measures, ensuring the confidentiality, integrity, and availability of PHI transmitted through email.

Picture this scenario:

You’re a doctor needing to inform a patient about their test results via email. Sending an email with the results attached might seem sufficient, but it could jeopardize your patient’s information.

It is important to be cautious when sending sensitive information through email, especially in the healthcare industry where the protection of patient data is crucial. Sending an email containing sensitive personal data such as medical information, financial account information, social security number, address, or phone number can be extremely risky because cybercriminals need only a minimal amount of personal data to cause maximum harm.

This is exactly what happened in May 2017 when BJC Healthcare, a healthcare organization based in Missouri, experienced a phishing attack that compromised the data of 287,876 patients from 19 affiliated hospitals. Three employees fell victim to the scam on March 6th, and despite detection by the security team on the same day, it was unclear if any patient information had been accessed. A review found that the accounts contained sensitive information, including treatments, medications, Social Security numbers, and health insurance data.

Instead, taking measures to secure the email in line with HIPAA regulations becomes crucial. Options include encryption, password protection, or utilizing a secure messaging platform.

In the words of the wise old saying, “an ounce of prevention is worth a pound of cure.”

Safeguarding your emails and protecting your patients’ data can avert data breaches and costly fines. Being cautious and prepared is always the wiser choice.

Now, let’s delve into the significance of HIPAA email security in 2023 and offer practical tips to safeguard sensitive patient information with peace of mind in this blog post.

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The Importance of Email in Healthcare Communication

Email has the potential to revolutionize healthcare communication by enhancing efficiency and streamlining processes. Here are some ways email can be utilized in healthcare:

  • Between healthcare providers: Email enables providers to communicate with each other, irrespective of their location. This facilitates care coordination, information sharing, and referrals.
  • Between healthcare providers and patients: Email provides a convenient means for providers to communicate with patients, particularly for non-urgent matters. This can improve patient satisfaction and adherence to treatment plans.
  • Between healthcare organizations: Email can facilitate communication between healthcare organizations, such as insurance companies and laboratories. This can improve the efficiency of the healthcare process.

Email offers numerous benefits, including:

  • Efficient communication: Email facilitates real-time communication while prioritizing data security and encryption protocols.
  • Convenient patient engagement: Email fosters a caring and connected relationship between providers and patients.
  • Time and cost savings: Email reduces administrative tasks, paperwork, and phone call volume, resulting in time and cost savings for providers.
  • Enhanced accessibility: Email allows patients to communicate with their providers from home, reducing the need for unnecessary in-person visits.
  • Improved documentation and record keeping: Email provides a written record of communication, improving documentation and record keeping.

Email is a versatile tool that can be leveraged in various ways to improve healthcare communication. By utilizing its capabilities, healthcare providers can enhance efficiency, streamline processes, and improve patient care.

Best Practices for HIPAA Compliant Email Security:

Healthcare organizations are constantly facing a range of threats to their email security, including phishing, Business Email Compromise (BEC), and malware distribution. These threats can have serious consequences, such as stolen credentials, fraudulent wire transfers, and ransomware attacks on healthcare networks. Advanced Persistent Threat (APT) actors and cybercriminals often target healthcare organizations via email, using sophisticated tactics that require multiple security solutions for defense-in-depth protection.

To protect against these threats, it’s important for healthcare organizations to implement best practices for HIPAA email security. Some of these best practices include encryption, secure email gateways, security awareness education, multi-factor authentication, DNS filtering, technical safeguards, business associate agreements, reasonable safeguards, email retention, and secure messaging solutions.

Let’s take a closer look at these practices and see how they can help enhance the security of your organization’s email communications.

Encryption:

According to HIPAA regulations, emails containing ePHI must be securely encrypted while in transit if they are sent beyond the protection of an internal email network, such as outside a firewall. The HIPAA Security Rule mandates the implementation of a robust mechanism for encrypting and decrypting ePHI, ensuring that access is granted only to authorized individuals or software programs.

HIPAA-covered bodies can receive up-to-date guidance on encryption from the National Institute of Standards and Technology (NIST), which currently recommends the use of Advanced Encryption Standard (AES) with 128, 192, or 256-bit encryption. However, as recommendations may change, it is important to regularly check NIST’s latest guidance before implementing email encryption.

Secure Email Gateways:

Secure email gateways protect inboxes from spam and malicious content by scanning incoming emails and utilizing blacklists. AI/machine learning capabilities detect deviations from standard emails and assign a score reflecting the probability of it being spam or malicious. Antivirus protection and behavioral analysis of attachments provide robust security. Outbound scanning and data loss prevention capabilities restrict external transmission of specific data.

Secure email gateways can be deployed as an on-premises solution or a cloud-based service, with the latter being optimal for Microsoft Office 365 accounts. Cloud-based services leverage the scalability of the cloud and ensure consistent performance during surges in email traffic.

Security Awareness Education:

Email security solutions block spam and most email threats, but no single solution provides complete protection. Security awareness training for the workforce is essential to teach employees security best practices and how to recognize and avoid phishing emails.

Training should be provided regularly, with annual sessions augmented by regular refresher sessions and phishing simulations to test effectiveness. Developing a security culture requires ongoing effort and commitment from everyone in the organization.

Multi Factor Authentication:

By requiring an additional form of authentication, such as a one-time code sent to a mobile device, multi factor authentication provides an extra layer of security to accounts. This helps prevent unauthorized access even if passwords are compromised through phishing attacks or brute force tactics.

While it may take slightly longer to access accounts with multi factor authentication, the added security is well worth it. In fact, Microsoft has reported that over 99% of automated attacks on accounts are blocked by multifactor authentication. By implementing this security measure, organizations can greatly enhance the protection of their accounts and prevent unauthorized access.

DKIM and SPF are two methods of email authentication that help detect email spoofing and prevent spam. DKIM adds a digital signature to outgoing messages, allowing receiving mail servers to verify the authenticity of the sender and the integrity of the message contents.

This reduces the likelihood of messages being marked as spam. SPF, on the other hand, publishes DNS records for a domain and works with email service providers to prevent unauthorized delivery of spoofing emails.

It is the first step in setting up full email authentication with SPF, DKIM, and DMARC. Both DKIM and SPF help protect against spammers impersonating your organization and improve the delivery of legitimate messages to recipients’ inboxes.

DNS Filtering:

DNS filtering provides an additional layer of defense against phishing and malware by enabling organizations to regulate the Internet content that their users can access.

Often used to restrict access to non-work-related websites, such as those related to adult visuals, gambling, and gaming, DNS filters employ blacklists of known malicious websites to offer protection against malicious links in emails and redirects to harmful websites through web browsing at the time of click.

Additionally, DNS filtering can be utilized to prevent the downloading of specific file types from the Internet, further bolstering security against web-based threats.

Business Associate Agreements:

Ensure that email providers sign a BAA with covered entities before sharing PHI. A Business Associate Agreement (BAA) is a required HIPAA compliance document between a covered entity and a business associate that agrees to share medical records in a secure and protected manner. In the event of an unauthorized breach, the business associate would carry all liability related to the incident. It is important for covered entities to carefully review and negotiate the terms of the BAA to ensure that their PHI is adequately protected.

Reasonable Safeguards:

Apply reasonable safeguards when discussing health issues and treatment with patients via email. Reasonable safeguards are appropriate administrative, technical, and physical safeguards that protect against uses and disclosures not permitted by the Privacy Rule, as well as limit incidental uses or disclosures. These safeguards may include using secure email systems, verifying the identity of the recipient before sending PHI, and ensuring that PHI is sent only to the minimum necessary individuals.

Email Retention:

In order to comply with individuals’ access requests and Accounting of Disclosure requests within the designated timeframe, it is essential to establish a comprehensive email retention system. According to the HIPAA Security Rule, electronic communications containing HIPAA procedure and policies must be retained for a minimum of six years.

Individuals are entitled to receive a detailed record of any disclosures of their PHI made by a covered entity, subject to certain exclusions. To request an accounting of disclosures, the individual must submit a written request to the covered entity. The accounting must include the date of the disclosure, the name of the entity or person who received the PHI, a brief description of the PHI disclosed, and a brief statement of the purpose of the disclosure.

Secure Messaging Solutions:

With the increasing use of personal devices by healthcare employees, organizations are exploring new ways to safeguard the privacy of communications made through these devices. Secure messaging solutions that comply with HIPAA requirements and support Bring Your Own Device (BYOD) policies are one such way.

These solutions allow authorized users to log into the platform using a unique username and password. All activities on the platform are recorded and can be audited, providing a complete audit trail of all messages sent and received.

Administrators can assign a “lifespan” to a message, after which it is automatically deleted from the platform. This helps to reduce the potential for errors and improve the overall security of the messaging system.

Secure messaging solutions offer the convenience of instant messaging and texts while supporting HIPAA compliance. They provide a secure way for healthcare organizations to communicate and share PHI with authorized individuals.

Conclusion:

In conclusion, HIPAA compliant email security is of utmost importance in protecting sensitive patient information. By implementing best practices for HIPAA email security, healthcare organizations can safeguard against threats such as phishing, Business Email Compromise (BEC), and malware distribution. These measures not only enhance the security of email communications but also help organizations to remain HIPAA compliant and protect the privacy of their patients.

We hope this post has emphasized the importance of HIPAA compliant email security in protecting sensitive patient information. If you have any specific topics you would like to learn more about in our upcoming blog posts, please let us know. We are always looking for ways to provide valuable information to our readers.