The Role of Encryption in HIPAA-Compliant Email: What You Need to Know

Email is one of the most widely used communication tools in healthcare. From coordinating patient care to handling billing and insurance verification, healthcare providers and their teams rely on email daily. However, email is also one of the biggest security risks in healthcare. 

Without proper safeguards, sensitive patient information can be intercepted, leaked, or accessed by unauthorized individuals–leading to potential HIPAA violations and costly data breaches. The good news is that all of those risks can be mitigated with HIPAA-compliant email.

Quick Links

• Understanding the Need for Secure Email Communication
• The Basics of HIPAA Email Encryption
• Types of Encryption for HIPAA-Compliant Email
• Protecting Your Patients and Your Practice with HIPAA-Compliant Email

Understanding the Need for Secure Email Communication

Since the Office for Civil Rights (OCR) began publishing information regarding healthcare data breaches online in 2009, the number of data breaches has been alarming. In 2023, OCR reported that hacking-related data breaches surged by 239% between January 1, 2018, and September 30, 2023, while ransomware attacks saw a 278% increase during the same timeframe. With such a high prevalence of attacks, it’s essential for healthcare practices to remain vigilant in their efforts to keep their data secure, and that includes email communications.

HIPAA regulations require healthcare organizations to implement safeguards to protect electronic protected health information (ePHI). One of the most effective ways to secure email communications is through encryption, which ensures that sensitive data remains protected from unauthorized access.

Without encryption, emails containing ePHI can be exposed to risks such as:

• Man-in-the-middle attacks: Hackers intercept unprotected emails in transit, gaining access to patient data.
• Phishing and spoofing: Cybercriminals manipulate emails to trick recipients into sharing credentials or downloading malware.
• Accidental exposure: Emails sent to the wrong recipient could expose ePHI without encryption to protect it.

Failure to secure email communications properly can lead to serious HIPAA violations, resulting in costly fines and reputational damage. In fact, the OCR can impose penalties ranging from $100 to $50,000 per violation, depending on the level of negligence. Additionally, organizations that experience data breaches may face class-action lawsuits, regulatory investigations, and the long-term loss of patient trust.

Ultimately for healthcare providers, encryption is more than just an IT best practice–it’s a necessity for HIPAA-compliance. 

The Basics of HIPAA Email Encryption

At its core, email encryption is a method of securing email messages by converting their contents into an unreadable format. Only authorized recipients with the correct decryption key can access and read the message, which prevents hackers, cybercriminals, or unauthorized third parties from intercepting and reading sensitive healthcare communications. For healthcare practices, HIPAA regulations require healthcare organizations to protect ePHI, and email encryption is one of the most effective ways to ensure compliance. 

There are two primary ways email encryption protects sensitive healthcare data:

1. Encryption in Transit: This type of encryption protects emails while they are being transmitted between the sender and the recipient. Without it, emails containing ePHI can be intercepted by hackers using man-in-the-middle attacks, potentially exposing patient data.
2. Encryption at Rest: This secures emails that are stored on a device or server, preventing unauthorized access even if the system is compromised. Without encryption at rest, stolen or improperly accessed emails could reveal sensitive information, leading to potential HIPAA violations.

While HIPAA doesn’t mandate a specific encryption method, it does classify encryption as an “addressable” safeguard under the Security Rule. This means healthcare organizations must either implement encryption or provide a documented justification for an alternative security measure. However, given the growing threat of cyberattacks and data breaches, encryption is widely considered the best practice for securing email communications that involve ePHI.

Beyond encryption, healthcare providers must also ensure that their email service providers comply with HIPAA requirements for Business Associate Agreements (BAAs), ensuring that the vendor follows HIPAA’s security and privacy rules. Any email provider that transmits, processes, or stores ePHI must sign a BAA, confirming their commitment to HIPAA-compliance. Without a signed BAA, healthcare organizations risk noncompliance, even if they use encryption.

Additionally, encrypted email enhances overall cybersecurity by mitigating risks associated with human error, one of the leading causes of data breaches. Practice staff may inadvertently send emails containing ePHI to unintended recipients or fall victim to phishing scams. With encryption in place, these mistakes are far less likely to result in a security incident, helping healthcare organizations maintain compliance, protect patient trust, and reduce liability.

In short, HIPAA requires healthcare organizations to implement reasonable security measures to protect ePHI, and encryption serves as one of the most effective ways to meet this requirement. Without encryption, emails containing sensitive patient data are vulnerable to interception, unauthorized access, and cyber threats.

Types of Encryption for HIPAA-compliant Email

Not all encryption methods offer the same level of protection, and when it comes to HIPAA-compliance, healthcare organizations must choose solutions that effectively safeguard ePHI. The right encryption method depends on factors such as how emails are transmitted, stored, and accessed.

1. Transport Layer Security (TLS) Encryption

TLS encryption is a widely used security protocol that encrypts emails while they are in transit between email servers. This prevents cybercriminals from intercepting messages during transmission, protecting sensitive data from unauthorized access. 

While TLS is an essential baseline for securing email communications, it only encrypts data while in motion, and once the email reaches its destination, it’s decrypted and stored in plain text unless additional encryption measures are in place. For healthcare organizations relying on TLS, it’s critical to confirm that both the sender’s and recipient’s email servers support and enforce TLS to maintain a secure connection.

2. End-to-End Encryption (E2EE)

End-to-end encryption provides a higher level of security by ensuring that only the sender and the intended recipient can access the email’s contents. Unlike TLS, E2EE encrypts the message before it leaves the sender’s device and keeps it encrypted until the recipient decrypts it with a unique key. 

This method prevents unauthorized access even if the email is intercepted or stored on a server, making it one of the most secure options for HIPAA-compliance. Healthcare organizations handling highly sensitive ePHI, such as patient records or test results, should prioritize end-to-end encryption for their email communications.

3. AES Encryption (At-Rest Encryption)

Advanced Encryption Standard (AES) is a robust encryption method used to secure data while it is stored (at rest) on servers or devices. HIPAA requires healthcare organizations to protect ePHI not only during transmission but also when it is stored. 

AES-256, the strongest version of this encryption standard, scrambles email content and attachments into unreadable code, ensuring that even if unauthorized users gain access to email servers, they won’t be able to read the encrypted messages.

4. PGP (Pretty Good Privacy) Encryption

PGP encryption is another common method for securing HIPAA-compliant emails. It uses a combination of symmetric and asymmetric encryption to protect messages, ensuring that only recipients with the proper private key can decrypt the content. 

PGP encryption also provides authentication through digital signatures, allowing healthcare organizations to verify that emails have not been altered or tampered with. While highly secure, PGP encryption can be complex to implement, requiring both senders and recipients to manage encryption keys properly.

5. S/MIME (Secure/Multipurpose Internet Mail Extensions) Encryption

S/MIME encryption provides email security through public key cryptography, enabling senders to encrypt messages and digitally sign them for authentication. Like PGP, S/MIME ensures that only authorized recipients can decrypt and read emails containing ePHI. 

Choosing the right encryption method depends on an organization’s specific needs, email communication practices, and risk management strategies. With that in mind, a multi-layered approach that combines different encryption techniques can provide the strongest protection against cyber threats while ensuring full HIPAA-compliance.

Protecting Your Patients and Your Practice with HIPAA-compliant Email

Though we use email every day, it can be easy to overlook how important it is when it comes to keeping your practice and your patients secure from outside threats. Cybercriminals actively target healthcare organizations, looking for vulnerabilities that expose sensitive patient data. And, a single unsecured email containing ePHI can lead to a costly data breach, HIPAA violations, and a loss of patient trust. That’s why implementing HIPAA-compliant email encryption isn’t just a best practice–it’s a necessity.

Managing HIPAA-compliant email security can be complex, but the right software solutions make it easier. iCoreConnect specializes in healthcare cybersecurity and compliance, offering a suite of solutions designed to protect sensitive patient information. 

iCoreExchange, a HIPAA-compliant email platform, provides end-to-end encryption, ensuring that emails containing ePHI remain secure whether they’re in transit or at rest. And, with seamless integration and intuitive security features, iCoreExchange helps healthcare providers safeguard their communications without disrupting workflows.

Don’t leave your email security to chance. Book a demo today and see how iCoreExchange encrypted HIPAA email can help you stay ahead of cybersecurity threats while keeping your patient information protected.