Guidelines for HIPAA Compliance in Emailing Sensitive Healthcare Information

Email is undeniably a fast and convenient method of communication, especially in the healthcare sector where quick referrals and the swift exchange of test results are often crucial. 

However, this convenience comes with significant risks if proper safeguards are not in place.

What is HIPAA (Health Insurance Portability and Accountability Act)?

 HIPAA, the Health Insurance Portability and Accountability Act, is a pivotal federal law enacted in 1996. Its primary role is to safeguard sensitive patient health information, preventing its disclosure without the patient's consent or knowledge. 

This law is of utmost importance as it ensures the privacy and security of individuals' health information.

HIPAA, enacted in 1996, was a significant step towards addressing critical issues within the healthcare industry. Its implementation aimed to enhance the portability and continuity of health insurance coverage for workers and their families. 

Also, it targeted waste, fraud, and abuse in health insurance and healthcare delivery. By setting national standards for health information protection, HIPAA has significantly contributed to the efficiency and effectiveness of the healthcare system.

HIPAA-covered entities, including healthcare providers, health plans, and healthcare clearinghouses, play a crucial role in protecting patient information. 

Their compliance with HIPAA regulations is not just a requirement, but a responsibility that ensures the privacy and security of patient health information. Additionally, business associates must also adhere to HIPAA guidelines, further strengthening the protection of patient information.

HIPAA compliance is structured around three fundamental rules:

• The Privacy Rule: This rule establishes national standards for the protection of PHI. It dictates how healthcare providers, insurers, and business associates must handle and share patient information to ensure privacy and confidentiality. It also grants patients rights over their health information, including rights to examine and obtain a copy of their health records and request corrections.
• The Security Rule: This rule sets standards for the security of electronic protected health information (ePHI). It requires covered entities to implement administrative, physical, and technical safeguards to ensure the confidentiality, integrity, and availability of ePHI. These safeguards are designed to protect against threats or hazards to the security of the information and unauthorized uses or disclosures.
• The Breach Notification Rule requires covered entities to notify affected individuals, the Department of Health and Human Services (HHS), and, in some cases, the media of a breach of unsecured PHI. The rule outlines the specific requirements for breach notifications, including timelines and the content of the messages.

By adhering to these rules, HIPAA-covered entities can help ensure the privacy and security of patient health information, foster trust between patients and healthcare providers, and maintain the integrity of the healthcare system.

What Counts as Protected Health Information (PHI)?

Protected Health Information (PHI) refers to any information in a medical record that can be used to identify an individual and created, used, or disclosed during health care services, such as diagnosis or treatment. 

Under the Health Insurance Portability and Accountability Act (HIPAA), PHI is strictly regulated to ensure patient privacy and confidentiality.

PHI encompasses a broad range of information, including:

• Personal Identifiers: This includes names, addresses, birthdates, and Social Security numbers. Any detail that can directly identify a patient falls under PHI.
• Medical Records: Information about patients' medical history, diagnoses, treatment plans, and other aspects of their health history or care.
• Healthcare Services: Records of the healthcare services a patient has received, including treatments, procedures, and any other interactions with healthcare providers.
• Billing and Payment Information: Details about the financial aspects of a patient's healthcare, including insurance information, payment records, and billing details.
• Photographs and Images: Any visual documentation identifying a patient, such as medical imaging (X-rays, MRIs) or pictures taken during medical procedures.
• Electronic Health Records (EHRs) are digital versions of a patient's paper chart, which include comprehensive data on the patient's health history, diagnosis, treatment plans, immunization dates, allergies, radiology images, and lab and test results.
• Communication Records: Transcripts and records of communication between patients and healthcare providers, including emails, phone calls, and appointment scheduling records.
• Biometric Data: Any biological data that can identify a patient, such as fingerprints, retinal scans, and voiceprints.
• Insurance Information: Details about a patient's health insurance coverage, including policy numbers and insurance providers.

To qualify as PHI under HIPAA, the information must be held or transmitted by a HIPAA-covered entity (such as healthcare providers, health plans, and healthcare clearinghouses) or a business associate of these entities.

The protection of PHI is crucial to maintain patient confidentiality and trust. Unauthorized disclosure of PHI can result in severe legal and financial repercussions, not to mention damage to the patient-provider relationship.

Hence, healthcare providers and associated entities must implement stringent safeguards to ensure that PHI is securely stored and shared only with authorized individuals. 

Best Practice Tips for Maintaining HIPAA Email Compliance​

Encrypt Everything to Start​

​Implementing robust encryption seems like the obvious move for securing patient health information in emails. Encryption scrambles messages during transit, preventing prying eyes, even if the data is intercepted in transit.

Leading healthcare email services are HIPAA-compliant and have enterprise-grade encryption automatically applied to cover all communication of protected health information (PHI). No extra settings adjustments needed, so there's no chance of anyone forgetting to apply encryption.

HIPAA email services also verify identities to prevent phishing attempts, let admins fully audit message activity, and enable revocation if devices become compromised – all table stakes features for safeguarding sensitive patient data.

Rather than cobble together piecemeal encryption protocols for standard business email, make the switch to purpose-built HIPAA email. Protecting PHI doesn't have to be technically daunting.

Verify All Recipients' Addresses 

Even with strong encryption, a simple human error like a misaddressed email could lead to PHI ending up in the wrong hands. 

Before hitting send on any message, pause to double check that the name and email address matches the intended recipient exactly. Consider addressing all recipients directly by name as well, for an extra layer confirming they should receive this information.

Similarly, use generic subject lines that won't reveal health details if viewed by an unintended recipient. Safe options include "Re: Your Medical Care" for patients or just the individual's name. Avoid summarizing confidential info in the subject, since those details display pre-open even in encrypted emails.

Only include additional addresses essential to that patient's care, avoiding extraneous names simply copied as a precaution. 

Every person granted visibility into protected health information should have an explicit, documentable need to know that information. Restricting access minimizes the risk of misdirected PHI within your organization.

Attachments Add Extra Risk

Attaching files like test results or prescription details may seem convenient. But you need to think twice about adding extra risk to sensitive patient information. 

First, consider if the encryption you use in the body text of email messages could securely include the details needed instead. That would eliminate the need for attachments that introduce more ways things could go wrong.

However, when attachments are truly necessary, pause and double check you actually have the right files for the right patient. When patient records look similar, it's easy to mix them up by accident on your end. Preventing that upfront takes a little more care, but it prevents bigger issues down the road.

Also, before hitting send, be sure any attachments look complete and display properly within the email draft itself. Catching a missing file or formatting problem at this stage allows you to fix things without having to retract an already sent message. 

This saves time and limits vulnerabilities that spilled information could expose. 

Ongoing Training to Make Safety Second Nature

​No doubt, staying vigilant about encryption, verifying addresses, and double checking attachments can feel tedious. But when it comes to privacy, you simply can't treat protections as optional or let them slip through the cracks. Patients trust you with their most intimate health details and medical histories. 

They deserve total confidence that we will keep that information secure.

The best way to make privacy second nature is by building it into your organizational culture through regular HIPAA compliance training. It's important to mandate email best practices as official policy, or even a core company value, so that every staff member understands and follows standardized safety procedures.

Over time, strong encryption, address checks, and cautious communication simply become a habit. They get baked into workflows as routine steps we take without thinking twice, with vigilance being absorbed as part of your organization's culture. 

And that shift pays off tremendously in preventing breaches, maintaining patient trust, and truly securing the sensitive health data patients entrust to you, even in such a convenient channel as email.

Wrapping up

​Privacy should be the number one priority for any healthcare provider. 

Patients put their trust in an organization by sharing intimate health details. It's on healthcare providers to honor that trust and handle such information responsibly, no matter what communication channels get used.

Be sure to build regular compliance training into organizational workflows too so email best practices become second nature for staff. 

Over time, privacy protection just becomes part of the culture.