Collecting data using HIPAA compliant email

Email is one of the most utilized communication tools in healthcare, finance, and many other sectors. In healthcare, it is a tool for patient-provider communication, appointment scheduling, prescription management, and secure data exchange. Beyond direct patient interactions, healthcare organizations use email to conduct surveys and gather research data. This guide explores how to securely collect data using email while maintaining compliance with HIPAA standards. We will cover best practices for encryption, consent management, secure form integration, and staff training to ensure safe and effective email-based data collection.

Can you collect data using email?

Yes, email can be used to collect data in several ways, including through patient intake forms, follow-up questionnaires, customer feedback requests, and compliance reporting. Healthcare providers may use email to gather patient-reported outcomes, conduct telehealth assessments, and streamline administrative tasks like insurance verification and billing inquiries. Research institutions and public health organizations also leverage email to distribute surveys, collect study participant data, and manage clinical trial communications.

While email can be an efficient data collection method, handling sensitive information comes with security and compliance challenges. Organizations subject to HIPAA regulations must implement safeguards to prevent unauthorized access, data breaches, and human error. Measures such as encryption, secure form integration, and consent management help ensure safe and compliant data collection.

Choosing a secure email service

The first step to securely collecting data via email is to use a secure, HIPAA compliant email provider. Not all email providers are equipped for secure data collection. Businesses and healthcare organizations should use an email service with:

• Seamless encryption: Ensures messages are secure in transit and at rest. This prevents unauthorized access or data tampering. While encryption is an addressable requirement under HIPAA, it remains a best practice.
• Access controls: Limits unauthorized access to emails containing sensitive data by requiring authentication methods such as multi-factor authentication (MFA) and role-based access permissions.
• Audit logs: Track email activity to maintain compliance, providing a detailed record of when emails are sent, accessed, or modified. “Not safeguarding audit logs and audit trails can allow hackers or malevolent insiders to cover their electronic tracks, making it difficult for Covered Entities and Business Associate to not only recover from breaches, but to prevent them before they happen,” says the U.S. Department of Health and Human Services (HHS).
• Business associate agreement (BAA): Having a BAA in place demonstrates HIPAA compliance by requiring third-party email providers to adhere to the same strict security and privacy standards for handling PHI as for covered entities.

The HIPAA compliant solution: Paubox Email Suite

One of the most highly-rated email service providers that meets these requirements is the Paubox Email Suite. Paubox offers seamless encryption, access controls, and an audit log feature. Additionally, Paubox signs a BAA, which guarantees that it adheres to the same stringent security protocols for handling PHI as required by HIPAA. By using Paubox, organizations can ensure secure and compliant communication, helping to safeguard patient data.

Encrypting emails and attachments

Encryption ensures that even if an email is intercepted, the content remains unreadable to unauthorized parties.

Types of encryption

• Transport layer security (TLS): Encrypts emails during transit between email servers to prevent unauthorized access while the email is being sent. It does not encrypt the email once received by the recipient.
• Secure/Multipurpose Internet Mail Extensions (S/MIME): Uses public and private keys to encrypt email contents and attachments, also allowing for email signing to verify authenticity.
• PGP (Pretty Good Privacy) / Open PGP: Similar to S/MIME, PGP uses asymmetric encryption with public and private keys for secure email and file attachment encryption, along with digital signatures.
• Password-protected attachments: Involves encrypting email attachments with a password, ensuring that only the recipient with the correct password can access the file.
• Full disk encryption (FDE): Encrypts all data on a device, including emails, ensuring protection if the device is lost or stolen.

Organizations should use automatic encryption to protect all outgoing emails and attachments.

Obtaining consent for email data collection

This ensures that the data collection process complies with legal and ethical standards, which is especially crucial in healthcare due to the emphasis on privacy and security.

How to obtain consent

• Explain clearly: Clearly state what data or information is being collected, why it’s needed, and who it may be shared with.
• Use simple language: Avoid jargon and ensure the person understands what they’re agreeing to.
• Ensure voluntary and informed consent: Consent should be freely given without pressure, and individuals should have enough information to make an informed decision.
• Opt-in: Consent should require an active choice, such as ticking a checkbox or signing a form.
• Allow withdrawal: Make it easy for individuals to withdraw consent at any time and inform them of any consequences.
• Keep records: Document the consent process for future reference.

See also: HIPAA Compliant Email: The Definitive Guide

Avoiding PHI and sensitive data in subject lines

To reduce security risks, never include PHI, personal information, or financial data in email subject lines. Instead, use generic phrases such as:

• "Secure message regarding your account"
• "Your requested information"
• "Secure document attached"

Learn more: How to write a great HIPAA compliant subject line

Using secure online forms instead of direct email responses

Rather than requesting sensitive data via email replies, use a HIPAA compliant web form to collect information securely.

HIPAA compliant forms: Paubox Forms

Paubox Forms is an excellent solution for securely collecting sensitive information online, offering a HIPAA compliant alternative to traditional email responses. By using Paubox Forms, organizations can create secure web forms that allow patients or clients to submit their data directly through an encrypted platform, eliminating the risks associated with emailing sensitive information. These forms are designed to ensure that all submitted data is encrypted both in transit and at rest, protecting it from unauthorized access. 

Training staff on email security and compliance

Jennie C De Gagne noted in a JMIR Publication that “email is ubiquitous in education and health care, where it is used for student-to-teacher, provider-to-provider, and patient-to-provider communications, but not all students, faculty members, and health professionals are skilled in its use.” To mitigate risks associated with the improper use of email, organizations must provide HIPAA email training. Employees handling sensitive data must be trained on:

• Recognizing phishing scams and security threats.
• Proper encryption and data handling techniques.
• HIPAA, GDPR, and CCPA regulations regarding email communications.
• How to report email security incidents.

Regular training helps prevent accidental data breaches and enhances overall security awareness.

Implementing data loss prevention (DLP) policies

Data Loss Prevention (DLP) tools are designed to help organizations protect sensitive information from being leaked or sent out without proper security protocols. These tools monitor outgoing emails, scanning both the content and attachments for sensitive data. Features include:

• Scanning of email content to detect sensitive data.
• Automated encryption enforcement for PHI-containing emails.
• Blocking unauthorized email transmissions.
• Custom alerts to notify security teams of potential violations.

Using DLP solutions enhances email security and reduces human error.

FAQs

What does it mean for an email service to be HIPAA compliant?

A HIPAA compliant email service follows strict security measures such as encryption, secure login protocols, and audit logging to protect sensitive patient information. It also ensures that the email provider signs a business associate agreement (BAA) to comply with HIPAA requirements.

What is the purpose of HIPAA in healthcare communication?

HIPAA ensures the protection of patients' sensitive health information, especially in electronic communications like email. The main purpose is to safeguard personal health information (PHI) from unauthorized access and ensure that healthcare organizations maintain privacy and security when communicating with patients and third parties.

Can I use standard email for sending protected health information (PHI)?

Standard email services are not secure enough to send PHI unless they are HIPAA compliant. A non-compliant service can expose sensitive information to unauthorized access, leading to potential breaches. Use a HIPAA compliant email provider that encrypts data and meets all necessary privacy and security standards.

What are the risks of using non-compliant email services in healthcare?

Using non-compliant email services can expose sensitive patient data to unauthorized access, leading to potential data breaches, identity theft, and violations of HIPAA regulations. These breaches can result in fines, loss of reputation, and legal consequences.