The Two-Tool Approach to HIPAA Email

Most HIPAA-compliant SaaS companies need two email tools: one for HIPAA-compliant communication containing PHI and one for marketing communication that never touches PHI. This is not ideal, but it is the practical reality. The tools that are best at HIPAA compliance (Paubox, LuxSci) are not great at marketing automation. The tools that are best at marketing (Sequenzy, ActiveCampaign) are not built for PHI handling.

The key is strict separation. Your marketing tool never sees patient data. Your HIPAA-compliant tool handles patient-facing communication. The two systems do not share data. This separation protects you legally and makes compliance audits straightforward.

What Counts as PHI in Email

Understanding what counts as PHI is critical for choosing your email approach. PHI includes any health information combined with a patient identifier. A patient's name plus an appointment date is PHI. A diagnosis plus a phone number is PHI. Even the fact that someone is a patient at a specific practice can be PHI.

Marketing emails to healthcare providers about your product are not PHI. Product updates, feature announcements, and educational content that never reference specific patients are safe for regular email tools. The line is clear: if the email references a specific patient or their health information, it requires HIPAA-compliant delivery.

BAAs Are Non-Negotiable

The Business Associate Agreement is the legal foundation of HIPAA-compliant email. Without a BAA, your email vendor is not legally obligated to protect PHI, and you are liable for any breach. With a BAA, both parties share responsibility for protecting patient data.

Always verify that the BAA covers your specific use case. Some vendors offer BAAs that exclude certain features or limit what data can be processed. Read the BAA carefully and have your compliance officer or legal counsel review it before signing.