HIPAA-compliant emails: Secure engagement for healthcare and wellness apps

When you hear “HIPAA,” you’re most likely thinking traditional healthcare. But the sector where HIPAA compliance is required is broader than that, reaching across healthtech, wellness, and even nutrition. If your app is offered by a licensed medical provider and bills insurance, it likely falls under HIPAA, even if it’s mobile-first.

Much like GDPR, HIPAA compliance isn’t optional: a single non-compliant message can lead to severe penalties. The good news is that you don’t have to trade compliance for performance—or stick with outdated tools. In this post, we’ll cover how to maximize your email campaigns’ effectiveness and stay HIPAA compliant.

What is HIPAA-compliant email?

HIPAA stands for Health Insurance Portability and Accountability Act that governs how protected health information (PHI) is collected, stored, and shared.

Building a HIPAA-compliant email strategy means ensuring your messages adhere to the rules for safely handling health-related information. If an email contains anything linked to a user’s health, it needs to be protected.

It also involves using a HIPAA-compliant tool; otherwise, you put your users’ data—and your company—at serious legal risk.

HIPAA compliance hinges on three key rules:

1. The Privacy Rule

This defines what counts as PHI and how it must be handled. It includes obvious data like diagnoses and prescriptions, but also any health-related data tied to an identifiable user, such as:

• A fitness tracker summary showing an increased heart rate during sleep
• A chat message from a mental health app user
• A telehealth platform’s follow-up email referencing a missed appointment

If this type of data is being sent over email, it must be protected.

2. The Security Rule

This governs the safeguarding of electronic PHI (ePHI). It requires:

• Administrative safeguards – policies, training, and internal oversight;
• Physical safeguards – secure data centers and device policies;
• Technical safeguards – encryption, access control, and audit logging.

For mobile apps and cloud-based platforms, technical safeguards are the frontline defense.

3. The Breach Notification Rule

If ePHI is exposed—whether through hacking, mishandling, or a misdirected email—HIPAA requires timely notification of the breach. That includes informing affected users, regulators, and in some cases, the media.

Prevention is critical.

Common misconceptions about HIPAA and email

“We’re not a hospital—this doesn’t apply to us.”

Wrong.

HIPAA isn’t just for hospitals. If you handle any health-related data on behalf of a covered entity (like a clinic or an insurer) or if you collect PHI yourself through an app, you may be classified as a “business associate” under HIPAA. Here are a few examples of apps that may fall under its scope:

• Telemedicine and virtual care apps
• Pharmacy platforms and prescription delivery
• Mental health and therapy services
• Fitness, wellness, and health coaching apps
• Medical devices or remote monitoring tools
• Health-adjacent e-commerce (e.g., DNA testing kits, nutritional supplements)
• Insurance and benefits platforms
• Any CRM or customer messaging platform handling medical-related support

In each case, if data tied to a user’s health is stored or sent, HIPAA applies.

“HIPAA is only about medical records.”

HIPAA is about all sorts of patients’ (or users’) identifiable private health data that can be accidentally exposed, including:.

• Fitness data — heart rate logs, calorie intake, step count, sleep patterns, etc.;
• Customer support chats and insights from them;
• Behavioral in-app data, such as search and app usage history, that potentially reveals a health condition or a treatment plan.
• Email content – A mismatch in the recipient’s name or unintentional exposure of health data in the subject line can trigger a breach. Stay alert to all the potential violations.

Why do HIPAA violations happen over email?

Standard email isn’t encrypted end-to-end, meaning PHI can be intercepted or exposed.
Unlike app-based or authenticated messages, email can land in an unsecured inbox, appear in previews, or be forwarded without restrictions. Subject lines can be read before encryption kicks in, and attachments can be downloaded on shared devices.

That’s why email requires extra controls—like strong encryption, neutral wording, secure portals, and consent-aware automation—to prevent accidental PHI exposure.

Here are some common examples that could be easily overlooked:

What to look for in a HIPAA-compliant email solution

Encryption (in transit and at rest)

Both the message and stored data must be encrypted using industry-standard protocols (e.g., TLS, AES-256).

✅ Pushwoosh uses robust encryption across all channels to ensure PHI is never exposed.

Access control and audit trails

You need to control who accesses PHI—and prove it. Audit logs help demonstrate compliance.

✅ Pushwoosh provides detailed access logging and flexible permission settings for each team member or system integration.

Business Associate Agreement (BAA)

HIPAA requires a signed BAA between covered entities and their service providers.

✅ Pushwoosh offers a BAA for eligible customers.

Secure data hosting

PHI should be stored in physically secure, monitored environments—ideally within HIPAA-compliant infrastructure.

✅ Pushwoosh hosts data in compliant environments with physical and network-level security protocols in place.

Only necessary data use

Only the minimum amount of PHI should be used or stored for a specific task.

✅ Pushwoosh supports scoped data handling and granular targeting to meet this principle.

Consent and preference management

Users must willingly opt in to communication channels, and it should be easy to opt out. This applies to email, push, SMS, and in-app notifications.

✅ Pushwoosh centralizes consent management across all messaging channels, respecting user privacy settings at scale.

Deliverability and performance

HIPAA compliance is pointless if your messages land in spam. Deliverability is essential.

✅ Pushwoosh ensures 97% deliverability with smart sender reputation tools and email best practices.

But the real challenge is that email is rarely your only point of contact.

Why HIPAA compliance is especially tricky for mobile apps

Challenge #1: Multiple tools

Customer data isn’t siloed—it moves across your CRM, messaging platforms, databases, and analytics tools.

The consequences?

• Many tools only encrypt data in one direction
• Few offer true audit trails or access controls
• Cross-channel opt-in/opt-out preferences can be difficult to sync
• Most channels aren’t HIPAA-compliant by default

Challenge #2: Multiple channels

Your marketing strategy likely spans across several touchpoints, like push notifications, in-app messages, SMS, email, etc.

This omnichannel approach improves engagement but it also fragments compliance. HIPAA compliance isn’t channel-specific—it’s system-wide. One unsecured channel can break the chain and expose all of your communication to legal and regulatory risk.

HIPAA-compliant omnichannel messaging: Going beyond email

Most “HIPAA email providers” stop at the inbox. Pushwoosh is an officially certified HIPAA-compliant solution for email marketing and beyond.

Let’s walk through a few real-world use cases when omnichannel HIPAA-compliant messaging is required:

Use case 1: Medication reminders

If your app falls under HIPAA and you want to schedule a reminder for your app’s users to take their medication—via a push notification, an email, or an in-app message, depending on their preferred channel. It seems simple, but because this reminder is directly tied to a person’s health and identity, it counts as PHI under HIPAA.

The challenge:

1. Too much detail in the wrong place: Push notifications or emails that include medication names or conditions (e.g., “Time to take your blood pressure pill”) may expose PHI if previews are visible on a locked screen or shared device.

2. Unsecured delivery: If the reminder is sent through a provider that doesn’t support encryption or access control, the data could be intercepted or misused—leading to a breach.

The solution:

• Use neutral notification text (e.g., “You have a scheduled reminder”) and direct users to secure in-app content.
• Set up event-based automations that send reminders at the right time, based on user preferences and consent.
• Ensure all messages travel through HIPAA-compliant infrastructure with encryption at rest and in transit.

Use case 2: In-app health surveys

You want to collect health-related feedback or symptom check-ins through in-app surveys—perhaps to track mood, pain levels, or post-visit recovery. This data helps you personalize care or assess treatment outcomes, but because it relates to a person’s health and is tied to their identity, it qualifies as PHI.

The challenge:

• Unprotected survey submissions: If the data users submit isn’t encrypted or access-controlled, it could be exposed in transit or at rest.
• Lack of auditability: Without detailed logging, it’s hard to prove who accessed the data, when, and why—something HIPAA auditors require.

The solution:

• Build surveys into secure in-app messages, ensuring responses never travel through unsecured third parties.
• Restrict access to survey results delivered via email using password-protected attachments.
• Use time-based automations to schedule surveys post-interaction (e.g., 24 hours after a telehealth session without disclosing the name of the procedure).
• Track submissions with detailed audit logs and reporting features.

Use case 3: Lab results notifications

You need to notify users when their lab results are available, without revealing sensitive health data in the notification itself. These alerts are high priority, but must be handled with care to avoid exposing diagnosis-related information.

The challenge:

• Sensitive content in subject lines or previews: “Your HIV test results are ready” is a clear HIPAA violation if shown in a push preview or inbox.
• Unsecured click-throughs: If the link in the message goes to a non-encrypted or publicly accessible page, PHI can be exposed.

The solution:

• Send generic messages like “Your results are ready” without referencing the test type or condition.
• Direct users to a secure, authenticated portal using dynamic links generated through Pushwoosh.
• Use user tags and segments to automate follow-ups while keeping message content generalized.
• Enable encrypted click tracking and session-based link expirations for extra security.

Compliance doesn’t mean compromise

You don’t have to choose between HIPAA compliance and great user engagement.

Pushwoosh helps healthcare, wellness, and health-adjacent brands deliver secure, high-performing omnichannel experiences—without sacrificing speed or flexibility.