Is Gmail HIPAA compliant?

Healthcare organizations, other HIPAA covered entities, and business associates need to ensure that the software products and applications used in their IT environments enable them to maintain HIPAA compliance. Everything from accounting programs to email solutions needs to implement the necessary functionality to ensure the safety of electronic protected health information (ePHI).

Gmail is one such application that's widely used by individuals and businesses. A Google product, Gmail provides free accounts suitable for personal use as well as more functional commercial options appropriate for implementation in a business setting.

But is Gmail HIPAA compliant? The short answer: Yes, Gmail is HIPAA compliant, but only with proper setup and precautions.

The most basic Gmail accounts are not designed to secure ePHI according to HIPAA regulations. However, organizations can take measures to raise the level of security provided by Gmail so it meets HIPAA compliance guidelines and supports the transmission of ePHI.

In this guide, we'll explore Gmail's limitations and what you can do to ensure that your organization is using Gmail in compliance with HIPAA regulations.

In this article: 

• The importance of HIPAA-compliant email platforms
• Is Gmail HIPAA compliant out of the box?
• What steps are needed to make Gmail HIPAA compliant?
• How data loss prevention supports HIPAA compliance
• Frequently asked questions

Th‎e importance of HIPAA-compliant email platforms

‎Violating HIPAA regulations through email can have serious consequences, including severe penalties. The penalties for violating HIPAA via email are just as severe as any other violations, with fines ranging from $100 to $50,000 per violation, and an annual cap of $2,067,813 million per incident. These penalties can have a significant financial impact on organizations that fail to comply with HIPAA regulations.

HIPAA violations can result in both civil and criminal penalties, with fines that are scaled based on the level of accountability. This means that the severity of the violation and the extent of the harm caused will be taken into consideration when determining the fines.

In addition to financial penalties, organizations that violate HIPAA regulations may also face a tarnished reputation, which can have long-lasting effects on their business.

It's crucial for organizations to ensure that they have proper safeguards in place when it comes to email communication, especially when dealing with sensitive patient information. Implementing secure email platforms that are HIPAA compliant can help mitigate the risk of violating HIPAA regulations and protect both the organization and the patients' privacy.

Is‎ Gmail HIPAA compliant out of the box?

‎‎Like other Google services like Google Meet and Google Voice, Gmail is not inherently HIPAA compliant and does not meet all the requirements for protecting ePHI. One of the key shortcomings of Gmail is the lack of email encryption for ePHI, which is a crucial aspect of HIPAA compliance.

Healthcare providers have two options when it comes to using email services in compliance with HIPAA. They can either prohibit the use and disclosure of ePHI in emails, except when patients request confidential communications via email, or they can ensure that the email service they use is HIPAA compliant.

For an email service to be HIPAA compliant, it must support compliance with the Administrative, Physical, and Technical Safeguards of the HIPAA Security Rule through a set of controls and monitoring capabilities.

Additionally, the vendor of the email service must be willing to enter into a Business Associate Agreement. This agreement ensures that the vendor will handle ePHI in a secure and compliant manner.

Companies subject to HIPAA standards need to be aware of the limitations of basic Gmail accounts. The platform’s free version is not HIPAA compliant, as it does not meet the safeguards outlined in the HIPAA Security Rule. This rule defines administrative, technical, and physical safeguards that must be implemented to meet compliance requirements.

The following limitations make free consumer Gmail accounts unsuitable for HIPAA compliance.

• Encryption - Data is not encrypted by default in Gmail. Without implementing encryption, sending ePHI in an email is a violation of HIPAA guidelines.
• Account access and authentication - The default access and authentication techniques used by Gmail do not meet HIPAA standards for the protection of ePHI. For example, there is no way to tell who has accessed emails containing ePHI with a default Gmail implementation. Users can log into their accounts with a single password that may not be strong enough to defend against brute-force hacking attempts.

In general, an organization must upgrade to a commercial Google Workspace subscription to achieve HIPAA compliance. This type of subscription offers the functionality required to meet HIPAA requirements.

Wh‎at steps are needed to make Gmail HIPAA compliant?

‎‎Healthcare organizations can use Gmail as their email platform and be confident of HIPAA compliance by taking the following steps.

Purchase a Google Workspace subscription

Gmail HIPAA compliance requires a Google Workspace subscription. This type of subscription is dependent on the other security measures in place to protect the environment. Companies with monitoring and account access management solutions may be able to use a limited business plan and meet HIPAA standards.

Google Workspace offers businesses a 14-day free trial to test Gmail for Business with a customized domain name. This trial period allows businesses to experience the features and functionality of Gmail for Business in their own environment.

During the trial, businesses can also benefit from on-call support provided by Google's technical team. This support ensures that businesses have access to assistance if they encounter any issues or require guidance during the trial period.

‎A Workspace Enterprise Plan is required for companies that have not implemented other means to secure email communication. This type of plan provides the necessary monitoring and access controls to secure ePHI with the Security Center. It also furnishes additional security with a Vault feature to archive sensitive emails and built-in data loss prevention capabilities.

Enter into a Business Associate Agreement (BAA) with Google

HIPAA standards require companies to enter into a BAA with third parties that handle ePHI for them. Organizations need to complete the necessary paperwork to ensure they have a valid BAA in place to maintain HIPAA compliance.

Configure Workspace security settings

It is essential to properly configure security settings within Google Workspace. Specific areas to concentrate on include:

• Requiring strong passwords by implementing a password complexity policy
• Enabling multi-factor authentication (MFA) to provide additional protection against compromised credentials being used to access ePHI
• Configuring role-based access controls (RBAC) to restrict user access to ePHI to align with their job requirements 

Google has produced a HIPAA Implementation Guide for all Workspace services, including Gmail, which explains the controls available to ensure messages are only opened by their intended recipients and that messages containing ePHI are not forwarded to third-party recipients.

Implement data encryption

‎‎Encryption should be implemented with the native capabilities available in Google Workspace. The admin console allows you to enable email encryption. This will protect emails sent with the Workspace environment.

Even though Google Workspace can be configured to comply with HIPAA regulations, there may still be encryption gaps in the email setup of recipients. This means that the security of email communication depends on both the sender's and recipient's email servers supporting Transport Layer Security (TLS).

If the recipient's server does not utilize TLS, the connection will be insecure and could potentially violate HIPAA regulations. Additional HIPAA-compliant encryption solutions that can protect data even if a recipient’s server does not support Transport Layer Security (TLS) may be required. This provides an extra layer of security to prevent unauthorized access to patient data during email transmission.

Train employees on HIPAA compliance

Training, policies, and procedures play a crucial role in ensuring Gmail HIPAA compliance. Organizations need to provide ongoing training to their employees on how to correctly use programs like Gmail and incorporate email practices for HIPAA compliance into their policies and procedures.

Employees may be familiar with how Gmail works, but they may not be as conscious of privacy and security when emailing friends and family members. HIPAA training specifically tailored to Gmail usage can help prevent bad habits from carrying over into the workplace.

Additional steps

Additional measures that can be taken to secure Gmail include:

• Regularly updating all Google Workspace applications to address newly discovered vulnerabilities
• Offering user education that stresses the importance of protecting ePHI in the environment
• Developing data handling policies that restrict unauthorized use of ePHI
• Conducting regular HIPAA compliance audits to ensure your organization remains compliant.

Ho‎w data loss prevention supports HIPAA compliance

‎A data loss prevention (DLP) platform supports HIPAA compliance by prohibiting deliberate or accidental misuse of an organization’s ePHI. The software accomplishes this feat by automatically enforcing an organization’s data handling policy which should define who can access ePHI and under what circumstances it can be used.

The Reveal Platform by Next is an advanced DLP solution that prevents any type of unauthorized use of ePHI and any other sensitive data in your environment. The platform employs endpoint agents powered by machine learning to restrict the unsafe use of ePHI. For instance, the tool will prohibit users from sending unencrypted ePHI via email.

Companies can schedule a Reveal demo to see how easy it is to provide advanced protection for ePHI and maintain HIPAA compliance. Contact our DLP experts to get started today.

Fr‎equently asked questions

Why is multi-factor authentication important for Gmail accounts?

Multi-factor authentication is important for protecting email accounts to limit the possibility that a single compromised password can expose a mailbox full of messages containing ePHI to threat actors. Forcing users to authenticate their identity using multiple methods is a proven technique for enhancing the security of Gmail as well as any account that contains sensitive information.

What is considered a strong password for protecting a Gmail account?

A password strong enough to protect a Gmail account containing ePHI should meet the following criteria.

• Length should be at least eight characters with more being better.
• Complexity should be enforced by requiring a mix of upper and lowercase letters, numbers, and special characters.
• Avoid common patterns and personal information that may make a password easy to guess.
• Enforce password expiration and history requirements to ensure passwords are changed regularly and old passwords are not repeated.

How does Reveal help protect ePHI in a Gmail environment?

Reveal helps protect ePHI in a Gmail environment by restricting all unauthorized use of this sensitive information. The platform ensures that unauthorized individuals cannot access ePHI and that any intentional or accidental misuse is prohibited. Reveal will not allow users to attach unencrypted ePHI to a Gmail message which would risk a data breach.