What are enhanced conversions?
Enhanced conversions is a Google Ads feature that sends hashed first-party customer data, such as an email address or phone number collected at conversion, to Google so it can match more conversions to ad clicks and views. There are versions for website conversions and for leads. For healthcare practices it raises HIPAA questions, because hashed patient contact details can still be PHI.
- Uses hashed (SHA-256) email, phone, name or address from the conversion.
- Two forms: enhanced conversions for web and for leads.
- Improves measurement and bidding when cookies and click IDs fall short.
- HHS has said hashing does not de-identify data; get compliance review first.
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How enhanced conversions work
When a person converts, for example by submitting a form, the site's Google tag or an API collects details the person entered, such as email address and phone number. These are normalized and hashed with the SHA-256 algorithm before being sent to Google. Google compares the hashed values with hashed data from signed-in Google accounts to link the conversion to an earlier ad interaction.
Enhanced conversions for web works on the website at the moment of conversion. Enhanced conversions for leads works with offline conversion import: the practice captures hashed contact details with the lead, then uploads them later when the lead converts in the CRM, such as when an appointment is booked.
The goal is more complete measurement as browsers limit cookies and users decline tracking. Better data also feeds Google's automated bidding.
How it applies to practice marketing
- Treat hashed contact data as PHI when it comes from patients or prospective patients giving health information to a covered entity.
- Check where the tag fires: booking, intake and condition forms are the highest-risk places.
- Know the vendor position: Google's ad products generally are not covered by a BAA, and Google's policies restrict using sensitive health information in ads data.
- Consider alternatives: some practices use only de-identified conversion events, or limit enhanced conversions to non-health forms such as careers or general newsletter sign-ups.
- Document the decision and who approved it.
See the HIPAA-safe Google Ads guide, the HIPAA-safe tracking guide and what a BAA covers.
Common mistakes and limits
The most common mistake is turning on enhanced conversions with automatic detection across a whole healthcare website. Automatic setups can pick up fields from forms the practice did not intend to include. Another is assuming hashing makes data anonymous. HHS guidance on tracking technologies has said that hashed identifiers are still identifiable for HIPAA purposes.
There is no single answer for every practice. A cosmetic-only practice, a hospital and a behavioral health clinic face different risks and state laws, such as consumer health data laws in some states. Make the decision with your compliance or legal team before enabling the feature, and recheck after website changes. Keep a written record of which conversion actions use enhanced conversions, which forms feed them and who approved the setup, so it can be audited later.
Related pages from the US team
HIPAA-safe Google Ads
Tracking and audiences without PHI.
HIPAA-safe tracking guide
What to send, and what not to.
Healthcare PPC agency, USA
Compliant Google Ads management.
US healthcare marketing glossary
Every term, defined in plain English.
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We benchmark your last 90 days, agree monthly goals with you, and track them live on Ichelon Agency OS with a report every Monday. Performance-Linked Payout Models are available. Our US leadership is based in Dallas, and strategy calls run in US business hours.
Common questions
What are Google Ads enhanced conversions?
A feature that sends hashed first-party data from a conversion, such as email address or phone number, to Google so it can match the conversion to ad interactions more reliably. There are versions for website conversions and for leads that convert offline.
Does hashing make enhanced conversion data HIPAA safe?
Not by default. HHS has said hashing identifiers does not de-identify them under HIPAA. If the data comes from patients or prospective patients sharing health information with a covered entity, sending it to an ad platform generally needs a lawful basis.
Can a medical practice use enhanced conversions?
Some can, with care and compliance review. Many practices limit it to forms without health information, use only de-identified conversion events, or skip it. The answer depends on the forms involved, state laws and the practice's risk tolerance.
What is the difference between enhanced conversions for web and for leads?
Enhanced conversions for web sends hashed data at the moment of a website conversion. Enhanced conversions for leads captures hashed data with the lead and uploads it later, when the lead converts offline in a CRM, such as a booked appointment.
A note on this guide: it explains marketing practice, not legal advice. Rules on privacy, advertising and insurance change and vary by state, so confirm anything compliance-related with your own counsel.
Considering enhanced conversions on a health website?
Book a 30-minute call. We'll review which forms are safe to measure and where to keep data out.