The following is an excerpt from Practice Perspectives: Vault's Guide to Legal Practice Areas.
Alexis Gilroy—Partner, Health Care
Alexis Gilroy, a national leader in the digital health industry, advises on complex transactional and health regulatory issues, with an emphasis on virtual health methods.
Focused on transactions in the digital health and health information technology (HIT) sectors for more than a decade, Alexis pairs practical experience with a keen understanding of novel federal and state regulatory requirements. Hospitals, health systems, and other health care providers across the U.S., as well as virtual health companies, technology organizations, e-commerce, pharmacy and retail leaders, life sciences businesses, and investors, seek her legal counsel on various e-health topics, including multijurisdictional business strategy and implementation, state-specific telehealth regulation, corporate practice of medicine, reimbursement, international second-opinion and telehealth programs, online prescribing, patient consent, credentialing by proxy, remote supervision, and fraud and abuse considerations.
Alexis speaks and writes extensively on matters involving digital health and has testified before legislative and regulatory bodies. A member of the board of directors of the American Telemedicine Association, she was an appointee to the Maryland Governor’s Telemedicine Task Force, a member of the Federation of State Medical Boards’ Workgroup on Telemedicine, and leader of the American Health Lawyers Association’s Telemedicine and E-Health Affinity Group.
Please provide an overview of what, substantively, your practice area entails.
In short, I am a health regulatory attorney with significant transactional background enabling me to structure, negotiate applicable documentation for, and lead various national and international health regulatory strategies for digital health providers, organizations, and investors.
What types of clients do you represent?
My historic client base includes investors and health care providers of all types (hospitals, health systems, and virtual care or telehealth organizations) operating in the U.S. and abroad. However, as digital health opportunities evolve, I am increasingly working with device manufacturers, technology companies, retail organizations, and life sciences institutions as well.
What types of cases/deals do you work on?
My client work involves various e-health topics, including multijurisdictional business strategy and implementation, state-specific telehealth regulation, corporate practice of medicine, reimbursement, international second-opinion and telehealth programs, online prescribing, patient consent, credentialing by proxy, remote supervision, and fraud and abuse considerations. I frequently develop and negotiate telehealth-specific services and affiliation contracts and manage health regulatory matters for M&A and equity transactions with both investor/buy-side and company/target-side experience. I’ve assisted retail organizations such as Wal-Mart and Walgreens in digital health pursuits, while providing support with various telehealth regulatory and transactional matters to Cleveland Clinic, Dignity Health, Houston Methodist, Loma Linda, Northwell Health, UPMC, and a number of other hospitals and health systems. My work with new “all virtual” emerging companies such as Specialists on Call, PWNHealth, and DirectDerm is particularly interesting and novel, as we assist clients in standing-up national telehealth operations compliant with all applicable state health care laws and requirements, while also negotiating and documenting arrangements with various customers and providers across the U.S.
How did you decide to practice in your area?
Thanks to a long-standing passion for and interest in health policy, my senior associate years found me managing numerous M&A and finance transactions for various early digital health and telehealth businesses. The relationships with these emerging companies, as well as their energy and promise, were compelling. I was hooked and wanted to be part of the digital health transformation. It was a very natural transition to digital health on a full-time basis. Digital health allows me to pair a background in transactional practice (often requiring a keen understanding of the business motives driving health care deals) with a subsector of health law mired in evolving business-oriented policy at the federal, state, and international levels.
What is a typical day or week like in your practice area?
A typical day finds me fielding multiple calls with clients and meeting with team members from our U.S. and international offices to consider unique regulatory questions for various digital health clients. I enjoy the ability to grow relationships with many different colleagues and clients, and the constant learning advances our collective experiences to better advise clients on novel topics.
What is the best thing about your practice area?
Every day I get to help clients solve new and interesting challenges to advance health care needs for consumers around the globe, working with colleagues who are engaged and extremely talented. We are playing a role in advancing what’s possible in health care delivery. What could be better?
What is the most challenging aspect of your practice area?
Digital health is constantly evolving, and while this is intellectually stimulating, it necessitates a commitment to tracking the stakeholders and the underlying business trends and policy-driving motives in the sector. Over the years, I’ve found that the most fulfilling way to manage this is to jump in and engage with health care-sector groups (not necessarily law-oriented). Sometimes just showing up and volunteering will lead to leadership opportunities. The insights and practical education you gather from industry meetings and publications are amazing; the relationships you develop in these settings are also tremendous and provide fulfilling connections to expand your referral network and resources for questions and mentoring. While the time involved in these professional-development activities isn’t typically billable or specific to one client, the returns, in terms of the level of guidance you are able to provide to clients, are priceless.
What training, classes, experience, or skills development would you recommend to someone who wishes to enter your practice area?
Classes in health law, technology law (including intellectual property topics), and cybersecurity, along with any practical business planning or transactional-oriented classes or clinics, would help build the foundation for a practice in digital health law. I found my classes with adjunct professors to be especially helpful for practicing in a transactional area. A course in accounting or on health policy is also likely to provide useful perspectives.
What misconceptions exist about your practice area? What do you wish you had known before joining your practice area?
Health care is a multifaceted industry with many players and incentives, and I wish I had understood in more detail the various stakeholders and their motives early in my career. Attorneys with provider, payor, or health care administrative exposure prior to law school have unique insights into the operational issues within the industry—a topic valuable to any health care attorney.
What is unique about your practice area at your firm, and how has it evolved since you have been at the firm?
Jones Day is truly a team-oriented law firm, which is very fulfilling for a professional and essential to a digital health practice, since it often necessitates collaborating with IP, corporate, finance, and international colleagues. Given the transformational opportunity within digital health, it is also reassuring to work in an environment that is on the cutting edge, with partners who care deeply about supporting our clients in their endeavors.
What activities do you enjoy when you are not in the office, and how do you make time for them?
When I’m not in the office, with a client, or supporting an American Telemedicine Association or other industry effort, you’ll find me enjoying time with my husband and two boys on a hike or at a Navy game; working in the garden; or playing tennis or golf. I’ve found that you make time for the things which mean the most to you, and frankly, the practice of law offers tremendous flexibility compared to careers that tie you to a specific location day in and day out for a specific period of time. It may mean that your day starts early or ends late, but you can certainly manage it. I have also found ways to combine family trips with professional conferences, and I believe both my family and my clients benefit. There is nothing like bonding with a client at an event to which you have both brought your children, and the kids gather valuable lifelong lessons as well.