The following is an excerpt from Practice Perspectives: Vault's Guide to Legal Practice Areas.
Alexis S. 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 care topics. Focused on transactions in the digital health sector 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 telehealth companies, technology organizations, e-commerce, pharmacy and retail leaders, life sciences businesses, and investors seek her legal counsel on various digital health topics, including multijurisdictional business strategy and implementation, state-specific telehealth regulation, corporate practice of medicine, reimbursement, international programs, online prescribing, patient consent, 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 and current vice president, 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.
Describe your practice area and what it entails.
In short, I am a health regulatory attorney with a significant trans-actional background enabling me to structure, negotiate applicable documentation for, and advise clients on various multi-jurisdictional health regulatory strategies for advancing digital health services. This involves working with hospitals, health systems, global retail and pharmacy organizations, life science companies, investors, technology and big-data companies (large and small), and emerging virtual care networks in various transactional ventures, compliance counseling needs, and advice pertaining to regulatory investigations.
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 and health care needs spark the interest of many non-traditional participants, I am increasingly working with device manufact-urers, technology and big-data companies, large global retail organizations, e-commerce networks, and life sciences institutions as well.
What types of cases/deals do you work on?
My client work involves various digital health topics, including evaluating multijurisdictional strategy and implementation given various jurisdiction-specific health, data, reimbursement, and fraud regulations and requirements. 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 on various telehealth regulatory and transactional matters to the likes of 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, Onduo, PWNHealth, Ro Health, and Nurx—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 choose this practice 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 like and/or what are some common tasks you perform?
A typical day finds me fielding multiple calls with clients, evaluating research on various state and international health regulatory topics for application to a particular client’s novel virtual care offering, marking up contracts for client’s proposed partnership or acquisition given health regulatory considerations, 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 advise clients better on novel topics. 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 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 is the most challenging aspect of practicing in this 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 yield leadership opportunities. The insights and practical education you gather from industry meetings and publications are amazing, and the relationships you develop in these settings are 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 misconceptions exist about 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. While there are certainly health-care-specific laws and regulations unique to this sector, a practice in health care is an industry-focused practice more than a legal-skill-specific practice; thus, a keen understanding of the health care industry is critical. 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?
Jones Day is truly a team-oriented law firm, which is very fulfilling for a professional and essential to a digital health practice, since working in this sector often necessitates collaborating with IP, corporate, finance, and international colleagues. Given the transformational opportunity within digital health, it is truly satisfying to collaborate in a legal practice environment on the cutting edge, with partners who care deeply about supporting our clients in their endeavors.
What are some typical tasks that a junior lawyer would perform in this practice area?
Junior lawyers are the foundation of our digital health team. Given the multi-jurisdictional research necessary for various digital health projects, junior lawyers are frequently involved in researching and considering novel questions of state or international health and data privacy regulation. Given these research projects often involve teams of associates, they often enjoy and experience the collaborative nature that is a true hallmark of practice life at Jones Day. Notably, as the digital health sector remains an area of ongoing legal and policy interpretation—similar to other topics our attorneys are trusted to handle firmwide—associates, even the most junior, benefit from teaming side-by-side with partners on the application of health regulatory and data privacy research to collectively advance novel legal constructions applicable to not only client interests but also an evolving body of health law and policy.