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Telehealth4Ukraine, led by CTeL and its partners, is working to compile a living database of healthcare clinicians who are interested in mobilizing to provide virtual humanitarian healthcare services in Ukraine and the surrounding region. This living database will be provided to a NGO on the ground who understands the critical and complex medical needs of Ukrainians and displaced citizens. Please complete this no-obligation interest form to learn more about the next steps and receive updates
- Contact Us
- info@CTeL.org
- 202.499.6970
Coalition Leaders
Dale Alverson, MD
Professor Emeritus and former Director of the Center for Telehealth, University of New Mexico
Dr. Alverson is Professor Emeritus and Regents’ Professor at the University of New Mexic. He is a former President of the American Telemedicine Association and has been involved in collaborative international programs to advance Telehealth nationally and globally, including consultation in the development of specific applications in collaboration with other countries. He is also a widely published and known presenter at national and international conferences regarding health information technologies, telehealth, and the digital transformation of healthcare.
Bryan Arkwright
Founder & Chief Research Officer - Cromford Health | Adjunct Faculty - Wake Forest University School of Law | Editorial Board Member - Partners in Digital Health
Bryan’s healthcare experiences to date include 16+ years working with Telehealth / Telemedicine / Virtual Care / Digital Health across integrated Health Systems, Academic Medical Centers, Startups, Higher Education (Research & Teaching), Established Technology Companies, and Consulting. He has over 30 published works across different books, book chapters, peer-reviewed journals, and industry articles and speaks/teaches CME regularly on the topic of digital health / telehealth since 2014 at regional, national, and international conferences/universities
• Founder and Chief Research Officer, Cromford Health
• Adjunct Faculty, Wake Forest University School of Law
• Adjunct Faculty, Ohio University, College of Health Sciences and Professions
• Seminar Series Invited Speaker, Ohio University, College of Health Sciences and Professions
• Healthcare Advisory Board, Transact Capital, LLC – Private Equity
• Editorial Board Member, Telehealth and Medicine
FRANCK BAUDINO
CEO and Founder of H4D
Dr. Franck Baudino is the CEO and Founder of H4D, an innovative French company that offers a connected medical office/booth solution, The Consult Station®. This first multi-disciplinary connected medical practice provides remote medical care for patients throughout their care pathways. Drawing on a network of doctors trained for remote consultations, H4D deploys its solutions both in France and internationally.
Dr. Baudino began his career as a doctor while simultaneously dedicating time to a large number of international organisations to cater to underserved areas and humanitarian missions in developing and emerging countries.
Besides his medical degree, Dr. Baudino also has a degree in Political Science and has spent much of his career designing better health delivery systems. He serves as an advisor to several private and public entities.
Gregory Ciottone, MD, FACEP, FFSEM
President, World Association for Disaster and Emergency Medicine, Founder, Beth Israel Deaconess Medical Center Fellowship in Disaster Medicine, Associate Professor of Emergency medicine, Harvard Medical School, Director, Medical Preparedness for the National Preparedness Leadership Initiative
Dr. Ciottone is an emergency physician and the President of the World Association for Disaster and Emergency Medicine. He is the Founding Director of the Beth Israel Deaconess Medical Center Fellowship in Disaster Medicine, as well as an Associate Professor of Emergency Medicine at Harvard Medical School, and an Instructor in the Department of Health Policy and Management at the Harvard T.H. Chan School of Public Health (HSPH). Dr. Ciottone is also the Director of Medical Preparedness for the National Preparedness Leadership Initiative, a joint program of the HSPH and the Harvard Kennedy School of Government, and has been serving as a consultant to the White House Medical Unit for over 10 years.
Dr. Ciottone’s clinical and field experience includes 25 years as a practicing emergency physician and over 500 missions as a flight physician on an aeromedical helicopter service. He has conducted educational programs in more than 30 countries around the world and has served as a disaster response fellowship director for the International Atomic Energy Agency. Dr. Ciottone has written over 150 scholarly works, including the first and second editions of his textbook Ciottone’s Disaster Medicine, and is the 2018 recipient of the American College of Emergency Physicians Disaster Medical Services Award, and the 2020 recipient of the American Academy of Disaster Medicine Distinguished Service Award.
Lisa Darsch, MSN, RN
Founder, Global Nurse Consultants Alliance (GNCA)
Lisa Darsch, MSN, RN, finds innovative solutions to global healthcare challenges by drawing on a unique mix of hands-on clinical nursing knowledge plus expertise in international policy, strategy, and health finance.
Operating at the intersection of education, health and entrepreneurship, Lisa guides global health organizations on project strategy, education design, and data-driven quality initiatives. She has achieved impressive results in improving patient outcomes, education and training, workforce development and universal healthcare access, working with key world health projects designed to meet Sustainable Development Goals (SDGs). She builds strong relationships with international health ministries, governments and companies across continents, and is currently working on projects in the U.S., Europe, Africa and India.
Lisa also inspires change as a public speaker and thought leader at major world events, and is passionate about empowering the next generation of nurses with tech innovation and other education methods. She actively practices and teaches nursing to engage with current clinical trends.
As an expert in U.S. and international healthcare finance, Lisa is also passionate about boosting health systems’ effectiveness by innovating and improving financial strategy. She has received the Follmer Bronze award from the Healthcare Financial Management Association (HFMA), for excellence in healthcare finance education, and regularly publishes in Healthcare Financial Management (HFM) magazine.
Ali Golshan, MD, MBA
Owner | Braid Medical Group
Ali Golshan, MD, is board certified and fellowship trained vascular and interventional radiologist specializing in the minimally invasive image guided treatment of vascular disease.
Dr. Golshan was inspired to study interventional radiology after the sudden death of his father due to a massive subarachnoid hemorrhage. Inspired by his father’s values, Dr. Golshan strives to give each patient personalized attention and exceptional care during every visit.
After graduating summa cum laude as valedictorian with a Bachelor of Science in molecular biology from the University of California, in Los Angeles (UCLA), Dr. Golshan earned a Master of Business Administration from the UCLA Anderson School of Management. He then earned his doctorate of medicine from the UCLA David Geffen School of Medicine.
Dr. Golshan completed his residency in radiology at UCLA. He went on to complete a fellowship in interventional radiology at Johns Hopkins University in Baltimore.
Dr. Golshan has a practice in Los Angeles, California and is also working on two early-stage startups: a minimally invasive medical device and a tech-enabled chronic disease management platform.
Michele Griffith, MD
Founder & President - 21st MD | Practicing Physician - TIAA Living Well, Health and Wellness Center | Medical Director - Premise Health
Dr. Michele Y. Griffith is a practicing physician specializing in Internal Medicine and Integrative Medicine at the TIAA Living Well, Health and Wellness Center in Charlotte, North Carolina. She has been a Medical Director for Premise Health for the last decade. She is also the founder and president of 21stMD, the virtual component of a Doctor in the House, PLLC and platform for health advocacy, wellness consulting, and telemedicine patient care.
Premise Health is a leading worksite healthcare company in the United States. Its worksite health model is designed to achieve better patient engagement through the delivery of quality healthcare and wellness programs that sustainably improve health outcomes of worksite and distributed workforces. Premise Health operates over 500 onsite health centers, pharmacies, and fitness centers in 46 states and 2 U.S. territories.
Combining her roles at Premise Health with her love of technology, Dr. Griffith is currently exploring the use of telemedicine as a tool to expand the delivery of integrative primary care. the occupational setting is a natural access point to reach a large percentage of working Americans. Nearly 30% of companies with more than 5,000 employees have on-site or near-site clinics offering some type of primary care.
The confluence of integrative medicine, large employer onsite clinics and telemedicine is a natural one” – Dr. Griffith
Dr. Griffith believes the synergistic potential of increased access, improved outcomes, and cost savings are substantial.
She has extensive experience as a primary care physician. 21stMD was launched to promote and advocate for the expanded use of technology and telemedicine as a mechanism to enhance access to high-quality healthcare for the unserved and underserved globally.
Dr. Griffith is board-certified in Internal Medicine and Integrative Medicine. A graduate of Columbia University College of Physicians and Surgeons, and has completed her Internal Medicine residency at Harvard Medical School/Mount Auburn Hospital. She completed her undergraduate studies at the University of Pennsylvania.
Michael Kotler, MD
President and CEO, RemoteMD; Medical Director, Chevron; Medical Director, Transocean
Michael D. Kotler, MD, is President and CEO of RemoteMD, a group of companies founded for the purpose of providing high quality medical care to people working and living in remote locations around the globe. RemoteMD's list of clients includes hundreds of companies large and small, including Archer Daniels Midland, Union Pacific Railroad, Chevron, Transocean, Noble Drilling, Maersk, Superior Energy Services, Schlumberger, and Motion Pictures & Television, to name just a few.
Dr. Kotler also currently serves as Medical Director for Chevron Corporation, Transocean, Schlumberger, Maersk, Union Pacific Railroad, Louisiana Offshore Oil Platform (LOOP), and Plaquemines Medical Center. In addition, he is on the teaching faculty at LSU School of Medicine in New Orleans and is the Program Director for “Occumedics,” a course he developed for advanced practice in the remote environment.
After retiring from his Regional Medical Director position for a nationwide emergency medicine group in 1998, Dr. Kotler conceptualized what turned out to be the first and arguably the most successful urgent care facility in the Greater New Orleans area, Pelican State Outpatient Center, which had more than 27,000 patient visits last year. Taking full advantage of his strategic location adjacent to the Gulf of Mexico and the oil and gas industry of southern Louisiana, Dr. Kotler built Pelican State into a world class provider of occupational medicine.
Multinational corporations began turning to Dr. Kotler for their offshore solutions for treating illness and injuries onsite in remote environments. Identifying the need for a higher level of care for these remote industrial environments, Dr. Kotler established RemoteMD. In its early days RemoteMD provided simple telephonic telemedicine. With deepwater drill rigs growing in size and complexity and venturing farther and farther offshore, and with exploration vessels venturing to the far reaches of the globe, the challenges became obvious. Recognizing the practice of telemedicine as so much more than just a technological solution, Dr. Kotler began to build a system to assure competence in its delivery. The system has since evolved into a family of companies: RemoteMD, RemoteMD Education & Training, RMD Technology Group, RemoteMD Medical Services, and RMD International K-9 & Security Services. Despite each company existing as an autonomous unit, together they represent a safe, secure and efficient medical system for the practice of real telemedicine, differentiating it from what he calls "tele-triage.”
Today RemoteMD delivers a variety of services to remote industrial sites, including 24/7/365 medical control, the provision of highly trained and educated paramedic and nurse "physician extenders" deployed worldwide, the provision of sophisticated, proprietary, highly encrypted & compressed HD telehealth camera systems, and the provision of sophisticated medical equipment, medical supplies, and a lengthy and sophisticated formulary of medications. When combined in the proper setting, all of these modalities together represent a legitimate, medically safe, secure, and efficient healthcare delivery system with tremendous implications, the most important one being the capability to practice real medicine remotely.
S. Yunkap Kwankam, PhD
Founder & Chief Executive Officer - Global eHealth Consultants | Chair - Innovation Working Group Task Force | Executive Director - International Society for Telemedicine and eHealth
Prof. S. Yunkap Kwankam is a world-renowned expert on digital health. He holds a Ph.D. in electrical engineering, and was elected to the following American honor associations; Eta Kappa Nu (Electrical Engineering), Tau Beta Pi (Engineering), and Sigma Xi (Research). He is currently CEO of Global eHealth Consultants, a Geneva-based consultancy, which has developed national digital health policies and strategies for several countries and international organizations.
He is also Executive Director, International Societ for Telemedicine and eHealth (ISfTeH), and served on several digital health advisory bodies including the Global Alliance for Health and Social Compact Advisory Board, World Economic Forum’s Global Agenda Council on Digital Health, Innovation Working Group Task Force on the Global Knowledge Commons for m-eHealth (Co-Chair), International Council of Nurses eHealth Strategy Advisory Group, and the Mobile Health Global Advisory Committee.
Prof. S. Yunkap Kwankam is also affiliated with roles such as being the Chief Innovation Adviser for the Care Innovation Corporation, a Co-Chair at the African Development Bank eHealth Awards Committee, being part of the WHO-PMNCH Advisory group on ICT for health, and part of the Board of Directors at SatelLife.
As a founding eHealth Coordinator at the World Health Organization Headquarters at Geneva (2004-2008), he was responsible for overall coordination of eHealth across the Organization. Before joining WHO in 2001, he was a Professor and Director of the Center of Health Technology at Yaounde, Cameroon.
Along with Prof. S. Yunkap Kwankam’s accomplishments, he also served as a consultant to WHO, ITU, UNIDO, the World Bank, and the US National Library of Medicine (NLM).
Jarone Lee, MD, MPH, FCCM
Vice Chief of Critical Care for the Division of Trauma, Emergency Surgery, Surgical Critical Care Medical Director of the Blake 12 Intensive Care Unit - Massachusetts General Hospital
Dr. Jarone Lee is the Vice Chief of Critical Care for the Division of Trauma, Emergency Surgery, Surgical Critical Care and the Medical Director of the Blake 12 Intensive Care Unit at Massachusetts General Hospital. He is dual trained in emergency medicine and critical care medicine. Dr. Lee holds the rank of Associate Professor at Harvard Medical School and has over 150 research publications and book chapters. He also serves as a Chief Medical Officer for MA-1 Disaster Medical Assistance Team (DMAT) in US Department of Health and Human Services (HHS) within the National Disaster Medical System (NDMS). He is a flight validated critical care physician with the NDMS Aeromedical Evacuation Team.
Dr. Lee is an advisor to the U.S. Government’s National Emergency Tele-Critical Care Network (NETCCN) and Massachusetts General Hospital’s program on medical device interoperability & cybersecurity (MD PnP).
Irving Kent Loh, MD, FACC, FAHA, FCCP, FACP
Co-founder & Chief Medical Officer of Infermedica
Dr. Irving Kent Loh is Co-founder & Chief Medical Officer of Infermedica, an artificial intelligence healthcare company. He is also a board-certified internist & subspecialty board-certified cardiac specialist.
Dr. Loh served as the past chair and member of the Technology & Innovation Committee. He was also one of the board of directors at the California Chapter of the American College of Cardiology where he organized & chaired a Colloquium on Artificial Intelligence Technology, and the Future of Cardiology.
At the Stanford School of Medicine, Dr. Loh was an esteemed Adjunct Lecturer in the Department of Medicine. He took his internal medicine residency and receive his MD at UC San Francisco.
Currently, Dr. Loh serves on 2 AI4H working groups for the International Telecommunication Union of the World Health Organization where he tackles Artificial Intelligence for Symptom Assessment & AI for Clinical Evaluations.
Dr. Loh is also a consultant and advisor to technology and telemedicine companies. He has been the principal investigator on over 160 clinical trials and was a TEDx speaker on the validation of medical advances with randomized, placebo-controlled clinical trials. He also has written a monthly healthcare newspaper column since 2000.
John Mattison, MD
Chief Medical Information Officer and Operating Partner - Arsenal Capital Partners
Physician, CMIO, HealthTech pioneer, International Interoperability standards founder, Co-editor of McGraw Hill Textbook on medical informatics, and author of many publications across healthcare technologies. Advisor to numerous startups and companies. Co-led EHR implementation, digital transformation, virtual care and remote monitoring for large healthcare system for over two decades. Currently CMIO and Operating Partner in Healthcare investment at ACP.
I think the only thing that we are missing is Ben’s bio, which I will have him send over.
Joseph McMenamin, MD, JD
Principal - McMenamin Law Offices
Joseph P. (“Joe”) McMenamin is the principal at McMenamin Law Offices (“MLO”). In Richmond, Virginia. Nearly all of MLO’s practice is devoted to advising companies and providers on digital medicine issues.
Dr. McMenamin has been involved in distance care since the mid-1990s. Before being admitted to the bar, Dr. McMenamin practiced emergency medicine at hospitals in Pennsylvania and Georgia on a part- time and full-time basis over a seven-year period overlapping his specialty training and legal education. He presently serves as General Counsel to the Virginia Telemedicine Network and as an associate professor of Legal Medicine at Virginia Commonwealth University. He also is a member of CTeL’s Legal Resource Team. He is board-certified in legal medicine and a Fellow of the College of Legal Medicine.
Ann Mehra
Strategic Data Analytics & Artificial Intelligence Leader, Splunk
“At Splunk, Ann Mehra serves as a trusted advisor with deep expertise in Machine Learning (ML), Artificial Intelligence (AI), Big Data, Cloud Computing (AWS, Microsoft, Google), Medical Device Security and Analytics, Telehealth Solutions Management for Commercial, Federal, SLED, and channel/Partners/SIs. Ann has had the fortunate experience to contribute and learn alongside some amazing leaders and innovators at Harvard University, Booz Allen Hamilton, Merck Pharmaceuticals, Sun Microsystems, Accenture, and CA Technologies.
Throughout her career, Ann has worked to build and evangelize on the AI data-to-everything platform leading to advances in R&D, solve complex data analytics challenges, and collaborating with strategic partners to make the world better for all.”
Rajiv Narula, MD
Chief Medical Officer - Sevaro Health
Dr. Narula’s passion for healthcare and technology has established him as one of today’s most impactful healthcare leaders. With his experience from University of California, San Diego and as former Director of Teleneuroscience at Cooper University Hospital, his goal is to make neurological care accessible and affordable to those who need it the most. His vision is to take proven methodologies while combining data, logistics and compassion to improve patient outcomes.
Christa Natoli
Executive Director - Center for Telehealth and eHealth Law (CTeL)
Christa Natoli is responsible for developing CTeL’s strategic mission. Ms. Natoli provides direct legal, regulatory, policy and consultative research services to the telehealth, investment, employer and tech community.
Ms. Natoli has extensive policy experience and knowledge in the areas of physician and nurse licensure, Internet prescribing, e-consultations, Medicaid reimbursement, mHealth, and international telemedicine. As CTeL’s Executive Director, Ms. Natoli has led research efforts on these topics. She is a published author and noted lecturer and speaker.
Before serving as CTeL’s Executive Director, Ms. Natoli assisted in editing former Pakistani Prime Minister Benazir Bhutto’s best-seller, Reconciliation: Islam, Democracy and the West, for which she received a special thank you in the book’s acknowledgments. Ms. Natoli is a graduate of Harvard University.
Jay Ostrowski, MA, LPC/S, NCC, ACS, BC-TMH
Chief Executive Officer - Adaptive Telehealth
Jay Ostrowski is a seasoned telehealth thought leader, pioneer, product/service developer, and telehealth subject matter expert.
His official roles are as the CEO of Behavioral Health Innovation and AdaptiveTelehealth.com where he develops and deploys programs for telehealth, telemental health, telebehavioral health and teleMAT, and designs HIPAA-secure (compliant) software applications (like Adaptive Telehealth). He also serves as a telehealth subject matter expert, consultant, trainer and implementation partner for the Mid-Atlantic Telehealth Resource Center, universities and health departments, and directs the Telebehavioral Health Center of Excellence and the MATRC.org website.
Credentials
- Licensed Professional Counselor (MI and SC)
- Licensed Professional Counselor Supervisor (SC)
- MA Counseling Psychology (cum laude), Trinity International University, Chicago, IL
- BA in experimental psychology, Baylor University, Waco TX
- Certifications: National Certified Counselor, Approved Clinical Supervisor, Certified Telemedicine Clinical Presenter, Board Certified-Telemental Health Provider (Founder)
Telehealth Service
- Board Certification in Telemental Health: Creator, primary author, and Telemental Health subject matter expert for the credential on behalf of the Center for Credentialing and Education.
- Telebehavioral Health Center of Excellence – Founder and Director. TBHCOE.org
- ATA Standards Committee and co-author of Practice Guidelines for Child and Adolescent Telemental Health (March 2017)
- Board member (former President, 12/2013-12/2015) of the International Society for Mental Health Online
- Consultative partner for Mid-Atlantic Telehealth Resource Center 2014-present
- Field Reviewer for SAMHSA TIP 60: Using Technology-Based Therapeutic Tools In Behavioral Health Services
- National Quality Forum & American Hospital Association Center for Health Innovation: Contributor Redesigning Care: A How-To Guide for Telebehavioral Health
Telehealth Research
- Journal Article: A Comparison of Telemental Health Terminology Used Across Mental Health State Li- censure Boards, 12/2016 The Professional Counselor journal
- Maintains a current database of telemental health platforms and resources https://www.telementalhealthcomparisons.com. The site is recommended as the selection tool of choice by Optum, Telehealth Resource Centers and State Licensing Boards
- Maintains a current database of all telemental/telebehavioral health laws in all states for all mental health professions (8 professions).
- Maintains a database of all telehealth ethical policies and best practices.
- Maintains a database of the top health insurers paying for telemental health in each US state and DC.
Telehealth Curriculum – Primary author: Evidence-based, peer-reviewed curriculum for the credential Board Certification in Telemental Health for the Center for Credentialing & Education
- Introduction to Telemental Health • Laws and Ethics in Telemental Health
- Crisis Planning & Risk Management in TMH • Presentation Skills in Telemental Health
- HIPAA Compliance in Telemental Health • Choosing & Using Technology in TMH
- Telemental Health Settings and Care Coordination • Orienting Clients/Patients to Telemental Health
- Direct-to-Consumer Telemental Health
Additional bespoke curriculum created for multiple graduate schools and medical schools.
Telehealth Software – Software Product Development Services
- Adaptive Telehealth – A HIPAA-secure white-labeled platform for multi-modal telemedicine and spe- cialized telemental health programming. One of the first HIPAA-secure platforms approved by Optum for Telemental Health services.
- DialCare Mental Wellness – A HIPAA-secure app for direct-to-consumer telemental health services.
- Breakthrough.com – Subject matter expert/product developer for several online therapy networks, including breakthrough.com (Awarded $5 million in Series A funding in 2013 and purchased by MDLive 11/2014)
- Clinical Assessment Grids – Created a system of comprehensive DSM-5 checklists that make diagnosing and documentation more efficient. (DSM-5 content licensed from the American Psychiatric Association.)
- Enigma Health (Formerly Muse)– Product developer for Cambia Health Solutions/Regence Blue Cross Blue Shield. Created an online therapy platform, online service model, clinical protocols and referral processes for mental health services.
- OnlineDWI – Pilot project in partnership with the State of North Carolina to provide remote video as- sessments and treatment for individuals who obtained a DWI NC.
- SleepCoach – Designed and sold an online insomnia treatment program purchased by Blue Cross Blue Shield of MA and chosen by an MIT-Harvard health informatics workgroup as the insomnia treatment of choice for the Vanguard Health System.
- Wyonline – Developed an online therapy platform (direct-to-consumer), clinic network, marketing program and referral process for the State of Wyoming Health Department.
*Non-disclosure agreements prevent descriptions of all endeavors.
Employment
CEO: Behavioral Health Innovation (BHI), Charlotte, NC. 1998-Present
- Telehealth Consultant and Product/Service Developer. Design, development, and deployment of HIPAA-compliant Telehealth services and HIPAA-secure software. Creation and deployment of tele- health training, online telehealth networks, and HIPAA-secure Apps with a specialization in telemental and telebehavioral health.
BHI is a boutique service development and deployment firm originally founded to serve the mental and behavioral health fields. Our strong expertise in telehealth and software development has led to expansion into remote patient monitoring, chronic care management, telehealth operations and the creation of digital health products and workflows. Our unique combination of skills and expertise include research and development, software development, clinical telehealth services, service deployment, project management, business development, innovation and research. We created Adaptive Telehealth to meet the ever-changing need for unique medical and behavioral health services within a HIPAA-compliant environment. Our staff include medical, mental health, and behavioral health treatment providers, project managers, and software engineers. We thrive on solving complex problems that serve the helping fields.
Consulting and Training Clients (partial list)
- Addiction Technology Transfer Centers (ATTC) (multiple) (US Federal Agency Subcontractor)
- American Telemedicine Association (ATA)
- American Association of State Counseling Boards
- Appalachian Regional Healthcare
- Appalachian Telemental Health Network
- Association for Addiction Professionals (NAADAC)
- Bay Rivers Telehealth Alliance
- Berkeley University
- Center for Credentialing and Education (CCE)
- Center for Medicaid and Medicare (US Federal Agency)
- Dubai Health Authority, Dubai Healthcare City
- George Mason University
- Harvard University Medical School
- Health Resource and Services Administration (HRSA) (US Federal Agency)
- National Institute of Health Library (NIH) (US Federal Agency)
- Mid-Atlantic Telehealth Resource Center (MATRC) (US Federal Agency Subcontractor)
- National Association of Social Workers
- National Business Group on Health
- National Board for Certified Counselors (NBCC)
- New Jersey City University
- North Carolina Department of Health and Human Services
- North Carolina Department of Rural Health
- North Carolina Department of Juvenile Justice (NC DJJ)
- North Carolina Social Work Association (NCSWA)
- Northeast Telehealth Resource Center (NETRC) (US Federal Agency Subcontractor)
- Office for the Advancement of Telehealth (OAT) (US Federal Agency)
- Old Dominion University
- Substance Abuse and Mental Health Services Administration (SAMHSA) (US Federal Agency)
- South Carolina Heart Center
- New Jersey Health Department
- University of Maryland
- University of Pennsylvania
- University of Virginia, Richmond
- University of Virginia, Wise
- Wake Forest Health Systems
- William and James College
- Wyoming Department of Health – Behavioral Health Division
Previous Work Experience:
Director of Product and Business Development: National Board for Certified Counselors (NBCC) and Affiliates. Greensboro, NC; 2/2011-4/2017
- Directed the research and development, strategy and sales of new products/service lines and technology.
- Authored 9 peer-reviewed telemental health courses for the Center for Credentialing & Educa- tion and provided training and consultation to state mental health license boards.
Director of Product & Business Development: LifeOptions, Grand Rapids, MI; 3/09-2/10 (closed)
- Researched, designed, directed the development and sales of technology-based, online behavioral health software and services for insurance providers, government entities and end users.
Director of Marketing and Operations: Pine Rest Christian Mental Health Services; 11/07-3/09
- Provided marketing and operations direction for a 28-clinic outpatient network
- Grew three outpatient clinics from negative cash flow to 186% above budget revenue in six months
- Created a new intake process that saved $100k+ annually for the outpatient network
Founder/CEO: Crossroads Counseling Center, Columbia, S.C.; 1996-2006. (Sold practices in late 2006)
- Founded and directed all aspects of a multi-location (4) mental/behavioral health practice (outpatient)
- Provided individual/marital counseling, group therapy and organizational consulting/training
Inpatient Program Therapist: Rapha Treatment Center, Chicago, IL, and Columbia SC. 1994-1996 (Clinic closed)
Jay resides near Charlotte, North Carolina.
René Quashie
Vice President of Digital Health Policy & Regulatory Affairs - The Consumer Technology Association (CTA)
René Quashie is the first-ever Vice President of Policy & Regulatory Affairs of Digital
Health. Quashie provides guidance on key technical and regulatory issues relating to
consumer digital health and wellness technology products, services, software and apps.
Quashie also works on behalf of CTA’s Health and Fitness Technology Division, which
supports the consumer health technology industry through advocacy, education,
research, standards work, policy initiatives and more. The division’s industry-consensus
accomplishments include the creation of CTA’s Guiding Principles on the Privacy and
Security of Personal Wellness Data, addressing how companies should treat
consumers’ personal wellness data.
CTA works closely with the Food and Drug Administration, the Centers for
Medicare and Medicaid Services, the Office of the National Coordinator and other
related government agencies.
Quashie previously was in private law practice at several national firms and earned his
law degree from George Washington University.
Azhar Rafiq, MD, MBA, MEd
Director of Medical Informatics - National Aeronautics and Space Administration (NASA)
Dr. Azhar Rafiq, serves as the Director of Medical Informatics for NASA Headquarters. In this role, Dr. Rafi leads multidisciplinary teams to execute digital transformation and clinical data management for all major NASA US locations at NASA NASA’s Office of Chief Health and Medical Officer. This includes enterprise level electronic medical record system, interoperability of medical data management, implementation of cybersecurity practices, and establishment of patient access to their medical records. Dr Rafiq also has a 25 year history of integrating innovative technology for equitable healthcare delivery with secure data management to remote populations as an Associate Professor in the Department of Surgery, at Virginia Commonwealth University’s School of Medicine. In this role he provides program management to improve quality of medical care for the underserved, and improved outcomes for rural populations globally with implementation of innovative telehealth services. He also serves on numerous federal advisory councils defining standards for Health Information technology.
Karen S. Rheuban, MD
Director of University of Virginia Center for Telehealth, Pediatric Cardiologist, and Professor University of Virginia
Dr. Karen Schulder Rheuban serves as Professor of Pediatrics, Senior Associate Dean for Continuing Medical Education and External Affairs and Director of the University of Virginia Center for Telehealth, which she co-founded in 1995. The Center serves as the hub of a 155 site telemedicine network in the Commonwealth of Virginia, funded in part, by federal and state grants and contracts, and has supported ambulatory and specialty patient visits, e-consults, remote patient monitoring services and thousands of hours of health professional and patient education. UVA is the home of the HRSA funded Mid-Atlantic Telehealth Resource Center, and following the COVID-19 Public Health Emergency, the UVA Center for Telehealth has received more than $7 million in federal funding from HRSA, the FCC and USDA for telehealth expansions. Dr. Rheuban is a fellow of the American College of Cardiology, the American Academy of Pediatrics and the American Telemedicine Association. She recently concluded two terms of service as chair of the Virginia Board of Medical Assistance Services (Medicaid). She chaired the 2020 Virginia Department of Health/Virginia Hospital and Healthcare Association’s COVID-19 Response Telehealth Working Group. She led the Institute of Medicine Workshop on Telehealth, serves on the American Medical Association’s Digital Medicine Payment Advisory Group, and the AAMC Telehealth Advisory Committee. Dr. Rheuban has previously testified before the US Senate, the US House of Representatives and the Virginia General Assembly regarding telehealth. With Dr. Elizabeth Krupinski, she co-edited the text “Understanding Telehealth”. Dr. Rheuban is listed in the “Best Doctors in America” database, and was profiled in the National Library of Medicine’s exhibit “Changing the Face of Medicine: Celebrating America’s Women Physicians.” In 2017, the University of Virginia recognized her with its Thomas Jefferson Award. Dr. Rheuban is the Executive Editor of the Journal of Telemedicine and eHealth.
Jay H. Sanders, MD, FACP, FACAAI, FATA
President and Chief Executive Officer - The Global Telemedicine Group / Professor of Medicine - Johns Hopkins School of Medicine
Jay H. Sanders, is the CEO of The Global Telemedicine Group, Professor of Medicine (Adjunct) at Johns Hopkins School of Medicine, the Founding Board Member, President Emeritus and Fellow of the American Telemedicine Association and he chaired the Scientific, Military and Medical Advisory Board of the National Science Foundation/NC State University ASSIST Sensor Center and headed the FCC Rural Healthcare Committee.
Known to many as the “Father of Telemedicine”, he was responsible for developing the first State-wide telemedicine system, the first Correctional telemedicine program, the first Tele-homecare technology, called “The Electronic House Call”, and the first Telemedicine kiosk. His consulting activities have included NASA, DOD, DARPA, HHS, the VA, the FCC, State Governments, the Southern Governors Association, the MIT Media Lab, WHO, academic institutions, investment firms, Fortune 500 companies, and International Governments. In 1994, he introduced telemedicine’s capability to the Assistant Secretary of Defense that culminated in the initiation of the use of this technology within DOD. He was subsequently asked to serve as the sole civilian representative on the DOD Telemedicine Board of Directors with the Surgeon Generals of the Army, Navy and Air Force. During the Clinton Administration he represented the USA to the G8 nations for telemedicine, and was appointed by former HHS Secretary Leavitt, to the Chronic Care Workgroup.
He is a graduate of Harvard Medical School, magna cum laude, a member of the honor medical society, AOA, and did his residency training at the Massachusetts General Hospital where he became Chief Medical Resident. In 1970, he developed the first Division of General Medicine in the country at the University of Miami where he was Professor of Medicine and Chief of Medicine at Jackson Memorial Hospital. Other academic appointments include being Professor of Medicine and Surgery at the Medical College of Georgia, where he was Director of the Telemedicine Institute, Visiting Professor of Medicine at the University of Pennsylvania, and Visiting Professor at Yale University School of Medicine.
Adam Solander, Esq
Partner | King & Spalding
As a data, privacy and security, health care, and employee benefits partner at King & Spalding LLP, Adam Solander provides counsel on data breach and cybersecurity issues across various industries, particularly health care. Adam represents clients with respect to employee benefits regulatory and compliance issues including designing, implementing, and maintaining employee benefit plans. He also advises clients on issues related to managed care laws and telemedicine.
Adam has experience helping clients preparing for, responding to, and recovering from data, privacy and security incidents. He is a Certified CSF Practitioner, a designation given by the Health Information Trust Alliance (HITRUST). This organization provides training to develop and maintain effective security programs for health care and life sciences companies that comply with security laws, regulations, and standards, including HITECH, HIPAA, PCI, JCAHO, CMS, ISO, NIST, and various other federal, state, and business requirements.
Prior to joining King & Spalding, Adam was a member of a nationally recognized law firm where he was a part of their health care and life sciences practice group. Much of his experience is centered around assisting health care clients with HIPAA compliance, ERISA, managed care laws, telemedicine, and privacy and data security. He also assisted private equity companies with evaluating privacy and security and employee benefits compliance risk in connection with potential investments.
Previously, he served as Health Policy Counsel at the ERISA Industry Committee. There, he counseled Fortune 500 companies on healthcare legislation, including ACA, the HITECH Act, and ERISA. He also has experience advocating on behalf of trade associations and advocacy groups to Congress and the Executive branch.
Ben Steinhafel
Director of Policy and External Affairs - Center for Telehealth and eHealth Law (CTeL)
Ben Steinhafel is the Director of Policy and External Affairs at the Center for Telehealth and e-Health Law (CTeL). Ben closely monitors the telehealth flexibilities issued at the state and federal levels and proactively educates policymakers on the benefits of expanded telehealth and its potential to increase access to care for all Americans.
Prior to joining CTeL, Ben served in the Executive Branch at the U.S. Office of Personnel Management in the Congressional, Legislative, and Intergovernmental Affairs Department. Ben also served in the U.S. House of Representatives as a health care advisor for former Congressman Jim Sensenbrenner.
Ian Tong, MD
Chief Medical Officer, Included Health
Ian Tong, MD leads Included Health’s clinical care delivery, including clinical products and service lines, clinical quality, and practice performance of the clinical staff. Prior, he was Chief Resident of Stanford Internal Medicine and Co-Medical Director of the Arbor Free Clinic. Ian holds a BA from University of California at Berkeley and medical degree from The University of Chicago – Pritzker. He completed residency and Chief residency at Stanford Hospital and Clinics and is currently a Clinical Assistant Professor (Affiliated) at Stanford University Medical School. He’s board certified in Internal Medicine. Ian has dedicated his career to improving equity in, and access to, high quality care. He lives in the San Francisco Bay Area with his wife and three children.
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Ukrainian Health Law FAQs
CTeL and the Telehealth4Ukraine Coalition
CTeL is a not-for-profit 501(c)(3) research institute that examines and analyzes the state and federal laws and regulations pertaining to telehealth.
UKRANIAN LAW, GENERAL
Ukraine’s health care laws and regulations are established by Ukraine’s legislative body, Verkhovna Rada (Supreme Council of Ukraine) and the Ukrainian Ministry of Health. Ukrainian health care law and regulations are governed by national law, not political subdivisions.
No. Ukrainian health law is uniform across the country. We need not worry about variations from one region, or oblast, or town to another.
There are 3 types of medical workers in Ukraine.
1. Doctors
2. Nurses
3. Help staff or service staff. (They are considered medical workers, but are unqualified to furnish health care services.)
Liability regulations are covered by the Supreme Council of Ukraine.
Yes. Martial law was declared in all territories of Ukraine on February 24, 2022.
UKRAINIAN TELEMEDICINE LAW, PEACETIME
Medical entities that possess specific licenses, or doctors who are registered as private entrepreneurs and possess specific licenses, can provide telemedicine services. A doctor in a medical entity that possesses such a license does not need his own individual license.
Under pertinent legislation, a medical entity that provides telemedicine services should have a telemedicine room, equipped with proper facilities. This requirement does not apply to a doctor (private entrepreneur). Such a physician need but have proper facilities
A special platform administered by Ukrainian Association of Development IT in medicine, https://esemi.org/, provides electronic communication between the participants and records all stages of consulting remotely. There is no obligation to register to provide telemedicine services, however.
Not at this writing.
No. There is no legal obligation to use this platform specifically. Moreover, there are many private platforms, where one can register as a consultant as well as a patient. A provider may also establish its own platform, provided it follows the legislative rules.
An attending physician prepares a Request for telemedicine consultation in the form of an electronic message with an electronic digital signature. (The officially required form is available here: https://centerdp.statinfo.com.ua/wp-content/uploads/2021/03/forma- 001-zaput.pdf). Any pertinent information, such as the results of a work-up of the patient, should be sent to the Consultant together with Request. The Attending physician informs the staff of the telemedicine office about the Request. The doctor at the telemedicine office registers the Request in the journal according to the Form № 003 / tm (https://docs.dtkt.ua/download/pdf/1216.2677.1 ). After registration, the staff of the telemedicine office informs the Consultant about the Request and submits a document [to the Consultant] in the form of a printed copy or electronic media. On the day of receipt of the Request, the Consultant prepares a response in accordance with the form of primary accounting documentation № 002 / tm (https://zakon.rada.gov.ua/laws/show/z1403-15#n3 ).
No. The consultant may accept or reject such a Request.
In practice, it is quick. All these issues, request and documents are submitted by electronic means. Many Ukrainian doctors (especially those aged 25-40) have good knowledge of English, because in Ukrainian medical universities it is obligatory to pass final exams in English as well as Ukrainian. Accordingly, the vast majority of Ukrainian doctors (especially those experienced in telemedicine) will be able to translate relevant medical documents into English.
Not at this writing. But the gist of the text is as follows: The information provided should include the patient’s last and first name, age, results of work-up, diagnosis, and questions to the consultant.
No. Telemedicine services can be provided synchronous online or just on an asynchronous remote basis, where the Consultant prepares his response exclusively on the basis of sent documents and the attending physician’s work-up
Yes. The Consultant may communicate with the attending physician, a patient and any other staff. There are no pertinent legislative requirements, so the foreign Consultant may choose a mutually agreeable type of communication.
LICENSURE AND CREDENTIALING
If you are acting as a consultant to a Ukrainian physician, you do not. If you were caring directly for a Ukrainian patient, you probably do.
The MOH website says that the country has waived the usual rules:
“Registration [the equivalent of licensure there] remains open to all health professionals from our friendly countries who wish to assist Ukrainian hospitals in providing assistance to victims….” See, Ukraine MOH, “Dear partners and friends of Ukraine ‒ representatives of different countries!” 3 March 2022, https://en.moz.gov.ua/article/news/dear-partners-and-friends-of-ukraine-‒-representatives-of-different-countries.Project Aimee (see below) is in receipt of a writing from the Ukrainian Ministry of Health stating that professionals aiding Ukrainians through the project may rely on their domestic US licenses and will enjoy immunity from tort claims arising out of their wartime services.
The Attending physician is the clinician who is making the diagnosis and prescribing medications. The Consultant is an advisor to the Attending, but does not issue orders of make the diagnostic or therapeutic decisions.
If a Ukrainian doctor is on the call, the Ukrainian physician would be the attending physician. If no Ukrainian doctor is on the call, this would be considered direct-to-patient care because the foreign doctor is making final decisions.
The foreign doctor providing the consult will not bear responsibility because he is not the attending physician. The Ukrainian doctor will make final decisions and bears responsibility
The Ministry of Health supplemented its original order on telemedicine with a new provision. The updated order allows Ukrainian heads of health care institutions, hospital clinics, and other in-country providers to engage with foreign doctors with sufficient experience and education to provide telemedicine services to Ukrainians. The previous order was silent on telemedicine. This updated letter expressly allows it.
The MOH letter outlines no formal procedure for approval. Heads of health care institutions have broad authority to decide on a provider’s credentials.
An English translation is not available at this time. Dexis Partners will translate the updated order for the Coalition.
Yes, with the approval of the head of a health care institution or a hospital clinics.
The only problem, which may occur is the suspicion of labor relations between doctors and retired doctors. However, as retired doctors will not provide help to the Ukrainian patients, but American doctors, so that the retired doctors have no connections to Ukraine personally, no legal issues may arise in this case.
Acorn Credentialing https://acorncredentialing.com has offered to verify the licenses of our coalition volunteers. Acorn Credentialing is able to quickly verify the licenses for all medical licensure groups.
Acorn Credentialing (“Acorn”) describes itself as “a complete solution that goes beyond basic functionality to create value through process efficiency and eliminating costs and risk. Providers, credentialing specialists, and insurance payers get tailored views of the information they need while Acorn streamlines workflows, automates tasks, and manages data.” https://acorncredentialing.com/about/.
The Telehealth4Ukraine Coalition is grateful to Acorn for its help in facilitating telehealth support for Ukrainians. Please note that the Coalition does not, and is not equipped to, offer services akin to those of Acorn, nor to evaluate the quality of those services nor of its business practices more generally, specifically including Acorn’s privacy practices, and makes no representations or warranties concerning them.
Professionals wishing to utilize Acorns’ capabilities are encouraged to read Acorn’s Terms of Use, https://acorncredentialing.com/terms-of-use/, and its Privacy Policy, https://acorncredentialing.com/privacy-policy/, and to direct all questions to Acorn. The Coalition plays and has played no role in assisting Acorn in any way, nor is it qualified to do so, nor has it contributed in any fashion or to any extent in either creating or describing Acorn’s services. Professionals utilizing Acorn’s services in aid of credentialing themselves for Ukrainian volunteer healthcare services do so at their own risk.
Once you complete the licensure verification process, the Telehealth4Ukraine Coalition will reach out to you directly to get you onboarded to the VSee Aimee platform. We anticipate training to take no longer than 30 minutes. The Coalition will also work with its volunteers to develop a schedule.
CTeL has enlisted the help of two former VA telehealth consultants, Stephanie Bidstrup and Kendall Adler, who have access to the VSee Aimee platform and have worked with the Aimee team to develop the onboarding and scheduling process. Once Acorn verifies the licensure of our volunteers, Stephanie and Kendall will host open meetings to get the volunteers onboarded and trained on the platform.
When the state of war in Ukraine is over, unless other laws on this matter are enacted, a US provider will be authorized to provide medical consultations only on the behalf of a medical establishment licensed in Ukraine
No. Only doctors can serve as independent providers in Ukraine. For example, nurses in Ukraine cannot make any decisions without oversite of their attending physician. Only doctors are provided medical authority under Ukraine law.
Yes. Nurses can provide medical services on their own in Ukraine.
According to the applicable Ukrainian legislation, a nurse who is going to start her own “medical” practice, has to:
1. Correspond to the requirements of the Decree of the Cabinet of Ministers of Ukraine “About the statement of Licensing conditions of carrying out economic activity on medical practice “ (available in Ukrainian here: ДКХП № 78);
2. Register as a private entrepreneur (the Ukrainian equivalent is FOP); and
3. Receive a license in the Ministry of Health of Ukraine.
Yes, if the head of a health care institution believes the nurse practitioner is able to play the role of consultant. Under such circumstances, the NP could provide services to patients or provide consultation to her colleagues without obstacles.
TORT LIABILITY
Yes. Doctors may bear responsibility for incorrect consultations based on negligence in providing services.
Plaintiff must prove the illegality of the actions of the medical worker, i.e., his or her direct violation of the requirements of the relevant regulations governing the provision of medical care.
They are very detailed and would take a long time to read.
Dexis Partners is preparing one.
Not so long as the final decisions are in the hands of the doctor in Ukraine. Responsibility for the quality of care will be borne directly by the Attending physician of the pertinent medical institution. Consultations are of an advisory nature, and the methods of treatment of the patient depend on the attending physician. That is, the role of a consultant is ancillary, subordinated to the priority of the attending physician.
Yes. The necessary condition for a doctor to be held liable for his professional activity is a direct connection between the doctor’s acts and harmful effects of such acts on the patient’s health and life. Under Ukrainian law, it is difficult to prove that there is a causal link between the actions of the person sued and the damage caused, because the human body’s response to medical intervention is not always unambiguous.
A forensic medical examination establishes or refutes the existence of such a connection. If the damage is attributable to individual characteristics of the patient’s body or was caused by the patient’s actions (non-compliance with the doctor’s recommendations, e.g.), the doctor’s liability is excluded. It is possible to recover funds for damages only if the negligence of the medical worker is proved. The mere fact of a patient’s health deterioration (or even death) during treatment is not grounds for imposing civil liability on a medical institution in Ukraine.
The amount of compensation in each case is set by the court. To calculate the amount of material costs, the patient must submit to the court the relevant documents (e.g., pharmacy checks).
The law does not provide for an upper or lower limit on the amount of non-pecuniary damage. Usually the court takes into account: the amount of monetary damages; the severity of physical and moral suffering; the nature of the reduction of abilities or deprivation of the opportunity to function; the culpability of the person who caused moral damage; and other circumstances that had a significant impact on the situation. The requirements of expediency and fairness are also taken into account.
The amount of compensation differs significantly from the practice of American courts. The predominant amount of compensation is 10-20 thousand hryvnias (about $329.82 to $659.73) in case of damage to health and up to 100 thousand hryvnias (approx. $3,385.54) if the doctor’s actions led to the patient’s death.
Provide explanations and give recommendations, but do not make a diagnosis and do not prescribe treatment. This way the US provider will not bear responsibility as an Attending physician does.
If you communicate with Ukrainian providers independent of the coalition, and in doing so you use a website, post a limitation of liability clause (known as disclaimer) on the website and/or in the application forms. A patient should be acquainted with the mentioned disclaimer before the consultation begins.
No. The disclaimer referred to here is for use only by a US provider who elects to offer services to Ukrainians independent of the coalition.
Yes, as long as it accurately reflects the relationship between the two parties.
Our website contains general medical information. Any information we provide cannot be considered as advice you should follow. The medical information on our website is provided without any guarantee of recovery. You should not rely on the information on our website as an alternative to medical advice from your attending physician. If you think you may be suffering from any medical condition, you should consult with your attending physician and visit him without delay. You should never delay visiting a doctor, ignoring medical advice, or stopping medical treatment because of the information on our website.
You understand that, owing to the limited nature of communicating with the interactive features of our website, any assistance you may receive through such features may be incomplete or may be misleading. Any assistance you may receive in connection with any other active features of our website is not specific advice and should not be relied upon without further independent confirmation and precise investigation by the attending physician. Nothing in this disclaimer will
• limit or exclude any liability for death or personal injury caused by negligence;
• limit or exclude any liability for fraud or fraudulent misrepresentation;
• limit any obligations in any way not permitted by applicable law; or • exclude any obligations that cannot be excluded in accordance with applicable Ukrainian law.
The patient needs to review the website and project type. Understanding and agreement can be documented with a check-box or pop-up to receive confirmation. Because it relates to healthcare, a check-box would be the better solution.
VSee purchased insurance ($1M/3M) for This American Doc from The Doctors’ Insurance Agency against tort liability for HCPs providing care abroad through Aimee. A volunteer who registers at ThisAmericanDoc will get coverage. Note: a doctor need not register individually; VSee can do bulk registrations. As with the waivers, however, at this writing this coverage does not extend beyond Aimee-affiliated professionals. The Doctor’s Insurance Agency certificate of coverage covers only “This American Doc, Inc.,” and not individual physicians.
Neither CTeL nor Telehealth4ukraine provides insurance of any kind.
If a Ukrainian patient sued a foreign doctor, litigation would be very difficult, as it would be necessary to send summonses abroad and get confirmation of receipt. Online litigation in Ukraine is not yet operational. All documents should be legalized in the defendant’s country. That is, such a lawsuit would be extremely time- and money consuming, with but a low chance of winning.
It is extremely unlikely that a foreign doctor will be sued. In fact, this is possible only in case of gross disregard for professional standards, a clear violation of medical protocols and the patient’s willingness to incur high costs of litigation.
In the case of pure consulting without making a diagnosis and prescribing treatment, such a risk is absent.
Yes. A healthcare professional may be held criminally liable for failing to perform or improperly performing his or her professional duties as a result of negligent or dishonest treatment, if this has resulted in serious consequences for the patient. A difficulty the prosecutor faces in all criminal cases against doctors is the impact of a significant number of evaluative concepts (in particular, the inability to unambiguously determine whether a doctor’s actions were appropriate or inappropriate, whether in full or superficially performed by a health worker, etc.).
To convict, the prosecutor must show that the defendant could at least either foresee the possibility of socially dangerous consequences of his own actions or should have foreseen them.
Criminal liability of a doctor in Ukraine is limited to cases of obvious neglect of professional duties – usually in the form of a direct violation of medical protocols, which the doctor has been acquainted with on receipt. In other cases, the corpus delicti (concrete evidence of a crime, such as a corpse) is absent. Therefore, cases of bringing doctors to criminal responsibility in Ukraine are very rare.
Clinician to clinician.
In Ukraine, such service may be provided only by doctors who have a Ukrainian medical education or legalized foreign diplomas. Therefore, there are three ways to provide care to Ukrainian patients directly:
1. Engage doctors with diplomas acknowledged in Ukraine, or
2. Cooperate with a Ukrainian medical institution and provide consultations on behalf of it, or
3. Provide online consultations.
Yes, but the process is very difficult and time-consuming.
Yes, clearly with respect to in-person care by a foreign provider. According to the Order of the Ministry of Health, “On the involvement of foreign medical workers in the provision of services to victims of martial law” from 2/26/2022 No. 383, foreign doctors may be involved in medical assistance in Ukraine. Until the state of war in Ukraine is at an end, there are no restrictions.
In pertinent part, the Order says:
Order of the Ministry of Health of Ukraine dated 26.02.2022 № 383: “On the involvement of foreign medical workers in providing assistance to victims of war under the applicability of martial law”
… in connection with the imposition of martial law in Ukraine in accordance with the Decree of the President of Ukraine of February 24, 2022 № 64/2022 “On the imposition of martial law in Ukraine,” in order to ensure timely, continuous assistance to victims, the minister of health of Ukraine ORDERS:
1) Heads of health care institutions during martial law:
….
4. if there is a necessity, to ensure the provision of medical care with the use of telemedicine with the involvement of foreign medical professionals who meet the requirements for professional education and qualifications of the country where the relevant medical worker works, in compliance with personal data protection legislation.
Order 383 remains in effect.
Statutes are higher authorities, with higher power, than MOH orders. The order remains binding, however, until a statute says otherwise.
Yes. This order protects both Ukrainian healthcare institutions and foreign consultants.
Yes. “Medical assistance” can be construed broadly.
Yes. Counsel at Dexis Partners have concluded that the same principle applies to medical services provided on a remote basis. Moreover, the representative of the Ministry of Health of Ukraine, Sergiy Ubogov, Director General of the Directorate of Medical Personnel, Education and Science of the Ministry of Health of Ukraine, also confirmed this conclusion over the phone. As of 13 May 2022, written confirmation pending.
The Director General reports directly to the Minister of Health.
Yes. This is possible, but unlikely.
Yes. We can interpret “victims of martial law” as meaning “Persons who became victims because of the war.” Dexis Partners believes “victims” of war can be interpreted broadly.
Foreign medical workers can be interpreted broadly to include broad range of specialists and licensee groups.
PRIVACY
Data Protection regulations in Ukraine are just on their way to development, which is why there is no precisely elaborated accountability mechanism for data protection violations.
Ukraine’s existing legislation on personal data protection is neither strict nor detailed. There is no special legislation on the processing of personal health information (PHI) in the field of online medical consultation (telemedicine). The Order of the Ministry of Health “On the organization of medical care with the use of telemedicine” provides no special requirements for the processing of personal data, referring only to the need to comply with the requirements of Art. 7 (6) of the Law on Personal Data Protection, which identifies cases in which health data cannot be processed. It means, as you provide health care services you are empowered to process health care data, which is considered as sensitive kind of data.
Under Ukrainian law, PHI is a category to which “special requirements” apply. Ukrainian law stipulates that uses and disclosures of PHI is allowed if it is necessary for health care purposes, however, in particular for: “establishing a medical diagnosis, providing care or treatment or providing medical services, operation of an electronic health care system provided that that such data are processed by a medical worker, rehabilitation specialist or other person of a health care institution, rehabilitation institution or a natural person – entrepreneur who has received a license to conduct business in medical practice, and its employees covered by the legislation on medical secrecy, employees of the central executive body implementing the state policy in the field of state financial guarantees of medical care, employees of the institution carrying out state sanitary and epidemiological supervision and activities in the field of public health, which received a license to conduct business in medical practice “.
This means restrictions on sharing private health information without patient consent. These laws are rarely enforced, however, and there are no significant penalties for violations.
There are exceptions for emergency services. The declaration of “martial law” would be considered an emergency.
No. The attending physician will already have obtained such a consent from the patient and is empowered to share patient’s information with other medical staff to the extent necessary for a patient’s relief.
Under Ukrainian legislation, every person should sign a specific declaration (a kind of agreement) with her family doctor, in which the person’s consent to data collection and sharing is also given. This family doctor fills out a particular form with a person’s information on the governmental platform e-health (https://ehealth.gov.ua/). That is why, as soon as the family doctor permits, the patient’s information may become available for all the doctors across the country. If a patient needs help, but a family doctor is not entitled to provide it owing to the lack of specific qualifications in the required field, a family doctor may send or make available the patient’s information to the specialist in charge (otolaryngologist, e.g.). That is why there is no necessity to receive a separate consent to data collection.
No. Ukraine is outside the EU and so the GDPR does not directly apply to it. The coalition is planning to bring services to Ukrainian refugees in neighboring countries, however, such as Poland and Romania, which are EU member states to which GDPR pertains.
Ukrainian regulations is less strict than the EU’s GDPR. Health institutions are asked not to share private health care information. Health institutions can share de-identified health care information. Before a Ukrainian court would consider health privacy suits, there must be significant damage to the patient.
Ukraine allows unconditional processing of PHI in the case of emergency medical care, when it is impossible to obtain the patient’s prior consent. In other cases when there is no emergency, it is recommended that the doctor obtain a separate written consent of individuals on the processing of personal data in the process of telemedicine.
There are two main mechanisms. Standard Contractual Clauses (“SCCs”) are pre-defined contractual clauses that can be included in agreements and bind both the sending and receiving entities to data protection principles consistent with those of the GDPR.
Binding Corporate Rules (“BCRs”) are intended for inter-entity data transfers. BCRs also require the parties to adhere to rules intended to protect the personal data that the process in GDPR-compliant fashion..
WAR CRIMES
Physicians for Human Rights developed an app called medicapt that clinicians could use to document injuries from SGBV for legal purposes.
Another tool: the Istanbul Protocol, the protocol for documenting torture
MISCELLLANEOUS
The most needed type of service is trauma surgery consultations in real time. Second: behavioral/mental health.
Roman Shurduk (Member of the Board at Ukrainian Coalition for Legal Aid) : +380672365546 WatsApp.
Project Aimee, https://seeaimee.vsee.me, a VSee project. Aimee is a telemedicine platform with a 17-year history of providing no-cost humanitarian health care services in refugee and war-torn areas. Project Aimee offers a “24×7 Ukrainian/English dispatch service to collect medical requests and match them with the appropriate physician.” Aimee is collaborating with American Duty, run by James Oleen, former US Army Public Affairs Officer. The Coalition will help VSee Aimee staff its platform with clinicians with diverse medical specialties and licenses.
If and when other platforms become available, however, the coalition would be happy to use them.
Doctor Online is a telemedicine company currently being utilized in Ukraine that has requested the Coalition’s database of clinicians. The platform was Ukrainian-based and recently purchased by a US based company. The platform is an asynchronous messaging app, with translation services built in. A U.S. clinician can interface with the app in English while the Ukrainian patient interfaces in Ukrainian or Russian. Doctor Online has not received a formal waiver to allow U.S.-based clinicians to utilize the application; however, the Ministry of Digital Transformation recently recommended this platform in a press release.
Doctor Online – Health Assistant – here the patient can consult a family doctor or a specialist, order medication or decipher the results of laboratory tests online on the portal.
Helsi Medical Service – here the patient can make an appointment with doctors of all specialties. The qualifications of all doctors are confirmed by the Ministry of Health. The patient does not need to have a declaration and a referral from a family doctor to register for a consultation; it is enough to choose the right specialist and the time of the consultation.
Likar.support is an online service where volunteer doctors will provide emergency medical care online.
Northwell Center for Global Health, https://mhealthintelligence.com/news/northwellhealth-provides-telehealth-services-assistance-toukraine?eid=CXTEL000000246916&elqCampaignId=25327&utm_source=nl&utm_medium=email&utm_campaign=newsletter&elqTrackId=36fa35a9448b4b538a9d84d5b530ea73&elq=8dccfc502c3c43eaa0fb49fd115295f6&elqaid=26144&elqat=1&elqCampaignId=25327
As Ukrinform reported, the mobile application TacticMedAid, which teaches first aid, has become available to Android users. TacticMedAid is also available to iOS users. The application provides two areas of instruction: for the military and for the civilian population. The block for servicemen contains algorithms of actions in case of various common types of injuries and wounds in combat, in the block for civilians – detailed information about stopping the bleeding.
teplo.app is an application that will help the patient get a free consultation with a psychologist if the patient’s request is related to war.
Viveo Cares Foundation is an application where doctors provide advice 24/7 to Ukrainians who have health problems and live in the country’s combat zone.
UC Davis Jana
The Ukrainian Student Association at Stanford: teleHELP
Language Line -the medical translation app is called Jeenie.
UMANA can provide contacts for translators. Logistical challenges with translation are ultimately what led UMANA to focus more on direct-to-patient telehealth, as it may be difficult to coordinate 3 different schedules. There are, however, both operational (e.g. regular shifts for translators) and software solutions (e.g. translation technology), that could help mitigate this. The technology to facilitate this isn’t yet built, however
UVa, UC Davis, UCLA
Ukraine is 7h ahead.
Vadym Terentuik