Watsi Medical Partner Manual & Policies

Spring 2017

Watsi connects donors from around the world with patients in need of medical care and enables them to directly fund low-cost, high-impact treatments. We partner with medical organizations (“Medical Partners” or “MPs”) to identify patients, provide treatment, and collect post-treatment updates. In return, Watsi provides a sustainable source of funding for medical care.

Watsi’s mission is to fund healthcare by connecting people.

Watsi’s vision is healthcare for everyone.

100% of every donation goes to our Medical Partners for the purpose of providing healthcare. All of our financials are publicly available online on our transparency document. Read more about how Watsi works here.

The goal of this manual is to govern our relationship together, set expectations, and clearly communicate Watsi’s policies and operations. While we expect these policies to be adhered to, we also rely on trust and open communication to change and revise them as needed. Please proactively communicate any issues, questions, or feedback to us anytime. Also, please note that the following is a live document and will be updated on a quarterly basis.

Table of Contents:

1. Medical Partner Baseline Criteria
2. Applying to be a Watsi Medical Partner
3. Medical Partner Onboarding: “Pilot” Period
4. Active Medical Partners
5. Pre-Approvals
6. Care Centers
7. Watsi <> MP Financial Agreement
8. Submitting Patient Profiles to Watsi
9. Submitting Patient Updates to Watsi
10. Auditing & Due Diligence
11. Partnership “Freezes”
12. Funds Transfers
13. Patient Privacy
14. Watsi <> MP Regular Communication
15. Medical Partner Resources
16. Watsi Contacts
17. Appendix I (Patient Profiles & Updates)

Medical Partner Baseline Criteria

• Must be a registered legal and licensed entity in its country of operation
• Must have a history of providing quality, reliable surgical treatment.
• The medical partner or affiliated care center, must have a strong, positive reputation within the local and national medical community.
• Must agree to submit to initial and ongoing due diligence.
• Ability to submit quality patient centric data
• Ability to provide financial statements.
• Must be able to designate an English speaking staff member and/or full-time volunteer to Watsi
• Must have reliable, consistent Internet.
• Must have a successful working relationship with at least one US-based 501c3 non-profit organization. Funds for patients will be transferred through this organization.
• Must have multiple care centers and ability to scale/expand to a network of care centers either in the same country or other countries.

Applying to be a Watsi Medical Partner

• Must go through a screening phone call with the Medical Operations Manager to review:

• Types of treatments
• Number of patients that can be submitted once the partnership has scaled up
• Review of care center (location, quality of services, provided)

• Once the screening call has been completed, the Medical Operations Manager will let the potential Medical Partner know if they are able to start the onboarding phase
• Medical Partners will be selected based on:

• Number of surgical treatments
• Average number of patients that can be submitted by Watsi per a month
• Ability to hire and maintain a staff member dedicated to Watsi
• Ability to receive funds in the United States through a registered 501c3 non-profit

• Be able to provide all of the following information to be able to submit patients on the website:

• Name of Organization (as it should appear on the website)
• Website URL
• Description of organization
• Logo
• Name of Organization as incorporated
• EIN
• Bank Account details (Routing # and Account #)
• List of email addresses that should receive transfer notifications
• Name of Watsi Representative
• Name of first pre-approvals
• First Care center

• Name
• Address
• Latitude / Longitude coordinates

Medical Partner Onboarding: “Pilot” Period

Before Watsi and MP agree to work together, we’ll take the following steps:

• Watsi will conduct a due diligence investigation. This can include reference checks, a site visit, and/or interviews with staff members, community members, and healthcare providers.
• The MP will submit one pre-approval request, and ten patient submissions within that pre-approval. If Watsi approves these cases, they will be posted on the site for funding. The MP will then submit patient treatment updates, and if they are approved, Watsi will transfer funds for the cases.
• If all goes smoothly with the first ten cases, the pilot period will end and the MP may begin submitting additional pre-approval requests and patients.
• The MP and Watsi will fill out the necessary legal documentation, including an MOU and Medical Partner Contract.
• The MP agrees to submit to ongoing auditing and due diligence beyond the pilot period

Active Medical Partners

• After a successful pilot period, an MP is considered “active.” The following sections outline our policies for active MPs.

Pre-Approvals

• Pre-approvals are treatments that Watsi funds per MP, per care center. Examples include: open reduction and internal fixation, chemotherapy, hernia repair surgery.
• As you’re deciding which pre-approval requests to submit, please keep the following characteristics in mind:

• The treatment is low-cost and high-impact
• The treatment has a concrete outcome -- fits with Watsi’s crowdfunding model
• The treatment has a high probability of success
• The MP has the operational capacity to support this treatment
• The MP has the administrative capacity to submit the number of patients projected for the pre-approval
• The MP can submit patients who need this treatment to Watsi before their treatment begins (we do not fund urgent and/or emergency care)

• Pre-approvals on Watsi tend to fall in the range of $100 - $1,500. Watsi is currently looking into increasing this amount and it will be communicated once this has been established
• MPs can request new pre-approvals on partners.watsi.org. The following must be submitted for Watsi to consider a pre-approval request:

• Care center

• Hospital, center, or clinic where the treatment will take place

• Range of diagnoses

• What conditions does this treatment treat?

• Brief description of treatment
• Treatment invoice

• A line-item breakdown of all costs associated with this treatment

• Projections (6 months out)

• An estimate of patients the MP anticipates submitting each month
• Projections are extremely important for Watsi’s ability to balance donations with patient numbers, as well as our ability to take on new pre-approvals. Please try to be as accurate as possible with projections. Even if you exceed the number of patients projected, Watsi will still fund them. The purpose of us having an accurate number for projections is to match our donation goals with average number of patients submitted. The more accurate you are, the more medical partners we can add on and more patients we can treat!

• Qualitative treatment information

• Information about the treatment, conditions it treats, and any relevant regional and/or cultural context about the treatment.

• The treatment invoice is a best estimate for a sustainable price for providing treatment. The true cost of care will undoubtedly vary from patient to patient. It is our hope that the average cost of providing a pre-approved medical treatment is equal to the fixed price agreed upon during the application process.
• MPs can request a re-evaluation of pre-approvals as necessary if prices or circumstances change.
• Once a pre-approval is open, it will remain open indefinitely as long as projections are updated on a continual basis on partners.watsi.org
• MPs can always see a list of active and inactive pre-approvals on the partners dashboard at partners.watsi.org.

Care Centers

• A care center is a hospital, clinic, or treatment center where an MP works to provide care to patients.
• Similar to a medical partner, a care center has the following characteristics:

• Must have a history of providing quality, reliable treatment.
• Must have a strong, positive reputation within the local and national medical community.
• Must agree to submit to initial and ongoing due diligence.
• Must be able to provide financial statements.
• Must have reliable, consistent Internet.

• Prior to onboarding a new care center, Watsi may conduct a due diligence investigation. This can include reference checks, a site visit, and/or interviews with staff members, community members, and healthcare providers.
• Pre-approvals must be tied to specific care center, as the timeline and cost (even for the same treatment) will inevitably vary per location. 

Watsi <> MP Financial Agreement

• Watsi may not make up more than 30% of a care center’s operating budget. We reserve the right to ask for financial statements to verify this. We have this limit in place to ensure that MPs have other consistent sources of funding, and that Watsi is never relied upon as the primary source of funding for an MP or care center.
• Watsi may request 990’s from the MP for Watsi to determine if there is an adequate base of other giving to ensure the MP is not fully funded by Watsi.

Submitting Patient Profiles to Watsi

• Patients must be submitted to Watsi before their treatment occurs. You may not submit a patient who has already begun treatment.

• Watsi always needs to be aware of the patients we are liable to fund.

• Patient profiles should be submitted (or draft started) as soon as the MP is confident that the patient’s treatment will happen.
• Patient profiles must be submitted in English
• If you have any questions about this rule, please email your point of contact at Watsi instead of guessing. ***Submitting patients after their treatment has begun (even a part of their treatment) could result in Watsi not transferring funds, or a partnership freeze.***

• MPs cannot begin treatment before submission with the expectation that Watsi will cover costs. This creates issues with our projected numbers and financial liability.

• Multiple submissions:

• You may submit a patient to Watsi more than once as long as it is not for the same treatment. Please include the original Watsi case ID(s) in any subsequent submission.
• The same patient can’t be submitted at the same time for for multiple treatments. In order to be submitted again, the patient must have received treatment and an update must have been submitted to Watsi.

• Use the “drafts” feature on partners.watsi.org to save partial submissions before submitting patients to Watsi.

• Multiple users can contribute to a draft before submission
• Partner users can have “restricted access” logins -- they can save and update drafts only, but not submit patients.

• Treatment Subsidies

• If a patient is contributing a portion of their treatment cost, or another organization/donor/etc. is helping to fund the treatment, please indicate this when asked “Is this treatment subsidized?” on the profile submission form.

• Watsi will only fund medical care for patients who are unable to pay for care (or some portion of care) themselves. We rely on our MPs to use their local knowledge to determine which patients are unable to pay for medical care. However, we reserve the right to request justification as necessary.
• Once a patient is submitted to Watsi, treatment may begin. Upon profile approval, we guarantee funding if the reported treatment happens, and unless we have reason to believe any information initially submitted was inaccurate or falsely reported.
• Turnaround time between profile submission and profile approval (or request for more information) will almost always be within 24-48 hours (during normal business days).
• It is okay for treatment to begin anytime after a profile is submitted (even if it has not been approved yet by the Medical Program Manager.
• For information and tips on update content to submit, please see Appendix I

Submitting Patient Updates to Watsi

• You must submit a treatment update no later than 30 days after the patient’s anticipated treatment date.
• If a patient’s treatment plan changes let your Watsi point of contact know. We may not be able to fund patients who received a different treatment than initially reported to us.
• If a patient’s treatment is delayed:

• Please leave a comment on their case and explain the reason for the treatment delay.
• If a patient’s expected treatment date is delayed more than 30 days, we may ask you to submit the update as “treatment did not happen.” The patient can be re-submitted at the time of their new treatment.

• If a patient receives some, but not all, of their treatment:

• Submit a “partial” treatment update, and explain the specific circumstances in the body of the update.
• Funds transfer for partial treatments will occur on a case-by-case basis. Depending on the the amount and type of treatment received, Watsi may or may not transfer funds for the case.

• If a patient’s treatment was unsuccessful:

• To the best of your ability, please explain why the treatment was unsuccessful in the update.
• Watsi will transfer funds for unsuccessful treatments if the treatment received was the treatment initially reported to Watsi, and if the treatment occurred in full.
• Out of respect for the patient, pease do not submit photographs of patients when the treatment was unsuccessful.

• If a patient’s treatment did not happen:

• Please explain why the treatment did not happen in the body of the update.
• Watsi will not transfer funds if the treatment did not happen.
• Out of respect for the patient, pease do not submit photographs of patients when the treatment did not happen.

• For information and tips on update content to submit, please see Appendix I

Auditing & Due Diligence

• Watsi is committed to transparently reporting all patient, treatment, and MP information to donors.
• We know that mistakes happen. Our goal with auditing and due diligence is to identify issues early on so that we can take proactive steps with MPs to find solutions, as well as decrease the instance of mistakes.

• Every month, Watsi will conduct a random case audit with each MP.

• Audits will take place via email.
• Partners will have one week to submit all requested audit information.
• Watsi can choose to audit any patient submitted by that partner, whether their treatment was in the past or is yet to happen.
• Requested audit information may include any of all of the following:

• Discharge papers
• Anesthesia records (if applicable)
• Invoices
• Surgery records
• Additional photographs (if available)
• Contact information
• Consent forms
• Watsi contacting physicians, staff, and/or patients directly to ask about their knowledge of the Watsi program.

• Watsi reserves the right to audit at any time and for any case. These audits may take place via email or in person (we will always give ample notice if we plan to visit in-person).
• We understand that certain information is not available for every patient, so we will work with you during audits to identify the appropriate documentation on a case-by-case basis.
• We will be auditing to ensure that...

• The patient’s identity was represented correctly, and the patient exists
• The type and/or cost of care was reported correctly, and the care occurred as reported
• The care occurred at the care center reported
• The care and reporting occurred in the proper sequence
• The rationale for care was represented correctly, and the care was necessary
• The delivery of care was represented correctly, and occurred in a dutiful manner

Partnership “Freezes”

• Watsi reserves the right to “freeze” (pause) a partnership or care center when policies are broken, treatment updates are not submitted, and/or there is reasonable suspicion of fraudulent activity, reporting errors, or mistakes.
• Partnership freezes occur to ensure that we have ample time to ensure that the information we are sending to donors is accurate.
• During a freeze:

• The MP or care center may not submit new patients to Watsi.
• Watsi will begin an investigation, which will vary based on the situation and the severity of the policy breach.
• If there is reason to believe in-flight cases with pending funds transfers were submitted incorrectly, or include content that we have reason to believe is inaccurate, we will pause funds transfers until we complete the investigation.

• An investigation during a freeze may include:

• Request for additional documentation such as photographs, discharge papers, anesthesia records, patient contacts, etc. Specific document requests will be made on a case-by-case basis.
• Phone calls and interviews between the Watsi team and patients, staff, physicians, or other hospital personnel.
• Watsi team visit to the care center and/or partner in question.

• Next steps will depend on the result of the investigation. Possible outcomes may include:

• “Full-speed ahead”

• If the investigation showed an easily recoverable error, MP / Watsi operations can resume as normal after the situation is resolved.

• “Probation”

• If the issue will take some time to repair, the MP can submit patients on a limited basis until we feel mutually confident that we can fully ramp back up.

• Partnership termination

• If the issue broke trust or is irreconcilable, we may terminate the partnership.

Funds Transfers

• Watsi will send treatment reimbursements in USD to your US-based 501c3 organization.
• Watsi’s system will automatically initiate a funds transfer for a case when an update is received and approved. Funds transfers may take up to 7 days to arrive in your bank account.
• MPs will receive an email each time funds are transferred per case.
• MPs can view all funds transfer history on partners.watsi.org/funds_transfers.

Patient Privacy

• It is extremely important to us that patients understand Watsi to the best of their ability, and consent to participate.
• Informed Consent

• It is important to draft a culturally sensitive consent form and have it translated into the appropriate local languages
• The consent form should be administered before patient intake is completed and the patient should sign off at the end, indicating that they have read the consent
• If the patient is unable to read the consent form, the representative should read them the consent form and have the patient place a thumbprint on the signature line
• The Medical Operations Manager can also provide examples from other partners of informed consent
• The patient (or patient’s parent/guardian if patient is a minor) must have the capacity to make a voluntary decision to participate in the Watsi program, and sign a Patient Waiver to this effect (alternatively, the patient can request their case remain private - see below).
• The privacy option is not for all patients but for those who are uncomfortable with their treatment, story and picture being placed on the Watsi website
• Patients under the age of 18 require signature from parent or guardian.
• It is the MP’s responsibility to explain to patients that their photos and stories could be shared on social media in addition to watsi.org.

• Legal Localization

• It is the MP’s responsibility to be in compliance with local law relating to health information collection, access, and storage.

• Privacy Requests

• All patients have the ability to request that their case remain private. This means that they will not have their photo and story posted online, but will still receive funding. All case and update submissions requirements remain the same for privacy cases.
• Watsi can designate any case as a privacy case after submission.
• A patient, their immediate family, next of kin, or an associated MP may request a case be made private at any time.
• Methods of ensuring that the patient is comfortable giving consent:

• Contact Priya and ask her for a sample patient profile (a sample of what donors see on the Watsi website). The Watsi care center representative can print this out and show it to the patient when administering consent and intake. 
• Some partners have found that sharing the patient’s profile with them once they have been placed on the Watsi website also helps them understand who is seeing their information. 

Watsi <> MP Regular Communication

• Watsi and the MP must have a regular, standing call. It is critical that these calls occur regularly.

• If more than three calls are missed in a row without ample advance notice, Watsi reserves the right to place the partner on a freeze until regular communication is possible.

• Watsi will always respond to emails as quickly as possible. You can expect to hear back from us within 24-48 hours (during business days).
• We want to make your work with Watsi as easy and seamless as possible. We are available via email, phone, Skype, WhatsApp, and are happy to use any app that is most convenient for you.
• Watsi takes your feedback and suggestions very seriously, so please speak up!

Medical Partner Resources

As a MP, you are part of a larger community of several Watsi MPs doing amazing work all around the world. As such, we want to help you however we can in connecting you to other MPs, or helping to further your work and mission.

• Do not hesitate to contact us if you have questions or would like more information about our other MPs.

Watsi Contacts

Watsi is based in San Francisco, CA, USA. We are located at: 2132 Folsom Street, Suite 2, San Francisco, CA 94110.

• Watsi MP Contact: Priya Kumar (priya@watsi.org); Skype: priya610
• Watsi Co-Founders: Chase Adam (chase@watsi.org) & Grace Garey (grace@watsi.org)
• Watsi Office Voicemail: +1 (256) 792-8747

APPENDIX I

Submitting Patient Profiles

Include:

Personal information

• Who are the patient’s family members?

• “Chhoeun is a 59-year-old retired soldier who is married and has three sons and four daughters.”

• What job does the patient (or the patient’s family members) have?

• “When she was 18 years old, Nyein moved to Bangkok to support her mother financially. She currently works as a babysitter and housekeeper in Bangkok, living with her employer’s family. She looks after the young children, prepares food, cleans the house, and does laundry.”
• “Joyce is studying in fourth grade.”

• What does the patient like to do in his or her free time?

• “During her free time, she likes to sing. She is also an excellent weaver who makes mats that she uses at her home or gives to her friends.”
• “When she is feeling well, Marvious enjoys playing with other children in her community.
• “John enjoys listening to the radio as he grazes his sheep and playing with his grandchildren when they return home from school. He also enjoys visiting his friends in the village to chat about ‘the nature of life and their youth.’”

• If the patient is a child, what does he or she want to be as an adult?

• “Emmarie is an 18-year-old college student who is studying criminology. Her dream is to protect and maintain peace in her country.”
• “Five-year-old Maria wants to become a doctor when she grows up.”

Medical information

• What was the diagnosis and why was the diagnosis made (what symptoms did the patient present with)?

• “When he was three weeks old, his mother noticed that his head was increasing rapidly in size. He could not hold his head up on his own. He was diagnosed with hydrocephalus, a condition in which excess cerebrospinal fluid accumulates in the brain.”

• What is the treatment that the patient will receive, and HOW will that treatment affect his or her symptoms/quality of life after recovery?

• “While malnutrition can have devastating effects, it is also very treatable. Growth monitoring, micronutrients, and food supplementation will help Antonio recover. He will gain weight and grow taller to catch up with other children his age, and his immune system will grow stronger.”

Do not include:

• Highly specific descriptions of where the patient lives. Donors will only recognize the names of countries or large cities/towns.

• Instead of this: “Smart is a 55-year-old man from the village of Mbeta located in the Central Region of Malawi.”
• Say this: “Smart is a 55-year-old man from a village in Malawi.”

• Lengthy descriptions of the patient’s medical journey. We do not need to know the names of previous hospitals the patient has visited. At most, a couple sentences about how the patient has been managing his or her symptoms or what treatments he or she has sought or undergone is sufficient. This description should focus on the condition that is being treated, not other conditions the patient has experienced.
• The patient’s income or salary. One sentence about why the family cannot afford treatment is sufficient.

• Instead of this: “He is a taxi driver and earns about 10,000 Baht (approx. 333 USD) per month.”
• Say this: “Aron’s parents operate a small business to earn a living. Their income, however, is not sufficient to pay for Aron’s surgery. They need help to raise $610.”

• Medical information/history about other members of the family, unless it is particularly relevant.

Tips:

• Always remember to cite the source of a patient quote if it is not the patient (name + relation to the patient is best).

Kahuma’s story:

Kahuma is a 14-month-old boy living in Uganda with his parents. His mother braids hair in her sister’s salon, and his father is a driver who transports fresh food from Fort Portal to Kampala. Together, they earn a small income.

Seven months ago, Kahuma developed a swelling in his left groin region. As the swelling grew, Kahuma began to cry and lose his appetite. He was diagnosed with a left inguinal hernia.

A hernia occurs when an internal organ pokes through a muscle wall, causing severe pain. Left untreated, a hernia can cause intestinal blockage or prevent blood from reaching vital parts of the intestines. On December 28, Kahuma’s doctors will perform surgery to repair the abdominal wall, remove the bulging tissue in his abdomen, and reposition his herniated tissue. The total cost of the procedure is $249, which covers the supplies, medications, and three days of inpatient care.

After Kahuma’s surgery, his pain and discomfort will be relieved.

Submitting Patient Updates

Include:

1. Describe how the specific surgery went.

• “Kizito's cataract surgery was a success! He is recovering well and has been discharged to return home.”
• “Jovin's fracture surgery was a complete success. He is expected to make a full recovery and continue to develop and grow with no evidence of deformity.”

2. Describe how the patient’s life has changed before and after surgery.

• “After three years of living with symptoms that made it hard for Kizito to farm and support his family, he is eager and excited to continue working.”
• “Jovin is extremely lucky that his mother was strong about seeking treatment for her son's feet. He will never even know that he was born with club feet except to hear the stories or maybe see pictures.”

3. Provide a quote:

• How has your life changed from before treatment to after?
• How does it make you feel knowing strangers funded this treatment?
• What do you want to say to the donors to encourage them to keep giving?

Do not include:

• Medical advice to patients

• “While playing and walking, he should be careful so as to not put all his weight on the injured hand.”

• Irrelevant medical issues

• “Daw Sein felt much better straight away after the surgery. The stomachache she used to have, but did not realize was caused by prolapsed uterus, was fully cured. Daw Sein still has joint pain but it does not worry her that much because she believes it is due to her old age.”

Reyes’s update:

Reyes underwent a successful biopsy, which actually repaired her condition. She no longer experiences pain and bleeding, so she feels more energy. Reyes’s biopsy did not show any cancerous or pre-cancerous tissue, so she does not need further treatment.

“My symptoms have gotten better,” says Reyes. “I feel so happy for all of the support that I have gotten. I am fighting for my seven children, and I want to see them grow and have the opportunity to study. Thank you for helping me do that.”

Patients who shall qualify for Resubmission to Watsi:

Criteria #1:

A patient with an entirely new condition that is unrelated to the condition previously sponsored by Watsi.

• Example: Patient was sponsored for clubfoot, and is now in need of a Hernia Repair.

Criteria #2

A patient in need of the exact same procedure sponsored by Watsi the 1st time, but is in need of it on a different part of their body.

• Example: A patient had a successful burn scar contracture release of right elbow. The next visit the plastic surgeon wants to release a contracture of the neck.
• Example: A patient was sponsored by Watsi the 1st time to fix a broken leg. The patient has now broken their hand.

For all the above, where possible, the need for second (and/or third) surgery WHERE KNOWN, must be indicated in the patient’s VERY FIRST profile submission to Watsi. Where unknown, it shall be assumed that the site did not anticipate a second/third surgery

For cases that DO NOT meet this criteria, Watsi MUST be consulted BEFORE submission and guidance shall be offered on a case by case basis

Patients who shall NOT qualify for Resubmission to Watsi

• Patients who are in need of a series of non-definitive multiple corrective surgical procedures

• Example: A patient suffers a severe burn to the face. The surgeon proposes a series of multiple surgeries. The 1st procedure will have minimum impact on quality of life (e.g. mild improvement in facial appearance) and is only a prelude to many more non-definitive surgeries

• Patients submitted for malnutrition

• Example: Patient was submitted for lactational failure and then resubmitted for malnutrition (both of these pre-approvals are malnutrition based)

Procedure for Patient Re-submission to Watsi:

1. In the ‘Patient Age’ ( Years, Months) indicate the patient’s ACCURATE age as at the point of resubmission-as this could very well have changed if it’s been-for example-one year since the 1st surgery/2nd surgery was done

2. In the ‘Patient Story’ section in the Watsi Portal, BEFORE proceeding to write about the patient, begin by stating in Asterisk and CAPS that the patient is a previous Watsi patient, the no. of surgery ( Second or third) and the Initial Watsi ID.

Example: ** PREVIOUS WATSI PATIENT, SECOND SURGERY, INITIAL WATSI ID #4567** OR Example: ** PREVIOUS WATSI PATIENT, THIRD SURGERY, INITIAL WATSI ID #4567** *Always state the INITIAL Watsi ID of the patient-not any other ID given after that.

3. After the title in CAPS above, and still in the ‘Patient Story’ section, in the patient's profile, include:

a. Which surgery the patient had undergone the VERY first time

b. If the surgery done was successful-this is the assumption that all surgeries were successful but later on, it has been found, that the patient shall still need additional surgery

d. The reason for needing a second surgery and the impact of this surgery

e. The procedure that now needs to be done

 4. All other personal and Family details shall remain the same as in the initial profile submitted to Watsi a. Example: If the patient’s parents were farmers with meagre income and hence cannot still afford treatment, this shall remain the same.

6. A new consent form must be administered to the patient to ensure that they agree to their information being shared and posted with Watsi