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2ND ANNUAL PEDIATRIC TELEHEALTH COLLOQUIUM NEEDS ASSESSMENT Pediatric Telehealth – Improving Outcomes for an Underserved Population Regionalization of children’s hospitals has enhanced quality of care for pediatric patients, but has created a disparity for those in non-urban areas. Telemedicine is an innovative means to fill the specialist void in rural communities by providing a new healthcare delivery model. UC Davis Children’s Hospital, a foremost leader in Pediatric Telehealth, has gathered national and international experts who will address pediatric care issues facing major academic centers and community and rural hospitals. WHO SHOULD ATTEND? This course is designed for family practitioners, emergency medicine physicians, pediatricians, nurse practitioners, physician assistants and others involved in providing pediatric care, as well as health system administrators, strategic and business development officers and information technology specialists interested in developing or expanding a sustainable telemedicine program. EDUCATIONAL OBJECTIVES After completing this conference, participants should be able to:

• Describe how telemedicine can improve outcomes for patients in both inpatient and outpatient settings • State predictors of success for inpatient and outpatient telehealth programs • Describe how telemental health is being applied in a variety of settings • Define alternative applications for telehealth technologies • Assess technical needs to design or expand a telemedicine system • Define current and future legislation affecting telehealth • Describe how telehealth is being applied in developing nations

ACCREDITATION This activity has been planned and implemented in accordance with the Essential Areas and Policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the Office of Continuing Medical Education at UC Davis Health System and the American Telemedicine Association. The Office of Continuing Medical Education of the UC Davis Health System is accredited by the ACCME to provide continuing medical education for physicians. Physician Credit: The Office of Continuing Medical Education of the University of California, Davis, Health System (School of Medicine, Medical Center and Medical Group) designates this educational activity for a maximum of 13.5 AMA PRA Category 1 Credits™ of the Physician’s Recognition Award of the American Medical Association. Physicians should only claim credit commensurate with the extent of their participation in the activity. The following may apply for CME Category 1 credit for license renewal: Physician Assistant: The National Commission on the Certification of Physician Assistants (NCCPA) states that AMA accredited Category 1 courses are acceptable for continuing medical education requirements for recertification. Registered Nurse: The California Board of Registered Nursing accepts CME Category 1 credit toward license renewal. On the BRN license renewal form, report the number of hours you attended (up to 13.5 hours of credit) and fill in “CME Category 1” for the provider number. Visit Our Website at: http://www.ucdmc.ucdavis.edu/children/telemedicine/ Or Register Online at: http://www.cevs.ucdavis.edu/Cofred/Public/Aca/ConfHome.cfm?confid=317

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PROGRAM AGENDA

Thursday, September 6, 2007 7:30 AM Continental Breakfast, Registration, Visit Exhibits

8:15 Welcome & Introduction - Overview of Telemedicine in Pediatrics

James Marcin, MD, MPH

8:45 Opening Keynote Speech: Resolving Geographical Disparities in Healthcare Thomas S. Nesbitt, MD, MPH

9:15 Telehealth Technology 101 Juan Trujano

9:45 Break Session 1: INPATIENT PANEL DISCUSSION James Marcin, MD MPH, Moderator This panel will explore the use of telemedicine and videoconferencing in the inpatient setting. Examples of programs using telemedicine in the Pediatric Intensive Care, Emergency Department, Neonatal Intensive Care and Inpatient Ward will be illustrated using the perspectives of both the specialist (hub) and remote (spoke) site. Innovative visions of how telemedicine can create virtual hospitals by connecting specialists from a variety of hub sites to hospitals caring for children that lack subspecialty services will be discussed. 10:00 Overview of Inpatient Telemedicine

James Marcin, MD, MPH

10:30 Telemedicine & PICU: The Oregon Health and Science University Experience Miles S. Ellenby, MD, FAAP

10:45 Starting a Remote ICU Program Thomas L.W. Roe, MD

11:00 The Use of Telemedicine in the ED Kourosh Parsapour, MD

11:15 Telemedicine & the ED: The Rural Perspective Charles Hott, MD

11:30 Telehealth and Pediatric Cardiac Disease Anita Grady, MD, FACC

12:00 PM Q&A Panel

12:15 Lunch and Demonstration (no CME credit) Visit Our Website at: http://www.ucdmc.ucdavis.edu/children/telemedicine/ Or Register Online at: http://www.cevs.ucdavis.edu/Cofred/Public/Aca/ConfHome.cfm?confid=317

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Session 2: TELEMENTAL HEALTH AND DEVELOPMENT Terry Rabinowitz, MD, FAPA, FAPM, Moderator The use of telemedicine holds promise for improving outcomes in pediatric mental health and pediatric development cases. Panelists will offer examples of how telemedicine is used by psychiatrists, psychologists, and developmental pediatric providers. Experts will discuss how these services can be provided to outpatient clinics, developmental centers, child protective services, and juvenile detention centers. 1:30 Overview of Telemental Health

Terry Rabinowitz, MD, FAPA, FAPM

1:50 Rural Early Access to Children’s Health (REACH): Developmental Screening and Early Intervention Services Deborah C. Hall, MD

2:10 Telemedicine in Neurodevelopmental Disorders Ira T. Lott, MD

2:30 Q & A Panel

2:45 Floor Demonstration with Vendors

5:00-6:00 Wine Reception Network with colleagues and faculty while enjoying light hors d’oeuvres and California wine.

Friday, September 7, 2007 7:30 AM Continental Breakfast, Registration, Visit Exhibits

Session 3: OUTPATIENT PANEL DISCUSSION Javeed Siddiqui, MD, MPH, Moderator Telemedicine is being successfully applied in outpatient settings. Panelists from various specialties will offer examples in child abuse, dentistry, neurology, endocrinology and weight management cases. Financially sustainable models will be discussed, and important management and programmatic issues to ensure a successful outpatient program will be explored.

8:30 Overview of Outpatient Telemedicine Javeed Siddiqui, MD, MPH

8:45 Child Abuse and Telemedicine Kristen MacLeod, MD

9:00 Teledentistry in Inner City Childcare Centers Dorota Kopycka-Kedzierawski, DDS, MPH

9:15 Endocrinology Dennis Styne, MD

9:30 Teleneurology Charles Niesen, MD

Visit Our Website at: http://www.ucdmc.ucdavis.edu/children/telemedicine/ Or Register Online at: http://www.cevs.ucdavis.edu/Cofred/Public/Aca/ConfHome.cfm?confid=317

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9:45 10:00

Telehealth Applications for Pediatric Obesity Ulfat Shaikh, MD, MPH Q&A Panel

10:15 Break

Session 4: ALTERNATIVE APPLICATIONS AND TELEHEALTH PANEL DISCUSSION Kourosh Parsapour, MD, Moderator Telemedicine can be used for a variety of alternative applications including interpreting services, childcare centers, and remotely linking patients with families. This panel will discuss these applications and explore what the future holds. 10:30 Introduction to Alternative Applications

Kourosh Parsapour, MD

10:50 Extending the Medical Home to Childcare, Schools and Retail Based Clinics Neil Herendeen, MD

11:10 The Future of Telemedicine and Remote Care Ravi Nemana

11:30 Q&A Panel

11:45 Oral Presentations 4 Selected Abstracts

12:45 PM Lunch and Demonstration (no CME credit)

2:00 Poster Presentations with Professor Rounds (no CME credit)

3:00 Hands On: Floor Demonstrations

5:00 Adjourn for the Day

Visit Our Website at: http://www.ucdmc.ucdavis.edu/children/telemedicine/ Or Register Online at: http://www.cevs.ucdavis.edu/Cofred/Public/Aca/ConfHome.cfm?confid=317

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Saturday, September 8, 2007 7:30 AM Continental Breakfast, Registration, Visit Exhibits

Session 5: ADMINISTRATIVE Karen S. Rheuban, MD, Moderator Legal and regulatory issues continue to present barriers to using telemedicine technology to better serve pediatric patients. Panelists will discuss current and future federal and state legislation governing telemedicine, as well as current and proposed lobbying efforts affecting the field. Strategies for successful implementation and management of new or growing telemedicine programs will be discussed, and program sustainability and predictors of success will be described. 8:30 Federal Legislation Governing Telemedicine Today

Karen S. Rheuban, MD

8:50 Research and Outcomes in Telemedicine Dena S. Puskin, ScD

9:10 Implementation of a Telemedicine Program Kathy Chorba

9:30 Predictors of Success: How Best to Nurture and Sustain a Telehealth Network Jana Katz-Bell, MPH

9:50 Break

10:00 A Roadmap to Telehealth Policies, Regulations and Reimbursement

Jana Katz-Bell, MPH

10:40 The Children’s Partnership: The Role of Advocacy in Increasing Access to Child Healthcare through Telemedicine Jenny Kattlove

11:00 Q&A Panel

11:15 Lunch (on your own)

Session 6: INTERNATIONAL TELEMEDICINE Philip O. Ozuah, MD, PhD, Moderator Telemedicine is used to provide consultations and education to children all over the world. Successful programs now connecting more than 100 countries, as well as country-specific programs in Latin America, Africa, the Middle East, and the Pacific Islands will be discussed.

12:30 PM An Overview of International Telemedicine Philip O. Ozuah, MD, PhD

12:50 Medical Missions for Children Frank J. Brady

1:10 International Telemedicine in South America

Dale Alverson, MD

Visit Our Website at: http://www.ucdmc.ucdavis.edu/children/telemedicine/ Or Register Online at: http://www.cevs.ucdavis.edu/Cofred/Public/Aca/ConfHome.cfm?confid=317

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1:30 Pediatric Telemedicine in the Military Anne Naclerio, MD, MPH, LTC, MC, USA

1:50 Telepediatrics: The Brisbane, Australia Experience Richard Wootton, DSc

2:10 Q&A Panel

2:25 Meeting Wrap-up James Marcin, MD, MPH

2:30 Colloquium Adjourns

CALIFORNIA AB 1195 With the passage of California Assembly Bill 1195, signed November 2005, continuing medical education courses with patient care components are required to include curricula in the subject of cultural and linguistic competency. It is the intent of the bill, which went into effect on July 1, 2006, to encourage physicians and surgeons, CME providers in the state of California, and the Accreditation Council for Continuing Medical Education to meet the cultural and linguistic concerns of a diverse patient population through appropriate professional development. The planners, speakers and authors of this CME activity have been encouraged to address issues relevant in their topic area. In addition, a variety of resources are available to address cultural and linguistic competency, some of which will be included in the syllabus or handout materials. Additional resources and information about CA AB 1195 can be found on our website at http://cme.ucdavis.edu.

UC DAVIS HEALTH SYSTEM CME MISSION The Office of Continuing Medical Education at the University of California, Davis, Health System (School of Medicine, Medical Center and Medical Group) offers physicians and other health-care professionals educational opportunities that foster excellence in patient care. In concert with the overall mission of the UC Davis Health System, our endeavor is supported by the Office of Continuing Medical Education Advisory Committee to ensure that activities comply with the Essentials and Standards of the Accreditation Council for Continuing Medical Education. We support the concept of continuous undergraduate, graduate and post-graduate medical education throughout the lifetime of the health-care professional. To achieve our mission, we support the expansion of both traditional and innovative modes of learning.

DISCLOSURE As a sponsor accredited by the Accreditation Council for Continuing Medical Education, the UC Davis Health System, Office of Continuing Medical Education must ensure balance, independence, objectivity and scientific rigor in all individually or jointly sponsored educational activities. Speakers, moderators, panel members and planning committee members participating in a sponsored activity are expected to disclose to the audience any significant financial interests or other relationships with manufacturers of commercial products and/or providers of commercial services that will be discussed in their presentations. The intent of this disclosure is not to prevent speakers with significant financial or other relationships from making presentations. Rather, disclosure allows listeners to determine if content is evidence based and free of commercial bias, and it demonstrates how speakers will resolve conflict when it exists. All presenters must agree to provide verbal disclosure prior to presentations. A complete disclosure statement and acknowledgment of commercial support for this program will be included in the syllabus provided at the activity. Visit Our Website at: http://www.ucdmc.ucdavis.edu/children/telemedicine/ Or Register Online at: http://www.cevs.ucdavis.edu/Cofred/Public/Aca/ConfHome.cfm?confid=317

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FACULTY

COURSE CO-CHAIRS James P. Marcin, MD, MPH, Director, Pediatric Telemedicine Program, Associate Professor of Pediatrics, Pediatric Critical Care, UC Davis Children’s Hospital Kourosh Parsapour, MD, Assistant Professor of Pediatrics, Pediatric Critical Care, UC Davis Children’s Hospital

GUEST FACULTY Dale Alverson, MD, Medical Director, Center for Telehealth and Cybermedicine Research, University of New Mexico, Professor of Pediatrics, Regents' Professor, University of New Mexico School of Medicine, Albuquerque, NM Recipient of the 2007 American Telemedicine Association President’s Award Frank J. Brady, Chairman, Medical Missions for Children, St. Joseph’s Children’s Hospital, Paterson, NJ Miles S. Ellenby, MD, FAAP, Assistant Professor, Pediatrics and Anesthesiology, Division of Critical Care Medicine, Doernbecher Children's Hospital, Oregon Health and Science University, Portland, OR Deborah C. Hall, MD, Medical Director, Rural Early Access to Children’s Health (REACH), Center for Development and Disability, Department of Pediatrics, University of New Mexico School of Medicine, Albuquerque, NM Neil Herendeen, MD, Director, Strong Pediatric Practice, Associate Professor of Pediatrics, Golisano Children's Hospital, Medical Director, Health-e-Access, University of Rochester Medical Center, Rochester, NY Charles Hott, MD, Emergency Medicine, Frank R. Howard Memorial Hospital, Willits, CA Jenny Kattlove, Health Policy Manager, The Children's Partnership, Everett, WA Dorota Kopycka-Kedzierawski DDS, MPH, Assistant Professor, Department of Community Dentistry and Oral Disease Prevention, University Dental Faculty Group, University of Rochester Medical Center, Rochester, NY Ira T. Lott, MD, Professor of Pediatrics and Neurology, Director, Child Neurology, Associate Dean, Clinical Neurosciences, Director, Neurosciences, UC Irvine Health System, Irvine, CA Ravi Nemana, MBA, Executive Director, Services Science, Management & Engineering, Center for Information Technology in the Interest of Society (CITRIS) at UC Berkeley, Berkeley, CA Charles Niesen, MD, Assistant Professor, Division of Pediatric Neurology, Cedars-Sinai Medical Center, Los Angeles, CA Lt. Col. Anne Naclerio, MD, MPH, Chief, Pediatric Critical Care, Tripler Army Medical Center, Honolulu, HI Visit Our Website at: http://www.ucdmc.ucdavis.edu/children/telemedicine/ Or Register Online at: http://www.cevs.ucdavis.edu/Cofred/Public/Aca/ConfHome.cfm?confid=317

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GUEST FACULTY CONTINUED Philip O. Ozuah, MD, PhD, Professor, University Chairman, Physician-in-Chief, Children's Hospital at Montefiore, Albert Einstein College of Medicine, Bronx, NY Dena S. Puskin, ScD, Director, Office for the Advancement of Telehealth, United States Health Resources and Services Administration, Rockville, MD Terry Rabinowitz, MD, FAPA, FAPM, Associate Professor of Psychiatry and Family Medicine, University of Vermont, Director Telepsychiatry, Fletcher Allen Health Care, Burlington, VT Chair, American Telemedicine Association Telemental Health Special Interest Group Karen S. Rheuban MD, Medical Director, Office of Telemedicine, Professor of Pediatrics, Senior Associate Dean for Continuing Medical Education, University of Virginia, Charlottesville, VA Vice President, American Telemedicine Association Thomas L. W. Roe, MD, Clinical Professor, Oregon Health Sciences University, Pediatrician, Peace Health Medical Group, Eugene, OR Richard Wootton, DSc, Director, Centre for Online Health, University of Queensland, Royal Children’s Hospital, Herston Queensland, Australia

UC DAVIS HEALTH SYSTEM FACULTY Kathy Chorba, Manager, Business and Program Development, Center for Health and Technology Anita Grady, MD, FACC, Assistant Professor, Pediatric Cardiology, UC Davis and UC San Francisco, Director, Pediatric and Fetal Echo Lab at UC Davis Jana Katz-Bell, MPH, Assistant Dean, Administration, Chief Administrative Officer, Center for Health and Technology Kristen MacLeod, MD, Pediatric Fellow, Volunteer Clinical Faculty, CAARE Diagnostic and Treatment Center, UC Davis Children’s Hospital Thomas S. Nesbitt, MD, MPH, Executive Associate Dean, UC Davis Health System Ulfat Shaikh, MD, MPH, Assistant Professor of Pediatrics, UC Davis School of Medicine Javeed Siddiqui, MD, MPH, Assistant Professor of Clinical Medicine, Division of Infectious and Immunologic Diseases, Associate Medical Director, Center for Health and Technology Dennis Styne, MD, Professor, Pediatric Endocrinology, UC Davis Health System Juan Trujano, Programmer III, Department of Pediatrics

CONFERENCE COORDINATOR Candace Sadorra, Program Administrator, Pediatric Telemedicine Program, UC Davis Health System Visit Our Website at: http://www.ucdmc.ucdavis.edu/children/telemedicine/ Or Register Online at: http://www.cevs.ucdavis.edu/Cofred/Public/Aca/ConfHome.cfm?confid=317

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ENROLLMENT AND REGISTRATION INFORMATION

Space is limited – enroll early. Tuition is $400 for physicians and $300 for other practitioners, rural physicians and UCDHS and UCD School of Medicine volunteer faculty, alumni, faculty and staff. See enrollment form for details. Tuition includes continental breakfast daily, lunch and afternoon refreshment breaks on Thursday and Friday, a course syllabus and certificate of attendance. Payment may be made by Visa, MasterCard, American Express, or Discover when enrolling online at http://www.cevs.ucdavis.edu/Cofred/Public/Aca/ConfHome.cfm?confid=317 Payment may be made by check when enrolling online, or by mail when completing the attached enrollment application. See below for information on purchase orders. Program materials cannot be guaranteed unless enrollment is received by August 15.

PURCHASE ORDERS Purchase orders are accepted. In order to complete your registration when paying by PO, you must fax a copy of the PO with your enrollment application to (916) 456-2235, attention: Candace Sadorra.

CANCELLATIONS AND REFUNDS Refunds for cancellation must be requested in writing by August 17 and will be subject to a $50 service charge. Refunds will not be made for cancellations postmarked after August 17, or for those who register but do not attend. UC Davis Children’s Hospital reserves the right to cancel this program. In such case, a full refund will be given.

REGISTRATION QUESTIONS? Contact Candace Sadorra: candace.sadorra@ucdmc.ucdavis.edu or (916) 734-3224

CONFERENCE LOCATION AND ACCOMMODATIONS Hyatt at Fisherman's Wharf 555 North Point Street San Francisco, CA (415) 563-1234 http://fishermanswharf.hyatt.com/hyatt/hotels/index.jsp The Hyatt at Fisherman’s Wharf is located in the heart of one of the top tourist destinations in the world featuring historical points of interest, wonderful local restaurants, shopping, Pier 39, Cable Cars, Ghirardelli Square and access to Alcatraz just steps from the front doors. The historic neighborhood of Fisherman’s Wharf is minutes from Chinatown, North Beach, the Golden Gate Bridge and Union Square. Visit Our Website at: http://www.ucdmc.ucdavis.edu/children/telemedicine/ Or Register Online at: http://www.cevs.ucdavis.edu/Cofred/Public/Aca/ConfHome.cfm?confid=317

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Staying at the Hyatt at Fisherman’s Wharf helps UC Davis meet contractual obligations with the hotel and assists in keeping future enrollment fee increases to a minimum. We ask that you consider the Hyatt at Fisherman’s Wharf when making your travel arrangements. A limited block of rooms is reserved until 5:00 pm, August 22 for conference participants at the discounted rate of $209 single or double occupancy plus hotel and sales tax. These rates may also be available if you wish to extend your stay. After August 22, rooms and rates will be based on availability. Go to https://resweb.passkey.com/Resweb.do?mode=welcome_gi_new&groupID=97419 or call 1-888-421-1442 and mention you are with the UC Davis Pediatric Telehealth Colloquium to receive the discounted rate.

PARKING The Hyatt at Fisherman’s Wharf offers overnight valet parking with in and out privileges at $38 plus 14 % tax per night. Day parking is $5.00 per hour, or $19.00 plus tax maximum for group attendees.

GROUND TRANSPORTATION Bay Area Rapid Transit: http://www.bart.gov/index.asp Lorrie’s Airport Service: http://myhotelshuttle.com/ or (415) 334-9000 SuperShuttle: http://supershuttle.com/ or 800-BLUEVAN

DRIVING DIRECTIONS Directions From San Francisco International Airport (18 miles), San Jose and points South: Take US-101 North. Take the I-280 North Exit towards the end of the freeway, which turns into King Street, which then becomes The Embarcadero. Continue approximately 2 miles and turn left on North Point Street. Continue five blocks to Taylor Street. The Hyatt entrance is on the left, on North Point Street. The Hyatt is located on North Point Street between Taylor and Jones Streets. From Points North: Take US-101 South. Turn left onto Van Ness Avenue, then turn right onto North Point Street. The Hyatt is located on North Point Street between Taylor and Jones Streets. From Oakland and Points East: Take I-80 West toward San Francisco. Take the Fremont Street exit. Turn right onto Howard Street. Turn left onto The Embarcadero. Continue to follow The Embarcadero. Make a slight left onto North Point Street. The Hyatt is located on North Point Street between Taylor and Jones Streets. Visit Our Website at: http://www.ucdmc.ucdavis.edu/children/telemedicine/ Or Register Online at: http://www.cevs.ucdavis.edu/Cofred/Public/Aca/ConfHome.cfm?confid=317

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