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Application Needs for Computing and Communications

INTRODUCTION

The requirements of national-scale applications for computing and communications pose both opportunities and challenges that derive, ultimately, from the increasing capabilities of the technologies on which these applications depend. Significant increases in computation and communications performance in recent years have made qualitative differences in what can be done with information technology. For example, widespread deployment of data networks and the increasing processing and display capabilities of personal computers and workstations have made possible a powerful and highly adaptable new medium of communication, the World Wide Web. Advances in performance have raised application users' expectations about what their information technology tools can be counted on to accomplish; as Box S.2 notes, computing and communications are becoming part of the essential national infrastructure on which important sectors of the nation's economy and society depend.

This chapter identifies opportunities for taking advantage of information infrastructure to support the missions of people and organizations in five important application areas—crisis management, digital libraries, electronic commerce, manufacturing, and health care. Reflecting the language that often is used by people seeking to apply technology to solve a problem, the chapter sometimes characterizes these opportunities as "needs" for technology. Society's dependence on information technology is not absolute; certainly, fire fighters can continue to put out fires without computerized maps, and doctors can write clinical reports with pen and paper. However, continued dramatic improvements in the



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--> 1 Application Needs for Computing and Communications INTRODUCTION The requirements of national-scale applications for computing and communications pose both opportunities and challenges that derive, ultimately, from the increasing capabilities of the technologies on which these applications depend. Significant increases in computation and communications performance in recent years have made qualitative differences in what can be done with information technology. For example, widespread deployment of data networks and the increasing processing and display capabilities of personal computers and workstations have made possible a powerful and highly adaptable new medium of communication, the World Wide Web. Advances in performance have raised application users' expectations about what their information technology tools can be counted on to accomplish; as Box S.2 notes, computing and communications are becoming part of the essential national infrastructure on which important sectors of the nation's economy and society depend. This chapter identifies opportunities for taking advantage of information infrastructure to support the missions of people and organizations in five important application areas—crisis management, digital libraries, electronic commerce, manufacturing, and health care. Reflecting the language that often is used by people seeking to apply technology to solve a problem, the chapter sometimes characterizes these opportunities as "needs" for technology. Society's dependence on information technology is not absolute; certainly, fire fighters can continue to put out fires without computerized maps, and doctors can write clinical reports with pen and paper. However, continued dramatic improvements in the

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--> quality, efficiency, accessibility, and dependability of nationally important industries and services are realizable through advances in information technology and the integration of those advances into the work modes of organizations and individuals (CSTB, 1994a,b). Whether the proposed advances are expressed as needs or as opportunities, research relating to enabling technologies remains essential; it is the foundation for progress in information technology generally and for advances in the nature and uses of information infrastructure. In addition, actual growth in the use of electronic information and communications systems in the United States and worldwide creates a need for research into the complex problems of managing information and integrating information and communications services into broader human activities that involve ordinary citizens, including specialists in areas other than information technology.1 To explore needs and opportunities for use of computing and communications in crisis management and other selected application areas, workshop participants examined four classes of technologies, loosely reflecting a layered model of information infrastructure, with each set of technologies providing capabilities used by the higher layers. The organization of each section in this chapter reflects this classification scheme, proceeding from lower to higher layers. Networking—technologies related to networked voice, video, and data communications, including physical facilities (e.g., circuits, switches, routers), the communications services that make use of them, and the architectures, protocols, and management mechanisms that make networks function. Key aspects include, for example, bandwidth, reliability, security, quality of service, and architectural support for the integration of higher-level functions across the network. Computation—technologies related to computer processing, particularly in a distributed context. Traditional computation-intensive functions include modeling, simulation, and some aspects of visualization, among others. Key aspects include, for example, strategies for maximizing the use of processing power (such as parallelism and distribution), programming models, software system composition, and management of processing and data flows across networks, including representation of time and temporal constraints in distributed computing. Information management—technologies contributing to the creation, storage, retrieval, and sharing of information across networks. Components that may be integrated within an information management system include traditional databases, object databases for design applications, multimedia servers, digital libraries, and distributed file systems, as well as software applications that process or manage information. They also include remote sensors attached to networks. Key aspects include, for example, balance between central and distributed control, exchange of diverse types and formats of information across boundaries,

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--> integration of real and synthetic information (e.g., in virtual environments), and easy construction of new applications from existing components. User-centered systems—technologies for maximizing the utility of computer-based systems for the people who use them, including natural human-computer interfaces, alternative modes of information representation (e.g., speech, hypertext, visualization), artificial intelligence-based decision support (including knowledge-based systems and newer techniques for coping with uncertainty), and work-group collaboration technologies. Key aspects include, for example, ease of use for individuals and groups and the ability of applications and systems to adapt to user-specific skills and needs. The technologies for communicating and using information are highly interrelated, and this scheme is not intended to be rigid or perfectly consistent in applying a layered approach. To simplify discussion, the application area demands for computing and communications that are examined in this chapter are distributed somewhat arbitrarily among these four areas. A particular computing or communications application (e.g., tool, system) may span all of these levels—for example, an information system that helps a user answer a question. The system would assist by translating a need for information into a formal expression that automated systems can understand, identifying potential information sources (including the vast array of sources available across networks such as the Internet), formulating a search strategy, accessing multiple sources across the network, integrating the retrieved data consistent with the user's original requirement, displaying the results in a form appropriate to both the user's needs and the nature of the information, and interacting with the user to refine and repeat the search. This system would incorporate both information management and user-centered technologies, and these would rely on a supporting infrastructure of networking and computation. CRISIS MANAGEMENT Definition and Characteristics Crisis management was selected as the focus for Workshops II and III in the Computer Science and Telecommunications Board's series of three workshops on high-performance computing and communications because crises place heavy demands on computing, communications, and information systems, and such systems have become crucial to providing necessary support in times of crisis. Crises are extreme events that cause significant disruption and put lives and property at risk. They require an immediate response, as well as coordinated application of resources, facilities, and efforts beyond those regularly available to handle routine problems. They can arise from many sources. Natural disasters such as major earthquakes, hurricanes, fires, and floods clearly can precipitate

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--> crises. Man-made crises can be accidental, such as oil spills or the release of toxic substances into the environment, or they may be intentional, such as bombings by terrorists. Warfare clearly presents a continuing set of crises, and although operational warfare concerns were largely outside the scope of the workshop series, many of the characteristics and computing and communications requirements of crisis management in other contexts overlap with the needs of warfare.2 The military requirements for command, control, communications, computing, and intelligence (C4I), for example, have much in common with the nonmilitary crisis management requirements for understanding a complex situation and preparing a coordinated response. The relatively more centralized and hierarchical structure of military command in comparison to civilian organizations, however, introduces differences in the needs for and the available approaches to computing and communications in the two contexts. As John Hwang, of the Federal Emergency Management Agency (FEMA), observed, "Military command and control is becoming a discipline; however, civil crisis management is still in its infancy as a discipline." When does a situation become a crisis? One workshop participant observed that when he had to call up staff to run the crisis center, it was a crisis. This tautological comment underscores that the human decision to invoke extraordinary resources and management priorities implies a situation distinct from "business as usual": standard practices no longer apply. Beyond this commonsense observation, experts whose careers revolve around crisis management sometimes offer differing perspectives on crises and crisis management. To simplify the discussion and be consistent with its limited scope for investigation, the steering committee has framed these issues in somewhat general terms in examining the relationships between the crisis-related conditions in which computing and communications may be used and the features or functions of those technologies that are needed. Crisis management has several phases or components with different time horizons. Among these are preparedness (including planning and training), crisis avoidance (averting a developing crisis), response, and recovery.3 Much of the discussion at the workshops centered on response-related activities, which offer particularly severe challenges across a range of technologies. Response to a crisis involves an initial reaction with available resources, a rapid assessment to determine the scope of the problem, mobilization of additional resources (such as personnel, equipment, supplies, communications, and information), and integrating resources to create an organization capable of managing and sustaining the required response and recovery. During and after the response, the need to disseminate information to the public, including the press, is an important part of the context within which crisis managers operate. The workshops also addressed questions of preparedness, since preparations and plans can alleviate difficulties associated with response and recovery from a crisis. Requirements at each phase differ. For example, conventional (e.g.,

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--> scheduled) training is needed for the earlier phases, while at crisis time, ''just-in-time" training is needed to bring people up to speed. Recognition of pre-crisis phases illuminates opportunities for specific preparations, such as the simulation of possible crises to identify likely needs, which can guide the pre-positioning of resources in anticipation of predictable kinds of crises (e.g., earthquakes, floods, or tornadoes in areas prone to such natural disasters) or the formation of plans to access them when needed. An analogy may be made to the emergency room of a hospital. Statistical expectations may help to pre-position equipment, supplies, and trained staff. During holidays, traffic accidents tend to increase. This situation can be handled with an increase in emergency room staffing and supplies to meet the predicted demand; however, the next emergency that is wheeled in the door is usually not predictable as to specifics. A major crisis that overwhelms the capacity of the emergency room in a way that cannot be predicted requires contingency plans and coordination with other organizations, in order to locate and bring in additional resources or to divert patients elsewhere. These tasks grow increasingly complex at scales larger than a single emergency room, where many organizations and kinds of resources become involved. Many such tasks relate directly to or make use of computing and communications, since important resources for crisis response and recovery include information repositories, computing capacity, and emergency communications links. Two sets of broad goals for using information resources to support crisis management, one from FEMA and one from the nongovernmental National Institute for Urban Search and Rescue (NI/USR), are presented in Box 1.1. Workshop participants identified several distinctive characteristics of crises and factors relevant to managing them: Magnitude. Crises overwhelm available resources. (This is the distinction made, at least for the purposes of the workshop series, between crises and emergencies.) In many cases, problems that are manageable at one level become crises as the magnitude of the problem increases beyond normal or expected bounds, thus overwhelming the resources on hand. An automobile accident or a fire in a single building requires emergency services—fire engines and ambulances are dispatched—but does not overwhelm those services and so is not a crisis. Overload situations may lead to crises. They may arise, for example, in telephone systems, power plants, weather centers, and hospital emergency rooms. Hospitals in a region may be prepared for a certain number of emergency patients within a 24-hour period, but will experience a crisis if ten times as many patients arrive. Urgency. Crises have a serious, immediate impact on people and property and require an immediate response. Lifesaving fire, rescue, and emergency medical services are clear examples. Citizens also want immediate access to information about obtaining disaster relief, such as emergency loans to replace lost homes and property, and rapid processing of claims. In some crises, a fast

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--> BOX 1.1 Goals for Using Information Resources in Crisis Management At Workshop II, John Hwang, of the Federal Emergency Management Agency (FEMA), identified four major areas for applying information technology: Situation assessment, both immediately after a crisis begins and updated throughout the crisis; Emergency lane communications so that emergency managers can communicate despite structural damage and traffic congestion—including broadband communications; Public access to emergency information, such as warnings, directions to shelters, and ways to obtain relief afterwards; and Claims processing after the crisis. The FEMA Information Systems Directorate's "Strategic Plan for Information Resources" (September 30, 1994)1 sets the following goals: Reduce the effect of potential or impending disasters. Improve training and exercising through the use of information technology. Enhance the local, State, and Federal Government's ability to set up response operations and provide direct disaster assistance after a Presidential disaster declaration. Improve victim registration and processing. Increase the availability and timeliness of emergency management information. Better coordination of Federal, State, and local emergency management functions. The National Institute of Urban Search and Rescue provides the following vision statement:2 "Vision 2000": Crisis Information System Without such a [crisis information] system there can be no coordinated, cost effective, efficient response. We have established the following goals for the crisis communication architecture: To Deliver the Right Information To the Right People Within the "Action Cycle" To Save the Greatest Number of Lives To Protect the Largest Amount of Property To Contain the Event at the Lowest Possible Level To Guarantee a Sustainable Economy for the United States. 1   Available from the FEMA Information Systems Directorate home page at http://femapub1.fema.gov/fema/infosys.html. 2   Available from NI/USR home page, http://www.silcom.com/~usar.

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--> response may reduce the need for later countermeasures. For example, in a communications network overload, a cascading problem may be avoided by isolating the failure quickly, thereby diminishing the need for greater corrective measures later. Although more slowly developing, broad-scale problems such as global climate change, disease, or overpopulation are crises of a long-term nature, workshop discussion generally centered on shorter-duration events with severe time pressures. (However, it is important to note that long-term effects may influence planning for short-term crises; for example, Steven Smith, of the National Center for Atmospheric Research, noted research suggesting that global warming is linked to an increase in the intensity of extreme weather-related disasters, such as floods and hurricanes.) Infrequency and unpredictability. Some high-magnitude events, such as earthquakes, are not necessarily unexpected, but they occur infrequently and their location and magnitude are unpredictable. Therefore, it is not feasible for agencies with constrained budgets to keep on hand the extraordinary resources needed to handle crises in every location where they might occur. The nature of the warning influences the ability to respond; earthquakes, for example, occur with effectively no warning, whereas approaching hurricanes can be tracked, although their exact landfall is difficult to predict more than a few hours in advance. Crisis management thus requires contingency plans for identifying needed resources—including resources that other agencies or organizations can offer—and deploying them rapidly. Uncertainty and incompleteness of information and resources (combined with a need to respond in spite of these shortfalls). Even with complete information, chaotic conditions during a crisis make the prediction of future conditions uncertain. A strategy of waiting and watching is not generally viable in a crisis, and so decision makers must be prepared to act despite these limitations and to change course as new information becomes available. Special need for information and access methods. Both prior to and during a crisis, there may be extraordinary needs for more and different sorts of information (both from the crisis scene and from remote sources of information and expertise), as well as for sharing and presentation of information to decision and judgment makers, analysts, workers in the field, and the public. These parties' needs create demands for information flows into, within, and out of the crisis area. Often, special tools and access methods are needed to consolidate information from disparate sources. For example, in the search and rescue efforts after the Oklahoma City bombing in April 1995, information was consolidated from many sources—including agencies with offices in the Alfred P. Murrah Building and nearby damaged buildings, architectural diagrams, city maps, digitized photographs of the scene, and reports from rescue workers—to map the buildings and determine the high-probability locations of missing people. This allowed the searches to focus on those locations, thereby avoiding useless and dangerous searches of lower-probability locations.

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--> Multidimensionality. Some events become crises because of their multidimensional nature and side effects. A crisis that damages the transportation system can create crises in systems that depend on transportation, such as medical services; it may also inhibit a rapid response, thus worsening the problem. A power failure in New York during a heat wave may cause not only health and safety risks for people caught in a subway system, but also economic disruption due to the interruption of computer-based financial transactions (e.g., stock trading). Several workshop participants commented on the greater consequences associated with physical events that caused economic disruption, especially disruption to the financial system of the country or world. Location and social context. Where a crisis occurs influences its nature and the ability to respond. Many communities apply a rational cost-benefit analysis that gives planning for highly unlikely events a low priority. Thus California, which expects to have earthquakes, is better prepared for them than are other states. Crises may be international, national, regional, state, or local in scope. International events have the broadest set of issues, but perhaps lower expectations from the U.S. public for speed and comprehensiveness of response. The political and social context can create resource limitations in local crisis management. This has obvious implications for communities' preparation for crises, among which is limited ability to acquire and use information technologies effectively. As Nicole Dash, of the University of Delaware, stated, In addition to technological advancements, we must also look at the human elements. One of our first priorities is to recognize that emergency management is often not a high priority in many communities. Community risk assessment tends to employ a rational choice approach in an attempt to balance cost and benefit. Because disaster is seen as rare, emergency planning is associated with high cost and low benefit. . . . In addition, emergency management personnel often lack the computer skills and hardware to utilize . . . technology oriented toward crisis management needs.4 The crisis management budget constraints of communities are outside the sphere of computing and communications research, but their implications are not. They demonstrate the potential value of research to make technology more affordable by reducing its complete life-cycle costs—making it not only cheaper to purchase, but also easier to set up and maintain, easier to integrate into existing organizational processes, and more usable without extensive training. Remote access to network-based resources and rapid deployment to crisis locations can also reduce costs to communities by making it possible to share resources. Comments in the workshops from crisis management professionals about the impracticality of learning and using complex, feature-overloaded equipment in the time- and resource-limited context of crisis management, however, showed that to realize these cost reductions, technology development must be informed by testing, measurement, and experience gained through deployment.5

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--> Scenarios Realistic crisis scenarios provide a context for understanding and analyzing the needs of crisis managers for computing and communications capabilities. The characteristics of crises discussed in the preceding section, "Definition and Characteristics," can be used in developing typical cases to motivate and test elements of a research agenda for computing and communications. Numerous crisis scenarios exist, developed by various civilian and military organizations for training and planning purposes. Access to some scenarios is necessarily restricted, in order to avoid spreading knowledge of vulnerabilities and response plans to potential adversaries. One publicly available scenario, which was used in Workshop III to stimulate and focus discussions, is summarized in Box 1.2. The scenario illustrates some of the range of demands that crises may raise. The steering committee also developed the fictional scenario presented in Box 1.3, describing a future crisis and some of the means by which relief officials might respond, given computing and communications capabilities beyond those currently available or tested in experimental contexts such as the Joint Warrior Interoperability Demonstrations (JWIDs) discussed in Box 1.2. These capabilities are extrapolated from current areas of research. The scenario draws on workshop discussions with both experienced crisis management officials and researchers in computing and communications. The scenario is somewhat fanciful and is not intended as a prediction of future capabilities or a recommendation for particular technical solutions. Its purpose is to illustrate specific ways in which breakthroughs and incremental advances in high-performance computing and communications could be motivated by the broad range of crisis management needs that workshop participants identified. Crisis Management Needs for Computing and Communications Networking and Communications When a crisis occurs, the first order of business is to find out what happened—to perform a situation assessment. Nicole Dash observed that a situation assessment poses two requirements related to communications. First, authorities (such as emergency services managers) at the location of the crisis must be able to communicate their community's situation to the world outside the crisis area; second, rapid response teams must be able to enter the area, perform an assessment, and communicate back what they find in real time. In many crises, the normal infrastructure of telephone and data networks will not be able to support these initial communications requirements, for one or more of the following reasons: the crisis is in a location with little communications infrastructure in normal times (such as a remote location or a developing country with weak infrastructure), the crisis itself has destroyed the infrastructure (as large natural

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--> disasters often do), or people overload the public networks by trying to call in or out of the area. The U.S. wireline telephone network is designed to maintain or restore basic voice communications in the event of emergencies, but it may not be possible to depend on complete restoration of telephone service. Walter McKnight, of the National Communications System (NCS), reported that a review by NCS found recurring communications shortfalls for national- and regional-level emergency users responding to disasters.6 These included the following: Inadequate voice services; Congested wireline and wireless services; Unknown radio frequencies for various relief organizations; Limited access to distributed information resources; Limited information sharing among different functional branches ("emergency support functions," such as transportation, communications, fire fighting, health and medical, hazardous materials, and food); Inability to send and receive electronic mail among users and regional offices (including difficulty finding users' addresses); and Lack of service provisioning (rapid setup) for telecommunications equipment and facilities. Commenting on the current state of crisis communications, John Hwang observed, I think one of the misconceptions is that . . . we have a very robust infrastructure already . . . that automatically, in times of crisis, is ready to deal with the emergency situation. It turns out that's just not true. . . . [I]n emergencies, there are a lot variables like mobility, survivability, breakdowns, things which just don't work the way you think [they're] supposed to work. Now, what happens is instead of depending on healing the entire infrastructure and bringing it back up again, what you have to do is find a way through it, which I always call the emergency lane problem. To respond to concern about congestion, federal agencies and telephone companies (both long-distance and local carriers) have worked together to develop the Government Emergency Telecommunications Service (GETS; see Government Issue, 1995).7 This is a program to reserve voice-grade, analog communications capacity (suitable for fax and modem as well as voice) for priority emergency users, such as federal, state, and local governments and industry personnel. Users access GETS by dialing a special 710 area code and entering a personal identification number (PIN). GETS became available in 1995 and was used in the JWID '95 exercise and in response to the Oklahoma City bombing, Louisiana floods, and (through international calling) the Kobe, Japan, earthquake.

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--> BOX 1.2 Joint Warrior Interoperability Demonstration 1995 Crisis Scenario The Department of Defense (DOD) conducts annual exercises for training and planning purposes and to demonstrate interoperability of the military services' information and communications systems. They are called Joint Warrior Interoperability Demonstrations (JWIDs). They seek to test and demonstrate technologies such as distributed collaboration and the use of intelligent decision aids; improved battle space management and a common tactical picture including integrated collateral intelligence information; improved joint, combined, and non-DOD agency interoperability; expanded use of commercial satellites and new switching technology; multilevel security; knowledge-based information presentation; expanded use of modeling and simulation including enhanced operations and simulation integration; telemedicine; and improved network management and planning, among others. In the JWID exercises, scenarios are used to create a framework for evaluating the performance of systems and planners in relation to valid, simulated operational requirements. Consistent with the growing military emphasis on operations other than war, recent JWIDs have addressed crisis management applications and have involved civilian agencies along with the military. The following scenario, related to natural disasters and subsequent complications, is excerpted from the description of Phase 3 of JWID '95 (conducted in September 1995).1 An earthquake measuring 7.6 on the Richter scale is registered by the U.S. Geological Survey as having occurred near New Madrid, Missouri. The epicenter is located at coordinates 36.5N–89.6W. The Director of the Arkansas Office of Emergency Services initiates response measures for the state. The Governor of the State of Arkansas, reacting to these actions, declares a State of Emergency and forwards request for Federal assistance. In response, elements of the Federal Response Plan [the federal coordination plan for responding to crises are activated and deployed to provide immediate response assistance and collection of data necessary to determine actual extent of damages. An initial Disaster Field Office is established at the State Emergency Operations Center to facilitate emergency response teams. Most of the state utilities and thoroughfares in the northeast quarter of the state are severely damaged or destroyed. Communications are limited to wireless in the damaged area. Loss of life and critical injuries are substantial and basic medical, shelter, power, food and water supplies are decimated. Some of the initial damages include: Seismic oscillation disrupts military communications capabilities in a southeasterly direction. A truck carrying chemical and/or biological ordnance destined for the Pine Bluff Arsenal is overturned and the payload (undetonated) is dispersed over a wide area. Numerous roads, bridges and interstate highways are inaccessible to emergency vehicles. Public utilities are nonexistent in the decimated area. Local telephone service is disrupted and limited. The populace of the affected area is without shelter, food, water and medical supplies. The JWID '95 Phase 3 exercise linked participants distributed in Arkansas and throughout the nation using the Government Emergency Telecommunications Service (GETS), which provides crisis managers with priority voice service over facilities of the public long-distance and local telephone services (Hazard Technology, 1995a). The National Aeronautics and Space Administration (NASA) Advanced Communications Technology Satellite (ACTS) and a commercial mobile data network were used for mobile communications. As part of the exercise, a state trooper "discovered" the spilled ordnance, identified it as dangerous using a database of chemical and biological hazards previously installed on his portable computer, and reported it via wireless e-mail to the Emergency Operations Center in Conway, Arkansas. There, an atmospheric dispersion model was run to predict areas in danger and to plan an evacuation and cleanup operation. Crisis managers shared maps, situation reports, briefings, weather data, and similar information over an "emergency information network," a secure subnetwork deployed over the Internet using World Wide Web technology. 1   Scenario document available from JWID home page, http://www.pacom.mil. Priority reservation systems of this kind do little for crisis response in regions where telephone infrastructure is damaged and not yet restored or has never existed. For these situations, wireless alternatives include terrestrial and satellite services. However, GETS does not have a mechanism for securing priority access to cellular telephone circuits, which typically become jammed during a crisis; this reduces its utility for users who must be mobile at the scene of a crisis. NCS has experimented with crisis communications integrating voice and data service via the T-1 (1.5 megabits per second) transponder of the National Aeronautics and Space Administration's (NASA's) Advanced Communications

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--> enterprise to be effective. However, the difficulty of integrating across these engineering functions is far from trivial. As David Jack, of the Boeing Company, said, Rationally we should be designing [a Boeing plane] from the tools [already installed] to reduce the manufacturing costs. We have some codes which we use for simulating the tooling. They tend to be rule-based. I haven't seen any clever way of handling those rules where the same rule may be used in configuring the airplane as is used in building the airplane. And you have got that huge logistical gap between the two. If you change one rule, does it change the other one? How do you manage that information? That's a problem that we're only starting to scratch up against. Simulation for prototyping purposes could yield more useful results if integrated with both virtual and actual tools that are to be used in production. Randy Katz, then of the Defense Advanced Research Projects Agency, discussed computational prototyping as . . . the ultimate dream of hyper-simulation that has been with the computer-aided design community for the last 40 years: the idea that you could have specialized accelerator hardware that could run simulations for you, [located] at special places across the network. You might include in your simulation actual processing equipment (e.g., ovens, furnaces and photolithography equipment); they will be connected, have a network interface on them. You'll like to be able to understand whether you can build a particular semiconductor process from end to end where some of the equipment exists, some is being designed, the process itself is being designed, combining a capability for simulation with the actual use of hardware devices that may exist. There are a lot of discovery, linkage, conversion, authentication, payment kinds of issues that take place in this kind of environment. You have to find the service providers . . . [and] be able to have assurances about intellectual property rights, just as you would with anything else you might decide to publish which could be copied and handed out without your knowledge. And, of course, you would like the use of these specialized pieces of equipment to be fee-for-service. Although the design phase is not itself a major cost item, decisions made at this stage lock in most of the full life-cycle cost of an aircraft, with perhaps 80 percent of total cost split roughly equally between maintenance and manufacturing. Thus, computational analysis should be applied in the design phase not only to optimize the product's performance parameters, but also to shorten the design and development cycle itself (reducing time to market) and to lower the later ongoing costs of manufacturing and maintenance. A hypothetical scenario from aircraft design illustrates how the integrated, design-for-manufacturability approach to engineering demands advances in computing and communications. The example considers design of a future military aircraft, perhaps 10 years in the future. This analysis is taken from a set of NASA-sponsored activities centered on a study of the Affordable Systems

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--> Optimization Process (ASOP), which involved an industrial team including Rockwell International, Northrop Grumman, McDonnell Douglas, General Electric, and General Motors.24 ASOP is one of several possible approaches to multidisciplinary analysis and design (MAD) and the results of the study should be generally valid for these other approaches. ASOP is designed as a software backplane (distributed across the nation) linking eight major services or modules. These are the design (process controller) engine; visualization toolkit; optimization engine; simulation engine; process (manufacturing, producibility, supportability) modeling toolkit; costing toolkit; analytic modeling toolkit; and geometry toolkit. These are linked to a set of databases defining both the product and the component properties. The hypothetical aircraft design and construction project could involve 6 major companies and 20,000 smaller subcontractors. This impressive virtual corporation would be very geographically dispersed on both a national and, probably, an international scale. The project could involve some 50 engineers at the first conceptual design phase. The later preliminary and detailed design stages could involve 200 and 2,000 engineers, respectively. The design would be fully electronic and would demand major computing, information systems, and networking resources. For example, some 10,000 separate programs would be involved in the design. These would range from a parallel CFD airflow simulation around the plane to an expert system to plan location of an inspection port to optimize maintainability. There are a correspondingly wide range of computing platforms from personal computers to high-performance platforms and a range of languages from spreadsheets to High Performance Fortran. The integrated multidisciplinary optimization does not involve linking all these programs together blindly, but rather a large number of sub-optimizations involving a small cluster of base programs at any one time. However, these clusters could well require linking geographically separated computing and information systems. Because an aircraft is a system that must function with very high reliability, a strict coordination and control of the many different components of the aircraft design is needed. In the ASOP model, there will be a master systems database with which all activities are synchronized at regular intervals, perhaps every month. The clustered suboptimizations represent a set of limited excursions from this base design, which are managed in a loosely synchronous fashion on a monthly basis. The configuration management and database system are both critical and represent a major difference between manufacturing and crisis management, where in the latter case, a real-time "as good as you can do" response is more important than a set of precisely controlled activities. Networking Intra- and interfirm collaboration among engineers and linked simulations and databases requires reliable, secure, and interoperable communications. The

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--> need for simulations to exchange large proprietary datasets leads to major requirements on both security and bandwidth for the communications infrastructure. Integrating actual tools together with virtual ones poses a specific research challenge for new control protocols that behave in predictable, understood ways across the actual-virtual boundary. More generally, information infrastructure supporting communication both between collaborating firms and within firms (e.g., manufacturing process control) is crucial to enabling the agile, distributed style of manufacturing envisioned in this section. Computation The computing resource for multidimensional optimization reflected in the ASOP scenario requires linkage of a wide variety of distributed machines ranging from small to large systems. This area is a severe test for metacomputing systems that support the synchronization and linkage of heterogeneous computing devices. These distributed simulations must be linked to the many databases involved in design and to the engineers making design decisions. Availability and performance requirements of distributed resources are likely much more predictable and stable than in the crisis management context; nevertheless, ease of setting up operational systems across organizational boundaries is a challenge to the success of distributed, collaborative projects. Information Management In manufacturing, there is a very structured set of databases that needs to be reliably interfaced with work flow, configuration management, and other tools. Crisis management, by contrast, emphasizes good interfaces to unanticipated databases. Manufacturing databases need to have high-performance capabilities when used to drive or support simulations. Critical to the successful linkage of many corporations with (logically if not physically) central information systems is the use of standards both in system (software) interfaces and in product data definitions. In the latter case, there could be some useful interactions between information technology standards development activities, such as Virtual Reality Modeling Language (VRML) for three-dimensional object representation, and industrial production standards development such as PDES/STEP (Product Data Exchange using the Standard for the Exchange of Product model data; CSTB, 1995b). Another critical problem in ASOP is integrating legacy systems. It is not economically reasonable to assume that industry will rewrite from scratch the large number of existing programs (10,000 in the scenario above), nor will firms rebuild all their databases to new information infrastructure standards. Using these resources across a broadly deployed information infrastructure requires advances in general-purpose, easily configurable technology for software

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--> integration (discussed in Chapter 2), for example, to take existing codes in multiple languages (e.g., Fortran, C, Lisp, Excel) and integrate them into a single, distributed system. User-centered Systems Both in crisis management and in manufacturing, critical decisions are made from composite systems involving humans, computers, and information systems. In crisis management, the emphasis is on intuitive judgment making with incomplete information. Manufacturing also requires good judgment for decision makers, but it represents a more classic decision support context that supplies engineers with information targeted very precisely at well-defined questions. These decisions need to be made by collaborations of geographically distributed engineers. This implies a need for collaboratory systems that link people and the information they need to make decisions. Health Care25 Computing and communications increasingly affect health care in many different forms. Among those discussed in the workshop series were direct patient care, medical research, development of new medical technologies, and management of financial and other aspects of health services. Health care will continue to be administered by a diverse collection of providers working in a very large number of geographical settings. The health care system in the future likely will be characterized by (1) integration of widespread databases; (2) digitization of most health care data modalities (e.g., x-rays, magnetic resonance imaging (MRI)), allowing their transmission across networks; and (3) increased application of telemedicine. Health care providers will need to discover and access information from many sites in order to be able to put together a comprehensive description of a patient's medical history. Although perhaps to a lesser extent than in crisis management, there are significant variability and unpredictability in both the types of information that must be obtained (text records, handwritten notes, medical imagery) and their location. For example, an integrated health care information infrastructure will be able to give providers ready access to an accurate and detailed account of a patient's medical history. Networked access could compensate for the current, almost complete lack of access to patient medical records in some kinds of crises, such as large natural disasters. At the same time, however, the infrastructure must protect the security and confidentiality of personal information. Medical decision support systems are increasingly used to help providers identify and evaluate different diagnostic workups and treatment plans. The ability to easily obtain large sets of longitudinal patient records will greatly facilitate the ability to carry out meaningful comparative analysis for clinical care

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--> and for health science and clinical research. Medical researchers and health care system administrators need to link multiple patient databases to one another and to auxiliary databases used to define such items as hospital facilities and procedures. Data must be encoded in a reasonably uniform fashion using standard vocabularies being developed—in the face of great challenges in achieving consensus among diverse parties—by the health care industry and medical informatics communities with the National Library of Medicine. Delays in formulating and agreeing on these standard vocabularies are part of the implementation context for health care computing and communications, and they are indicative of the challenge of hammering out a consensus on standards in most national-scale application areas. Networking The health care-specific applications of networking revolve around telemedicine. Telemedicine will enable remote consultation with individuals in their homes (an advantage for both mobility-impaired and rural patients) and with remote specialists. Telemedicine should support not only voice and video communications, but also real-time data from a range of medical sensors such as heart monitors and blood chemistry analyzers. Although the bandwidth requirements associated with textual medical record information are modest, digitization of most health care modalities will lead to increasing bandwidth requirements. The need to deliver the data to remote computing resources for processing and integrating in real time also adds complexity to the management of the overall application—for example, integrating, on one hand, the requirements of voice communications for low latency even at the expense of reduced quality with, on the other hand, sensor data that may require low-noise characteristics to be useful. Integrating real-time sensor data—including data from field-deployed sensors, as in telemedicine—into a continuously updated patient record is another potentially valuable application. In addition to bandwidth and service requirements, difficult security issues arise because of the confidential nature of health care records and the potentially large number of health care providers who have a need to know about particular aspects of a patient's medical record. Strong guarantees of privacy, protection, and authentication will be required.26 New models of privacy and protection are needed to address emergency "need-to-know" circumstances, while providing for secure protection of privacy. The type of de facto protection afforded by the current health care system, which still is based largely on paper and disconnected computer systems, will diminish as medical information is placed on networks and powerful information location and retrieval mechanisms become available. There are important similarities between the requirements associated with emergency health care and crisis management. Network management must cope with near-real-time constraints that arise in emergency situations. Priority

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--> schemes must be structured to give priority to queries related to caring for emergency and critical care patients. During applications that are critical to life (such as image processing or expert assistance during surgery), uninterrupted, reliable service is vital. If the computational and network resources used for these applications are being used at the same time for other applications, mechanisms must be in place to prevent the denial of service due to resource limits. Computation The ability to generate large databases of longitudinal clinical records, combined with substantial computational resources, will enable statistically meaningful comparative analysis for clinical care and health science research. This analysis could enable identification of medically distinct models and templates to describe diagnostic workups and care plans, thereby improving the efficiency and effectiveness of health care. Secure methods are required, however, to disaggregate the information needed for such analysis from data that could be used to identify individuals. Routine testing is another potentially important computational demand. There are a number of high-volume, computationally intensive image screening applications (such as mammograms and Pap smears) in which semiautomated, well-implemented image processing methods could have a strong positive impact on efficiency and accuracy. Although real-time processing is not critical in this area, the huge volume of data to be processed imposes serious requirements for computational power. In addition, whereas some routine testing examples would simply involve the analysis of individual acquisitions, more robust methods would also include database acquisition and manipulation. One potentially valuable example is the use of change detection algorithms in mammography, in which a current scan is normalized and registered to a previously acquired scan of the patient; then the two are compared to highlight potential differences. Such an application would be enhanced further by the ability to register a new scan automatically to a canonical (standard healthy) reference or atlas, including estimating the deformation of the scan to account for patient variability. By registering to an atlas, any detected anatomical changes could be interpreted further based on knowledge of the tissue type associated with the matched portion of the atlas. Image processing is of course just one of many potential data inputs about patients that could benefit from this type of semiautomation. Computer-based patient status tracking, automatic record updating, and detection of changes and anomalies could be applied across a wide range of medical sensor inputs as well as clinical observations by health practitioners. Significant computational challenges arise in the context of areas associated with integrating robotics and image processing. The medical community increasingly seeks minimally invasive surgical procedures, with the expected benefits of reduced complications, reduced trauma for the patients, and reduced length of

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--> hospital stays, leading to reduced costs and an increased quality of life for patients. More effective use of minimally invasive procedures requires improvements in automatic or semiautomatic methods to localize anatomical structures for the surgeon and to facilitate presurgical planning. These methods should also support navigation of devices (by robot or surgeon) within the body and delivery of treatment and procedures in minimally invasive ways. One example of a significant computational challenge is enhanced reality visualizations, in which segmented and labeled anatomical models, acquired through three-dimensional medical sensors (such as MRI and computerized tomography (CT)) are automatically registered with the patient and displayed to the surgeon in a superimposed visualization showing internal structures directly overlaid on top of the patient, from the correct viewpoint. Ideally, such structures would be tracked and their registration refined over time, to maintain a consistent visualization as the surgeon changes view, the patient moves, and the patient's tissues deform. This problem is particularly relevant in endoscopic applications, where the surgeon has a limited field of view and navigation and localization become critically important. A second challenge is the use of robotic devices to assist a surgeon.27 Such devices include remote manipulation and tactile feedback devices for palpation of internal tissue, systems to deliver surgical tools and procedures to inaccessible locations (e.g., in sinus surgery), and tools to improve the accuracy and reliability of surgical procedures. Key computing requirements in these applications are real-time processing, high-bandwidth data storage and retrieval, and computational and data reliability. The creation of new medical devices can benefit from more extensive use of computer simulation. Simulations can reduce the time required to complete a design as well as the time needed for testing. With good three-dimensional models, the designer can evaluate the effect of various device parameters in its future physiological environment. For example, the ability to perform accurate simulations of blood flow through the heart with an artificial valve would help in the design of such devices. High-performance computing could allow the implementation of a more accurate model of the heart and greatly reduce the time it takes to perform such a complex simulation. Computational chemistry and molecular modeling are being applied to drug design, with scope for continued improvement as greater computing resources become available. There are potentially important overlaps between the types of computations that need to be carried out in the contexts of health care and crisis management. Both application areas make significant use of sensor data, and both will potentially benefit from different forms of data fusion. Both areas can benefit from increased use of simulation. Because medical care is an important facet of crisis management, the ability to access patient records would also be of potential use to crisis managers in providing postdisaster medical care. If crisis managers have information about the individuals affected by a disaster, an ability to access their

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--> longitudinal medical records could be used to help prioritize relief efforts by determining which individuals might have preexisting conditions requiring special attention. Information Management To coordinate patient care, it is necessary to be able to integrate inputs reliably from a subset of a very large number of heterogeneous databases. It should be possible to construct longitudinal medical records recording the care and health of each individual, by discovering and integrating distributed information obtained from multiple health care providers. Resource discovery is an important need because, in many cases, neither patients or providers are able to recall or locate key past health care providers. There is also a need to locate representative case histories for comparative purposes. Although some of these tasks can be performed in advance of emergencies, this is not always possible. In addition, integrating medical sensor data to update patient status adds further complexity and real-time constraints. The real-time character of medical emergencies (particularly if they occur in the large-scale context of a disaster or other crisis) highlights the importance of efficiency of these resource discovery and retrieval mechanisms. Currently only a small fraction of electronically stored medical data is in a form that is readily usable in automated clinical analyses, such as studies of treatment effectiveness. This situation will change as current practice improves and the health care community moves from computer databases that are largely oriented toward billing to databases aimed at recording information relevant to observing and improving individuals' care and health. The ability to obtain and process large sets of longitudinal patient records would greatly facilitate the ability to carry out meaningful comparative analysis both for clinical care and for health science and clinical research. There is a range of architectural approaches available for aggregating data for use in health systems research and in epidemiological studies. At one extreme is World Wide Web technology with knowledge agents accessing the database, which itself is in distributed form. The other extreme involves the occasional collection of needed information to a central aggregated database, which is then mined. (A centralized database incorporating medical records of everyone in the United States would be infeasible with current technology,28 and so this should be understood as an extreme example, beyond current capabilities.) Intermediate solutions correspond to generalizations of data-caching strategies familiar in parallel and distributed computing (e.g., dividing the data and storing each part closest to where it will be needed for access or processing). Aggregating patient records for health research raises problems of maintaining the privacy of personal information, because it is difficult to sanitize patient records by removing all data that could disclose a patient's identity (including

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--> telephone numbers, addresses, birthdates, and others). These problems are made more complex if the later identification of individuals by aggregating these data with other information sources such as financial records is also to be deterred. These threats indicate opportunities for technological advances to help prevent such compromises of privacy while facilitating legitimate research (IOM, 1994). Both health care and crisis management share a need to search a heterogeneous collection of databases. In the health care context, it usually is not necessary to access databases that have unanticipated qualitative features. Both emergency health care and crisis management share analogous security and policy issues associated with the need to access crucial information rapidly without incurring significant security-related delays. User-centered Systems An integrated health care information infrastructure would be capable of giving providers ready access to an accurate and detailed account of a patient's medical history. However, this information is useful only if the caregiver can readily obtain and understand critical information, especially during emergencies. Significant, continued research efforts are needed to improve both the caregiver's ease of using medical information systems and the ease with which caregivers may insert new clinical information electronically into patient records. These embody issues both within and outside computing and communications technology. Examples of the former include user interfaces, natural language processing, and handwriting recognition, whereas broader implementation contexts might include incorporating informatics into medical school curricula. Even with access to all available information, health care providers are often faced with—and are trained for—making intuitive decisions when available information is not complete. Economic pressures in the health care industry, however, have created a need for providers to justify the medical treatment they provide. This pressure is spurring research into the development of health care decision support. One important area that may underlie the development of decision support systems is the need for standard encoding processes to represent care plans and diseases. (This is not only a problem of finding technically optimal encoding schemes; as noted above, there are also challenges in reaching consensus among diverse parties about what names to use to distinguish various diseases, conditions, treatments, and the like.) These techniques should support the development of process representations, the automatic detection of processes from database records, and identification of similar process representations. This is analogous to crisis managers' need for support in making judgments, but with less unpredictability about the types of decisions that must be made, and therefore the ability to tailor rule-based decision support systems toward specific questions. Health care would also benefit from increased deployment of remote

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--> collaboration technologies optimized for telemedicine, teleradiology, and perhaps telesurgery, along with remote sensing mechanisms to facilitate remote physical examinations. Effective use of these tools requires not only bandwidth and security, but also effective shared environments for communicating and working collaboratively with information about patients and resources. There is a strong overlap between this application need and crisis management, where the expertise and equipment for health care delivery may be damaged or remote from the crisis location. NOTES 1.   The Information Infrastructure Technology and Applications component of the federal High Performance Computing and Communications Initiative was formed in 1994 to promote research and development of technologies for a broadly accessible national information infrastructure. The Digital Libraries Initiative discussed in this chapter funds a range of projects related to information storage, discovery, integration, and retrieval. 2.   The distinction between military and civilian crises does not necessarily extend to the mix of participants in a crisis response. For example, military personnel are frequently called upon to provide relief from natural disasters, and civilian relief organizations may be present in low-intensity military conflicts. 3.   Sometimes mitigation is included by crisis managers as another stage of crisis management. Mitigation involves efforts to lessen the impact disasters have on people and property. Examples of mitigation include using zoning to keep homes away from floodplains, engineering bridges to withstand earthquakes, and enforcing effective building codes to protect property from hurricanes. Successful mitigation has the effect of reducing the impact of a crisis and perhaps keeping a situation from becoming a crisis. For a detailed case study, see FEMA (1993). 4.   For further discussion of information technology costs, training needs, and usage patterns in civilian crisis management organizations, see Drabek (1991). 5.   For detailed discussions of the importance of deployment and feedback from actual users in the design and development of information technologies, see Landauer (1995) and CSTB (1994a, pp. 181-184). 6.   NCS is the primary agency responsible for communications functions in the Federal Response Plan for disasters. The study was conducted as part of a review of needs for a new service, the Emergency Response Link (ERLink), that the NCS is developing. 7.   See also the NCS's GETS home page, http://164.117.147.223/~nc-pp/html/gets.htm. 8.   Civilian relief agencies sometimes call upon U.S. military units to deploy similar capabilities. 9.   Available from NI/USR home page, http://niusr.org/vision.html. 10.   Whereas in a single organization it might be possible to dictate standards for interoperability, achieving agreement on standards is much more difficult when resources are owned and controlled by different organizations. This circumstance is increasingly common in many national-scale applications. 11.   An interesting note on the impact of the regulatory policy environment on scientific experimentation is illustrated by the fact, reported by Egill Hauksson at Workshop II, that the California Institute of Technology (Caltech) was unable to deploy an experimental earthquake network for all of California, rather than just Southern California, because the network service donor, Pacific Bell, was unable to carry communications between the two halves of the state on its own networks. It would have to hand off the communications to a long-distance carrier, which as Hauksson noted, could have less direct incentive to support a public need in California than would a local firm such as Pacific Bell.

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--> 12.   The Consequences Assessment Tool uses a model to predict damage from high winds that is adapted from a nuclear blast effects model developed by the Defense Nuclear Agency. The assessment tool is described in detail in Linz and Bryant (1994). 13.   For additional details, see NOAA HPCC home page, http://hpcc1.hpcc.noaa.gov/hpcc. 14.   Workshop participants observed that good judgments require not only access to information, but also a good general education on the part of judgment makers. 15.   See Drabek (1991) for results of a detailed investigation of the relationship between training and information technology use in crisis management organizations. 16.   Workshop series participant Clifford Lynch, Office of the President, University of California, made valuable contributions to this section. For a discussion of these research issues in greater depth and breadth, see Lynch and Garcia-Molina (1995). 17.   The unpredictable timing of such demands highlights the potential benefit of continuous update of information in both GIS and digital libraries, or at least the incorporation of associated information (meta-data) about the currency and expected reliability of information. 18.   Ordering and distribution of information-based (intangible) products can be nearly simultaneous, but the supporting accounting and inventory information, payment, and actual funds transfer may lag. The resulting decoupling of the accounting and payment information from the ordering and delivery of goods and services increases the credit risks associated with a transaction. 19.   Each payment mechanism tends to work in a manner analogous to a physical mechanism such as credit cards, checks, or cash. Developing and deploying interoperable, seamless support for multiple payment mechanisms at an economically feasible cost is a challenge with both institutional aspects (e.g., negotiating contractual frameworks) and requirements for research. 20.   Incorporation of video and sound into Web pages increases the richness of the content provided, but also increases the bandwidth required for access. 21.   Networks among ATMs involve links with known and stable locations and relatively predictable load patterns (unlike the networks needed for crisis management). 22.   For a more complete overview, see CSTB (1995b). 23.   This illustrates what might be called ''Amdahl's law for practical HPCC." For a classic discussion of key principles, see Amdahl (1967). 24.   For a detailed description, see Syracuse University and Multidisciplinary Analysis and Design Industrial Consortium Team 2 (1995). 25.   Workshop series participant Joel Saltz, of the University of Maryland, made valuable contributions to this section. For a discussion of these research issues in greater depth and breadth, see Davis et al. (1995). 26.   For a discussion of medical record privacy issues in a networked environment, see IOM (1994). 27.   Robots may find application in other elements of health care, such as handling and inspection of clinical or research specimens. 28.   The current research frontier is petabyte-sized databases. An estimate from the NSF Workshop on High Performance Computing and Communications and Health Care (Davis et al., 1995) postulated that nationwide adoption of computerized patient records over the next decade will yield a full database size of 10 terabytes, which is well beyond current database management capabilities. This corresponds to the equivalent of 100 text pages for each of 100 million patients.