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'HOV' Lanes for 'Superhighway'
NIH Joins Next Generation Internet,
Internet2 Development Efforts

By Carla Garnett

On the Front Page...

Almost 30 years old and already the Internet is, well, sluggish sometimes, especially while performing high-speed, high-capacity applications. Try juggling a few large-file sites in the heart of the day, then imagine how long it would take to crunch very large amounts of data for a research project or conduct a virtual reality experiment on the Internet. Add in the ever-increasing popularity of the so-called information superhighway and you easily could find yourself sitting in the mother of all traffic jams. Or worse, maybe you have an interesting new concept with 'Net application, but, anticipating the tie-ups, do not even attempt developing the potentially valuable task. That's what was happening a little more than 2 years ago when some of the country's top universities and science and technology companies teamed up with the government to begin developing two powerful alternatives to the Internet -- the Next Generation Internet (NGI) and Internet2.

Continued...
"Today's Internet suffers from its own success," said Dr. Michael Ackerman, assistant director for high performance computing and communications (HPCC) at the National Library of Medicine, which has been instrumental in getting NIH involved early on with the NGI and Internet2 initiatives. "Technology designed for a network of thousands is laboring to serve millions."

Future Shock Absorbers?

To ensure that the Internet will be able to handle the pressure of future usage, he continued, Vice President Gore announced in spring 1996 the administration's support of NGI, which marshals the resources of such government entities as the National Science Foundation (NSF), the Department of Defense, NASA and NLM.

One of NSF's biggest contributions so far is development with MCI of the very-high-speed Backbone Network Service (vBNS) in 1995, which provides a high bandwidth network for research applications. According to information at its Web site, the nationwide network operates at a speed of 622 megabits per second using MCI's network of advanced switching and fiber optic transmission technologies. At that speed, the project boasts, "322 copies of a 300-page book can be sent every 7 seconds."

High performance interchange of the NGI/Internet2 (ATM switching equipment) located in NLM's Computer Science Branch, Lister Hill Center

Ackerman notes that as an NIH component, NLM -- purveyor of the grand Visible Human Project several years ago -- has long endorsed applying HPCC technology to health research. "The library has plans to sponsor a variety of NGI healthcare applications in such areas as advanced telemedicine and distance learning," he said. The development of NGI is necessary for such applications, he explained, because they often require the "nearly instantaneous transfer of massive amounts of data. Perhaps, more importantly, the transfer must be highly reliable and the integrity of the data must be rigorously maintained."

What NIH will contribute to both NGI and Internet2 are start-up investment funds, technological and engineering expertise, and development of medical research applications that can make the best of expanded 'Net capability.

No Time for Tie-Ups

"With NIH's biomedical research mission and increasingly more complex science applications, it's really more critical for NIH to be able to communicate at high speeds with universities than with most other agencies of the federal government," said Roger Fajman, head of the systems development and support section of DCRT's Network Systems Branch and one of NIH's liaisons to Internet2, a smaller-scale project developed by a group of universities with aims similar to NGI. NIH was the first non-university organization to become a regular member of the more than 115-institution Internet2 consortium whose goal is to build a high-speed, members-only network devoted solely to science, research and education pursuits.

Currently, the Internet is open basically to anyone with a computer connection and a service provider. While universal access is good in most respects, it obviously also significantly increases on-line traffic, which is not at all good for what are called "data-intensive" or "data-mining" applications. These applications require higher bandwidth (connection speed) and larger capacity than is possible with so many other travelers on the 'Net. Fajman says to think of it this way: The typical television image is updated electronically about 30 times per second; in contrast, most video images on computers are updated at varying speeds of about 5 times per second. "Video images on computers are usually much smaller than TV pictures," he explains. "The size of the images affects the data rate." If Internet2 can bring network computer imaging up to speed, imagine the boon to telemedicine and teleconferencing alone.

Coming to a GigaPoP Near You

By mid-1998, Internet2 will consist of several GigaPoPs, or high-speed, high-capacity connection points to the vBNS and other national networks, around the nation. These will link Internet2 members to each other for communication and, ultimately, scientific collaboration.

NIH's nearest vBNS connection point will probably be in Perryman, Md., near Aberdeen, according to Fajman. Internet2 GigaPoPs are as close to NIH as the University of Maryland, College Park. Since the cost of connecting at high speed to Perryman is quite high, connecting to a local GigaPoP can save money and provide other benefits as well. Other institutions in the Washington and Baltimore areas are in the process of or are considering connecting to the Baltimore-Washington GigaPoP.

Examples of some probable NGI/Internet2 applications include medical imaging for pathology, radiology and mammography, and maintenance and retrieval of multimedia data for patient records. A medical researcher on NIH's campus, for instance, would be able to consult with a physician at a university teaching hospital across country in real-time, while they both simultaneously view a patient's echocardiogram on their computer screens. (See sidebars for a description of several of NIH's early potential NGI/Internet2 forays. Also, researchers who want to discuss potential Internet2 applications can contact Fajman by phone, 402-4265, or email, rf4w@nih.gov.)

"Much of the healthcare community is just discovering the advantages and efficiencies afforded through use of advanced communications technologies such as the Internet," concluded Ackerman. "Getting medical practices connected -- in rural areas, for example -- is also still a formidable problem. NLM advocates progress in these areas while encouraging, publicizing and showcasing advanced patient care and medical research applications that use evolving NGI capabilities."

Aside from developing useful applications to take advantage of the increased capacity of these "HOV lanes" on the 'Net, what also remains to be worked out is how the two projects will work together. NGI, a government endeavor, is currently better funded and more expansive, but Internet2, the university-led effort, is further along in its implementation -- Internet2 GigaPoPs have already popped up in several areas nationwide and many Internet2 members, including NIH, are already in various stages of upgrading their servers and fiber optic equipment in preparation for connection. Eventually, according to DCRT and NLM experts, NGI and Internet2 probably will need to merge. Regardless of when and how the two link, though, NIH -- as a charter member of both projects -- is in prime position to reap the benefits for medical research.

First Steps on
New High-Tech Frontier

The National Library of Medicine has pioneered several key underlying technologies that are candidates for the Next Generation Internet and Internet2, according to Mike Gill of NLM's Communications Engineering Branch (CEB). One of the technologies being examined currently is asynchronous transfer mode, or ATM, which could improve transmission speed of live video, video databases, and large image files beyond the capabilities the Internet now has. CEB has been test-driving some of its NGI/Internet2-bound teleconferencing prototypes for a little more than
a year now.

Electronics engineer Mike Gill (r) of NLM's Communications Engineering Branch jokes that the branch's browser-based medical information retrieval system, or WebMIRS, was "just a gleam in" Rodney Long's eye about 18 months ago. WebMIRS developer Long (l) says if all goes well, the Java applet -- which allows the more than 20,000 x-rays and other key medical data from the National Health and Nutrition Examination Survey to be viewed via the Internet -- will be online by late spring.

In December 1996, CEB demonstrated its WebMIRS, a Java application prototype that allowed digitized x-rays and associated text datafiles in a multimedia database at NLM to be sent to the annual meeting of the Radiological Society of North America in Chicago. Taped and live (digitized) video were also transmitted, and a live 2-way question and answer video session enabled a scientist on campus to participate simultaneously in the meeting hundreds of miles away.

The second ATM trial -- a collaboration with DCRT -- transmitted the proceedings of a 4-day gene therapy conference from the Natcher Bldg. to M.D. Anderson Cancer Center in Houston via digitized video.

Last June, the ATM trial network carried the TeleHealth Care 1997 conference sponsored by the Texas Health Science Libraries Consortium at Baylor College of Medicine.

Most recently, NLM -- again teaming up with DCRT -- transmitted Jan. 21-22 the video proceedings of the "Developing U.S. Public Health Service Policy in Xenotransplantation" conference, sponsored by FDA, NIH, CDC and HRSA, to the M.D. Anderson Center in Houston. [For details on the conference see http://www.fda.gov/cber/meetings/xeno012198.htm.]

"All these trials demonstrated the high capacity service available via a technology that will be part of the infrastructure supporting Next Generation Internet and Internet2 applications," said Gill.


High-Performance Telemedicine:
The Radiology Consultation WorkStation

By Kenneth M. Kempner

The Radiology Consultation WorkStation (RCWS) is a multimedia, medical-imaging workstation that has been developed by staff of the image management and communication section of DCRT's Computational Bioscience and Engineering Laboratory.

Envisioned as a node in a nationwide telemedicine network supporting an electronic radiology environment, the RCWS uses a high-speed asynchronous transfer mode (ATM) network as the communication infrastructure. Each RCWS system enables the high-resolution display of medical images and provides a mechanism for remote consultations between medical specialists in one location and colleagues at multiple sites.


The Radiology Consultation WorkStation includes four monitors: two high-resolution black-and-white electronic view boxes (shown above) for displaying radiographic images, a standard color computer display, and a high-resolution video monitor to show video signals from the collaborative site. A pan/tilt/zoom video camera, mounted atop the video monitor, sends images through the ATM network to other sites.

Video and sound are transported through a high-speed 155 Mbits/sec ATM link to connecting RCWS systems elsewhere on an ATM network. Video capability is provided with a higher quality "S-video" camera and color monitor. Other video input devices will soon be added to the RCWS, including an S-VHS video cassette recorder, a high-resolution patient exam camera, and an overhead projector. Microphones and speakers allow voice communication. Two high-resolution monochrome image display systems function as electronic view boxes to show 14x17-inch electronic films.

"Telecursor" contouring can be performed in a manual or semi-automated consultation mode, allowing each participating clinician to outline features or regions for discussion and comparison. These will be transmitted in real-time during the RCWS consultation session.

Radiotherapy treatment planning is targeted as the initial application for RCWS. DCRT engineers and programming staff are working closely with Drs. Laurie Herscher and Rosemary Altemus and other staff members of the NCI Radiation Oncology Branch. Dr. R. Nick Bryan and staff members of the Clinical Center's diagnostic radiology department are also collaborators on the project. The RCWS is being tailored to help process CT image data before development of a radiotherapy treatment plan.

RCWS systems will soon be installed at Walter Reed Army Medical Center and the National Naval Medical Center enabling more effective collaboration between medical staff at radiation oncology clinics at these institutions and their NCI ROB colleagues.

An application being planned involves studies related to swallowing disorders, laryngeal function, and head and neck cancer. Dr. Barbara Sonies of the CC rehabilitation medicine department plans to use the RCWS to evaluate patients from St. Louis Barnes-Jewish Hospital's speech pathology department.

Speed Thrills

"DCRT has been looking at asynchronous transfer mode (ATM) ever since it was proposed as the technology of the future, around '93 or '94," says Jeff Hancock of DCRT's Network Systems Branch. Specifically, NSB has been looking at the technology as a way to increase the speed of the NIHnet backbone; offer higher performing and more flexible connectivity options to the institutes on and off campus; and transmit voice, video and data over the same network.

Jeff Hancock of DCRT's Network Systems Branch

DCRT has installed ATM switches around campus to support the division's scientific research and to allow transmission of real-time, full-motion video between buildings. Conferences from Natcher or Masur, Hancock explains, can be turned into ATM cells and transmitted to the rest of the NIH ATM infrastructure (desktop or remote conference center), to the conventional NIHnet and Internet, or to any site that connects to DCRT via ATM.

"We have also been actively involved in connecting our ATM infrastructure to high-speed ATM testbeds in the area," Hancock continues. "DCRT and NLM share, in all respects -- bandwidth, costs and technical administration -- a link to the DARPA-funded and Bell Atlantic-run ATDnet. [ATDnet (http://www.atd.net) is a high performance networking testbed in the area. Established by the Defense Advanced Research Projects Agency (DARPA) to enable collaboration among Defense and other federal agencies, ATDnet serves primarily as an experimental platform for diverse network research and demonstration initiatives.]

"This link is six times faster than the current 100Mbit NIHnet backbone links," Hancock says. "ATDnet has been used to test the effects of delay upon video transmission and as a way to connect collaborative sites in the metropolitan (National Naval Medical Center and Walter Reed Army Medical Center, for example) and wide (Washington University in St. Louis, if things go as planned) areas."

DCRT is also testing Bell Atlantic's production cell relay service that uses ATM. This service will allow varying ATM connectivity options to any off-campus building in the Washington area and will allow DCRT for the first time to offer the same quality of data transmission (plus video and voice transmission) to off- campus users who have typically had to endure lower speed connectivity due to cost. "Initial tests in Rockledge have been so successful that the TLCs [technical LAN coordinators] there call us and complain when they notice we have switched them back to the old connection," Hancock remarks.

Typically, on the current NIHnet, DCRT connects users to each other via routers, which are high speed interconnection devices. These devices stop all traffic and examine it to determine the best path on which to forward the data. When messages are sent, they pass through two or more routers, which delay the transmission of the message.

"Savvy institutes have been requesting direct connections between buildings for years in order to bypass this delay but there is not enough fiber to go around," Hancock explains. "With current technology, all LANs are connected to a DCRT router in each building and communicate over the NIHnet backbone. With ATM technology and the use of virtual LANs, DCRT could maintain ATM links that would connect NIH buildings to the NIHnet, but also provide dedicated bandwidth for direct data connections (called supernetting) between buildings as well as voice and video traffic. ATM's traffic management features allow different traffic types to be identified and run over the same fiber links. So where several fiber links would have been necessary, only one is needed."


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