From digital dawn to the Next Generation Internet in biomedical Information Technology

Amsterdam 12 April 1999 Since 1996, Dr. Swamy Laxminarayan is the Editor-in-Chief of the IEEE Transactions on Information Technology in Biomedicine (T-ITB). This scientific journal, launched under the sponsorship of the IEEE Engineering in Medicine and Biology Society (EMBS), addresses and highlights state-of-the-art application and infrastructure topics in medicine, biology and health care. At the recent ITIS-ITAB'99 Conference, Dr. Laxminarayan, in the role of Conference Co-Chair, presented an overview of the Information Technology (IT) Road Map as today's health care society rapidly moves from the basic Internet evolution to the initiatives of the Next Generation Internet (NGI), and from entity-centred technologies to a human-centric paradigm. The audience received an exploratory impression of the future convergence between IT and medicine.

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Since 1996, Dr. Swamy Laxminarayan is the Editor-in-Chief of the IEEE Transactions on Information Technology in Biomedicine (T-ITB). This scientific journal, launched under the sponsorship of the IEEE Engineering in Medicine and Biology Society (EMBS), addresses and highlights state-of-the-art application and infrastructure topics in medicine, biology and health care. At the recent ITIS-ITAB'99 Conference, Dr. Laxminarayan, in the role of Conference Co-Chair, presented an overview of the Information Technology (IT) Road Map as today's health care society rapidly moves from the basic Internet evolution to the initiatives of the Next Generation Internet (NGI), and from entity-centred technologies to a human-centric paradigm. The audience received an exploratory impression of the future convergence between IT and medicine.

In two years time, the T-ITB journal has developed a clear profile with regard to its paper acceptance policy, focusing on seven related themes. These range from networking and information infrastructure design; clinical and health care information systems; and distributed computing over high- performance computing and communications in medicine; audio, video, and multimedia applications; and all kinds of collaborative technologies in health care delivery to global information technology applications and issues. Each of these themes includes a whole range of already established or emerging IT applications. The list is very long but integrates innovative concepts, such as health information networks, remote services, security, electronic health care records, digital libraries, data mining, visualization and advanced multi-modality imaging in medicine, telemedicine and all of its specialities, robotics applications, virtual reality, and disease prevention through global networks.

Dr. Laxminarayan ascertains that some of the IT applications in biomedicine have come to fruition while others still remain in a continuous development process. A few initiatives even have largely exceeded the researchers' wildest imagination. As for the Internet, this tool has evolved into a real knowlegde-centric paradigm. The latest efforts involve the creation of an Interplanetary Internet Protocol, the birth of an architecture framework, provided with all the interplanetary gateways and communication interfaces for the eventual future manned and unmanned space missions, planned from the year 2040. When casting a look on the information infrastructure foresight, there are a number of specific developments playing a dominant role in the solution of complicated issues, like bandwidth constraints, traffic congestion, security, standards, interoperability, real-time multimedia flow operations, quality of service (QoS) problems, and on-demand data access.

The uniqueness of the TCP/IP protocol, the design of intelligent packets and active networks, the multicasting support, the transition from version four of the Internet protocol to version six, the various voice, video, and multimedia applications, and the so-called super supercomputer desktops address those types of challenges. Every single day, the Internet user is confronted with the existence of innumerable globally distributed and heterogeneous information repositories and information resources. At present, the need occurs to build an intelligent information retrieval infrastructure to organize and manage the billions of digital objects in this huge collection of databases. Questions rise on how to achieve a scalable, interoperable, and usable system. The concept of digital libraries emerges as an efficient solution to the issue of capturing, storing, organizing, searching, processing, and retrieving knowledge from all these electronic text, images, and multimedia data collections.

A major example of a vast structure of hundreds of small independent and heterogeneous data sources available to researchers, forms the domain of bioinformatics. Researchers in both areas of functional genomics and drug design are trying to understand the various roles proteins and genes play in different organisms and tissues. They require a discovery and verification paradigm based on data warehousing, data mining, and digital libraries. In this regard, the ambitious human genome project has been set up to identify the sequences of amino acids that constitute the proteins by using nuclear magnetic resonance and crystallography. This 3D structure determination is performed with advanced computer techniques to accelerate the analysis of known structures, sequences of proteins, folding properties, genetic trait as well as expression. It would indeed be exciting to get a fairly quick response to intelligent queries such as the comparison of the structural homologies of all proteins expressed in the human eyeball which lie on chromosomes 7, 8 or 11 and which are implicated with glaucoma.

Returning to the IT Road Map, Dr. Laxminarayan compares the concept of superconductivity, the phenomenon of almost perfect conductivity shown by certain substances at temperatures approaching absolute zero, discovered in 1967, with the concept of superconnectivity, today's phenomenon of almost perfect transmission of communication and information through the human habitation of the universe via computers. In the United States, the definition for a national information infrastructure (NII) emerged back in the eighties as "a system to deliver to all citizens the information they need, when and where they want it, but at a very affordable price". We need to replace the term "information" by the word "knowledge" today, as we moved from a national to a global information infrastructure via High Performance Computing and Communications (HPCC) techniques, the vBNS services, Internet2 and the future Internet3, as well as the Next Generation Internet.

In order to maintain competitiveness, the United States, in the eighties, have defined a whole range of agents, referred to as the national challenges, such as digital libraries, the need for education, life long learning, and health care, national security, environment, and so on. Today, the Health Care Agenda is one of the main topics, enabling health care providers to share critical data, increase accessibility, and reduce costs. In the early nineties, the massive parallel computing infrastructure came into existence, as to address the so-called grand challenges, relating to better drugs design, exploration of new molecules, structure analysis of biological molecules, and real time medical imaging. The HPCC development requires a continuous platform transition from megaflop to gigaflop, and from teraflop over petaflop to exaflop.

In 1986, the vBNS or very high speed network was launched, and currently operates at a speed of 622 megabits per second via Asynchronous Transfer Mode (ATM). Moving on from the vBNS, the research community in the US joined together involving 120 universities, to form the University Corporation for Advanced Internet Development (UCAID) for the creation of Internet2 with access to the vBNS. More recently, the multi-agency NGII or Next Generation Internet Initiative was set up to create state-of-the-art end-to-end networking technologies, able to provide speeds which are 100 to 1000 times faster than the current Internet, for advanced applications. Examples are the analysis of gene sequences, and the Visible Human Project, which will use NGI facilities for surgical simulators, remote control telemedicine, and distributed imaging of PET. In the next two or three years, all these applications are bound to come into function.

The future approaches to supercomputing and knowledge networking will be resolved in the convergence of computing and communications, in the spring of digital libraries, in the increased capacity to mine data, in high confidence systems for privacy, security and reliability, as well as in intelligent systems for collaboration between people and machines. We kindly invite you to visit the HPCC Web site for more details on High Performance Computing and Communications.


Leslie Versweyveld

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