First Outsource the Tech, than the Surgeons, than the Patients

Saritha Rai of the NY Times chats about how India, Singapore, and so forth are becoming low-cost surgery centers for global patients – including Americans. It’s just too costly here for most folks. And it’s the same doctors you’d see here, because most of them trained here in America. It’s just the surgery center is a, ahh, bit remote.

I don’t know if anyone has noticed, but this trend impacts the development and deployment of new techologies in health care significantly. Up until recently, the telemedicine craze has dealt with providing medical resources to poor areas more effectively, like an Indian reservation (common example). But the problem is there is no relationship with the doctors doing remote diagnostics, there is no high bandwidth connectivity, and there is no technical maintanance at the remote end. In other words, there are far too many other factors to make this work in practice at this time. William Jolitz spoke to this vexing dilemma in TeleMedicine Journal in the mid-90’s.

But if patients are “outsourcing themselves” as Rai describes, telemedicine becomes very practical. The high speed lines exist, the monies to maintain the technologies at either end exist, and they could use telemedicine as a diagnostic / relationship building tool before the patient flies to India (or Singapore or whereever) for actual treatment.

I think this will be a real trend here. And it completely changes the orientation of the healthcare technology industry from records to communications!

No, it’s not “High Power”, it’s now “Low Power”

You may have heard that servers at Google have been packed so tight they catch fire in the datacenter. Turns out power dissipation is the key – even laptops get hot, and servers stacked are fire hazards. It’s the power, everybody – the limiting factor to communications is power (according to Broadcom). What a difference a few years make. When I was invited to a meeting about InterProphet and SiliconTCP over at a major infrastructure company back then, the gal assigned to evaluate my work laughed at me when I seriously brought up the issue of low power and TCP. Of course, she also wanted to boast about some thesis she’d done on TCP about twenty years after everyone else. One (male) engineer, in hearing the description of the meeting said it was the first all-woman “pissing competition” on record. I told him just because I’m assigned a woman for due diligence because I’m a woman too doesn’t mean I get a free ride – frequently it’s the opposite. Alas, there’s no secret sisterhood in business, but envy is universal.

So, how do you swap hot hotswap servers? The key is low power TCP – you can’t burn out the stack anymore adding more and more processors (not to mention the management overhead) even in the datacenter (sorry Intel). You need to get the lowest power TCP stack possible. And that means a no-processor design.

The nontech “what does a low-power TCP hardware implementation do for me” (what a mouthful) is you get real full video on cellphones without burning out the battery as quickly. Since I’m doing automated full video production these days, that’s kind of my interest too. Paul Baran wrote the basic patents on cellular communications for audio/video. But he couldn’t achieve it fully because of this limit. He was so far ahead of his time it’s amazing. I wonder what he’d think now?

So Silicon Valley isn’t really dead technologically, despite what some people like to say. There are a lot of technology problems still to be solved, discussed in black and white in some legendary patents and papers from people like Baran that created entire industries. It’s all right here. When I read patents, it’s pretty clear to me that “everything *hasn’t* been invented yet”.

Unix was invented when I was in high school. The Internet – gee, it was old hat at Berkeley when I got there. Packet-switching? Baran. Cellular. Baran et. al. But no one man or woman could anticipate *everything* because a lot of the pieces just weren’t in place. So the inventors carefully outlined why things couldn’t work, or came up with nonviable solutions because of these missing pieces. It’s all there – if anyone wants to take the time to read it.

First They Watch the Movie, and Then They Read the Book

When Margaret Heffernan was on her book tour for The Naked Truth, an insider look at women in business, I grabbed her after the talk and had her do a brief pitch to her readers. Took me about five minutes to produce with MinutePitch. It was very satisfying to see the author of the book tell me why I should buy it. And as an open source pioneer in operating systems () and author of books and articles myself, I sure understand the need to speak to your reader directly. The Internet is the key for distribution – if you can get it off your camera first.

That’s what VidLit is about too, according to Daniel Terdiman at Wired. “To date, VidLit founder Liz Dubelman has created VidLit videos for seven books and has five more in the works. They range from one to three minutes and cost approximately $3,500 a minute to produce.”

Why that kind of cash, when advances for the lesser lights are usually in the $5,000 – $10,000 range, and when selling a printing run of 2,000 – 5,000 is doing great? M.J Rose, a novelist (formerly a contributor to Wired) thinks that “initiatives like VidLit and a few others are crucial in an era in which authors are having a harder time than ever getting publicity. ‘We’re in a crisis situation in publishing where there are 150,000-plus books published a year and review space has been cut by about 50 percent across the board. Either magazines have completely cut their review space, or newspapers have cut it back, or they’re using syndicated reviews’.”

The loss of review space is why they also like to plug a short vid into a blog. “Amazon spokeswoman Kristin Schaefer Mariani said that the company has begun incorporating VidLit videos as part of its “larger, ongoing effort to provide customers with a range of content to help them find and discover products that best meet their needs.”

I know Margaret was really surprised when my interview was just a digital camera and a few minutes work – she’s a former BBC producer and expected a TV crew. But she’s a smart cookie, and knows there’s nothing better than a pitch from the heart.

Checksums – Don’t Leave the Server Without Them

Lloyd Wood commenting on an e2e post recently was asked why UDP has an end-to-end checksum on the packet since it doesn’t do retransmissions, and should it be turned off. Lloyd noted UDP “could have the checksum turned off, which proved disastrous for a number of applications, subtly corrupted filing systems which didn’t have higher-level end2end checks”. Lloyd is exactly right here. But why would someone turn off UDP checksums in the first place – it doesn’t seem to make sense, does it?

It is often the case that people turn off UDP checksums to “buy” more performance by relying on the CRC of the ethernet packet. So this is not a stupid question – it’s a very smart question, and a lot of smart people get fooled by the simplicity of the process. Performance gain by turning off checksums now can be obviated through the use of intelligent NIC technologies like SiliconTCP and TOE that calculate the checksum as the packet is being received.

This is a surprisingly common problem in datacenters – sometimes the problem would be a switch, sometimes a configuration error, sometimes a programming error in the application, and so forth. I most recently experienced this problem with an overheated ethernet switch passing video on an internal network. Since we don’t have things like SiliconTCP in commodity switches yet, check that switch if you’re having problems. In the meantime, here’s a few little datacenter horror stories to put in your pocket.

Fun Friday – the Curse of BSD and the Four Mistakes

My discussion earlier this week on inaccuracies in papers discussing the evolution and history of resulted in some very interesting questions (see Oh, Goodie! Another Academic on 386BSD…). And a really nice question from suresh at Berkeley: “I’d like to hear your opinion: why did BSD lose to Linux in the battle for OSS hegemony..? How was the BSD release architecture (e.g. what was the political process) decided on? Some friends of fine [sic] swear by the FreeBSD operating system, but they are a minority.”

So Fun Friday is answering the really simple question “Why Did BSD Fail?”. Oh, this is a big one, but I’m game if you are…

I Really Don’t Think Lessing of Him…

Nice little mention of Larry Lessig’s work and the impact of peer-to-peer in Mediapost today. Of course, they did get a few points wrong, like his name, as I quickly pointed out to them: “The author of “Free Culture” is Lawrence Lessig, professor of law at Stanford Law School, not “Laurence Lessing”. A published review (Sept 04) of his book has just been made available on the web”. Enjoy the article by Jim Meskauskas, ignoring the typos – it could happen to anyone.

First You Shoot the Movie, then You Sell the Movie, and then You Eat!

Well, there must be something in consumer-generated content after all. Brightcove, founded by former Macromedia CTO Jeremy Allaire, says they want to sell your movies (cartoons, shorts, jibjab imitations) on the Internet. “We don’t expect to see any significant Hollywood content” in the relatively near future. Our expectation is to not allow pornography”. “Expectations”? Don’t know what that quite means. But if you provide the movie, they’ll provide the site.

As Michael Kanellos of Cnet notes, “Is there a market for obscure content? While people differ in their opinions on that subject, Allaire asserts that at least there is a huge quantity of it…Brightcove’s presentation was one of the more crowded ones at the conference and drew, among others, Mitchell Kertzman of Hummer Winblad Ventures and Vinod Khosla of Kleiner Perkins Caufield & Byers.” Do you smell money yet?

Oh, Goodie! Another Academic on 386BSD…

Another paper handed to me, this one on “open source governance” (isn’t that a bit of a oxymoron?), with the usual “Isn’t this wrong about ?” attached to the email. With the John Adams philosophy that “facts are stubborn things” firmly in place, I perused it, leaving errors outside of for others to find.

Oh, boy. I found it to contain serious inaccuracies with respect to the history of – which is absolutely amazing for an academic paper since was extensively written about in one of the lead trade magazines of the time – Dr. Dobbs Journal – in a 17-part series Porting Unix to the 386 documenting it’s evolution, and also distributed through the magazine, and had multiple releases via the net per standard Berkeley Software Distribution methods. So it’s not as if one can’t find lots of source material from the authors. But this paper is riddled with errors with respect to release governance, intentions and motivations, and control – and that pretty much covers everything in “governance”, doesn’t it? So here’s the real story…

It’s a Camera! It’s a Phone! So Get Your Mouth Out of My Eye!

Cellphones with embedded cameras sound really neat to most people, just like combo fax/printer/copier/PCs. Since we already are tethered to the electronic beasties, why not carry one with a camera – then you can take pics while you chat?

The problem, like super-combo devices, is that you get something at the cost of another item – in this case picture quality, much less video quality. So while people are buying them in droves, Kodak CEO Dan Carp (yes, that’s his name) worries that people will find them too unusable – “Today, camera phones are imaging-capable but photographically disabled”, according to Ben Charny of Cnet.

Fun Friday: What If We Built an Operating System, and Nobody Came?

Well, Red Hat put lots of time and money into creating a professional developer version of Linux, put it on the market at $2,500 per “computer”, and in two weeks a clone of it called CentOS done by a squad of open source developers was put on the net for free. It’s hard to compete with “free”.

According to Stephen Shankland of Cnet “It’s clear, however, that many Red Hat clone users aren’t likely to embrace the original anytime soon. ‘I don’t pay for Linux, and I have absolutely no need for a Red Hat-style subscription (for) support,’ said Collins Richey, a Denver Linux enthusiast who uses CentOS on his personal computers to keep them compatible with work machines. ‘I’m considering recommending CentOS for limited use as a trial project…at work’.”

Red Hat tries to put a positive spin on it, saying “If they try versions that are not supported or supported inadequately, they will get a hint of the value propositions that are available for Linux and ultimately turn to a company that can support their businesses,” (Leigh Day, Red Hat spokeswoman). Some most assuredly will. But if my bit of experience in this area is any indicator, I believe that customers will wait until it is hacked, cudgeled, and otherwise moulded until it becomes good enough to be supported in-house. And still remains free. It may not be profitable to Red Hat, but it is “free enterprise” at its finest.