V.B.A. NEWS - March 2000

Our membership is growing- 189 at last official count, new programs abound-see The VBA MBA review in this Newsletter, the annual meeting will be held in a new location- The Homestead Resort in Hot Springs, VA, the Board of Directors has a clear vision of of goals for 2000- see EDCOMM 2000, and financially we are on solid ground with money in our bank account.

The largest undertaking of the year by far is our Annual Meeting. Brian Blackwell, the VBA Vice President has organized a committee and is well underway in the planning process for this years successful event with the theme "ONWARD and UPWARD". Many of you may be wondering how the VBA chose The Homestead in Hot Springs as its meeting site. After three consecutive years in Williamsburg, the Board had requests to move the meeting west to attract new attendees from western Virginia and West Virginia. After an extensive search, The Homestead was chosen based on location, facilities and the financial package offered to the VBA. Meeting packets with complete details will be mailed out to everyone by the end of April. The Board is excited about the new location and all of the amenities offered by such a fine resort as The Homestead. It will be a memorable meeting and one that spouses and significant others will definitely want to attend. I encourage you to get a glimpse of the resort at www.thehomestead.com.

The VBA is your organization. If you have suggestions or comments, please direct them to me or any other Board member.

"ONWARD and UPWARD" in 2000!

Al Strickler
VBA President

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Reality Vs Perception
Y2K in Retrospect

I don't want to rekindle the discussion, but would like to share some personal reflections or, should I say, afterthoughts.

As some of us may recall, several persons did state in public that they did not expect any substantial safety problems with Y2k. For example, Dr. Shope, FDA's Director of the Division of Electronics and Computer Science, had testified on 6/26/97 to the Congress that "[c]omputer software frequently is embedded as a 'component' of devices, i.e., software contained on a microchip to control device operation... It is unlikely that most of these products would be impacted by the 'Year 2000' problem. Almost none of these devices require knowledge of the current date to operate safely and effectively." Some manufacturers also disclosed that their products would not harm anyone in spite of some possible date stamp problems.

Obviously none of us were--and could be--100% sure that nothing will happen (even Dr. Shope used the words "almost none"). We all did what we believed was necessary to prevent any problems from happening. Some went to the extent of testing all the equipment within their facilities, while others relied primarily on compliance statements provided by the manufacturers. Many pieces of equipment were upgraded or replaced, some old equipment was discarded. Nevertheless, there were several OEMs who refused to evaluate their older products, claiming that they were "obsolete." Some OEMs also limited their compliance statements to a few software revision levels. A few OEMs made last minute revisions to their Y2k statements and at least one stopped providing upgrades because it was creating other problems. By New Year's eve, all we could do was to pray that we did not miss anything important.

I have to agree that if anything really serious happened shortly after the rollover, there was not much a healthcare technology professional could do. We did not design the equipment, nor were we privileged to know how the internal hardware and software operated. Aside from resetting the clock, there was not much else to do. If an injury or death occurred, internal incident policy would have required the staff to quarantine the equipment. Immediate testing or evaluating the equipment is not allowed, because you do not want to spoil the evidence.

Why, then, did healthcare technology professionals feel that they had to be on duty? I believe we were there for one primary reason: to assure the patients and clinicians that we are there in case any problems showed up. It was essential for our "customers" to feel confident that they could count on a competent professional who understands technology if the Y2k bug bit. Just like the FAA's Administrator, Jane Garvey, who was aboard an airliner when the GMT rolled over, we wanted our customers to feel reassured.

For the same reason, MEDIQ/PRN had people here on Dec. 31st. As a rental company, there was nothing we could do to save the patient or for the healthcare organization if Y2k affected a piece of rental equipment. Nevertheless, we were here to reassure customers who called to check whether the equipment rented from us was compliant or not. We also wanted them to be able to speak to someone knowledgeable in case a patient incident was reported.

A second, but almost as important, reason healthcare technology professionals wanted to be on site is we wanted to make sure whatever Y2k problem reported was indeed due to Y2k. Too often, a problem is attributed to something that is not necessarily the actual cause. We all witnessed too many mishaps to know sometimes you have to be there and prove that the problem is not caused by the equipment or, in this case, by the embedded hardware and software.

As technical professionals, we need to keep our heads clear and objective. We should be skeptical of unsubstantiated claims and refrain from spreading rumors. In addition, as a member of healthcare community, we need to be compassionate and keenly aware of the importance of human communication, which encompasses not only written and spoken words, but also body languages and physical presence. Often perception is what counts, not reality. If one focuses solely on reality, he/she can be an excellent technical professional. However, to be a superb healthcare technology professional, one needs to appreciate the subjective needs of his/her customers and communicate with them accordingly!

Hope we all learned a few lessons from this non-event. The camaraderie and spontaneous cooperation from many countries was a truly enjoyable experience for me. Wish everyone, including the fellow who started the debate, a New Year full of peace, happiness, freedom, and accomplishments.

Binseng Wang, Sc.D., C.C.E.
National Quality Director
MEDIQ PRN Life Support Services, Inc.
One MEDIQ Plaza
Pennsauken, NJ 08110 - USA
Telephone: (800)-222-4776 or (856)-662-3200, extension 5516.
Fax: (856)-661-1635 or (856)-661-0278

CONGRATULATIONS TO THE VBA MBA

The Virginia Commonwealth University School of Business was our host for the first ever VBA MBA program on February 25th. Designed by the VBA Board of Directors to provide Biomedical managers and high achievers challenging but pertinent material which they could use immediately upon return to their respective departments. Fifteen eager individuals attended a full day of well-organized fast flowing material which kept everyone alert and participating.

Dr. Ed Spede, a Brooklyn, NY native with a CPA and Ph. D. in Accounting, started the morning session with an entertaining and lively overview of the principles of accounting for the non-finance professional. He clearly explained the relationships between balance sheets, statements of cash flows, income statements and statements of shareholder equity (which is not easy in 2+ hours!). This provided participants with insight into how hospital managers and administration make decisions based on financial criteria. Using the newfound knowledge, the financial statements for Columbia/HCA were analyzed.

After a stroll across campus for lunch on a spring like day, participants were electrified by Dr. Randy Barker (VCU teacher of the year in 1996) and his interactive material on motivation, teamwork and leadership of technically oriented employees. Much time was spent focusing on leadership and real case scenarios in the hospital environment. Situational leadership, the ability to adapt any of the four basic leadership styles- telling, selling, participating or delegating, is gaining in academic and business popularity as a model for effective leadership.

Participants finished the day with Dr. Bob Trumble discussing perception, communication and negotiation. A former Dean of the Business School (he received the outstanding teacher award for 1997), Dr. Trumble pushed attendees to use their "brain power" to analyze perception. Perception is influenced by recognition, interpretation and expectations. Those are the determinants in any negotiation and must be better understood if negotiation participants are going to reach mutually beneficial results.

All participants were challenged and energized by the stimulating curriculum and many commented on a repeat session in the next 6-12 months.

Many thanks to our attendees-

(l-r) Al Strickler- Strickler Medical, Greg Mika- UHS, David Thompson- Martha Jefferson Hospital, Mark Evans- Strickler Medical, Tom Berry- Childrens Hospital of Kings Daughters, Virgil Smoot- Childrens Hospital of Kings Daughters, Brian Blackwell- Centra Health, Lee Gilley- Centra Health, Mike Carlton- Datex-Ohmeda, Dr. Randy Barker-VCU, Rick Davis- Premier/Riverside Regional, Joe Dent- Premier/Riverside Regional, David Peters- Southampton Memorial, Bruce Jones- Premier/ Winchester Hospital, Pat Kelly- Premier/ Bon Secours Richmond, Dr. Bob Trumble-VCU. Not pictured - Andy Holden- Novare/Mary Washington Hospital

Gigabit Ethernet Leads the Way Over Fiber

The growing demand for bandwidth is indisputable on both campus and intrabuilding backbones. The ever rising demand for bandwidth, specifically in the backbone, has created an immediate requirement for gigabit speeds. Indeed, products already are shipping and demand for them is surpassing market acceptance projections. In support of this bandwidth need, the IEEE approved the IEEE 802.3z standard, the standard for Gigabit Ethernet over optical fiber on June 29, 1998. The standard reflects more than two years of discussions and extensive testing, assuring interoperability among manufacturers for both LAN electronics and cabling. A fiber-only solution, it is another example of how fiber optic technology is driving standards development.

The need for gigabit speeds is driven by a number of factors. First, is the significant change in data traffic patterns. In the past, 20% of the traffic generated on the local (horizontal) network typically went onto the backbone. Now, the commonly accepted rule is that 80% of the local traffic goes onto the backbone. This is caused by the creation of server farms to store information (data warehousing). The use of private Intranets is opening the door to a new generation of multimedia client/server applications. And, the movement from shared to switched Ethernet for the local network combined with the movement from 10 to 100 Mbps Ethernet increases the responsiveness of the local network, which much be carried through to the backbone, especially given the change in data traffic patterns.

The need for Gigabit speeds is indisputable and immediate, but which Gigabit technology will be adopted? The Gigabit Ethernet Alliance predicts that the answer is Gigabit Ethernet. More than 85% of premises network connections already use Ethernet -- and Gigabit Ethernet promises to offer the same network reliability, availability of management and troubleshooting tools, scalability, and low cost that the industry has experienced with 10 and 100 Mbps Ethernet.

The Technology and the Options

Unlike previous Ethernet specifications for fiber, which offered only one solution to the user, Gigabit Ethernet offers two, depending on the transceiver (light source) that is used. One option is known as 1000BASE-SX (short wavelength laser) and the other is 1000BASE-LX (long wavelength laser) hence the "S" and "L". While the entire network can, and probably will, comprise both short and long wavelength segments, the two solutions are not interoperable, i.e., the electronics on both ends of a segment must be either SX or LX but not mixed. The two options are necessary to satisfy the various distance requirements in a premises network, specifically if a campus backbone is involved, and also to address cost related issues. 1000BASE-SX is targeted primarily for horizontal, centralized cabling and short intrabuilding backbone networks while 1000BASE-LX is will be used primarily for long intrabuilding and campus backbones networks.

Each of the two electronics options supports several fiber types and bandwidth specifications. 1000BASE-SX specifies 62.5 or 50mm multimode fiber, while 1000BASE-LX can use either multimode or singlemode fiber. Both options specify the use of lasers.

Why Lasers -- What Happened to LEDs?

Gigabit Ethernet specifies the use of lasers because LEDs (Light Emitting Diodes) can not modulate (turn on and off) fast enough to support Gigabit speeds. Offering far greater performance capabilities than LEDs, laser-based electronics have been relatively expensive. Today, a new cost-effective laser, specifically designed for use with multimode fiber, is available. This relatively new, but proven, technology is called a VCSEL (Vertical Cavity Surface Emitting Laser). VCSELs are cost-effective to produce for a number of reasons, most significantly because they are surface emitting, just like LEDs. This means they can be made and tested in massive wafer form. Edge-emitting lasers (traditional singlemode lasers), in contrast, must be cut out of the wafer before testing. The 1000BASE-SX standard also allows for the use of inexpensive CD lasers. Most industry experts and suppliers expect that VCSELs, along with CD lasers, in support of 1000BASE-SX, will be the predominate solution in the market place and that VCSELs hold the key to the future for intrabuilding fiber networks. Edge-emitting lasers are used for 1000BASE-LX solutions. While they can be utilized on multimode fiber, experts anticipate their primary application will be for campus singlemode systems.

The Use of Lasers with Multimode Fiber

Lasers have been used for a number of years on multimode fiber, specifically in Fibre Channel applications. However, testing conducted by the IEEE prior to the approval of the Gigabit Ethernet standard, revealed a problem that could potentially occur on the existing base of optical fiber: differential mode delay (DMD) that causes increased jitter. While the vast majority of fibers tested performed equal to or better than expected, some fibers suffered from DMD. This issue has been addressed and resolved within the standard by conditioning and qualifying the launch of the laser, specifying receiver bandwidth, adding receiver stress tests, shortening link lengths from the original projections, and reallocating the jitter budget.

For 1000BASE-LX, the laser launch could not be conditioned at the transmitter level because of its requirement to operate with both multimode and singlemode fibers. Therefore, when using 1000BASE-LX products on multimode fiber (either 62.5 mm or 50 mm), a special launch conditioning patch cord, called a Mode Conditioning Patch Cord, must be used at both ends of the link, typically between the patch panel and the LAN electronics. This mode conditioning patch cord is not required with 1000BASE-SX systems or with 1000BASE-LX systems operating on singlemode fiber.

Distances and Fiber Types

In the past, it has been possible to define one solution for all premises cabling applications, i.e., horizontal (100 meters), centralized networks (up to 300 meters), intrabuilding backbones (up to 500 meters) or campus backbones (up to 2000 meters). However, for data rates above 155 Mbps, a single solution no longer is achievable. Hence, the IEEE Gigabit Ethernet standard include several options to cover all premises cabling applications, including both new cable deployment and the upgrade of the installed base of fiber.

Summary

The fiber optic industry has worked long and hard with the IEEE and TIA to develop a specification for Gigabit Ethernet that is robust and that assures interoperability based on worst-case performance. Tremendous effort was spent to determine that Gigabit Ethernet would perform over the installed base of optical fiber within the established parameters. In addition to round robin testing performed by many manufacturers, interoperability also has been demonstrated at New Hampshire Interoperability Lab and at several NetWorld+InterOp trade shows.

Several options have been specified to insure that a solution is available for all premises network needs. The fiber optic industry has developed Gigabit solutions for 62.5-mm multimode fiber (which was initially standardized upon in the mid-1980s) allowing for successful operation out to 550 meters. Additionally, the standard recognizes the cost-benefits of 50-mm multimode fiber, specifically for lengths between 220 or 275 and 550 meters. At the same time the industry has developed a cost-effective laser, VCSELs, for use with multimode fiber. However, the ultimate proof lies in its application: LAN electronic providers have been shipping product and systems since late 1997 and they are performing up to and beyond expectations.

1 Tony Beam contributed this article on behalf of the TIA Fiber Optics LAN Section. He is the Director, Global Systems Marketing, NETCONNECT SYSTEMS, at AMP, Inc.

VBA 7th Annual Meeting

Plan for the VBA 7th Annual Meeting at The HOMESTEAD in Hot Springs VA, September 20-22,2000. Below (reprinted with permission of The HOMESTEAD) from their website, www.thehomestead.com, are some of the things you can enjoy during your stay at The HOMESTEAD. We will be a bit early for the ski/snow season but check out all the other offerings.

From the website:

"Check Out Our Golf and Ski Getaway!

Since 1766, The Homestead has offered visitors an incomparable retreat; an incredibly grand escape, located amidst the beauty of Virginia's Allegheny Mountains. When you visit, you will find luxuriously appointed rooms and suites, superb dining and exquisite shopping, in addition to traditional Southern hospitality in a gracious atmosphere.

The Homestead is 15,000 acres of relaxation and recreation for the whole family. Here you may choose to do as little or as much as you desire. There are three premier golf courses - including the acclaimed Cascades Course - as well as our renowned Spa and Spa Salon. Along with horseback and carriage rides, shooting sports, 100 miles of hiking and biking trails, fly fishing, falconry, bowling, skiing, ice skating, snowboarding, and a year-round children's program."

As you can see there are many things to occupy your "free" time. Also for your family to enjoy if you can bring them along. (The VBA rate is "per room" not "per person")

Where is The HOMESTEAD?

From Roanoke - 75 miles

· I-581 north to I-81 north
· I-81 north to exti 150b (Troutville/U.S. 220 north exit)
· 220 north to Clifton Forge (follow signs to I-64 west to Covington)
· I-64 west to exit 16 (first Covington exit)
· At exit 16, pick up 220 north, follow 220 north to The Homestead (you will be about 25 miles away once you get on 220)
· 1.5 hours driving time

From Richmond - 180 miles

· I-64 west to exit 187 (this will put you on I-81 north)
· I-81 north to exit 222 (you will only be on I-81 north about 1/4 mile)
· Exit 222 will put you on Rt. 250 west,
· Rt. 250 west to Rt. 254 west (both of these routes will be in Staunton)
· Rt. 254 west to Rt. 42 south
· Rt. 42 south to Rt. 39 west
· Rt. 39 west to U.S. 220 south
· 3.5 hours driving time

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