Wednesday, September 24, 2003

Schlumberger's "Watson" Newton

Watson Vitale U


I was recently lucky enough to win bidding on a Schlumberger Newton through eBay. I know many of you Newtonians are interested in this thing, so I have put a special post together on my Newton blog to give you a peek.

The original Newton Inc. website had the following blurb on the product:
  • The Schlumberger "Watson" is a dedicated solution for the French healthcare market. It incorporates two smartcard readers that allow for secure electronic transactions in healthcare, thus reducing the cost of processing claims significantly. (Sources: 1, 2, 3, 4)

The 1997 cost for a Watson unit was Fr12,000, with an additional Fr15,000 for an accounting package, and none of this included the costs of the modem transmissions, which in France are often on a per-minute basis. (Source: 5, 6). This made the Watson a very expensive option for French medical practitioners. I am not sure how many units were bought by Schlumberger and how many were eventually converted into Watsons. The cancellation of the Newton by Apple in February of 1998 doomed further development of the Watson by Schlumberger, which went on to develop other devices for this market (see below). The Watson project was one of the forerunners of this concept.

HARDWARE: Hand unit
The "Watson" system is basically a France-localized MP2000 with some added circuitry in a slightly bigger case, and a specialized cradle. The case is built around the basic MP2000 innards, with a few changes: the case houses a built-in card that occupies the top slot, allowing the insertion of the patient's smart card. The rear of the case also has another slot with similar connections for the physician's smart card.
Watson Top 3Watson Base Front
Watson NakedWatson Screen


The flip-back door and latch are familiar, but rather than clips to retain the door, the Watson uses a magnetic system (the light green segment on the door, which 'sticks' to a corresponding magnet embedded in the lower case).
Watson Cover 1


The On/Off switch has been moved to the bottom of the unit simply by using longer wires on the original switch. (Schlumberger missed an opportunity to improve on this piece of hardware, which is somewhat finicky -- like those on several of my other MP2x00s, this switch is no longer reliable).
Watson On/Off

The series of data and power contacts visible here above the switch (the "socle") are described below.

The top end of the Watson preserves the IR window, the interconnect jack, and the DC power jack, however these last two are more recessed in the extended housing, and are usually hidden under a cover that is somewhat difficult to remove. Because power and Dock-I/O connectivity are supplied by the special cradle (see below) these jacks would rarely be needed in day to day use in a French physician's office.
Watson InterconnectWatson Interconnect 2


The largest physical change is that the Watson does not have two memory card slots available for use: the upper one is permanently occupied by some of the extra circuitry. The lower slot is available as in the regular MP2x00 series, just above the battery slot.
Watson Side


The additions to the Newton system were made to ensure patient confidentiality and financial security of transactions within France's national health system, SESAM-Vitale, which is highly regulated and also highly automated. Each insured person carries a Vitale smartcard which contains their relevant information:
  • Identity number of the insured
  • First and family names
  • Health Insurance scheme
  • Fund and unit to which the insured is attached
  • Names of beneficiaries
  • Rights to services
  • Exemptions, if any
  • Right to Universal Medical Coverage (CMU), if applicable
  • Additional coverage info


No medical information is stored by the card. This card has 10 contacts (note that the reader in the Watson could actually read a 16-contact card). Since the most frequently changed smart-card would be that of the patient, this card slot is accessible while the Watson is in its cradle. The reading circuitry for this card is what occupies the top memory card slot.
Watson Vitale U
Watson Vitale Close
Watson Vitale All


Each person using the SESAM-Vitale system receives a letter and pamphlet similar to the following one, sent by a French student friend (all relevant info removed, click on image for LARGE version, and no, it's not Paul G.):
Vitale Letter Obverse

Vitale Letter Reverse

Vitale Pamphlet Obverse

Vitale Pamphlet Reverse


Each practitioner in the system carries a "Carte Professionel de Santé" or CPS smartcard which uniquely identifies the doctor. The CPS card holds the keys and certificates necessary to carry out electronic signatures and to encrypt transmissions, based on a public key system. This card allowed access to the "Réseau Santé Social" (RSS), a secure electronic healthcare network, through the cradle's modem (described below). This card has 8 contacts. The Watson has a completely separate system for reading this card, built into the back (lower) casing of the unit. It is visible as a narrow slot to the right of the green ejection button in the first picture below, and as the slot with the triangular metallic portion visible in the second picture. The physical ejection mechanism for this card is visible as the lighter green button, which you squeeze to actuate, reminescent of the MP130. The arm that is moved by this button to push the card out is visible int the third photo below. The slot for this card is inaccessible when the Watson is in its base, as it is assumed that only one physician would need access to the Watson when in its cradle.
Watson Side
Watson BottomWatson Back All


The simultaneous use of both cards allowed the doctor to sign an electronic record of the care given (Feuille de Soins Eléctroniques, FSE). The FSE serves both as medical record and as a financial claim for reimbursement. (Source: 5, 6)

Close-ups of the CPS smartcard circuitry:
Watson Smart Card
Watson Smart Close
Watson Smart 2


HARDWARE: Cradle
The cradle is just as nicely designed as the hand unit, and provides a place to rest the Watson in a position convenient for handwriting (being sloped towards the user) and to simultaneously synchronize with a desktop, recharge, and connect through a modem to the RSS.

Watson Base Front
Watson Base All
Watson Base Not
Watson Base Rear
Watson Base Side


Connections from the cradle to the Watson are made through two sets of contacts: fifteen for data and three for power.
Watson Base Socle

These match the contacts on the bottom case of the Watson:
Watson Socle Close
Watson Ribbon Socle


The cradle has a built-in modem called "Kortex" and connections for both Mac and PC serial ports.
Watson Base Under
Watson Base Under 2

Watson Kortex Label
Watson Kortex Naked

Watson Base Cxns
Watson Kortex Cxns 2


SOFTWARE
The Watson used a France-localized NewtonOS: ROM F2.1 (F1-037)-1, with several specialized extensions to deal with the added smart-card circuitry and Kortex modem.
Watson Mem Info

(due to built-in soft- and hardware security, absolutely no I/O is possible without a physician's CPS smart card inserted-- so I couldn't get screenshots - sorry).

The system had an internal RAM of 3523 Kb, and a Sytem RAM Installed 924 Kb (note that they are listed in the picture above as kilo "octets" as used in France for bytes).

There apparently also existed Watsons with a system numbered (B1-007)-1, possibly for Belgium, but I have not been able to confirm the existence of Watsons specialized for Belgium or of a separate OS version. What is certain is that in preparation for the pan-European integration of health systems under the European Union, a bi-national experiment in health-care systems compatibility called TRANSCARDS was carried out in the area of Thiérache in the 2000-2002 period, allowing Belgian citizens access to eight nearby hospitals in France. The Belgian Watson OS may have been a positioning for a wider use of the system, which was made permanent on January 1, 2003. A similar experiment was carried out in the Alsace region, giving French citizens needing dialysis access to German hospitals, but I cannot find any traces of Watson use in that context. (source (.pdf), and I note as an aside that in typically schizophrenic fashion, Québec is part of this system)

A specialized program to handle software settings for the Watson was called, imaginatively, "Configuration," and has the following items:
Watson Mem Config

  • Access code setup
  • Personal Information
  • Professional Information
  • Default Settings
  • Holidays
  • Transmission(Comm) Parameters
  • Communications Log
  • Active Code Values
  • A4 Printing
  • A5 Printing
  • Prior Agreement Printing
  • Handwriting Recognition
  • Sleep

Note that some of these overlap with the functions of the Prefs application, which was also present.

In order for a lot of this extra hardware to operate, there are a lot of extensions that are not found on other Newtons.
Watson Extensions

Here's a list of these special extensions:
  • B2 Unit
  • Back Light
  • CanonDriver:HMS.SLB
  • DeskJetDriver:HMS.SLB
  • EpsonDriver:HMS.SLB
  • HeapEx Angel
  • InstallWP
  • LexmarkDriver:HMS.SLB
  • NOEMIE Unit
  • PrintEntente
  • SmartCardHandler:HMS.SLB
  • SocleInterne
  • XMODEM-CNAMTS:HMS.SLB
  • FSE Print

NOEMIE stands for Norme Ouverte d'Échange entre l'assurance Maladie et les Intervenants Extérieurs, or Open Exchange Format between Health insurers and External service Providers. This was the format of a reply-file to the service provider giving either confirmation or reasons for rejection.

Xmodem-CNAMTS is a file transfer protocol to allow connection to the central CNAM system. CNAMTS stands for Caisse Nationale d'Assurance Maladie de Travailleurs Salariés, or National Account of Health Insurance of Salaried Workers. The older CNAMTS system has now been replaced by AMeli, "on-line Health Insurance."

The Storage folder in Extras of course has many specialized soups that are protected -- patient data, accounting/billing, etc. (all deleted before I got the unit, of course).
Watson Stockage


(to do: list/translate the stores)

Both Apple and Schlumberger have long killed the project and removed references from their on-line materials to the equipment and software. One remaining French software developer involved in the support of the Watson program still has a driver posted -- Easter Eggs still has a link for the SLB Watson 3.0F modem enabler.

Schlumberger today:
After the cancellation of the Newton, Schlumberger moved on to produce other devices for the highly automated French healthcare system. From simple Vitale card readers like the MagIC 6000 and 6100, to integrated systems like the Ingénius-Saficard.

This webpage was composed on an eMate using Notes, nHTML & HiLite2000, then wirelessly posted with nBlog

Julian Jaynes:

I'm not sure whether a score of 7/10 indicates an inability to distinguish which lobe I fall into...

Equinoctial quiz

Monday, September 22, 2003

Bean sídhe & preta:

I see from the searches carried out on this site that two ghosts from my past have googled me, and found dura mater. Welcome. You didn't find what you thought might be here, did you?

Heh. History, baggage -- we all have it.

I also noted that a Lockheed-Martin employee was here, I assume for the NOAA N' post...

Wednesday, September 17, 2003

Tiny Tim:

The article title was "Insects as Sources of Proteins for Man: Valorization of Disgusting Resources" by Eraldo Medeiros Costa-Neto, Interciencia 28(3) pp. 136-140 (in Portuguese). How could I not read this, as I prepare for Hurricane Isabel?

First, I have to confess that I have indeed participated in entomophagy. And not of the involuntary, nocturnal type, or even the agonized coughing type when one inhales a fast flying thing while running or cycling. This was the purposeful eating of insects. And they were yummy.

In an area of Colombia called Santander, there is a particularly large ant that is deep fried and then salted. You can buy little bags of them from street vendors. I've even bought vacuum-packed cans of them. They taste like bacon bits. Once you get past the fact that they have heads, big fat abdomens, and thoraxes with six legs, that is.

I first encountered them when I was about six or seven years old, at an outdoors Christmas party we would go to every year. I thought they were smoked peanuts. My father had a good laugh at my expense when he asked if I knew what I was eating -- but I put my mind to it, just like falling off a bicycle, and I made myself go back and have some more. I've been an ant fan ever since.

I took one of those cans to England with me to give to the rest of my family, and I used to take bags of them to Canada to school. Needless to say, few others tried them. But some did, and they joined me in feasts of ants on melted cheese toast, ants on salad, and ant sandwiches.

In any case, the article was fairly predictable: yes, insects are a good source of protein; yes, insect consumption varies with culture; and yes, insects could be better used to feed humans. There was an interesting discussion of insect-based economics and possibilities as animal feed. But the general western answer is still going to be... yuck. Boiled locust and roasted witchetty grubs? No way. We'll leave that for reality TV, thank you very much.

The most interesting part of the article turned out to be the references. A writhing selection for your delection:

  • Allport S., 2000, The primal feast: food, sex, foraging and love. Harmony, New York. 260 pp.
  • Blum M.S., 1994, The limits of entomophagy: a discretionary gourmand in a world of toxic insects. in The Food Insects Newsletter 7(1):1 p. 6-11. (I note: 'gourmand' and not 'gourmet', and the fact that there is a newsletter dedicted to entomophagy...)
  • DeFoliart G.R., 1995, Edible insects as minilivestock in Biodiversity and Conservation, 4, p. 306-321. (yee haw, git along little bees)
  • DeFoliart G.R., 2002, The human use of insects as a food resource: a bibliographic account in progress. (I nearly fell off my chair when I read the note at the top of this page about the author's health... sorry).
  • Krajick K., 1994, A swarm of tasty treats. in The Food Insects Newsletter 7(2):1 p. 3-4. (mmm... just run through it with your mouth open!)
  • Pemberton R.W., 1995, Catching and eating dragonflies in Bali and elsewhere in Asia. in American Entomologist 41, p. 97-99. ("M...yesss, they were particularly good last year. Don't you think so darling?" --- "But not as good as Phuket, sweetums." -- "Oh, I had forgotten that trip...")
  • Rose M., 1993, Tanajuras fritas: um prato muito apreciado. in Jornal do Comércio, 16 maio, p. 12. (Ant queens --apreciadas, but by whom? -- perhaps a good place to use the Spanish-Portuguese faux ami "exquisito!")

Tuesday, September 16, 2003

Remember Floyd:

...and four years ago we were cowering in the face of Hurricane Floyd, another large storm that threatened to come ashore as a Category 4, but weakened to 2 before pounding the Carolina and Virginia coasts.

Floyd from space, enhanced (GSFC)


Even though Floyd had weakened considerably, the flooding caused large problems when the Tar, Neuse, Pamlico and Roanoake Rivers overran their banks. The floodwaters drowned thousands of chickens and pigs, and swept materials from farm livestock sewage holding ponds into the rivers.

Floyd was categorized as a 500-year storm. A more useful, but fully equivalent way of thinking of this is to consider the event as having a 0.2 percent probability of ocurring in any given year. The 500-year method is very prone to seducing people into thinking that now they had gone through Floyd, they had 499 safe years left -- a classic case of the gambler's fallacy. Well, surprise, here we are four years later, with Isabel knocking at our door - and what are the chances? Exactly the same as before -- they are independent events.

The Hurricane Hunters have some great photos from inside the eyes of various storms. This one shows some amazing cloud structure in Floyd:

Sept 13 Floyd structure


Here's the Isabel NOAA Forecast Advisory Archive.

This is a link to a loop of the latest water vapor images from the GOES satellite (an earlier version of the satellite Lockheed-Martin dropped on the floor last Saturday...). Water vapor tends to show the flow structures much better, and the flow of the images often reminds me that we live on a planet similar to Venus, Jupiter, etc. (oh, except for that 'life' thingy).

...and I see that the NOAA image server seems to be hostile to Mac/IE browsers, sigh... but Safari seems to work.

Our happy little home:

Full Disk Visible, EastFull Disk Visible, Indian OceanFull Disk Visible, GOES-9

Monday, September 15, 2003

Gates, Jobs, McNealy, etc. etc.

It was good to wake up laughing today -- news that a handheld phone was being released with a Windows operating system made me think that just as we get rid of the telephone solicitation scourge here in the U.S., we will be opening opportunities for viruses to call everybody in our cellphone's directory... argh, and with all the junk numbers I compulsively keep in my phone from all my travels, that would be a very expensive virus.

I'm waiting for an all-in-one integrated wearable CDMA2000 EV-DO/EDGSM/CDPD/WiFi phone, GPS and PDA iPOD. But for now I still have my trusty 1997 Newton, which does just fine thanks - it's fully capable of doing most of the above. It's just such a brick.

Thursday, September 11, 2003

Day 729:

Sunrise at the Pentagon was really peaceful today. An orange glow off the yellow armored windows was a nice counterpoint to the pink reflection off the sandstone facing, with a pale, almost full moon in the background.

As it was two years ago.

Seeing all the flurry of government activity in those intervening years, I realize that the current Federal budget deficit is driven by many of the anti-terrorism efforts. The deficit, or rather its time-derivative, is extremely sensitive to further terrorist events. What is our vulnerability to this? Would a series of small events within our borders drive the deficit in a completely irrational way?

It's like a statement of relative risk: "I am happy to put Skin-so-soft on my infant to keep away mosquitos, but don't you dare include apples with Alar in the batch you use to make apple juice for school kids." The perception of risk in these two cases is completely skewed by emotion, and the public pressure results in a completely inappropriate allocation of public resources and public attention (unusual amount of funding for control of a small risk, and the media focus on conflict instead of comparative risk). For the Alar case, the risk of developing cancer is somewhere between 5 and 50 per million (Consumer's Union estimate vs. the higher EPA estimate). In these cases I always like to look at my relative risks list, and ask myself: "does this decision make sense?" So - 5 in a million is 1 in 200,000 which puts the annualized risk from getting cancer from Alar consumption somewhere between contracting Malaria and dying from Group A Strep. At 50 in a million, the risk jumps to a level between dying from falling and dying from suffocation.

Now we get to the emotional part: if I am predisposed to doubt the danger, I rationalize by saying "if the danger were truly 50 in a million, we would be hearing about a lot of cancers incontrovertibly linked to Alar, but we are not, and therefore the danger is overblown." Conversely, if I were predisposed to think that pesticides are dangerous, I would say that evidence of risk at this level really does support pulling the product. (A good academic resource for pesticide use risk is the Cornell Environmental Risk Analysis Program).

The question for terrorism then is: "what is the appropriate amount to spend on security against an intrinsically unpredictable event?" And there is no answer, precisely because it contains the emotional and irrational element. However much it takes to feel safe. However much it takes to satisfy the public. And public satisfaction is a moving target. It's not the facts, it's the emotions that count. It's not the science, it's the politics that count. They are both legitimate viewpoints.

I am reminded of some of the analyses of the Soviet collapse, which stated that the Soviet response to the U.S.'s SDI effort bankrupted their system. One has to hope that doesn't happen to us because a small series of terrorist strikes in the homeland cause a totally unproportional, and emotional response.

Wednesday, September 10, 2003

oooops...

...and you feel bad when you drop your cellphone. The NOAA N-Prime spacecraft, lying on the floor of the test chamber after it was dropped off a cart on Saturday. You can bet that there is someone who works at Lockheed-Martin's Sunnyvale facility is now having anxious, sleepless nights.


NOAA N-Prime would have been launched in 2008 as the last of a long series of polar orbiting weather satellites (POES). Interestingly, some of the refurbished Air Force Titan 2 ICBMs from the US strategic nuclear forces have been used to launch the NOAA satellites.

Monday, September 08, 2003

Joseph Campbell:

When I was young(er), I had a very vivid dream about pouring molten lead over a colander or sieve, and having the droplets fall down a long tower, forming little balls of shot at the bottom as they cooled and solidified.

You can imagine my amusement when I read some years later that this is how lead shot has been manufactured for several hundred years. You can imagine my amazement, however, when I learned that there is actually a legend surrounding the invention of this method which involves a dream. A dream that involved pouring molten lead over a colander or sieve, and having the droplets fall in a tower into a pool of water at the bottom.

I was immediately faced with a rational conundrum. How could this be explained?

My current list of possibilities, in increasing order of my own skepticism:
  • The dream is actually a Jungian archetype, and is probably more common than is generally thought, or may be in a closely related form. Whoever had this dream was somehow "primed" by their circumstances, as I must have been. Literally, the dream led to something useful, however it had a meaning within the dreamers' psyches that was not really tied to 'the production of lead shot.'
  • My later realizations are a product of memory modification. It is well known that memory is extremely plastic, and it will reorganize itself when its model of reality is threatened. The only thing I am sure of is that I believe that this is the correct order in which these events occurred. But I know full well that it can be demonstrated that the mind will reorder events so that they 'make sense' when in fact they ocurred in a different sequence (and I have another post coming on that subject). How this threatened my model of reality, I do not know.
  • I am Watts, the original dreamer, reincarnated. Umm, not sure. I don't know enough about this person to find other coincidences - and besides, that kind of thing (looking for coincidences in lives) is an enterprise ripe for statistical errors. Kind of like reading the horoscope, and feeling it fits (of course it does, it's made that way on purpose). "Good grief! Watts wore shoes! So do I!"
  • I am a medium for Watts' spirit. OK, I'm reaching here...

Any suggestions?

Saturday, September 06, 2003

Empty Quarter:

The largest deserts on Earth are not on land. They are the oceans. They are vast empty spaces, devoid of macrobiota. Most people think the oceans are full of fish, and that is due to the fact that very few people have really been away from the continental shelves, and out into the deeps.

I am always amazed at how truly empty the oceans are, both on the surface, and below. It is so empty that your nose forgets the smells of land. When I crossed from Papeete to the Marquesas, we could smell Fatu Hiva long before we ever saw its ragged skyline. It is so empty that a swim becomes a fright when you look down, and realize that the bottom is three miles away.

Far from land, the only things that survive are the bigger ones -fish like tuna & mackerel, turtles and whales, etc.- the things that can survive a crossing from island chain to island chain, hopping from guyot to guyot. Away from the shallows, there just isn't enough of an ecosystem to support many fish. That's why we have always fished in places like George's Bank, and not far out over the benthic deeps. That's why people marooned on the high seas are at risk of starvation.

And that's why fisheries management is such a big deal. We can't just fish elsewhere - we're already fishing eyerywhere. And we also barely know what we are managing: for most species, we don't really understand the population dynamics, and what sparse data we have is often outdated. Imagine an agricultural system where we went out with large earthmoving equipment like graders and caterpillars, clearcutting a forest, and then sorting out the resulting heap to find if we got any corn. In a January 17 post, I touched on the issue of having the sea supplement the land for feeding - building on Antony Trewavas' phrasing, I would call the fishing industry today "fully mechanized hunter-gathering."

So don't look to the sea for mankind's salvation: it is mostly a barren place, good for contemplation and introspection, but not for feeding many more desperate millions. We are already probably pushing its feeding capacity limits, and are possibly near a bifurcation point of a complex, non-linear, dynamic system that could suddenly shift into a completely different regime -- one where we have no knowledge of its behaviour, and worse, one where we have no place.

Hand written on a Newton, and submitted wirelessly from bed.

Monday, September 01, 2003

Sci vs. Pol:

What matters in science: facts, and not people's perceptions of them. What matters in politics: people's perception of facts, and not the facts themselves.