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The August 15, 2004 Issue Provided by System Dynamics Inc.
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In This Issue

Our July/August Newsletter

Heard on the Net

Briefly Noted
Updates, Observations and Trends

Transforming Disease Care Into Health Care
Can Broadband Help?

Telco Video Services
Maybe this Time?

802.11a for Consumers
An Interview with Atheros Communications

"Software Based Radios" for Wireless
Interview with picoChip

New Plain-Text Summary Report Format

Upcoming Conferences

Your Voice -
Readers' Comments

Our July/August Newsletter

This report covers both July and August. We received several inquiries about what happened to our July report, so thought we'd explain.

Because of some medical complications experienced by our daughter in California, we spent several weeks out of our office. It was great that broadband technology allowed us to move our office across the country, and research and write most of this report from our daughter's dining room table.

Sandy with our 4-day-old granddaughter --> Click for larger pictureAll is well now, and for those reading the HTML version of this report, we include a picture of the happy ending to this story.

Heard on the Net

News about People and Companies Influencing The Broadband Home

People News

Sat Gill was appointed VP, sales & marketing for Incognito Software. He previously held management positions with Rogers Cable. ( )

Kim D. Kelly was appointed President & CEO, Arroyo Video Solutions. Paul Sherer will become EVP of technology and CTO. Prior to joining Arroyo, Kelly was President and COO of Insight Communications Co. ( )

Mark Komanecky and some former colleagues from Broadband Access Systems (BAS)/ADC and Matrix Partners have formed a new company 4Core to provide solutions for controlling home entertainment and home automation systems. ( )

Paul McBride was named CEO of Interactive Enterprise; he was formerly COO. Paul Monnelly, the former CFO, was named COO. ( )

Jon Moore was appointed CTO of Video Internet Broadcasting Corporation (VIB TV). Previously Moore was principal engineer with the Grant County Public Utility District and its FTTH architecture. ( )

James Norrod was named CEO at Narad Networks. Norrod has worked with many startups in recent years, and formerly headed Telebit Corp. ( )

Perry Satterlee was named COO of Clearwire Corp. Satterlee was previously at another Craig McCaw company, Nextel Partners. ( )

Petro Shimonishi was named VP of Marketing for NetStreams. She brings a long background in home electronics. ( )

(Please email to report a change in your position.)

Company News


Alvarion, a broadband wireless manufacturer, is acquiring Interwave, a 3G equipment maker, for $56 million. ( ) ( )

SupportSoft is acquiring Core Networks for $17 million, in order to offer complete service automation for service providers. ( ) ( )

First Avenue Networks (FAN) is buying Teligent's 24 GHz spectrum licenses and other assets in a stock transaction valued at $99 million. ( ) ( )


AirWave, a Wi-Fi network management software provider, has obtained $7 million in new funding. ( )

Akimbo, an IP VOD start-up, closed $12 million in series-B financing. ( )

Arcwave, a developer of wireless solutions for the cable industry, has received $8 million in new financing. ( )

Artimi, a fabless semiconductor developer of Ultra Wideband (UWB) silicon, has closed a $14 million Series A funding round. ( )

Aruba Wireless, a provider of Wi-Fi security systems, has obtained an additional $27 million in equity financing. ( )

Aura Communications, a developer of personal wireless communications, has closed an $11 million funding round. ( )

BroadLight, a supplier of components for FTTP deployments, has received additional Series C funding bringing the total round to $17.9 million. ( )

CinemaNow, a provider of broadband content-on-demand distribution and technology, has obtained $11 million in Series D financing. ( )

Kasenna, an IP video delivery company, closed a $15 million investment round. ( )

Lightningcast, a platform company for broadband advertising, completed a $5 million round of venture financing. ( )

Motia, a fabless semiconductor company that makes smart-antenna silicon products, closed its third round of funding with $12 million. ( )

Navini a wireless broadband technology provider, has raised $30 million in additional financing. ( )

PacketHop, a mobile mesh broadband communications company, has obtained $10 million in a Series B round of financing. ( )

Redline Communications, a provider of standards-based broadband wireless equipment, has secured $18 million in financing. ( )

Wave7 Optics, a provider of FTTP network equipment, announced an additional $6M in funding. ( )

Wayport, a provider of high speed access for travelers, has raised approximately $20 million in a private placement. ( )

Worldgate Communications, a provider of video telephones, completed a private placement of $7.55 million. ( )

Other News

ArrayComm's iBurst broadband wireless system will be deployed throughout South Africa by Wireless Business Solutions (WBS). WBS expects to cover more than 80% of the 45 million population within three years. The base stations are being manufactured by Kyocera. ( ) ( ) ( )

Broadband4Homes has been launched in the US as a service aggregator and smart homes product and service provider. It was formed by Sequoyah International Restructuring and Technology Alliance Group. ( ) announced that its Arkados subsidiary entered into a development agreement with Leviton Manufacturing Co. to create powerline carrier networking applications for Leviton. Arkados develops technology products for the powerline communication industry. ( ) ( )

Comcast and Time Warner Cable announced creation of OCAP Development, LLC, a joint venture dedicated to creating an OpenCable Applications Platform (OCAP) middleware implementation. The joint venture expects its middleware to help accelerate development of next generation of interactive television applications that will be portable and interoperable across cable networks. ( ) ( )

CTAM Europe, a chapter of the Cable & Telecommunications Association for Marketing, announced its formal launch. They also announced their first annual Euro-Summit, to be held in Budapest, Hungary on September 9th and 10th. ( )

The Digital Home Working Group has changed its name to the Digital Living Network Alliance (DLNA) to mark its shift from working group to formal alliance. They also released their guidelines, called Home Networked Device Interoperability Guidelines version 1.0, which have been under development during the past year, and will be supported by a compliance testing and certification logo program. Since its formation the group has grown from less than 20 members to over 140, representing 14 countries. ( )

Editors Note: Silicon Strategies and EE Times wrote in May about a Chinese "home-grown standard for interoperability among electronics devices in the home". The standard is called Intelligent Grouping and Resource Sharing (IGRS), and is reported to be similar to and competitive with the DLNA effort. Over twenty Chinese groups are supporting the standard, and the Chinese Ministry of Information Industry (MII) is supporting the project. DLNA responded to our question about IGRS by saying "..., it is DLNA's position that IGRS and DLNA are not competitors. Rather, the associations have the potential to complement each other."

Intellon announced that Packard Bell has started embedding Intellon's Powerline Networking ICs in its new European desktop machines. The HomePlug powerline networking technology is built into the power supply, so a user can connect a PC to a network simply by plugging it into a power outlet. ( ) ( )

Motive announced that BT has chosen to standardize on Motive technology to build self-management capabilities into BT's entire existing and next-generation consumer and business data services. The Motive software will help BT automate a range of management tasks for any type of data service, in both networked residential and business environments. ( ) ( )

Scientific-Atlanta has created a consumer-oriented Web demonstration to aid consumer understanding of HDTV and DVR capabilities. ( )

USA Video Interactive has released Version 2.0 of their MediaSentinel digital watermarking software, developed to support the requirements of the movie industry. ( )

The Utah Telecommunication Open Infrastructure Agency (UTOPIA) has finally closed financing for Phase One of their ambitious fiber-to-the-home network. It had been slowed down by intense objections from the incumbent carriers. The effort is now scaled back to cover 11 cities--down from the original 18. Construction is beginning and Phase 1 of the network--which will be open for use by other service providers--is expected to be completed within a year. ( )

Verizon announced the first service offering of their FTTP network in Texas and additional fiber deployments, including Florida and California. The new service name is Verizon Fios and offers three Internet speed/price points, ranging between 5 Mbps down/2 Mbps up and 30 down/5 up. These are available either stand-alone or as part of a bundle of calling services. Accelerating the competition with cable, Verizon has set a monthly price of $49.95 for 15/2 Mbps, with a $5 discount when bundling with local and long distance telephone service. ( ) ( )

WeRoam, a company with services to integrate GSM and WLAN services and enable WLAN roaming, has recently entered roaming agreements in Israel, Greece and Ireland. The company has over 10,000 Wi-Fi hotspot locations worldwide. ( )

WildBlue announced its first satellite payload successfully launched and its high speed Internet service is scheduled to begin in early 2005. Initial targets will be communities currently unserved by wired broadband. Services will be introduced in locations around the continental U.S., using a "spot beam" architecture with modified DOCSIS technology. WildBlue also announced the selection of Convergys, Interactive Enterprise and Incognito Software for support functions. Speeds at launch will be downstream up to 1.5 Mbps and upstream up to 256K, with prices starting at $49.95 per month. ( )


The new IEEE 802.3ah specification for Ethernet in the First Mile (EFM) has been ratified. It expands the range and reach of Ethernet transport for use in the Metro and Access networks. ( )

The IEEE also recently published the Wi-Fi security standard 802.11i, and the updated WiMAX standard 802.16-2004. ( ) ( )

The Society of Cable Telecommunications Engineers (SCTE) announced that SCTE 90-1 2004 has achieved American National Standards Institute (ANSI) approval. It is based on CableLabs’ OpenCable Application Platform (OCAP) specification. OCAP allows cable operators, content providers, and consumer electronics manufacturers to write applications one time that will run on all OCAP-compliant devices. ( ) ( ) ( )


The UK's Office of Telecommunications (Ofcom) has published a roadmap of the steps for 2004-05 to introduce greater flexibility and freedom of use to radio spectrum management. Their initial statement was issued on spectrum trading, which will allow companies and individuals holding licenses to operate wireless transmission services to buy and sell their rights in an open market. Draft regulations are expected in September and final rules in November. Other planned dates include December 2004 for the publication of a draft roadmap for mobile and wireless broadband services. ( )

Briefly Noted: Updates, Observations and Trends

We’ve decided to make “briefly noted” a section of its own. Each month it collects miscellaneous happenings, studies, trends or observations that you might have missed. This month’s tidbits verify how broadband is increasingly a part of consumers' lives and includes several pieces on VoIP, IP VOD, and video mail.

Broadband Services

Hotel Broadband a "Must Have"

InStat/MDR has published a report indicating that hotel broadband deployment activity is expanding rapidly, as hotels increasingly view broadband as a "must have". "The primary driving factor is guest demand for broadband service and hotels see broadband now as an essential element of the guestroom, along with a bed, telephone, and TV". This is the logical outcome of a trend we started writing about in 2002. ( )

Broadband or Breakfast?

2Wire, Inc has released the result of a study of 400 broadband subscribers which suggests "that broadband connectivity is permeating all aspects of subscribers' lives, with availability of Internet access strongly influencing vacation destinations, daily routines and working practices." Among its factoids, it indicates that "half of American broadband subscribers consider checking email the most essential part of their morning routines, beating out eating breakfast and reading the paper." ( )

The Year of VoIP -- Now!

Here are a few of the indicators in the US that VoIP has really arrived big time:

  • AT&T has reached 100 major markets with its CallVantage VoIP service; it has also announced it will no longer promote standard consumer voice services and is focusing its resources on VoIP, which can serve both business and consumer markets, and data networking for businesses.
  • Verizon announced its new VoIP over broadband service, called VoiceWing, which provides unlimited calling within the U.S. for $39.95.
  • Small new companies are sprouting like weeds to offer VoIP services. VoIP Inc has launched eGlobalphone, a primary line residential VoIP service, in 9 U.S. states. Others include StarNet's VoiceEclipse residential VoIP service. ( ) ( )
  • ...and these are just a few in addition to those we wrote about last December in IP Telephony -- Coming of Age in the US.

Many places around the world have been out in front of the US:

  • In Japan, Yahoo! Broadband has for some time been bundling ADSL and VoIP phone service with huge take rates, thereby scaring major providers into offering a similar service.
  • From the UK, David Moloney, Editor in Chief of Total Telecom, emailed us saying: "...VoIP over BB is completely the buzz word this year, and most operators are launching services." ( )

In a different class from the incumbents, disrupters are also busy:

  • Skype has expanded beyond computer-to-computer voice services by completing agreements with COLT, iBasis, Level 3, and Teleglobe to provide call termination services worldwide. The new SkypeOut pre-pay service allows people to call any land-line or mobile phones at local rates, using Skype software. ( )

Unexpected Consequences?

Communications via POTS telephony has been taken for granted not only by ordinary consumers but also by a variety of industries that have used these telephone lines as part of their product/applications fabric. As VoIP telephony becomes more commonplace and increasing numbers of consumers drop their POTS lines, there are going to be some unexpected surprises for the unwary. One of these--the incompatibility of VoIP telephony with alarm systems--was recently pointed out by Joan Engebretson in America's Network. In the article, Engebretson points to two issues. One is the well-known issue of lack of central office powering in the event of a power failure (although battery back-up mitigates this as long as the battery lasts). The other is the reliance of the alarm industry on long-standing protocols which don't work properly in the new digital environment. ( )

Worst Nightmares--VoIP spam

We hope VoIP providers are paying close attention to security issues and are heading off something which sounds like my worst nightmare (well,...maybe not really the very worst). It's voice spam, or "VAM" as it was dubbed on the Engadget Web site. The implications are awful. When telemarketers call, at least they have to place calls one at a time. However, with VoIP, the message goes right into your inbox, lurking for the next time you go to check voice mail. The difference from telemarketers is that the VAM voicemail could be put into lots of people's inboxes simultaneously. Already one company has issued a press release about filing a patent application for its method to identify and block VoIP spam. ( )

IP VOD -- Coming of Age?

When the New York Times has a headline like "An Online Supplier for Your Desktop Cineplex", it seems like the broadband world we've been talking about is really arriving. The article reviews four current Internet VOD services: Starz Ticket, Movielink, Cinemanow and Movieflix. It concludes that, while Internet VOD misses out on some aspects of renting a movie--like selection and clerk recommendations, "in other ways it makes an ideal way to rent movies." ( )

Video Mail from Comcast

Comcast has added video mail as its latest application -- continuing its quest to distinguish its service by new applications rather than price cuts. Comcast Video Mail, available to its customers at no additional charge, enables users to create video messages up to 45 seconds in length, using their personal computer and a webcam. They can also use Comcast Video Mail to send personalized video greeting cards and to share their digital photos via narrated photo slideshows. The application is based on the Vibe Solutions Communications Platform -- previously mentioned in our February 2004 report. We expect this is the beginning of video applications becoming more widespread in the future. ( ) ( )

Transforming Disease Care Into Health Care: Can Broadband Help?

We've talked for years about applying broadband in ways that help make people's lives better. At the recent Healthcare Unbound Conference in Boston, hearing about how broadband contributes to keeping people alive and functioning longer and better was pretty exciting stuff. Speakers included those on the front lines of health care, who have conducted studies about how broadband, along with several other key technologies, is producing measurable results.

Eric Dishman speaking at Heathcare Unbound --> Click for larger pictureWe usually write about broadband access, home networking and consumer electronics. How did we find ourselves speaking at a healthcare conference? After we ran Eric Dishman's article Repurposing Broadband: Home Health Technologies for the Worldwide Age Wave, we got an email from Vince Kuraitis of Better Health Technologies. He was helping to select speakers for the Healthcare Unbound Conference and asked us to join in a workshop on "Smart Homes and Smart Phones." We were delighted to participate, since the intent was to begin a dialog between us plus others from the technology side and a wonderful collection of healthcare experts. More about the workshop below.

The title of the conference derives from a study by Forrester in 2002. Its basic premise is that we can improve access to, the quality of and the cost effectiveness of healthcare by moving it away from institutions and doctor's offices and into wherever people live and work. Telemedicine is a related term and concept. One succinct definition of healthcare unbound is "technology in, on, and around the body that frees care from formal institutions".

Framing the Problem: It's More Than Technology

We suspect that many of our readers who have dealt with the US healthcare system for themselves or their aging relatives have come away, as we did, shaking our heads. It's tragic but true that the US spends so much money on "healthcare," has such great technologies that could be applied, and yet has so fundamentally broken a system--see a recent Washington Post article on this. A line we heard repeatedly at the conference is that ours is not really a "healthcare" system, but rather a "sickness care" system.

Vince Kuraitis speaking at Healthcare Unbound --> Click for larger pictureAs the opening speaker, Vince Kuraitis summarized the current situation:

  • People prefer to live in their homes and communities
  • They prefer to avoid institutional care as long as possible
  • The population in the developed world is aging
  • The opportunity for healthcare unbound technologies is huge
  • Healthcare unbound is disruptive to the existing players--and therefore they will fight it
  • But it is the right thing to do.

He described healthcare as being in the early stages of a sea change, during which the human body will become the focus of technology applications for the next decade. The raw ingredients are mostly in place. These include pervasive computing, non-invasive measurements and communications technologies to create the "body area network" or BAN. Those familiar with the hierarchy of networking, starting from the wide area and working toward the person, will understand this is the next step in the logical progression from wide area network (WAN) to metropolitan area network (MAN) to local area network (LAN) to personal area network (PAN).

Joseph Kvedar speaking at Healthcare Unbound --> Click for larger pictureTechnology is only one ingredient in fixing the situation. Dr. Joseph Kvedar, Director of Partners Telemedicine and President of the American Telemedicine Association, and others made clear that in some ways it is the simplest. The prerequisites for getting from today's world to the one we want for the future include:

  • Health-conscious consumer behavior: all those things you've heard about giving up Big Macs, stopping smoking, exercising more, etc.
  • A sustainable economic model: the current economic model pays for sick patients that show up at a doctor's office or hospital emergency room, but not for keeping people out of these places. A quote from Dr. Moore's presentation (referenced below) was "You must not understand…I get paid to take care of sick patients who show up on my doorstep, not to keep them out.”
  • Enabling policy: this is the thorny issue Hillary Clinton and others tried (unsuccessfully) to resolve during her husband's US presidency.

Technology still has some challenges in getting to really "usable technologies", which Dr. Kvedar defined as reliable, "wear and forget" (fully integrated so there is no user interface) and disposable.

Other speakers noted that at least two more things would have to change to make healthcare unbound a reality. First, people need to learn how to do things differently--and people's behavior does not change easily. Second, the economics for a sustainable economic model need to look at the total costs of patient care--not just looking in "silos" as many health organizations do now. For example, the ROI of homecare taken by itself may not look that good, but if you count the cost savings from reducing emergency room visits and hospital readmissions, the ROI looks great. The talk by Drs. Moore and Woodbridge (see below) clearly illustrated this point.

Michael Barrett speaking at Healthcare Unbound --> Click for larger pictureMichael Barrett of Critical Mass Consulting gave an interesting keynote in which he observed that the aging of the population in the developed world plus the availability of new technologies can cause disease and disability trends go off in different directions. He believes that "healthcare unbound" can re-order the links between age and dependence. As an example, he spoke about the following translations which occur today:

  • “I am 75.” (Age)
  • “I have arthritis.” (Disease/condition)
  • “I have trouble walking long distances.” (Disability)
  • “I can’t shop for myself.” (Dependence)

He pointed out that new technology products and services can negate these equations:

  • Age ≠ disease: Products and services promote prevention, wellness, risk reduction, and behavioral change
  • Disease ≠ disability: Products and services neutralize disease’s impact on physical activity, mental alertness, and emotional balance
  • Disability ≠ dependence: Products and services enable independent living despite disabilities

Case Studies

Dr. Kvedar observed that a study of his own organization's healthcare costs showed that 3% of the patients account for 40% of the costs and 1/2% account for 20%; this is similar to what other organizations have found. Kuraitis and others focused on the understanding that if you can determine which diseases and chronic conditions account for most of the illness, disability and cost, there is a logical path to attacking the problem: identify which value propositions most effectively address them, which technologies we need to create those value propositions, and which environments they work in. This is the path that much of today's work is focused on.

Several of the case studies showed credible and convincing outcomes focused on leading diseases and conditions. Let's look at three to see what actually happened.


The essence of a talk by Dr. Larry Gottlieb, Chief Medical Officer of Intermed Advisors was the need to transform the management of chronic diseases such as diabetes from "episodic" (providing treatment when something goes wrong or happens to get caught) to "continuous". The work he reported on involved people with diabetes and was done in conjunction with Joslin Diabetes Center in Boston. The statistics indicate that there were 15 million people in the US with diabetes (in 2002) and 177 million worldwide (in 2000).

His technique involves the use of home monitoring devices (for diabetes it includes measuring blood pressure, glucose, oxygen saturation and weight) and the automatic transmission of biometric data from those devices to physicians and care managers. A key in this work has been sophisticated mathematical time-series analysis to characterize each patient's individual pattern. The mathematics plus the continuous monitoring can quickly and accurately discover trends by looking at the stability of results and the variance. The key is to decrease the cycle time between evaluations and interventions and use the information to make behavioral changes which prevent future adverse events.

The second part of making such a program successful is to make it self-care oriented. Intermed has developed a simple personal interface using a Web pad, or a PC for users who already have one and are comfortable with it. A "virtual nurse" provides frequent positive feedback to the subject--in the form of a human sounding voice, pictures and animation, and simple progress charts to encourage improvements and make suggestions.

The keys to the success of this program are that it is frequent, personalized, self-care oriented and affordable. The subjects generally see participation as an excellent way to avoid the complications of diabetes which can include stroke, eye disease and amputations.

Chronic Heart Failure

Dr. Robert Scott of Ochsner Clinic --> Click for larger pictureThe second study was reported by Dr. Robert Scott from the Department of Cardiovascular Medicine at Ochsner Clinic Foundation of New Orleans. In this case, the subjects were those with unstable chronic heart failure (CHF). Again, home-based electronic patient monitoring was employed -- in this case using the HomMed telemonitoring system (see below). The work involved a group of 115 adult patients with CHF who participated in home monitoring and a control population of 158 people with similar conditions who did not take part. Because of the more serious condition of these patients, their daily results were monitored by trained healthcare professionals. The frequency of all hospital and emergency room visits was reduced by 41% in the program participants, reducing overall costs and improving their quality of life.

Veterans Administration

A third study was described by Doctors Randall Moore of American Telecare and Peter Woodbridge of the Roudebush Veterans Affairs Medical Center. It involved care coordination and telehealth for the US Veterans Administration (VA). Although US Veterans Hospitals were at one time at the trailing edge of technology and innovation, they are currently a bright example of its success. By re-engineering their clinical and operational processes, and employing video (systems and phones) plus monitoring and messaging devices, they saw improvement in diabetic control and chronic heart failure.

Dr. Moore and Dr. Woodbridge showed a dramatic reduction in hospital and ER admits --> Click for larger pictureTheir presentation included a chart showing the dramatic reduction in hospital and ER admissions before and after Telehealth. They reported that the ROI of Home Care alone was good but not compelling; however at a systemwide level it was >400%.

"Smart Homes and Smart Phones"

Connecting Consumers To Create Healthcare Unbound

We spoke in a post-conference workshop moderated by Michael Barrett of Critical Mass Consulting that also included presenters from the University of Virginia Health Sciences Center, MIT and Qualcomm. Our only concern about speaking in this session was its title, which talked about "smart homes"--a phrase we generally try to avoid. Steven Intille, Technology Director of Changing Places/House_n at MIT was on the same wavelength, saying in his talk that there is no such thing as a "smart home", only "smarter people" who are properly enabled.

Stephen's talk focused on the difference between teaching and controlling. He believes that technologies that people will appreciate are those which are fundamentally useful and/or provide the user with lots of benefits. He distinguished between four levels at which technology might operate in a home setting:

  • to control or automate--the user has no choice
  • passive alerts
  • active teacher--alerts that provide information as to why the alert has been given
  • "just in time" active teacher--which adds to the above a level of immediacy at the "teachable moment"

Stephen is testing his premise in an electronically-mediated house at MIT, where volunteer subjects move in for a 10 day stay. The idea behind what happens in the house is that user empowerment is very important. This is quite different than the "smart" home which acts automatically. We hope to see the outcomes of these studies to understand the results and implications. We wonder if the application of this theory may be quite appropriate in some circumstances--such as diabetes control--and inappropriate in others--such as dementia care.

Robin Felder described the Sleep Monitor --> Click for larger pictureRobin Felder, Director of the Medical Automation Research Center at the University of Virginia, spoke about Eldercare Technologies at MARC and how they are aiming at personalized care enabled by technology. In this work, they have created technologies which allow vital signs to be monitored passively. A gait monitor is one example; it distinguishes between normal, limping and shuffling gaits, detects falls and detects changes in pace and gait mode over time. A sleep monitor uses sensors to passively measure sleep quality, sleep depth and vital signs. The technology, which they have named Home Guardian, was deployed for 24 subjects at a Volunteers of America assisted-living facility and ran for three months. Those with the lowest pre-monitoring quality of life showed increases of 66%, 90%, 12%, 54%, 40% and 8% respectively. Robin is continuing work on "the three p's" -- Predictive, Preventive, and Personalized Medicine.

Our talk focused on the broadband home and how healthcare ready it is. We described the infrastructure—-to and in the home-—that home healthcare products can assume in the future. We discussed how this infrastructure was used in some current home healthcare applications, and referred to the work by Telefonica in Spain we looked at last year.

In looking at today's healthcare technology prototypes and products, we observed that most fail to assume the future will include a persistent connection to the home (broadband) or a home networking infrastructure, both of which are becoming more widespread.

Comparing what exists in healthcare today with other applications/products that have reached mass market proportions (such as PCs, cellular telephony and Wi-Fi), it appears that the prerequisites for mass deployments are still some time in the future. In our experience, these prerequisites include both an appropriate target architecture and the development of a technology ecosystem. Each of the home healthcare systems we’ve seen appear to be complete end-to-end solutions. In the absence of an appropriate "home healthcare ecosystem" this is probably "the only way to do it today".

We suggested the audience think about what will it take to get there from here and what efforts are underway to facilitate the development of a successful technology ecosystem for home healthcare.


Like most conferences, Healthcare Unbound had a good-sized exhibit floor, demonstrating a variety of products and services. Many of these contained some variety of monitoring devices, communications capabilities, and processing; these facilitate interactivity between those who have some type of illness or condition requiring medical oversight and the health professionals who care for them. Products from HomMed and FitSense illustrated the range of products and services in the exhibit area.

HomMed Genesis Monitor --> Click for larger pictureThe HomMed Sentry Monitor is used for those who have had recent hospitalization or emergency room visits; those with conditions requiring frequent monitoring or trending of their health status to assist in their clinical management; and those who are trying to avoid admission to alternative living facilities or are having a poor record of compliance with medications, diet or self-monitoring. Basic units contain such devices as a digital scale, blood pressure cuff, and finger sensors for obtaining heart rate and oxygen saturation; other medical peripherals--such as a glucose meter or peakflow meter--can also be attached. They include communications capabilities (usually POTS and a digital 2-way pager) plus an interactive capability--in this case voice and text prompts and a simple interface which guides the user through the process.

JD Ginty showed us the FitSense Pacer --> Click for larger pictureThe FitSense technology is quite different: it is applicable not only for medical conditions but also for fitness, sports and life-safety. These products use miniature, wearable bio-sensors with wireless data links to track physiological variables such as activity, heart rate, blood pressure, weight, core body temperature and skin temperature. Their BodyLAN (TM) enabled systems use a proprietary two-way radio protocol, networking intelligent sensors that process, collect and transmit data. The data can be viewed in real-time on a watch, cell phone or PDA or moved off the body through a gateway to a local or remote database. One example is their Pacer, an activity monitor/pedometer which measures the user's step count, distance traveled, speed and calorie burn. It can be used along with their Pulser heart rate monitor to record associated heart rate data. Although these can be used to monitor a patient's exercise compliance at home, it is equally applicable for healthy physical fitness buffs who want to track the progress of their training programs.

Reflecting back on all that we learned during Healthcare Unbound, we're unclear as to how fast what is possible via technology will be translated into what will be available and affordable. As with many significant changes in how people live and work, home healthcare requires some very basic changes in consumer expectations, government policies, and business and personal incentives. These fundamentally influence the rate of progress and vary from country to country. There is no question that "healthcare unbound" will come to pass in the next 10 to 15 years, but many of the keys to change lie in government policies regarding healthcare and the associated reimbursement systems.

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Telco Video Services: Maybe this Time?

Those with some history in broadband may remember the on-again, off-again behavior of the US telcos with respect to providing cable-like video services. Their forays included Bell Atlantic's video push in the late 1990s, Pacific Bell's MMDS-based service in San Jose, BellSouth's launch of digital wireless cable service in Orlando, plus ones from SNET and Ameritech using HFC. Well, it's deja vu all over again (to quote Yogi Berra). Might it have some staying power this time?

Outside the US it is already happening. We've covered some of the deployments in previous reports, including Fastweb in Italy and the MTS deployment in Manitoba.

Here are some signals that show this time it could be real in the US:


  • DSL improvements--like ADSL2 and VDSL--plus fiber rollouts are improving telco's available bandwidth.
  • Advanced video compression using H.264, Microsoft Windows Media 9 Series or Real Video 10 is significantly lowering the amount of bandwidth needed to deliver video (standard definition video at 1 to 1.5 Mbps, high definition at 5 to 6 Mbps).


  • IP settops are being manufactured by an increasing number of companies at affordable prices.
  • Thomson has expanded its activities in North America, including its IP video settop.
  • Boxes like 2Wire's Home Portal residential gateway are intended to make the consumer experience of telco video the same as that from cable companies by integrating satellite broadcast and IP video on demand.

Content and DRM

  • Companies like Movielink and CinemaNow are aggregating movie rights for IP delivery
  • The major US telcos have made deals with satellite services for delivery of broadcast TV
  • Digital rights management solutions such as Microsoft's Windows Media Digital Rights Management Software are being adopted by companies including Disney, America Online and CinemaNow.

Companies doing it

  • Many smaller US telcos have led the way in deployments of video services. Examples include companies you probably haven't heard of such as Heart of Iowa Communications Cooperative, James Valley Telecommunications and Matanuska Telephone Association.
  • Verizon has announced their fiber deployments are underway in Texas, California and Florida (see "Heard on the Net") and has indicated it plans to offer a video service in 2005 as an alternative to cable TV.

    802.11a for Consumers: An Interview with Atheros Communications

We've long admired Atheros Communications, the leader in 802.11a Wi-Fi technology. During our family visit in California, we arranged to meet in person with Sheung Li, Product Line Manager, Home Networks, and Susanna Auyeung, Manager, Product Applications. We discussed the future of 802.11a, and looked at some technology advancements for consumer applications.

"Dual-mode" and "Tri-mode" Devices

802.11a operates in the 5 GHz frequency band, and was published as a standard in 1999 along with the slower 802.11b operating in the 2.4 GHz band. The popular 802.11g, standardized last year, is based on 802.11a, but operates in the same 2.4 GHz band as 802.11b. 802.11g devices always support 802.11b, and are called "dual-mode" devices. Newer "tri-mode" devices add 802.11a as well and operate in both frequency bands. Sheung told us that Atheros is the dominant supplier of chips used in tri-mode devices, and is second in dual-mode chips.

The 2.4 GHz band is quite congested, and consumers often experience interference from portable telephones, microwave ovens and other Wi-Fi networks operating in the same band. The 5 GHz band is much less congested, and has much more available bandwidth: 12 channels compared with the 3 effective channels in the 2.4 GHz band. So we've wondered when consumer products based on 802.11a would come to the market.

In the US at the present time, 802.11a is targeted to the large-enterprise market, while 802.11g is targeted to consumers and small business. Device manufacturers have charged a considerable premium for 802.11a and tri-mode access points, routers and LAN cards compared with dual-mode devices.

We asked Sheung what the underlying cost difference was between dual-mode and tri-mode devices. He wouldn't tell us the exact bill-of-materials (BOM) cost, but said the difference was "less than a Big Mac Value Meal", well under $5.00 here in New Jersey. In the US, the street price difference between dual-mode and tri-mode devices is much higher than that, so it didn't surprise us when Sheung said that in 2003, tri-mode devices represented only 11% of the Wi-Fi market.

Interestingly, he said we shouldn't view the US as being representative of the global Wi-Fi market. For example, he said "Japan is split 50/50." Part of the difference is the high concentration of apartments (5 GHz channels are much less congested than 2.4 Ghz), and part is pricing that better reflects the BOM difference. But the biggest difference is that "sales people in Japan SELL A/G" as a better long-term purchase, whereas sales people in the US sell only G.

We asked about the prospects for 802.11a in the consumer market, and Sheung said he expected Media Center PCs and Extenders to play a major role. MC Extenders are digital media adapters designed to move content from Media Center PCs to home TVs, scheduled to reach the market this fall. Because they are designed for high-quality video, they will work best with 802.11a. Sheung believes many manufacturers will include 802.11a support in Media Center PCs and Extenders.

Reference Designs and Consumer Devices

Tri-mode USB reference design --> Click for larger pictureTri-mode access point reference design --> Click for larger pictureSusanna showed us Atheros reference designs and devices based on them. The reference designs were all based on the current AR5000 series--the "fifth generation" of Atheros 802.11a chip designs. We were intrigued by the tri-mode USB reference design based on the current AR5005UX chip set, which uses two Atheros chips: the AR5112 dual-band radio-on-a-chip which supports both 2.4 and 5 GHz transmit and receive; and the AR5523 multiprotocol MAC/baseband processor which does all the digital work. We also liked the tri-mode AR5005AP-X configurable access point reference design. These both show how small tri-mode devices are getting.

"Mickey Fan" Wi-Fi equipment in Japan --> Click for larger pictureSusanna also showed us a sampling of consumer devices based on Atheros chips. We were especially amused by the "Mickey Fan" Wi-Fi access point and LAN card marketed by NTT in Japan.

Advanced Wireless Video Applications

We discussed the application of wireless networking for video applications--especially for high-definition video, which requires sustained speeds of about 20 Mbps. In the past, this has been nearly impossible for Wi-Fi devices, which experience a rapid falloff of speed from walls and floors between wireless devices, and often suffer from interruptions which would "break" the video.

Sheung showed us the specifications for their new chipset, the AR5005VA, a tri-mode device specifically designed for wireless video networking. This includes the full security features of the new 802.11i standard, has QoS features from the draft 802.11e standard, and is designed to interface directly with digital TV, DVD and DVR chipsets.

Atheros claims the chipset can "blanket homes up to 6,000 square feet with video-quality coverage". That's quite a claim, since current 802.11a devices don't come close to that range. Sheung said the new chipset has two features to enable greater range for video applications:

  • Multiple radio/smart antenna: The chipset supports multiple antennas for transmit beamforming and receive combining. This approach, often called multiple-input multiple-output (MIMO), is a key component of the 802.11n effort to create a super-high-speed successor to the current Wi-Fi standards.
  • Transmit speed backoff: Data-oriented devices attempt to transmit at the maximum possible speed, and tolerate occasional interruptions from interference, say by somebody walking between an access point and a portable device. TV does not work acceptably with interruptions. So the new chipset "backs off" from the maximum speed to a lower speed which will carry the TV content but which provides an added margin for interference.

Sheung showed us a demonstration of the new chipset. He said the chips are sampling now, and we should expect to see devices based on them at CES in January.

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"Software Based Radios" for Wireless: Interview with picoChip

We recently saw a report saying that a British chip maker called picoChip had demonstrated a "software based" modem for WiMAX base stations. It said their technology would allow "equipment manufacturers to upgrade to the formal 802.16d specification down the road, as well as to other future 802.16 amendments."

We were intrigued by this announcement. While we've heard that "software controlled radios" would be important for future wireless applications, we didn't realize they were available today. To learn more about picoChip's products and plans, we talked on the phone with Rupert Baines, Vice President of Marketing.

picoChip is based in Bath, England, an old and beautiful city we visited a few years ago, famous for its Georgian architecture and spectacular Roman Baths. We hadn't thought of Bath as a place for advanced chip technology, so we asked Rupert why picoChip was based there. He explained that the nearby city of Bristol is a center for UK chip design: "there are more chip designers in Bristol than anywhere else". He said the University of Bristol is very good, and many chip companies including Conexant, ST, Infineon and Intel have design groups in Bristol.

picoChip PC101 --> Click for larger picturepicoChip builds high-performance processors optimized for building flexible wireless base stations. They introduced the PC101 18 months ago, and have started sampling its successor, the PC102. These are based on a "massively parallel" architecture: each chip has hundreds of 16-bit RISC processors interconnected by a 32-bit bus; the processors come in several versions, optimized for different functions. We've been used to thinking about processor performance in terms of "millions of instructions per second" or MIPS, but each picoChip device provides hundreds of GIPS (giga-instructions per second)--by contrast, the fastest Pentium today is about 10 GIPS. And it's easy to couple picoChip devices together to get nearly super-computer power from a handful of chips on a board.

To complement its processors, picoChip provides programming for wireless applications, some free and some for an added fee. Rupert explained that for some customers "we supply libraries of typical code available for free, but they must customize it & complete it." On the other hand "for WCDMA and WiMAX we have software reference designs. These are complete, tested, compliant, warrantied full implementations. And we do charge separately for this code."

picoChip has released both libraries and complete reference designs for the European 3G standard UMTS/WCDMA FDD, and is developing designs for other "flavors" of 3G.

We have written before about WiMAX, most recently in The WiMAX Drumbeat. WiMAX is developing through several stages. The original standards were 802.16 and 802.16a; these have now been consolidated into a new published standard called IEEE 802.16-2004 (but sometimes still called 802.16d). The 802.16e standard, expected in 2005, will add mobility.

picoChip says that base stations designed with their chips and reference designs will support 802.16a initially, will be software upgradable to 802.16-2004 to pass WiMAX certification tests, and will later be further upgradable to the 802.16e mobility standard. This should be very attractive to carriers deploying WiMAX base stations.

The picoChip devices are not inexpensive--they cost "a couple of hundred dollars" each. Base stations need a lot of processing power to handle multiple users simultaneously--the reference design for a 32 user UMTS FDD microcell base station requires four PC102 devices. But they simplify designing wireless base stations, and Rupert said "We are doing very well in design wins."

We're sure that picoChip is not the only company taking the "software radio" approach, but it's the first one we've looked at closely and we see its approach as the wave of the future. While picoChip is focused today on the power required for base stations, they or other companies will eventually apply the same approach to consumer wireless products. Rupert told us "the same architecture works fine in CPE" but needs only "10 to 30 processors" to support a single user rather than the thousand or so for a base station.

That suggests that in the not-too-distant future we'll see "software radios" built into consumer devices. They'll be able to talk with Wi-Fi inside the house or at a hot spot, with WiMAX wherever it's available, and with several versions of 3G everywhere else.

And pretty soon this will be built into every laptop and PDA.

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Upcoming Conferences

We had the pleasure of speaking at last year's Broadband World Forum in London and had hoped to attend their upcoming conference in Venice in September. However, unexpected family events and a backlog of other projects have us wondering if we will be able to attend this year. It sounds like an excellent program and will be taking place September 20-23, 2004 at the Palazzo del Casinò and Cinema, Venice, Italy. A sampling of the topics to be covered includes Video Solutions over Broadband, Integrating Broadband Multimedia Services in Fixed and Mobile Networks, and The Digital Home: Trends and Strategies.

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Your Voice -- Readers' Comments

Michael Robinson of VegaStream wrote "Re: the article on Gracenote in the latest broadband home report and their music recognition capability. A company called Shazam has launched a music recognition service in the UK - it is amazing and needs to be used to be believed."

And from Bill Moore of Radio Time came this: "I have been reading your newsletter for years – so think you might be interested in a new radio guide service we have created. The recent column on Meta data was right on. In our case we have created a guide to radio programming covering thousands of stations and programs. Try setting up an account to see for yourself."

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