the engineering laboratory and in the clinical environment. Here both the technological agent and the user agent must work collaboratively to insure that the best technological solution is provided and to insure that the clinical objectives are met. Finally, once a solution has been evaluated and found to be useful, there remains perhaps the most important function of all; that is, the injection of the solution into the user community so that there remains not a one-of-a-kind system being operated as prototype somewhere, but rather a system which becomes an accepted component of the armamentarium of health care delivery. This latter task falls to two groups. First is the user agent, for it has a far greater ability to influence the ultimate users and carry the results to the delivery system at large than does the technological agent. The mission-oriented federal health agency often has leverage through the use of funding control, ability to promulgate certain rules and regulations, and influence upon health operations and legislation not available to the technological agent to further this transfer process. The other type of user agent (e.g., American Hospital Association), while not a federal agency, is a body that has direct influence upon the user community and therefore is in an excellent position to serve as a distributor of the new technology application. In the ultimate, it is the degree to which the solution is adopted throughout the user community that measures the success of the transfer process. Of critical importance, therefore, is the conviction of the user agent that the device, process or technique proposed for transfer is sound and worth distributing. This conviction can best be achieved when the user agent participates with the technological developer throughout the transfer process, thus identifying the resulting product as being as much his as that of the technological agent. It is a rare case, indeed, where the technological agent can unilaterally choose the problem, develop the technology, create the solution (e.g., a new "black box") and then create a strong motivation in the user agent to serve as the distributor. The second necessary partner in the widespread transfer of technology is industry. Here, as elsewhere in the overall process, there have been problems. The NAE has considered this question in some detail. Among the chief conclusions derived from an in-depth survey of fifty companies involved in biomedical engineering were these: 1 1. That industry faces several problems in becoming active, including lack of an identifiable market of sufficient size for new medical instruments and fear of legal repercussions which could result from misjudgment in an endeavor directly influencing human life. 2. That there is no informed consumer demand for better or new products or services. 3. That there is an absence of competitive cost pressures and incentives for cost reduction by new technology because of the historical development of hospitals along philanthropic lines and the presence of third party insurance companies to pay the bills. The Committee believes that by engaging NASA, HEW, and private industry in a cooperative program, such as the one attempted in pulmonary care, some of these problems will be alleviated promptly. Reducing the remaining impediments, caused by uncoordinated methods of health care delivery in this country, must await other, bolder attacks. The lending of intellect In most attempts used so far to transfer technology and, indeed, in the model proposed above, there remains a delineation of two groups: the technological group and the user group. The process involves the transfer of information and hardware between these groups, collaborative activity between them, and people with experience in both. The Committee proposes that an efficient mechanism to bring this about is the transfer not only of information hardware and software but also the transfer of people; that is, assigning technologists well-versed in the technology deemed transferable to full-time, albeit temporary, positions in organizations of the user community faced with solving user problems. For example, NASA engineers could be assigned full-time duty in a hospital, a city communications department or a university project developing prosthetics for 1 Committee on the Interplay of Engineering with Biology and Medicine, "An Assessment of Industrial Activity in the Field of Biomedical Engineering." National Academy of Engineering, Washington, D.C. (1971). the handicapped. This could constitute a technological agent's sole contribution to a specific transfer process, the lending of intellect. When the task is complete, such persons could return to their regular duties. Not only would the user community benefit from such an arrangement; cross-fertilization would occur and the technologist returning to the space agency would bring a broader outlook and, perhaps, even new technological concepts that would accrue to NASA's benefit-technology transfer can be a two-way street. TECHNOLOGY UTILIZATION MANAGEMENT WITHIN NASA The Committee experiences lead it to offer several recommendations which could enhance the technology utilization (TU) program within NASA. 1. Assignment of people.-It was suggested that one effective means of transferring technology is the lending of intellect-the assignment of NASA employees to operate within the community that will be the ultimate recipient of the transfer. Because of current administrative constraints in the agency, this is very difficult to accomplish. It has been done in only a few selected instances such as assignments made under the Federal Intergovernmental Personnel Act of 1970. It is far easier for NASA to contract for a $75,000 technology transfer hardware development than it is to obtain approval to "lend" a $25,000 per year salaried engineer who, working in the user's community for a year or two, could accomplish equivalent, if not more effective, transfer functions. NASA could strengthen its TU program considerably if constraints to assigning personnel to extra-NASA institutions and to internal technology utilization projects were reduced. 2. Strengthening interagency collaboration.-Some problems that developed in this area came as a surprise to the Committee. In developing the contractual agreement between the Academy and the Agency to conduct this study, NASA consistently emphasized its desire for aid in developing mutual, collaborative programs between NASA and mission-oriented health agencies. Perhaps naively, the Committee did not anticipate serious difficulty. Yet in attempting to accomplish that end, the Committee often was frustrated by a seeming reluctance on the part of agencies to cooperate. This reluctance was found in the health agencies as well as within NASA. Some examples are in order. In the pulmonary care project, the Committee has yet to be successful in developing funding support in either the National Institutes of Health (NIH) or the Health Services and Mental Health Administration (HSMHA). In this case, the reluctance came from those agencies, although obtaining a definite commitment from NASA as to what it would contribute in the form of hardware and engineering expertise has also been difficult. Having that information might have made approaches to the health agency more effective. A lesson learned from that experience is the desirability of coordinating the offering of technology with the current priorities and thrusts of the health agencies. When the technology offered matches the user agent's needs, the probability of negotiating a joint program is greatly increased. Further, the health agency's priorities and thrusts should be excellent indicators of significant current problems demanding attention. At the height of the pulmonary care project, for example, neither NIH nor HSMHA was placing heavy emphasis on pulmonary care hardware development; in fact, the National Heart and Lung Institute (NHLI) initiated a study of its own on technology needs in pulmonary care. Until that effort is complete and the agency moves toward implementation of its recommendations, NHLI is not very inclined to provide any substantial support. In its health care technology transfer program, NASA should maintain close contact with the mission-oriented health agencies and other user institutions and stay apprised of continually changing and emerging program thrusts and priorities. Further, when a collaborative transfer project is undertaken, a willingness on the part of all agencies involved to share management prerogatives as well as resources is a necessity. 3. Internal management control of technology utilization projections.—Since the Office of Technology Utilization is a staff office in the agency while the personnel in the NASA Field Centers conducting TU programs are in line management, the Office of Technology Utilization has little management control of the projects is funds through or in the Field Centers. The NASA commitment to technology utilization and transfer would be considerably strengthened if means were developed by top management that would permit direct headquarter management control of technology utilization projects originating in and funded by the Office of Technology Utilization. A closing statement The national technological resources could be beneficially exploited in a way that has gone heretofore untapped. NASA, other agencies of government and the private sector can all assist toward that end. Required are: 1. An expansion of the concept of technology transfer to include large, more imaginative development, evaluation and deployment schemes addressed to significant and universal problems. 2. True interagency and inter-institutional collaboration from problem definition to user acceptance. 3. A recognition of the needs and capability of American industry. COMPUTER BRAILLE TRANSLATION OF THE ATLANTA SCHOOL SYSTEM SUMMARY A system has been developed at the Atlanta Public Schools to translate and produce hard copy braille on an IBM System 360/Model 50. The purpose of this project is an attempt to make braille materials accessible to visually impaired students so that they may compete successfully with their sighted classmates. This paper discusses the different phases involved in the translation system, including problems, the personnel involved, the necessary hardware, and operation of the software packages. COMPUTER BRAILLE PROJECT The Atlanta Public School System has a multi-faceted educational program for blind students. All such students receive instruction in regular classrooms along with their sighted classmates under the guidance of a regular classroom teacher. This instruction is augmented by the services of a "vision teacher" who visits school on a rotating basis and works with the blind student and with his regular classroom teacher. When possible, textbooks are obtained from the American Printing House for the Blind and from the school system's own Library for the Blind. In those frequent cases when needed books are not available, a group of approximately twenty volunteers transcribes these volumes, working at their homes with braille-writers. Materials for the sighted in the Atlanta Public Library System number approximately 700,000 volumes, excluding periodicals, newspapers, film strips, or other materials. The Atlanta Branch of the Library of Congress, Division for the Blind and Physically Handicapped has only 7,000 volumes on tape, on talking book records, and in braille. The discrepancy between the amount, kind, and availability of reading materials for sighted and blind students is one of the major weaknesses in the overall education program for visually impaired pupils and is an indication of the magnitude of the problem in obtaining a minimum of needed instructional materials. The Computer Braille Project in the Atlanta Public School System, funded under Title VI of the Elementary and Secondary Education Act (ESEA) was designed to develop a program to alleviate this problem of limited reading materials by providing braille materials for the visually impaired via the computer. The project is bringing about increased accessibility of educational material in braille for blind students in attendance with their sighted schoolmates. Under the present system books and other materials are copied onto either a typewriter-like device (ATS terminal) which is connected to a computer or a typewriter equipped with special characters which can be read by a document reader. The materials thus copied are proofread and corrected, then subsequently stored on magnetic tape. These tapes are then used as input to the braille translator. Next the output of the translator is embossed into braille by a high speed printer equipped with a specially made device. The printer speed is approximately 300 braille lines per minute or 200 characters per second. The entire system runs on an IBM 360, Model 50 Computer. The braille translator, DOTSYS HII, was developed by the Massachusetts Institute of Technology (MIT) under contract from the Atlanta Board of Education. The program contains extensive capability for text editing. Among these are tabulation controls, page and line formatting, poetry, and special braille symbols. It is capable of producing two types of braille as well as an inkprint proof copy for a sighted braille editor and punched card output to be used for compatability with other systems. The two types of braille are (1) a low quality braille produced on standard computer paper for use by computer programmers and (2) a high quality braille for the general reader produced on 90-lb. paper utilizing an interchangeable print train which works very much on the same principle as a braille-writer. An interface program accepts the output of ATS, which consists of archives tapes, and converts them to a form compatible to the DOTSYS III program. This program makes use of certain features of ATS commands, DOTSYS III commands, teleprocessing characters, and rules of Standard English Braille. Although experience with the software indicates a high degree of performance it is continuously undergoing modifications in order to improve the accuracy of translation and its flexibility within the environment for which it was designed. Both programs use complier-oriented languages. The ATS to DOTSYS III program is written in PL/1 and DOTSYS III in COBOL. Experiments are being conducted with the use of a document reader as input to DOTSYS III. In this application, a service bureau is contracted to provide the input. The typist prepares the document on an IBM selectric typewriter using an optical character reader (OCR-A) type element. The pages are scanned and the output placed on tape. Since the output is in binary coded decimal (BCD), a simple interface routine is used to convert the information to extended binary coded decimal interchange code (EBCDIC), because DOTSYS III makes extensive use of the characters on the 029 keypunch. Many of these characters are not present in BCD. It then becomes necessary to use some of the little-used symbols on the typewriter keyboard as DOTSYS III editing symbols. The interface routine accommodates the conversion of these characters as well. The service bureau uses IBM selectric typewriters, a system/360, model 20 computer, and a Farrington optical scanner. Under consideration is the investigation of Control Data's Model 915 document reader which uses 8-bit characters. The use of this equipment would practically eliminate any character conversion and consequently the sacrificing of keys on the typewriter for editing symbols. One of the chief goals for using an automated system such as has been described is the total elimination of the need to know braille by those persons within the system who must prepare the input. Although this goal has not been totally attained, it is within reach in the foreseeable future. One of the chief problems is the rather vigorous standards set forth by the rules of Standard English Braille including the unique formatting of braille publications. A partial solution to these problems will be the utilization of an input editor whose job will be to examine each publication to uncover any unique formatting situations and to look at the DOTSYS III printout for any major deviation from the braille rules. Obviously an input editor must have at least a partial knowledge of braille and braille book formats, and preferably a background in data processing in order to determine the cause of the errors encountered. The progress of the project has been substantial but like any other, it has had its problems as well as its rewards. For example, some of the previously encountered problems were the correct formating of braille title pages, tables of contents. indexes, tables and charts, and test materials, as well as errors in translation. Solution to these problems was found by merely becoming familiar with the ATS and DOTSYS III editing commands and a little ingenuity in their application. The correction of errors in translation was not so easy. When received, the DOTSYS III program was not 100 percent operational. As translations were made, errors were found and corrected. Some of these involved modification to the dictionary and other modifications to the program itself. Because of the specific requirements within a textbook environment certain additions became apparent. Among these were an inkprint page number in braille and double line spacing in textbooks produced for the primary grades. Due to the absence of a final documentation of the DOTSYS III program much time was spent in trial and error with dictionary changes and program modifications. The project has presented many satisfying experiences. Among the first braille translations was the Ohio State University Psychological Test for a visually impaired student competing with sighted students for the Governor's Honor Programs. This enabled the student to take the test without outside help. One instance where computer braille proved helpful was the translation of an ecology book which permitted a visually impaired student to enroll in a newly organized oceanography course. Another highlight of the project was meeting the daily demands of the first visually impaired student-programmer to enroll in the Atlanta Area Technical School. With the assistance of MIT, IBM, Georgia Institute of Technology, Georgia State Department of Education, and many others, the Atlanta Public School System has made a significant contribution toward automating processes of braille production. A system has been designed not for one particular agency but for anyone who has the necessary equipment. It is believed that modern technology and know-how have brought together such components and skills to make this the most thoroughly automated system presently available. It will prove to be a most powerful tool in the hands of its users and should usher in a new era in providing a better life for the visually impaired. MASSACHUSETTS INSTITUTE OF TECHNOLOGY, TACCOMA COMMUNICATION SYSTEM FOR THE DEAF-BLIND TACCOM (for "tactile communication") is a wireless remote paging system designed for the deaf-blind in particular, but with possible applications for the singly-handicapped deaf or blind. The TACCOM pocket receiver is the core of the system; it functions like the pocket pagers carried by physicians in a hospital, but with one important difference: instead of beeping to alert its user, it vibrates. (It feels like an electric toothbrush running.) The receiver has the appearance of a tiny transistor radio and measures 22' X % X 5'. It weighs 6.3 ounces. It employs rechargeable batteries and is normally plugged into a battery charger at night when not in use. Two primary applications are: (1) To provide an effective “doorbell” for a deaf-blind person who may be alone in his house; and, (2) To effect an alarm system (e.g., for fire, etc.) in an institution or other setting where a number of deaf-blind persons may be spread about and must all be summoned at once. The equipment involved includes the pocket receivers (one for each user), the centrally-located 115 volt transmitter, and a loop antenna which runs around the area to be covered by the radio signal. This service area can be fairly large— one hundred thousand square feet or more. The transmitter can be connected to push buttons at convenient locations, fire alarm boxes, time clocks-whatever suits the end purpose. Ancilliary attachments make possible other TACCOM applications: 1. End-of-line indicator for brailler or typewriter. 2. Auditory cue indicator (phone ringing, baby crying, etc.) 3. Ambient light indicator. 4. Message system (Morse code signalling, etc.) 5. Teaching/training aid. 30-825 - 74-3 |