History of APHA Software Exchange and Delta Omega Alpha Collaboration
Free computer software applications were available for downloading in the Software Exchange of the APHA 1996 meeting.
About 30 applications were selected for their usefulness as working tools for Public Health professionals. Also, in the Computer Theater of that meeting were presented uses that have been made of such software programs. Additionally, in this website, a selection of these public domain programs plus others are continuously and universally available.
How did these facilities for obtaining free public health software tools--the APHA Software Exchange, Computer Theater, and the Delta Omega Website--come about, and why? How have they changed in the decade and a half since such exchanges of software began? How can they be sustained? These questions are addressed below in the personal recollections of the parties responsible.
GORDON BLACK recalls (1962?/-1996)
DON WALLACE recalls (1982-1991):
My efforts to establish what is now known as the Computer Theater and Software Exchange came out of the Annual Meeting of the American Public Health Association (APHA) in Montreal in 1982. I attended that meeting as a newly elected delegate of the Health Administration Section. I had just attended SCAMC meetings (Symposium on Computer Applications in Medical Care) in Washington where I met Gordon Black and his wife, Lou, running a Software Exchange. They were having a heck of a lot of fun besides providing shareware software to all interested visitors.
In 1982 the use of personal computers was spreading like wild fire. But, in Montreal, nothing was so impressive as the absolute absence of any automation equipment or activity in the APHA Exhibition Hall. I was shocked. No personal computers in the exhibition hall of the APHA meetings? Well, I knew where to find at least one. Gordon Black had told me he would be in Montreal with a computer. I went looking for Gordon.
I found Gordon on something like the 15th floor of the Montreal Hilton. He was there with his computers. He had three computers in his room, more than the APHA had in its entire exhibition. What was Gordon doing? He was busy dismantling the Hilton's wall telephone jack. Screws were lying about, and little red and black wires were sprouting from the jack. I asked Gordon what he was up to. He told me he couldn't get his modem to work because the Hilton had screwed up the telephone wiring that he was about to fix.
Why did Gordon have to fix the Hilton's wiring? Well, he and a physician friend had a commitment to go on-line with Compuserve and keep the entire United States informed of what was happening at the Montreal APHA meetings.
In the next day or so, the Chairman of the Health Administration Section asked what I, as a newly elected delegate of the Health Administration Section, would like to do. I told him the APHA meetings were sadly lacking for automation and I would like to try to do something about it. The Chairman said fine, do something about it. I mentioned the software exchange I had seen Gordon and his wife conducting in Washington, DC, and asked the Chairman if the Health Administration Section would sponsor such an activity.
It took three years. Finally, in 1985 in Washington, DC, the Computer Software exchange became an official activity of the Annual Meetings of the American Public Health Association sponsored by the Health Administration Section.
The activity was named that year, too. Even before the meetings began Gordon Black told me I had chosen the wrong name. He said I should have called the Software Exchange the Computer Theater and Software Exchange. It has been the Computer Theater and Software Exchange ever since. And, that name still fits the function.
Bob Johnson, the APHA annual meetings coordinator, gave the Exchange space just inside the entrance. And that was all the support the Exchange received. The APHA provided nothing except space.
The space was a small anteroom of otherwise unusable space literally between the two entrance doors of the Washington Sheraton Hotel. Gordon Black was there with a friend, Sandy MacIntosh. Because the APHA provided no support, we used borrowed and furnished equipment. For example, one of the computers we had was a laptop.
It was my Radio Shack Model 100. We manned the little area daily and had a lot of fun talking about computers and copying shareware to floppies.
In those early years, the Health Administration Section sponsored the Computer Theater and Software Exchange, but all the work and support came from individuals. This led to a struggle. Did the activity belong to those of us providing equipment, scrounging up shareware and doing the work, or did it belong to the Health Administration Section and the APHA.
I favored organization of the Computer Theater and Software Exchange as an official activity of the APHA and Health Administration Section. Gordon and Sandy seemed to feel it was a private activity taking place during the APHA meetings. This issue was not resolved for years. Today, the issue is resolved. The Computer Theater and Software Exchange is an official activity of the APHA.
I vividly recall one of the visitors to the Exchange in 1985 was a fellow named Bob Juni. I had known Bob since our Viet Nam days of the late 60s. We had become friends when I was a consultant there with the State Department and AID while still a resident at the Johns Hopkins School of Hygiene and Public Health. When I returned to Viet Nam a few years later with the U.S. Army, Bob let me stay in his apartment when he was out of town.
Bob Juni spent a lot of time with me in that first Exchange. This was puzzling because he clearly didn't know much about computers. Little would I have guessed Bob would later replace me or how his effort would make the Exchange portion of the activity blossom. Or, that I would have to acknowledge his expertise with computers.
The APHA first provided support for equipment in Las Vegas in 1986. It rented a MacIntosh and an IBM PC and made this equipment available to the Exchange. I had my Radio Shack Model 100 there, again. Bob Juni spent a lot of time in the Exchange doing little more than sitting and observing.
The Exchange really got going in New Orleans in 1987. The Health Administration Section was the sponsor once more. Bob Johnson gave us a large room in a central location. And, the APHA even installed data grade telephone lines. But, that was all.
Gordon Black showed up with four computers and a laser printer. Sandy MacIntosh liked MacIntosh computers and he brought two of these. A Hitachi distributor loaned me a CD-ROM player, which I hand-carried from Washington. Dr. Abeytunga of Canadian Center for Occupational Health and Safety (CCOHS) loaned me two CD-ROM disks containing the National Institute of Occupational Safety and Health (NIOSH) Registry of Toxic Effects of Chemical Substances (RTECS) and NIOSHTIC databases and Silver Platter loaned a number of disks. A fellow with Federal Emergency Management
Agency connections in Mississippi brought a cellular telephone and alphanumeric pager. We had all we needed.
Bob Juni was in New Orleans. He got involved. He sold the disks for the Software Exchange and kept track of the money. For the first time, the cost of the disks used in distributing shareware, always before paid out of pocket, was recovered.
A tall, attractive, flashily dressed nurse, Margaret Beaman, came into the exchange several times. She finally introduced herself. She was looking for something to do. She volunteered a bit of her time that year and volunteered to help out in Boston the following year.
Margaret helped another way, too. My employer, the U.S. Army, had not funded my trip to New Orleans, so I paid my own way. Because I couldn't afford convention hotel rates, I hid out at night in the Computer room, sleeping on the floor under the exhibit tables so the Security Patrols wouldn't see me. Margaret knew of my situation and let me borrow her room to shower and clean up each day. Margaret has always been that kind of a friend.
The Computer Software Exchange and Theater was quite successful in Boston in 1988. The APHA once again did not provide support other than the room and data grade telephone lines. Gordon Black obtained, as I recall, three IBM PCs and three MacIntosh computers directly from the headquarters of these companies. Margaret Beaman and I arrived on Saturday and spent most of the next 24 hours in the Exchange setting up the computers and getting them to work to our satisfaction.
Bob Juni arrived on Sunday and helped throughout the meetings. Margaret Beaman was there and said she wanted to take charge of the Computer Theater. Since the exchange portion took all of my time, I thought that was great. Maybe the theater could amount to something after all. Little could I have guessed what Margaret would do with it.
I also recall Gordon Black left early. Margaret and I were to return the computers to IBM and Apple. It took nearly nine months for IBM and Apple to acknowledge the computers were returned promptly and appropriately.
In 1989, the APHA meetings were in Chicago. Again, the APHA provided no support beyond space. Margaret obtained seven IBM computers from a vendor she know and Sandy MacIntosh came up with two MacIntoshes. Margaret and I arrived on Friday. Setting the Exchange up the Exchange absorbed the next 36 hours, nonstop. I recall, also, that Gordon Black induced a manufacturer to loan us a large minicomputer. I didn't know what to do with a mini-computer, so I didn't let the vendor set it up. I don't think Gordon Black has ever forgiven me.
Bob Johnson and the APHA clearly assumed responsibility for the Computer Theater and Software Exchange in New York in 1990. For the first time, the APHA rented all necessary equipment. As important, the vendor set the equipment up and maintained the equipment during the meetings.
Margaret Beaman and Bob Juni worked throughout the meetings. Margaret organized and ran the Theater; and Bob did most of the work in the Exchange. All things considered, the Computer Theater had run well and had required no more than a reasonable effort. It felt pretty good.
The APHA meetings were in Atlanta in 1991. I was not funded by the Army, so I did not attend. Margaret Beaman and Bob Juni were there. They took over. I have remained involved at the periphery, but have contributed relatively little since.
BOB JUNI recalls (1991-1996):
My tale picks up at the 1991 Annual Meeting in Atlanta. Don Wallace could not come but I had visited him in the Computer Theater and Software Exchange at previous meetings, had hung around to help and had gotten involved. At this meeting, APHA had provided two small rooms connected by a back corridor. Margaret Beaman was holding formal presentations in the one room while Sandy MacIntosh and Gordon Black had several computers where people had the opportunity to actually operate a selected program.
Gordon was holding scheduled tutorials on the use of a software program that Ohio State University (OSU) had been developing for peer review organizations under a Health Care and Financing Administration (HCFA) contract. He had been loaned a half dozen IBM computers that he used for his class instruction. There were a number of public health programs from OSU loaded onto the hard drives of these machines. People could view and copy programs onto their own diskette if they wanted to try them out.
Sandy MacIntosh had a number of disks of MAC programs that he had brought from the SCAMC meetings. People could make copies on a MAC machine that was there. He also passed out applications for a society of people interested in the use of this technology in public health, called "Communication and Computer Applications in Public Health" (CCAPH). I joined, but Sandy couldn't get the society organized and not much came of it except a couple of newsletters.
Mike MacDonald, another APHA member interested in the PH potential of computers, with Margaret Beaman, ran a gathering at the end of the APHA Annual Meeting. All those who were involved in, or just interested in, this activity would try to better organize it for next year's meeting. I volunteered to gather all the public health software programs written for the IBM-type computer and have them organized for the 1992 meeting in Washington. Sandy MacIntosh would continue to bring disks from a collection maintained by the American Medical Informatics Association (AMIA).
Mike MacDonald tried to use CCAPH as the working medium for APHA members to sketch out the directions these computer activities should take, and to plan for future programs of the Computer Theater and Software Exchange. However, CCAPH did not solidify into a working structure capable of running it, nor were Don Wallace and the Health Administration Section any longer the sponsors.
In 1992, APHA provided two large adjoining rooms. One was setup as a lecture hall with a projection screen connected with a computer, and was designated as the Computer Theater. The other had tables and chairs where 10 IBM computers loaned by a computer sales agency were hooked up in a local network for hands-on use by attendees. Under these circumstances, the DOS Library part could be set up as an integrated package of the public health software applications, and displayed on-line rather than being available only on separate diskettes.
By scouting before the meeting I had found around 20 software programs that had been developed by a number of public health agencies--Federal, State, and local--as a means of improving or organizing various projects in which they were interested. These programs covered a wide range of public health subjects, and brought knowledge and skill capabilities to users of the increasingly popular personal computer.
Each program was consolidated to fit on one or more 1.44 megabyte floppy diskettes. The individual applications were then inserted into a shell program that displayed them and facilitated user-friendly copying. The entire collection was then pre-loaded onto the hard drives in the ten IBM computers, together with an index of all the programs and a brief description of each program, to assist selection. Each application could be copied easily and studied at home. The speed and ease of this arrangement helped attendees to become aware of the utility of electronic technology, as well as to acquire software tools for public health work.
Formerly, visitors had looked through piles of diskettes, then made copies of their selections, diskette to diskette. To simplify this, I modified an interface that displayed an index of all programs and easily called up the description for any selected disk. The viewer then could copy it to a blank floppy diskette by simply pressing the <enter> key. . This easy-to-use arrangement drew many attendees to see what software was available Over 1500 disks were sold at cost to attendees who had not come prepared with their own blank diskettes for making copies.
Through its popularity as a place where computer neophytes could get public health software tools to use in their work, the Software Exchange served to introduce public health workers coming in from the field to the uses of electronic technology being developed in various public health agencies. Those making presentations in the Computer Theater about programs they had developed for use of the new electronic technology for public health found it convenient to announce that these programs could be copied in the Software Exchange. Thus, the Computer Theater, where papers on the application of computer technology to a public health subject could be presented in a computer environment, and the Software Exchange, where the applications could be copied, complemented each other.
I began to visit Federal and State public health agencies to find additional programs that were in the public domain and available for inclusion in the APHA software collection. Some of the programs identified in this manner were Cluster, the Health Information Retrieval System, and the Medical Quality Improvement System. By 1995, the Software Exchange had become established as an organized forum for introducing professionals attending the Annual APHA Meeting to public domain electronic products that were being used by agencies to enhance public health projects.
Training of groups in the use of new software tools was introduced only recently. In 1993, the Software Exchange facilities were used by the Epidemiological Program Office of CDC. It put on a day and a half tutorial for teachers of epidemiology on the use of its widely reputed, multipurpose program, EpiInfo. A companion geographic information system for mapping public health statistics, Epi Map, was also introduced. That year the software collection had grown to 50 high density disks from which 1781 copies were made. Considering the time pressure on attendees, who often had to choose from more than a dozen events each hour of the meeting, these figures evidence the popularity of the Software Exchange with both the producers of public domain, public health software and with the public health professional attending the Annual Meetings.
In 1993 a first "Call For Abstracts" for the Computer Theater and Software Exchange was published in the January Am. J. Public Health, along with calls for abstracts from each Section, SPIG, and Caucus. Continued activism by individuals led to the invitation for the Coordinator of the Computer Theater to attend the 1994 Spring meeting of the APHA Program Planning Committee, the official body for setting up the general program schedule for the annual meetings. In this way, definite commitments from APHA for support to a joint program was obtained.. Also, a single point of contact with APHA staff had been developed for coordinating the facilities support needed for both the Theater presentations and for the hands-on experience with multiple computers in the Software Exchange. However, the gathering of public health software between meetings and the organization of events for the Software Exchange was still done entirely by volunteer effort without guidance from any organizational body within APHA. Also, the need for software library sciences in determining title status of softwares, and for cataloguing them, became evident.
In the 1994 APHA meeting, in D.C., the offer of an Exposition of interactive educational software by the National Library of Medicine led to APHA's provision of a third room separate from both the Software Exchange and the Computer Theater. Gordon Black was given the opportunity to organize an exposition of additional uses of electronic technology that were being tried out by various public health agencies. Forty governmental and non-commercial projects were displayed, showing the cutting edge of computer technology in public health. This exposition was next to the Computer Theater so attendees to announced programs in the Theater were exposed to the power of this technology in public health.
Thus, wider uses were being made of the Software Exchange. Actually, hands-on teaching and actual experience manipulating applications on computers had been goals from the beginning, but were limited by the few resources available. However, it seemed that formalizing the APHA Software Collection and tracking attendance at and copies made in the Software Exchange had given these activities substance and recognition in APHA's planning cycle for Annual Meetings. Still, there was no recognized sponsoring body within APHA that could mobilize the efforts needed to do more than invite volunteer tutorials.
One APHA member who had been volunteering help in running the Software Exchange, Mel Thorne, was particularly interested in making available these programs to students in a School of Public Health where he was a faculty member. This served to further crystallize the concept of an organized collection of public domain (or copyrighted for non-commercial public health use only) software that enhanced public health practice in some way. After the 1994 meeting, steps were taken to explore other ways, in addition to the APHA Annual Meetings,.of getting these programs in the hands of public health professionals.
While copying these softwares is a means, the ultimate goal of these activities is the improvement of public health work through their effective utilization. Hence the formal listing as the "Computer Theater and Laboratory".
Routines used in Biostatistics and Epidemiology have lent themselves very readily to rewriting as electronic executable programs. They are the greater portion of software that performs some function or manipulation. Over a dozen of these work with or run under Epi Info. Other softwares provide factual information. These are electronic data and knowledge bases, as well as tools for the tabulation and presentation of data, both numerical and text. The major purpose of continuing the Exchange, and acting as a clearinghouse for public health oriented software, is to explore the potential of electronics to further public health goals.
Institutionally, however, the Computer Theater and Software Exchange remains today only an organizationally unstructured rallying point for public health professionals of all disciplines interested in public health software applications. It is merely a name by which computer tools and applications are shown in the program schedule. It is still not an established body within the APHA organizational structure, nor is it mentioned in the APHA website.
Melvyn C. Thorne (1993-1996) recalls:
Taking the Software Exchange from APHA to a University, and then onto Internet
I first saw public domain software, that could be copied legally without charge, on visiting my old school colleague Don Wallace at the APHA software exchange in the early 80's.
By the late 80's I found myself unofficially introducing the excellent WHO/CDC software application EpiInfo to young professionals, usually after-hours, in developing countries--Tunisia, Morocco, Malawi among others--where I was officially providing unrelated technical consultations. Personal computers had recently entered the various Central division offices of Ministries of Health, or were just beginning to arrive in Provincial or District offices. A growing number of my developing country colleagues and counterparts also had their own desktop or laptop computers. All were interested in good quality software applications that could be used as tools in their public health work, but most had few dollars or other hard currency to spend.
EpiInfo was easy to use to write memos, questionnaires, or other forms for collecting data. It also made it easy to convert such documents into the data bases into which the collected data could be entered. Additionally, it made it easy to analyze the entered data via tables that could be printed easily. Further, having been produced with public funds, EpiInfo could be copied free of charge by anyone for themselves and for anyone else. Thus it was a valuable resource for professionals in the Ministry of Health of any poor country in which there were enough microcomputers. On many evenings I found myself showing colleagues on my laptop how easy it was to call up EpiInfo, make forms, enter data, then make analyses with cross-tabulations. Then they usually made copies of the program for themselves and their friends.
Such sharing of a good, public domain software application with colleagues in the field was so clearly appreciated and useful that I was led to visit the APHA Software Exchange (SE) in the early 90's to see what other free electronic tools were available for public health professionals.
I found other interesting programs among the approximately 30 offerings for MS-DOS systems that had been assembled by the SE Coordinator, Dr. Bob Juni. Seeing that he was an elderly gentleman working with little assistance, I offered to help out. This involved explaining to visitors how to use the access program on the several computers, as well as explaining the uses of some of the softwares. I also sold inexpensive diskettes to those who needed them, and, subsequently, helped to find additional public domain public health software programs. In the companion Software Theater, run by Margaret Beamen, I also had an opportunity to present a method of using EpiInfo as an audio-visual aid for teaching basics of survey research. We had done this successfully during a WHO workshop in Morocco on Health Systems Research.
From my involvement with the Software Exchange (SE) and Theater, it also became clear that many APHA Annual Meeting attendees who might have been happy to see and copy programs for themselves at the SE were not doing so. Many did not know about the Software Exchange. Others, who would have liked to stop in either had no time for it, given the many choices among sessions each hour, or insufficient time to review the approximately thirty programs offered. I was also thinking about students and fellow faculty at my School of Public Health who were not able to attend the APHA meeting every year. Hence, I asked Dr. Juni if he would be willing, after the APHA 1993 meeting, to help me make some of these programs available at the Johns Hopkins University School of Hygiene and Public Health (Hygiene).
Dr. Juni kindly came to Hygiene where he gave a seminar about the scouting he had done to find the software programs that were being developed by various US Government agencies as useful tools for public health professionals. He then consulted with Hygiene's Department of Computer Services which agreed to let us use one old desktop computer with about 12 kilobytes of memory available on its hard disk. We selected 6 of the 28 programs to put up on this space.
The following year we used the same old computer at Hygiene but were able to put up the entire APHA 1994 Software Exchange of 29 programs on my external 88 megabyte Syquest Drive, attached to the parallel port, which I loaned for this purpose for five months.
In order to extend the time during which these public domain softwares would be available, and to extend their availability to alumni and colleagues everywhere, in 1995 I enlisted the support of the Delta Omega Public Health Honorary Society and the School's Information Services to put up a Delta Omega Alpha Website:
"Public Domain Software for Public Health Professionals".
The address is http://www.sph.jhu.edu/org/DeltaOmega/software. This website currently contains one page for brief descriptions with links to downloading of 10 public domain programs, another page for about 20 sets of basic public health documents, this brief history page, and a fourth page for links to other useful electronic resources for Public Health, such as addresses and links to PH websites. Suggestions for improving this website may be made via the email address contained in it will be much appreciated.
In addition, the Software Exchange and Johns Hopkins Delta Omega Alpha will currently assist any Delta Omega chapter that wishes to make available the entire APHA Software Exchange at its School of Public Health via an external memory device, e.g. Syquest or Iomega drives. Providing such a service locally will make the entire collection available as well as provide much rapider copying, and without the charges of being on-line. However, it requires provision of an appropriate memory storage device, copying the APHA SE onto a cartridge, attachment to a local computer, and communicating the availability of this arrangement to the local academic community.
In summary, numerous software tools for public health work have been developed and put into the Public Domain in the past 15 years. The APHA Software Exchange and Theater have served the APHA professional community by describing and presenting them, and by making them available for easy copying. The possibility of widening this availability beyond the few harried days at each year's Annual Meeting has been made feasible by the development of progressively less expensive memory storage peripheral devices and of widespread availability of downloading files from the Internet.
In addition to further improvement in the Delta Omega Alpha website, which is universally available to all able to use a browser on the internet, the other main things that I feel need to be done to promote access of public health professionals to public domain softwares are the following:
- establish a corps of volunteers to help and gradually take over some of the work from Dr. Juni, who is in his 80's and not in the best of health, to provide continuity
- develop enough computer resource availability in the Software Exchange so that the actual applications can be put up on a separate computer for demonstration and use, to complement the mere descriptions of them which are now available
- develop software coordinators within each of the APHA Sections so that the SWEX softwares collected reflect their interests and take advantage of what they know
- increase the number of teaching workshops within the Software Exchange
- develop multimedia tutorial programs for the several applications to facilitate self-instruction by visitors to the Software Exchange.