| UHN Palm Newsletter (May 2002) - Late Again It seems that every month the Newsletter comes out a bit later than the month before. Why is that? Well, for one thing, I have a day job that keeps me busy. For another, life can be full of surprises. So this month we will look at some of the topics I have been working on and why they are not quite ready for public airing -- but we'll air them anyway or you'll never get anything to read.
The Migration Continues - or Maybe Not In last month's issue I wrote about starting to transfer applications and data that used to reside on my Palm IIIxe to my new Handera HE330. Now I'll let you know how this has been coming along. Apart from the built-in ToDo list, scheduler and address book, I use my Palm PDA primarily for medical references. Some material is "home-grown", such as lists of clinic phone numbers I commonly call. I also use some published "ebooks". I would find the Palm far less useful to lug around if I couldn't use it as a portable medical library. The usual way applications and their data files are installed on a new PDA is to HotSync to one's desktop PC. However the HE330, like most newer Palm OS devices, has a slot in the top that will hold a memory card. This gives one the option of copying applications from a PC to the memory card. To do this I invested in an Acom multi-flash card reader - a gizmo the size of a small paperback book which plugs into one of my PC's USB ports (but there are other brands). I can copy to and from the card and then plug the card into my new Palm. As a bonus, I can use the card reader to transfer photos from my digital camera to my PC. Sandisk is another firm that makes an adapter which accepts a memory card. This adapter plugs into a PCMCIA slot on your PC or laptop. Some apps will work from the card; others will need to be copied from the card to the Palm PDA's main memory. Either way, transferring to and from the card is faster than HotSync and the files won't vanish from the card if the Palm's batteries quit. As I pointed out last month this also allows me to have a powerful backup facility on my Palm PDA. So with all these tools, you'd think I had an easy time getting it all up and running - but I didn't. I have spent the last five weeks discovering that installing applications to the Handera is a bit of a gamble. Some applications I have used for years on a Palm IIIxe don't like the Compact Flash (CF) memory card of the HE330. As a result, I have had the annoying experience of installing several programs in a row only to find that the last one destabilized the PDA and forced me to uninstall it. More than once I had to uninstall everything and start from scratch. Not nice. Many programs were written before Palm PDAs could use memory cards, and much of this software can't handle them. Programs that have given me trouble include: - BrainForest (Aportis), an outliner and notetaker. I have prepared so many outlines with this that it would be a major inconvenience to have to switch to a different outliner program but there are several others.
- PEPID, a medical reference for emergency physicians. See more about PEPID below.
- MidCapsHack, facilitates entering capital letters in Grafitti. (Rui has several other Grafitti improvements at his site, which is worth checking out).
- … and several others I won't mention now.
Thus I find myself playing a sort of Russian roulette: loading a new program then checking to see if it runs properly. Then loading another program…. Sooner or later something always blows up. The problems stem in large part from the non-standard screen (320 X 240 pixels instead of the usual 160 X 160) and the nonstandard (for Palm) CF card. The exotic hardware makes some software cranky. To a lesser extent this also affects Sony PDAs with their 320 X 320 screens. It doesn't help that there is no version of Palm OS 4 that runs on the Handera. Version 4 facilitates running applications from the CF or other memory expansion cards. The Handera uses a modified version 3.5 OS which, to put it charitably, is inadequate for the job. Let's face it, the Palm OS wasn't created for managing files and applications like a desktop PC or even a PocketPC handheld computer from Microsoft. One other rule of thumb: data files that can be modified should not be installed on a memory card. Most Palm programs don't handle writing to the memory card well, although they usually can read from it. For example, iSiloX is what I use to create notes and web pages on my PC. I then convert these files to Palm data format and copy them onto my Palm. The iSilo  reader program can't modify these texts on the Palm, only view them. So I can put these files on a CF memory card, plug the card into my HE330, and there are no problems. If the iSilo reader was also a word processor that could edit the files, it might not be able to write back to the card and thus could end up losing any changes I had made. If your PDA doesn't have a built-in program to access read-only data on a memory card, you can buy PiDirect II (Pitech) which will enable access. Fortunately, if you are in the market for a new Palm PDA, you won't have to settle for the short-comings of Handera's memory system. There are already new Sony devices with better screens and more bells and whistles than the HE330. These Sony PDAs reputedly use a standard approach to managing memory to avoid hassles when you install software. I say "reputedly" because I don't own a Sony to test this, but it should probably work like the PiDirect software described above. Also, Palm Is releasing OS5 later this year. The new OS, and the faster pocket computers it supports, will permit better screens and memory management in future. Palm, Sony, HandSpring and Handera are all developing new PDAs that will use OS5. Looking for a new PDA with more memory? All you have to do is sit on your hands for a while and you will get a better solution then the half-way house I find myself in now. Of course, as new features are added, pocket computers may also come to resemble their desktop cousins. Noone ever accused Microsoft of making a crash-proof operating system and PDAs could go down the same path if we aren't lucky.
Backup If you do have a Palm PDA with a memory card, you can backup your RAM (main working memory) to the card with any number of programs. Last month we mentioned BackupBuddy and CardSync. I forgot to mention PiBackup II. This program will also perform scheduled backups to a CF card. Very clever and works with HandSpring and Handera devices.
Emergency Medical Reference Texts A few years ago I met a medical resident at the Toronto General Hospital who carried around a Palm computer with the 5Minute Medical Consult text loaded. This ebook is concerned with internal medicine, but I was so impressed by the concept that I bought my own Palm III and began looking for references more suited to Emergency Medicine. Fast forward two years. Now I am spoilt for choice as there are numerous books one can get. With the increased memory on my new Handera, I checked out a few.  eMedicine is a very useful website with a wealth of tools for physicians and nurses. I often refer to articles on their site when treating patients with unfamiliar problems. They publish subsets of their online database on CD (for desktop PC) and in Palm OS format as well. I purchased the Emergency Medicine package. It uses the MobiPocket Reader and works just like a large textbook. Fortunately, the 8 Mb main file will run from a memory card.
There is a serviceable Table of Contents and an alphabetic listing of topics as well as a well-designed search tool. I have only two complaints about the software. The first is that no algorithms or pictorial material are shown despite occasional references to pictures. I think this is simply careless editing. The second complaint is that eMedicine EM loads and searches through text a little slowly. Well, it is a big book….  Skyscape, the publishers of the 5 Minute Internal Medical Consult now have a PDA version of their new baby, the 5 Minute Emergency Medical Consult. I found this eBook to be limited by its table of contents, and relatively brief list of topics. Its search tools were not great either. Fortunately, since I first reviewed it, 5MEC has been improved and has a much better table of contents and more sophisticated search engine. Moreover, each topic is organized with shortcuts that allow the reader to easily jump to sub-topics such as clinical presentation, investigations, and treatment. Not as extensive as eMedicine EM, the 5MEMC weighs in at about 4 Mb and will fit more easily on a Palm with less memory or no memory card.
 I mentioned PEPID earlier, as one of the programs which gave me grief when I tried to install it on my HE 330. PEPID has been available for desktop and handheld computer for several years. In addition to providing notes about specific illnesses it also has well-organized sections on ACLS, approach to the poisoned patients, and (after September 11, 2001) a section on biohazard and chemical warfare victim treatment. For a limited time, the publisher has thrown in a prescribing formulary and a database of Canadian medication names. PEPID needs about 4Mb of room and will run fine on most Palm devices, but not the Handera. What I can see looks useful but I couldn't properly test the Canadian drug database, or the conversion tool because the software kept crashing. I have to say I have never had this much trouble with a Palm program before and it's deeply frustrating. The vendor has been trying to make it working and I will let you know if it gets sorted out. Meanwhile, PEPID will probably run just fine on your PDA.
You can find reference works for other health professionals in nursing and EMS, for example. A few places to look: One last point. If you are purchasing for a group of students or colleagues and looking for possible changes and responsiveness from the publisher or if you are having problems (like I did) with installation and want support, then it never hurts to contact the publisher to see what they say or do. The folks at PEPID were very receptive to my difficulties and, even though Handera owners form a small part of their clientele, they have been working with me, answering my email, and sending me updates to test. The support team at eMedicine has never replied to any of my email. And when I contacted MobiPocket to see if they could answer my questions, I received an automated email reply warning me not to send junk mail or there would be consequences! How friendly and supportive…. If you or I behaved that way to a patient we would face disciplinary action, but "support" is still an evolving idea in the world of software. Caveat emptor. Try the free trials or test downloads. Talk to your colleagues who own pocket computers. These eBooks aren't ruinously expensive but they aren't free either, and your time and trouble getting them to work is worth something too.
Medical "Doc" of the Month When I want to convert a webpage or a document on my PC to Palm format, I use iSiloX and have the iSilo reader on my Handera for actually reading the document on the go. iSiloX is free but the reader software costs money -- what about other free converters? You might want to check ScrewDriver which is pretty basic. The web site has links to other useful online resources and will also point you to Tucows where you can download free and shareware reader programs. As I have mentioned in previous issues you have numerous other options: - small text files can be cut and pasted into a memo on your Palm.
- online websites can be converted into Palm files and browsed with AvantGo or Plucker (both free) or iSiloX (shareware).
Hack of the Month Pop! is a clever little tool with two main functions. Originally it enabled users to pop up a list of text entries to make it easier to fill in fields for forms or memos. Now it can also be used as a shortcut to launch an application. I can't find the author's homepage, but extensive information about the program is available at DigitalGlyph.
In Times to Come Next month I will wrap up my discussion of setting up my (not-so new anymore) Handera. I hope to report on antimicrobial guidelines and drug prescription handbooks. Until then, enjoy!
This is one of a continuing series of newsletters on Palm handheld computers, prepared for doctors, nurses, IT professionals and video game afficionados at the UHN. Feel free to pass copies around electronically or on paper. To subscribe, or complain, contact the author at the following address: p.arnold.mpr@sympatico.ca
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