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    UHN Palm Newsletter (June 2002) - Finally

    Well, it's been a long hard road but at last my Handera 330 is running all my software. I'm surprised I had energy and time leftover to find other things to write about. But I did - see below. Meanwhile, I think my Palm is almost stable - I guess you could say it is about as good as Windows 98….

    The End of the Road

    No, I haven't decided to retire and noone died. The heading refers to the fact that I have finally finished testing, updating and modifying all the software I used to have on my Palm IIIxe and even found some new ones stable enough to run on the new Handera 330.

    It feels like I bought the new PDA a year ago instead of at the end of March. Those who have been following the saga will by now know that only my rigorous testing routine kept me from going bonkers as various programs blew up and crashed spectacularly and unpredictably for the past few months. Contrast this mess to my last upgrade (from a Palm IIIx to the IIIxe) when all I did was put the new device in its HotSync cradle and push the button: everything transferred over and worked. Period.

    But now that I have tracked down all the software that didn't like the Handera 330's non-standard screen I can share with you some Great Truths:

    • if you upgrade to cool new PDAs with non-standard features you will have a hot time tracking down all the incompatible software. Be prepared to invest the effort or stick to standard models.
    • surviving without data loss requires diligent backup habits. If you haven't gotten into the habit of copying the Palm folder on your PC to a safe place and making backups from the PDA using something like PiBackup or BackupBuddy then you are cruising for a bruising.
    • stability is one of the marvellous and underrated advantages of the Palm OS. How many times has your Palm locked up or crashed on you compared to your Windows PC? I have enough aggravation keeping my desktop PC working - I don't want that nonsense with my PDA too. I didn't fully appreciate this until I began to struggle with my new gizmo.
      · when you are updating to a new PDA, make sure to visit the web sites of software you use. I was astounded at the number of programs which had been updated to new versions in the past six months (since the last time I looked). Many of those updates solved problems I was having getting stuff to work on the HE330. I would have saved myself a lot of aggravation if I had followed that strategy in April. But, hey!, you're reading this to learn from my mistakes, right?

    Is there a happy ending here? More like a happy beginning. Now that I have shaken off (I hope) the bugs, and loaded up the Handera I still have about four megabytes of RAM free in the main memory and about eighty megabytes free on the Compact Flash accessory card. Now I can start looking into all those medical reference programs that would never fit on my old Palm. The enlarged screen gives me room for larger text pages and tables. The Voice Recorder has potential too.

    In future months look for some articles about how I am using the Handera's unique feature set in my work as an emergency department physician.

    Buttoned Up

    I use my PDA at the hospital so I am concerned about someone accessing my private data. I relied upon Gridlock to password protect my IIIxe. One of its outstanding advantages over the standard Palm password system was that it would not let a thief HotSync to copy my files onto his PC and thus bypass the password. Gridlock works just fine on my new PDA. The website has a FAQ (Frequently Asked Questions) section with answers to any questions you might have about the software. I even found a newer version than the one I was using.

    I also use CryptoPad (available at any website that features freeware) to not just block access to but also encrypt the contents of text documents that I wanted to protect. Unfortunately, CryptoPad was one of the programs that didn't seem to work on my Handera. Once again, a quick search online found an updated version and this works just fine. The authors are also developing a program to update memos on your desktop PC. If there are any other Handera owners out there, you can get a version of CryptoPad modified specially for the HE330 at GeekZilla.

    If you still use the Palm's built-in password protection but have forgotten your password there is still hope for you. ForgetPass will help you recover your files that are password-protected. Maybe.

    Chapura Cloak is a program which will encrypt files on your Palm. An additional advantage is that it encrypts the PC backups of those files too. This prevents a thief from bypassing your security by HotSyncing your Palm on his PC. Clever and not expensive.

    More Medical References

    Last month I listed several medical references you can obtain for your Palm device. I left out a bunch (I needed something to write about this month too!) and I will duly mention one of them now. The Washington Manual, spiral-bound, is what I carried around with me throughout medical school and part of of my post-grad too. Now it's available for the Palm from Franklin Medical Publishers. You can read a (not-too-favourable) review by a medical student in Synapse, a publication from the medical school at the University of California, San Francisco. Synapse is actually rather well done and worth checking from time-to-time if you are a medical student or using handheld computers in health care.

    There are many other well-known titles available from Franklin, such as StedMan's Medical Dictionary. Check them out but be forewarned: even with a high-speed internet connection, I found that their site's pages loaded and updated very slowly indeed. Maybe they were just very busy….

    You may prefer to source your medical texts, CDRoms and Palm modules from RAmEx Ars Medica which has a much snappier website and features many different publishers. If you already know the title you seek, their search engine will find it in their site. The Washington Manual, for example, in several forms, is here.

    If anyone is interested in trying out Pepid, which I described last month, for their PC, PocketPC or Palm I have two pieces of good news. First off, the vendor has cracked the problems with Handera devices. As a result, the program should work fine on all current Palm OS devices. It certainly does work well on mine now. I will check it out in more detail and in comparison with eMedicine in the coming months. The second piece of good news is that you can obtain free two-week demos of Pepid. There are versions for medical students, nurses, emergency physicians and internists. If your internet access prevents you from downloading the demo files (they average about three megabytes) I can get CDs of the Pepid demos for you to try courtesy of the developer. Anyone who wants a CD should drop me a note at the email address noted at the end of the newsletter. Please note that I can't mail these out so you would have to come pick them up.

    NNT and LR

    Do those acronyms mean anything to you? Recently I had to refamiliarize myself with some biomedical statistics. It brought back painful memories of university courses I barely survived, and incomprehensible formulas I usually couldn't calculate correctly. If this describes your situation, then help may be at hand. (On the other hand, if this seems like gobbledegook to you, then just mutter an incantation and skip to the next article).

    The University of Toronto's Centre for Evidence-Based Medicine has good tutorials and (even better) online calculators for the most useful statistical calculations. There is also a downloadable calculator for your Palm which will help you figure out NNTs, ARRs, ORs and much more. Like all the best Palm medical solutions out there, this one is free. You can also download tables of Likelihood Ratios, NNTs and SpIn/Out.

    Another useful medical calculator is MedCalc. It has a few built-in formulas for generating Likelihood Ratios and post-test probabilities and NNTs.

    The most flexible solution for generating customized formulas and scratchpads used to to be MathPad and its medical extensions, like MedCalc 3000 but MathPad is no longer supported by its author and I am not sure how new users can get access to a version without "nag" messages. Mind you, it is still perfectly functional despite those messages. You can develop your own formulas if you need to. I have emailed the author about the registration issue and will report back to you if I learn anything helpful.

    For those with a need to learn more about biostatistics, there are a slew of online texts available which should save you from spending your money on such things in future. Search the Web.

    Medical "Doc" of the Month

    I decided to leave out pictures this month so I would have room to squeeze in a copy of MedCalc, the versatile medical calculator I mentioned above. There's something here for everyone: pregnancy due dates, pediatric IV fluids, and more exotic stuff too. You can also customize it to mask the formulas you don't want to see in the menu.

    Hack of the Month

    FlipHack. If you want to be able to flip your screen around, but don't want to pay the exorbitant cost of a Handera, you could pick up this little freeware hack. Now in version 1.1, it lets you hold the Palm sideways for reading. How useful is that? You decide.

    Medical Computing

    There's still time for you to dash out to your travel agent and book a flight to the IMICH conference on June 14. Every year IMICH looks at mobile healthcare technologies and is where new devices and software are introduced.

    Are you curious whether using Palms in the Emergency Department helps to reduce medical errors? Read about the early stages of a research project attempting to answer this question.

    Hospital and medical school libraries are hopping on the PDA bandwagon. The University of Arizona Medical School Library compiled this snapshot of what US med schools are doing to support Palm PDA users. From the table, you can see that many libraries provide a link point so their users can download various reading materials to their Palm PDAs.

    A more detailed report about medical library involvement with Palms comes from an an Aussie medical librarian. She took a hard look at how her clients were using the library and their PDAs in order to figure out better ways of getting them what they need. For example, they developed hands-on courses for internet search techniques because noone was doing searches from inside the library any more and therefore they didn't get access to librarians and librarians didn't get feedback. One spinoff of their program - besides promoting easier access to EBM databases and prescribing info - was the goodwill and sense of teamwork with clinicians that flowed from the library being on the cutting edge of health care delivery.

    In Times to Come

    Next month we will put the shoe on the other foot. After spending a few months getting my new Palm tuned up, I noticed that my desktop PC is a little wonky: web browser is cranky, some apps like to die, registry files are bloated. Mac and Linux users can snicker all they want but I plan to restore my Win98 PC to health. This means my PDA may have to carry the ball for a few days -- or, if things go seriously wrong, a few weeks. I'm starting on this right now and hope to be back to tell you about it in July.

    Until then, enjoy!

    This is the latest issue of a newsletter on Palm handheld computers, prepared for doctors, nurses, paramedics, IT professionals and others who need tools that work. Feel free to pass copies around electronically or on paper. Currently, the newsletter is completely free to read, but I charge a dollar for every copy you delete from your hard drive (not!). To subscribe, unsubscribe, present burnt offerings, obtain back issues, change your email address or complain, contact the author at:

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