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    The Medical Palm Review

    January, 2003 (V4N1) - New Year, New Look

    Welcome to 2003! Among the changes we will see this year here is another one: this newsletter has changed its name and its face. The production team is the same and the newsletter is still dedicated to providing news, reviews, and the occasional rant about Palm PDAs and portable computers in health care and education. I hope you enjoy the ride.

    So, What Happened?

    This newsletter started out as an occasional fact sheet for some of my colleagues at the University Health Network. We all felt challenged (read: intimidated) by housestaff doctors and students who could whip out PDAs and read off all sorts of references during morning report. Several of us bought similar gizmos in self-defence. In comparing notes with coworkers, I found we all had similar questions and problems. With far too much time on my hands, I started finding answers and was besieged by requests for assistance. The newsletter was born out of my research - I had to stay one step ahead of all those questions!

    In the past three years, however, my readership has moved away from staff doctors at the UHN. Now I count nurses, paramedics, residents, students, technical support types and even a few lawyers among my readers. This diverse group is not based at the UHN. Many readers are not even physically located in Canada. Furthermore, the UHN does not play any role in the creation or support of the newsletter. Hence the name change. But Medical Palm Review will continue to reflect the broad scope of the UHN Palm Newsletter, in its subject matter and the range of interests of its readers.

    The other big change for us this year: the newsletter now has an online home address. Once the website programming is completed, I will no longer send out each issue as a bulky email attachment. Instead, you will receive a brief email with notification of the new issue and a link to a website where you can find the newsletter. You will be able to read it online or download it for browsing later. This strategy prevents problems with overflowing mailboxes rejecting the newsletter (HotMail users: this means you). I can even include more pictures without making your email service provider cranky.

    The website will also provide an archive for back issues to be retrieved or searched for the tidbits you need. For test purposes, this month the website comes from here (like most web documents, clicking on underlined text in the Review will take you to another website with more info or downloads). In future issues the link may point elsewhere so don't bookmark the site just yet.

    With the new name and the online home come some modest cosmetic changes as well. Please do let me know if you find that readability has suffered or you are having problems retrieving the newsletters.

    After all this, can advertising or subscription fees be far behind? Very far behind: I still have no intention of charging you to read my deathless prose or of asking advertisers to annoy you. You're welcome.

    Outlines and Shadows

    An unwelcome change in the new year: Aportis has folded, taking its text reader (Aportis Doc) with it. Another of their products, BrainForest, a handy outliner, has been sold to Ultrasoft.

    I have used BrainForest for years. Like all outline generators, its strength is having a table of contents on one screen which can be expanded to reveal more detailed text. I use it to create lecture notes or instructions for technical procedures I perform too infrequently to remember all the details. With outline software, I can glance at the overview to jog my memory, or expand individual topics if I need the finer points.

    Something similar can be done with web page programming, then importing to your PDA using AvantGo or iSilo but web pages work differently from outlines. Links in a web page take you to a different part of the document: to get back to the table of contents requires you to carefully put in navigation links ("Back", "Home", etc) on the notes you are generating. It takes care to do this well. This seems like alot of work for rough notes. In fact, you can't even do this kind of word processing very readily on the Palm PDA's small screen using Graffiti. BrainForest let me create useful notes on my PC or on the PDA - whenever I needed to. Generating web page code is alot more trouble and needs a big screen PC (for my aging eyes).

    Well, maybe Ultrasoft will keep BrainForest alive. And there are other outliners:

    Still, if I want to use text files or web pages, there are lots of tools. As I have become more proficient at using MicroSoft Word and DreamWeaver I have been getting comfortable creating documents on my PC then importing them to my Palm PDA. I use iSiloX for this task as it handles text, Word files, web pages and graphics equally well. It even can manage tables. Furthermore, if I give some thought to document organization and layout, then plain text without any links or hierarchical structure works fine for some subjects. I still use the MemoPad applet on my Palm for many topics.

    BrainForest is showing its age (not compatible with higher resolution screens, for example) but it does the job so it still has a place on my handheld. But it's not irreplaceable.

    Sony, Sony, Sony

    Well, it sounds better than "Clié, Clié, Clié". The fact is, Sony's PalmOS devices are starting to dominate the scene. Not only do their features often eclipse Palm's offerings, but there seem to be new models every time you turn around.

    Case in point, I recently wrote about the PEG NX70V with its impressive multimedia capabilities (camera, MP3 player), 16 megabytes of RAM and pin-sharp screen resolution. Well, now there is the PEG NZ90 (see photo). This device has a two megapixel camera with flash (ie. as good as my Canon digicam which is bigger and weighs more than the Sony PDA), an even better screen, BlueTooth radio link to your headphones or phone handset, wireless networking capability built-in, and an even better screen (480 X 320 pixels when you collapse the virtual graffiti area out of the way). You can read an early review on InfoSync. This is bound to hurt Palm's sales of the new Tungsten T. Sony has announced that the NZ90 will go on sale in February.

    Sony has even opted for a removeable lithium battery pack. This means there will be much more flexibility about how to recharge. The thing even sports a Type I Compact Flash slot. If Sony or third parties get around to providing driver software, then you will be able to put memory, modems, or other devices into that slot.

    Sony has singlehandedly upped the ante and put Palm devices out in front of PocketPC handhelds for features and power. I can't wait to see what they come up with next.

    You can keep an eye on Sony Clié developments by signing up for a newsletter at PDABuzz and by bookmarking CliéSource which is an unofficial source of news, reviews, software and tips.


    The only thing missing from the NZ90 is a cell phone and maybe a GPS satellite navigation tool. Since Samsung (iPhone500) and Hitachi (Communicator) have both produced PocketPC devices with built-in phones, will there be a riposte soon from Sony? What about Palm?

    I think Sony and Palm are too smart to try to crack the phone market in Japan. Phones there are as much fashion accessories as tools, and have their own market dynamic. Using BlueTooth wireless networking to enable a Palm PDA and phone to share phone numbers is probably a safer bet then asking people to hold a PDA the size of a small book up to their ear to make a phone call. BlueTooth-enabled headsets connect wirelessly to your cell phone and suitable Palm PDA. You can find models by Motorola and other companies.

    Besides, you can buy a GPS device to attach to your Palm or Sony from Mapopolis. You can even buy a handheld GPS locator with a Palm PDA builti-in. The Garmin iQue has many of the best features of the Sony Cliés and a built-in GPS antenna too. It actually costs less than some PDAs with less memory and poorer screens. With one of these you'll never get lost looking for that off-service patient's room again.

    Medical "Doc" of the Month

    MedRules calculates prior probabilities for many disorders and has guides to ordering tests, discussion of risk with patients, and more. References are provided for the calculations, but all the work takes place unseen in the background so you can't evaluate whether you agree with the methods and numbers: you get a result and have to decide if you like it.

    I am not enclosing a copy of MedRules with this issue of the Medical Palm Review because you can download it from PalmGear by clicking on the underlined link at the beginning of the previous paragraph or by clicking on the screenshot above.

    Hack of the Month

    ChangeName is not really a Hack. You don't need Xmaster or HackMaster to use it and it doesn't modify your Palm's operations dynamically. What it does do is allow you to change the name of the user in your HotSync and User databases. This is handy when you are upgrading to a new PDA or using one PC to HotSync several PDAs. If you think you have to perform this task then check it out. If it seems useless, bizarre and scary then don't mess with it or you're sure to regret it. Yes, I found that out in the usual way....

    Would it be more useful to have some tips on using Graffiti? The Palm website has some, as does CNet. But, this week there is news that Palm has licenced the Jot text entry system from another company to replace Graffiti in future PDAs. So if you hate Graffiti, now you have an excuse not to get better at using it. Or to buy a portable keyboard.

    Medical Computing

    HandyVaid is yet another attempt to use handheld computers to augment the capability of rural paramedical workers in the third world. Using handhelds to deliver care in rural India: field workers are to collect info from patients using standard consult forms on a PDA. Forms will then be transferred to MDs in town who would then send back diagnosis, prescriptions and treatment advice. The project started as a telemedicine clinic system and switched to PDAs when the founders realized that there weren't enough telemedicine resources in the areas they were trying to reach.

    Sadly, HandyVaid's website is down alot recently and the link in this article may not be working when you read this. Why? One can only speculate. A PDA with the necessary base station to transmit data by phone line or radio to town may be even farther beyond the capabilities of many rural communities in India than telemedicine clinics using PCs. The financing of such a project could be used to train a considerable number of health care workers, buy large quantities of medications, or access clean water supplies for many small communities. Adopting PDAs in that role may be a step too far and too fast in the face of other needs with a different cost base and return on investment. HandVaid may survive and be able to make a difference, but is it the right way to spend those resources? If the venture gets going, I hope that the results are reported. What do you think?

    In Times to Come

    Next month is the big website rollout (keep your fingers crossed). I hope that the archive of past issues will be ready for those who might find it useful.

    We will have a look at other handheld medical devices and more software.

    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. To subscribe, unsubscribe, present burnt offerings, obtain back issues, change your email address or complain, contact the author at: Please note the new email address

    Visit our website for the latest Medical Palm Review newsletter and the archive of back issues.