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    The Medical Palm Review

    March 2003 (V4N3) - Road Warrior Gets Wet

    Yes, it's true. I took my PDA with me when I went on vacation, a seven day cruise in the Caribbean. The sea was calm but my computing experience was choppy.

    Anchors Aweigh

    I have frequently travelled with a Palm PDA. I find it usable in the air, on the road, or on a train. But I never took it to sea before. Forget those mental images of Paul Arnold in a Viking longboat: at 80,000 tons, a Caribbean cruise liner is more of a giant floating hotel. It even has a library and a casino. So there wasn't much chance of spilling sea water on my Handera 330! With a small desk in the cabin, I figured on catching up on my notes for this issue of the Medical Palm Review.

    The plan was to use my folding keyboard and the PDA to make notes from some reading material. I had set up HanDBase for taking notes, but I could also scribble the occasional idea into the MemoPad. I also planned to use the VoicePad dictation feature for note-taking. I rarely use the folding keyboard while at home. It's just much easier to use a desktop PC with a full-size screen and keyboard. This would be the first major test of word-processing on-the-go for me.

    A few observations about travelling light. By the time you pack spare batteries or a recharger, the folding keyboard, and other accessories, a PDA is not so portable anymore. Electronic devices aren't waterproof either. A zip-lock baggie is a good precaution. When you stroll down the gangplank for an day trip to the beach, you may not want to risk sun, sand, water and curious islanders, not to mention the extra weight in your shoulder bag. I left my Palm gear in my cabin on those occasions. Besides, you know the old saying: "all work and no play...".

    The air trip to Miami was only three hours. Still, I had time to take out the folding keyboard and try my hand at taking notes. The tray table for in-flight meals was at just the right height and distance for comfortable work. I actually made some progress, but then glanced over at the guy sitting to my left. He was catching up on some work too. But he had a fancy new Toshiba Satellite laptop PC. He also had a way of glancing at me and my scruffy setup as though I might have fleas. It could have been worse, however: on the trip back to Toronto, the man in the next seat was watching DVDs on his Sony Viao. Sigh.

    Once aboard the ship, I quickly learned that my cabin lighting was a bust when using the keyboard with my Handera. Because I can't adjust the angle of the PDA when it is attached, light falling at the wrong angle leaves the screen too dark or reflecting like a mirror. The ship's library, with its desks and reading lamps, was the only place that worked out (see photo). Newer PDAs with colour screens and backlights would probably suffer less from this. Nonetheless, on your cruise you may want to look into using a keyboard with a wireless link (Pocket Top) for more flexibility in positioning your screen.

    When in the library I got a fair bit of attention from other would-be sea warriors who missed their eMail, eBay or what-have-you and didn't want to spring for the one dollar per minute ship's Internet café. One Korean fellow was most intrigued until he learned that my Handera was made under license in his home town, after which his face fell and he wandered off.

    The liner had a satellite Internet hookup which was fairly speedy, and a dozen PCs for passengers to use. Theoretically, I could have downloaded email to my Handera for later reading. I have tried email software and had some success with MultiMail but it has been discontinued. (You can find lots of alternatives at PalmSource). As luck would have it, all the ship's public PCs were locked up behind cabinet doors in such a way that I couldn't have connected to my PDA even if I had the right cables.

    Even more interesting, the ship had its own internal hardwired LAN. On one occasion I found a ship's employee downloading her email to a laptop. But without her access privileges and passwords, the network (and its high speed satellite Internet link) were off-limits to me. I didn't mind. Getting away from the forty-odd email messages I receive everyday was a positive aspect of the cruise.

    (I confidently predict that future cruiseliners will wire up the passenger cabins and public areas. We will use them to order all sorts of services (that we will be billed for). And with bar-code bracelets or portable computing devices, passengers won't have to carry their wallets to buy drinks or tip waiters. And just when are they going to provide this access? When they know we won't hack into the blackjack tables in the casino, or the propulsion control systems....)

    My digital camera uses Compact Flash cards to store pictures. The Handera does too, so a handful of cards could be used for snapshots, memory backups, etc. It would have been even more convenient if the camera were built into my PDA. Some new Sony Cliés have cameras included but they are a little too big and bulky for your shirt pocket.

    I didn't need the spare batteries or recharger during the seven day cruise. Even making use of the backlight, a black-and-green monochrome screen is pretty frugal with the juice. There was a compatible power outlet in my cabin had I needed it.

    While on board I couldn't resist going down to the ship's infirmary to meet the doctor and get a tour. He has quite the facility with the ability to run a cardiac arrest code, give thrombolytic drugs, suture and splint. He told me that keeping several medical references on a portable computer is a cool idea but he has access to texts on CD and the Internet from his desktop PC. The whole infirmary is mobile, so who needs mobile medical computers?

    I enjoyed tinkering with my PDA during the cruise, but I would be a liar if I left you with the impression that I got alot done with it. Those beaches in Mexico and Honduras were much too inviting. Why else do you suppose the newsletter is so late this month?

    Share and Share Alike, Part Deux

    Last month we looked at a few software and online solutions to data sharing among multiple users. I'd like to touch on that subject again with a few more ideas and comments. Warning: the following is fairly well larded with "geek speak", please read while sitting down.

    • You can share data between PocketPC, Palm and Psion handhelds using a variety of software. Chris de Herrera has a somewhat dated list and some tips at his website.
    • You can share web page-type content with multiple users if you all use AvantGo. The good part: as long as the webpages are on a public server so AvantGo's servers can find them, it's easy. The bad part: for private stuff you have to configure conduits through your hospital's firewall and that does represent a data security risk. There are also costs involved in setting up the server. Not a casual solution.
    • Multiple users can synchronize files from a desktop PC with an infrared "dongle" (yes, that is the technical term for it) in your department. This eliminates questions of compatible connectors or cradles for the myriad of different PDAs. Actisys sells such hardware/software solutions. Problems do exist: everyone shares the same files potentially unless you configure a PC to function as a "sync server" and each time one syncs the files to a different PC one has to put up with repetitive backups of the entire file set (the different servers don't know what you already synchronized). -
    • Wireless networking to your LAN or the Internet gives you more flexibility and choice about what to share and data security. Clarinet Systems provides solutions to that sort of problem but this will require money, staff and a corporate IT department.
    • If the data you want to share is on big mainframe computers (eg. Hospital, big business or government) then your IT department may be able to provide "middleware" to extract stuff from servers, patient databases, etc.
    • Some places to look for ideas about data-sharing and technology in the healthcare environment: Xtend Communications, Medical Defense Partnership for Reinvention and Mercury MD.

    One last word. Once you decide to setup data sharing or wireless networks, who maintains and updates the content? A recurring problem with high tech initiatives is that after the initial purchases, programming and deployment are completed the funding dries up and there is noone around to mind the shop. It's important to think about this ahead of time. Fortunately, tools (such as Macromedia's Contribute) allow almost anyone to manage website content. Thus you can get admin assistants, teachers, front-line healthcare workers and just about anyone else to "participate" (i.e. Add this task on to their regular jobs without additional recognition or pay). With luck and a bit of forethought, you can create a data-sharing setup that needs only incremental maintenance and updating so the workload is manageable.

    A Tale of Two Sonys

    Hardware convergence continues. Sony has cameras and MP3 music players built into their top-end Cliés. Palm has the new Tungsten W model with built-in phone, etc. Handspring's Treo is primarily a phone with PDA features. No doubt there will be other Palm OS 5 phones soon. Samsung has even developed Palm-on-a-chip systems ready to be incorporated into ever-smaller PDAs.

    But there are other sorts of convergence going on. With fashion (PhoneScoop has pix of new Motorola "wearables" - but this may be "vapourware" - i.e. not real yet). With your hip flask (you know, the one for your medicinal brandy) - of course, they claim the vodka is just for powering the fuel cell - sure.... Still, it's less toxic than a methanol-based fuel cell from Toshiba.

    And there is still hardware divergence too: devices getting simpler and with fewer features in order to tempt you to spend some money on a new PDA. These gizmos clearly don't have everything

    • the new Sony Peg-TG50 (read more about it here)
    • another new Sony, the SJ22, features little more than a great colour screen at a low, low price

    Sony epitomizes this dichotomy: they simultaneously are releasing new models that are upmarket (many included features) and downmarket (inexpensive basic feature set). What's their marketing plan? To capture both ends of the Palm market? The only area they haven't entered is the Palm-telephone gear. And with their newer models sporting WiFi wireless networking and BlueTooth to talk to your cell phone, maybe they have that covered too.

    This issue of what sort of PDA to buy is particularly resonant for me due to the progressively wonky screen behaviour of my poor Handera 330. I may need to look for a replacement very soon. Just what features would I like on my new PDA??

    Medical "Doc" of the Month

    The next edition of the Five Minute Emergency Medicine Consult is in final preparation for release in mid 2003. A version for PDA should be released also. For those of us who work in Emergency Medicine and Nursing, or pre-hospital care, it is a handy reference tool. I was not a great fan of the original PDA edition (despite being one of its many authors) but I'm looking forward to seeing whether this one will be an improvement. Meanwhile, I continue to use Pepid and eMedicine emergency medicine reference texts on my Handera. Pepid has recently been enhanced with various calculators and other enhancements such as a prescription drug guide and a drug interaction checker.

    Medical Computing

    The US government is evaluating a system to alert physicians about biological warfare attacks in America. Based upon the automatic update system used by Epocrates for its popular prescription guidelines software, the system is still in early testing.

    Having trouble waking up in the morning? The Airclock uses an IR port to link to any home appliance that uses a remote control, such as a stereo or TV. Not really a medical device but it seemed neat so I included it here....

    Sonosite is a company that makes truly tiny ultrasound equipment (see photo at the right). This isn't a PDA, nor does it plug into a PDA, but their product line is so cool and compact that I wonder how long it will be before we all start carrying around these things instead of stethoscopes.

    Think that the portable ultrasound is small? IBM has developed a heart monitor that fits on your wrist and uses BlueTooth to send an alert if the wearer experiences a dysrhythmia.


    In Times to Come

    Will I get a new PDA? One other thing that happened during my vacation cruise: the warranty expired on my Handera without my having ever received any satisfactory response from the manufacturer or his local agent. In April I will have to get a backup Palm device (probably soon to be my primary Palm device). Let's talk wishlist, folks....

    Until April, enjoy!

    This is one of a continuing series of newsletters on Palm handheld computers, prepared for doctors, nurses, IT professionals, educators and gadget lovers everywhere. Feel free to pass copies around electronically or on paper. To subscribe, or complain, contact the author at the following address:

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