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    The Medical Palm Review

    May, 2003 (V4N5) - Palm Comes Out Swinging

    In less time than it took me to figure out how to recharge the battery in my new Sony Clié NZ90, Palm has struck back with not one but two new handhelds that are very intriguing. I could have bought them both for the price of one Clié....


    There seems to be something of a war going on now. After the latest barrage from Sony, Palm has issued its riposte: two new models, and discounting (already!) of the Tungsten T model. To sharpen the point, Palm is offering a USD50 rebate for your old Palm when you buy a new one from them. This is shaping up to be a very good year to get a new PDA.

    The Zire 71 is aimed at the user who wants more memory and a faster processor but also multimedia features. It sports a high-resolution colour screen, a built-in camera, and the ability to play MP3 music files. The camera has no flash, has a resolution of only one megapixel (good for 5-by-7 prints) and can't shoot video but it has a clever sliding cover to protect the lens (see photo at right). Sound quality for the MP3 player is only fair, unless you use a decent pair of headphones (not included). There is no screen cover so you will need to think about how to protect it. Look for cases and other options to be offered by various third parties soon. This attractive little package is so much cheaper than the SONY NZ-90 I picked up in March that I'm disgusted. As usual, InfoSync has an early review and David Pogue's Circuits column (you can find it in the New York Times archive) covered it also.

    The Tungsten C is Palm's other new offering. It is intended for the serious user who wants a high-res colour screen but is more interested in lots of memory, and a faster device - much faster. With OS5, many bulky applications, like medical texts, can be installed on the extended memory card (older versions of the Palm system could not do this) but with 64 megabytes of RAM on the PDA itself, most user won't need to. You can save the memory card for MP3 files because the Tungsten C also plays music (through a monophone headset jack). This PDA has built in wireless networking (WiFi) and a thumb keyboard and encryption for data and communication. You can browse the Internet or use it instead of a RIM Blackberry messaging device. (Earlier this month, Palm and RIM announced that they will team up to offer RIM's service on Palm devices. Read about it at PDA cortex.) Read a review of the Tungsten C at InfoSync.

    Both these new Palms use OS5, the latest version of Palm's software system. The good things about OS5 are its speed, and the ability to run software programs from accessory memory cards. The downside is that OS5 has compatibility issues with older third party programs, especially hacks and programs that don't know how to handle high resolution screens. Palm also has replaced Grafitti with Grafitti II (also known as Jot, and available for older Palms) for writing with the stylus. New users will not find this a hardship, but those upgrading will need to adjust to a few different keystrokes.

    As far as wireless networking goes, Sony NX and NZ series Clies have a slot for a WiFi card, but it costs extra. I didn't get one when I bought my NZ90 (it would have added about CD200 to the price). A recent review of the card strongly recommended that you upgrade the driver software (free from Sony) to fix a few bugs if you use this card. The article was also critical of the poor range, higher than average price and power drain issues with this card. Comparison testing with Palm's Tungsten C has not been done yet, as far as I know, but the Sony product has all the earmarks of a pioneer: expensive, with modest capabilities.

    The CEO of Sony admitted in an interview with AlwaysOn that he would like to own PalmSource, the Palm software company, and Symbian, the cell phone software consortium, to save royalty fees. With Palm taking a leaf from Sony's book and cranking out new and attractive models more frequently, it doesn't look like Sony will be buying the Palm HW division just yet.

    Procedure logging reprise

    In times gone by (see, for example, the September 2000 issue) we have looked at software for keeping procedure logs for trainees. Here are some updated ideas.

    • University of Toronto third year medical students use homegrown software and IntelliSync's Enterprise server to build a database of their activities during their Family Medicine rotation. The assembled feedback is used to monitor each student's progress as well as for course planning.
    • e-Residency offers a variety of tools to help administer medical residency training. including procedure logs, evaluations, group scheduling. They use an AvantGo channel to synchronise procedure logs centrally. I should mention that they also stream "case-of-the-week" and other newsletters to your PDA. I am not sure how much customization of content they permit for different training environments but they are in use at about two dozen medical schools. This service is not well-suited to non-medical training, for example, paramedics or nurses.
    • E*value is web-based or can use your PDA for schedules, logs, email notifications and evaluation for training programs. It is not focused exclusively upon medical or residency training, and can be customized for each client
    • New Innovations is primarily a web-based system and is not as elaborate as e-Residency or E*value. The PDA functionality is basic but solid. You can clearly see from its screens that this service has its roots in database software systems - that it has not been turned into a glossy website.
    • is designed primarily for online evaluations but procedure tracking can be incorporated as well. There is no explicit support for PDAs.

    All these products and services can be reinvented locally if you want to use Pendragon Forms or Satellite Forms. But you need hardware, programmers and commitment. Only you can decide whether to buy or to roll your own.

    Medical Computing

    The Canadian Medical Association Journal had two recent articles on buying PDAs for medical users. The online versions are available to members of the CMA but hard copies can be found in hospital and medical school libraries:

    • hardware: CMAJ 2002;167(7), p775-80. This is already a little dated, but discusses pros and cons of major platforms.
    • software: CMAJ 2003;168(6), p727-34. Discusses reference works, pharmacopeia, and other programs useful to physicians.

    The Pharmacy Department at Auburn looks at PDAs, reviews software and websites and more. As always, the hardware comparisons rapidly become dated (eg. common RAM sizes, multimedia capability, etc). Nonetheless, reviewing this material gives the prospective buyer some ideas about major features and how to prioritize them before spending alot of money.

    IMICH, the nursing and computing conference, has been postponed to Oct 2003 (date TBA) due to the impact of the Iraq war and SARS outbreak on travel in Canada.

    Speaking of SARS, In the March 2003 issue of the MPR I mentioned a report about how the US Government was testing use of ePocrates for alerting physicians about bioterrorist attacks. But identifying that such an attack is in progress requires realtime reporting of cases. The University of Pitsburgh is developing methods for doing just that at its RODS laboratory. Currently, the surveillance and reporting modules are for desktop computers, but software for PDAs should eventually follow.

    In Times to Come

    Next month I really would like to get back to the topic of putting images and charts on your PDA. As long as I don't get distracted by more new toys... I will also continue to reload my previous apps or replace ones which don't like OS5 or the Clie screen.

    Until then, enjoy!

    This is one of a continuing series of newsletters on Palm handheld computers, prepared for doctors, nurses, IT professionals, educators and other people who need tools that work. 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.