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    The Medical Palm Review

    April, 2004 (V5N4) - Mobile Computing Redux

    What tools do you really need to take your show on the road? I revisited the vexed question of what a PDA is for and come up with some, well, conventional answers. More about what I got, what it weighed (alot), what it cost (alot), and how I integrated it into the working environment follows.

    Just this past March, we had something of an Arnold family reunion. My brother and sister brought their laptops and kept up with their e-mail and their work and business activities. When required they could plug into the phone system to browse the web. They could download photos from digital cameras and burn CDs for the rest of us.

    I had my Kyocera Palm OS handheld and a Targus folding keyboard. I could tap out a note or two but the small screen made serious browsing impossible. I couldn't do anything with digital photographs.

    The plain fact is that they could do more stuff than I could.

    I told myself it didn't matter. After all, I was on holiday with my daughter and dog. I wanted a break from e-mail and I had no business activities to monitor. It didn't get to me, but it did get me thinking. Did my handheld meet all my needs?

    The Kyocera, as I have described previously, combines a cell phone and Palm OS computer. I can manage my ToDo list, address book, appointments and manage some basic e-mail tasks. It also keeps several medical references close to hand for when I am at the hospital. All of this weighs only six ounces, "boots" instantly when I flip open the case, and communicates smoothly with my Windows PC. The battery can run all day on a single charge.

    A laptop would weigh several kilos and take 1-2 minutes to boot up. It would not be nearly as portable as my PDA and the battery would not hold up for more than a few hours of use before recharging. Not practical for schlepping around the hospital. Its main advantages would be a larger screen and better keyboard than a handheld.

    But then I started to think outside the box. My PDA rules when I am on foot, but there is mobile and then there is mobile. Sure it would be handy to be able to work in the kitchen or the home office or on the back deck without compromising screen size and without copying data files - but how often do I really need to leave home with full-bore computing power? Instead of replacing my PDA, why not get a laptop to replace my desktop PC?

    What would I need to make that strategy work?

    • Ports to communicate with my PDA would be essential. I would need USB for the HotSync cradle. Almost as important, I would need a way to copy files to and from the Kyocera's Secure Digital (SD) data card. I opted for a model with USB ports but also a PCMCIA slot. I can put SD cards in an adapter and use them like a floppy disk in that slot. This saves the extra weight of an external floppy drive. This also turns out to be the last weight-saving decision I will make with this computer purchase.
    • Windows operating system. I like Linux (particularly the price) but I need to support a scanner and specialized Palm software that has no Open Source equivalent.
    • Wads of cash. Laptop computers are much more expensive than their desktop cousins with equivalent capability.
    • A large screen. I like to work with several open windows as I write. That means two monitors on a desktop. To get similar ability on a laptop (i.e.. 2000 X 760 roughly) means a better laptop screen. More wads of cash.
    • New eyeglasses. Yup, to peer at the smaller screen with the higher resolution needs a prescription with a greater focal depth of field or I would be hunched over and squinting. My optometrist seemed very familiar with this problem. The new eyeglasses weren't cheap either.
    • Wireless router. This permits web and printer access from various parts of the house.
    • Carrying case with shoulder strap. My regular briefcase has no padding and no pockets that fit a large laptop.

    I eventually plunked down my money for a Dell 8600 laptop. What I like about it: very quiet compared to my desktop; great fifteen inch, high resolution screen; I can work anywhere in the house or office without restriction. What I don't like: cramped keyboard; screen and keyboard connected so it's hard to choose a comfortable working posture; seven pound weight means this is not for a weak-shouldered road warrior like me.

    It was easy to reinstall my Palm Desktop software on the laptop. Then I HotSynced the Kyocera, specifying the "handheld overrides desktop" setting. Other applications installed quickly ad I used the network to transfer over my data files. I am typing up this newsletter on the new machine and it's working well as a replacement for my desktop machine.

    But there is no way I am carrying this to the hospital as a "portable" reference. The combination of light weight, daytimer and cell phone in the Kyocera is vastly preferable for when I am away from the office.

    Bottom line: I work in a variety of environments. No one solution fits all needs. But a laptop allows me to do computing tasks in multiple locales and complements my PDA more flexibly than a desktop PC. Both provide mobile computing capability.

    How the Other Half Lives

    There are other ways to increase the power of portable computers. But I believe that they will be eclipsed by increasingly capable mobile phones. The latest models have Palm-like daybook features, cameras, wireless networking, and (of course) cellular telephony. This is compelling stuff in a small package priced well below Pocket PCs or Palm PDAs.

    There are lots of indications that the market is heading that way and the pocket computer will be subsumed in a portable communication and web-browsing multimedia tool. For example:

    • Nokia has bought out its partners in the Symbian project and PalmSource has developed OS 6 (AKA Cobalt). There are rumours that they are in talks with Palm. This is an opportunity to roll Palm OS into lots of cell phones.
    • New Chinese cell phones have built-in browsers from Opera - it's a reasonable capability for a phone, but it begs the question: who needs Palm?
    • New data card formats have been devised: Reduced Size MMC and small SD cards are aimed at the cell phone market, in order to reduce weight and power requirements. The ability to store images and large text files on a phone overlaps the PDA-as-pocket-textbook.
    • Some PDAs incorporate phone features already. Kyocera, RIM and Palm are in that market, with more to follow.
    • Even Sony, which has resisted incorporating phone features in its Clié PDAs, has built wireless connectivity into its latest TH55 model.

    What's missing? Primarily, cell phones lack a convenient interface for text entry (those tiny keyboards) and they sacrifice screen size for portability. Come to think of it, those are the major deficiencies of pure PDAs too. That's not much to build a brand on. Palm had better mind its step.

    More about Us

    In recent issues we described how to convert the Review using AvantGo or iSiloX. If you want to download the latest issue without the navigation frames and links you can find it here.

    If you use AvantGo you can instruct it to use that link each month to download the latest issue. In fact you can then avoid surfing to the website altogether.

    Fair warning: this worked just fine with iSiloX. I believe there would be no issues with AvantGo, but am not certain. I spent ten minutes trying to sign up with AvantGo for test purposes but canceled after ploughing through all the detailed questionnaires. I don't want to help them too much with their targeted advertising just for the privilege of accessing some news providers, when the same benefits can be had without hassles through using iSiloX or Plucker and a list of compliant news sites.

    Medical "Doc" of the Month

    ePocrates has published a new program for PDAs. ePocrates Dx is integrated with Griffith 5 Minute Clinical Consult to give the user a diagnostic tool with medical reference material and links to their ePocrates Rx prescription drug manual. There is a short tour of the software on the publisher's website. Like their pharmacopoeia text, the Dx program will oblige the user to update regularly.

    Other software

    Bobby Hill (from Los Angeles) writes that I missed a program in my recent article about data sharing between PDAs. It's called SyncUs. The product offers considerable flexibility as to which appointments get copied, and you can preview changed entries before copying them.

    Mobile TS is a wireless LAN terminal for Palm which enables remote control of a desktop PC from a Palm device. This has some interesting possibilities for room stock management, medication prescribing, and patient care.

    Medical Computing

    Data from Forrester's Consumers Technographics 2003 North American Bench Mark Study indicate that 408,020 physicians and 559,800 nurses are currently using PDAs. So we're not alone....

    A recent news article describes how hospitals are using wireless networks to link doctors to patient and lab data both within the institutional walls and when they are on the road.

    In Times to Come

    Another big multicasualty training exercise is coming up for University of Toronto Emergency Medicine residents. We plan to convert some online reference materials into Palm documents for them. Look for about it next month...

    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.