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    The Medical Palm Review

    December, 2005 (V6N10) - 'Tis The Season

    Be careful what you ask for. Because you just might get it.

    Time for Toys

    Christmas came early for me. After my Kyocera smartphone died I needed a new combination mobile phone and Palm computer. As the cost would be partly covered by my employer, I could pick whatever I wanted. However my mobile phone service provider only supports one model --the Palm Treo 650. This restriction took most of the fun out of shopping.

    So, I'm all set for high-tech toys this holiday season. But how about you? Thinking about a new gadget? There is both good news and bad news on the hardware shopping front this year.

    First, the bad news. There really aren't many players left in the Palm OS field any more. Sony has dropped out removing the source of many new designs. Kyocera does not appear to have a new model to replace the reliable 7135. There are only a few niche products such as the Garmin iQue 3600 which integrates Palm software with a GPS receiver, or ruggedized Palm PDAs for fieldworkers like the Meazura from Aceeca.

    This really just leaves Palm itself in the consumer marketplace. And, with their recent announcement that they would be making Treo 650 smartphones for the Pocket PC market, one wonders about Palm's own sense of commitment. Furthermore, although PalmOne (the hardware maker) changed its name to Palm again, PalmSource (the Palm OS and software developer half of the company) has been bought by Access. Access is the firm that developed the NetFront mobile web browser but they seem a little limited in background to carry the ball for millions of PDA users. It's just a sad story, folks....

    Fortunately, a quick tour of the Palm website reveals that the company still has a solid range of models and has even proliferated into niches formerly occupied only by the Sony Clié PDAs.

    At this point I might tell you about the different PDAs out there, and which ones I like. But I won't do that yet. Instead, I would like to bore you a bit with my favourite topic when it comes to buying new hardware. Here are my rules for buying a new PDA.

    1. Think about whether my current PDA can do the job if I upgrade its software or add an accessory or two.
    2. Think about what I need before going to the store. I won't get all the information needed, particularly negative comments, inside the shop. And there is such a wealth of information to be had on PDAs and electronic gear.
    3. Do some Internet research including a Google search for complaints, discussion fora and critical reviews. In addition, look up websites such as the Gadgeteer, Palm Infocenter, PalmLoyal, PDALive, CNet, PocketGoddess, and PalmZone. Pay particular attention to comments of (dis)satisfied users.
    4. Armed with this information, it's time to go shopping. Plan to ask lots of questions, to heft and handle and squint at the screen of the device(s) on the short list.
    5. If my trip to the store forces a rethink, leave to reconsider and do more research if needed - don't make a snap decision. As the old saying goes: act in haste, repent at leisure.
    6. Loop points 2-5 until I am comfortable with my decisions.
    7. Go buy the new accessories or PDA.

    Why so careful? My PDA is an important part of my daily work. If it doesn't do what I want the way I want it to then I am sunk. And then there is the dilemma of whether to get just what I need today or to pay extra for memory or power that I might want as my needs change. If I found myself frequently having to upgrade as I bumped into the limits of my gear, then I might as well spend extra up front on speed, memory or a better screen.

    In fact, I more often get a new PDA when an older one dies but if your handheld still works, ask yourself what it lacks that you need to upgrade for. Wireless networking? Cell phone? More memory? Extra cash burning a hole in your pocket? Craving a new toy?!

    Last month I described how I came to get a new smart phone. But before my Kyocera died, But I was already starting to think about getting something new.

    I had already run out of internal memory because of the medical texts on my Kyo. I had resisted installing those books on the external memory card because they run so much slower that way. But, with only 16 Mb, internal memory was inadequate for my library. Also the screen had a low resolution which was not satisfactory for displaying photos of rashes or ECGs. If I had been shopping for a new device on the basis of wanting an upgrade, these are the features I would have wanted to address.

    Before I bought the Treo 650 I did some research (as per my own guidelines) but in the end had no choice because it was the only smart phone supported by my service provider. Did I get some meaningful improvements over the Kyocera?

    The Treo 650 has 23 Mb of internal memory which sounds like an improvement over 16 Mb. But the memory is not used as efficiently as on older devices so the actual increase in capacity is rather modest. Fortunately, I found that many of my medical texts will run from an external SD memory card quite nicely because the newer version of Palm OS on the Treo has been improved. That, plus the faster processor chip mean that I can run applications quite handily from an external card without a performance penalty. And that means that I have the equivalent of 256 Mb of memory for applications. As a bonus, the Treo 650's memory won't be erased if the battery runs down.

    The screen resolution and colour are also much better, so I think that I lucked in overall.

    On the flip side, if I use the SD slot for application and data storage, it is harder to use it for a plug-in adapter for presentation projectors or other devices.

    The bottom line is that you need to think a bit about the pros and cons of each new model as they are often difficult to compare one to another. It helps to have a very clear idea of what you need, what you want, and what is not important.

    One more point. Although the hardware has been a "trade up", the transition has not been without incident. The device has a different heft and I am still getting used to that. The Treo has a stubby antenna that can't break off and doesn't need to be extended and retracted when making phone calls. But that means it emits more radio energy than the Kyocera. I am using a plug-in ear bud as much as possible just in case.

    The keyboard and button layout is different so I have to get used to that also. If I had played with the Treo before deciding what to buy, some of this might have put me off.

    Something I wouldn't have known before buying is that much of the built-in software works differently from older models. That has forced me to rejig my contact database and appointment manager software to adjust. I will need to buy an upgraded version of Time & Chaos, which I use for this purpose, as the Treo 650 won't work with the edition I have.

    The screen has no cover so a stick-on plastic protector is essential. There is no case or belt holster so I guess I still need Santa to bring me something.

    No matter how well you prepare, you can expect some disruption when you change something as personal as your PDA. So shop wisely, but also look on the changes as an opportunity to reassess what you do and why you do it. Make the changes consciously and thoughtfully if you can.

    Nuts and Bolts

    If you haven't already run out to buy a new PDA, I do have some comments to make about the new models from Palm as well as a few accessories that caught my eye. (You can see pictures and detailed information on all the following PDAs at Palm Canada, or indeed any Palm website. You can find independent reviews of all these devices by simply Googling with terms like "Palm Zire 72 review".)

    The Z22 is an inexpensive basic organizer with low resolution colour screen, 20 Mb of available memory and no SD slot for external memory cards. It is adequate for what it sets out to be (inexpensive starter device) but health care workers will quickly outgrow it with medical references and graphic images. Of note, the memory is nonvolatile so your data is safe if the battery discharges. Some reviewers have suggested that this is a good way for users of paper planners and daytimers to dip a toe in the water. That makes sense but the Z22 is still not on my short list to recommend to a physician or paramedic. C$150.

    The Zire 31 is often described as being superseded by the Z22. And it's true it has a similar screen, even less memory and a higher price. But it is still available on the Palm Store web site at this writing and has one important feature which the newer PDA lacks. The Zire 31 has a SD slot for external memory cards. Whether this makes it worth about C$50 more than than the Z22 is your call. This PDA sits right at the boundary between just adequate functionality for a health care professional (in terms of memory, speed, screen quality) and extra features (music player, camera, cell phone, higher speed, better screen) that are the hallmark of more expensive systems. That's right, after this things quickly get alot more expensive. C$200.

    The Tungsten E2 is faster, has a better screen, 26 Mb of memory and Bluetooth built-in so you can use wireless earphones for listening to music. It includes a SD expansion slot. It has Documents To Go software to let you share Microsoft Office documents with your PC. It has no voice recorder or wireless networking. C$300.

    The Zire 72 adds a 1.2 megapixel camera, a better screen and a faster processor. It provides 24 Mb of memory which is a bit less than the Tungsten E2. There is also a voice recorder which can be used as a dictation device. It has an expansion slot for memory cards and Bluetooth It has a solid reputation and most health care workers would find it quite sufficient for their needs if they don't need wireless networking or a phone built-in. C$400.

    The Tungsten T5 provides two principal enhancements. The first is its excellent screen. Whereas the Zire 72 and Tungsten E2 have resolutions of 320 X 320 pixels, the T5 has 320 X480. This is great for demonstrating pictures of rashes and ECGs. There is also 215 Mb of memory, of which 55 Mb is for programs and 160 Mb can be used as a USB key drive. This is enough to transfer some data files - handy for mobile educators to port a substantial number of teaching files to other PCs. However there is still no wireless networking. C$500.

    The Palm T|X looks alot like the T5 and has 100 Mb of usable memory, the same big screen as the T5, Bluetooth, and built-in wireless networking. Reviewers have been generally impressed with its battery life but wireless networking eats amps and the battery cannot be swapped. This is, in my view, a significant step up from the T5 as WiFi and increased user memory trumps the USB drive, yet it costs less. A good choice for mobile workers who want wireless access to hospital electronic records or clinic management networks and so on. C$400.

    The LifeDrive improves further on the 320 X 480 screen by making it easy to use it in sideways or upright mode. It also packs 32 Mb of memory and a 4 GB hard drive which can double as a USB drive to port files between different PCs. Bluetooth and WiFi are included. The downside is that it is big, a little sluggish, and has poorer battery life. People who want an MP3 player will prefer something lighter with better battery life. Palm recently released an updated version to address complaints about battery performance and audio quality. The price will give you pause unless you really need that 4 GB of portable storage, in which case it is cheaper to buy the LifeDrive than to get a T|X, a handful of 1 GB SD memory cards and an external memory card reader for plugging into PCs. C$700.

    Both Treo 600 and Treo 650 model smartphones are available. I don't think there is any good reason to get a Treo 600 unless you want to save money, because the 650 is just so much better with its higher resolution screen, faster processor, nonvolatile memory (prevents data loss if the battery fails), and built-in Bluetooth. Both devices have a simple camera (less than 1 megapixel). The battery can be swapped out. The Prices will vary depending on the cellular service plan you purchase in your area but you should be prepared to pay perhaps US$200-700 for the 650, and less for the 600 model.

    You already know what I bought. Now you know what else is out there. Enjoy choosing! Not to rush you or anything, but Palm has announced that the rebates, deals, and special pricing on their PDAs and accessories are due to expire on December fourteenth or when supplies run out. What do you think will happen on December fifteenth? I think prices will fall a bit on low end models but stay up on the high end ones. We'll see if I am right....

    Small Parts

    There are alternatives to buying a new PDA. For example, if your current device is satisfactory but you want wireless networking, Palm sells a WiFi card for the SD slot. They charge US$100 for it and it does drain your battery but it is a cheaper option than an entirely new PDA.

    Here's a different twist. If you have accessories such as keyboards or external modems which plug into older PDAs, you may be able to use them with a newer handhelds if you get The Bridge. It comes in various configurations. One of them may let you regain the use of an accessory you put in the closet.

    Another chameleon-like device is the Socket Mobile Power Pack recharging system for multiple devices. You can use its high-capacity battery to recharge a variety of PDAs, cell phones, MP3 players, and so on. Adapters are required for some makes and models.

    The Bachmann InfraReady Adapter plugs into just about any printer which is then able to accept and print documents from your Palm handheld.

    The Pitch Duo wireless presentation device saves your expansion slot for memory cards. It uses your USB cable connector or Bluetooth to link your PDA to a projector. It allows you to control slide presentations from your PDA or to display your PDA screen to the audience. A nice touch is that you can load a presentation onto the Pitch Duo and have it loop on the projector while you disconnect the PDA and do other things

    If you want to get fancy, you could spring for a leather case from Piel-Frama or Vaja.

    It's not just hardware that helps you enhance an older PDA and extend its service life. Software can also. For example, Documents To Go lets you share Microsoft Office files with your PC. QuickOffice has similar abilities and has been upgraded also (now supports WiFi networks so you can open and mod documents on the move).

    Do you want to use your PDA as a wireless phone? Many newer PDAs are powerful enough, particularly if they have WiFi built-in already. CounterPath, Vonage, Cicero Networks, among others, all are making or attempting to make wireless Internet telephony available on PDAs using software. This may not be available in time for Christmas this year, but gives us something to ask Santa for next year.

    Card Export II screenshotWhy buy a LifeDrive just to have a PDA that doubles as an external USB drive. Card Export II from Softick lets your PDA be a card reader for your desktop PC. It doesn't even need you to install drivers on the desktop computer. Not too shabby for US$15 and you can swap as many memory cards in and out of your PDA as you want. I seem to have accumulated quite a few SD memory cards now so this is something to think about for me too....

    If your PDA doesn't have voice recording built-in but can play MP3s you may be able to add dictation ability with a program like SoundRec (free but funky), Audacity, or mVoice. Some clever sparks feed the voice recording data files into speech recognition software on their PCs to get digital transcripts of conversations and meetings - but this is not easy to do accurately.

    BlueNomad has recently released a new version of BackupBuddy for the Mac, helping to keep the connection between Palm and Mac alive. They have also enhanced BackupBuddy VFS for making backups from your Palm to an external data card. They also have a new security suite including BackupBuddy VFS, a password encryption utility, and a cleanup program for removing applications and their little support files which tend to accumulate even when the parent app is removed. These little extras help to make a PDA more secure and less prone to resets.

    All things considered, this is a good time to shop for a new PDA, but it's also a good time to tune up the old one and save some money for that winter cruise holiday you were thinking about.

    Medical "Doc" of the Month

    The October 2005 issue of The Lancet featured a review of PDA usage in health care (Baumgart DC. Personal digital assistants in health care: experienced clinicians in the palm of your hand? Lancet 2005; 366: 1210–22). If you have access to the paper, online or PDA version of that journal, I recommend using that article to persuade your manager or department head to fund the purchase of handheld computers for your work environment.

    Medical Computing

    'Tis the season to receive gifts as well as to spend money. So it is with the latest issue of the pdaMD newsletter. Chris Helopoulos (author of The Medical Professionals Guide to Handheld Computing) has a helpful article about free medical software that you may find useful. One link is to Merck Medicus. In addition to the free Merck downloads, this site's home page has links to several other handy web pages, such as the National Guideline Clearinghouse, The American College of Physicians PDA Portal, and the American College of Cardiology Foundation, all of which offer (you guessed it) more free clinical tools, guidelines and documents.

    Setting search limits in PubMed on Tap (from the NLM web site)The Merck PDA software enables users to conduct MEDLINE searches when they HotSync or using wireless networking. The National Library of Medicine's wireless network access program (called PubMed on Tap) is also available for your handheld computer. This lets you perform searches on the fly, provided you are within range of a wireless network or are using a smartphone with the ability to dial in to the Internet

    The other sites Mr. Helopoulos describes are similarly replete with enough useful stuff to keep you busy until long after Santa has had the sleigh detailed.

    But, if you are wondering whether putting guidelines on PDAs is actually useful or not, you may want to look over the article by Morgan Price in the November 2005 Canadian Family Physician entitled Can hand-held computers improve adherence to guidelines?.

    In Times to Come

    I hope your holidays are happy and, if you can't keep your current handheld Palm device running with an upgrade or new part, that Santa brings you something you can use.

    Next month, we'll see how much more progress I made with adapting to the Treo 650. And we'll have a look at music and sound files on PDAs.

    Until then, Enjoy!

    This is one of a continuing series of newsletters about Palm handheld computers, prepared for doctors, nurses, IT professionals, educators and other people who need tools that work. The Review is published monthly on our web site. Subscription is free; the principal benefit is receiving e-mail notification of new issues.

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