|The Medical Palm Review |
January, 2006 (V7N1) - Spreading the Word
Time was, people read the newspapers. Then came radio, followed by TV. Once the Internet came along, we got newsgroups, web sites, RSS feeds, and blogs. Now that we are into mobile computing there is push e-mail, more RSS feeds, and Podcasts. With podcasts we can bring something just like the radio and TV experience to our handheld computers. Is this a good idea?
News or Noise - Podcasts and RSS on tap
My daughter wanted an iPod for Christmas. Since I am not a big fan of the music my girl enjoys (Hillary Duff?), a music player with earphones had some appeal to me so I looked into it. Unfortunately, the boys in Cupertino wanted hundreds of dollars for an MP3 player with a stylish exterior. Wasn't there anything cheaper? In fact, couldn't I put MP3 music files on one of my Palms and let her listen to that?
It turns out that those Palm PDAs that don't have music player software built-in (most new models do) can often install one, like RealPlayer, Aeroplayer, Busker or Pocket Tunes. Provided the PDA has a decent sound chip and a jack for headphones, a reasonable musical experience may ensue although none of these solutions will please an audiophile.
What's even better, MP3 files can be used for much more than music. There is no reason a newscast, lecture, panel discussion or other voice file could not be made available instead of music. Such files, known as podcasts in honour of the Apple iPod, can be readily downloaded to a desktop PC (see Jake Ludington's excellent primer on receiving podcasts for Windows PC users).
The hallmark of a podcast is not only a sound file that can be played on a portable MP3 player, but also that it is made available through a distribution channel. This raises the question: if I prepare an MP3 file of a lecture, how do I get it onto your PDA? Or onto multiple PDAs?
I have been accustomed to distributing teaching materials to PDAs as text files in iSilo format. Some people use AvantGo to have text articles or news sent automatically to their PDA. RSS (Really Simple Syndication) is another method of automatically pushing text files or news onto your PDA or PC. ComputerWorld has an excellent description of RSS feeds and how to make use of them. One way or another it is not difficult to get reading material onto a handheld computer.
Podcasts can be distributed similarly. You can e-mail a file to all your students or have them download it from your website. RSS lets them receive your lectures automatically. Many people use RSS and Quick News to listen to news reports that are sent via wireless network or HotSync to their PDAs. Quick News handles text and audio data streams. Anyone who signs up for the RSS feed will receive the content, just as anyone who tunes their radio to the BBC will be able to hear their news broadcasts. A little research reveals a wealth of advice on this topic. PalmFocus has a description of the various ways you can get existing podcasts onto your PDA and how to listen to them. Basically, although there are niche products for podcast acquisition and playback on your PDA, podcasts (once downloaded) can be played back just like a music MP3 file -- with ordinary music player software. The technically savvy can just copy the podcast file from a website to an external memory card and then plug that into their PDA as Aaron Walker points out in his PDA Life column published in The Daily Press last month..
Moving Beyond Music
As podcasting increases in popularity, MP3s on a variety of Palm topics are popping up everywhere. 1SRC has much of its Palm-oriented editorial and news content available for download as MP3 files for listening or as web pages for reading. Jeff Kirvin, a popular writer about handheld computing, posts a regular podcast on 1SRC (look in the top right corner of the home page). The Palmaddict news and discussion site puts up a podcast regularly. Podcast.net, PodcastDirectory and Podcast Alley have growing libraries of material. Searching there for "Palm" or "PDA" or other keywords elicits substantial directories of listening material. Productivity Portfolio has an article which describes sites and search engines that help you locate podcasts on the topics of your choice. Palm itself encourages developers to send them MP3 audio recordings about their products for inclusion in its regular promotional podcasts.
Most of the above sources feature podcasts about Palm hardware and software. But they also have collections of podcasts on health themes for the general public. There seems to be little available in the way of formal nursing or medical educational material. Many blogs on medical topics are available as podcasts that are updated periodically. Blog Explosion has some examples. The Johns Hopkins website does have a weekly podcast on health news but it appears to be intended for a general audience, rather than health care workers. The New England Journal of Medicine publishes regular podcasts in which one or more doctors debate health care issues.
And, of course, commercial publishers are getting into the act. MedicineNet is a website which offers podcasts for the general public on a variety of topics. Their site seems to be at least partly funded by advertising. Audio-Digest Foundation has begun offering CME as podcasts.
But if you look hard enough, you can find some didactic academic content in the form of podcasts. Stanford University has opened a repository of podcasts on iTunes. The public content is free and includes podcasts of lectures, seminars, speeches and interviews given by Stanford faculty or guest speakers. This material is not, for the most part, about health care. Jefferson Emergency Medicine has assembled a small number of lectures as podcasts.
Multimedia Extravaganzas - Not Yet
What I haven't found (yet) online is evidence that medical educators or conference organizers are converting lecture materials into podcasts in a systematic or structured way. If one looks at a website like McGill University's Continuing Medical Education web page, one finds recorded seminars which present video of the presenting speaker alongside the associated PowerPoint presentation. Why isn't that sort of material available for the PDA?
Well, for one thing, a PDA screen is too small to show live video and PowerPoint slides side by side. But one could certainly look at the slides with a "voice-over" by the speaker or simply have the video of the speaker. A sufficiently dull presenter should be able to put you to sleep as quickly on a PDA screen as on a TV screen or in a live lecture. Perhaps that is another reason that multimedia educational content on PDAs is not popular: too many lectures are deadly. We may not have a choice about who lectures us in college but we can choose to do our e-learning in a less stupefying way.
Some material may lend itself to an instructional video, such as demonstrating how to insert an intravenous line. But would that small screen permit the learner to see important anatomical landmarks and technical tips? Crafting a video or PowerPoint display for a PDA requires some planning.
Once you have created a suitable video, there are a few technical considerations involved in to transferring it to your PDA. The files will be huge, and will thus require an external memory card. Older and slower PDAs, or those which can't handle colour, will struggle to present video smoothly. Look into these issues if you are planning to purchase a new PDA.
The popularity of video on handheld devices is bound to receive a boost from Apple (again) as their newest iPods download and display TV shows as well as play music. Help is also available for those of us who want to convert other video to run on PDAs.
For example, there is Lathe, a program which converts digital video on your PC to run on Palm or Pocket PC devices. Palmaddict has a review. Lathe is optimized to use the free TCPMP video player on Palm devices. Unfortunately, the Lathe website does not give up its secrets easily: I found no FAQ or instructions on using Lathe. Kinoma Producer is another commercial program that converts MPEG-4 digital videos to run on handhelds. Kinoma's player is not free like TCPMP but the converter and movie player work well.
Thus the pieces are available to create videos that can be displayed on a handheld computer.
Roll Your Own
Okay, you're ready to create audio or video recordings to display on your Palm. How to make your own podcasts? (Maybe they should be called PalmCasts?) Here are some websites with help for you:
With this material to get me started, I may just do some experimenting with podcasts myself. Oh, and what did my daughter get for Christmas? Why she got an iPod of course. All her friends were using iPods and my old PDAs just didn't look cool enough. Apparently, the music is only part of the equation, the other parts being fashion and peer pressure. Who knew?
Medical "Doc" of the Month
Pedi-Dose is a pediatric medication dosage calculator that also does weight-based advanced life support medication calculations (see image at right), defibrillation energy settings and fluid infusions. No length-based calculation method is provided. It also has a Parkland burn patient fluid replacement calculator that uses a handy pictorial map of the body. You can edit the drug list and dosages if you like. The software is "donation ware": although the author requests no payment, he encourages a charitable donation to the American Heart Association if you use the software program.
One of the nice things about Pedi-Dose is that it was developed by a physician using Orbworks to meet his particular needs for treating pediatric patients, an age group he didn't deal with often enough to be able to remember drug dosages and other critical calculations off the top of his head. This is exactly the sort of niche application that pocket reference computers make possible: customized solutions for a customer base of one. Only, in this case, I think many people will find this particular program quite helpful.
I use PEPID ED and it has similar capabilities to Pedi-Dose but not all collected into one simple menu. I don't see many pediatric patients in my typical daily work either, so I have two choices now. One choice is to use PEPID and Pedi-Dose. Alternatively, I can drill and rehearse looking up the info I would need for a typical resuscitation so I know where to find it in a hurry. Since PEPID ED includes weight-based and length-based calculations for pediatric emergency drugs, I think I will follow the second plan. For those who don't subscribe to PEPID ED, I think Pedi-Dose is a worthwhile addition to your bag of tricks.
And Orbworks is an excellent programming environment for the Palm platform. Recommended.
Read this article from SearchMobileComputing.com about wireless networking at an American health centre. The "unplugged" system allows improved linkages between people on the move and better access to patient data. The downside: security and maintenance issues.
A study reported in JAMA (Clinical Decision Support and Appropriateness of Antimicrobial Prescribing: A Randomized Study, Samore et al., JAMA.2005; 294: 2305-2314) showed how PDAs reduced antibiotic use. In effect they improved physician compliance with medication guidelines. JAMA online is only available to subscribers but you can read an article about the study on the DeseretNews.com site.
Nuts and Bolts
Palm offers online seminars (which are themselves a form of dissemination) about some of their products. In particular, they promote the Palm T|X Handheld as a tool for education. Check out their "webinar" or download the presentation slides and Q&A. In a nutshell, the a student can use wireless networking to get e-mail and file attachments from a school's servers. The large screen on the T|X makes video alot more interesting as well.
Meanwhile, I continue to explore my new Treo 650, and the migration of programs and tools from my old Kyocera is almost complete.
The biggest change is that I have stopped using Time&Chaos as my appointment and phone book manager. After five years, that is no small matter but the new Palm Desktop software is good enough -- in fact it's quite decent as a standalone product for Windows users even if they don't have a Palm PDA. Furthermore, HotSyncing to the handheld is more reliable without another program in the loop. It was not too difficult to import tasks, contact listings and appointments to the Desktop program. Then one HotSync put my life back into my Palm. The look and feel of the appointment and task managers on the handheld are different than previous version but I am gradually getting used to it.
The Treo 650 synchronizes with my e-mail accounts either wirelessly or when I HotSync. Because this PDA comes with Documents To Go I can also look at Microsoft Word or Excel file attachments. Now I routinely load up my mail by HotSync before heading out of the office to the hospital, read the mail on the subway, and post my replies either by using the cellular modem built-in, or by HotSyncing again when I return to the office. It couldn't be much easier than this.
My only concern is the HotSync cable itself. The business end has lots of fiddly little prongs and no cradle to protect them when attaching or detaching the smartphone. The connector also has a button to initiate the HotSync and I often accidentally push it when I only mean to connect or disconnect the cable. Not the best design I ever saw.
Hack of the Month
Longtime readers of the Review know that I liked to check out web sites and e-mail software on my (now defunct) Kyocera smartphone. To avoid paying for cellular air time when experimenting I used Softick PPP to access my PC's Internet connection via the HotSync cable.
My new Treo uses VersaMail to get my e-mail via cellular modem or via the HotSync cable and doesn't even require the Softick PPP program to do this when plugged into my PC. The Blazer web browser is a different matter. It doesn't work with my PC's Internet connection even with the help of Softick PPP. The browser will supposedly work with a Bluetooth adapter in the PC's USB port but I don't have such an adapter. Basically, Blazer wants me to dial up the Internet using the smartphone as a modem. Because this is expensive when just noodling around, I went looking for another option.
One alternative is to install a second browser which is more relaxed about connection protocols. I downloaded the Eudora Internet Suite which is now free but is also discontinued and unsupported by the developer. The Eudora Palm browser works fine with my Treo's wireless Internet service or via the HotSync cable.
Another problem solved and you can't beat the price.
In Times to Come
Next month I will describe more of the changes I implemented on the Treo 650. I have a few ideas about how to employ the Task Manager, Memos, VersaMail, and Documents To Go to help my teaching and clinical work in the Emergency Department.
Until then, Happy New Year to all!
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