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    The Medical Palm Review

    February, 2006 (V7N2) - (Con)Verging on the Ridiculous

    Can your PDA do everything? I mean, absolutely everything? If so, your worries may just be starting....

    All Singing, All Dancing

    At dinner one day this week, my friend's teenage son showed me his new Sony PSP2 game device. At twelve ounces it was the size of an older model cell phone. He uses it to watch movies, or play a video game while listening to MP3 music files. He proudly pointed out the built-in wireless networking and web browser software. But he conceded that, even without a cell phone, battery life is shorter than the length of some of the movies he tries to watch.

    Convergence is the term computer gurus use when they talk about making one device that meets all your mobile computing, communication and entertainment needs. What a great idea: one gizmo that fits in your pocket and functions as a cell phone, pocket computer, digital camera, music player and video game box.

    The Sony PSP2 is a good example of another aspect of convergence: there is more than one path that leads to a given point. The features of this game machine resemble those of the Palm T|X which is primarily a PDA.

    Convergence replaced the older buzzword/concept of interoperability a few years ago. Interoperability was supposed to be about having your various gadgets communicate with each other so they could share data and collectively provide capabilities which were beyond each device individually. We can still see vestiges of interoperability in today's electronic devices. For example, many laptop PCs have Bluetooth adapters to access the Internet with the help of a Bluetooth-enabled cell phone or slots for sharing memory cards with a digital camera. This is a useful idea because if your laptop battery quits, you can still make calls with the cell phone.

    However the hot trend now is to jam as much capability into one device as possible. Inevitably, this results in compromises. Battery life is the biggest casualty. Only a few years ago a monochrome-screen Palm device would run a few weeks on a brace of triple-A batteries. Wireless communications and colour screens have taken their toll on that. And the screen size grows or shrinks depending on whether the vendor wants to position as a PDA or as a portable television. The fluctuation in size and weight from one model to another sometimes results in considerable violence to the idea of "pocket computing" - and some damage to pocket fabric as well.

    And convergence has not really sunk in with content and service providers either. There is a standard music file format (MP3) for portable and desktop computers. But (so far) video CDs and DVDs are not offered in a format that can be copied directly to your PDA.

    Microsoft Office documents need little handling to run on PocketPC computers but that is not true for Palm devices. Synchronizing between desktop PC and PDA does force some formating and structure modification. Even PC documents designed for multiple platforms, such as Adobe PDF, need to be manipulated to run on mobile devices. If sharing such files is important to you, you may need to invest in additional software to make it all work. And as "standards" evolve you may need to invest in such software more than once.

    The other problem with having every conceivable function loaded onto one mobile device is that if (when) it fails your inconvenience is proportionately greater. When my Kyocera smart phone died I had to cope with losing my cell phone, my pocket medical references, my MP3 player and my daytimer.

    Since I have a few old PDAs around the office, you would think that I could bounce back quickly but it's not that simple. I was able to transfer the daytimer data fairly easily by synchronizing with the Palm Desktop software on my PC but some other programs that run on the Kyocera (colour, 16 Mb RAM) wouldn't play nicely on the older Handera HE330 (monochrome screen, 8 Mb RAM) that I brought out of retirement. Some programs were too big to fit. Others needed a newer version of the operating system or a colour screen. And the medical references are licensed to my PDA with a specific HotSync ID. Changing over required a few phone calls or e-mails to the various vendors.

    In future, I could solve the comparability problem by purchasing my new PDAs two at a time (ensuring that they have similar features) and then configuring them with the same HotSync ID - assuming I want to spend the extra money.

    The bottom line is that for reliability, you need to make sure you have paid attention to a principle even older than convergence and interoperability. That concept is called redundancy.

    Lost in Translation

    Do you want to squeeze the maximum out of your sophisticated gadget? These programs will help you share documents or files with your PC, and enjoy music and video too.

    • Plain text PC documents can be synchronized with Palm Memos. File Link is not a separate program, but rather a function of the Palm Desktop software. File Link also allows you to synchronize contact info, appointments and ToDo lists between multiple PDAs. Unfortunately, File Link does not work with the Treo 650 and a few other models. Check the Palm Knowledge Base for a information and a list of excluded devices.
    • Web pages can be converted to Palm format documents with AvantGo, Plucker or iSiloX. I generally prefer this option to using a web browser because the converters do a better job of rendering big-screen web sites for the itty bitty Palm screen. Of course browsers are better for real-time access.
    • Microsoft Office is the standard for word processing, spreadsheets, and presentation software for desktop PCs. Getting Office files onto your Palm and keeping them synchronized between PC and Palm PDA is a snap with Documents to Go or QuickOffice Premier Both allow users great flexibility in using these basic software tools. They even offer spelling checkers now. Even my "ancient" HE330 can use an older edition of QuickWord to share documents with my Windows PC.
    • Adobe PDF files can be read on your Palm with the help of the free converter and reader software from Adobe. PDF formating and style are preserved as much as possible (bearing in mind the smaller screen) but the trade off is that documents load and scroll rather slowly. Documents to Go version 8 also supports reading PDF files.
    • Microsoft Access database files on a PC are readily shared with Palm PDAs. The tools to convert between Access and Mobiledb, JFile, or HanDBase are included with these programs and any of them may meet your needs unless you need to integrate the data table into a relational database structure or an external document. There are other Access conversion programs available along with programming tools and strategies discussed at websites such as File_Save_As and AppForge.
    • Music and audio conversion and players were extensively covered in the January 2006 issue of the Review.
    • TealMovie screenshotVideo can be played on your PDA but it must be encoded to the right size to fit the screen of your PDA. Although this shrinks the file size relative to the original PC MPEG file or DVD, you will definitely need an external memory storage card for the very large data files involved. There are many choices. Last year MobileTechReview took a good look at three of the best known commercial players and their conversion capabilities. They gave high marks to Kinoma and MMPlayer. The reviewer was less impressed with TealMovie but it has been updated extensively since then. Other commercial packages include SmartMovie, Roxio PhotoSuite Mobile, and DVD Studio. Some late model Sony Cliés have built-in video player software and will also run third-party software. Last, but definitely not least is TCPMP, a free media player which does an excellent job on audio and video material. The TCPMP site has links to info about video file conversion for your PDA.
    • Games designed for PC, Atari, NES and other platforms can be run on your PDA if you load an emulator first. PDArcade has emulator modules for a wide range of game machines and software. I seem to recall that there was some legal controversy over some PDA game emulators in the past so you should verify that this will not break copyright laws where you reside.

    The ability to take your PC data on the road without the PC is very liberating. Theoretically, you can replace your heavy laptop with a gizmo that fits in your pocket. Just remember the tradeoffs: screen size, keyboard comfort, battery life, prolonged HotSync times.

    Medical "Doc" of the Month

    Well, I wanted to tell you about the daER problem-based medical charting system. Apparently, it is designed for use in the Emergency Department or clinic setting and received positive comments in a recent conversation with some of my American colleagues. Regrettably, the daER website offers little information. To access the online demonstration, you have to log in, for which you need a customer ID. And you can't get that unless you have purchased a system. But there is a cryptic message explaining that they are not currently setting up any new accounts. This is a particularly lame way to build a web site. Well, enough grousing - on to other matters for which information is not so closely guarded.

    The Royal Children's Hospital in Melbourne, Australia has an array of clinical guidelines available at their web site. These are quite good although there is no indication if they are evidence-based or peer reviewed. The CPGs are organized alphabetically without a table of contents or index, making them harder to use. At least there is a search tool on the web site. There is a downloadable version in iSilo format for PDAs. Astoundingly, they failed to include many of the guidelines in the PDA version - anything in Microsoft Word or PDF is supplied only as a link to the Internet document. This might be adequate for a PDA with a wireless connection and the necessary reader program (e.g.. Documents To Go), but it seriously cripples the guidelines for the rest of us. Oops, I'm grousing again.

    These products and web sites may work well in specific contexts or for certain groups of clients, but they are not really designed for the wider world to discover. Maybe that will improve.

    Medical Computing

    Kingston General Hospital in Ontario has begun using a wireless network for medical records, Internet access, and patient care. Recently they added the ability to remotely reprogram IV pumps. This will be much faster and less labour-intensive than hunting down each device and reprogramming it manually. KGH plans to expand the role of the wireless network to encompass other patient care roles.

    The Healthcare Information and Management Systems Society (HIMSS) is holding its sixth annual conference in San Diego in February. This is a big shindig for people who buy, sell and use computer technology in health care. There will be about one thousand exhibitors and six days of talks, workshops and panel discussions. Mobile applications, wireless networking, web-based solutions - all these buzzwords and more will be covered.

    Hack of the Month

    Card Directories screenshotCard Directories is a free program that helps you HotSync files to an external memory card even if they don't have a link to a Palm program. Otherwise they tend not to copy when you HotSync or connect with Bluetooth. This is handy for game emulations, movies and music files, among others. It's also handy if you use the memory card as a sort of portable data drive to share files with other devices and want to copy data files when you HotSync.

    Another way to to accomplish the same objective is to use an external card reader. Plug this device into your PC and any memory card functions as an external hard drive. Then you can copy files to or from the card before reinserting it into your PDA. You can create folders and copy files wherever you choose. This solves the HotSync integration problem and is also alot faster for big files (e.g.. movies) than HotSync.

    And yet another way is to use the Card Export program and your PDA's HotSync cable. I reviewed Card Export in the December 2005 issue of the Review.

    Nuts and Bolts

    Still getting my Treo 650 ramped up. Within a month I had converted from my contact and appointment management software (Time&Chaos) and got all my medical applications set up. Since then I have been slowly reorganizing other aspects of the way I work.

    Mostly this consisted of checking online for updates of the utilities and small programs I used on the now-defunct Kyocera. For example, BigClock was my alarm clock and timer but the Treo has a built-in alarm clock that seems adequate so far. BackupBuddy has been seemingly working normally but when I checked the HotSync log file I discovered that my configuration data files were not being saved because the software was registered to a different user ID (the Kyocera). That could have been serious.

    The HotSync cable ends in a fiddly connector instead of a bulky supporting cradle. This is lighter to carry around but turns out to not fit well. If you don't mate it precisely with the Treo then the connection is not reliable. And all the metal contacts are sitting in the open looking rather fragile. More than once while struggling to connect or disconnect the thing I accidentally pressed on the button that starts a HotSync.

    There is no Expense applet in the Treo 650 PDA so I whipped up a small spreadsheet and added it to the list of files that Documents to Go synchronizes with the desktop PC. This is just as easy to use and will come in handy.

    I tried using the built-in Bluetooth wireless protocol so that a friend could send me a Java file from his laptop. The copy appeared to have succeeded but when I checked later the file was nowhere to be found. It probably didn't work because the file was an unrecognized type (ie. not associated with a Palm application running on my PDA). Perhaps I could have avoided that problem if I had used Card Directories (described above). Something to test next month.

    The built-in snapshot camera (640 X 320 pixels) with digital zoom is turning out to be handy for taking snapshots of an ECG for later reference or teaching. Resolution is not good enough for photographing rashes but could be used to record the state of someone's cellulitic leg, for comparison on a follow-up visit. Currently my hospital patient record system has no mechanism for incorporating such photos so I have made little use of this capability.

    Targus PA870 folding keyboardThe Treo's tiny keyboard has turned out to be surprisingly effective for entering short notes or appointment information. However, a proper keyboard is crucial to typing up large documents. It sure would lighten my luggage to use the Treo instead of a laptop on road trips - even more so now that I have Documents To Go and USB key drive software. I have two folding keyboards for Palm PDAs. One is an old Palm Portable Keyboard that plugs into the HotSync slot of older model Palm and Handera PDAs. The other is the Targus PA870 Universal Wireless Keyboard. It turns out that neither is compatible with the Treo 650. Even MidWest PCB Designs hasn't gotten around to making a suitable adapter yet.

    If I couldn't use the Treo for text entry that didn't mean I had no other options. I tried my old Handera HE330 with the Palm Portable keyboard and QuickOffice software to improvise a portable word processor. The extra weight of the second PDA is trivial next to the heft of my eight pound luggable laptop PC with power adapter and extra battery. In fact I took the HE330 and keyboard with me to a three day seminar and found that its triple-A cells easily lasted for the whole time. When I returned home I HotSynced and opened Microsoft Word to retrieve my notes. It all worked well and the data files could be copied to external memory cards for safekeeping too.

    Other benefits accrue. Since the HE330 shares the Palm Desktop manager with my Treo 650, I can keep my appointment and contact information on both devices in case one fails. And, in a pinch, I can use the Treo's thumb keyboard for text entry. Both devices use SD cards for external memory, and the HE330 also uses Compact Flash cards. With backup software, I can make copies of notes and texts onto memory cards, and store the cards elsewhere for safety. Once again, redundancy comes to the rescue.

    In Times to Come

    I'm off to San Diego for the HIMSS meeting (see Medical Computing section). I plan to leave my laptop at home. Instead I will use a PDA and an external keyboard for working with documents, spreadsheets, databases presentation software and e-mail. Can I really squeeze a mobile office into such a small package? I will report back next month. If everything works and the lights stay on I may even have something to say about trends in health care automation and informatics.

    Until March, 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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