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    The Medical Palm Review

    July-August, 2006 (V7N7) - "Sea Change" or "See Change"?

    Lately I am out of sorts and my PDA is out of synch. And, to my surprise, I find that I am using my PDA less than before. What's up with that?

    I got on the scales last week and was startled to note that I had gained a few pounds. It could have something to do with the leftovers from the big party -- there was a lot of excellent pastry in the fridge. But I suspect something both more insidious and more compelling.

    For the last six months I have been working far fewer shifts in the Emergency Department. Instead of ten hours of go-go on my feet, with nary a break for food or rest, I now spend many weekdays at a desk. The hours are better and the stress is less, but I still have the same appetite.

    My PDA was configured to meet the needs of a doctor on the move. Medical references to compensate for lack of time to go to the medical library. Prescribing manuals to replace the heavy blue-bound CPS prescription manual. Calculators and treatment algorithms to replace unavailable consultant staff doctors.

    These days I spend as much time consulting on medical computing issues as I do seeing patients. It's quite a change, and not just on my waistline. My Treo 650 gets most of its workout as a cell phone, its other capabilities are less critical when I am anchored to a desktop PC with broadband Internet access.

    I do make good use of my Palm PDA when I venture forth to meetings or to teach away from my office. I take notes, particularly with Bonsai, my outliner and project manager software. I can consult my schedule, look up a contact's phone number, check my e-mail. All of this is good.

    But my laptop is proving indispensable on the road. I need to compare documents side by side or edit text. It's just too difficult to work with a small screen.

    Two recent developments in the online world have also given me reason to reflect. The first is the proposed citywide WiFi network for Toronto. Will my PDA be able to take advantage of wireless broadband services? The second innovation is Google Calendar. This is the only the latest online tool which lets one delocalize personal data storage. I can carry my work schedule with me or I can use wireless Internet access to check look it up.

    The desktop PC paradigm is also mutating. People can carry their data around on USB data keys. You can run applications from data keys as well. You can bring your preferred desktop layout, Internet bookmarks, and e-mail along. USB keys are evolving to have ever more capabilities, such as the new USB key drives made by U3 (the demo is quite compelling). If you want to bring your preferred operating system on a CD you can do that too, and execute your computing chores anywhere there's a PC with a CD drive.

    If the emphasis shifts from data portability to data accessibility, then the type of mobile computing device I need will evolve also. It's too soon to make any drastic changes; the Toronto WiFi network isn't up and running yet, and Google Calendar is still in beta. But if I put all my core data on a key, isn't that as good as a PDA? Alternatively, is the PDA model of carrying and synchronizing with a PC at home or office the best one? Can I get a mobile system that is continuously synchronized? BackupBuddy.Net will let your Treo 650 synchronize to a data centre via the Internet but this isn't quite the same thing.

    Well, no. What if there is no PC to plug the key into? What if the USB ports are on the back of the PC where I can't reach them without crawling under furniture? My patients would enjoy that spectacle. And I can't use that arrangement on a city bus. What if the wireless network doesn't extend to the building I am in?

    My idea of a cool mobile setup would be a USB key drive that can be plugged into my PC or into my PDA. That way I get a choice of hardware platforms to access the data, depending on where I am and what is available. If the PDA has WiFi, then I get even more ways to share data. I like flexibility and I like the "belt and suspenders" approach: give me more than one way to manage and backup my valuable data, please.

    Change will keep on coming, but my PDA will stay with me, for now. Because the alternatives aren't mature yet. The only other thing I am sure about is that all these proposed new features will make battery life, for PDAs and laptops, even worse than it already is.

    Medical "Doc" of the Month

    The American College of Cardiology offers a heart sounds recognition course. The material consists of a series of MP3 sound files. You can downloadable the files to your MP3 player or PDA. If your Palm didn't come with software to play MP3s, you may be able to download some (see previous issues of the Review).

    Medical Computing

    Telzuit wireless cardiac monitoring systemHolter monitors are so passé, now that Telzuit's new cardiac monitoring system is here. Adhesive pads on the patient's chest connect to a Treo via Bluetooth wireless networking. The Treo in turn uses the cellular telephone network to transmit telemetry to the Telzuit data centre.

    There's no shortage of other innovative ways to use Bluetooth, WiFi, and cellular telephony to track patients and equipment, transmit data, and control systems. The principle obstacle is cost.

    RFID is much cheaper, more compact, and needs less power. It is finding widespread popularity in applications where tracking is more important than telemetry. For example, recently, a hospital in Jena, Germany, piloted the use of RFID to track medication administration to patients. A Google search for "Palm RFID scanner" turned up literally dozens of devices to let your PDA scan RFID tags. Firms such as Grabba, Tek, and Sirit have sled modules or SD card plug-ins for a range of RFID tasks.

    Nuts and Bolts

    There's such a thing as being too mobile. If your hand shakes when taking photos with your Treo, or your arm isn't long enough to frame the shot you want, then you should look at the Cellpod by Joy Innovations. Basically it is a tripod for your camera phone or PDA.

    Recharging PDAs continues to challenge travelers. Several more solar powered recharging devices have recently hit the market. Advantages include: no need for adapters to local power supply systems and low cost of sunlight compared to batteries. Disadvantage: due to the modest size of the converter panels, they take a few hours to recharge a PDA even in bright sunlight. These models all have internal batteries for power storage.

    • Solar Style SC002 rechargerSolarStyle SC002. Has adapters for several Palm models and Garmin GPS devices, among others.
    • Proporta Solar Charger for Mobile Devices. Will recharge a wide range of Palm PDAs.
    • Solio. This is the most expensive option but has an even wider range of adapters (at extra cost) for various devices. Naturally, this is the only one which claims compatibility with my Treo 650.

    Meanwhile, there is no WiFi solution for the Treo 650 so I can only access the web using cellular service. Expensive, and dependent on accessibility of the cellular network. Not the mobile Internet solution I had in mind.

    Hack of the Month

    I used to keep track of work-related expenses using a little expense applet (really just a mini-database) which was a freebie that came with my old Palm PDAs.

    Later, with newer PDAs, I would note expenses in the Memo applet or with a HanDBase database. I could then periodically transfer the info to an Excel spreadsheet on my PC.

    Most recently I have been using Doc2Go because I that way I could add expense info to the spreadsheet on either the PC or the PDA and it would be kept synchronized between automatically.

    Somehow, this week, the PC version became corrupted and I had to delete it and start over. I don't know if this can be laid at the doorstep of the synchronization process or Doc2Go. But it highlights one of the risks when we get fancy.

    I backup regularly but in this case, perhaps too regularly: my backups had also become corrupted without my ever noticing. Sigh.

    I have tried reproducing the problem. It appears to happen when I tinker with cell formats on the Excel spreadsheet on the Windows PC. The PDA copy faithfully preserves the corrupted information and the worksheet becomes useless on that platform also. Cute.

    At the cost of some convenience, it may be safer for me to go back to using the Memo applet again because I can't ensure that this sort of problem won't happen again when Doc2Go synchronizes spreadsheets. Sometimes, less integration means more data integrity.

    In Times to Come

    Well I'm off to grumble about my hardware and software annoyances. While lazing about this summer, I will grouse about the high cost of the accessories needed to make my Treo better. You won't hear from me again until September.

    If you're lucky, I won't share all of my new grumbles with you.

    Until then, dear readers, 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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