| The Medical Palm Review October, 2006 (V7N9) - Smartphones On My Mind Smartphones. Is there anything they can't do? Everywhere you look there's a new one or an accessory or an upgrade. Not to mention that they are also the primary focus of new models from Palm. Are there particular benefits for healthcare workers? Oh yeah. But can a doctor still get by with an older PDA?
ET, Phone Home Smartphones are where it's at these days. The Palm site always features promotions of its Treo line and offers a range of accessories. If you don't have one of your own yet, you may feel tempted to trade up from your current pocket computer. Meanwhile, cell phone manufacturers continue to encroach on the PDA space with smartphone offerings. The Nokia N95 has GPS, multimedia, wireless Internet and a microSD memory card slot. Even Apple is jumping on the bandwagon, with rumors of an iPhone swirling about. The range of accessories and add-ons for smartphones has caught up with cell phones. One can even find articles about smartphone accessories in the New York Times online edition And it's not just the hardware. Most of the new developments in the Palm world revolve around enterprise mail, wireless networking, multimedia downloads - all applications which require a live connection to the world outside your pocket. Palm is hosting some online seminars (webinars) about developing wireless-enabled applications for enterprises. They have been developing tools to use with Microsoft's .NET technology. Smartphones have been proposed as electronic wallets. Another idea: smartphones as passkeys and for log-in authentication at work. Even utility software is gravitating towards wireless telephony and networking. Blue Nomad, makers of the popular BackupBuddy, has introduced BackupBuddy.Net is a new service that lets your Treo backup to an online data repository. Could be pricey but does provide protection. Health care workers on the move potentially benefit in obvious ways from PDAs with WiFi, and cellular telephony. The possible advantages for those who work in hospital environments are also considerable. If your PDA has a built-in wireless telephone, you can look up patient records from a central repository, send/receive pages and make telephone calls without hunting for a nursing station. Home care nurses can use smartphones to consult with hospital-based staff and transmit photos of, say, skin ulcers. Integration of charting software into the PDAs saves time and managing assignments and schedules online reduces travel time. For health care educators, wireless PDAs or smartphones make it easier to transmit files to students and to receive their feedback. U of T med students are starting to use eLog to track their clinical experience during rotations. I think that eLog is cleverly implemented for several reasons. First of all, the concept is ingenious: students can be "in touch" with preceptors remotely, helping to overcome their dispersal to training sites all over the city. Students who already use a PDA and benefit from its features (scheduling, e-mail, task list, etc.) will find eLog a comfortable additional tool. Those who buy a PDA just for eLog, at first, will find it handy to put medical texts on the device, with other benefits to follow. This virtuous circle may broaden the appeal of PDAs within the University of Toronto medical community. Furthermore, eLog doesn't require a particular communications ability on the part of the PDA. If your device "does" wireless, then you can update your file that way. If not, you can update when you drop your Palm into its HotSync cradle attached to your PC. Some rotations even let students update their files using a web page. In other words, the communications or networking capability doesn't have to be integrated into the PDA. The U of T folk who implemented this tried not to make too many assumptions about the capabilities and hardware of their users. This broadens the potential base of users and increases failure tolerance. It also means that medical students with smartphones are not the only ones who can use this system. The key thing about smartphones is the integration with its attendant simplification of some tasks. But this has disadvantages too. Battery life may be a problem. Data backup is even more critical because the data is concentrated in one plastic case instead of two. Data theft can occur by hacking into the device via its wireless communications, not just by stealing the physical hardware. Cost is another problem. Even when purchased with a cell phone service contract, smartphones are rather pricey compared to ordinary cell phones, many of which are free with a two or three year deal. Can you plug your older PDA into a regular cell phone and use the latter as a modem? No problem for many models. Can you use your PC to download a movie onto a smart data card, and plug that into your PDA instead of racking up airtime to transfer the file directly? Widely available already. Is all that a little fiddly - using cables and cradles and software workarounds? You betcha! But it's cheap and it works. Let's face it: smartphones are the wave of the future. But, attractive as the new toys are, users who carry older PDAs and cell phones are not in the Stone Age and can get a few more years of use out of their devices. Unless temptation strikes, there is still some life left in older Palm PDAs after all.
Controlling the Chaos I have some computer responsibilities at my hospital. I maintain our emergency department intranet site. I also look after desktop workstations - make sure they are working properly, follow up on maintenance calls when things break, etc. I have found it handy to keep track of that stuff on my Treo. One day (while on semi-permanent hold with the Help Desk) I used HanDBase to quickly whip up a database with start date, fix date, site, workstation ID tag, problem description and case number. Now I can not only keep track of which problems are still outstanding, but also I can also "data mine" for which machines have repeated service calls, etc. The whole task is made easier by the recent HanDBase upgrade which supports one-hand navigation on the Treo. There is also a plug-in for HanDBase which lets users take photos with the Treo's built-in camera and add those pictures to a database records. Now I can cradle the phone with my shoulder while juggling PC cables under a desk and updating the service note on the Treo. And people wonder why my neck and back seem deformed.  I try to collect service tips, configuration info and useful utilities and save them on the Treo's data card. I can use the Treo like a USB key drive if I have a USB HotSync cable and the Card Export utility program. This lets me transfer files to a PC whenever I need to. I could skip the cable and software if I had the Proporta SD card with built-in USB connector.
Medical "Doc" of the Month These articles are a few years old now but still have worthwhile information about prehospital communications and computing systems. Cady G. 200 city survey. JEMS 2001 annual report on EMS operational & clinical trends in large, urban areas. JEMS 2002; 27: 46–70. Bashford C, Veenema M. Tele-collaboration in EMS communications: new concepts & technology challenge EMS systems to think outside the box for communications. JEMS 2002; 27: 82–86.
Medical Computing The British Medical Journal (BMJ) PDA webpages are a concise, understated, but effective resource. In addition to the downloadable version of the Journal itself, there are links to useful software, other medical resources and PDA titles from BMJ books. Recommended. The Ectopic Brain site seems to have moved and is called ectopicbrain now. Under any name this is an excellent site with links to many useful resources for health care workers who want to boost the utility of their PDAs. Very highly recommended.
Hack of the Month  Are you looking for a backup solution other than BackupBuddy? Freeware like NVBackup or commercial software like BackupMan may be what you are looking for. But don't expect the same feature set as the Blue Nomad product - it didn't become one of the market leading packages for nothing.
In Times to Come November is when the impending end of the year becomes undeniable. Now that I am over fifty, old age is clearly on my agenda too. Believe it or not, I can make a PDA topic out of that. See you (dimly) next month!
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