Palm Personal Digital Assistants in Paeds.org

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• General Paeds
• Generic Skills
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• Not paeds
• PDA

Updated 2 February 2007.

There are medical PDA downloads (free) available at my online file store.

Welcome! This is basically a walk through everything I know about PDA use in medicine, so I hope it will be useful for all those new users who are struggling with information feast/famine.

Bias for this page is clearly towards paediatrics, palm devices, Tungstens and Macs! Sorry! Suggestions and constructive criticism welcome.

If you are an experienced user, you will be aware of the desperate shortage of UK related sites. Please help! I think we should all support PDA Consult, which has discussion groups and file storage for shared resources.

Contents

• Why you need a PDA
• Choosing your PDA
• Get started now! Free paeds stuff.
• Medical applications including patient databases, text books, calculators, journals, guidelines.
• General applications including website and document viewers, organizers, image viewers.
• The best websites for news, reviews, downloads
• For beginners - friendly websites
• Clever stuff - bluetooth, isync, blogging
• Getting help!

Why you need a PDA

Things you can do with a PDA at work

• Keep a list of jobs you need to do for the day
• Plan your career goals!
• Scribble down those nuggets of wisdom you pick up along the way
• Keep all the hospital phone numbers you need to hand
• Keep your logbook
• Keep your rota
• Track your patients
• Drug formulary
• Calculate body surface area, feeds, age in weeks (for plotting growth)
• Protocols
• Up to date journal articles

Choosing your Personal Digital Assistant

I follow Mohammed's basic advice on this. Choose Palm rather than PocketPC type machines because you get more for your money with Palm, and although PocketPCs may be better for the "Power User" I worry that PocketPCs crash more. Having said that, my T3 started crashing regularly in its second year of life, but it was fine before that!

I have chosen the Palm Tunsten T5 - nice big bright screen, pretty slim, bluetooth so it syncs with my mobile phone (see below), I like the drive mode which lets you connect it up to a computer as a removable drive. Shame you don't get the voice recorder, or indeed the ability to flash up the time by pressing the central key...

Loved my T3 - big screen, unique slider which I thought was quite useful, although the t5 is hardly any bigger. Other models around just now - the Life Drive with its massive hard drive and Wifi, great for carrying around tons of documents and music/pics/video but a bit slow, chunky and mind you don't drop it... One of the other Tungstens has Wifi if you really have to have it, else you have to get a plug in attachment. The Zire is a nice looking machine if you want a (not very good) camera and are not too fussed about a big screen (good for reading webpages/magazines, spreadsheets). Always loved the look of the Sony Clie NX73C (RIP).

There are lots of PDAs available on ebay but most are being sent from the US so beware VAT being charged at customs and having a useless power supply (don't stick it in the mains unless it CLEARLY says 240V on the transformer...).

Do get yourself a screen protector and a case. I have tried the Brando screen protector (they ship internationally), which is good but you lose some screen brightness and it's scratchy to write on. Boxwave is smoother to write on. You can always try making your own out of the stuff you use to wrap textbooks...

Get Started Now!

If you want to get started quickly, go to my online collection of palm files. Check out the Read_me file for full details. Here you can download (all for free), among others:

• Abase, an excellent growth chart program, with UK 1990 Freeman data, including all the weird things like interocular distance. Gives you exact standard deviations and draws pretty graphs...
• Critical care journal - evidence based topics (isilo format, see below)
• Children's Hospital Handbook (isilo format, see below)
• APLS handbook (isilo format, see below)
• Green book on immunizations (part)(isilo format, see below)
• Guidelines on asthma, Kawasaki, DKA, pneumonia (isilo format, see below)
• Collections of evidence based topics including Archimedes (isilo format, see below)
• Weight converter and feed calculator (excel files, use Documents to go to read them, see below)
• Cochrane Neonatal Reviews - you can get the latest update by pointing iSilo at the NICHD Cochrane page.

Isilo is a program for viewing webpages and documents with pictures and tables on palm. It costs $17 but is highly recommended because you can make your own documents using the sister application IsiloX, which runs on a desktop computer. Download it now, you can try it for free for a month.

To install - ZIP files are compressed, you have to double click on them to open them up into a folder, then read the README file for more information. The other files can just get installed directly: from Hotsync, choose Install file and then select the file. Then press your hotsync button.

Medical Apps

The classic free medical applications:

• Epocrates is a drug formulary. Potentially you could get your hospital formulary included.
• Medcalc is a medical calculator, you won't use all the formulas but you can create your own custom list, plus there is background information on all the formulas. Archimedes from Skyscape is in colour but is less convenient to use and not free.
• Patient tracker is a patient database, but it's very American and not very easy to use. You can buy an add-on desktop program to synchronise information. Wardwatch ($19) and patientkeeper personal ($34) have been suggested as alternatives. You could also make your own using a database program (see below).
• Eponyms for a great list of all those eponymous syndromes and signs.
• Royal Children's hospital, Melbourne guidelines - Isilo format, massive 11Mb!
• ECG guide, not paeds specific.
• There are a couple of free neonatal resources, including nutrition and growth calculators. You can get US nutrient data on foods.

Right, I know lots of you are dying to get your hands on the BNF or Royal College Medicines for Children. There used to be a version of the BNF available for free, but they got uppity about people using it and have blocked attempts to download their online site. So you now have to buy the official version on SD card for a considerable sum of cash. Medicines for Children is supposed to be coming out in an official version but we're still waiting. In the meantime, you can use my cut down version (see my online file store, link at top of the page). There is a cheap Australian formulary ($10 covers you up to 2008, free trial) which looks pretty good. APLS guidelines are available for about £30 from the BMJ bookshop.

Kidnorms from calculates normal values for ecg/development etc ($17), Kidometer does more for the same price, and you get a 30 day trial period. There does not appear to be a UK version at present.

CogniQ is a subscriptions service where you can request journal abstracts, full text articles and do medline/Best evidence searches (not for Mac). Similarly, Inforetriever is a subscription service which scans over a 100 journals (but NOT Archives of Disease in Childhood) and supplies you with the evidence based POEMs. Nice idea, but costs $249 a year. You can try the trial if you have the necessary 35 Mb of card memory.

MD on Tap allows you to do actual MEDLINE searches wirelessly if you have a Palm with a wireless connection for free.

Shots 2005 - latest immunization information (but US) for adults, children and missed doses.

You can get a selection of abstracts and full text articles from Pediatrics each month. Need to register, but free. MDConsult has a free PDA service including journal articles, medical calculators and drug information but you need to have a MDConsult password (usually available through your trust via Athens, see Literature, and a Windows PC.

Evidence-based medicine guidelines is a Finnish commercial product giving over 900 guidelines, based on Cochrane. MeSH searching and photos are neat. Needs 64Mb card. "Regular" updates available, whatever that means. Cost 99 euros.

Clinical Evidence - has child health section, selection of topics with option to add responses. £33 for pda version, with 12 months of updates. Free trial.

Skyscape's 5 min ped consult: good for general, but expensive ($69). Similarly Pocket Medicine's Treatment Strategy for peds: excellent. ($50)

Pedisuite ($45) is an American drug/fluid/growth calculator.

Clinical Medicine Consult is an Isilo format textbook by subscription (ie regularly updated), paeds as well as other specialties. Demo available.

Physik's Lists ($15) is a database of 1000 cards arranged into 13 categories eg eponyms, basic science, not paeds specific. Editable, because it uses List, a notecard program. Simple, searchable.

PocketConsult from Elsevier offers a range of PDA "channels" which include Alerts from MD consult, Elsevier Health Journals, Journal abstracts from MEDLINE. The application on your PDA includes a search form: after synchronizing, your search is ready to run on the Elsevier website. Certain Elsevier web sites allow you to save content directly to your PDA. Windows only, unfortunately.

Similarly, Skyscape's Artbeat offers CDC updates, Medline for free, plus some other services on a fee basis eg InfoPOEMS. Windows only.

Pubmed offers a Medline service optimized for mobile internet enabled devices.

General Apps

Date Books

General points first - read Covey's Seven Habits of Highly Effective Individuals to learn a bit more about time management. If you're really serious, look at this really indepth look at using Palms for productivity.

There are a couple of excellent alternatives to the built in date book. I recommend Datebk5. Costs $25 (profits to Gorilla haven!), but you can use it with reduced functions for free. It allows you to add colours, fonts, icons and alarms to entries. You can have a split screen view with addresses at the top, combined to do items and appointments below. You can also create Entry templates for common events. The same basic databases are used so the normal conduits are used to back up and synchronize.

Agendus is another integrated date book, to do, and address application. It also costs $25. It lets you add icons, colours, alarms to entries, plus it lets you link direct to address information for a particular datebook entry. Addresses are tabbed, and can be viewed by email, phone or address. Create new item button lets you choose between new memo, address, to do etc. Uses basic palm databases so syncs as normal. You can even choose a background photo from memory stick.

Databases

J file ($24) and Handbase (handbase.com, $29), customisable, sync with Access. I've been using the trial version of J file, it works well and because I only have 1 database so far I don't have to pay anything for it. It's in colour, you can see and edit all patients on 1 screen or open all the details on one patient. You can sort patients by ward and customize popup lists. But you can't link Todo items. Pendragon database has been recommended,but costs $120! (free web browser).

List (free) is a simple notecard program, with 2 customizable fields and a space for the main note.

Email

This will depend on whether you have a smartphone or not, and what you use for email on your desktop. There is an Apple Mail conduit available on Version Tracker, for Tiger only. For Panther a suggestion is to use MacNoteTaker and some scripts from osaxen.com

VersaMail ($30 or preinstalled from Palm) can do wireless or hotsync (not on Mac).

Agendus Mail ($20) does wireless or through Hotsync. Supports attachments and HTML. No mac version.

SnapperMail, Aileron, Mark/Space Mail, MailToGo, InBox to Go (windows) are for wireless devices, or palm plus bluetooth phone.

Gopher king is a subscription service ($39.95 a year) for consolidating all of your email accounts. You need a wireless device.

OneMail runs on PC only, free version available.

Eudora Internet Suite does wireless or hotsync, includes both a simple web browser and email client. There is a free version and a $20 version. Mac version does not currently support hotsync.

Beyond Contacts does Outlook synchronization incl email. Windows, obviously.

Mail+ (Mail Plus) 1.5.1 by NetOrion is a very old program, does not work well on OS5.

Attach to Hand Mail by TLA Software is another old program, needs the old Palm Mail conduit not found on Tungstens. Transfer by HotSync. Windows only.

InstantEmail is another old program that works wirelessly or by HotSync, but I don't know how exactly - windows only.

Website Viewers

I have tried browsing the internet via my bluetooth phone and a dial-up account. Virgin doesn't support GPRS which may be faster. There are a few websites that are optimised for palm devices eg:

• Google - http://www.google.com/palm
• Flickr - m.flickr.com
• Google maps - google.com/gmm
• Wapedia - en.wapedia.mobi
• h2g2 - www.bbc.co.uk/dna/h2g2/pda
• Yellow pages - mobile.yell.com/uk

Otherwise there are sites that will optimize other sites for you: phonifier.com, skweeze.net.

Mostly I transfer web content from my desktop to my palm so I can browse at leisure without paying mobile rates. Web content is nicer than using text documents because you can have a document with clickable links, which is compatible with desktops, palms and pocket PCs.

Repligo will put a button in Internet Explorer that will trigger conversion. It can also display pdf, Word docs, excel and powerpoint files. You just choose Repligo from print menu to convert. Supports 480x320 screen, bookmarks, allows zooming in to see graphics and tables, else easy view and landscape format. Copies to clipboard. No Mac desktop, and I hear it struggles with big pages ($29, viewer is free).

Avantgo - can find, show images, different fonts. But can't do Frames, not Mac OSX unless downgrade, and the only editing is copy whole page to memo.

iSilo - can find, show images, different fonts, colours, plus tables, stylesheets. IsiloX is the desktop version - Mac OSX compatible. $17, so cheaper than repligo but not quite as flexible. Lots of isilo resources out there eg neonatal cochrane reviews (see above).

Sunrise is an open source (free) program that can also read RSS news feeds. Pluckr is another open source program, says it can do RSS and PDF too.

If it's RSS news feeds you're after, Feedblendr is a website where you can mix RSS feeds and get just one feed, in a RSS, web or special mobile format (free). Oherwise Newsmac lets you select feeds for export to Palm (but not images).

Document Viewers

Documents to Go comes free with lots of Palms although there's usually a more up to date version, and is a way of working with Word, Excel and Powerpoint files then sending them back to your desktop computer. You can use to edit the actual Word/etc files on the palm, or convert to and from a special palm format. With the latest version you can view PDF files. It crashes regularly in my experience.

Handstory is a document and ebook reader, which also lets you clip bits of webpages ($)- basic (free) version is text only, so not great for viewing webpages. Tealdoc is a document reader but also converts html $16. Qvadis express reader ($26, converts html to palm doc). Wordsmith ($30) syncs with microsoft Word only, on PCs only. Fastwriter edits word docs, html ($30). Quickoffice does Word, Excel, Powerpoint ($40, PC only).

Quick mention of Acrobat Reader for palm: it's free, does full sizable graphics, font styles, find, bookmarks. But there's no editing, only copying. REALLY slow page loading, and often crashes. To read PDFs (which are usually big files, so make sure you have enough memory) try Documents to Go (see above), Repligo or PalmPDF (free).

Others

Q Pocket is a great little addition for memopad - it searches all your memos as you type (free).

Wikipad is a way of having lots of different notes that can be linked together via keywords, easily created by putting 2 capitals in one word (free). Notestudio is a hardcore wiki program with desktop and a palm version ($50) - you need the Missing Sync unfortunately.

Shadowplan is a deceptively simple database program, where you create nested lists, but can then link them to your Todo or Memo program, set target dates, checkboxes, filter. With a bit of practice you can organize things much better because you don't have to jump backwards and forwards between different applications. Costs £10 for the handheld version only, plus £5-10 for the extra desktop (Mac or PC) version.

Bonsai is along similar lines, but uses colours and icons. Only has a PC desktop version ($16, plus another $20 if you want the desktop version).

Powerguard - Back up precious data to memory card. You can back up data Manually, Daily, On Power Off.

DA launcher is for launching little utility programs eg clock, backlight, graffiti reference guide, word count.

I use Penpencol for doing diagrams,because you can draw a picture bigger than the screen, plus it's hi-res and free! Also recommended are tealnote, guineabrain.

You can get Palm OS emulator, eg for demonstrating PDA uses on a desktop.

Certain files cannot be beamed, but Beambox program may allow.

For transferring images from a Mac you need the Missing Sync or Splashphoto. AcidImage ($18) works simply by transferring JPEGs over by Hotsync. Documents to Go (see above) has a picture viewer but quality is very poor. Graphic converter can export images as pdb files for image viewer.

For putting video on your palm, there's Kinoma player 3ex. Plays back mp4 video as well as mp3s and iTunes AAC files. You can use Kinoma producer to convert videos on your desktop, or ffmpegx (for mac). Video settings: format is mp4 ffmpeg, bitrate is 174, width is 480, height 272, frame rate 12. Audio settings are AAC, 64 kbits/s. Crop 48 off top and bottom (preview button lets you check your cropping). You need a 256Mb card to hold a whole film. MMplayer lets you watch .avi files but it's still beta and the sound is terrible.

Presenter-to-go enables you to do powerpoint presentations using just your PDA! Expensive though. QuickOfficePro can let you view Powerpoint ($49), as can Documents to Go.

Metro is a free guide to city public transport networks in different parts of the world including the London Underground and Nightbus service!

Textplus ($19) autosuggests words as you graffiti or type. Demo.

The Most Useful Sites

The ideal site, in my opinion, would offer good reviews of different applications, discussion groups for getting help, would be searchable, and would let you know when it changed (by email ideally).

PDAMD.com for medical software, discussions. Handango and Palmgear for huge range of software, commercial and other. There are often special deals on, especially if you sign up for email newsletters. Check out the Synchronized magazine. UK based discussions at PDA Consult.

Pbrain for great reviews of palm medical software, including docs and isilo files. Version Tracker for palm (and PC/Mac) software, but specifically for the most recent updates. Journal to Go (free) specialty journal abstracts. Mac OS9 only. Memoware for ebooks, databases, assorted materials. Download.com for comprehensive software source, searchable and with reviews (also for PC/Mac). Clie and Mac site, if your French is up to it...

There are a number of medical textbooks available in PDA format, if you don't mind paying for them. Some of them allow you to print pages off. APLS guidelines are available, as is the Oxford Handbook of Clinical medicine.

Introductory Sites

• healthypalmpilot.com is a refreshingly uncluttered site which besides introductory tutorials groups together different medical apps into databases, etc and has reviews. You can search and sign up for email updates. You are also invited to share your own stuff.
• newmediamedicine.com has a small collection of good articles and a (quiet) discussion forum. The site doesn't seem to get updated often. The site also focuses on e-learning.
• meistermed.com is a badly designed commercial site, but does have a useful collection of isilo files listed by specialty. Nice powerpoint presentation on how to make your own hyperlinked documents just using Word.
• medicalpocketpc has good articles on PDAs in medicine, but is obviously a Pocket PC dedicated site.
• Pediatrics on hand- Non-profit, has up to date news, also Parent and Nurse sections. Good reviews. Done by subspecialty. US based.
• Others - medicalapproaches.com for a free medical (adult) textbook aimed at juniors, pdacortex.com has reviews, links to free and commercial downloads.

Clever Stuff

Bluetooth

You can hotsync without using the cradle, but it's slower, and you still have to near the computer. But if you have just one file you want to send, you can use a file transfer utility to zap it over without having to do a whole hotsync. Even more excitingly, you can use a bluetooth mobile phone to connect to the internet (I use a Sony Ericsson T610, but most of the bluetooth phones should work). You can also connect to the internet via a desktop connection, but obviously you need to be within range (7-100m depending on your adapter), so good if someone else is using the computer or you want to lounge on the sofa.

I'm using a Belkin USB bluetooth adapter. Make sure you have the latest bluetooth software from Apple (currently v1.33). Plug it in, and run the bluetooth setup assistant utility. Make bluetooth discoverable on your palm (click on the bluetooth symbol in the toolbar), then launch system preferences on your mac. Click on Bluetooth, then under the Devices tab, create a new pairing. Hopefully your mac and palm can find each other.

Hotsync

To do this, you open preferences on your palm, choose connection, then create a new one. Call it "bluetooth sync" or something, choose Connect to PC, Via Bluetooth, then select device. You should see your mac if you've set it up correctly.

Now launch the hotsync application from your palm. Under the hotsync symbol, you can now choose Bluetooth sync which you have created. Make sure you that Local is highlighted above the symbol, and in LANsync prefs you have selected LANsync (not sure this is important).

Back to your Mac. Open Palm Desktop, then choose Hotsync Settings. Under Connection Settings tab, you should see an option "bluetooth-pda-sync". Highlight it, then under settings, choose Null Modem 115200. Now go tick the box, and make sure hotsync is enable.

Now you can click the hotsync symbol to start the hotsync.

Internet sharing

Download technohappymeal's scripts. Install them in your Library.

To set up, disable hotsync in Palm desktop, and uncheck the box next to bluetooth pda sync in the connection settings tab.

Run the share airport/ethernet script as appropriate. You will be asked for your password, but otherwise nothing else should happen! Then open system preferences, choose sharing, then under the internet tab, press Start.

On your palm, open preferences and choose Network. Create a new service, call it Mac bluetooth or something, leave the username and password blank, choose the bluetooth sync connection you set up above from the drop down menu. In the details, choose PPP, uncheck the Query DNS box, and enter the primary DNS address as 192.168.0.1. Leave the secondary DNS blank, and check the automatic IP address box. In the Script page here, choose End.

Now when you press Connect you should get a "Signing on" message.

Now you can surf using Webpro or similar! Thanks to Clie and Co's tutorial, Geekzone Guide and the help pages at technohappymeal.com.

File transfer

You can exchange files with other bluetooth PDAs faster than by infrared; just choose Send instead of Beam. Or for transfering files to/from a desktop, Apple's bluetooth software includes a file transfer app which is simple and works well. In OSX 10.3, you get a option to send to bluetooth device from the Finder: look in File - Services. Even better, there is Drag'n'tooth, shareware $10, where you can drag files on to the dock icon to transfer them (even more than 1 file at a time), you can select which device you want from the dock menu, and you can even send text direct to Memopad (haven't managed to get this to work yet).

iSync

I use iSync to synchronize addresses, tasks and appointments across my Mac, palm, mobile phone and ipod (well, you never know...). You need to install both isync plus the isync conduit for palm destop (from Apple). You start up Isync, select your device, choose Sync now then immediately press the hotsync button on the cradle while isync is running. After the first sync, Isync will work automatically during a normal sync. Unfortunately, iCal does not recognize new categories created in your Palm Calendar application. This will hopefully be resolved in future updates.

Blogging

Mobilog is an open source way of blogging from your PDA, including photos. You need to have email capabilities on your PDA and appropriate server abilities.

Getting help

Use one of the links that has a discussion forum if it's a medical related issue. For general PDA stuff:

• Palmone Tungsten T3 site - tips, user stories, forum. Also Mac user area.
• Tungsten tips
• Palm UK site
• Palm newsletter archive
• Rob's Mac/Palm pages - links to useful software. Limited but up to date.
• Expansys have a T3 forum