PDA Resources

These resources are provided courtesy of Gary Greenberg, MD, and the ACOEM Medical Informatics Section.

Dr. Greenberg's Disclaimer:

1. I have almost no knowledge about Windows CE / Portable PC devices. This website will ignore them. As an early adopter for this technology, I was deeply committed to PalmOS resources l-o-n-g before Windows hit the street. Guess I haven't round any reason to switch. I am VERY gratified that Duke Med students graduating in 2009 just got PalmOS devices... otherwise, I'd have nobody local to share with!
2. I am not (never been) paid or supported by any of the manufacturers, distributors, vendors, developers or programmers for these products. I have been invited to use free (beta) versions of several programs listed below, but I consider myself a reviewer, rather than an endorser, and there are several I haven't listed when I found the program deficient. I have been invited to serve on ePocrates (unpaid!) "advocates" group. It means I get the spiffiest version for free and early.

Purchase Options

If you don't yet own a Palm device, the choices can be overwhelming (but much less than it used to be!).

There used to be many manufacturers of PalmOS devices, but now there's just a few. In fact, Palm makes all the "pure" PDA ones, and Garmin combines them with a UPS, and Treo makes combination phones (used to be HandSpring).

For the ones that are comingled with a cell phone (Treo) here's a comparison table.

For historical value, here's the list of vintage Palm devices, and their features. I recommend looking at a few different discount online hardware vendors, showing prices and feature-lists:

Buy.com, Outpost.com, Amazon.com, MobilePlanet, BuynShop

My favorite shopping site is Froogle (yes a clever pun and mis-spelling). This is a Google-powered shopping engine and price aggregator. A powerful search for all PalmOS PDAs between $50 - $500 is here, and includes used, rebuilt and orphaned models.

Many prices are indexed at PriceWatch.com but you won't find a word of description.

Similarly, BizRate is an index of prices from various online vendors.

Notes:

• Each 2MB of flexible memory stores approximately 6,000 addresses, years of appointments, 1,500 to-do items, 1,500 memos, 400 messages. There's almost no possibility that you'll run out of RAM with these sorts of data.

• RAM capabilities will be used up by applications (special programs) MUCH faster than by simply storing data like appointments, memos and addresses.

• Sharing a cradle or cable with your companions is smart. This is the least compatible of Palms' features. Various Tungsten's use different model cables and cradles. You can't even find this information on the website, and need to carefully examine the PHOTO of the device's undersurface. It's like determining the sex of kittens.

• When choosing a Palm device, your choice of RAM expansion cards is another aspect of potential incompatibility with your partners' or with current equipment. Palm most recently uses SD cards, and having an external reader for these data devices is very handy for data backup and for installing L-A-R-G-E files, direct to the card. These are very low cost, eg a reader for every kind of card I ever heard of is $11, here.

Contents of Gary Greenberg's Palm

Well, it's actually a Tungsten E, replacing a Tungsten C, which was provided to me by DUHS (for WiFi use and testing) to replace my own and again Tungsten E, which replaced a Palm m515, replacing my HandEra 330, replacing a TRGPro, which replaced a Palm IIIxe, which replaced a Palm III, which followed a Palm 500 equipped with a pager-card, which replaced a Palm 100. Looks from my accumulated calendar data that I became a Palm-guy in September 1996.

Alphabetical order, each title links to download or order site

Non-software Purchases

• Grip-It strips to prevent slipping catastrophe

• Many, many cases are available, including all the followingvariables:
  • Belt clip or not
  • Notebook attached or not
  • Sideways or vertical
  • Leather or padded foam neoprene or metal or fabric
  • Device strapped in or velcro-attached
  • Open top or side or all around
  • Flip open or zipper or clasp or whatever
  I once lost my Pilot (for a week) when the removeable clip came off my case, leaving me just the clip on my belt
  I've used the Palm.Com belt-clip one made of leather, and then used The Pouch. For my most recent Palms, I've used Slipper Tungsten E, and have had no accidental clip releases (but have twice purchased replacement spring-loaded-locking clips).

• Screen covers are apparently controversial. I have ceased using them when I realized that I rarely cause even minor scratches, in the ~2 years that I use a Palm. I believe that it's better to use those withOUT adhesive. Others endorse carefully trimmed sheets of "overhead" projector acrylic sheets. NuShield s advertise sophisticated polymer chemistry protection.

• Scotchtape works great over the "Graffitti" area, especially with temporary adhesive can be replaced easily, offers better feel for writing Grafitti. Look for BLUE box, called #811. This is not a good idea for the new Palms with a collapsing "virtual" Grafitti area.

• External Keyboards are convenient for extensive note-taking, eg long meetings, educational conferences
  • Collapsible Keyboard ($100)
  • Fellowes Keyboard
  • GoType Keyboard ($70)
  • Micro Innovations Wireless ($100)
  • PalmOne's own keyboard ($70)

Web information
too many great sites to count!

Dr. Greenberg's Recommendations:

Definitive site for software, including purchase, download, upgrade, you-name-it.: Palm Gear HQ

Great informal narrative resources by/for doctors:

• Jim Thompson's site (a generous enthusiast)

• Peripheral Brain (a Family Medicine Resident's hand-created site)

• U-Wisc Handheld Computers in Family Medicine
  • Terrific resource with carefully compiled lists and reviews of essential programs, other sites, and resources

• Healthy PalmPilot hundreds of databases, resources, external links, program reviews.

• PDA Healthcare Portal Instructive, and a bit stiff. Includes aggregate reviews of many programs and resources.

• PDAMD (a commercial site)

• HandheldMed (another commercial site)

• Medical Piloteer Webring, Links to many medical sites

• Graffitti Tricks make Palm use easier

• My own authored / compiled resources:
  US Mortality Tables (text)

• PDAs for HEALTHCARE PROVIDERS

• Informatics Review

• Tutorial to Palm Tips & Tricks, including downloading and installing new software

Maillists / Communities

Most of the commercial sites want you to stay and chat

PDAMD 's forum

palm-med (free subscription at University of Michigan, available as daily digest)

comp.sys.palmtops.pilot newsgroup, hundreds and hundreds of daily messages to review

Data Integrity / Maintenance

What does gets Hot-Synched?

• Fundamentals are Addressbook, Memopad, ToDoList, Calendar
• Other data where the install operation created specific and supplemental data conduits for Hot-Synching.
  • Examples are SplashID's passwords, certain photo management programs.
  • You can see these conduits working during a Synch session, and
  • You can also find them listed if you open the Hot-Synch "Custom" window inside the HotSynch icon on the Windows taskbar.

What else is at risk?

• Commercial and free software you've installed
• iSilo docs
• Pictures, MP3's , recorded audio memos
• All configuration files, customization of the programs (eg the categorization of files in your launcher or "favorites" listing.
• Supplemental data for programs you use (eg ePocrates notes)

What can hurt your Palm (& lose your data)?

Battery died (especially the rechargeable ones). This dpes require a l-o-n-g period of neglect, since the data is still viable and protected when the Palm is merely too tired to turn on. From there to fully brain-dead is still days-to-weeks

• Screen stops responding
• Software knots your session and “warm reset” (button on the back) won’t help (Blinking top-left cursor, on off on off on off on off)
• Physical damage: Falls, jumps, hides to a non-secure situation (eg into a toilet)
• Cold reset is required (Reset button while holding down power button)

How do you protect your data, your software, your configurations?

Layers of security:

1. Synch to several sites.
(Privacy is a later topic, see below.) Everytime you see a colleague has a matching cradle, synch there. If you have a work & home (or home x 2) PC's, install the Palm software on both, and migrate the cable/cradle to each in turn, then synch. Each Palm can safely synch to multiple desktops (somewhat slower than usual). Each desktop installation can accommodate any number of Palms.

2. Own or share an installed backup program that works through Hot-Synching
Back-upBuddy. This program ($30) keeps a copy of every file on your Palm on your desktop... and will automatically restore what goes missing. Sharing ownership is legit, since once it's installed on a single machine, several users can store a copy of their entire Paml's contents on that same machine.

3. Copy everything to your external RAM.
Using the file manager programs (list available), copy your whole Palm’s native RAM to a subdirectory within your external RAM card (memory stick, CF card, SD card, Visor expansion card). This RAM is non-volatile, it’s portable into a replacement device and is more easily backed-up.
Backup programs are listed above.

4. Auto-update this RAM-card backup.
BackupBuddyVFS (part of BackupBuddy, see above) and some of the more sophisticated backup programs provide daily back-ups of any updated file to your external card. It copies every changed Palm file to my RAM card at 3AM daily. Other back-up programs are listed above.

5. Copy RAM card to desktop.
Own or share a card reader for your version of external RAM. These are cheap (~$12 or less), and link either to your laptop’s PCMCIA slot, or to the USB slot. I have a single reader that speaks CF, SD, MemoryStick, MM.

Card readers are also very nice for moving large iSilo text files, Word files, MP3's, photos, and pdf's onto your Palm's card. This is lightning fast compared with using Hot-Synch to move data through the cable to the Palm and then to the card.

6. Back up your PC’s data. (now, and frequently)
If you can write CD’s, make a copy of your cherished files to CD and take it to another site, eg office to home and visa-versa. Your whole Palm back-up subdirectory is an easy grab, and while you’re at it, copy your “My Documents”, your email address book, your browser bookmarks, your digital photos (even those you’ve just saved from emails).

Just as easy, and even more accessible, why not Winzip a whole copy of your Palm back-up (with a password) and send it to your Gmail (or Hotmail or Yahoo) account, so it lives on professionally managed server, and is available to you regardless what happens to your home or office?

Smart Document Creation

Getting stuff from the PC screen to the Palm. The options listed below are in order of sophistication.

1. See if it's already out there

2. Cut & Paste, directly into a memo

The tool that allows you to cut & paste from one program (eg e-mail) to another (eg Palm desktop's Memos) is the Windows Clipboard. To enhance this capability, I recommend ClipMate ($30), a utility which retains your clips, either permanently or in a stack of the most recent data-grabs. Great and necessary features include:

a. Serial clips. This is like high-lighting with your mouse and retaining whatever you found important.
b. Combining clips. This allows you to combine the last several clips, and assemble them into a single “paste”.
c. De-formatting clips. Remove carriage returns, indents, bold/italics commands. Even remove the awful email quote marks like >> and ::.
d. Saving clips for later. Paragraphs you use a lot are available in a non-transient list, only a couple of keystrokes away.

3. Create a “doc” file

Memos are only allowed to reach 4 Kb in size.

Big (even GIANT) files you don’t need to edit again, and just want to be able to read (eg. the biographies of the incoming intern class) can be compressed and stored on your Palm.

Other examples include the whole hospital phonebook, a big list of medical Spanish phrases, the entire ICD-9 code-list, every telephone area code in N. America.

a. Own and install a doc reader (iSilo preferred, see above)
b. Create the text file
c. Utilize one of the doc compressing tools (I use MakeDocW. It’s free. iSiloX does this too (see below))
d. “Install” the file into your Palm

4. Use iSiloX to capture (once) and save a whole web-complex of files

Free with the iSilo doc reader is iSiloX, a program that allows the capture of a web-page and an arbitrary click-depth for secondary linked pages. These are then combined into a proprietary format (no longer a “doc”), that iSilo can use, including the live links from page to page. For example: the table of contents and actual abstracts (linked from the front page) in a particular issue of JAMA. Amazing examples of pre-prepared iSilo documents: CIA World Fact Book, Code-Meister structured ICD-9 listing, U.S. Army Medical Research Institute of Infectious Diseases (USAMRIID) Bio-Hazard handbook.
Use the card reader to enable direct copy to the RAM card. Many files will be (MUCH) too large to pass “through” the Palm’s own synchronize conduit.

5. Use AvantGo to create a “Custom Channel”

AvantGo is a free tool that gathers information from the WWW for display on your Palm (and away from online wires and your desktop). Cool pre-existing channels include the New York Times (and all the content on its front page), and a directory of all the movies at all the theaters near your specific area code.
If there’s a dynamic website you need to monitor (eg the residency call schedule), then you can create a special AvantGo “channel” that reaches out to that site, and copies the data into your Palm new for each Hot-Synch. You specify how many links “deep” the file grabber reaches.

6. Translate & Import a file you like in a format you're comfortable with

If you want to create or obtain a file as an Excel spreadsheet, a Word document or an Acrobat file, you can copy them to your Palm through several special conduit and commercial viewing programs. Documents To Go offers all three of these file types, as does Quickoffice and Mobipocket. Docs to Go is free with some PDA's from Palm, and QuickOffice is free with the HandEra. This is how the ACOEM chose to distribute its schedule and meeting details.

Privacy, Confidentiality, Secrecy, Security

1. Assume that your Palm’s content isnever perfectly protected

2. HIPAA (Health Insurance Portability & Accountability Act)

Not surprisingly, when the clinical data is captured from hospital sources, “responsibility for data management and ensuring the security of information resides with the hospital”. That means that the use of PDAs for casual use and clinical data is likely to soon be the topic of strict DHIS rules. That means my opinion and advice will be moot (if not mute).

3. Responsible (even if not fully legal) precautions include certain safeguards.

Ask yourself how much protection would you be embarrassed NOT to provide.

A) At least use the security provided to you.
Create a password and designate sensitive files as “private”
Add false digits to sensitive codes/account information

B) Automatic time-out programs are a good idea,
even just to show a stranger who found your Palm how to return it. If you have a new Palm, the OS' “Security” program includes the option to require your password after a pre-determined idle period. If you don’t have this option, it can be added via Check-In ($11) or TealLock ($17). The latter program has tons of other advantages, but no desktop protection. Secret! and Secret! Desktop ($35) encrypt the data on your PC and backups too. OnlyMe ($10) has clever additions, including a single encrypted keystroke unlock and comprehensive protection of the whole PDA's contents.

4. PalmOS internal security is convenient, reasonable but NOT impenetrable

Recognize that even though the Palm programs (handheld & desktop) may require a password to see specific data, that a serious hacker can use other non-protected tools to parse stored files, especially once on a PC. There are several programs which encrypt files stored on your Palm so this won't happen. Once encrypted, files are still unreadable in backup (RAM-card & desktop), and are clearly more secure.

The non-financial price is lthe risk of losing the password, and the difficulty in sharing such files.

Optimum Use of Your Palm’s Limited Space / Memory

1. Buy a Palm that has a RAM slot (modern ones all do).

2. Learn how to move data and applications to/from your RAM card.

There are TONS of Palm-based file managers, which function just like the Windows Explorer. Each allows the user to see a list of files, and move or copy them to RAM card, and even to create sub-directories on the RAM card.

Choose among: TealMover, PocketFolder, MyWorkbench, McFile, FileZ (free), FilePoint, FileInfo, FileMan. If you have a HandEra, you get CardPro for free. If you have a Sony Clie, you get  MSGATE included in your operating system.

3. Learn about VFS

a. Launcher Programs are easiest
In current Palm devices, a sophisticated “Launcher” program can read this subdirectory RAMCard:/Palm/Launcher as if it were the internal Palm memory. That’s a great place to store non-critical programs. A general principle is that the data in this directory is where you’d put the read-only resource or reference files. It’s probably NOT where the program will store your tiny configuration files.

I use Zlauncher, and previously Launch’Em.  Launcher X ($19),  MegaLauncher ($20) are examples

 b. Make use of specific programs’ ability to store individual files externally

• iSilo stores and manages data at RAMCard:\palm\programs\iSilo
• JFile stores in RAMCard:\palm\programs\JFile
• HanDBase has its own too.

4. Think about what you put where (Palm v card)

5. Expect / demand that programs run from external RAM

Skyscape programs (Lexidrugs, 5-Min Clinical Consult, others) offer specific installation instructions for storing massive data outside the Palm. RAMCard:\palm\programs\msfiles. This is very nicely done, and very stable, reliable.

Hopkins’ Antibiotic Guide and the Palm version of Sanford have a separate installation technique. For Sanford, the off-Palm implementation is painfully s-l-o-w and moderately unstable.

Clinical Pharmacology OnHand for Palm seems to be free for Duke personnel, and requires 13 MB of RAM(!). All but 1 MB are intended for external installation.

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