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PDAs and the Orthopaedic Surgeon PDF Print E-mail

Don Johnson, M.D., FRCSC
Director Sports Medicine Clinic Carleton University
Ottawa, ON

So someone gave you one of those cool new Palm devices so that you can get organized and stop leaving little slips of paper around the office and home. Well, the device is still sitting in the box, but with good intentions to start using it when you have the time. Up until now you have functioned just fine, thank you, without any electronic gadgets. The question is what can the PDA (personal device assistant) do for you that you can't already do now? The quick answer is not much more, but maybe a little more efficiently and certainly with more flare. The major stumbling block is to get started. It seems a daunting task to take your entire address book and type it into the Palm programme. The truth of the matter is, you can probably find an address quicker in the old notebook than in the Palm.  

There are several things to keep in mind when you decide to make the switch. The device must be small: if it doesn't fit into your pocket, you probably won't use it. You should have some other need to use it other than simply as an address book. For example, you want to access the Epocrates drug reference manual or you want to check the sports scores between cases. Maybe you want to enter data for the hip registry, or for your own cases. If you have a better reason to use a PDA, you will be a little bit more motivated to go through the learning curve.

So, what is available in the hand held market? One of the first, and most popular PDAs was the Palm Pilot (16 million devices sold). Newton by Apple was actually the first, but was discontinued by a poor marketing decision. With only a monochrome screen, low storage and poor delivery history, the Palm had serious competition. By converging with wireless phones, this technology is going to show the greatest growth in the next few years. The market for handhelds is estimated to increase by 44% from 2002 to 2004. The newer devices with more storage, wireless connectivity and better screens have left the Palm a little behind. The main rivals are the Visor, which is a little cheaper and uses the Palm operating system. The Sony device, CLIE PEG-N710C is a really good multimedia PDA using the Palm 0S with a memory stick for storage of pictures, music and video. The other competitors are the IPAC by Compaq, the Jornada by HP and the Casio which all use the Pocket PC operating system from Microsoft. This is a scaled-down mobile version of the main Microsoft products, Outlook, Word, Excel, Reader, Internet Explorer and Windows Media Player.

One of the mobile phones by Samsung and another by Kyocera have the Palm operating system and screen integrated as one device. It will be very interesting to see how this technology convergence plays out. With the advent of the much faster 3G technology, the wireless phone will provide much faster access to the Internet. The advantages of these gadgets are that they turn on instantly to give you quick access to the address book, notes, to do lists, and applications that run on the Palm OS such as databases, and Avantgo: a web-based information centre.



Operating Systems
There are two main systems, the Palm OS and the Pocket PC from Microsoft. Which one is better and will win out in the end? I don't know, but don't discount Microsoft.

The main features on the Palm are:

  • Address and phone book. One of the unique features that I like about this PDA is that someone can beam their business card to me, and all this information is then entered into my address book. This makes it much easier compared to typing in all the business cards that I get at each meeting.
  • Date book. All the daily events for the next five years can be entered into the Outlook programme and downloaded to the Palm. But, you don't have to use Outlook, the Palm comes with a stand-alone desktop programme for scheduling. The reverse is also true. If you enter a new event while traveling and away from your main computer, this is automatically updated on the next sync. If you are making the switch from paper to electronic, have your secretary type in all that information.
  • Memo pad. You can write on the screen using graffiti or you can write using a programme that records your very own hard-to-read handwriting!
  • To do list. All the up-coming deadlines can be typed in on the desktop and downloaded to the handheld.
  • Mail. This PDA loads any of your e-mail that is downloaded and not read. You can read and reply to the mail at any time and send the messages out the next time that you sync the Palm.

All of these programmes can be synchronized to Outlook each time that you put the device in the cradle and push the “hot sync” button. The newer devices connect through the faster USB port rather than the slower serial port.

  • Epocrates. This drug reference book is invaluable to anyone who has to order medications. (After you have been a sports medicine orthopaedic surgeon for a few years, you only have to know about four drugs!) Epocrates is updated about once a month from the web site: www.epocrates.com
  • Expense book. This is good for someone who plans a budget.
  • Documents to go. Any word document from your hard drive may be loaded on the Palm. It compresses the programme and removes the formatting, but restores it when you sync it back to your hard drive. This programme combined with the portable folding keyboard makes my life much easier; no more nine-pound laptops to lug around. Now, with the colour and lighted screen, I can take notes in a darkened lecture room, or read the sports scores if the speaker is boring!
  • AvantGo. The web based channels of CNN, The New York Times, PC magazine, Sports Illustrated, and so on, may be subscribed to, for free, and updated each time that you sync the device.
  • HandDase. This is another one of the 1000 or so programmes designed for the Palm. This is a database that allows you to enter 30 fields. It is useful for a surgical logbook, to keep track of interesting patients, or to make a list of patients for rounds.
  • Access database. A compression programme is available to allow you to transfer your access database to the Palm. This takes quite a bit of space and is a good use for the expansion cards.

To access more medical programmes for the Palm go to www.pdaMD.com

What does the Pocket PC operating system offer? The main feature is that you can do everything that the Palm OS does, without downloading and installing other software. The familiar Microsoft programmes such as Word, Excel, Windows Media Player, Internet Explorer and Outlook are all loaded and ready to use on the handheld device. A couple of other programmes such as Pocket TV to view mpeg movies, and Ipresenter to view PowerPoint presentations, will round out the necessary software.

The Pocket PC is synchronizeded with your main computer by active sync. This will download all the Outlook mail, calendar, to do lists and memos. You can modify these on your handheld and then sync back to your main computer. Avantgo is also loaded and configured. You pick your channels from the Avantgo web site and each time you sync, the information is downloaded on the handheld.

The note function of Pocket PC has been improved compared to the Palm. On the Palm you have to use the graffiti function to write a note. On the Pocket PC software, you can write in your own handwriting, or dictate a short note. This is stored as a .wav file that can be played back later when you have time to listen and make a formal note. I find that this is one of the most useful functions on the device. I make use of the short dictated note several times a day.

Comparison Chart for the Palm, Sony, IPAC and HP Jornada

PDA model

Palm 505

Sony 760C

IPAC 3850

HP Jornada

Size

Palm is the smallest, easily fits into a pocket.

Slightly larger than the Palm.

Largest of the 3 and no longer fits in a pocket with the expansion sleeve.

Palm sized.

Battery

Rechargeable.

Longest battery life.

Rechargeable.

Rechargeable.

Shortest battery life.

Removable.

Rechargeable.

Screen

Only marginal screen brightness.

Write on screen in graffiti, or actual writing with add on programme.

Brightest and best screen resolution for pictures 320x320.

Screen is larger than Palm.

Write on screen in graffiti, or actual writing.

Has biggest screen with good brightness by backlight from both sides.

Write on screen by taping on keyboard or actual script. Screen writing can be combined with dictation of short notes.

Bright screen, backlit on only one side, slightly smaller than Compaq. Has same screen function to type or write.

Operating system

Palm OS 33 mb

8 mb memory

Palm OS 33 mb

64 memory

Pocket PC

64 memory

Pocket PC

64 memory

Programmes

Address Book

Date Book

Expense

Mail

Memo

Note pad

To do List

All sync with Windows Outlook

Palm reader

Photosuite (still images and video)

Avantgo

Epocrates

Documents to go

(sync Word and Excel files).

Address Book

Date Book

Expense

Mail

Memo

Note pad

To do List

All sync with Windows Outlook

Gmovie - video programme

Audioplayer

PG Pocket for still images

Conflicts with some programmes.

Address book

Date book

To do list

Outlook Mail

Windows media player (for audio and video - with external speaker)

Internet Explorer

Notes

Excel

Word

PowerPoint player

Book reader

Easily syncs with Microsoft office programmes including Outlook.

Same programmes as Compaq.

The dictated note function comes on with one press of a button on the side of the device.

Epocrates is not available as a Pocket PC version.

Keyboard

(all extras)

Portable full sized keyboard available.

Portable full sized keyboard available.

Targus portable keyboard can be attached.

Targus keyboard.

Expansion card

Multimedia is the secure digital card - 64 mb.

Memory stick up to 128 mb.

Multimedia is the secure digital card - 64 mb.

Expansion sleeve available that holds cards up to 2 gig.

Built in slot for flash memory cards up to 2 gig.

Multimedia

Plays video slowly from expansion cards. No audio.

Sony plays quick time compressed video from the memory stick. Easy to load on computer and transfer to PDA. Audio needs earphones, no external speaker.

Plays mp3 files

Plays video and audio, at acceptable resolution. Can fill the screen with image. Microphone allows dictation to notes and listening to video clips.

PocketTV plays mgeg video.

Plays video and audio, at acceptable resolution. Can fill the screen with image. Microphone allows dictation to notes and listening to video clips.

Pocket TV plays mpeg video.

Connection

USB

Wireless

Infrared transfer between all.

USB

Wireless

Infrared transfer between all.

USB

Wireless with bluetooth

Can infrared to Palm OS.

USB

Infrared

Wireless

Ease of use for beginner

Good, but difficult to add the 3rd party programmes to make it function like the Pocket PC.

Same as Palm.

Easy to add mp3 and video files with Sony software. Works well with Sony computers and cameras that use the memory stick.

Easy to set up and configure if you use Windows and Outlook as your mail server.

Easy to set up and configure if you use Windows and Outlook as your mail server.

Cost

$400 US approx

$500 US approx

$600 US approx

$600 US


Summary
In my opinion, the HP has a slight edge as it maintains the size of the Palm, but has all of the functions of the IPAC. The Pocket PC operating system is the easiest to use if you use Microsoft office with Outlook as your mail client.