“What’s new in ... Hand-held Devices: New Applications for the PalmPilot (tm)” was first published in the ASA Newsletter (ASA Newsletter March 2000; 64 (3): 22-23/copyright 2000) and is reprinted with permission of the American Society of Anesthesiologists, 520 N.Northwest Highway, Park Ridge, Illinois 60068-2573.

If you don’t already own a PalmPilot, it is now time to buy one. There are new applications, some medically oriented and others that are either fun or informative. I will give you a quick summary of these advances with web addresses to obtain them. Obviously, PalmPilots come with a standard set of applications (contacts, calendar, tasks, notes, clock, etc.) but the trick to making them really useful is to download other programs from the Internet. Some of these are free, but the majority cost between $ 10 and $30. You can download almost all of them for a free trial period.

First, which Palm Pilot should you buy? My opinion is to stay away from the CE handhelds since they have battery life problems, are larger, and are not as easy to use as the Palms. There is, however, a difference of opinion and many do like the CE handhelds. I will not make any recommendations for CE machines.

My first choice is the Visor Deluxe ($249.) which can be purchased over the Web at www.handspring.com . The Visor will accept plug-in modules such as GPS, MP3 player, camera, voice recorder, and games (some not yet available). Be sure to buy the maximum amount of available memory (8 MB). You can also get an 8 MB plug-in module for a total of 16 MB available memory. See below for Visors packaged with the PDR and memory module at a slight discount.

My second choice is the 3Com Palm IIIc. This is the new color handheld that became available March 2000. It is expensive ($ 449.) but has a great display. It has the necessary 8 MB of memory, unfortunately not expandable.

My third choice is the 3Com Palm Vx ($399.). This comes with 8MB of memory installed. Do not buy the older Palm V with only 2 MB of memory. The Palm Vx costs more than the Visor but does have a great look and feel, besides fitting nicely in your pocket.

I would not buy the newer Palm VII that has a wireless radio capability since it only comes with 2 MB memory. Using the AvantGo software discussed below will give you almost the same capabilities as the wireless Palms.

Now, why do you need this much memory? There are many medical programs available that eat up lots of memory. These allow you to access PDR-type drug information, clinical diagnosis databases, medical textbooks, and drug interactions databases.

There are several drug programs available, but you might as well get the free one first. Go to www.ePocrates.com and download the free drug database. It only takes up 0.9 MB of your available 8 MB. The developers of the website promise to keep the database current. One good thing about this drug database is the ability to add your own notes to the drug entries. I am using it now and highly recommend it.

Another drug and drug interaction database is Apothecarium (www.skyscape.com/k2) This contains both LexiDrugs (1.7 MB) and Interact (1.0 MB) and sells for $ 110. This program, if fully installed, will take up 2.7 MB of your available 8MB memory. It is a complete drug and drug interaction database that is easy to use. You can also buy the LexiDrugs database alone at the same site for $ 70.

The PDR drug database was released for the Palm platform in March 2000. (http://www.franklin.com). It is bundled with the Visor Deluxe with the plug-in 8 MB module for $450. If you already have the Visor, you can buy the 8 MB module with the PDR database for $ 200. You can also get the PDR database on CD-ROM or as a very large downloaded file. There are various Visor configurations and prices available on the Franklin web site. You can download a free demo version of this database now at: www.franklin.com/medical/pdr_palm.html . It takes up around 3 MB of memory. The full PDR database takes up 5 MB although you can install various smaller subsets of the drug database (for example, cardiovascular drugs only).

I also like 5 Minute Clinical Consult ($ 65.) (www.skyscape.com/k2) that is an excellent disease and treatment database. This is a large program that eats up 2.6 MB of your 8 MB memory. But- it is worth it. As an example, I recently had a case of Charcot-Marie-Tooth Disease and was able to find out the details of this disease in the OR in a few minutes (it is not a dental problem of women).

One of the most exciting new technologies is AvantGo, a program that allows you to automatically download updated information from various web sites. My own list of sites that I download daily include: New England Journal of Medicine abstracts, Wall Street Journal, New York Times, Yahoo Reuter Health News Summary, Handheld Med News, and Joke of the Day. You can also get reviews of restaurants for most major cities along with current events and shows. The list of downloadable sites grows daily and can only be appreciated by visiting the web site (www.avantgo.com). When you synchronize your Palm with your desktop computer, the information in AvantGo is automatically made current with old information deleted. I have around 1 MB of memory devoted to my AvantGo database, so you can see why I recommended getting the 8 MB memory. Believe it or not, AvantGo is a free download.

AvantGo can do even more, however. It is very easy to take any web site (the ASA’s web site (www.asahq.org), for example) and set that site up as one of your AvantGo synchronized sites. The ASA could easily have a web page of upcoming ASA meetings, a directory of ASA officers, or current news releases pertinent to anesthesiologists that would be updated regularly. These specialized web pages do need to be simplified so they can be read on the small Palm screen. I am working with the ASA to implement some sort of AvantGo compatible page soon.

Another program that I recommend is Documents to Go (www.dataviz.com) for $40. This program synchronizes any Excel spreadsheet or Word document with your Palm. The synchronization is automatic each time you link your handheld with your desktop. This allows you to carry data files or information that you have developed on your desktop computer on your Palm. You cannot edit these files on your handheld. If you want to edit an actual mini-spreadsheet, there are several programs available- my favorite is QuickSheet ($ 50.).

Where can you find all of these programs? A good place to start is 3Com’s own web site, (www.palm.com). This will lead you to many other very useful sites that have downloadable Palm programs. One of my favorite sites is Tucows (pda.tucows.com/palm) because they actually rate the usefulness of programs.

One very useful site is Handheldmed (http://www.handheldmed.com). This site compiles all the medically oriented programs and also reviews hardware and software from a physician’s viewpoint. There is also a “webring” for medical Palm applications at http://healthypalmpilot.hypermart.net/webring. This has a large number of medical computing sites that are worth visiting. I have attached this list of sites at the end of this article.

I really have just given you a small sampling of the useful programs that are now available for the Palm platform. Buy a Visor Deluxe or 3Com Palm IIIc or Vx and explore the many web sites yourself for more useful programs.

And a final program recommendation if you like California wines. WineScore ($25.) (www.winescore.com) is a Palm program that rates 5300 California wines by type, vineyard, and vintage. Remember- life is too short to drink cheap wine.

Author’s Note: This article was originally published in the ASA Newsletter, March 2000. It has been updated and enlarged.

Medical WebRing Sites (March 2000)

• Malaysian Medical PalmPilot Page - Web page dedicated to my medical programs for the palm pilot and malaysia http://go.webring.org/go?ring=medpilot;id=10;go/t_top

• VIRTMED CORPORATION HOMEPAGE - The VIRTMED Corporation offers industry-leading palmtop and data synchronization products for physicians and healthcare providers. The http://go.webring.org/go?ring=medpilot;id=21;go/t_top VIRTMED GlobalSync? Server delivers high-performance transactions between modern handheld devices and existing healthcare data resources. It is scalable, HIPAA data transmission-ready, and features centralized administration. Palmtop application

• Moose's Links - My new Medical Palm website. I finally fixed my computer so expect this site to be updated frequently as originally planned. http://go.webring.org/go?ring=medpilot;id=8;go/t_top

• PregCalc Obstetrical Calculator - PregCalc is the obstetrical calculator for PalmOS. It can calculate EDD, mean fetal measurements, gestational age for any given date, and much more. http://go.webring.org/go?ring=medpilot;id=22;go/t_top

• Handheldmed.com - Complete web community dedicated to clinical handheld computing http://go.webring.org/go?ring=medpilot;id=9;go/t_top

• BILL'S NEWTON AND PALM III PAGE - Page describing the way I use the Palm IIIx and the Newton Message Pad in my medical practice. http://go.webring.org/go?ring=medpilot;id=9;go/t_top

• Thomas.net - Medically oriented uses for the Palm Pilot; my humble opinion of the best uses for the pilot in medicine and an occasional thought about why I choose what I do. Good for neophytes and advanced users alike. http://go.webring.org/go?ring=medpilot;id=13;go/t_top

• QVADIS - Qvadis - makers of award-winning Express Reader all-in-one PC and Palm document reader, and provider of e-text resources, including reviewed and updated e-text links (including Medical Texts category), Palm news, print and electronic bookstore, and more! http://go.webring.org/go?ring=medpilot;id=42;go/t_top

• Synapsesoft, Inc. - Featuring procedure and patient tracking software (ProcLog and Rounder) for the Palm platform. Both ProcLog and Rounder are integrated on the same database structure to eliminate duplicate data entry. Several database options to support individual and departmental HotSync connectivity are available http://go.webring.org/go?ring=medpilot;id=25;go/t_top

• Pen Computer Solutions - Pen Computer Solutions designs, programs and integrates custom medical software applications for the PalmPilot, Palm III, IIIx, V, VII and Symbol SPT 1500.http://go.webring.org/go?ring=medpilot;id=28;go/t_top e-MedTools Medical Software - Palm Pilot and Win95/98 - The developers of several titles related to Evidence based medicine, microbiology, medical records, and common calculations. http://go.webring.org/go?ring=medpilot;id=23;go/t_top

• PocketMD - PocketMD software enables a simplified and sophisticated patient database management system for students and physicians. A 700+ drug database is included as a component of the program.

• Y Technology, Inc. - Y Technology, Inc... Software for the Palm Computing Platform... Designed for the Health Care Professional... Home of SoapDish(TM). http://go.webring.org/go?ring=medpilot;id=38;go/t_top

• Family Medicine Palm Pilot Corner - Designed to help medical professionals get the most out of their Palm Pilots. Aimed primarily at Pilot beginners or those thinking about buying a Pilot. Contains information on essential programs to install, sites with medical software, and creating your own Pilot documents and databases. http://go.webring.org/go?ring=medpilot;id=3;go/t_top

• STAT E&M Coder & STAT ICD-9 Finder - STAT E&M Coder is a unique PalmPilot application that guides you through the HCFA 1997 Evaluation and Management coding algorithms to arrive at the correct level of service that you have documented. STAT ICD-9 Finder is a comprehensive list of over 15,000 diagnosis codes in DOC format. http://go.webring.org/go?ring=medpilot;id=2;go/t_top

• Andrew Yee's Medical Eponym Page for the Palm - Rovsing's sign? Virchow's node? Here's a database of over 900 common and obscure medical eponyms in Doc and JFile Pro formats. http://go.webring.org/go?ring=medpilot;id=40;go/t_top

• K2 Consultants, Inc. - K2 has been developing Medical Software for the hand-held platforms since 1993. Involved with institutions such as Harvard Medical School, Pfizer Health Solutions, Blue Cross, etc on Palm projects. http://go.webring.org/go?ring=medpilot;id=18;go/t_top

• Pilot First Aid Page - A complete collection of First Aid information for the Pilot, available as individual files (both DOC and plain txt formats) or as a single bookmarked DOC file. http://go.webring.org/go?ring=medpilot;id=12;go/t_top

• 1-Box? - Simplifying Practice Management - 1-Box? simplifies practice management by integrating Palm?, desktop, and Internet functionality. Compatible with the most popular practice management software, 1-Box? is the only product that consolidates patient/insurance information, rounds information, and diagnostic/procedure codes. http://go.webring.org/go?ring=medpilot;id=24;go/t_top

• Jim's PalmPilot Pages - Eclectic collection of tips, links and software from an Emergency Physician who has been into Palm devices since the Pilot5000.http://go.webring.org/go?ring=medpilot;id=5;go/t_top