A Palm-Top Computer in Every Practice?
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Keep your eye on PDAs. They may be the next step in health care information technology.
Fam Pract Manag. 2000 Sep;7(8):59-60.
Palm-top computers (or PDAs, personal digital assistants) have found their way into innumerable lab-coat pockets across the country, replacing venerable paper-based agendas and 3-x-5 index cards. What is it about these little electronic marvels that makes them so appealing to physicians?
For starters, PDAs give physicians access to an enormous volume of information where they need it most: at the point of care. The addition of software enables physicians to turn their PDAs into patient-tracking devices, prescribing tools, medical calculators and repositories of medical information.
Then there's the price: The Palm IIIe, for instance, has built-in calendar, address book, to-do list and memo pad features and retails for $149, but can sometimes be purchased for less on the Internet from sites such as OnVia.com and Outpost.com. There's also the size: The Palm IIIe is less than 5 inches tall, weighs about 6 ounces, fits easily into a shirt pocket and runs for weeks on two AAA batteries. It's also extremely easy to use, even for a non-technical person. With just the press of a button, I can transfer (or “hotsync”) information from my Palm to my desktop computer and vice versa.
There are a number of brands of PDAs available, but the majority of physicians (including me) use the Palm or other brands that use the Palm operating system (Handspring Visor, TRG Pro).
Adding just a few applications can turn even the most basic Palm-compatible PDA into a useful practice partner. There are literally thousands of third-party applications available, some written by physicians for physicians, some available for free (called “freeware”) or for a nominal charge (called “shareware”). I have found that many general-purpose applications for Palm devices can also be adapted for medical use, including a wide variety of databases, spreadsheets and document readers.
Web sites for Palm PDA users
Palm Computing - www.palm.com
CollectiveMed - www.collectivemed.com
Healthy PalmPilot - www.healthypalmpilot.com
Handheldmed - www.handheldmed.com
Handango - www.handango.com
Handspring – www.handspring.com
MemoWare - www.memoware.com
PalmGear H.Q. - www.palmgear.com
PDA MD.com - www.pdamd.com
Peripheral Brain – pbrain.hypermart.net
One application that is a vital addition to any Palm-compatible is the document reader. It enables the user to view “doc” files, such as books and medical files, and download simple text documents from the Web. (And no, despite the similarity in extension, these are not the same as Microsoft Word “.doc” files.) Several vendors offer reader programs, including AportisDoc Mobile ($30; www.aportis.com) and TealDoc ($16.95; www.tealpoint.com/softdoc.htm).
Other core applications include patient management systems such as PatientKeeper (www.patientkeeper.com) and database programs such as HanDbase (www.handbase.com) and Jfile (www.land-j.com), drug handbooks such as ePocrates qRx (www.epocrates.com/) and the 2000 Physicians' Desk Reference (www.pdr.net).
It's also easy to create your own doc files using a Palm. For instance, I wanted to find an easier way to look up ICD-9 codes, something many of us do countless times throughout the day. Most of the medically oriented PDA Web sites offer downloadable ICD-9 lists and databases. However, for the most part, they are large and cumbersome, and eat up a lot of memory. I wanted only the ICD-9 codes most commonly used in family practice so that I could keep my search time to a minimum. I found that Family Practice Management publishes such a list. [An updated version of the list is available at http://www.aafp.org/fpm/icd9.]
By simply cutting and pasting text from the FPM Web site to my Windows' NotePad and then using a doc converter program to create the final doc file, I quickly added this information to my Palm. Having this resource on my Palm has saved me a tremendous amount of time in the office. Just think: Now you can take that beat-up black book you've had since medical school, transfer its contents to your palm-top computer and finally throw that book away!
All work, no play?
Not if you've got a Palm. If you're looking for a little diversion, try adding a free Web browser like Avantgo (www.avantgo.com) to your Palm and spend the next boring meeting reading up-to-the-minute news, weather and sports, or surfing 400 channels especially designed for a Palm's small screen. Of course I would be remiss not to tell you that you can also play computer games on your Palm — hundreds of them. But that's an altogether different article!
Dr. Willyard is a family practice resident at Riverside Family Practice in Newport News, Va., and a longtime hand-held-computing enthusiast.
Copyright © 2000 by the American Academy of Family Physicians.
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