HandheldMed Physician PDA usage review by Dr. Kevin Leung July 4, 1999 The personal digital assistant (PDA) is a great idea for doctor's that are technologically minded in today's inteconnected world. To this end, I've been using the Windows CE 2.0 Palm-sized PC manufactured by Uniden. I am currently a 2nd year resident in Family Practice training at McMaster University in Ontario, Canada. This review will focus on 3 things: my choice of PDAs, what it's daily use consists of and what my recommendations would be for those that haven't jumped in yet. The PDA There are only 3 main routes to choose for PDAs at the time of this writing. The ubiquitous palmpilot by 3com is the machine of choice for many doctors that are only interested in scheduling and contact information. The second choice (not very popular in North America) would be the use of a EPOC32 based machine. In one word, the PSION series of computers. But they involve keyboards. Finally, the Windows CE devices come in 3 flavours, the Palm-sized PC (PSPC), the handheld with keyboard (HPC) and the new HPC/pros which are generally larger and function as mini-notebooks. The choice of the Uniden PC100 hinged upon several factors. 1) It has a built in Compactflash slot which allows peripherals, especially compactflash memory, to be added into the machine. I thought that this would be crucial as medical texts and reference material tends to be large. 2) It comes with a built-in 28.8 softmodem. No add-ons. Just hook up a phone cable to it and you have net, email and channel access. 3) Features. Although the palmpilots are easier to use, they currently lack many of the features that are available in the windows CE environment. Usage I throw my PSPC into my lab coat pocket and bag almost every day. It easily replaces my old "black book" and it actually weighed less than my old notebook. I find that there are only 3 main times that I use the system. The first is to access scheduling and contact managment information. That is, for the most part, it's functionality is that of a simple PDA. Secondly, I have several textbooks, notes and my peripheral brain programmed into the machine. I wish that the system were faster though because when I need access to the information, even the 1 second delay seems interminable. This is especially true when searching through the file system which seems sluggish. Thirdly, I have installed a plethora of games and more importantly, AVANTGO onto the system. In my opinion, the push technology onto the palm is the KILLER App. I find myself accessing the latest news (which I've synced onto my PSPC before heading to work) all the time. It is like having the paper with you all the time and reading it when you have free time. Recommendations As you might have noticed, I don't use my PDA for patient management. The input method with the pen is too slow and inconsistent to make this current generation of devices useful for widespread input of accurate information. Indeed, when I find myself wanting to add something, I find the nearest desktop and type it in there before transferring it onto my PSPC's peripheral brain files. I like windows CE. However, the system is sluggish and somewhat complex to learn how to use. I would choose the palmpilot but it's limited memory size and high cost (compared to the Uniden PC100) turned me away. I've added a 15mb compactflash card to the system and now I take whole textbooks along with me. The limitation of this is that there aren't that many textbooks available for windows CE. Ironically, @Hand medical technologies has a whole slew of medical texts but their reader can only be used on the palmpilot. For example, their Merck manual is 4 mb large and requires that the user upgrade their Palmpilot with the TRG memory update in order to fit it on. Yet, my PC100 could easily store the Merck manual on it but there doesn't exist a windows CE version of the reader. Final Thoughts In summary, I still think that the PDA market is in its infancy and for doctors can act as a reference and scheduling tool primarily. I would recommend the palmpilot to those of you who do not need the extra storage space above 4 mb (IIIx) but AT LEAST get yourself a 2 mb (III) version of the palm devices as that will be the minimum you will need to store your peripheral brain files. If you want a cheaper device with built in modem, expandability and nifty features though, reach for the windows CE machine. In trade, you'll have to put up with a little sluggishness in performance that is quite tolerable if not ideal. I really don't think it matters much which system you use though. The PDA market is in its growth phase much like PCs were at in the early 1980's. There is a lot you can do but it hasn't become easy yet. I expect that I'll be upgrading in less than 2 years time to a device that is the size of the Palm V but with color, expandibility and lots more memory.