Hand Held Medicine

In general, we have listed only software that is of general use and interest; however, more detailed special reports on PalmOS software intended for particular specialties are in the works, and are being added to the Documents section of this site as they become available.

First, although there has been a lot of talk about viruses for the PalmOS, we have still not yet actually seen such a virus “in the wild” and do not consider it necessary to purchase on of the PalmOS virus checker programs currently available. This may change in the future.

Second, we have not recommended any Personal Information Manager (PIM) synchronization programs, because there are too many different systems and configurations in use out there to recommend any specific solution. In our experience, the conduits for Outlook, Outlook Express, Groupwise, Exchange, and MeetingMaker seem to work fine (once properly configured), but are unfortunately still limited to syncing to a single account-you won’t be able to sync to Groupwise from the hospital and then MeetingMaker from your campus office.

Third, we have avoided are those programs that require additional hardware in order to operate, such as the ActiveECG cardiac monitor ( www.activecenter.com ), or the Margi PresenterToGo module ( www.margi.com ) that gives PalmOS handhelds a VGA out for presentations.

One of the key features of the Palm is the ability to program custom applications to suit your needs. There are a wide variety of applications available that allow you to design and test your own palm program on the PC and then HotSync the program for use on your palm.

To test your program on the PC, there is a Palm emulator available at http://www.palmos.com/dev/tools/emulator/ that simulates the functionality of an actual Palm device. So you do not have to actually load the application to your device to run and test it. When you are satisfied that the program runs correctly on the POSE emulator, you can then HotSync the program to your Palm.

This document provides an overview of the most popular applications available to program your Palm and includes the pros and cons of each.
NSBasic

NSBasic is an Integrated Development Environment (IDE) based on the BASIC programming language and is very similar to Visual Basic. This IDE includes all the normal features, like source-code editing, but it’s most useful aspect is the Visual Designer, which allows you to graphically lay out your objects and set their properties. The language itself includes several groups of built-in functions and commands. The functions, which are add-ons to the standard BASIC language, provide additional support for math, file I/O (input/output), serial I/O, graphics and windowing functions. Additional commands provide support for advanced graphical user interfaces (GUI’s) and to show input and output objects and dialog boxes.

When the development process is complete, NSBasic produces a standard Palm executable (PRC file). The PRC files will work on all devices running Palm OS 3.0 or later. The files also run properly under OS 2.0, but some features, such as the additional fonts included with OS 3.x, are not available.

The biggest advantages of NSBasic are its ease of use, web design capacities and small learning curve.

The main disadvantage of NSBasic is that it compiles a program into pseudo-code (p-code). As a result, a runtime component is required to convert the p-code into Palm’s native code. Therefore, application performance is not as good as a comparable application written in C. However, most programs written in NSBasic appear to run at a speed equivalent to the built-in Palm applications. Operations that involve activities like updating the screen are approximately the same speed as any Palm application, but performance takes a blow when doing CPU-intensive mathematical computations. This limitation is minor for most applications, but might be a problem for complex mathematical applications.

URL: http://www.nsbasic.com/palm/
Crossfire/MobileVB

AppForge’s Crossfire and MobileVB are the leading mobile and wireless application solution for Microsoft Visual Basic developers. Crossfire integrates directly into Visual Basic .NET while MobileVB integrates directly into Visual Basic 6.0 enabling you to immediately write applications, using the Visual Basic programming language.

Visual Basic is a powerful programming language that’s easy to learn, and Crossfire/MobileVB works in the same way and includes many of the same functions and methods as Visual Basic. To develop a program, you first create the user interface by “drawing” controls, such as text boxes and command buttons, on a form. Next, you set properties for the controls to specify values such as caption, color, and size. Finally, you write code to add functionality to your program. A completed program is compiled into a PRC file for use on your Palm. To run this program on the Palm a program called Booster is required to convert the VB code to Palm’s native code.

The advantages of Crossfire/MobileVB are: it has a small learning curve, great support, and a fast development life cycle.

The MAJOR disadvantages of Crossfire/MobileVB are the requirement of a runtime component (Booster) installed on the Palm (which requires buying a licence for each device using your program), and the cost to get this application up and running (it’s an expensive program).

URL: www.appforge.com/products/small-business/
CASL

CASL (Compact Application Solution Language) is a Windows based rapid application development (RAD) tool that enables developers to easily create their own PDA applications. The CASL language is similar to Visual Basic and it allows you to create programs that take advantage of the graphical user interface found on today’s PDA’s.

Like NSBasic and Crossfire/MobileVB, CASL’s code is compiled into p-code, which gets interpreted by a separate 44 KB Palm runtime. CASL also has a Pro version (CASLpro) that takes CASL code and compiles it to C code, which is then compiled by the open source PRC – Tools compiler to a native Palm OS program. This means that no runtime is required on the Palm and the application will, therefore, run faster.

The advantages of CASL are its ease of use and fast application development time. With an easy to use GUI and many built in functions, you can create applications in hardly no time at all.

One disadvantage of CASL is the requirement of a runtime that will slow your application down, and that can be eliminated by using the CASLpro version. The major disadvantage of CASL is the lack of documentation for the language. There are no dedicated textbooks on this language, and fewer web resources are available in comparison to the other languages covered in this document.

URL: http://www.caslsoft.com
J2ME

J2ME (Java 2 Micro Edition) is the Java platform for consumer and embedded devices. The J2ME architecture defines configurations, profiles and optional packages as elements for building complete Java runtime environments that meet the requirements for a broad range of devices. Each combination is optimized for the memory, processing power, and I/O capabilities of a related category of devices. The result is a common Java platform that fully leverages each type of device to deliver a rich user experience.

The configuration that was developed for PDAs and mobile phones is the Connected Limited Device Configuration (CLDC). The CLDC combined with it’s profile – Mobile Information Device Profile (MIDP) – is the Java runtime environment for today’s mobile information devices such as phones and entry level PDAs.

To develop your PDA applications, there is a toolkit (J2ME Wireless Toolkit) available that contains both the CLDC and the MIDP. This toolkit provides the emulation environment, documentation and examples needed to develop your PDA applications.

Programs compiled using the Wireless Toolkit can be converted into a PRC file for use on your PDA. However, in order to run this program, your must also have a virtual machine (runtime component) installed on your Palm. This virtual machine is only a few kilobytes in size, and its function is to convert the Java bytecode into your Palms native code. Because this conversion of code has to take place, your applications performance will be slightly slower. As explained in the NSBasic section, this may or may not have a noticeable impact on performance. It all depends on how CPU-intensive your program is.

The advantages of using Java’s J2ME are its cost (free) andits cross platform portability. A Java program written using the J2ME Wireless Toolkit will run on any mobile information device that has a virtual machine.

Java’s J2ME has three disadvantages: a steep learning curve, slower application development, and slower application performance. As explained in this section, J2ME for PDAs is composed of the CLDC and the MIDP, and learning the functionality of these API’s takes time to learn and develop. The J2ME also requires a virtual machine on your device that will slow your application down.

URL: http://java.sun.com/j2me/
CodeWarrior for Palm OS

CodeWarior for Palm OS is the official development environment for the Palm OS. It has the distinction of being the most favored environment by Palm Computing, simply because they used it to write Palm OS. This commercial development environment allows you to create ANSI C and C++ programs on either Windows or Macintosh systems. It currently includes Palm’s Conduit Software Development Kit, and Palm’s own documentation assumes that you are using it. Therefore, because your code is written based on the Palm OS, no separate runtime component is installed on the device. As a result, the resulting application is usually small and efficient.

The CodeWarrior Integrated Development Environment (IDE) provides an editor, project manager, C/C++ compiler, linker, and target device interface that enables source and assembly level debugging.

The advantage of using CodeWarrior for Palm OS is that your applications, in comparison to the other development environments, are typically smaller, more efficient, and run faster.

The disadvantage of using CodeWarrior for Palm OS is that it has the greatest learning curve of all the development environments. Although C and C++ are very efficient languages, they tend to be more difficult to learn than Java, Visual Basic, and scripting languages.

URL: http://www.metrowerks.com/
Summary

There are many applications available for Palm program development, and this document only provides an overview of the most popular applications. A summary of these applications is provided in the following table.
NSBasic Crossfire/
MobileVB CASL J2ME CodeWarrior
Programming Language Basic Visual Basic Similar to VB Java C / C++
Steep Learning Curve No No No Yes Yes
Development Time Fast Fast Fast Average Slow
Runtime (VM) Required Yes Yes Yes (Std)
No (Pro) Yes No
Cost Moderate Expensive Cheap (Std)
Moderate (Pro) Free Moderate

Overall, which application you choose depends on the type of programs you develop (are they CPU intensive), your programming skills, development time required, and your budget.

There is no clear winner in this category, so we do not currently have a recommendation to make. Most of the products available are too expensive, too specialized, too American, or too complex to be of general interest or use at the Dalhousie Faculty of Medicine. Some of the options include PatientKeeper ( www.patientkeeper.com ), PatientTracker ( www.handheldmed.com ) and WardWatch ( www.torlesse.com ), and HandEchart ( www.ddhsoftware.com ).

The Palm committee is currently considering a plan to create a customized patient tracker for use by Dalhousie medical students and residents using hanDBase, making the widespread use of a standard database program like this much more important.

Utilities are programs that improve upon the default operating system of your computer. They can add new functions to your computer or they can make your computer easier to use, faster, more secure, etc.

Launchers

Launchers are Palm programs that help you organize your applications and give you ready access to features such as beaming, deleting and file management with a “drag-and-drop” interface. They give your Palm a Windows-type “feel” by placing information such as date, time, available memory and battery level on the screen and allow you to organize your applications, typically in a tab-style format (see picture below which shows a launcher called Launchem) for quick access.

(In the picture above you can see the symbol of a garbage can in the lower green bar. To delete an application you simply drag it to the garbage can, much as you would in Windows.)

There are many different Launchers to choose from but the three we like the most are Launchem, LauncherX, and ZLauncher. All of these are very stable, attractively designed and reasonably priced. They also both offer Virtual File Sharing (VFS) functionality that allows you to place programs on an external memory card (if your Palm has an external memory card slot) so that you can store virtually unlimited amounts of information and programs on your handheld.

Hacks

Another type of extremely useful addition to the PalmOS prior to version 5.0 are programs called Hacks. When people hear the word “hack” they often think of hackers and pirated software. Although this may be the context when referring to Windows (or other operating systems), a Hack for a Palm computer is a small program that extends the functionality of their computer.

Hacks will only work with PalmOS versions prior to 5.0

Before we start using Hacks we first have to install a “Hack Manager” which is a program that controls the function of added Hacks. There are several different programs that you can use for this purpose. The original HackMaster was developed in 1997 but has been superseded by more stable and user-friendly programs. We use X-Master, a free hack extension manager available at www.linkesoft.com. Another, more feature-rich program called TealMaster is available at www.tealpoint.com for $9.95 US.

Once you have your Hack extension manager installed one of the first Hacks you should install is McPhling available at www.Handango.com (Note: There is a version of McPhling available for OS5 devices which works without the use of a Hack Manager; in fact a Hack Manager does not work at all on a Palm running OS5).

With McPhling in place a simple stroke of the stylus from the menu area to the applications area of the graffiti region on your Palm will bring up a user-definable pop-up menu with the most recently used and/or favourite programs so that you can quickly switch between the multitude of programs you’ll want to have installed. Also a stroke from the applications area to the graffiti area will switch to the previously opened program. This is of tremendous benefit when navigating from program to program. (Note: there are many ways to custom configure this application the methods I have mentioned are based on the widely used original HackMaster defaults). McPhling is available for $12 US and is available on an honour system registration, i.e. – it is a fully functional program and only you will know if you haven’t paid. One of the wonderful things about the Palm OS is the availability of software from the tens of thousands of software developers at a reasonable cost. Only with your support can these programs remain at such reasonable prices.

Another useful Hack, especially for people new to graffiti handwriting, is TealEcho. It is available from www.tealpoint.com for $11.95 US. This program superimposes the image of the letter/number you are entering in the graffiti area over the program area so you can instantly have feedback about the character you are entering. Even once you have mastered graffiti you will still appreciate the ability to see exactly what you are writing.

Also available from tealpoint.com is TealMagnify. For all those finding some of the small text and images difficult to read, simply by pressing on the Search Area of the Graffiti AREA brings-up a magnified view of the area of screen you are viewing. TealMagnify costs $11.95 US (a whole lot cheaper than new bifocals!).

Another useful hack is the Keyboard+Graffiti Hack available from Handago.com for free. It is listed as KeyB+Graffiti by Rui Oliveira. When you can’t remember the graffiti symbol for a character pressing on the “a” or “1″ on the bottom corners of the graffiti area brings up a virtual keyboard for easy character entry. Unfortunately, in this mode, you have to keep turning off the virtual keyboard before entering more characters with graffiti, only to find you need the virtual keyboard for another character. This Hack allows you to continue entering graffiti characters even when the virtual keyboard is in place.

There are many other Hacks available for the Palm OS but these are among the most useful.

Security

Security is also an important issue for many users of Palm handhelds, especially if you are using your Palm to keep patient information. Again there are many different Palm security programs available but the important point is not to rely on the built in security of your Palm device as this can be easily by-passed to access all of your information. This subject is dealt with in much more detail on our Security page.

Backup

Finally, the subject of backups is an important one–just as important in the Palm world as it is with desktop computers. In the days of PalmOS versions 1.x through 3.x, we found that the built-in HotSync was inconsistent in the way that it dealt with backing up 3rd party applications, missing many. For this reason, we recommended the use of BackupBuddy ( www.bluenomad.com ), a program that would back up everything on your Palm more thoroughly than the built-in Palm backup routine does (including all 3rd-party applications), and also checked for viruses, allowed full beaming of anything on your Palm, and synced the Palm to your computer’s clock.

Since PalmOS 4 the 3rd party program backup problem in HotSync has been fixed, and for this reason some people believe BackupBuddy to be redundant. However, it still has some advantages, including better control over what gets backed up and what doesn’t, the ability to back up flash ROM, detailed logging, time synchronization with the desktop computer, and regularly scheduled backups. The VFS version even allows scheduled backups to and individual-file restores from expansion memory cards–but does not work on PalmOS version 5. Many recent models, such as the Sony Clies, come with their own backup programs designed specially for them, such as Sony’s MS Backup (for memory sticks). These programs are very usable, though they are still not as slick and well-integrated as BackupBuddy. And there are a variety of good shareware titles (CardBackup or BackupMan) which have similar functionality.

For a good discussion of the pros and cons of BackupBuddy, see:

www.jimthompson.net/palmpda/Tips/backuptips.htm

In the end, we still recommend BackupBuddy if you are using a Palm with an OS version earlier than 4.0, and users with 4.x units may also find it a more flexible and useful backup option than HotSync alone, especially if you are backing up to expansion memory cards (which is certainly convenient). However, users with 5.x units will probably want to use either the backup program that comes with their Palm, or else one of the shareware titles that adds some flexibility to the process. Whatever you do, make sure you HotSync often, keep a record of all your software licence numbers and activation keys in a safe place, and remember that if you only back up to your memory expansion card, and you lose your Palm with the card in it, you may as well have not backed up at all!

There are two major types of web browsers for the Palm: “live” browsers (Blazer, PalmScape, NetFront) which use active Internet connections (wired or wireless), and “offline” web browsers (AvantGo, Plucker, HandStory) which download web pages during hotsync and save them on the Palm for later viewing. In this section, we will cover offline browsers only–live browsers, because they require a live Internet connection to work, will be covered in the Connectivity section.

AvantGo ( www.avantgo.com ) was one of the first offline web browsers, and has become a standard. It allows you to download web content onto your Palm every time you synchronize, so that you can take it with you and view it later, while disconnected from the Internet. AvantGo is actually a combination of software that you install on your Palm (about 290MB), a conduit that you install on your computer, and an account that you set up on their website, which is where you identify the website (or “channels”) that you want to view. The software is also available for the PocketPC–and can event be used as a “live” browser if you do have an Internet connection.

A huge variety of websites have optimized channels available to AvantGo users, from general interest news sites to specialty medical sites. Some of the most respected medical journals make their tables of contents and abstracts available in this format, though the list is constantly changing (check with the Kellogg Library for more information about individual journals). The Canadian Medical Association ( www.cma.ca ) has also started a channel, with current and archived news stories from CMAJ and the Medical Post and a CME section that typically includes a review article on some medical topic.

The DalMedix intranet has its own AvantGo custom channel available, allowing users to take news and notices, undergraduate student schedules, a faculty email/phone book, and even departmental calendars with them on their Palm. In the future, this channel may also be used to distribute clinical practice guidelines, case logging databases, and other information or tools of use to Faculty of Medicine users. Instructions for setting up this channel can be found in the DalMedix sitemap / help page (look under the “How do I…” section).

In early 2002, AvantGo announced its plans to cut off its heavily used free custom channel service, and to charge for all custom channels with 8 or more subscribers (including non-profit and educational institutions like us). Although our service has not yet been interrupted, this may affect the selection of 3rd-party channels available, and may also mean an upcoming change in the DalMedix channel.

The good news is that there are a variety of high-quality, open-source AvantGo alternatives available, the chief among them being Plucker ( www.plkr.org ). Plucker combines an easy-to-use desktop program and a handheld reader, does away with the need for a server account to act as middleman, and it’s free. It takes a little tweaking, but we encourage you to try it out.

A second alternative is HandStory ( www.handstory.com ), an eBook reader that comes in a freely-downloadable Basic version. This well-liked reader application has a feature called Web Clipping, in which “Web sites are regularly updated into web clips to be synced at a pre-designated time on a daily basis. Just press the HotSync button on your Palm cradle to sync web clips for offline web browsing.” It can also be used as a general-purpose content viewer for your Palm, for viewing DOC files, eBooks (in HandStory format), and images.

The Palm’s standard security functionality is too cumbersome to use, and is very easy to break into, using applications that are available freely on the Internet. This is true of all versions of the operating system (including version 5) and has been well documented. Even the well-respected SANS institute has produced a study of the security of PalmOS handhelds.

TealLock replaces the PalmOS’s built-in system with a powerful and flexible application with many activation and customization options, essentially giving your Palm the same type of PIN security your bank uses for ATMs. And the cost of TealLock ( www.tealpoint.com ) is also very low when compared to similar programs that cost much more. The size of the program is under 100KB, so security need not crowd out other applications. There are many, many programs that do similar things, but our experience with TealLock has been trouble-free, which is why we recommend it; there have been problems reported with the Tungsten T5, though. PalmSource’s recommended security add-on is OnlyMe, from Tranzoa, and it’s possible that this is also a good solution (we haven’t tested it yet).

In medicine, data security is not an option: it is essential. All Palm users at the Faculty of Medicine should own and use TealLock or a similar program.

Although viruses, trojan horses, and other “malware” are major problems in the world of regular computers, they are still not much more than a curiosity in the world of Palms. The Symantec AntiVirus site lists only 9 identified Palm viruses, none of them at all common, and all can be found and fixed by the regular Symantec AntiVirus program when the .prc files are still on the computer, prior to installation. In our opinion, a dedicated anti-virus program is not necessary on the Palm itself–just make sure that the one on your computer is turned on, is up-to-date, and is set to check .prc files (not all are set this way by default).

Another type of security application for PalmOS handhelds is the secure password archive, a way for users to securely record the details of their various computer, network, and website accounts, as well as other private information like ATM and credit cards. They do require a password to enter them-but it’s possible that it will become the only password you have to remember! The best example of this type of software is STRIP (Secure Tool for Remembering Important Passwords), which is free, and uses 256-bit AES encryption. STRIP is available at the following site:

www.zetetic.net

If you’re looking for a more graphical and feature-rich password archive, with a desktop companion to make it even easier to manage and enter the database, and are willing to spend a little bit of money, take a look at SplashID ($19.95US), from SplashData:

www.splashdata.com

In our experience, Splash Data produces some of the slickest, easiest to install and use Palm applications on the market today. If you have lots of images on your Palm (or Clie) you may also want to try their SplashPhoto image viewer, which is excellent.

There are several options for building PalmOS handheld databases:

Write the program in a low-level computer language like C++ and then compile it for the Palm operating system. Programs written this way are fast, efficient, and completely customizable. But this option is very expensive and requires highly skilled programmers.
Purchase a custom-built database from a software engineer. Also an expensive option, and one that limits your ability to customize the database yourself.
Buy an off-the-shelf software product like HanDBase to build your own database. This is the most popular, and least expensive option.

If you do decide to use off-the-shelf PalmOS database software (which we recommend), your next choice is the category of product to use: basic, mainstream, or specialized:

Basic database products. List is the most basic prototype for handheld database products. List allows only two 120-character label fields, and one 4-kb note field. List is as basic as a database product can be. It is free; so it is a good place to start if you have never used a handheld database. But most users soon want more functionality than List provides.

Mainstream database products. The mainstream products offer larger feature sets, but contain less programming power than the specialized group. They have rudimentary form design, simple relational features and basic desktop companion programs. They can handle enterprise projects that require 2-way synchronization with a network of users. You can design a database right on your handheld, and they allow you to build as complex a database as most users are likely to want.

Popular mainstream database applications like HanDBase, SmartList To Go (formerly ThinkDB), JFile and MobileDB are increasingly sophisticated. They are inexpensive, easy to use, fairly powerful and well supported by their developers. HanDBase Plus 3.0 is particularly remarkable for its power, ease of use, and small size (470KB).

Specialized database products. Mainstream databases do not match the functionality of desktop or server database programs like Access, FileMaker or Oracle-this is where specialized products come in. These products do not allow you to design a database on the handheld; instead, you build a database on the desktop, freeze the design, and then deploy the design to a handheld along with a small “run-time” engine that enables the extra functionality to work on the handheld. The handheld version of the desktop database is much less functional than the desktop version, but still has more capability than is possible with the mainstream products.

Pendragon Forms is the least expensive of this specialized group, and was designed for the average Microsoft Access user in mind. Pendragon Forms databases have to be built on the desktop under Microsoft Access. The user works within a specialized Access database to design forms that are converted to a Palm file for use on a Palm handheld. The resulting databases are tightly integrated with Access. You cannot modify the database design on the handheld, though.

Our recommendation. For most medical users mainstream database software will be sufficient, and our recommendation is HanDBase ( www.ddhsoftware.com ) because of the number of medical databases available in this format; its ease of use, simplicity, and speed; its PocketPC compatibility; the fact that it supports semi-relational databases (where JFile doesn’t); and the fact that the desktop application and conduit are easy to use and stable (we haven’t reviewed SmartList To Go from DataViz yet). It integrates well with Windows computers via a desktop “companion” program and conduit (both included in the “Plus” package at US$29.99). An Access sync conduit is available (or included in the Pro version), and a special ODBC driver is available (or included in the Enterprise version) if you want to link HanDBase directly to desktop databases. It only takes about 195KB on your Palm.

Once you have HanDBase, the next step is to find some databases that you can download and view. A huge variety of databases are available at the ddh Software website, including ICD9 and other coding databases, anatomy databases, herbal drug references, and many more. Many are free, but some do cost money, so make sure to check. But one of the great advantages of using HanDBase is the ease with which you can create databases of your own.

Most recent PDAs come with their own image viewing software; for example, the T5 comes with an application named Media, which can be used to list and view images, send them to other PDAs (via infrared or bluetooth), and organize them into albums. It works with a new part of the Palm Desktop, making it easy to copy images to your Palm, and take them off.

FireViewer was our original (2001) recommendation in this area, and was at one point one of the best image viewers available for monochrome PalmOS units. It now supports colour screens as well, including the T5. This program is no longer free (which was always a good selling point), but it does come with FireConverter, a powerful Windows program for converting regular images (.bmp, .gif, .jpg) and even movies (.avi, .mov) into files that can be viewed on the Palm.

However, FireViewer is not as slick and easy to use as SplashPhoto, from Splash Data. SplashPhoto works like an interactive photo contact sheet, displaying all of the images on your device in a single, scrollable page of thumbnails, and allowing you to zoom into them, beam them to others, or or turn them into a slide show. It has a 30-day full-functionality demo version.

Another well-regarded image viewer for the PalmOS is AcidImage, from Red Mercury.

Note that you can’t actually do any drawing on your Palm with either of these programs–for that, you will need something like TealPaint (from www.tealpoint.com). But our experience has shown that is usually much easier to create images on your computer (or with a digital camera), and to use the Palm simply as a viewer.

In recent years, with units that come with faster processors and more memory, the possibility of playing video on a PalmOS handheld has become a reality. Our favorite video player for the PalmOS is the free Kinoma Player (www.kinoma.com), which already comes bundled with many higher-end units. We have produced a number of clinical procedure videos using Kinoma Producer, and these are available on our Common Currency website.

We have looked at many document readers, word processors, and desktop companions, but in the end, DocumentsToGo from DataViz ( www.dataviz.com ) is one of the most comprehensive. It reads Palm DOC documents as well as Word, WordPerfect, Excel, and now even PowerPoint and PDF (Adobe Acrobat) files. Although you can edit documents with it, it’s not meant as a “full-featured” word processor like WordSmith ( www.bluenomad.com ), which is highly regarded, or a mini-Microsoft Office suite like QuickOffice ( www.quickoffice.com ). But for real-world use on a handheld, it’s very useful. It measures about 2MB in size for the program (more for documents). Note that QuickOffice or older versions of DocumentsToGo are included with some Palm, HandEra, and Sony models. The current version is version 7; DataViz also produces a PDA database program (SmartList To Go), and a variety of other useful titles.

Note that although DocumentsToGo will support text-based Adobe Acrobat files, it’s probably a better idea to use the actual Acrobat Reader for Palm or PocketPC to read these files, as it will support a fuller set of features, including image slideshows. Like DocumentsToGo, the Acrobat reader comes with a desktop application and a PDA application.

iSilo is a popular document reader that uses HTML format to save 20% more memory than the standard Palm doc format. Many documents of medical interest, both free and commercial, are available in this format (including the Clinical Medicine Consult series), and a free and very powerful converter application named iSiloX is available to convert existing HTML and text files to the iSilo format. Because the document format is based on HTML, creating documents is very easy, and they can include images, tables, and a wide variety of formatting. The latest reader, version 4.25, can be tried for 30 days and then used indefinitely in limited-functionality “free mode” (which admittedly has very limited utility because it doesn’t support links between pages, images, or tables) or can be purchased online at www.isilo.com. The reader can be used to view both standard Palm doc files as well as iSilo files. We highly recommend getting iSilo because we are standardizing on iSilo as our preferred format for the creation of ebooks, and are in fact currently working on a number of titles.

For another very good free reader, consider Palm’s own free eReader that comes bundled with many PDAs and is available at www.ereader.com. There is also a commercial Pro version with user-selectable fonts, as well as the commercial (but inexpensive) eBook Studio application for creating nice-looking documents. They also distribute (though they don’t promote it) DropBook, a free application that allows you to create ebooks from Microsoft Word documents. DropBook works well, but you’ll have to spend some time learning how to use it and you will need to know how to manually install files into folders.

Finally, HandStory is yet another good, similarly-priced, and feature-laden alternative to iSilo–they even offer a free Basic version, which includes offline web browser and image viewing capabilities. For an excellent, though somewhat dated (June 2002) listing and review of these and many other eBook readers, see:

www.the-gadgeteer.com/docreaders-review.html

If you already have one or more of these readers, make sure to visit the following site to find medical documents and references in a wide variety of formats:

www.memoware.com

Finally, we want to mention Bonsai Outliner, from Natara ( www.natara.com ). Natara is a hierarchical outliner that can be very useful for recording clinical guidelines and other structured text, and can synchronize to a desktop application as well. For an interesting description of how one doctor has used Bonsai to create a “peripheral brain,” see the following:

www.jimthompson.net/palmpda/Bonsai/Peripheral_Brain.htm

There are a variety of high-quality medical study tools for PDAs available, including:

MCCQE Toronto Notes (U of T) is an up-to-date, comprehensive 1300 page review of 30 medical specialties. It includes a fully revised PDA version for valuable quick reference on the ward, and before exams.
Netter’s Anatomy Flashcards (Medical Wizards) contains over 350 high resolution anatomy images, covering all body areas.
MedicalMnemonics is an online and PDA-based database of medical mnemonics for students.

Finally, there is an interesting, and free, differential diagnosis tool named Diagnosaurus, from McGraw-Hill. It offers 1000+ differential diagnoses, and allows you to explore by disease, symptom, or organ system.

If you know of more good study tools for medical students that will run on a PDA, please let us know, so we can list them here.