The Palmdoc Chronicles

Friday, August 29, 2003

Coping with Info Overload using your Palm & RSS

Wired News: Aggregators Attack Info Overload is an interesting article which highlights the increasing popularity of "News Aggregators". I don't know about you, but I suffer from the "Not Enough Time" syndrome and anything which can save me from having to say, surf for information is most welcome. Lots of medical information is now available from Newsfeeds. These come in XML or RSS (rich site summary) format. You need to have a News Aggregator to be able to "pull" in the feeds of your choice. But having set the Aggregator, you no longer have to surf over to the sites for the articles you one. You can peruse the topic headings and selectively click on the links of your choice.

Now what about the Palm? There's no news aggregator for Palm OS AFAIK. This is my solution:

1) I use Amphetadesk - which is a Web based News aggregator. It's easy to setup and available on multiple platforms - Windows, Mac and Linux.

2) Having setup the Newsfeeds and getting Amphetadesk to work properly, you get to view all your "news channels" in a single web page (in my case it is http://127.0.0.1:8888/index.html - don't bother clicking on this link - it opens only on your local machine)

3) I set iSiloX to convert http://127.0.0.1:8888/index.html to an iSilo document (0 link depth). The conversion is perfect and I can take my updated Amphetadesk aggregated News with me to browse offline.

Where to get Newsfeeds? A good place to start is Syndic8 where you can find Medical newsfeeds in XML/RSS format from sites like Moreover, Medscape and others. Sometimes, the description may be too brief and the drawback of this system is that clicking on the "link" in iSilo does not take you to the external web page obviously, but you can Copy & Paste the URL into a Webbrowser (I use WebBrowserPro on my T|T) if you happen to have Internet access (I use Bluetooth to connect with a Bluetooth enabled PC with ADSL access at work but you could do this say over GPRS or WiFi)

Elton Billing

If you are interested in a billing solution, you might check out Elton Billing which is based on Pendragon Forms. Pendragon is another database solution for the Palm which allows you to desing database forms on the PDA and synchronize the data with server databases. The Elton billing solution is for gastroenterology or general use and is compatible with Access 97, 2000 and XP.

Wednesday, August 27, 2003

Evidence Based Pearls

EBP 1.3 has been released in Palmgear.
Application Description:
Evidence Based Pearls (EBP) is the dynamic application you need for providing quality, evidence based care!
EBP provides you with the most important patient centered EBM research at the point of care; accessed through an easy to use interface.
Additionally, this program provides you with a portal to record your Personal Pearls into the EBP database, personalizing this application with your "little black book" of clinical information.
Quarterly, you receive an update of the database, without losing your Personal Pearls. Periodically, we will send you email alerts to keep you current on important medical research.
By having Evidence Based Pearls on your PDA, you will have on hand the information to provide quality care wherever you treat patients.
Our editorial board is comprised of primary care physicians, all of whom are clinical faculty at major medical teaching institutions and nationally recognized for their expertise in quality clinical care and Evidence Based Medicine.
Each topic is derived from a well-respected publication, analyzed by our board, and condensed into a "pearl". Also included is an abbreviated abstract, and journal reference.
This tool will help you stay on top of the clinical information explosion by providing an analysis and summary of important, patient centered research.

Monday, August 25, 2003

ER Suite and Medical Wizards

pdaMD.com features a review on ER Suite and Medical by an ER Nurse.
Cardiology specials from Skyscape

If you are a cardiologist, you might be interested to know that Skyscape is having a special offer for cardiologists. The commercial (I am not getting paid for this, just passing on the good news!):
Save 15% when you buy ANY three or more titles! Maximize these best-selling titles when you cross-reference with other Skyscape-powered diagnosis, drug, and drug interaction references.

5mCardiac™, DrDrugs™, CrdBrdRev™
Use a mini-library in the palm of your hand with Skyscape's special value packages! Improve your professional efficiency and save money with this special offer that includes three best selling titles. Discover the benefits of cross-indexing 5mCardiac (The AHA Clinical Cardiac Consult), the expert guide to common and rare cardiac abnormalities; DrDrugs (Drug Guide for Physicians), a premier drug guide; and CrdBrdRev (Cardiology Intensive Board Review), a highly focused question-and-answer review that is geared specifically to candidates taking the Cardiovascular Boards and the Cardiovascular section of the Internal Medicine Boards. Buy now and save!

Wednesday, August 20, 2003

Automated billing

Right now where I work, billing consultation is done manually and I have to fill in "vouchers". If I forget, then my loss. Primitive workflow? You bet.
In the article on Brigham & Women's Hospital Chooses Handhelds, the electronic solution utilising PatientKeeper sounds so elegant.
"According to PatientKeeper, the PatientKeeper Charge Capture Application Suite automates a billing process that typically relies on individual billing cards. Instead of jotting information on the cards, doctors use the PatientKeeper system to simply check off the customizable diagnosis codes and services performed on their handhelds. The PatientKeeper Clinical Application Suite consists of a variety of tools for reading and analyzing all types of patient data such laboratory results, medication lists, allergies, and clinical documentation."
Anatomy 4.0

This is one subject which requires constant revision. What better way to do this than to carry the information in the Palm of your hand? Anatomy 4.0 has been updated and now supports database storage in the memory card (i.e. VFS support).

Application Description:Anatomy is a quick reference of human anatomy for the Palm OS. Ten databases describe the different body systems. The information in each database is categorized into different "Detail Views".
The registered version will allow full access to all of the following databases:
Arteries, Veins , Lymphatics , Bones , Joints , Muscles , Brain Structures ,Nerves ,Visceral Organs ,Surface Anatomy

Tuesday, August 19, 2003

HaemOncRules 1.1

I have released the updated version of HaemOncRules with 17 modules now. The new modules are:
- ECOG and Karnofsky scores
- Heparin dosing algorithm
- DVT diagnostic algorithm

You can get this freeware from Palmgear, Freewarepalm, Handango or my software page.

I look forward to more feedback and suggestions for improvement.


Monday, August 18, 2003

Free Palm Medical Software

While surfing today, I stumbled across this page:
PalmDiary dot Com - Free Medical Palm Software which has a fairly long list of Palm Medical software. Some titles appear new to me and I will be checking these out.
Baby check

We have all sorts of "trackers" for PalmOS now - track your BP, track your blood glucose etc. Now with FreewarePalm: BabyCheck v1.0 you can track your baby's progress :)
Description:
Babies information administration.
Features:
- Weight and Height follow up during the 3 first years
- Visual check with the average values
- List of the first words
- Birth information: Weight, Height, Date and Time
- Zodiacal sign
- Firstname symbolic (lucky number, lucky period)
This program works in Kg or Lb, Cm or In.



MedRules Rulez!
PalmGear Announces Top 10 Applications for Palm-Connected Handhelds for July

The top 10 applications on the PalmGear site in July were:

* Aerodrome Software's AeroPlayer, an enhancement that turns a Tungsten T,
Tungsten C or Zire 71 into a portable MP3 audio player.
* Datoru Drosibas Tehnologijas' FlyZip XR, a compressing and decompressing
utility that doubles the amount of information stored on Palm OS
handhelds without modifying the hardware.
* ZZTECH's ZLauncher, a system management program integrating the system
supervisor, application/database manager and expansion card manager.
* Ardiri's Lemmings, a fun free game for the Palm, implemented from the
classic game originally created by Psygnosis.
* Ants Technologies' DataKeeper, a database utility that maintains
personal information such as passwords, credit cards, bank information,
birthdays, flights, hotels and URLs in a single location.
* PocketSensei's SilverScreen, a tool that customizes your Palm OS
interface with a library of various stylish themes.
* Kent Willyard's MedRules, a medical application that features clinical
prediction rules.
* Ants Technologies' DateBook on Clock, brings users address book, date
book, to do list, mail, etc. onto one easy to read interface.
* Arcona Magi's Medieval Heroes, a free historical strategy game.
* PDA 3Dware's 3D Blockout, the only three-dimensional falling blocks game
for the Palm.

Sunday, August 17, 2003

Medical Abbreviations

I am sure many a medical or nursing student have emerged from wards bewildered by case note entries such as:

Pt 44 yr old Ind M c/o SOB 3 mths, LOA and LOW. BNO for 4 days. PHI of HBP, NIDDM . o/e T 38 PERL EENT NAD, CVS DRNM, Abd L°S°K°

Doctors are guilty of such horrible indecipherable abbreviations (as if the writing is not bad enough!!).

I came across 2 freebies in Palmgear.com which may be useful to those struggling to cope with this issue.

Medical Abbreviations by Krystof J. Neumann is one.
Application Description:Medical Abbreviations is a FREE, very easy to use, searchable database that currently includes over 2000 common and not-so-common medical abbreviations from AA to ZPP, and from HEENT to BRBPR, that was compiled with the hope of reducing some of the confusion that results from the use abbreviations in medical charting.

For some reason I could not run this program on my T|T. Perhaps it is not OS 5 compatible. I shall try it a bit later on my m515 and post the results here. Anyway no harm trying it as it may work for you.

Medical Abbreviations 3.0 is an iSilo document by Kiup Alex Kim . This has over 3000 abbreviations. The released version is free but the author (a medical student) can send you updated versions if you wish, for a nominal fee

There are other Payware Medical Abbreviations on Palmgear, some purporting to contain over 10,000 listings (goodness, are there that many).
I'll bet none have "UFEME" - can you guess what this obscure abbreviation stands for - it's used I think only in my part of the world ;)




Saturday, August 16, 2003

Moses Cone Health System

"The doctors, on average, save anywhere from 30 to 90 minutes per day by using this solution in their rounds. The time saved gets pretty staggering when you talk about how many people we have per hospital."

According to John Jenkins, CIO at Moses Cone, "The challenges that we have are that the physicians need a convenient way to collect information about the patients they are caring for. We have clinical systems in place, but they require going to a computer, sitting down, and getting the information; then, either transposing it to a piece of paper or remembering what they've seen to go deal with their patient. It was inconvenient and it was fairly time-consuming. What we were looking for was a solution that would be easy for the physician to carry around and could present the clinical data that they needed for their patient care one that they could get to very easily and quickly. MercuryMD and the Palm handheld provide that solution for us."

How did they use MercuryMD's MData to perform all this wizardry?

"Several infrared beaming stations are located around the hospital buildings. Pointing the Palm handheld at one of the beaming stations allows clinicians to download patient data, treatment plans, lab results, and other patient information. The doctors, on average, save anywhere from 30 to 90 minutes each day. Pharmacists, who previously had to write or print information about each patient every morning, can also access patient records and prescriptions via Palm handhelds. The Palm handheld solution results in less paperwork and saves each pharmacist an hour or more a day"

Read the full Palm article here on how Moses Cone Health Systems did it.

Friday, August 15, 2003

Jim's new Palm

Jim Thompson, another Palm toting emergency medico has upgraded to the T|T2. His My Tungsten T2 page details his thoughts on his new Palm. It apparently was a necessity as Jim's NR70 died. As for me my T|T is still going strong and the T|T2 is too little an improvement to justify an upgrade. I am holding out for the T|T3 or possibly trhe rumoured T|C2 (with WiFi AND Bluetooth). But really 320x480 would be the bigger lure and I do need more Ram. Jim hasn't discovered the joys of Bluetooth yet ;) He says "I have never felt compelled to spend hundreds and hundreds of dollars upgrading handhelds and cellphones to surf the Internet slowly on a small screen. ". Jim, Jim. Not just the surfing. Most of my Bluetooth activity involves sending and collecting SMSs from my Bluetooth capable phone (the cheap, battery efficient lightweight Ericsson T39) which remains in my pocket. Dialing from the T|T via Bluetooth to the phone and then picking up the call on the Bluetooth HBH-30 headset is the ultimate in geekiness.
I am reminded in this tropical part of the world, there's another famous Jim Thompson. Same moniker but quite a different character - his disappearance is still a mystery today. He was last seen in Cameron Highlands, a highland resort in my home country. But I digress.......
BluefishRx Prescription Writer



BlueFish Wireless Prescription writer sounds like a very good idea. I was fascinated that they have incorporated Biometric Signature Verification. I wonder how the Palm will standup to this in real life. Sending the order wirelessly to the pharmacy sounds real cool too.

Wednesday, August 13, 2003

DateToolz 1.0

DateToolz, written by yours truly has been released as freeware on Palmgear (and hopefully soon on Freewarepalm.com). For me, I just wanted a tool which I could easily use to schedule appointments for patients. I use Agendus every day but one thing it lacks is an easy way to say schedule an appointment 15 weeks or 100 days in advance. Imagine trying to pick out the date on the popup Date picker. Now with McPhling, I can swicth to DateToolz easily, select the date, hit the Schedule It button and paste the patient's Name. Then one more Tap adds the appointment complete with the [brackets] which links the appointment to the contact Agendus-style.

Tuesday, August 12, 2003

HaemOncRules in Palmgear

Haemonc Rules appears in Palmgear at last. Had alot of difficulty submitting the software as there seemd to be a bug in Palmgear's software submission mechanism. Even their Search engine seems to be buggy. Keying in Haemoncrules in the search gives rise to absolutely nothing. Something's not quite right hear Palmgear people......
HaemoncRules is a collection of algorithms for computing diagnostic criteria, prognosis and clinical decision making in Haematology-Oncology. The current version 1.0 has 14 modules. I have actually done three more so will be updating to version 1.1 in a week or two.
Got a headache?

MemoWare : Headache Diary keeps track of your headaches in HanDbase and MobileDB formats. Keeping track of your symptoms particularly with chronic disorders is a good idea so you can present your information accurately to your physician.

Saturday, August 09, 2003

My Dead Palm

Palmdoc's Palm-Pilot- Professional Resting Place chronicles the passing of my first Palm PDA. This thing replaced all the sheets of note paper and little booklets I used to carry around in the wards in my bulging Labcoat pockets. Since then, I have never looked back and gone on to a IIIx, m505, m515 and now a Tungsten T. All were in working condition until the Pilot Professional finally died this year. RIP.

Friday, August 08, 2003

DateToolz

I am currently on holiday, away from the noise and pollution of the city. The air is nice and clean up north here. But sadly, there is no broadband and I only have a very very slow dial-up which is flaky at best. What to do with all the spare time? More NSBasic programming of course :)
One of the things I find when I use Agendus to schedule appointments is the lack of an easy way to schedule the item x weeks/days ahead of the current date (one has to manually count the days/weeks on the Popupdate picker). What I wanted is a system to work out the new date and then automatically put in a new Datebook entry for that date. Thus Datecalc came into fruition. I also put in a checkbox so that the patient's names are enclosed in brackets simulating Agendus' link to the contact. A bit clunky but it works. I thought I'd also put in other useful (to me anyway) Date calculation features. Agecalc will work out the days/weeks/months/years elapsed from the "birthdate" which could be anything you want, e.g. date of transplant. I also threw in a pregnancy EDD/gestation calculator, Pregcalc. I know, I know some of these are available in various freeware Palm software out there but I cobbled these together as they are tools which I would be using and hopefully someone out there will find this useful as well. Watch out for DateToolz in Freewarepalm.com (and Palmgear if they can get their act together)

Thursday, August 07, 2003

I need more memory

M-Systems to boost memory in Palm handhelds | CNET.com sounds like good news to me. I am running low with less than 3MB on my TT. Trouble is so many medical apps eat Ram, e.g. ePocrates. Skyscape apps too best reside in Ram as the Smartlink feature requires them to be so.

What to do? I am skipping the T2 upgrade and will wait for the T3 which hopefully comes out in October.....

Tuesday, August 05, 2003

Drips

Drips has been updated to v 1.4
Description:
Calculates IV doses for drugs.
It allows use of multiple units e.g. lbs vs kg or mcg/kg/min vs mg/min.
One can save frequently used patterns / drug mixes, and beam them.

Freeware.

Emergency First Aid Guide

Free First Aid Guide spotted in Palmgear.
Application Description:First Aid instructions, useful to have at hand in an emergency situation. Consists of nine Memo Pad pages.
Table of contents
1 First: Check, Call, Care
2 Consent
3 ABCs: Airway, Breathing, Circulation
4 Diagnosis and First Aid
5 First Aid For Bleeding
6 First Aid and Possible Spinal Injury
7 First Aid and Mental Status
8 Shock

Looks pretty basic. But it's free :)
Hey I wonder how the guy managed to submit his software into Palmgear. I am still getting submission errors trying to get HaemOncRules submitted as freeware into Palmgear. Tech support did email me that there was a problem but they haven't got back to me since then and it still doesn't work!!!
Chemotherapy protocol database

I was quite interested when I spotted the one in the DDHsoftware ( the makers of HanDbase) gallery by Felice Musicco. But somehow when I downloaded it, it could not convert properly to Handbase 3.0. Bummer.
I do use HanDbase extensively and I carry around my own database of chemotherapy protocols (in Haematology-Oncology) - see pic on the left . These serve more as an aide memoire since most of the protocols in daily work are printed. Anyone want to share their own database?

Sunday, August 03, 2003

Another example of checking for Drug Interaction with your Palm

Here's another Doctor who's finding Epocrates indispensable - spotted in The Herald Tribune

"O'Neil admits that drug interactions were little understood when he was in medical school nearly 30 years ago. People were taking fewer vitamins and herbal supplements back then, too.

But now he doesn't take any chances.

He uses a hand-held computer in his office to cross-reference drugs, foods and supplements to give his patients the latest information about things that could help or hurt them when they're on certain medications.

"There's a wonderful program I use that I've recommended to other doctors. It's called ePocrates. It's not that expensive, maybe $50 a year, and I can download it into my Palm Pilot, which I can keep with me to do multiple checks on drugs and herbal supplements," O'Neil said. "

Sounds useful? You bet! You really will appreciate how handy it is to be able to detect possible interactions on the spot. Like the time I spotted the Lamotrigine + Carbamazepine interaction

The article also lists some useful tips for patients.
One being "Make a list of of all the drugs and supplements you use. Take the list to your doctor and pharmacist and review it at every visit. Or fill a bag with all the drugs, supplements and over-the-counter medications you take and ask your doctor to evaluate your risk of harmful interactions."
I still am waiting for the day when a patient of mine will say "Doc, here's the list of medications I am taking. I'll beam it over to you......"

Friday, August 01, 2003

Palm Program Names

Sometimes these can be somewhat funny and misleading. VD Image Viewer does not have pictures of syphilis infected genitals. Rectogen has little to do with the distal portion of the gastrointestinal tract. Also Ward Org won't be of help to Interns or doctors managing their wards.

Hmmm....... ;)
My PalmOS Software Page

You can view my PalmOS "productions" in this webpage.
HaemOncRules has been released in Freewarepalm. Somehow I can't submit it to Palmgear - I keep getting an error:
"You have received this page because an error has occurred. Be assured that the issue you are experiencing has been forwarded to our development team and that we are working to get this issue corrected as quickly as possible. We appreciate your patience and thank you for your business"
Looks like their new web system has lots of bugs to be ironed out.