The Palmdoc Chronicles

Tuesday, September 28, 2004

Haemoncorules - PPC version?

You might be aware that I am the author of Haemoncrules - a freeware application for PalmOS. I developed this as a hobby and also because these are algorithms and formulae which I find useful in my line of work. This is a snapshot of version 1.5 which will include the FLIPI index for low grade lymphoma and also one of the warfarin dosing algorithms.
I have had some queries on a Pocket PC version. Since developing a PPC version will take more time and expense (the development software alone costs US$150), whether I do so would depend on the response to this little poll:

Vote for PPC version
Are you interested in a Pocket PC Version of Haemoncrules?


Would you be happy to donate (say US$5) towards the development of one?



View Results

New Pacific Primary Titles

Pacific Primary Care have released:
Clinical Pediatrics 2005 v1
Clinical Dermatology 2005 v1

Saturday, September 25, 2004

Point of Care

A study by Manhattan Research shows that adoption of Point-of-care techologies by Physicians (including Electronic Medical Records, PDAs and Electronic Prescribing) may be stalling. Key findings:

-Only 140,000 U.S. practicing physicians are using EMR to document clinical data today, although another 283,000 are interested in using EMR in the future. EMR use and adoption is expected to moderately grow through 2006.
- Today, 235,400 U.S. practicing physicians use a PDA for professional and other uses, and about half of the non-PDA users express some level of interest in future PDA use. That said, PDA adoption by U.S. physicians is expected to experience limited growth through 2006.
- Just 43,800 U.S. practicing physicians use electronic prescribing, but the vast majority is interested in future use. Physician adoption of eRx is expected to experience significant growth through 2006. However, considerable challenges remain in this market sector – namely demonstrating the value to the end user physician.

Are the barriers really that hard to overcome? I think people will utilise technology if they find it truly useful and saves time. If technology makes our daily work more cumbersome, then it will not take off.
As far as PDAs are concerned, I really don't know if it will stall. For me, a PDA for quick reference during ward rounds is indispensible. I don't know how I coped prior to the days without a PDA!

Friday, September 24, 2004


Skyscape has released a new title NDH05™ (Nursing2005 Drug Handbook) 7.0.1

Up-to-the-minute information on over 1,000 generic and 3,500 brand-name drugs is just a click away with Nursing2005 Drug Handbook for PDA. This 25th Anniversary edition now includes Rapid Onset interactions information, calling attention to interactions that may be moderate to severe and appear within 24 hours of administration.

It's the passion

PDA users are a loyal bunch, with 85% of Microsoft Windows Mobile users and 82% of Palm OS users saying they plan to stick with the same operating system with their next purchase. That's according to a new survey from Dublin, Calif.-based AvantGo, a division of mobile technology vendor iAnywhere that offers free personalized Web sites to PDA and smartphone users. AvantGo this month polled 3,260 users for its 2004 Mobile Lifestyle survey.

The number of people who plan to stay with the same operating system was the most surprising finding of the survey, which also asked users to rank important hand-held features, according to Neil Versen, senior director at AvantGo. Brand loyalty is something hospitals have to take into account as they deploy PDA applications for physicians, health care information technology executives say.

"Physicians tend to be pretty passionate about the device they select and use," says Sameer Bade, M.D., assistant vice president for clinical IT strategies at MedStar Health, a Columbia, Md.-based, seven-hospital health system.

Source: Mobilehealthdata

I think that's true of PDA users in general. At any pda forum, Palm vs PPC flame wars are a common occurance. Hopefully more hospital IT personnel will take this into account before rolling out systems which support only one platform.
So are you passionate about the device you use?

Wednesday, September 22, 2004

Duke goes wireless with PK

Mobilehealthdata reports:

Duke University Health System in Durham, N.C., has implemented technology from Boston-based PatientKeeper Inc., enabling more than 300 clinicians to use PDAs to access clinical results wirelessly via the PatientKeeper mobile platform.

I'm getting closer now tothis scenario. I can access the hospital LIS (and clinical results) on the LAN from my clinic but I sure hope the hospital goes wireless - and I can use my Wifi enabled T3 to access lab results on the go. The system uses normal web browsers so it shouldn't be a problem for the T3's Webbrowserpro.

Tuesday, September 21, 2004

Screenshot: Pubmed on Tap

Now with a Wifi enable T3, I can explore more wireless apps. This is a screenshot of Pubmed on Tap which I mentioned before. It is a free application which allows you to search Pubmed directly as long as you have an Internet connection on your Palm. Posted by Hello

Wifi is vital

In eight outpatient clinics within Boston's Brigham and Women's Hospital, nurses are wheeling IV poles outfitted with monitors and wireless PDAs into patient exam rooms. They use the technology to record patient vital signs, which are automatically sent to the hospital's electronic medical records system.
The vital sign monitors, which vary by clinic, are connected to the IV poles and the PDAs. Nurses use the PDAs to enter qualifying data, such as where on a person's body a blood pressure reading was taken from, and send the information to the electronic records system.

Source: MobileHealthData

Wifi is going to be more and more important. Speculation has it that it's going to be a prominent missing feature in palmOne's up and coming new model called the T5. Brighthand has already commented that palmOne needs to "get on the Wifi bandwagon". At least palmOne has released the SD Wifi card for the T3 and Z72 models. I took the plunge and decided to get one since I have Wifi at work and at home as well so I thought it would be quite useful to me. If the T5 or whatever future model has dual wireless, I'd upgrade in a heartbeat but if not, I'll stick to my T3 thank you.

Saturday, September 18, 2004


"Do not rely on the continuous availability of this online version of the Be-eN-eF to support clinical decisions at the point of care". I agree. Offline is better.... :) Posted by Hello

CMDT Online

MobileHealthData reports:

McGraw-Hill Medical Publishing has launched an online version of the medical textbook Current Medical Diagnosis & Treatment. Physicians can access the digital book at and download sections of the text onto PDAs. Access is free until Oct. 31, and the site will be continually updated with new information

Operating word: free - well at least until October 31. Requires you to sign up with them.
I really would like to see CMDT made available in FULL for the Palm in an easy to use format and perhaps Unbound Medicine or Skyscape should take this up.

Friday, September 17, 2004


Chemodose is an opensource/GPL software in alpha development which aims to "include all common dosing calculations on a single page".
Its a tiny 13kb file at the moment and it allows you to enter height, weight, creatinine and works out IBW, BSA. You enter the unit dose required (eg mg/m2) and then you get the calculated final dose.
Quite bare bones at the moment but has potential. There are no protocols incorporated at the moment.

Appraising and Applying Evidence

Robert Badgett has released version 2 of Appraising and Applying Evidence. Version 2 adds confidence intervals for all measures of risk and NNT. This freeware looks like a great way to understand and critically review medical literature. Definitely not for the first and last paragraph readers ;)

Includes a 2x2 table that accepts the usual 4 cells, but also will complete missing cells if you provide row or column totals. Has equations for diagnosis and includes Fagan nomogram. Has equations for NNT including deriving the NNT from odds ratios and adjusting the NNT for transportation across prevalences. Can perform Bayesian analyses of statistical significance. Creates evidence tables from multiple studies and exports the tables to memopad. Has epidemiology glossary with examples from classic studies.

Thursday, September 16, 2004


What's your next PDA upgrade? Thinking of getting a smartphone.? I think the Treo600 is quite a good device but I wish they did not have the ugly antenna sticking out and more importantly it lacks Bluetooth which is important if you want to use wireless handsfree headsets with it. The Treo600 is supposed to come with Bluetooth, has a high res screen and nice backlit keys (but unfortunately still has that ugly antenna) and would be a tempting upgrade especially if you don't want to carry two devices.

PalmLoyal has this story about ImpactRx Choosing Treo 600 Smartphones

palmOne, Inc. (Nasdaq: PLMO) announced that ImpactRx, an innovative provider of market insight to the pharmaceutical industry, has purchased several hundred Treo(TM) 600 smartphones from palmOne for its longitudinal physician network. The devices will be used to collect information that is used to measure the relationship between pharmaceutical sales activities and physician prescribing behavior.

A palmOne customer since 2001, ImpactRx will add the Treo 600 to its current portfolio of mobile devices, which currently includes Zire(TM) and Tungsten(TM) handhelds from palmOne. Physicians can take advantage of the Sprint nationwide high-speed network to quickly and easily download information to the ImpactRx database

As for me, I think I'll pass on smartphones for now. I don't mind carrying two devices. I prefer a bigger PDA screen and would want to see a Wifi + Bluetooth combo from palmOne (will they ever listen?)


Skyscape has released MediLact™ 7.0.5 which is the Skyscape PDA version of Medications & Mothers' Milk 2004, 11th Ed.

Now in its eleventh edition, Medications and Mothers' Milk is a worldwide best-selling reference for evaluating medication use in breastfeeding mothers. Since its original publication in 1992, Medications and Mothers' Milk has quickly become the most comprehensive source throughout the world for professionals and for mothers seeking the best pharmacological advice on breastfeeding. The reader will find exact data on the degree of transfer of medications into human milk, the effect on mother and infant, and the relative risk to the infant. This all-inclusive reference contains the most current information available in this field including new studies and additional drug entries.
Written by renowned Clinical Pharmacologist, Dr. Thomas W. Hale, Medications and Mothers' Milk provides the reader with easy to understand explanations of how drugs enter milk, their problems if any, and the relative safety of their use in breastfeeding mothers.

Tuesday, September 14, 2004

GFR Calculator

GFR calculator v1.0 has been released as freeware and allows you to calculate the GFR.
OK I guess if you want something handy only to work out this value, otherwise GFR and tons of other medical calculations are available with the great freebie Medcalc

Clinical Constellation Suite

Skyscape(R), Inc. ( today announced Clinical Constellation, the most comprehensive and integrated suite of decision support resources for handheld devices. Building on the success of other specialty Constellation Suites released earlier in the year, the Clinical Constellation continues the Skyscape tradition of bringing trusted and reputable information for use by clinicians at the point-of-care.
Clinical Constellation offers an intuitive, all-in-one solution providing unparalleled and detailed coverage of critical information about drugs, diseases, interactions, lab information, treatment options and guidelines. The suite includes Griffith's 5-Minute Clinical Consult, 2004 Pocket Book of Infectious Disease Therapy, The AHFS Dosing Companion, Bakerman's ABC's of Interpretive Laboratory Data, The Medical Letter's Handbook of Adverse Drug Interactions, The Guide to Popular Natural Products, ICD-9-CM classification codes, the Archimedes(TM) medical calculator and ARTbeat(TM) dynamic information channels.

Learn more about the Constellation Suite.
The whole package costs US$139.95 and it's a bargain at this price. Pity they didn't put a comprehensive drug package like A2Z Drugs - looks like a star is missing from this constellation ;)


The Podiatric Handheld Page has a free e-book in iSilo format containing information pertaining to podiatry called the Footbook. Download it for free.

Thursday, September 09, 2004

Bluefish update

Bluefish have updated their core applications BluefishRx ICD-9 5.10 and BluefishRx Prescription Writer 5.10.


Skyscape has released BartlettID04™ (2004 Pocket Book of Infectious Disease Therapy, 12th Ed.)

Written by noted authority Dr. John Bartlett, this practical reference on PDA covers all relevant aspects of antibiotics. You'll receive the latest information on dosage, trade names, price, indications, interactions, use in pregnancy, and renal failure. Management guidelines given by organ system and disease category provide you with rapid access to the best available therapies. Tabular material will contain newly approved antibiotics and new recommendations for management.

Wednesday, September 08, 2004

Free Medical Journals

Everyone loves freebies. In case you are not aware, there are free fulltext journals you can access online and these are being promoted by The website.
One of the major ones is the British Medical Journal which still is free. Colleagues still ask me how I get to read the BMJ regularly on my Tungsten T3 and I do so using the BMJ's PDA service via HighWire Press. When you sign up with Highwire you get to install a little Highwire reader app and also a conduit which updates the free subscriptions. I know I mentioned Highwirepress in one of my previous blogs but I think its worth repeating it here and post some new screenshots.

This is the starting page of the Highwire PalmOS application. You can see that I subscribe to JCO (table of contents and abstracts only - pity no full text!) and the BMJ (mostly full text)
This is the view of the BMJ contents delivered via the Highwire conduit. It's text only and no images but I'm not complaining since it's free! claims that the NEJM provides full text for articles older than 6 months but I think this is no longer true. A great pity!! C'mon NEJM, give us a break here.......

Tuesday, September 07, 2004

Wilderness medicine

The Academic Emergency Medicine Online has a full text article on Field Guide to Wilderness Medicine, 2nd Edition CD-ROM PDA Software. I have no idea what the actual contents are but if you have full access, you might be interested.

Sunday, September 05, 2004


Leo of has some thoughts on E-mail as a way of communicating with patient.
What about you? I use my PDA and Sony-Ericsson mobile phones (I carry two with me) to keep in touch with patients. One of the phones is used solely for data communications - SMS and GPRS access. My Tungsten T3 connects with the phone wirelessly via Bluetooth - something I find very handy indeed. I can then send and receive SMS messages to/from patients. SMS messages although short are convenient and unobstrusive - they do not disturb you or demand an instant reply. In fact if my patients want to contact me directly I give out only my data phone number and tell them they can SMS me. If they wish to talk to me then I can SMS back a fixed line number for them to call when I am free. Voice calls to my data phone are greeted by a voice message saying only SMS messages are accepted as I am not free to take a call. Another great thing about SMS is the charges are very reasonable and are a great way for patients out of town (and even out of the country) to keep in touch.
Recently I have been trying out Skype which is an excellent VOIP solution for Windows (and now Mac). They have a beta version for PPCs and I sincerely hope they they'll come out with a PalmOS version in future - now that there are quite a few Wifi options in the Palm PDA world like the SD Wifi cards for the Zire 71,72 and T3; Tungsten C; Sony TH55 and UX-50 and others (e.g. using the Guyver or Enfora case). I'd rather keep my mobile number private and calling other mobile phones gives the number away (unless you have CLIR service). Using SkypeOut VOIP would help you keep your phone number private and even save costs. I have called numbers in the US, Canada and Australia and the SkypeOut sound quality is pretty good (there were early glitches but they are improving) now. Highly recommended.

If you are a Skype user and want to see a PalmOS version, vote here for one!

Saturday, September 04, 2004

Ophthalmology Calculator v1.0

Ophthalmology Calculator v1.0 is available for download as Freeware.

*** IOLC******
Intraocular lens power calculator.
Most common formula to calculate lens power.
Input variables and press 'calculate'. If desired correction is set to 0, correction will be plano.
Formula used are:
Hoffer Q
Holladay II
Holladay I

Thursday, September 02, 2004


Skyscape has released PoisonOD™ 7.0.7 which is the PDA version of Poisoning & Drug Overdose

The best manual on the diagnosis and treatment of poisoning and drug overdose. Thoroughly updated, this reference features extensive information summarizing toxicity and workplace exposure guidelines for over 500 industrial chemicals, and an index containing the ingredients of over 150 common commercial products.

Key Features
* Thoroughly updated
* Current references for each monograph now included
* New material on nutritional supplements
* The latest on chemical and biological weapons
* Up-to-date pharmacokinetic values for common drugs
* Current toxicity and workplace exposure guidelines for over 500 industrial chemicals
* Detailed index, with ingredients of over 150 common commercial product

Natural Standard

Handheldmed Announces the Release of Natural Standard - Reliable Alternative Medicine Information Formatted For Handheld Devices


Handheldmed Inc. and Natural Standard today announced release of Natural Standard(R) for use on handheld computers and personal digital assistants. Widely considered the most authoritative and reliable reference of its kind, Natural Standard is the product of an international collaboration of top researchers and clinicians that provides impartial evidence-based information about herbs, supplements, modalities and conditions and traditional health techniques for professionals and consumers. Coupled with Handheldmed Technology, Natural Standard will for the first time be made available to mobile health professionals whenever they need it, wherever they are.
Almost half of Americans use complementary and alternative medicine, according to a recent study in the Journal of the American Medical Association. Yet, most healthcare professionals have limited knowledge in this area, and published information is often inaccurate or supported only by manufacturers. "Natural Standard analyzes thousands of scientific studies to provide in-depth information about effectiveness, safety, interactions, pregnancy and breastfeeding precautions, pharmacology, history, and expert opinion," according to Ethan Basch, MD, a Chief Editor of Natural Standard who received his medical training at Harvard Medical School. Natural Standard includes contributors from more than 100 prestigious universities worldwide. Authors and editors are some of the most prominent experts in their respective fields, and include medical doctors, pharmacists, naturopaths, acupuncturists, chiropractors, dentists, toxicologists, nurses, and representatives from other diverse health care backgrounds.
According to Dr. Harley Goldberg, a Medical Director at Kaiser Permanente, "the lack of safety and effectiveness evidence for alternative therapies has confounded physicians and the medical community... how do we know if it is safe, or if it will help? And how do we weigh the risks and benefits? Natural Standard has provided just what the doctor ordered: an easy-to-use, evidence-based review to tell us what is known, and what is not."

Wednesday, September 01, 2004


Skyscape has released EmergAir™ 7.0.5

The newly updated Second Edition of the Manual of Emergency Airway Management is now available in PDA format. Prepared by the faculty of the National Emergency Airway Management Course, this handy guide offers step-by-step instructions on techniques, drug administration, and prevention and management of complications and includes extensive coverage of difficult clinical scenarios.
Easy-to-follow algorithms, diagrams, and helpful mnemonics appear throughout. Entries are templated to ensure consistent organization. Evidence-based analysis of procedures is included whenever possible. A section on implementation includes stocking the airway cart, establishing protocols, training, and skill retention.

ePocrates Essentials - Reviews

ePocrates Essentials is the suite from ePocrates which combines Epocrates Rx Pro (premium drug reference), Epocrates Dx (disease reference based on 5MCC) and Epocrates Lab (a diagnostic reference) in an easy to use, updateable and integrated format.
Would you want to pay for this package?
Well to help you in your decision are two reviews:

Review: Epocrates Essentials, A Medical Professional's Trusted Assistant (Palm Boulevard)


Feature - ePocrates Essentials from

I must say I am tempted to upgrade ;)