Asco PDA Portal

Joined Docsboard (finally hehe) which looks like a great site if you are a Doc with a keen interest in computers and PDAs.
Picked up a useful pointer : Asco has a PDA Portal. Works like Avantgo and is free - so go check it out.

I'm still strongly in the PalmOS camp in case anyone is worried I have defected :P. I am using a palmOne T5 for my daily PDA use. I still am interested in getting a Dell Axim X50v as a second/spare PDA and also to see what the "Darkside" is all about - hopefully I won't get assimilated!
Latest latest news about my dead T3 is that palmOne support has now "escalated" my issue with them to the Customer Service Manager. So hopefully I'll see a better deal than a replacement costing US$125 with a "generous" 3 month warranty....

CME Watch

CME Watch is now 1.0

Description: Keep Track of your CME Hours on your Palm! This program automatically Adds and summarizes Total CME Hours!! NEW in Version 1.0: -Export to Memo Pad -Various Bug Fixes -Print to PalmPrint -Archive older CME Records -NOW FREEWARE!!

Turning to the Dark Side....part II

Well, the dead T3 saga is practically over. palmOne's stand is that since the unit is out of warranty, they will issue a replacement for US$125 and provide a "generous" 3 months warranty on this unit. They can keep it for all I care. It should be at least 6 months warranty given that price and the reliability of a refurbished unit is always in question. I have not had a happy experience with my T3 as I had to replace it twice already.

In preparation for the Dark side, I have switched back to syncing with Outlook instead of Palm Desktop with my T5 (yes, the sole remaining Palm I have, which I have paid good money to palmOne to field test for them).
Eventually when I get my hands on a Dell Axim X50V I can easily migrate my PIM data over. I have identified WM2003 replacements for practically every PDA application I use today so I think the switch can be made. I won't miss Agendus too much as I could rely on Agendus for Windows on the Desktop for clinic use, to manage Patient Appointments. I find Agendus for Windows a far better PIM manager than Outlook and it works on top of Outlook or Palm Desktop and can read PIM data from either source.

Have any of you medical Palm PDA users made the switch from Palm to PPC/WM2003? Care to share your experience/advice/words of wisdom? If you could email me your thoughts and experiences on this matter I'd appreciate it. I also still have alot of Gmail invitations to give out so more FREE Gmail invites for those who write in!

Pepid Lab Manual

Pepid have launched a new Lab Manual to complement their suite of medical references.

PEPID's new Laboratory Manual includes detailed information on 300 common lab tests. Information for each test includes all of the following sub titles (on applicable tests):
* Critical Values - listed first with links to High and Low Interpretation and symptoms and treatments
* Description - Common use of test, crucial ordering points
* Method Differences - Sensitivity/specificity, screening/confirmation use
* Normal Reference Ranges - Presented in standard and SI units with gender and age differentials. Instant information with links to High and Low interpretation and symptoms and treatments.
* Interpretation High & Interpretation Low - Includes general comments, medical causes, factitious/spurious causes and drug causes with links to symptoms and treatment
* Related Tests - lists commonly related tests, testing strategies, and other considerations
* Equations - links to related PEPID equations/calculators
* Physiology - Underlying processes of substance/metabolite being measured. Lists the origin, function, detrimental effects and excretion.
* Tech Info - Collection methodology and guidelines

NCLEX-RN8

Skyscape has released NCLEX-RN8 which is Lippincott's Review for NCLEX-RN®, 8th Ed.

The newly updated Eighth Edition of the top-selling NCLEX-RN® review is available in PDA format for easy study on the go. This edition reflects the current NCLEX® test plan and contains more than 5,000 total test questions—including alternate-format questions—to help students practice taking the exam. Organized by practice area—childbearing family and neonate, child health, adult medical-surgical, and psychiatric-mental health—this PDA program contains more questions than any other NCLEX-RN® review, and explains the rationale for correct and incorrect answers. Five comprehensive tests resembling the format of the NCLEX-RN® are also included.

Taber's Cyclopedic Medical Dictionary

Unbound Medicine has released Taber's Cyclopedic Medical Dictionary 20th Edition 2.1

Application Description Taber's Cyclopedic Medical Dictionary, published by F.A. Davis, defines more terms than any other health science dictionary. With approximately 56,000 terms in all — including 8,400 new and revised terms — the NEW Tabers 20th is the most comprehensive health science dictionary available today.

Physician's Desk Reference

Spotted in Memoware: Physician's Desk Reference (4 Titles of the PDR: Rx Guide, OTC Guide, Herbal Guide, and Supplement Guide). I have not tested this. Apparently in iSilo format.

IQMax

MobileHealthData reports that IQMax, a "vendor of PDA-based mobile health applications, has debuted IQRounds. The new application enables caregiver access to inpatient clinical results and other patient information and can run on PDAs with the Palm OS or Windows Mobile operating systems."
Now forget about "patient tracking" type of info. This is something I could really use - the ability to access lab results while rounding, without having to constantly walk over to the desktop computers. I think hospitals are too slow implementing wireless technologies which will really make like easier for doctors and nurses.

Medical tricorder

Any Trek fans out there (I'm bemoaning the demise of Enterprise btw :( - that and my T3's demise is soooo depressing )
Anyway, I did come across an article in a computer magazine which predicts the incorporation of special detectors within PDAs for the likes of chemical hazards and what not. I guess we could even see PDAs compbined with hand held cancer detectors .

OK at the moment it is all science fiction but I did recall one funny incident a while back. There is a "Star Trek Tricorder" for PalmOS. For a lark I demo'd it in the medical staff lounge to a colleague. We scanned a sleeping Orthopod and lo and behold, the Tricorder reading was "No intelligent lifeform found". It works! Go try it out ;)

Clinical Allergy & Immunology

Pacific Primary Care have updated Clinical Allergy & Immunology v2006

Application Description Topics include: general immunology, immune deficiency, transplantations (lung, kidney, heart, bone marrow, pancreas liver), complete vaccination information, allergic disorders such as rhinitis, drug reactions, asthma, skin reactions, latex allergy, food allergies, anaphylaxis, urticaria and much more Edited by both adult and pediatric allergists.

Turning to the Dark Side....

My Dead T3 
Yes my T3 died (RIP) recently. The screen suddenly went blank. All efforts to resuscitate it came to naught. I could not send it back to palmOne hospital as it did not have any insurance cover (i.e. it's out of warranty). All manner of resets did not evoke any sign of life.
I then left it alone hoping the battery would drain after a couple of days then re-charged it overnight but nothing happened. I even disassembled it - as you can see from the post-mortem picture above. Not a clue as to the cause of death. Should I call in CSI?

Luckily I purchased a T5 last month and at the moment I am using it. I am not entirely happy with the T5 as I do miss the voice recorder function and I think the new file system is a bit buggy, and palmOne is slow in coming out with a patch.
So this "Palm Jedi" is now thinking the unthinkable. Should I go to the "Dark side" and get a PeePeeSee?

The Dell Axim X50v is something I am considering given the hardware specs (VGA screen, dual wireless, replaceable batteries) which look superior to the T5's. The thought of switching software platforms is rather daunting though but others have done it. Docsboard has a couple of threads on this:
Dell Axim X30 (the 624 MHz version) or Palm Tungsten T3?
Windows Mobile (PocketPC) 2003 Dell Axim X50v
The crucial bit is to see how Contact management will be on the PPC platform - this will pit Pocket Informant against Agendus Pro.
As for medical programs, I think there playing field is almost equal nowadays as there are versions for the PPC as there are for Palm e.g. ePocrates.
Of course it means work for me to as I would then definitely have to port Haemoncrules over to the PPC platform :P

I think what I'll do is get the Axim X50V when Dell has a discount sale like they did recently over here. I'll slowly set it up to see if the switch is feasible.
In the meantime I have fired off an email to palmOne support detailing my gripe with them. A $300+ investment which lasted a little over a year is pretty pathetic. palmOne's PDAs have been suffering a decline in build quality and reliability over the years. Unless something is done to stop the rot, 2005 will be the year Palm died.

Stellar use of technology

MobileHealthData reports:

Durham, N.C.-based bioMerieux Inc. has released a Web-based system that integrates and analyzes patient microbiology information to offer physicians decision support. The STELLARA clinical intervention and patient monitoring software integrates with the vendor's antibiotic resistance results application as well as a hospital's lab and pharmacy systems. It also offers therapeutic recommendations for such results suggested by various medical best practices. The system, which can be used on PDAs running the Palm OS operating system, is available in four levels. The first level offers real-time connectivity to back-end data systems. The second level can feed the aggregated data to pharmacists and clinicians. The third and fourth levels offer alerting capabilities. The system, which will be live in 12 hospitals by June, can increase patient safety by giving clinicians access to the most up-to-date information at the point of care, vendor executives say.

You can download a demo from bioMerieux's website. For physicians who deal with infections and need quick and accurate advice on choice of antibiotics, this looks interesting.

As an aside, the bioMerieux page has pictures of Tungsten|C's - currently palmOne's ONLY PDA with built-in Wifi and this is getting very long in the tooth and an update long overdue - is it ever coming?
My T3 died lately and I have my T5 as my only PDA. I always feel more comfortable with a backup at hand but looking at palmOne's line-up, it's quite pathetic. I don't want a smarthpone with crippled Ram capacity and no Wifi. I want a dual-wireless PDA with both Bluetooth and built-in Wifi. Sadly, for the first time in years, I have to look at the Pocket PC camp and the Dell Axim X50V is looking more attractive each day!

C-Tools overview

C-Tools 2.0 has been released and is an excellent free Personal Digital Assistant (PDA) software package that helps doctors and their staff prevent, diagnose and treat cancer.
New Media Medicine has a good overview here
I hope to be able to review it in good time.

ePocrates at heart

A message from the ePocrates team:

February 14th is not just Valentine's Day; it's also Congenital Heart Defect Awareness Day, and National Donor Day. This month we also recognize American Heart Month, National Wear Red Day on 2/4 (for women's heart disease awareness), Cardiovascular Rehabilitation Week 2/13-19, National Women's Heart Day on 2/18 and Heart Failure Awareness Week 2/13-19. Epocrates offers many features that will help you care for your patients' heart health, including: * The latest information on cardiac drugs and drug interactions * Free StatCholesterol tool (includes ATPIII cholesterol guidelines and coronary heart disease risk calculator) * Free HTN QuickRef™ tool (includes JNC7 guidelines and Framingham Risk Calculator) * Insurance coverage information and pricing to help you save patients money * Patient medication instructions in English and Spanish * Diagnosis and treatment of cardiovascular diseases and conditions * Treatment recommendations for infections e.g. endocarditis, pericarditis * Cardiology calculators, clinical criteria and decision trees * Differential diagnosis and follow-up for AHA-recommended C-Reactive Protein Test * Preventative measures for Endocarditis Prophylaxis and hypertension * ICD-9 codes to help you get reimbursed To learn more about all of these valuable features, visit our Heart Health Web Page. Warm Wishes, The Epocrates Team

Goodness, I didn't realise there were so many "heart related" awareness days/weeks/months.
Here's wishing you all a Happy Valentine's Day ;)

User experience: Darlene

Darlene writes:

I have a treo 600 packed with medical information. I work with cancer patients as a patient advocate and cancer guide. I have both allopathic programs and CAM programs. The herbal programs allow me to check for herbs that may interfere with pharmaceuticals. I use the chemotherapy programs and staging programs for oncology. I could not work without my Treo. I also can get updates and cancer alerts from the various webs to which I subscribe. Darlene

Looking up drug information is probably the most frequent medical app usage I think. Well, it is for me (right up there next to Medcalc) and yes it is handy to look up regular drug info as well as herbal drug info.
There is still a "wow" factor and patients are often impressed e.g. when you convince them that they should not be taking Ginseng with their Warfarin by showing them the info from your herbal formulary on the Palm.
For physicians, it's far less embarassing looking up info on the Palm than a book!

A free Gmail invitation has gone out to Darlene and I still have plenty left. Please write in for one!

User experience: elmo

Well, not Sesame Street's Elmo, but elmo of KVPUG wrote:

I am a house pharmacist and this is an example how i use my Zire 72 when Dr. ask me questions about drug dosing. 1. 5MCC (to get a brief info about the disease) 2. Oxford Medical Dict (much easy to understand compare to stedmans) 3. MedCalc (to calculate CrCl - lazy to use calculator) 4. Lexi Drug (to get the dosing of a drug for eg renal impairment) 5. Johns Hopkins Antibiotic (if the drug is Ab) 6. Micromedex (sometimes to double check the doses, just in case) Then only i tell the Dr. 7. PIER (for extra reading at home) i also use InfoRetriever for clinical practice guidelines and drug trials (even though PIER is more than sufficient) as reference, IdentADrug in drug identification, Epocrates to keep me updated about current trend in medicine, kdic (introduced by palmdoc) to refer to chinese words so i can label the medicine for the patients in chinese. For drug interactions, i use micromedex. ABCLabData for lab related enquiry. Future...mmm...i think everyone in medical field will use palm as their main reference in their practice. As a pharmacist it is better for us to start off now, hoping in future not getting replaced by palm. Else we will need to find another job.

Thanks for writing in elmo! A free Gmail invite goes out to you (you may need to check your Bulk email folder as sometimes it goes there).
No, I don't think pharmacists will ever be replaced by PDAs ;) Technology may threaten certain jobs though e.g. with telemedicine, non-interventional radiologists may find themselves out of a job, replaced by remote reporting.

OK folks, I got plenty more GMail invitations so please write in!

Mobile medical imaging

There's a discussion going on in KVPUG about mobile imaging tools for Radiologists as reported in News.com
This is a report on an Opensource application which uses Apple iPods to store and view radiology images. Quite clever.
But then someone in KVPUG also posted:

All this is known tech.. I have referred cases of trauma victims just by sending a MMS from my HP to my colleagues and you can see them running to the operating theatre.. no need Ipod... why not just view on the bigscreen of t3/t5? even better WHEN palm does a 640x480... In GHKL (I was doing ortho) during my calls I carry my digicam, see cases, take photos, show my consultant and make decision when viewing on my t3..some decisions to amputate were made from a t3 screen..

Interesting application of a T3. So do you use your PDA for mobile medical imaging?
I can imagine the PDAs with built in cams like the Zire72 and the Treos may actually come in quite handy.

Clinical Nephrology 2006

Pacific Primary Care have updated Clinical Nephrology 2006 in Palmgear. Kudos to them for updating their excellent text references but to nit-pick a little, must they always name their editions 1 year in advance? :P

Topics include: acute & chronic renal failure, edema, hypertension, acid-base physiology, hematuria, proteinuria, rhabdomyolysis, electrolytes, urinalysis, cystic diseases, cancer, RTA, drug dosing in renal failure, cystic casease, renal drug toxicity, electrolytes, labs, kidney transplant and more much, much more...

Gmail reminder

Google's getting very generous and I still have 50 free Gmail invitations to give out. So if you care to end me an email about your Palm Medical coomputing thoughts and experiences (which I'll post here) I'll send you the invite.
Gmail's great - 1 Gb of storage, 10MB attachments, fast and easy to use.

Harrison's in Palmgear!

Has someone made a mistake here? Harrisons Principles of Internal Medicine "stripped and converted to iSilo format" available as freeware in Palmgear? Goodness. I wonder how long this will last there before it's withdrawn? 8-0

Henry Ford and Rcopia

New Media Medicine reports that Henry Ford Health System has chosen Rcopia ePrescribing to improve patient safety and reduce prescription-related costs.

Physicians can use DrFirst Rcopia via the web on desktop, laptop and tablet PCs. Mobile implementation is powered by DrFirst Rcopia for Palm OS(R), which integrates seamlessly with the web-based system to ensure full on-line and off-line functionality.

Palm tutorials

Spotted in PalmAddicts:

I run a website for doctors called New Media Medicine – www.newmediamedicine.com. The site has information on electronic medical records systems which includes the use of PDAs. We’ve recently added a couple of flash tutorials on how to use Date Book and Address Book in clinical settings. It would be great if you could mention this on your website and include us in your list of links. - Chris Paton

I find that at least 2/3 of the time on the PDA is spent on the builtin "PIM" apps - datebook, contacts, tasks and memos. I notice that many doctor colleagues and indeed PDA users in general aren't maximising the functions available to them in this area. For instance, they will just lump all their contacts into "Unfiled" and don't bother to categorise them or don't organise their phone numbers properly into Work, Mobile etc.
If you fall into this category, do take the trouble to run through the Flash tutorials in the New Media Medicine site.
Datebook Tutorial
Address Book - Part 1
Address Book - Part 2
Address Book - Part 3
Address Book - Part 4

While you're there, New Media Medicine looks like a great link for EMR. There's also notice of a Royal Society of Medicine Handheld Computers Workshop which will be held on April 7, 2005 in London.

ScolioMeter 1.1

ScolioMeter has been updated to support OS 5 machines. Grab this freeware idiopathic adolescent scoliosis guide from Palmgear.

Description: ScolioMeter is handy guide to help primary care physicians decide when to refer, how to treat, and what to look for in idiopathic adolescent scoliosis. Both "thin" (requires NSBRuntime) and "fat" (no runtime required) versions of the app are included for your convenience.

PDAs find happiness

Newswise reports that a new study employing PDAs has found that patients with severe illnesses and disabilities don’t wallow in misery and self-pity all the time, and in fact may be just as happy as those without major medical conditions.
I thought it was a novel way to study mood, especially using PDAs to beep and prompt the patient to assess their mood.

The researchers made their surprising finding by having 49 pairs of dialysis patients and healthy people report their mood every few hours for a week, using a handheld personal digital assistant (PDA) such as a Palm. The patients had all been in dialysis for at least three months, visiting a hemodialysis center three or more times a week for hours at a time to have their blood cleaned because their kidneys had failed. Lead author Jason Riis, a former U-M graduate student now at Princeton University, programmed the PDAs to beep randomly during each two-hour period of an entire week, and prompt participants to report their mood at those random moments by completing a quick series of ratings. “The big advantage of using PDAs is that you can get representative snapshots of a person’s experience, rather than just relying on their overall impressions of their lives,” says Riis, adding that several studies have shown such overall impressions to be biased in a variety of ways. “Our snapshots revealed that the patients were in good moods the vast majority of the time, and that their moods were not substantially worse than those of the healthy people.”

Eponyms

Medical Eponyms, freeware for PalmOS by Andrew Yee has been updated to version 1.83 with 1550 eponyms. There is also a PPC version plus it is also available in multiple database formats - Jfile, Handbase, MobileDB, iSilo, Doc and Tomeraider - if you prefer.
Great job, Andrew!

Feedback: Rich Chen

Rich Chen writes:

Hi ! My name is Rich Chen, and I am an internal medicine physician practicing in the suburbs of Washington, DC, USA. I'm on my second Palm Vx, having dropped the first one in a toilet a couple of years back. I carry it around at work all the time, and feel almost naked without it. Its 8Mb RAM is fully packed with usually <100K to spare. Stuff on my Palm: - Epocrates Rx Pro - MedCalc - Shots 2005 - MDRD GRF calculator - dTree (mini-mental status calculator) - hospital telephone directories - a whole bunch (2,500+) of ICD-9 diagnosis codes, as our practice has found that the best way to code accurately is for doctors to do it ourselves. I'll upgrade when this machine fails. The digitizer of this refurbished unit has never been as good as the original and now requires recalibration every couple of days. I'm not sure to stick with Palm or to go with PocketPC, given that Palm hardware seems to be a product cycle or so behind PocketPC these days with features and processor speed. Our hospitals are now supporting wireless (IR) transmission of patient data and I'm looking forwards to eventually using a PDA capable of this, along with WiFi/BT, and a VGA screen. Hopefully Palm will develop a machine to keep my business. I just got my wife, also an internist, a Zire 72 last month, at 60% off retail. She really enjoys playing games on it but hasn't used the medical applications at all. Thank you!

Thanks for writing in Rich. A Gmail invite has gone out to you!
Hmmm, I really think the Vx is due for an upgrade. I agree with you that its a dilemma nowadays to decide between Palm and PPC. The PIM handling on Palm is still superior but that is only one of the few advantages left. PPC hardware is beter value for money and if built-in Wifi is important than I think PPCs like the Dell AXim X50v are excellent value and make better choices given that palmOne has not upgraded their "Wifi builtin" Tungsten T|C model (c'mon palmOne, buck up - where IS that dual wireless PDA we're all waiting for!!!). Most Palm medical apps nowadays have PPC equivalents so its not a big problem. My current PDA is a Tungsten T5 and I have Wifi access with palmOne's SD Wifi card. I'm pretty happy with it overall - you don't lose data if you forget to charge and I like Drive mode/File transfer.
The advantage of upgrading from the Vx is that you get a PDA with external storage capability - something the Vx does not have and vital given the large databases found in medical apps today.
Let us know what you decided on eventually!

Medcalc updated

Medcalc, the great free medical calculator with tons of formulae, has been updated once again and in version 5.2, the changes are:
- Adds 3 formulas (cardiac output [echo], opiate equivalence, O2 tank remaining time)
- The usual bug fixes

I was thinking of adding an Opiate equivalence module to Haemoncrules but this guy has beaten me to it :P

More free Gmail invites

I've got even more free Gmail invites to give out! All you gotta do is to write to me and share your Palm Medical computing experience - what you use, your favorite apps, your thoughts on Palm's future etc.

ProfileMD Classic

ProfileMD has been updated and is a useful freeware app for storing your personal heath record.

Description: ProfileMD Classic is a personal health record for PalmOS handhelds. ProfileMD Classic allows you to track allergies, medications, surgeries, and illnesses. Update Description: v1.02: - Support for landscape screens. - Added sections for blood pressure, blood sugar, weight, peak flow, symptom log and more!

Skyscape in Sierra Leone

If you are thinking of joining Doctors without Borders or something similar, then don't forget to pack your PDA and your Skyscape or other references with you. Skyscape has this story on how Physicians Helping Children in Africa have found Skyscape references like 5MCC so useful.

Taber's Unbound

Unbound Medicine has updated the popular Taber's Cyclopedic Medical Dictionary and the 20th edition is now available.

Taber's Cyclopedic Medical Dictionary, published by F.A. Davis, defines more terms than any other health science dictionary. With approximately 56,000 terms in all — including 8,400 new and revised terms — Taber's 20th is the most comprehensive health science dictionary available today.

I think a dictionary in your Palm PDA is very handy. Now and then you may have the need to look up the definition of something obscure like "pampiniform".
It's hard to choose between Taber's and Stedman's medical dictionary. I think both are very good.

Size matters

J Faughnan bemoans the fact that "no company will again make devices to fit into the front pockets of americans".
I guess he is referring to the current batch of bulky PDAs, particularly the less slim PPCs (e.g. the iPaq 47xx). Thankfully my T5 is still slim enough to put in my front-shirt pocket.
I think size is important. If you don't carry your PDA with you, you aren't going to use it often. The front pocket is a handy location and an important consideration for me since I don't wear a lab coat anymore nowadays. I have a surgeon colleague who worked thru several PDas because of his habit of leaving them in his back pocket.

Palmdoc says, "if it can't fit in the front pocket, it ain't a PDA"

Blackberry health warning

Well, the BBC now reports that using Blackberries may be hazardous to your health - repetitive use could cause arthritis or harm tendons in the thumb.
I detest keypads. Give me minimalistic buttons and Graffiti anyday. When I look up information on a PDA (contacts, drug info or whatever) I sure hope designers do take into account single handed action simplicity. I really appreciate it when designers make use of the Dpad and rocker buttons to facilitate this one handed use. Isuppose better wear out only one thumb as opposed to two!
For writing notes and text messages, I would then switch to Graffiti. I find it faster than using a tiny keypad.

The future

Well, the data shows that PDA growth in the medical world is indeed stagnating.
Maybe palmOne has got it right when it is concentrating on Smartphones. Data from canalys.com shows that smartphones are up a phenomenal 101%.
Well, I had a first hand look at the Treo650 last weekend and I must say it does look like a nice smartphone. The screen is absolutely brilliant for its size. Ntech of KVPUG has a review here.
I would not switch yet until palmOne comes up with:
- a smartphone with much more Ram than the paltry 32MB of which only 22MB is available. The new file system hogs even more Ram per application. Already I am down to 13MB from my 55MB available in my T5 so unless a 64 MB (and preferably 128MB) is released, this is the main limitation for me. Moving applications to card just is not the same and does slow me down.
- Wifi. Preferably builtin. I would also like to see a good VOIP solution. At the moment Skype is very popular but there is still no PalmOS version unfortunately. PPC PDAs have the advantage of being able to run PocketSkype.
- a larger screen. I am spoilt by the size of the T5's screen. No, it doesn't have to be that big but it would be nice to support 320x480 resolution.
- Support for bluetooth audio profile is a must and do use BT 1.2 not the outdated 1.1, and for heaven's sake don't leave out things like a proper stereo audio jack.

I don't know if the T5 is the last PDA I'll ever use from palmOne. I sure hope they'll release that elusive "power Palm user's dream machine" with dual wireless and great battery life. If they don't do so, I suspect many will hop over to the PPC bandwagon where there seems to be better value for money in terms of hardware capability. The Dell Axim X50V for instance is great and if priced say 25% lower on discount (which Dell did recently over here) it is a great bargain.