Pretest for medical students

Medical students can now prepare better for their Medical and Surgical clerkships with these new apps from Malone Consulting:
PreTest: Medicine PocketTest 1.22
PreTest: Surgery PocketTest 1.02

Sounds like a great idea and the apps are reasonably priced too.

Another PDA Survey

MobileHealthData reports that a survey by Forrester Research found that "Though more than half of U.S. physicians regularly use PDAs, most rely on their hand-helds for administrative tasks rather than accessing clinical data"
The key findings:
- 57 % of physicians regularly use PDAs during the workday
- 80 % who use PDAs track their appointments via the devices
- 87 % use them to store contact information
- 65 % of physician PDA users check drug references via hand-helds
- 7 % of physician PDA users said they use hand-helds to order medications
- 6 % use them to access patient records
- 5 % of respondents use PDAs to view lab results.

It seems to me that doctors will use PDAs for the things which are useful to them and more importantly in a way easy for then to use and will not slow them down in their daily work. This may partly explain why the % really declines when the PDA use involves acessing hospital or pharmacy information.
Its not quite there yet!


[Posted with hblogger 2.0 http://www.normsoft.com/hblogger/]

Skyscape - which platform?

Someone asked me which looks better - Skyscape apps on Palm or PPC?
Well as someone who now owns bot a Palm (T5) and a PPC (Dell Axim x50v) I can say they both look great.
You can view sample screenshots here
I notice though that the search function on the T5 runs a little slow and this is one of the few things which seems to run slower on the T5 compared with the x50v.

Wireless Merck

Preess Announcement:

Charlottesville, VA, March 22, 2005— Unbound Medicine, a leader in knowledge management solutions for healthcare, today introduced a wireless medical resource for physicians and other healthcare professionals. In partnership with Merck & Co., Inc., Unbound Medicine now gives clinicians 24-hour access to select medical information from the MerckMedicus internet site using their wireless Personal Digital Assistant (PDA), Blackberry, or smartphone. “We are pleased to extend our partnership with Merck to deliver trusted medical information to the point of need,” said William Detmer, MD, president and CEO of Unbound Medicine. “As physicians are constantly on the go during the average day, the new wireless MerckMedicus will help them find answers when questions arise and stay abreast of the latest advances in medicine.” Using Unbound Medicine’s powerful mobile platform, current medical resources can be accessed using a wireless internet connection to www.merckmedicus.com, including: The Merck Manual of Diagnosis and Therapy, MEDLINE Journal abstracts, Pocket Guide to Diagnostic Tests, and Reuters Medical News. The Personal Search Assistant allows clinicians to query more than 11 million medical articles in the MEDLINE database from their handheld or wireless device in real-time without access fees or advertising content. The wireless option is compatible with cellular phones with web-browsing capabilities, smartphones, and other wireless devices that use Pocket PC, Blackberry, or Palm OS operating systems. It follows the launch of Mobile MerckMedicus, which was designed for non-wireless PDAs and introduced by Unbound Medicine and Merck in 2004. For more information on wireless MerckMedicus, or to register, visit www.merckmedicus.com.

Here's hoping yet again for palmOne's dual wireless PDA. Many things are going wireless and unless palmOne comes out with a new model with builtin Wifi, they are going to be left far behind. I just got myself a Dell Axim x50v see what a PPC is really like. no I haven't been sucked into the "dark side" ;) as my daily PDA is still the T5. However I must say builtin wireless is very handy. The T5 with 400Mhz though is still much faster than the X50v at 624 Mhz and can run rings round it :P

Gmail invitations up for grabs!

I've still got plenty of free Gmail invitations so if you can email me & share your Palm/PPC/PDA Medical thoughts, I'll be happy to send you an invite!

OnTimeRx Italian

OnTimeRx 2.4 - è disponibile per gli utenti di lingua italiana

Well its nice to see mutli-language options for great apps like OnTimeRx which is a very useful medication reminder. This is a terrific way for developers to refresh their applications IMO.
Hopefully the author of OnTimeRx can come up with Asian language versions e.g. in Chinese and Japanese. A Malay/Indonesian version would be easy to come out with since this language uses the Roman alphabet.

For more info visit the OnTimeRx Homepage

New Skyscape releases

Natural Medicines Comprehensive Database 2005 - Natural Medicines Comprehensive Database 2005 gives you everything you want to know about herbs, vitamins, minerals, supplements.

Physicians' Cancer Chemotherapy Drug Manual 2005 - Completely revised and updated for 2005, this practical handbook is an up-to-date guide to all aspects of cancer chemotherapy.

Clinical Hematology-Oncology 2006 v1

CG Weber/ Pacific Primary Care has just released Clinical Hematology-Oncology 2006 v1 in Palmgear.

Description An extensive reference text on the presentation, diagnosis, treatment and differential of Hem-Onc conditions. Topics include: cancers, Oncologic Emergencies, DVT, pulmonary embolism, the anemia's, lead toxicity, sickle cell, prophyria, cancer syndromes & tx, blood cell abnormalities, transfusion medicine, bleeding disorders, DIC... Features: illustrations and hyperlinks. Detailed workups and extensive treatment options. Edited by a board certified Hematologist-Oncologist.

Just purchased it myself from Palmgear - it's a bargain at US$11.95. Almost 1 Mb in size so it's really packed with information. Sometimes you just want to read up on a topic much like a book rather than an Outline like Skyscape's applications and here is where iSilo shines - you can create your own Fonts with iSiloX and and the hyperlinking within the text document is superb.
I haven't really read thru the book - but just jumping to the section on Myelodysplastic syndrome, I was impressed to see fairly up-to-date information on the new WHO classification and drug treatment like Azacitidine and Lenalidomide mentioned.

Using PDAs to study alcohol and aggression

Spotted in Palmaddicts:

Peter Hoaken at The University of Western Ontario wants to further explore the ties between alcohol and human aggression by collecting information using PDAs.
Source: Canada Newswire

They didn't quit say whether the PDAs were PalmOS or PPC but I'll bet they are PalmOS. Surely in an inebriated state it would be too difficult to tap tap tap tap tap on a PPC compared with click-tap on a Palm ;)

Hopkin's Opioid Conversion software

Read about the Hopkin's Opioid Conversion Software from Ectopic Brain's site.
Registration is free - you will be given a serial number to input.
What I can add is it works fine on my T5.

MDRD 1.0

Timothy Allen has released MDRD 1.0 on Palmgear

Description: A must for medical students rotating on nephrology or anyone wishing to have the most accurate estimate of GFR. MDRD calculates GFR from the serum creatinine using the revised quadratic MDRD equation from Rule,AD, Annals of Internal Medicine 2004;141:929-936. This equation has been found to be substantially more accurate than the original MDRD equation and the Cockoff and Gault equation.

Freeware.

ClinRx

ClinRx has been updated and is now version 5.1f
This app does "Creatinine Clearance, Renal Dosing, and Vanco/Amglycoside Kinetics for adults and peds". The new version incorporates a Renal dosing table update.

Alterblog

I decided to retire my Blurty and move on to Livejournal. Blurty at times is quite slow and I find Livejournal has more features.
Palmdoc Live will feature my thoughts and ramblings on non-medical PDA matters but still concentrate on Palm and computer related stuff.....

Another Palmdoc

Hey, there's a clone running loose :P
Palmdocs is a good resource for doctors with PDAs.
There are tutorials as well as some great free iSilo medical references. I like the Flash tutorial which shows you how to make your own iSilo medical reference using Word + iSiloX.

Get Wiser

The NLM has released a free PDA tool to help first responders when they arrive at a hazardous material (Hazmat) incident, such as a chemical spill.
MedicalNewsToday reports:

WISER (Wireless Information System for Emergency Responders) provides the emergency responder with critical information on hazardous substances, including physical characteristics, human health data, and containment and suppression information. Employing the unique characteristics of a PDA (Personal Digital Assistant), WISER is customized for easy navigation and quick access to key information required by first responders. To aid decision making, users can specify the role they are currently performing at the scene of an incident, and WISER organizes the critical information in a sequence most relevant to a first responder on-the-scene, a Hazmat specialist, or an emergency medical specialist (EMS)

Wiser for PalmOS and PPC are now available for free download

Schwartz Principles of Surgery

USBMIS is now inviting beta testers for their up coming Schwartz Principles of Surgery, PDA Edition. Palmd and PPC versions are available

Description: With its extensive content and custom-designed user interface, Schwartz Principles of Surgery, PDA Edition enables you quick access to the answers you need to make the right diagnosis or initiate a treatment. Interlinked content, a notes feature, and custom bookmarks make this more than a reference application. Schwartz Principles of Surgery has developed into the ultimate PDA tool for anyone enrolled in a surgical clerkship or surgical residency. Schwartz's textbook of surgery is one of the world's most well known references in general surgery. This reference is considered a must for anyone studying or training in the field of surgery. This edition has extensive information about: * Trauma * Transplantation * Oncology * Congenital and acquired heart diseases * Wound healing physiology and care

PEPID RN Student Clinical Companion

Pepid have released PEPID RN Student Clinical Companion on Palmgear. It's a whopping US$119.95 but you get Pepid RN, drug database and the clinical companion which is billed as "fully integrated into PEPID RN and is the only comprehensive, point-of-care clinical reference tool designed specifically for student nurses", and is available for both PDA and Internet access.

Geriatrics At Your Fingertips

The GAYF has been updated and the 2005 book edition has been released.
New Features of Geriatrics At Your Fingertips® 2005, include:
Fully updates text, with information on new medications released as recently as November 2004
* Newly revised user-friendly algorithms
* New section on tinnitus, bi-polar disorder, skin and soft-tissue infections, chronic kidney failure, hyperkalemia, and fecal incontinence
* New assessment instruments include Palliative Performance Scale (PPS), Karnofsky Scale, and Reisberg Functional Assessment Staging (FAST) Scale
The PDA version will be available free sometime in Spring.

Uptodate for non-PPCs

Those of us without a PPC and type II CF Card storage need not fret. We can access UpToDate wirelessly. Just surf over to UpToDate's PDA portal and login. I think it is more practical than stuffing it all into a memory card. It also drives home the fact that palmOne MUST take Wifi seriously and come up with more models with builtin Wifi.

Screenshot using my T5 + SD Wifi card:

Haemoncrules 1.8

I have updated Haemoncrules and it is now version 1.8 with a total of 30 modules

The changes:
- Added a Malignant/Benign Menu filter
- Added Lansky to Performance scores
- Updated PRV Diagnosis
- Added ET Diagnosis

Visit the HaemOncRules Homepage for more details and the download link.

Oh, it's still freeware ;) And as I still don't have a PPC, there still isn't a PPC version, sorry ;)

Getting Medscape articles on your PDA

Medscape is a great and free online resource for medical doctors.
Sometime back, a colleague of mind who uses a palmOne Tungsten|E asked me how to get copies of Medscape articles into his PDA for offline reading.
Well, some of you might be wondering the same thing so I will run through a few solutions for offline reading.

The most important thing is to select the Print option from Medscape: normally an icon which looks like somewhere at the top of the article.

1) Repligo. This is a great product from Cerience. The reader is free but the converter is not free but is very easy to use. Once you install the converter, Repligo will be installed as a "printer driver" so all you do is select the usual File/Print and then Repligo as the printer. You could do this for any thing else including PDF documents by the way.

2)iSilo. This is a popular shareware ebook reader and like repligo has text and image capability as well as great hypertext linking. For Medscape, after selecting the Print option, you need to Save the page as a HTML document. Just choose File/Save Page As from your Browser and select a page to save the HTML document somewhere on your hard drive. Using the free iSiloX converter, you then convert this HTML document into an iSilo compatible pdb file which you can sync to your Palm or install in Palm/Programs/iSilo on your Card.



Snapshot of iSilo view of a Medscape article 

3)Plucker/Sunrise combo. This third option is completely free. The reader is called Plucker.This is a free offline HTML reader and a great alternative to iSilo. Download the latest (version 1.8).
You need to save the Medscape page as a HTML file as in iSilo above (after selecting the Print page display)
There are several alternatives to convert HTML files but the one I use is Sunrise. It requires Java but is a nice way to convert local or online web pages (and RSS feeds) to Plucker format. You can download Sunrise from Palmgear (latest version is 0.41f) and read more from the Author's webpage

There are other solutions of course, but the above three are relatively easy ways to get Medscape articles with all the text and pictures onto your handheld. So CS Wong, if you are reading this, HTH!

New Palm for Gruntdoc

I guess it will happen to all of us at some stage. Your PDA will die on you. Nothing is forever and worse still, due to what I suspect is built-in self-destruct obsolescence, it will die on you sooner than the PDAs made 5 years ago.
Gruntdoc got a T5 to replace his TT. I guess this is good for palmOne since like him (and me for that matter), many are reticent about migrating to the WM2003 platform mainly because we are familiar with PalmOS and also we have invested time, money and software in PalmOS.
The T5 is a decent PDA but it falls short in the aesthetics department. I do wish palmOne will come out with a sexier looking device, and for goodness' sake, please come out with a dual wireless one. You really can't claim to be a "connected organizer" if you remain disconnected from the Wifi world. Although you have the SD Wifi card, it is a pain having to slot it in and out. So c'mon palmOne, wheres the Palm for power users?

Feedback: Switch Story I

Brian S writes in:

I also had a cursed Palm T3, which had a defective digitizer. Palm refused to honor the aftermarket Palm extended warranty, but they finally relented after the seventh call to Palm tech support in India. I have become VERY disenchanted with Palm’s customer support, or lack thereof. This was the sixth Palm pda that I have owned. I switched back to Windows Mobile 2003, when I bought a HP Ipaq 4155. This is the seventh Pocket PC that I have owned. I mainly use Skyscape and Tarascon medical reference software. I also occasionally use Medical Wizard’s Netter flash cards for reference and patient teaching. Activesync can be a REAL pain in the butt sometimes. Do frequent backups.

Thanks for your feedback Brian. A free Gmail invite goes out to you. Plenty more invitations so do write and share your experience if you have switched from Palm to PPC and vice versa.
As for me, after pestering palmOne with emails detailing my disappointing experience with my T3, the Customer Service Manager agreed to treat my case as "in warranty" and I got an SRO for a replacement. So my dead T3 is now off to palmOne. Well this has been beyond my expectations and it has been nice of palmOne to consider individual pleas like mine. However they could pay heed to better quality control - the T3 is a great design and the T5 by comparison is dull. It just needed better QC and less annoying breakdowns like digitiser issues and screen buzz issues.
I think part of the blame for the declining PDA market is the fact that there aren't many "imaginative" and "enticing" models out there to choose from. Hey, not everyone wants a smartphone with tiny screens and limited Ram/Expandibility. Where are the PDAs for power users? I sure hope palmOne will come up something interesting this year.
So the upside is I still haven't succumbed to the dark side yet ;)

PDE

Well, this week's issue of the NEJM has an article which tells us that what we hold in our hands is not a PDA but a PDE (Personal Digital Educator).

"What's his infection sensitive to?" In 1995, getting the answer to this question required a house officer to find an unoccupied computer at the nursing station, sign on, and traverse the necessary screens to get the culture result. Armed with the answer -- say, "levofloxacin" -- she would ask the follow-up question: "What's the renal dosing?" The next step would typically entail a search for a tattered copy of a drug reference manual. In 2000, the house officer still needed to turn to the computer for the first answer, but for the second, she might have skipped the scavenger hunt and pulled out her personal digital assistant (PDA). A few quick taps and scribbles, and she had her answer.

The author, Dr. Cimino talks about the various sources of data - standalaone, synchronisation (ala Avantgo) mode and what I think will become more important in time to come, the wireless mode. There is only so much you can store on the PDA, even if you have that 4GB CF Card, it's always never enough. Eventually we'll be using handheld devices to look up information wirelessly.

I found this bit interesting:

The synchronization mode is also being exploited by educators to monitor the clinical experiences of trainees. For example, third-year medical students at Columbia use a case log on their PDAs to collect information about the patients they see. These cases are transferred to a central database, where clerkship directors can review students' encounters to ensure that there is an appropriate mix of cases. The Columbia School of Nursing integrates a patient-tracking log with a variety of decision aids to monitor the extent to which students are providing evidence-based care.

I wish more medical schools could be as innovative as this!

Dr Cimino ends the article with this:

In 2005, when the same question arises -- "What's his infection sensitive to?" -- the PDA comes into play immediately (see the figure). A few taps, and the PDA obtains the answer from the clinical-information system: "levofloxacin." Then "What's the renal dosing?" One additional tap on the PDA screen provides the answer.

How I wish! In fact what is now known as the new Intern's Palmomental Reflex, (something again first published in the NEJM) should be a reflex all doctors learn to use!!

Morbidly obese

It's nice to rely your own software when the need arises. The need surely arose when we had to transplant a "morbidly obese" individual with AML. Height 173 cm, Weight over 120 Kg.
The dose of Busulphan (4mg/kg/day) is dependent on Ideal Body Weight (+0.25) so I whipped out Fatcalc (instead of Haemoncrules for a change). The dose difference was huge - more than 100mg a day had we relied on the actual body weight.
Well, I tell my patients that slimming comes as a free package together with the stem cell transplantation so hopefully this guy will slim down after the transplant! ';)

Dx/Rx: Heart Failure

Skyscape has revamped their website and the design looks nicer. They also have newly released Dx/Rx: Heart Failure:

Tightly organized into a super-condensed outline bulleted format, this handy manual details precise, up-to-date information for diagnosis and treatment of Heart Failure. Throughout the reference, tables and figures summarize important clinical data and current professional society recommendations, while salient references direct readers to additional information. Current, quick, and concise, for instant access on the ward or in the clinic!