Clinical PDAs : Handheld Technology, Applications, and Practical Implementation in

Healthcare Education

Robert B. Trelease, Ph.D.

Associate Professor and

Associate Director,

Instructional Design and Technology Unit Dean’s Office, UCLA School of Medicine

Handheld Generations I:• Generation 1: The Apple Newton (RIP 1998)• MessagePad 2000/2100 Specifications:

– Size: 1.12" x 4.7" x 8.3".

– Weight: 22.4 ounces

– Processor/Chip: 160 MHz StrongARM SA-110 RISC

– RAM: 5MB (2100 has 8 MB)

– ROM: 8MB

– Power/Battery: 4 AA alkaline batteries (optional rechargeable)

– Screen Type: transflective backlit LCD, Touch Screen Resolution: 100 dpi; Size: 480 by 320

– PCMCIA Slot(s): Two Type II PC Card slots

– Ports: Serial, sound I/O

Handheld Generations II:• Generation 2+: Palm (Pilots) and Their Siblings

– Size: 0.67 " x 3.17 " x 5.06 " (IIIc)

– Weight: 6.8 ounces (IIIc)

– Processor/Chip: Motorola 68328(EZ) 16-33 MHz

– RAM: 2-8 MB

– ROM: 2MB

– Power/Battery: 2 AAA alkaline batteries (optional rechargeable)

– Screen Type: TFT active matrix, Touch Screen Resolution: 100 dpi; Size: 160 by 160, grayscale or color (to 16 bit)

– Expansion Slot(s): SpringBoard, TRG, m505, CLIE

– Ports: Serial/USB and IRdA and speaker

Handheld Generations III:• Generation 3+: WinCE (3.1) Pocket PCs

– Size: 0.68" x 3.28" x 5.11" (iPAQ bare)

– Weight: ~6 ounces

– Processors/Chips: 133-206 MHz RISCs

– RAM: 16-32 MB

– ROM: 16 MB

– Power/Battery: rechargeable

– Screen Type: TFT active matrix, Touch Screen Resolution: 100 dpi; Size: 240 by 320

– Expansion Slot(s): CF, Expansion Pack (iPAQ)

– Ports: Serial/USB and IRdA

– Built-in ‘CD-quality stereo (speaker/outputs) and microphone

Serving the King I: Palm OS Capabilities

• Text: up to ~20 characters wide by 16 lines

• “Handwriting” (Graffiti) entry in silkscreen panel at bottom of screen: No visual feedback and users need to learn special alphabet

• Graphics JPEG and GIF with add-on programs (160 x 160 pixel limit*)

• Sound: beeps from speaker, primitive WAV player SW, SpringBoard MP3 and recorder modules, no built-in input

• Networking with modems, CDPD, ethernet, wireless (with SpringBoard)

Palm OS Capabilities: About Syncing and Networking

• PDAs may work as stand-alone devices BUT they are dependent on a networked workstation or laptop for effective use

• On HotSyncing, changes and additions to PDA personal information manager data (date book appointments, addresses, memos, mail, and to-do list items) are synchronized with those on the workstation

• On HotSyncing, programs to be installed are transferred from PC to PDA

• On HotSyncing, Web pages from designated sites are downloaded through the PC to the PDA

• All these transfers occur automatically with little or no attention from the PDA user

• PDAs can be networked directly through cell modems (CDPD) or special NICs

Palm OS Capabilities II: About Syncing and Networking

Syncing can use:

• USB/serial port

• Infrared (IRdA) port

• Network connection (TCP/IP)

There is NO direct access to files on the PDA from the syncing computer!

Palm OS Capabilities: About Files and Programs

• Program (application) files have a .prc (‘program resource) filename extension on host computers or servers

• Program data files have a .pdb (‘program database) filename extension on host computers or servers

• All .prc and .pdb files are loaded and installed on Palm OS devices during synchronization

• If a program allows, data (.pdbs) can be beamed from one PDA to another via infrared

• Except for special developer’s tools, files are generally NOT freely uploadable from PalmOS PDAs to PCs

• Special filters and programs can be used to produce .pdb files for Palm OS (e.g., Word PalmDocs filter for producing reader DOC files

• Web servers can be used to distribute .prc and .pdb files

Palm OS Capabilities II: Wireless Networking

• “cellular modem”: CDPD

• Wireless ethernet (IEEE 802.11b or WiFi)

Palm OS Capabilities II: Wireless Networking

• Wireless Web connection to remote server (through Apple AirPort)

Serving the King II: Useful Resourcesfor Medical Education

• Personal Information Manager (PIM) utilities

• PDA-dedicated Web sites (e.g., HandHeldMed)

• Programming Environments (CodeWarrior, etc) and the PalmOS Simulator (POSE)

• Document Readers (TealDoc, AportisDoc, iSilo, MobiPocket, HandHeldMed Reader, Acrobat!)

• Database managers (Jfile, HanDBase)

• Web (Clipping) browsers (e.g. AvantGo)

• Patient records (PatientTracker, PatientKeeper, 5 Minute Clinical Consult)

• Pharmacopeiae (ePocrates qRx, Tarrascon, PDR)

• Decision Support (e.g. MedRules)

• Reference Books (e.g. Harrison’s)

• General PDA sites:– PDAstreet: www.pdastreet.com

– PalmOS home: www.palmos.com

– MS Pocket PC home: www.pocketpc.com

• Useful commercial PDA sales sites:– Handango: www.handango.com

– MobilePlanet: www.mobileplanet.com

• Medical PDA sites:– HandheldMed: www.handheldmed.com

– pdaMD: www.pdamd.com

PDA Resources on the Web

PDA Resources on the Web: HandHeldMed

PDA Resources on the Web: pdaMD

PDA Resources on the Web: PDAStreet

Serving the King II: Useful Resourcesfor Medical Education – Doc Readers

Document Readers (use “DOC” PDB files) TealDoc, AportisDoc, iSilo, MobiPocket, HandHeldMed Reader

Document can be prepared with standard programs (e.g., Word) and converted to PDBs (e.g., with a Word filter or MakeDocW.exe)

DOCs can contain internal links and indexingSome DOC readers multifunction (e.g., iSILO handling HTML)DOC PDBs can be downloaded from Web sites for loading at synchronization

Serving the King II: Useful Resourcesfor Medical Education - Adobe Acrobat

Serving the King II: Useful Resourcesfor Medical Education - AvantGo

What is it?

Client- and server-side software for downloading and “clipping” content from Web servers AND interacting with online databases through Web Uis. AvantGo can be used with PalmOS, Pocket PCs, and RIM Blackberry 2-way wireless email ‘pager’ devices

What’s on the Client side?

A streamlined, graphics-capable PDA Web browser (offline AND online) and workstation sync software (“Channels Manager”) that downloads Web pages filtered by the AvantGo Server

What’s on the Server side?

A modified Apache Web server that maintains a database of user- selected URLs and delivers this selected content to Clients at synchronization

Serving the King II: Useful Resourcesfor Medical Education - AvantGo

How do I get AvantGo?

The free (“public’) Client software is downloadable from www.avantgo.com. Some PDAs ship with it. Commercial (“Enterprise”) Server and Client software can be purchased from AvantGo

What’s kind of content can the public AvantGoClient deliver?

Basic text and graphics Web pages, including tables and menus, but NO FRAMES; standard HTML, ASP, and Cold Fusion pages

What else is included in the Enterprise AvantGo client?

ECMA 2 compatible Javascript capability (ECMA 3 coming), registered SSL key, ability to deliver PDB and PRC files, XML compatibility in next release

Serving the King II: Useful Resourcesfor Medical Education - AvantGo

Comparison of Palm OS PDAs

The Next Generation of Multimedia PC: WinCE, Sound and Vision

– Weight: ~6 ounces

– Processors/Chip: 133-206 MHz RISC

– RAM: 16-64 (!) MB

– ROM: 16 MB

– Screen Type: TFT active matrix, Touch Screen Resolution: 100 dpi; Size: 240 by 320

– Expansion Slot(s): CF, Expansion Pack (iPAQ)

– Ports: Serial/USB and IRdA

– Built-in ‘CD-quality stereo (speaker/outputs) and microphone

The Next Generation of Multimedia PC: Comparing the Basics I

Built-in Pocket Office Programs

The Next Generation of Multimedia PC: Comparing the Basics II

More font choices and real estate for eBooks

The Next Generation of Multimedia PC: Comparing the Basics III

Entering Notes (Memos) with Keyboard

The Next Generation of Multimedia PC: Comparing the Basics IV

Calendar/Datebook

The Next Generation of Multimedia PC: Comparing the Basics IV

Handwriting Recognition Instead of Grafitti

The Next Generation of Multimedia PC:Beyond the Palm OS Basics

Pocket Internet Explorer

The Next Generation of Multimedia PC:Beyond the Palm OS Basics

Pocket Internet Explorer: Exported Powerpoint lecture slides

The Next Generation of Multimedia PC:Beyond the Palm OS Basics

Sound and Vision: MP3, WAV, WMA, ASF, MPEG4 formats supported

The Next Generation of Multimedia PC:Beyond the Palm OS Basics

Convenient High-Speed Networking

• Personal Information Manager (PIM) utilities

• Programming Environments (Visual Studio, etc)

• Document Readers (MobiPocket, HandHeldMed Reader, Microsoft Reader)

• Database managers (‘EXCEL’, ADOCE)

• Web (Clipping) browsers IE and AvantGo

• Patient records (PatientTracker)

• Pharmacopeiae (PDR)

• Decision Support (e.g. 5 Minute Clinical Consult)

• Reference Books (e.g. Harrison’s)

Why WinCE: Useful Resourcesfor Medical Education

Useful Resources for Medical Education: AvantGo

Pocket PC Models

<Compaq iPAQ 3650 200 MHz StrongARM CPU

Casio Cassiopeia EM-500 >150 MHz NEC/MIPS

VR 4122 CPU

HP Jornada 548 >133 MHz Hitachi SH-3 CPU

What Next?

• Pocket PCs push Palm OS PDA manufacturers to enhance device capabilities

• Increasing power and capability of handheld devices

• Convergence of Phone, Page, and PIM technologies

• Wearable computer technology evolves

• Enhanced display technologies (e.g., ocular displays)

• More flexible high-speed networking

Thanks for Your Interest!