Thursday, 4 October 2007

PDAs in Medicine Revisited

I have written about the use of PDAs in everyday medical practise in the past, but I would like to revisit that topic once again.

I was recently consulted by a junior doctor about the advantages of using Pocket PC devices which run Windows Mobile software-- here is a summary of my answer.....

Well, currently there has been a massive explosion of PDAs coming onto the market running various different operating systems including: Windows Mobile 6, Symbian, Blackberry, Apple (iPhone / Touch) although not the good old Palm OS [which has not changed in a long time !].

Which platform do you choose from such a wide choice??
Well, I perhaps have an answer. It really depends on what you want to use it for. If it is for lots of medical books then the Pocket PC devices are currently what I would recommend. For example, Skyscape products ( provide medical texts for Palm, PPC, Blackberry and iPhone. From my experience, the Palm version texts can cause the Palm device to crash (examples Clie NX80, TH55, Palm LifeDrive), which does not appear to happen on PPC platform.

I have no experience of the other platforms running this software so it would be inappropriate to comment further. However, Skyscape products are Excellent !! They have all the major manuals covering every area of medicine. I would highly recommend visiting the site to see for yourself.

Some good books to check out are the Oxford handbooks, Merck Manual (very good !), Harrison's Manual, MedConsult (Prof Tierney's text) and the Washington Manuals....see for yourself. They are downloadable as trial software so you can test them and see how good they really are!

UpToDate is a relatively pricey text if one compares to a standard textbook, but the fact that it is updated several times per year and that it is highly referenced with Evidence makes it a worthwhile addition for any serious physician or department. It is also available on Palm (not Clie devices) and Pocket PC. However, the other platforms are currently unsupported.

Moreover, Pocket PC can also run the Palm OS 5.0 equivalent software known as Styletap ( and this enables Palm lovers to run their Palm OS software on top of a Pocket PC software structure and at the same time they have the added bonus of Multi-Tasking as Windows is running in the background, which was absent on the pure Palm-based systems.

With new machines coming with up to 8 or 16 GB as standard (HTC X7501 8GB, Apple ipod Touch) and more and more books can be stored electronically then the current Palm based devices have lost the competitive edge.
By having a PDA with electronic books, it enables checking of information on the move e.g. on the ward, at the bedside, whilst travelling or even sitting at your empty desk. Yes, it will be empty as you will not longer need paper books :)

The PDAs currently running Symbian or Blackberry are gradually being catered for by medical text solutions, but it may be sometime before they can fully compete with the Windows selection of products.

The most interesting thing at the moment is the ipod Touch but it lacks a microphone (hence, no dictation ability on the ward), no bluetooth (no A2DP wireless music), no Infrared (no beaming of documents), but for multimedia purposes and of course, MP3 it is seemingly very good. It does have Wifi which means online texts such as UpToDate can be accessed---but you need to be in range of a Wifi connection !!
As the product line matures and more medical texts are produced for it, it may be the next PDA to invest in.....

Bottom Line: I would currently recommend buying a Pocket PC running Windows Mobile 6 for your daily use of electronic books, note keeping, word processing, email etc.... The higher range devices are fast, stable and are obviously compatible with the new Vista OS. The Palm and PPC devices have the largest amount of software produced although the PPC platform has edged ahead and the PPC devices are proving to be more stable.

Please consider :)

Tuesday, 2 October 2007

US Navy Medical Meeting

Last week was our first combined meeting with the Yokosuka US Navy doctors and their Japanese residents.

The meeting was well attended and there was a long and short case presented by the two Third year residents from this hospital.

The first case was a work-up for Fever of Unknown Origin which, in the end, was diagnosed as a lymphoma. The short case was for work-up of non-specific symptoms such as myalgia, mild fever and raised inflammatory markers which was diagnosed as a vasculitis.

The two third year residents spoke completely in English and were able to answer the excellent and direct questions from the US Navy doctors and residents, which generated very good and informative discussion.

The Third year residents did extremely well especially as it was their first time to present in another language!!

After the meeting we had a party, and for one new member of the US team who has recently come to Japan, it was his first time to see live sashimi.... unfortunately, he was not inclined to eat it, but it was delicious !! :)

These combined meetings are planned to occur on a monthly basis and I see this as a great opportunity for learning English presentation skills, how to answer medical questions in English under pressure and to discuss similarities and differences in disease presentation, investigation and treatment in an Evidenced Based Environment.

This hospital's Internal Medicine department is now probably one of the most unique facilities in Japan and it not only offers daily teaching in English from me, but it now offers a monthly American addition and it is a most exciting time to be at this institution !

Photos courtesy of Dr Shin Fukuda