Buying medical software for a new PDA?

Why are Personal Digital Assistants (PDAs) helpful for physicians, nurses, dentists, and paramedics?

Although some users of handheld devices (PDAs, cell phones, and iPods) use PDAs for multimedia, games, or business, many medical professionals use them as reference libraries. As a nursing student, it has been very helpful to have a dictionary, medical reference, lab reference, and medical encyclopedia for day-to-day clinical use. Many practitioners use the free program Epocrates, which organizes current updates of medications, including action, indications, contraindications, side effects, cost, and dose. Another free application (which is at least as helpful and clinically authoritative) is MerckMedicus. It includes a lab test manual, the Merck Manual (an encyclopedia of many diseases), and abstracts of as many medical and nursing journals as you care to follow, which is useful if you're trying to focus on a particular discipline within medicine. Drawbacks? Epocrates lacks subtantial information about pharmacokinetics and IV drug compatibility, and MerckMedicus lacks many common lab tests and radiology exams -- which means that healthcare providers must supplement these books or purchase other software.

I also download PDF files of journal articles from the internet (medical reference libraries such as OVID, Medline, and CINAHL) onto a PC or Mac desktop, then transfer them to my PDA using a free, customized version of Adobe Acrobat.

Many crummy free medical programs abound, but I found two that were actually useful: a website from which you can download free, current CDC shot schedules, and a website that offers a free Geriatrics textbook. (The last two are also nice to look at.)

Palm vs Microsoft on PDAs

There are two basic types of operating system platforms: Palm and Microsoft. Confusingly, Palm makes its own hardware and its own software platform (and the Microsoft platform on the Treo 700). The Palm website has a helpful comparison chart of its devices, found here. For Microsoft PC platforms, there are literally dozens of manufacturers. A company that delivers excellent value (for what you pay) is Dell, which has a comparison chart for their products here.

If you are looking for the best basic gadget without the fancy doo-dads, you have to comparison shop. If you simply want a no-frills PDA with a date planner, calendar and a couple of medical programs (you will probably want at least 30 MB of memory), consider buying a low-end device, but make sure that it has an SD memory card slot, which allows you to buy extra memory (see "hidden costs" below). A helpful website to compare all devices is bargainpda.com, which seems fair, honest, and uses a search engine of multiple sites to find low prices.

Hidden Costs, SD cards, and Cases

Ah, the hidden costs: for extra memory on a SD memory card, you're looking at $35-$100 for 1 GB of memory (only necessary if you plan to store two dozen references, or lots of MP3 files, or long videos of your dog or niece, or for some games). Other hidden costs: a metal or leather case can run from $25-100, a keyboard for typing papers or patient evaluations is $60, and most medical programs cost $50 (see below).

Speaking of cases, they are a must for protecting fragile hardware. In my experience, aluminum cases hold up best in patient care environments, partly because they are easier to clean. Palm, Dell, HP and other manufacturers sell tailor-made cases at their respective websites. Fancy leather ones are made by Piel Frama, Vaja, and Covertec.

Here's an example of how these applications have been useful to me in clinical practice as a student:

With the PDA's word program (DocsToGo, free with Palm PDAs; MS Word is free with PC platforms), I can write my reports about patients at the bedside, then upload ("sync") and edit them on my computer at home. This way I have the patient's information while I'm at the hospital, and most of the reports can be finished at the same time that I collect information. This process definitely beats writing a patient's information down once on scrap paper and typing it again later, and was worth the price of the PDA. The copy/paste function also allows me to copy from all of my reference manuals directly into my patient reports. The collapsible keyboard that I use also speeds up the whole process considerably and was about $60; I use it during classes, and now I'm mostly paperless. (I can make the information HIPAA compliant by eliminating personal identifiers about a patient before leaving a clinical area.)