Which hand-held computer is better for doctors? - Canadian Family ...

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Which hand-held computer is better for doctors?

Part 2: Comparing models with Microsoft operating systems Anatoly Dobrousin, MD Igor Wilderman, MD, CCFP

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n this article (the first article1 was devoted to handheld computers with Palm operating systems) we will discuss how to choose a hand-held computer running Microsoft operating systems (Windows and Pocket PC 2003). As noted in Part 1,1 these devices are more expensive, bigger, and more powerful than Palm OS–based machines. In 2002 Windows-based devices comprised about 30% of the Canadian hand-held market; Palm OS–based devices about 70%.2 This situation has probably changed now because Pocket PCs are catching up in all parameters, and many useful applications already exist for both systems.

Operating system All but one of the reviewed devices (Cassiopeia E-200) run on the Pocket PC 2003 OS. This system is similar to the desktop Windows, familiar to many users. For example, it allows several applications to run simultaneously. More than that, if the machine is turned off without closing applications, they will still be running when the device is turned back on. This is certainly an advantage to this type of personal digital assistant (PDA). It also has all the Windowsrelated problems, however; the Pocket PC 2003 OS probably causes a PDA to “freeze” more often than a Palm OS. In addition, some applications do not run on the Pocket PC 2003 platform.

RAM and NAND Random access memory (RAM) is the internal memory. You can read, write, and delete from it. It is lost when the PDA crashes. It is also called “volatile memory.” NAND flash memory is used to prevent data loss due to loss of power or unexpected system failure by backing up the data.

Display and keyboard Almost all reviewed Pocket PC– and Windowsbased PDAs have the Thin Film Transistor (with 65 536 colours) display of 9 cm (3.5 inches) or more diagonally and 240 x 320 resolution and an onscreen keyboard. Users dissatisfied with the onscreen keyboard can use a device with built-in keyboard, such as an HP iPaq-H4350, or can attach a portable one, which usually costs about $100.

Modem The modem is an add-on device, which can be purchased for $170 to $180 and is easily installed in the expansion memory slot. Devices with only one slot, however, are limited to using modem or memory cards one at a time. Some machines come with integrated connectivity. Most are wireless and use the advanced Bluetooth or 802.11b (Wi-Fi) protocols for the connection. Also, you will be able to find at least a few models using telephone modems to connect the device to the telephone line.

Syncing Communication between Pocket PC– or Windowsbased PDAs and desktop computers is the same as with the Palm OS: via universal serial bus (USB) or infrared ports.

Batteries Because Pocket PC OS computers are more powerful than Palm OS computers, they consume more energy. All of the devices are equipped with lithium batteries, which are easily replaced in most models.

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devices. However, 64 MB might not suffice for some users. An important feature to check for is the option for memory expandability of the PDA. Similar to the Palm OS devices, memory is added with the help of memory cards. Secure Digital (SD) and Compact FlashTM (CF) are the most common types of memory cards. A Secure Digital Input Output (SDIO) card slot allows users to connect either standard memory expansion SD cards or different devices like bar code scanners or Bluetooth wireless connection cards.

All of the reviewed models can play MP3 files, record voices, and play them back. Almost all have integrated microphones, speakers, and jacks for headphones. The speaker is usually weak, however, so headphones will be needed in order to listen to music.

Software Manufacturers add different software packages, but basic software is more or less the same. Almost all companies provide customers with an application manager program, which allows users to shut down any application running in the background if the device starts to “stutter.”

Making choices Any of the basic units could satisfy the requirements of medical professionals: relatively moderate price, small size, and an option to expand the memory. Roughly, we can subdivide these units into two categories: relatively slow devices with 206- to 300-MHz processors (Table 1) and more rapid 400-MHz machines (Table 2), all of which have the Pocket PC 2003 operating system. They all have display resolution of 240 x 320.

Memory expansion slots Physicians will need a lot of memory to store and run multiple medical applications. Today’s Pocket PC–operating PDAs usually come with 64 MB of RAM, and in fact, we decided to review only these Table 1. Windows-based PDAs with 206- to 300-MHz processors MODEL CHARACTERISTIC

HP IPAQ H1940

DELL AXIM X3*

TOSHIBA E400

CASSIOPEIA E-200*

Price (CAD)

$400

Processor (MHz)

Samsung 266

Starting from $279

$450

$600

Intel 300

Intel 300

Intel 206

Random access memory (MB)

64

32-64

64

64

Price for optional 128-MB memory

$100 SD

$70 Compact Flash (CF) $100 SD

$100 SD

$70 CF $100 SD

Modem

Optional

No data

N/A

Optional

Dimensions (inches)

4.46 x 2.75 x 0.5

4.6 x 3.0 x 0.59

4.9 x 3.0 x 0.4

5.3 x 3.2 x 0.7

Weight

4.37 oz /124 g

4.8 oz/139 g

4.6 oz/137 g

6.7 oz/190 g

In box

Cradle, stylus, manuals

Cradle, stylus, manuals

Cradle, stylus, adapter, case

Cradle, stylus, case, AC adaptor with AC cable

Pros (3,4,5)

Supercompact, sharp screen, Bluetooth,‡ removable battery

Thin and light, removable, rechargeable battery, dual expansion card slots

Small, powerful processor, NAND flash memory, voice command

Dual expansion card slots

Cons (3,4,5)

Only one memory expansion slot, headphone jack is not standard size, no protective cover included

No built-in Bluetooth or Wi-Fi,‡ uncomfortable stylus, relatively short battery life, only basic software included

Only one memory expansion slot, display is inferior to HewlettPackard’s

Difficult to slip into cradle, design could be better, problems with support of digital cameras

†

*These models are available only on the Internet. † Final price depends on customized model. ‡ Bluetooth and Wi-Fi are protocols of wireless connection. Prices for wireless connection are not included.

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Table 2. Windows-based PDAs with 400-MHz processor speeds MODEL CHARACTERISTICS

HP IPAQ H2210

AXIM X3I DELL POCKET PC*

HP IPAQ H5550

HP IPAQ H4350

TOSHIBA E800

Price (CAD)

$549

Starting from $479

$899

$699

$850

Display size (inches)

3.5

3.5

3.8

3.5

4.0, ATI video card

Connection port

USB, Bluetooth

USB and IrDA

Serial, USB, wireless, Bluetooth, and IrDA

USB, IrDA, Bluetooth

RGB (monitor), USB, DC-In, and IrDA

Memory expansion slot

SD, SDIO, and CF

SD and CF

SDIO

SDIO and MMc

SD, SDIO, and CF

Price for optional 128-MB memory

$70 CF $100 SD

$70 CF $100 SD

$100 SD

$100 SD

$100 CF $90 SD

Wireless connectivity

Bluetooth,‡ wireless ready

Integrated wireless 802.11b‡

Integrated wireless, 802.11b, Bluetooth

Integrated wireless, 802.11b, Bluetooth

Wireless LAN, 802.11b

Dimensions (inches)

4.5 x 3.0 x 0.6

4.6 x 3.0 x 0.59

5.4 x 3.3 x 0.6

5.4 x 2.9 x 0.6

5.3 x 3.0 x 0.6

Weight

5.1 oz/144 g

6.9 oz/196 g

7.3 oz/207 g

4.7 oz/165 g

6.8 oz/198 g

Random access memory (MB)

64

64

128

64

128

ROM (MB)

32

64

48

32

32

In box

Cradle, stylus, manuals

Cradle, stylus, manuals

Cradle, stylus, adapter, case

Cradle, stylus, manuals

Cradle, stylus, adapter, case

Pros (3,4,5)

Compact, dual expansion slots, Bluetooth, removable battery, universal remote control

Dual expansion card slots, inexpensive, snazzy cradle, long battery life, big ROM memory, 802.11b wireless

Biometric fingerprint reader for security, big RAM size, Bluetooth

Bluetooth and Wi-Fi, built-in keyboard, high capacity, removable cell

Large display, NAND flash memory, able to support 800 x 600 VGA resolution, dual expansion card slots, built-in wireless LAN, 802.11b, voice command

Cons (3,4,5)

Alarm feature is unstable

Fairly bulky, big, poor tech and customer support, only basic software included

Unreliable Wi-Fi connection, alarm does not work if device is off

Larger than average, Bulky, no Bluetooth keyboard uncomfortable for long use

†

CF—compact flash, MMc—multimedia card, SD—secure digital, SDIO—secure digital input-output. *This model is available only on the Internet. † Final price depends on customized model. ‡ Bluetooth and 802.11b (Wi-Fi) are different protocols of wireless connection. The price for wireless connection is not included

Table 3 summarizes some of the most useful software for physicians, which might help them decide how much memory they need for their PDAs. Also, take into account that the effective RAM on 64-MB Pocket PCs is about 56 to 58 MB and the basic software bundle (including Office, Outlook, etc) occupies about 8 MB. It is also worth leaving about 3 to 4 Mb for personal records (telephone book, calendar, things to do, and memos), and at least 16 MB free of software for normal functioning of the PDA. The total memory required by an average user is often above 60 to 70 MB, which might require purchasing an expansion memory card. Although there are many models, their technical characteristics are very similar. It seems wise (and less expensive if you are on a budget) to choose

a model with two expansion slots for more functionality. Dell offers a nice option for configuring the device according to your needs. Toshiba handheld computers come with NAND flash memory, which is important in preventing accidental data loss. If the most important feature you are looking for is the compact size, however, Hewlett-Packard’s PDAs are the best choice. If you are using demanding graphic applications, Toshiba e800 with its most advanced graphic chip would be the best choice, but there are not too many applications that would use its full power. Users who consider security as the most vital issue would probably find their best option to be HP iPaq H5550. At time of writing, the best hand-held computer for cost-to-functionality ratio was HP iPaq H4350.4

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Table 3. Software most popular among physicians for Pocket PCs CHARGE

MEMORY ON PDA* (MB)

• DrugGuide (drug guide for nurses)

Commercial

7.5

• Tarascon Pocket Pharmacopoeia

Commercial

5.0

• BartlettID™ (2002 Pocket Book of Infectious Disease Therapy)

Commercial

2.6

• OCM-Internal Medicine

Commercial

4.4

• Cecil Pocket

Commercial

3.9

• Washington Manual

Commercial

3.5

• PktMedTM (Pocket Medicine-The MGH Handbook of Internal Medicine)

Commercial

1.2

• Merck Manual

Commercial

6.9

• Harrison’s Manual of Medicine

Commercial

5.4

• 5-Minute Clinical Consult (5MCC) from Skyscape 2004

Commercial

9.5

• Inforetriever 2003 with 5MCC from Infopoems

Commercial

30.0

• FerriGuide (Ferri’s Practical Guide to the Care of the Medical Patient)

Commercial

5.8

Free

0.5

Commercial

4.5

• Acrobat reader 1.0

Free

3.0

• IA presenter for ATI 2.1

Free†

3.1

• Ifacts: drug interactions checker

Commercial

6.2

• OPUS: dictation system

Commercial

6.5

• Taber’s Cyclopedic Medical Dictionary, 19th ed

Commercial

17.0

APPLICATIONS

Drug databases

Internal medicine

Clinical reference

Calculator • Archimedes Miscellaneous • PocketMSDict and English Pro Dictionary 1.70f

*The required memory size shown as indicated by a manufacturer. † Included in Toshiba software package.

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The variety of PDAs on the market might make choosing the “right for your needs” device difficult. We hope our article will facilitate the choice of PDA for many physicians. Dr Dobrousin is a second-year resident in the Department of Family Medicine at the University of Alberta in Edmonton. Dr Wilderman is a family physician in Thornhill, Ont. References

1. Wilderman I, Dobrousin A, Cameron S. Which hand-held computer is better for doctors? Part 1: Comparing models with Palm operating systems. Can Fam Physician 2003;49:1507-11. 2. Chapelle D. The computer paper (Alberta Edition). 2002;15(12):26. 3. Our top five Wi-Fi PDAs. San Francisco, Calif: ZDNet: Handhelds; 2004. Available from: http://reviews-zdnet.com.com/Handhelds/2001-3127_16-0.html?tag=ont-pda. Accessed 2004 Feb 12. 4. CNET Reviews. Handheld devices. San Francisco, Calif: CNET Networds; 2004. Available from: http://reviews.cnet.com/Handhelds/2001-3127_7-0.html?tag=cnetfd.glnav. Accessed 2004 Feb 12. 5. Handhelds & PDAs. Burnaby, BC: Future Shop Canada; 2004. http://www.futureshop. ca/catalog/class.asp?logon=&langid=EN&dept=19&WLBS=fsweb15&catid=1005. Accessed 2004 Feb 12.

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Bulletin Board Antibiotics: Use them wisely

The national report card on antibiotic resistance was recently released. The report was the work of the National Information Program on Antibiotics (NIPA), a coalition of physicians, pharmacists, and patient groups, who have been working since 1996 to raise awareness of the threat of antibiotic resistance and the importance of using antibiotics wisely. Data show that, while rates of high-level resistance have remained stable, the rate of penicillin-resistant Streptococcus pneumoniae was slightly lower in 2003 than in 2002, and is lower in Canada than in many other parts of the world. For more information, contact Natalie Pavlenko or Christopher Windsor of Hill & Knowlton Canada at (416) 413-4658 or (416) 413-4746 or 1-800-565-4535.

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