Hey Dataviz? Why are you not porting Smartlistogo?

Okay, So I am being somewhat rude in my title, but for good reason. I bought an iPhone recently and followed the latest downloads of Handbase, the relational database tool, which to be honest, on a Palm device pales in comparison to Smartlistogo, which has a much richer calculator and conditional line statement handling. A recent survey on the Dataviz smartlistogo website shows a need for the company to port this app to the iPhone and other smartphones. However, there has been no word from the company in regards to doing this.

When you have one of the best programs ever written for a mobile device sitting in your lap, I cannot believe that you would not want to transfer that to another platform or at least look into doing this. Or at the very least IMPROVE UPON THE PRODUCT on the Palm.

I had lunch last week with an esteemed colleague and we discussed databases and the reason why he was staying with Palm. The people in attendance were split down the middle - 3 with iPhones, 3 with Palm devices. The number one thing for the 3 with Palm devices echoed was the lack of software on the iPhone and the rudimentary nature of the Apps that are presently being written. I can agree wholeheartedly with that opinion. Handbase's program, although good (a full review to follow), is still in a relative beta phase. Some of this appears to be due to Apple and not the company - which I have been told by at least two people and I can testify to the veracity of such statements personally - (Handbase/ DDHSoftware) are working diligently on adding more features. The main feature - forms, was not submitted to Apple yet, but they are working on this. Handbase for the iPhone works well, but is very rudimentary and I really believe that the equation section and conditional formulas section could be improved. An example is listed below:

Handbase conditional formulas are akin to this:

o If A then B, else C.

While Smartlistogo's conditional formulas are more complex:

o If A then B, else C.
or If A and B, then D.
or If A or B, then E.

You can see how this comes in handy. For example, another feature missing in Handbase is the monitor function. In Smartlist, you can change the color of a cell, using conditional statements like the one listed, add a marker, ie. *** which when added to a table, makes it stand out.

Example:

A pregnant patient requires a repeat C-Section. You could put in a conditional statement that will make this show up every time you look at the list view:

Example:

Field 1 = "***"
Field 2 = " Checkbox"
Field 3 = " "

Smartlistogo:
If Field 2 = "checkbox" ( <=== in this case the box is checked), then Field 1 (***).

The same can be done in Handbase.

However, let's say that our same patient has something due between week 16 and week 20,
then you have problems with HandBase. This sort of thing would require a conditional statement that would take into account the time interval. Something not easily accomplished with Handbase:

TN=Time Now.
A= 16
B= 20
C= "***"

Smartlist:

if TN > A, but < B then C.

Name: Jenny Sample
Age: 28
Weeks: 17
Msafp: ***
Csec:

Every time you look at your list (and I do), you can tell what needs to be done. I have markers for a lot of things. It is really a good feature, currently missing in Handbase and leaving a GAPING BIG HOLE FOR DATAVIZ TO FILL IN.

So again I ask this question, as many others are doing:

DATAVIZ, WHY ARE YOU NOT PORTING SMARTLISTOGO AND WHY ARE YOU NOT SUPPORTING IT?

What I see happening here is that Handbase's DDH Software will own this entire platform mainly because of their incredible desire to listen to customers and push the envelope. As I stated to you before, I have been the recipient of their help when an email was sent to them. Not only did I get the help that I needed (Version 1.000 of the program crashed incessantly), but the company was also helpful in discussing their features and open to questions, criticisms and suggestions. The last time I tried that with Dataviz, I received very little response.

To Dataviz's defense, I do see that they are busily working on their flagship product - Office and will probably be the first company to produce 2 way editing of Office documents on the iPhone, something that is obviously needed very badly. So that leaves their "hobby" sitting around rotting in the wilderness. Perhaps they could sell it to someone or give it to the open source community. Smartlist is such a good program that I think it would be sad to see it go.

May be DDHSoftware will take up where our good friends at Dataviz have left off? There's something to be said about doing one thing and doing it well (ie. Oracle versus Microsoft. Oracle is the better database).

Chime in with your thoughts on this.


LDD.

NEWSFLASH: HANDBASE FOR IPHONE JUST RELEASED !!!!

I just received an email from DDH Software that they have just released Handbase for the iPhone.
This marks the very first Relational Database released for the iPhone.

I will post my review once I play with it for a while.

LDD.

Is Apple taking over the Handheld Med App Industry?

I just finished reading a small ditty on Macrumors.com on medical software. It seems that some of the simple apps that were originally written on the Palm platform are slowly being ported over to the Apple iPhone/iTouch.

A few months ago I questioned whether Medical Apps would find their way into the App store and eventually the iPhone. Well, it is beginning to happen. And it is not just the simple apps that are porting themselves over. Epocrates was the first major player to port its application first to an online only version for iPhone 1 and now a native app version for iPhone 3G. Now comes word that iSilo is quietly waiting in line to have its native app ported over to the iPhone (amazing that they have to wait in line with all of the other developers).

Simple apps such as calculators (Medcalc for Palm) are being emulated ad nauseum. One product, MEDIQUATIONS is going for $ 4.99 and appears to be the front runner for Medcalc emulation. However, there are a number of other programs with similar ideas going for free. A rudimentary program is iPhone Medical Calculator . This particular program continues to update quite regularly and I would assume that it will only take a short while before it begins competing with or surpassing the equations stored in the modest "Medical-Student-is-hungry-please-give-5-bucks-for-my-program" version. By the way, I am not joking about that last part, Mediquations was written by a 3rd year Medical student.

MacRumors, as I have just learned today, is actually run by a Physician who just recently retired from his 2 year Nephrology Practice, so he has a handle on Medical software. Pop over to the link (just click on the title of this piece) and see Dr. Arnold Kim's entire blog entry. What is interesting is the following post from one of the readers, responding to Dr. Kim's article:

"i know several doctors who are just loving the new medical apps for the iPhone and can finally ditch their palms. opening this us to the market for apps was genius and is helping the iPhone break into areas traditionally dominated by other handhelds for too long."

- Taken from Macrumors.com.

Unless Palm does something really quickly, my prediction of a huge move to the Apple platform could become a reality very soon.


But Wait !!!!


NOT SO FAST!!!! There are a few negative things that I have seen already in the App store. For example, there is a program called Eponyms, selling for $1.99. I mean really? Is that a medical necessity? This is the kind of program that should be free and cost nothing at all. After all, there is a website from which the database is probably founded, that could be ported directly into the device. Not really worthy, but that's my opinion.

But while we're on "my opinion," maybe it's time to take a look at another little ditty, mentioned in the same article, "OB Patient Tracker." Golly, I have an OB patient tracker that I created with Smartlistogo. And it does a lot more than what this one does on the iPhone, yet the iPhone version is selling for $14.99 !!! I applaud the free market system. However, I think that what we are seeing is the Gold Rush Movement. The first in show line coming out rather quickly and making a lot of money along the way. More power to them, but I am going to wait a little longer before giving up on Palm.

However, I predict that the real "killer apps" for the iPhone Medical community are being written right now and will come out before June of next year. I also predict that many of them are being written in Garages, Living Rooms and Study Halls. The home of NSBASIC and Code Warrior, has been ransacked by the new Cottage Industry - The iPhone. And to think, all Palm had to do was release an SDK and give programmers full access to programming tools instead of releasing an SDK with very little ability for "non-C-programmers" to do anything but buy an expensive suite or rely on something like castlebasic. What Apple did was release an SDK - albeit a restricted one - but gave the programmers the tools to create the software. Much of it is rudimentary, as in the early days of Palm, but that will soon change as programmers become more sophisticated. (I would jump at a chance to buy something from Pen Computer Solutions for example, a leader in relational database software. Having programmed two major databases with this software, it is a true leader and compatible with many enterprise solutions).

It is beginning to look as though Apple will become a major player in the Medical Software market. They are already leading in the pricing department (many apps are well under $15). And that is where it all starts. They are letting the market decide upon the prices and it will only be a matter of time before the rudimentary players will give way to the dynamic suites that are on the Palm devices now.

I am going out on a limb here, but I am also predicting that if a developer comes out with a real relational database application that is both simple to use and graphically beautiful; lending itself to creation on the fly without a desktop and as easy to use as SMARTLISTOGO with MS OFFICE or OPEN OFFICE compatibility, then there will be a deluge of Physicians leaving Palm.

Devices are becoming convergence vehicles, bringing together several file formats that people are demanding to be opened in a handheld device. For example Apple opens PDF's without a flaw, while Palm and Microsoft continue to stumble on this format, even though it is obvious that it is now the default for most documents. However Palm excels, where Apple's handheld remains dormant when it comes to opening, editing and creating Excel and Word documents (Dataviz Documents to Go and Mobisystems' Office). Physicians are looking for complete and total convergence now and the devices will need to answer to this need. So far, the iPhone is promising a lot and starting to deliver. Although it is a closed system, it appears to be catching on with many and is promising even more to come. Palm....while still the leader in the space, is showing signs of fatigue. The promises of a new device and a new operating system have been echoing for at least 3 years. With no reasonable competitor in sight, we put up with it. But this is not happening anymore. With the promise of Google's Android and the already successful launch of the iPhone, Palm will need to work harder to not only stay on top, but maybe to compete.

I am holding some confidence that they will do something very special next year.


LDD.

* Picture of iPhone vs. Treo taken from Palminfocenter.com. (Link)


Update October, 2008:

I wrote the above article before I purchased an iPhone 3G and a few things have changed since that time. First, ePocrates has just announced an update to its iPhone program. They will now have on-device storage of pill pictures, which will speed up the lookups. Additionally, they plan to eventually add the insurance coverage app that is so useful on the desktop and Palm versions.

I have it on good authority that the first native relational database to make it to the iPhone will come from Handbase developer, DDH Software. You may have read about me ragging on this company for nickel and diming on the Palm Platform for plugins, when they are standard on Documents-to-go's Smartlistogo, but DDH is a very formidable and respectable company and I really welcome their entry into this space. It is sorely needed. Now I will have to go and buy their software, since I plan to use the iPhone for many things. Check the website and blog, I will finally put up my smartlistogo apps for free download.

Another note is that Eponym's founder woke up and is now giving away the software. Additionally, the Gold Rush appears to be ending in the App store.

LDD.

SUPPORT SMARTLISTOGO

I have been perusing the web and there appears to be an effort underway to port or garner support for my favorite Palm app, Smartlistogo. A grassroots effort seems to be forming to get the software maker to make the program available on other platforms.

I can say that I wholeheartedly agree with this move. This is such an important program for the Palm Community that I can barely sit here and watch what Dataviz has done with it ......... Absolutely Nothing! Since updating it to Version 3.00x, the company has all but abandoned it, leaving only the Apps page, supported by the vast number of users, to create applications for it.

In perusing the Yahoo Web board, some of the users are angry that Dataviz has really done nothing more with this robust piece of software. Picture support is lacking; support for the new version of Access is also lacking. But more importantly, it appears that updates have ceased. I cannot tell the last time I saw any updates to the plug-in section.

An interesting side note is the fact that the author of the poll mentions that porting the main data file is really the most important thing to do and cites the success of Splashdata! to interestingly port over many of the main data files such as SplashiD! so that they can be used on any platform. So, one encrypted data file can be accessed by Windows Mobile, Palm, Apple, RIM, etc. Dataviz is using the Access file system, mainly either comma delimited or tab delimited files which should find easy support cross platform.

I would love to support this initiative. Dataviz acknowledging by doing any of the following - Support, update, port or open access - any of these would sound very good to me. If you get the chance, and I guess you have to have a Yahoo account to participate, pop over to the Yahoo board and give your vote too.

LDD.

I like the iPhone 3G, but it's missing something....

One of the things that I was looking forward to testing and using on the iPhone 3G was the ability to use it as an Enterprise device and personal device. I wanted to be able to have both my work calendar and personal calendar on the same device. I wanted to be able to separate my contacts by having my personal home contacts and work contacts apart. Alas, for all of the pomp and pageantry erected for the device, it still cannot do this. Additionally, it cannot edit documents because there is no "cut and paste" command !!

I think that Palm is safe for a little while at least. These were things that I thought would be fundamental to the device. I will have to wait and see if these improvements are noted later on in the year. The whole concept of separating my family calendar from my work calendar was really appealing. Now, I will have to wait a little longer to see if I am going to get one of these devices.


Taken from Engadget,

"the system is unable to let enterprise contacts and calendars coexist on the same device with personal contacts and calendars. (Personal and corp email get along just fine, though.)"

http://www.engadget.com/2008/07/11/iphone-3g-review/

Palm Getting Ready for Something New.....

I think that many of us have been predicting the fall of Palm for some time now. But a few sources are exclaiming that Palm is not quite done yet. Palm has apparently been working quietly on its new linux operating system NOVA. Additionally, they have had a very influential person in the design team for at least a year now. The designer of the Helio/Sidekick, Matias Duarte has been on board and is thought to have been brought over by Jon Rubinstein, the co inventor of the iPod.

This is very important news, because it means that Palm is betting the farm on NOVA. If this thing doesn't work, it could be lights out. It remains to be seen whether they will make a clean break or land in the world of Microsoft's Windows Mobile problem - trying to support legacy software. But for those of us sitting on the sidelines wondering whether we should jump ship to the Apple camp, this could be the twig that makes us sit up and take notice.

Again, for those of you not excited by this, this is big news. It means a complete overhaul of the Palm computing platform and more importantly a radical shift in the User Interface - maybe keyboards that can actually fit a real person, mmgh. I would say that if Palm can just keep on schedule, we may be looking at one of the greatest comebacks in the technology field. (Remember Palm ---- Lots of onboard memory, multitasking, wifi, gigabytes of extended memory and you'll do alright).



Resources:

Engadget.
Electronista.
Matias Duarte's blog.
Matias's Resume (pdf file).

Pictures: The Helio - Top Left.
The Sidekick - Bottom Right.


LDD.

Wonder why Garnet persists?

Our good friends at Access have just released Garnet (Palm OS 5) for Nokia Tablets. This means that the PalmOS will run in a virtual machine and have the look and feel of a Palm device. No word on whether NVFS programs will work. The same holds true for significant database files.

For more information, check out Access Garnet

Hotsyncing is supported surprisingly, as is graffiti. Access is still seeking developers for the platform, coming out with their own emulator to ensure that software will be compatible.
An interesting notice is found on their developer page though. It appears that they have had some problems with compatibility and appear to be working hard at correcting these. Programs listed that have thus far been "corrected" or that now work on the device are:

• Google Maps(TM) (crash when accessing network)
• Agendus (application failed to launch)
• MegaBowling (crash when using 5 way navigation)
• MMPlayer (application failed to start)
• Pocket Tunes (various crashes)
• WorldMate (application failed to start)
• CorePlayer (application crashes)
• CredibleMed Easy E&M(TM) (application failed to start)
• ICUmath (application failed to start)
• Parens (and all applications that use the MathLib)

The last one, Parens is interesting, since the majority of medical software use the MathLib. Another interesting note is the finding of no less than 2 medical programs on the list, a sign that the medical community may be losing its long love affair with Palm.

On the downside of all of this however is the question of age. How long will Access survive using the same outdated operating system that Palm continues to use? For an emulator, this may not be a bad nostalgic ride in the park, but for true day to day activity, will we ever progress past Garnet? Access's answer to this could be found in the following graph that they outline in the website, showing Garnet to have an edge on Windows Mobile when it comes to applications written. But one needs to remember that this graph is from 2005 and does not include the Palm Windows Mobile relationship. But the point is well taken as to why they would continue to support the platform (Yes, I know there's also the question of the millions spent on buying the rights to do so, but we won't digress):



On the plus side though, one could consider leaving Palm and buying a Nokia, if you run a lot of programs on your Palm that do not require NVFS, ie Calculators and small nonNVFS database files. I do see the potential, given Nokia has so little software for medicine.


LDD.

Reference:

Access OS5 download and information site
Access Developer Site for testing

Apple SDK

I had the opportunity to look at the SDK developmental platform for the iPhone last week, after signing up to become a member of the Developmental Team. Don't worry, anyone can sign up for this, it's not special. What I ended up downloading was a collection of videos showing how to use Cocoa (the developmental environment) to create Visual - C programs. It was a little heady, given the fact that I am not a C-Programmer.

But the results are definitely interesting. The buttons (virtual) are all accessible in the sdk, just like in Visual Basic. But they appear to be much more powerful, with pre-scripted macros already in place. There is nice fluid movement on the screen.

The actual writing of code is not simple, but again, there are many examples and macros that you simply plug into a button, that it looks a lot easier than writing in Visual Basic. There are address macros which automatically populate the correct fields. Again, somewhat similar to some of the visual basic sdk stuff. However with such automation, some programs may get that "look the same" feeling.

The products that I have seen thus far have been impressive. Credit Apple for showing these a month in advance and then allowing us to absorb all the hype before July 11th. It is becoming a frenzy at the moment. The medical applications, showing MRI and Pet scans at the WDC were impressive. I am still looking for other medical applications however to take over database tasks such as Smartlist, HandBase and OB programs found on the Palm platform. I have no doubt that they are just around the corner.

For the iPhone to be really successful, Apple must come out with a Database Program that will blow everything away. They already have Filemaker on the Mac end and I could see something coming from this, with the ability to put in conditional flags etc. Additionally, any database file must be simple to program.

Perhaps the most impressive thing that I saw last week and in the videos offered by the Developer team, was the over-the-air connectivity. I believe that I first saw this created well with Mobisystems Office on the Palm. I stand by that today. It is almost unwritten anywhere, but I truly believe that this suite was (before they went awry with the open source PDF) the best ever created for a Palm Top Device. The fact that they offered remote storage, accessible by the Lifedrive over the air, was jaw-dropping. It acted like a FTP service and it still works really well (did I mention that it's free)?

The Apple versions of this, in both Exchange and MobileMe are the next step forward. 20 Gigabytes of storage for MobileMe and if it works as advertised, seamless access to personal files both on the home computer and on the iPhone. Exchange's ability to auto sync to the office calendar and email is fantastic. One wonders if there will be an ability to have Exchange and MobileMe work at the same time, so that a personal calendar can be superimposed upon the Exchange calendar on the iPhone? Can Exchange be turned on and then off, without erasing the calendar. On the Lifedrive, if you try to sync the calendar to the desktop, it wipes out the Exchange dates. The same holds true when syncing to Exchange. Hopefully these fine points will be worked out.

Overall, I am impressed by the products. As for the SDK, I have not had the opportunity to work with it yet. I cannot tell if it will be simple to use or not. I am a little disappointed that Apple did not adopt the Widget route, so that we could transport the widgets to the iPhone, but it would appear that the company is doing everything right at the present time. A slow roll out and updated hardware to match.


LDD.

Lifedrive Essentials: BILITOOL (For Medical Professionals)

Have you ever been enamored by a piece of software that you just had to take a pause, inhale slowly and say "wow!?" Well I did just that this last weekend. One of our beloved nurses on the floor, decided that she had had enough of the waffling that most physicians do when they get a bilirubin level on a newborn. She had been made aware, by the Residents-in-Training of a new online tool called BILITOOL.ORG. This online program allows you to put in the date and time of birth of a baby and the hour at which the blood was drawn (if you know the age of the baby already, it has the ability to accept that as well). It will then take all of the data from the now relished and quoted BHUTANI GRAPH and display not only the risk category that your baby is in, but offer suggestions about when to place the baby on phototherapy.

I keep a copy of the BHUTANI GRAPH in my pocket at all times. I made a copy of it when the paper first came out and decreased its size, laminating it and saving it in my wallet. I do the same thing for the immunization schedules. My decision making is always done on a patient by patient basis mainly taken from BHUTANI's paper (Bhutani VK, Johnson L, Sivieri EM. Predictive ability of a predischarge hour-specific serum bilirubin for subsequent significant hyperbilirubinemia in healthy term and near-term newborns. Pediatrics . 1999;103:6-14).

So, if I have a baby who is term and has a lot of bruising or a cephalohematoma, I know very well that within the first 24 hours, that baby is going to have a high bilirubin level. Whether it is high enough to start phototherapy has always been the issue. Many of us will not do this unless the numbers approach 18; then there are some who will wait for 20; or 14 (all numbers at 48 hours). However, for myself, if the index of suspicion is high ie. ABO incompatibility, uncertain dates, prolific jaundice after 12 hours, a mother with beta strep, I am inclined to start phototherpy a lot earlier than the allotted 24 hours. In fact, I am inclined to order a bili at 12 hours based on my index of suspicion and the aforementioned issues (obvious jaundice and decreased responsiveness) and on the AAP guidelines. But not everyone will do this. As clinicians, we still have that index of suspicion and clinical awareness and independence.

So where is the line drawn? For our seasoned nurse, it became a never ending battle among physicians. One would start phototherapy, one would not. Same scenario, different treatment plans. And none of the plans were wrong, usually leading to the same outcome --> Healthy baby.

Naturally, I was skeptical about BILITOOL at first, until I found that it conformed to the BHUTANI graph completely. I was particularly fascinated by the fact that the program took into account the various factors that accompanied the baby. All of the ones listed above are incorporated into the decision making model. A link to the Pediatrics listing for risk factors is a plus. The decision to start phototherapy is outlined in a nice table. See the diagram below:




Palm Software

What is an added plus for this program is the fact that the program, in addition to being online, is also available as a standalone download for all Palm devices. And does it work brilliantly? It is probably even better on the Palm than online. You are again greeted with two different ways to enter data, either by length of time or by date and time of birth:




Once the data is entered, you press (Calculate Risk Zone) and voila, you are greeted with the essential information taken from the BHUTANI GRAPH:




The beauty of this is that not only is there risk stratification, there is also a guideline as to whether to start Phototherapy or not:







Risk stratification is further defined by pressing one of the icons, where you are led to definitions of high, medium and low risk:




In the event that you have a baby "who is on the fence," you are also given the neurotoxicity risk factors to consider. As the adage goes, "Cure the problem and you'll cure the disease." So correcting the acidosis or the sepsis will enhance the correction of the bilirubinemia. This is priceless, particularly if you are not thinking about G6PD deficiency or hypoalbuminemia:





And finally, threshold guidelines are given for the baby, with age and other considerations given. This is really priceless:



Again, these numbers correspond not only to the BHUTANI GRAPH and paper, but also to the American Academy of Pediatrics (AAP) guidelines on the treatment of hyperbilirubinemia, with risk factors. This is really an impressive piece of work.

The authors are also impressive. Drs. Tony Burgos and Chris Longhurst are both Assistant Professors at Stanford University School of Medicine. Dr. Burgos is the Medical Director at Stanford's Lucille Packard Children's Hospital, while Dr. Longhurst is Physician lead and director of Informatics. Dr. Stuart Turner is at the Health Informatics Graduate Program at U.C. Davis.

This is an impressive lead of physicians heading this program. The software is free and appears to be a part of the Creative Commons license. Unbelievable, for the amount of work that must have gone into this piece of software, both on the online side and on the Palm side. I commend Drs. Burgos, Longhurst and Turner for creating this incredible tool. It is one of the best that I have seen in a long time.

If you deal with newborn babies, this piece of software is a must-have in your collection. I am still looking for flaws after a week of dealing with 3 hyperbili babies and I have yet to find one. The papers used for reference are of the finest caliber that can be found on the subject. They are peer reviewed and in the authoratitive journal on Pediatrics in America. Again, I highly recommend that you go to www.bilitool.org, you will not be disappointed.


LDD.

More on Epocrates......

Today, I have learned that Epocrates will be filing an IPO, with the expected symbol: EPOC, presumably on the NASDAQ. I only hope that my concerns about privacy will be heeded and that EPOC will not hold all of the names/members in its database as pawns to be sold to the nearest advertiser. That is my new fear. I have concerns about companies trying to make earnings reports each quarter and what they will do to make it happen.

Hopefully, growth will come from organic growth of membership and subscriptions and not from nefarious selling of names and prescribing practices.


LDD.

Caveat Emptor: Apple SDK - will it change the Medical PDA?

From the very first day that the iPhone was mentioned, I pictured the writing on the wall. Palm would be knocked from its seat atop the medical apps world. Windows CE/Mobile would be a 3rd class citizen. I saw images of xrays, speech recognition software, e-readers with superior screens and that virtual keyboard, which seemed to beat graffiti, hands down overtaking anything that had ever preceded it.

However, from my perch, overlooking the sea of change, I perceived something else. It came to me last month when Steve Jobs debuted the iPhone SDK. One of the programs shown, running natively on the iPhone was EPOCRATES - My favorite medical app. Although I was happy to see EPOCRATES joining the sea of change, I began to have a slightly negative chill run through my veins this week.

One of the nice things about EPOCRATES is its seemless nature, jumping back and forth between applications and searches and updating itself almost automatically. However, herein lies the problem. PRIVACY !!!

For those of us who use EPOCRATES daily, we know that the company saves a list of the drug searches that are placed in the search box. If we use the online version, these searches are recorded. What becomes of these searches? Who views them? Are they open to scrutiny from drug companies etc ?

And who can forget the day when you bought your first PDA and it appeared robust, clean and snappy. Then you installed a few apps and suddenly you found your then large 64 mb memory turning to scraps and your brand new spiffy device beginning to crawl, falling victim to MEMORY HOGGING!

EPOCRATES is huge! It literally takes over your Palm device when you install it. It begs to be updated if you are 30 days out. It allows you to earn CME on your device by browsing over documents. Data, unknown to you, is sent back to Epocrates. What becomes of it? What else is being sent to EPOCRATES?

Don't get me wrong. I think EPOCRATES is fantastic. I have just signed up for another year to use them, but I use them as an example. There are a lot of companies competing to be a part of the Apple halo effect. There is pent up demand, akin to the early Palm days. But could we find ourselves in the same software bind that beckons us to leave Palm or Windows CE/Mobile? Will the new medical software take up 1/2 to 3/4 of the disk space, leaving what little space on the device useless, thus slowing the machine down to a dull roar? Will we be the subject of constant data mining, going on behind the scenes, with programs calling back to home (How would you like to be on vacation in another state, using your iPhone, not knowing that you are being tracked by one of the pieces of software that you have installed, because it calls home every time you turn on your device)?

We are all looking at the fantastic potential the iPhone and possibly other new devices have in store for us. But we must be careful not to let this fascination with advancement cloud our judgment, giving away our souls in the process. Medicine is an art and a science, but if we let others dictate what we should do, even surreptitiously, just to make life a little easier, we stand the chance of not living up to our maxim: Primum non nocere. As we embark upon this great future, we must DEMAND this of the software makers also.


LDD.

SDHC Lifedrive Upgrade to 32 gigs? Dmitry Grinberg says YES WE CAN.

Today, I read an article by long time Microsoft supporter David Dejean, in Computerworld. He discusses the work of Dmitry Grinberg, a software developer who has offered to write a driver to enable the SD card reader in the Lifedrive to accept the 8 to 32 gb SDHC cards.

Dmitry has a website named Palmpowerups.com . You may remember Dmitry put out an overclocking program to accelerate the Lifedrive. It was able to also decrease (underclock) the lifedrive for greater stability. He is quite a capable programmer and I think that he will come through in June or July with this.

If you get a chance, drop over to Dmitry's site, but more importantly, head on over to David Dejean's site. Wow, news continues for the Lifedrive...


LDD.

More waiting for Linux

I just received an email from a programmer stating that Palm Inc. is expected to release a Linux based OS code named NOVA. We can expect the first devices running Nova in the first quarter of 2009. Unil then, Palm will be pushing the Centro. According to this source, Access will continue to work on ALP Linux, but there is no certainty as to who will be building the devices in question for the ALP system.

In terms of compatibility, this appears to be a major hold up, in that both are working on backwards compatibility of software. To me, I think that they need to make a clean break, but I guess Palm's base is still entrenched in the old software.

Although most of this information has been out since January, I am only now starting to believe it due to the programmer discussing this with me. Additionally, I think that Palm may indeed pull out all of the stops in January or perhaps surprise us with a 3rd quarter release or announcement - just like the old days. Additionally, NS Basic appears to be one of the first companies to line up with Palm for the new Linux based machines. Good to hear.

Following my discussion with my programming friend, I scoured the internet for stories on this. The most interesting one came from PalmInfocenter's January posting. They have gone on to state that the next generation OS is currently being tested internally on a yet to be released product code-named Zeppelin.

More information, although this appears to be rumor (from mytreo.net) supports the probability that this new device will have wifi and may come under the Treo name (800's). Again this paragraph is all rumor. I stand by the paragraphs preceding this one.


LDD.

Software or Hardware?

So, another bad quarter for Palm Inc. You can read the numbers on a financial blog somewhere, they were dismal. Yes, the Centro is selling like hot cakes, but with its $99 price tag, it has done nothing for revenue or income and in fact has obviously cannibalised the Treo. On the conference call, there was mention of 2 new Treos coming out, but unless these have a very sexy look to them, this could be another dismal showing. There is some excitement knowing that one of Apples' hardware designers is now on the Palm team, but Palm will lose either way if they do what I believe they will: If they come up with a similar Treo that looks remotely like the 600 or 700 series, no one will be excited; if they come out with a brand new original "cool" Treo, but carrying the same OS 5 operating system, no one will be excited.

With the SDK being released for the iPhone, Palm essentially has 3 months to come up with something dramatic. The iPhone SDK, as I thought it would be, is actually quite amazing, according to a few developers whom I have spoken to. With Epocrates now releasing its software natively on the iPhone, we are seeing the migration to this device. It is only a matter of time, before Dataviz, Mobisystems and others do the same. I am expecting physicians to leave the Palm fold in droves. There is already an online petition being written for physicians to use the iphone as a medical device and requesting that software be written for it, leading to easy migration away from Palm.

I have not yet left! I am still using my Lifedrive, albeit reluctantly due to its lack of speed and its weight. Yes, I was excited about the refurbished iphones being sold by AT&T for $250.00, just slightly above what I would have expected to pay for a new TX. But I am still using a Palm device. Why? Well, it is not as simple as many on Engadget and other tech sites believe, to just drop this device. For a physician who is using critical data files, such as those found in Splashdata, Handbase, Smartlist and other proprietary programs for which there are no substitutes, walking away to another platform is not that simple. For Apple, despite its SDK, it will still take at least 6-12 months for developers to write software that will be of the same complexity as those found on the Palm. There is a plethora of software for the Palm and that is why the demise of this company is so hard to bear.

It is software, NOT HARDWARE, that has been the achilles heel of this company. Its failure to release OS 6.0 or Linux; its failure to offer multitasking or a definite roadmap for its developers has led to this problem that we have now. Without giving up anything (the developer has an NDA), I have seen a few programs on the iPhone that have simply made my jaw drop. Xrays shown in fantastic detail with no blurring with magnification. Why couldn't Palm come up with this? Any attempt to mix graphic visuals with text and wifi will crash your hard drive on a Lifedrive and soft reset the TX.

So, here we go again. Three months to go and we will either see Palm rise like a Phoenix or (and I take this from the great Mike Cane)..... do so poorly that they have to go private. Innovation is a difficult thing to do.


LDD.

Styletap may provide an answer for those of us on the wings

So this serves as the first post for the year. And what a discovery. Styletap, a company known more for their Windows Mobile products than anything else, specializes in creating Palm Emulation software for these devices. It would appear that our Windows friends have been taking advantage of the wonderful Palm software through emulation (and I must say they have kept quiet about it...:)).

Now the company has provided a proof of concept video that embarks upon turning the whole handheld market into disarray. For now, it's been Palm vs. Microsoft in the handheld space, with the former taking its knocks, almost becoming extinct. Now, Apple has joined the party. As I noted back in January of last year, Widgets will probably be the entry point for most software when the iPhone SDK comes out later this month. But what is now interesting is the fact that Styletap has created a Palm Emulator for the iPhone/iTouch! For those of us sitting on the side, wondering what it would be like to have an iPhone, but holding back because of software issues, this could be very interesting.

One of the programs noted in the video is iSilo. This is a must-have for most Palm owners who have medical software. The demonstration appears flawless and also incorporates the Apple virtual keyboard. Another program, Statgrowth from Statcoder is also shown (http://www.statcoder.com/). This important tool is a must-have if you need baseline numbers. The collection of software tools from Statcoder include:

1. Stat E&M Coder.
2. Stat ICD-9 Coder.
3. Stat CPT Coder.
4. Stat NCD Lab Coverage.
5. Stat Growth-BP.
6. Stat Cholesterol.
7. Grace ACS risk.
8. Stat Cardiac Clearance.
9. Stat Hypertension JNC 7.
10. Stat A-Fib Stroke Risk.
11. Depression PHQ-9 Score.
12. Stat Diabetes.

All of these follow the same engine and so should work with the emulator. Noticeably absent, and a major concern, is a relational database program or software that requires any form of significant data entry/storage. I would think that this would create significant issues with the disk. All of the programs listed are essentially, non-volatile ram resident programs. The type that would work on any non-nvfs file system or early Palm systems.

Of course, with the release of the SDK for the iPhone and iTouch, the emulator may become irrelevant, with companies deciding to "emulate" the most successful Palm programs natively. There are now 4 million + iPhones in the hands of customers, a large enough base to make it worthwhile for the software developers to look at this. As I write this, I am still waiting for an answer from Dataviz in regards to writing for the iPhone/iTouch. It would seem that this would be a profitable venture for them too.

Over the next few months, I think that the handheld space will once again become important as this proof-of-concept emulator may be the tip of the iceberg.