PalmOS Clinical Computing, the ‘Ectopic Cortex’

Updated: July, 2008
Gary Greenberg, MD ( email )

What’s all the fuss?

  • Never lose information you intend to remember
    •   Phone numbers
    •   Names
    •   Appointments
    •   Facts
    •   Lists
  • Access information without waiting for boot-up
  • Input (or modify) information on the fly
    •   Internal Touch Keyboard
    •   "Grafitti"
    •   Additional optional tools, some very clever
      •   Attachable touch-type keyboards
  • Copy information instantly (nearly) into your own possession, from:
    • Web
    • E-mail
    • Electronic files (eg word-processing, database, spreadsheet)
  • Share information with colleagues, family
    • Accumulate knowledge
    • Accurate, near immediate transmission
  • Maintain back-ups of all the data you value
    •   Your PC
    •   Any other colleagues/friend’s
    •   Many other options for archive and safe-keeping

Disclaimer:

  1. I have almost no knowledge about Windows CE / Portable PC devices. This website will ignore them. As an early adopter for this technology, I was deeply committed to PalmOS resources l-o-n-g before Windows hit the street. Guess I haven’t round any reason to switch. I am VERY gratified that Duke Med students graduating in 2009 just got PalmOS devices… otherwise, I’d have nobody local to share with!
  2. I am not (never been) paid or supported by any of the manufacturers, distributors, vendors, developers or programmers for these products. I have been invited to use free (beta) versions of several programs listed below, but I consider myself a reviewer, rather than an endorser, and there are several I haven’t listed when I found the program deficient. I have been invited to serve on ePocrates (unpaid!) "advocates" group. It means I get the spiffiest version for free and early.

Synchronization Basics /Example

Action PDA Desktop
Enter Dental Appointment into PDA
Synchronize to copy to desktop
Enter Teacher appointment at desk
Synchronize to copy to PDA
Add Birthday to Desktop
Remove dentist appointment from PDA
Comment:
Notice that the calendar discrepancy before synch’ing is the same for the Dentist appt as for the Teacher Conference, but the OS could tell that you wanted to copy the ADDITION of Birthday to the handheld, and copy the DELETION of the dentist to the desktop.
Synchronize to copy both event AND deletion

Purchase Options

If you don’t yet own a Palm device, the choices can be overwhelming (but much less than it used to be!).

There used to be many manufacturers of PalmOS devices, but now there’s just a few. In fact, Palm makes all the "pure" PDA ones, and Garmin combines them with a UPS, and Treo makes combination phones (used to be HandSpring).

For the ones that are comingled with a cell phone (Treo) here’s a comparison table.

For historical value, here’s the list of vintage Palm devices, and their features.
I recommend looking at a few different discount online hardware vendors, showing prices and feature-lists:

Buy.com, Outpost.com, Amazon.com, MobilePlanet, BuynShop

My favorite shopping site is Froogle (yes a clever pun and mis-spelling). This is a Google-powered shopping engine and price aggregator. A powerful search for all PalmOS PDAs between $50 – $500 is here, and includes used, rebuilt and orphaned models.

Many prices are indexed at PriceWatch.com but you won’t find a word of description.

Similarly, BizRate is an index of prices from various online vendors.

Notes:

Contents of Gary Greenberg’s Palm

Well, it’s actually a Tungsten E, replacing a Tungsten C, which was provided to me by DUHS (for WiFi use and testing) to replace my own and again Tungsten E, which replaced a Palm m515, replacing my HandEra 330, replacing a TRGPro, which replaced a Palm IIIxe, which replaced a Palm III, which followed a Palm 500 equipped with a pager-card, which replaced a Palm 100. Looks from my accumulated calendar data that I became a Palm-guy in September 1996.

Alphabetical order, each title links to download or order site
American Heart Association Guidelines

Several well formatted, formal position statements on heart care.  Unfortunately, requires their own special viewer "The APPRISOR", 326 KB. Examples include:  

  • ACC/AHA Pocket Guideline: Chronic Heart Failure in the Adult
  • ACC/AHA Pocket Guidelines for Coronary Artery Bypass Graft Surgery
  • ACC/AHA Pocket Guidelines for Management of Patients With ST-Elevation Myocardial Infarctiom
  • Chronic Stable Angina
  • Implantation of Cardiac Pacemakers
  • Valvular Heart Disease
  • Percutaneous Coronary Intervention; ACC/AHA/SCAI Pocket Guideline Free.
    		•
    Audible Player

    This is a very cool online subscription service offering digital downloads of audiobooks. The implementation of the playback from PalmOS devices does not require the MP3 software, and runs very well… but used considerable battery power. If you’re going to sign up, let me know first, and I get credit for recruiting you.

    Software is free, pay for each book or an annual subscription.
    AvantGo Amazing program which seizes and encapsulates material from webpages, auto-updating on each synchronizing episode (if desktop is online). Hosting firm allows free registration for several pre-prepared "channels" including all the (full-text!) articles from the front page of the New York Times, plus all updates from your choice of hundreds of contemporary URL’s, including The Onion, movie schedules, etc.

    Free for usual profile, more for wholesale data-grab.
    Backup Programs

    I have used Back-up BuddyVFS so long that I thought it was part of the Palm OS, and forgot it to be a commercial program (usually $25, sometimes "on sale" $20).

    There’s a BackupBuddyVFS Personal version that has limited functionality, saving data to card-only, and is only $10.

    Other programs are less famous and less costly, and unfamilar to me. Features to consider are whether the program allows you to have automatic scheduled backups (eg overnight), incremental back-ups (ie copy only new or changed files), multiple copies of back-ups (to separate sub-directories), or even compressed file storage to take up less room on the RAM card.

    TealBackup $20, PiBackup II $15 , BackupMan $15, Resco Backup $15, OnGuard Backup $15, Pocket Backup, $10, Instant Backup $10, and several others are free (which can be worrisome for such a critical functionality) SmartBackup, Backup, NVBackup, Inner Backup

    Another option is to use a file management tool to "manually" select all files (*.*) on the Palm and send copies to the external RAM. Filez (below) is a free example of this kind of program. Z-Launcher (also below) is a program menuing / launching program, and it also includes a robust and well-designed file manager.

    Bio-Hazard Manual (loads directly to Palm)

    		 USAMRIID’s Medical Management of Biological Casualties Handbook resides here on the web.
    The US Army Institute of Infectious Diseases has a free complex document (requires iSilo, see below). The text itself is surprisingly small, only 149K. Free.
    Calc! Powerful, simple calculator with parentheses, editable formula use, high end trig and log functions.
    Shareware: $12.50
    Cesium Clock, with timers, count-down, alarm, large font, multiple time-zones, stopwatch, w/laps 
    Shareware Others include Big Clock , which is free.
    Chem Hazard Treatment Guide (loads directly to Palm) This is an iSilo consolidation & compression of a very powerful resource. Treatment Of Chemical Agent Casualties And Conventional Military Chemical Injuries, FM8-285. The document resides at  Office of the Surgeon General
    Medical NBC (Nuclear, Biological and Chemical). This rather large reference required considerable work to get the whole contents into a single subdirectory and then to simplify the HTML links, with reformatting for Palm. Otherwise, the text and content are entirely unchanged 388Kb, Free.
    CIA World Fact Book HUGE doc file, free, with every amazing fact about every country in the world. Imagine population, literacy, miles of paved roads, cash crops, HIV sero-positivity, plus a map and the flag. Online, it’s here.
    6.5 Meg (yes, Meg), so needs to live on your external RAM. Read it with iSilo.
    Free.
    CityZen A map of the whole world, incl 3,350 geographic items (2861 cities, 194 countries, 233 islands, 62 lakes and oceans)!! Can calculate distances, search for key sites.
    Free
    Clinical Pharmacology OnHand A (barely) portable version of Clinical Pharmacology, which is my favorite onlinedrug reference site (commercially licensed by the Duke Medical Library). The Palm product requires and makes good use of external RAM, or else nobody could install it! I find it emphasizes true pharmacology (ie kinetics, interactions) much more than humble doc-topics like therapeutics. It’s capable of auto-updating, but failed to achieve this on my machine without tying itself into knots.
    $100/yr (free through Duke’s license)
    CurrCalc Converts ANY kind of data between units, incl weight, time, speed, currency, temp, even currency. 
    I made downloadable tables that allow direct translation within the whole class of narcotics, benzodiazepines, glucocorticoids. If you use these and like them, let me know. I wonder if ANYbody is using this program as a clinical dosing calculator.
    Entirely customizable, intuitive fast to use. An all around OK calculator, too.
    Shareware, $13.
    Element Periodic Table of Elements; Amazingly easy database and image for quick lookups 
    Shareware, $10.
    ePharmacopoeia by Tarascon The electronic version of the very popular pocket reference book. Much easier to read for the bifocal set.
    Now a fully developed, auto-updated subscription.
    $28/yr
    ePocrates
    Disclaimer: 
    The company gave me a free "editorial" copy of the newest version of this program. I’ve been a fan and paying customer for years before this. 
    New disclosure: They’ve recruited me to be an "Advocate" and I now have an ePocrates hat, bag and water bottle, in exchange for completing questionnaires.
    		 Like a PDR, faster, categorical and incl just the pill-sizes, adv effects, drug class and high-risk or high-prob interactions. Prices are quoted from Drugstore.com. Most useful clinical Plam program I know. 
     
  • Now auto-updates with new information without fuss. 
  • ePocrates Rx, 2.5 MB Free
    • ePocrates Rx Pro, ver 6, 3.0 MB , $60/yr, includes additional features:
      • qID (antibiotic guide)
      • reference tables (eg SBE prophylaxis, inhaler colors, ACLS meds)
      • integrated herbal/alternative meds 
      • opportunity to filter med choices through your choice of healthplan formularies, so you can prescribe to each insurer’s coverage idiosyncracies.
    • ePocrates Dx ($60/yr) includes a version of 5 Min Clinical Consult, but it’s not as easy to read and search as the un-attached ones.
    • ePocrates Lab is part of the most inclusive tool ($140/yr), and includes a database of lab tests, most useful for the inclusion of pricing information. They call the combined product "Epocrates Essentials". Honestly, it’s NOT essential.
    • ePocrates Sx is a differential diagnosis engine, especially useful for students, but a nice reminder of wide-ranging explanations for specific symptom clusters.
    • Filez

    Free tool provides "Windows Explorer" tools to manage content of your internal Palm files, and for your external RAM card. Subdirectory, wild-card, multi-parameter sorts are very useful. A commercial tool with similar capabilities is Tealmover, $15. File management is built-in for Z-Launcher (see below), and very capable.
    FindHack

    Very slick replacement for the otherwise AWFUL PalmOS search tool. Allows search for wildcards, and limits to the current database (eg Addresses).

    Even though it is called "hack", it is a stand-alone program, and does work in PalmOS 5

    $15
    Five Minute 
    Clinical Consultant    		 Yes, the whole book. It’s a great way to find the rest of the differential dx, the complications that you’ve never seen and the manifestations of illness that would prove/disprove a diagnosis. 
    It’s $65, both from SkyscapeHandHeldMed. They used to differ, and may still present the data in different formats. 
    For $75 there’s a 3rd version, from LexiComp.
    There’s a ?reduced version within the highest-end version of ePocrates ("Essentials"), for $60/yr.
    GrxView Photo Viewer

    View, sort, zoom, auto-load photos or other graphics files as GIF or JPEG files in RAM or on card. Seems more flexible than the internal Palm prg which breaks often. Reads data from external card quickly and readily.

    $15

    ICDMeister

    Well coded iSilo doc file that allows fast reference to ICD-9 codes, with simplified organ system organization, and quick search. The structure is of numerous linked pages, very much like a complex web-domain.

    Shareware, $40 1st yr, then $20/yr thereafter (seems a lot for a simple document, but it’s more accessible and useful than free standing programs).

    Intellifind

    Makes it easier to find where you put data that might have been been stored in an odd place. EG, a restaurant that was noted on your calendar or in a DOC review or a memo (instead of your addressbook) can be found more interactively and by several slick search parameters. 
    Shareware (times out in a month)

    $15
    International Chemical Safety Cards (ICSCs) The ICSCs project is an undertaking of the  International Programme on Chemical Safety (IPCS), affiliated with International Occupational Safety and Health Information Centre . NIOSH makes this database available at its site. 

    This file is VERY LARGE: 4.6 Meg This may be because I chose to use the NIOSH version, which includes several supplemental tables. You will need iSilo (see below) to manage the internal text compression and hyperlinks.
    iSilo
    Actually, I also use SmartDoc (it can edit doc files on the Palm), but recommend this one because it manages linked text, like the CIA & NIOSH compendia, see below).
    		 Display giant text files (larger than the Palm memo-prg permits), including data compression and scrolling. 
    Wonderfully stable use of larger files on external RAM cards.
    iSilo is unique in that it also holds formatted HTML files (from the web), graphics and apparently compresses text files even tighter than the other doc-readers listed below. 
    Shareware $20.

    Other options: AportisDoc ; TealDoc , SmartDoc , Qvadis , RichReader (free) , CSpotRun (free)
    A review of all document readers is available online 
    Newest on the horizon is Apprisor, free.
    Johns Hopkins Antibiotic Guide Much easier to use in Palm, but less definitive, less complete than Sanford (see below), but smaller, auto-updating if you synch from an online PC and $25 (new charge via Skyscape as of 2008).
    JFile Pro Flat-file database, for tables sortable by any parameter (Eg: anti-depressant meds, US-States, US Presidents) 
    Licensed software, $25

    Other option: HanDBase, where prices are $30 – $100, depending on programming tools you purchase.
    MedCalc Powerful clinical calculator, including >30 separate parameters, eg: GFR, Osmotic gap (plasma & stool), BSA, BMI… you name it. 
    Free.
    MedMath Another wonderful clinical calculator, with EBM calculations as well as lab parameters. 
    Free.
    MedRules Another medical calculator, but more regarding risks and decisions, than for physiological parameters and clinical factors. Even shows citations for any calculation (eg Ranson’s Criteria for pancreatitis mortality). 
    Free.
    Merck Manual Classic simple introduction to clinical topics. Cheaper and wider range topics than 5 Min Clinical Consults.
    Inexplicably, this text is free to enrolled clinical professionals, and offers auto-updates and a very simple interface, but is also for sale ($80) here.
    MentSTAT

    Very small and simple program that provides reminder for doing and scoring the Folstein MiniMental exam.

    Free
    NIOSH Pocket Guide to Chemical Hazards
    Updated: 11/2005
    		 From the National Institute of Occupational Health and Safety , the Pocket Guide is "a source of general industrial hygiene information on several hundred chemicals/classes for workers, employers, and occupational health professionals". I downloaded the digital text, and compressed it to a BIG (nearly 1.4 Meg) iSilo document. Most users will want to put this in their external RAM card, depending on their setup. This is a hyper-linked series of web-pages, and will run only on iSilo, not other ‘doc’ readers.

    In case it works better: here’s the old version, created in 2004.
    PDAReach A miraculous program that allows PC on-screen (& thus projectible), live, fully active use of your actual Palm (attached via its Hot-Synch cable). Tthe best teaching tool I’ve ever used for showing PDAs. I can’t believe how powerful, attractive, flexible, intuitive and simple-to-install!
    $24
    Don’t even THINK of using the Palm Emulator, which is awkward to impossible, and requires that your desktop run programs several years too-new for the device it’s emulating.
    PEPID Several programs, more narrative than tabular, but including a pharmacopoeia as well as diagnostic and clinical/therapeutic recommendations. There’s a shareware 1-month trial, then subscribe for 6,12,24 months.
    $110/yr for each program: All Physicians, Emergency Medicine, Clinical Nursing, Medical Student, Emergency Medical Services, Portable Drug Companion
    I never have used or bought this.
    Redi-Reference – Clinical Guidelines Many guidelines from AHA, NIH, CDC, incl JNC-VI, Asthma guidelines, STD Rx programs. 120 Kb, $20
    Sanford Guide to Antimicrobial Therapy

    This is obviously the most authoritative ID consult tool.

    Unfortunately, it’s not as easy to use as the pocket book with the tiny print.

    The interface leads the user through choice after choice and then finally provides some recommendations. My clinical problem with it is that you can’t see what would have been recommended if the patient WERE (eg) allergic to PCN. 
    $28/yr ; Very deepfully copy-protected (incl your Palm hardware’s serial number) . Very s-l-o-w is you decide to install it in external RAM card, (also relatively unstable there). In main RAM, it’s BIG.
    Shots A quick reference guide to the 2006 Childhood Immunization Schedule, a collaboration of the Advisory Committee on Immunization Practices (ACIP), the American Academy of Pediatrics (AAP) and the American Academy of Family Physicians (AAFP), and the 2005-2006 Adult Immunization Schedule, recommended by the Advisory Committee on Immunization Practices (ACIP). Details on each vaccine are available by clicking on the vaccine names. Three versions are available, with high- or low-resolution photos of the infections, or none.Free
    SplashID

    Retains passwords and access information in an encrypted format, both on the Palm (better than the internal password for PalmOS), and on any backed-up format (eg card or desktop).

    $30
    STAT Cholesterol Calculate recommendations based on the new "Third Report of the Expert Panel on Detect., Eval., & Rx of High Blood Cholesterol in Adults" guidelines 
    Free.
    This program’s website links to another palm-based, free lipid-action calculator at the ATP-III / NCEP home site . They state their own program does not underestimate CAD risk.
    STAT GrowthCharts Calculate accurate growth percentiles and Z scores using the newly revised CDC Growth Charts including the new Body Mass Index-for-age charts. 
    Free.
    Teal Lock

    Smart Palm lock. Allows many types of passwords, auto-locks after certain time, certain command, with varying security for different files. Long password for changing features, short password for simple entry.

    $20
    Teal Paint Draw digital images on Palm, many brushes, shapes, tools, fills 
    $20

    TextPlus

    Very powerful & flexible text-entry tool that permits users to recognize and complete any word that’s begun, from a large vocabulary in a glossary file, based on frequency of prior use. Also offers the opportunity to add, create, combine both vocabuary and phrase books. Best of all, the glossary and phrase files are managed on the PC, in regular text-editors, then re-imported to the Palm, so you have all your screen space & keyboard capabilities.
    $15
    UltraLingua Language Dictionaries

    Very smart language translation dictionaries. Provides full vocabulary (website says 350,000), but also decodes numerical strings, conjugates verbs in 12 tenses, allows uers to add their own vocabulary. Most of the huge datafiles can be kept on the external RAM card.

    $30 per language (I have English <-> Spanish and English <->French and English<->Italian)

    Since I use them very differently, I can say I like the Spanish most (I’m a struggling but active learner), the Italian least (tried to make it work as a phrase book, for a language I didn’t intend to learn) and French middle, since I know lots of French and used it only to remind me of specific words.
    USPTF / AHRQ Prevention Guidelines

    Free reminder / decision tool for recommended prevention practices (including the level of evidence-based support) for patients, chosen my age, gender, clinical circumstance (eg pregnancy)., as evaluated by the U.S. Preventive Services Task Force. Distributed by the Agency of Healthcare Research & Quality. The program linked to the left includes its own search capabilities, but there’s also a web/hypertext version (for online use or creating a customized iSilo or SunRise database) and a downloadable a print/PDF version, too.
    Vindigo Guides, reviews, interactive instructions, schedules and great travel resources for many cities: 
    Atlanta
    Austin
    Baltimore
    Bergen & Passaic, NJ
    Berkeley & Oakland
    Boston
    Buffalo
    Charlotte
    Chicago (3 vers)
    Cincinnati
    Cleveland
    Columbus
    Dallas
    Denver
    Detroit
    Fort Worth
    Greensboro    		 Hartford, CT
    Honolulu
    Houston
    Hudson Cnty, NJ
    Indianapolis
    Jacksonville
    Kansas City
    Knoxville
    Las Vegas
    London
    Long Beach
    Los Angeles
    Louisville
    Mercer Cnty, NJ
    Miami
    Middlesex Cnty, NJ
    Monmouth Cnty, NJ
    Montgomery Cnty    		 N. Virginia N 
    N. Virginia S
    Nassau Cnty, NY
    New Orleans
    New York City
    Norfolk
    Omaha
    Orange Cnty
    Orlando
    Pasadena, Burbank, Glendale
    Philadelphia (3 vers)
    Phoenix
    Pittsburgh
    Portland
    Prince George’s Cnty
    Providence    		 Ral./Dur./Chap.Hill
    Rochester
    Sacramento
    Saint Louis
    Salt Lake City
    San Antonio
    San Diego
    San Francisco
    San Jose
    Seattle (4 vers)
    Somerset Cnty, NJ
    Suffolk Cnty, NY
    Tampa Bay
    The Hamptons, NY
    Twin Cities MN
    Washington, DC
    Westchester Cnty, NY
    Winston-Salem
     $25/yr (after the first month)
    WISER WISER (Wireless Information System for Emergency Responders) is a system designed to assist First Responders in hazardous material incidents. Developed by the National Library of Medicine, WISER provides a wide range of information on hazardous substances, including substance identification support, physical characteristics, human health information, and containment and suppression guidance. The informational content is similar to NIOSH Pocket Guide, but simpler vocabulary.
    Even though it’s called wireless, what they mean is self-contained (no net access is needed)
    Free.
    ZLauncher Even better utility than Launch’em, this tool offers integration of all programs (internal or external RAM), screen organization, tab menu capability, an internal file manager, direct access to beaming from internal or external RAM and (for those interested) wall paper and screen images.
    Shareware, $20
    911 (or .911) A FREE resource that incorporates content from Outlines in Clinical Medicine/Medical Emergencies and the CDC regarding potentially rapidly-spreading diseases, including SARS & bio-terrorism agents. This merges nicely into the 5-Min Clinical Consult and Bartlett’s Infectious Disease software from the same vendor, but stands alone nicely. Routinely checks for updates, so more uptodate than the other titles by this vendor.

    Non-software Purchases

     

    Web information
            too many great sites to count!

    Dr. Greenberg’s Recommendations:

    Definitive  site for software, including purchase, download, upgrade, you-name-it.: Palm Gear HQ

    Great informal narrative resources by/for doctors:

    Maillists / Communities

    Most of the commercial sites want you to stay and chat

    PDAMD ‘s forum

    palm-med (free subscription at University of Michigan, available as daily digest)

    comp.sys.palmtops.pilot newsgroup, hundreds and hundreds of daily messages to review
     

    Data Integrity / Maintenance

    What does gets Hot-Synched?
    What else is at risk?
     What can hurt your Palm (& lose your data)?

     Battery died (especially the rechargeable ones). This dpes require a l-o-n-g period of neglect, since the data is still viable and protected when the Palm is merely too tired to turn on. From there to fully brain-dead is still days-to-weeks 
    Screen stops responding
    Software knots your session and “warm reset” (button on the back) won’t help (Blinking top-left cursor, on off on off on off on off)
    Physical damage: Falls, jumps, hides to a non-secure situation (eg into a toilet)
    Cold reset is required (Reset button while holding down power button)

     

    How do you protect your data, your software, your configurations?
    Layers of security:

    Smart Document Creation

    Getting stuff from the PC screen to the Palm. The options listed below are in order of sophistication.
    1. See if it’s already out there
    2. Cut & Paste, directly into a memo
    a. Serial clips. This is like high-lighting with your mouse and retaining whatever you found important.
    b. Combining clips. This allows you to combine the last several clips, and assemble them into a single “paste”.
    c. De-formatting clips. Remove carriage returns, indents, bold/italics commands. Even remove the awful email quote marks like >> and ::.
    d. Saving clips for later. Paragraphs you use a lot are available in a non-transient list, only a couple of keystrokes away.
    3. Create a “doc” file

    a. Own and install a doc reader (iSilo preferred, see above)
    b. Create the text file
    c. Utilize one of the doc compressing tools (I use MakeDocW. It’s free. iSiloX does this too (see below))
    d. “Install” the file into your Palm

     

    4. Use iSiloX to capture (once) and save a whole web-complex of files
    5. Use AvantGo to create a “Custom Channel”
    6. Translate & Import a file you like in a format you’re comfortable with

    Privacy, Confidentiality, Secrecy, Security

    1. Assume that your Palm’s content is never perfectly protected
    2. HIPAA (Health Insurance Portability & Accountability Act)
    3. Responsible (even if not fully legal) precautions include certain safeguards.
    4. PalmOS internal security is convenient, reasonable but NOT impenetrable

    Optimum Use of Your Palm’s Limited Space / Memory

    1. Buy a Palm that has a RAM slot (modern ones all do).
    2. Learn how to move data and applications to/from your RAM card.
    There are TONS of Palm-based file managers, which function just like the Windows Explorer. Each allows the user to see a list of files, and move or copy them to RAM card, and even to create sub-directories on the RAM card.
    Choose among: TealMover, PocketFolder, MyWorkbench, McFile, FileZ (free), FilePoint, FileInfo, FileMan. If you have a HandEra, you get CardPro for free. If you have a Sony Clie, you get  MSGATE included in your operating system.
    3. Learn about VFS
    a. Launcher Programs are easiest
    In current Palm devices, a sophisticated “Launcher” program can read this subdirectory RAMCard:/Palm/Launcher as if it were the internal Palm memory. That’s a great place to store non-critical programs. A general principle is that the data in this directory is where you’d put the read-only resource or reference files. It’s probably NOT where the program will store your tiny configuration files.

    I use Zlauncher, and previously Launch’Em.  Launcher X ($19),  MegaLauncher ($20) are examples

     b. Make use of specific programs’ ability to store individual files externally

  • iSilo stores and manages data at RAMCard:palmprogramsiSilo
  • JFile stores in RAMCard:palmprogramsJFile
  • HanDBase has its own too.
    • 4. Think about what you put where (Palm v card)
    5. Expect / demand that programs run from external RAM
    Skyscape programs (Lexidrugs, 5-Min Clinical Consult, others) offer specific installation instructions for storing massive data outside the Palm. RAMCard:palmprogramsmsfiles. This is very nicely done, and very stable, reliable.

    Hopkins’ Antibiotic Guide and the Palm version of Sanford have a separate installation technique. For Sanford, the off-Palm implementation is painfully s-l-o-w and moderately unstable.

    Clinical Pharmacology OnHand for Palm seems to be free for Duke personnel, and requires 13 MB of RAM(!). All but 1 MB are intended for external installation.

    For questions: e-mail Gary Greenberg, MD


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