Med Student to Med Student Guide to Buying a PDA

When some of us enter medical school, we are told by the school that we need to buy a certain type of PDA. For the rest of us, we are daunted by the possibilities. PDAs are expensive, and we want to feel that we're making the right choice. Many of our classmates have different kinds, and we're not quite sure where to start. Here's where to start. AMSA has developed an affiliation with PDA/MD to purchase great handhelds with needed medical software at a discount. This guide will supplement that unbeatable resource.

4 Steps by Buying Your PDA
1 Deciding on a Device. Do you want just a PDA, or do you want a combined PDA/Cell Phone Learn More	2 Two main types of operating systems are out there: the Palm OS and the Windows Mobile. Nowadays, both types of operating systems are out there for both PDAs and Smartphones Learn More	3 Lots of bells and whistles are offered with PDA packages, including Wi-Fi, Memory, and Bluetooth. Learn More	4 Now that you've picked out the PDA that's made for you, put it to good use with software. Lots of old pocket books are now in Mobile format. Textbooks too Learn More

1. Deciding on a Device
A lot of different manufacturers are designing PDAs, but some are designed more for business than medicine. It would be nice if some great systems were designed just for medical students (working on that!) but for now, nothing is standardized. Some schools and hospitals have required items, others have recommended ones,and still others leave it wide open.

Two basic categories or upfront decisions include

1. Buying a regular PDA
2. Buying a combined PDA/phone
   (a third is the famous blackberry, but right now this is still best for business needs)

A regular PDA such as the Palms and PocketPCs currently available that do not include a phone component may be better for in-hospital use because they tend to have more functionality and better memory, including wi-fi which some schools and hospitals provide. If you like your cell phone and don’t mind carrying it around, this might be a better deal.

A combined PDA/cell phone or Smart Phone is ideal for people who are always on the go and want everything in one device, but right now misses out on including wi-fi. This is fine for internet and email because that is accessible via the cell phone coverage. An example of this device is the Palm Treo.

2. Operating Systems
Now that you’ve thought about the pros and cons about a PDA or a Smartphone/PDA combination, you need to decide on your operating system. The two choices are Palm OS or Windows PocketPC (both are available on PDAs and Smartphones) This is similar to a pc or mac decision. Some software reaches across both platforms, while some software is better suited to one or the other. Most places I know are recommending the Palm OS because more software is available and designed for medical purposes, although this is rapidly changing. However, Palm has a majority of the market and many of your peers may be using the Palm platform, in which case you can share programs or data. The PocketPC version tends to be richer in media capabilities, but check the specific devices for their capabilities.

3. Bells and Whistles
PDAs now have a wide range of options, with an attached range of price-tags. It’s good to think about what you’d like. Here are the options available that are of concern:

1. Memory: How much is currently on the handheld. Yes, bigger is better, and this changes rapidly so just make a quick list of features while shopping around. Despite expandable memory, the more hardwired the better because some applications do not play nicely with the insertable disks.
   
   
2. Insertable/Expandable Memory: All should include this feature, and the most common option is the Secure Digital or SD card. More the merrier. Like said above, some applications need to be on the main memory (ePocrates for instance). But a majority should be fine on the SD card.
   
   
3. Wi-Fi: If you can get it, you might want it, especially if your handheld isn’t a smartphone/treo. In the not too distant future, we will be able to integrate our pdas with hospital wi-fi for patient records. This may be available to some clerkships (Brigham & Women’s Hospital) this year, but most of us may really wait until residency to see this really used well. Otherwise, checking email or the web is handy.

4. Software
You’ll find most anything available, mostly for free but some with a fee. In
general, you get what you pay for, but careful detail is key when it comes to medical software. First, check your school’s intranet or website for free software that could be provided. Many tools and calculators are available on the internet for free, but it’s always good to make sure it’s from a credible source. AMSA is offering Pharm-Free toolkits direct from the NIH to replace ad-laden MedTools as part of the free ePocrates drug database for instance.

Pieces you'll want if you’re going with the PDA:

1. Drug database. Even attendings need these even though they don’t want to admit to it. These should provide dosing regimens, metabolism, contraindications, mechanism of action, warnings, etc. A drug interaction tool should be included to double-check your orders for serious
   contraindications. The supply and demand market has essentially provided this to everyone for free, via free ePocrates or other tools. Some premium tools are available including ePocrates Rx Pro (HMS 3rd and 4th years receive this upgrade for free) or Lexi-Comp drugs. So, in summary, get something but don’t pay much for it, if anything.
   
   
2. Pocket-Books: Many books come in handy, and these are often updated annually. These require purchasing the text, just like you would a regular book, so expect to pay some money. Check out your school’s bookstore
   and browse through the hardcopy to make sure the content is worth the price. If so, consider buying it electronically. It’s fully searchable, quick, doesn’t get lost easily, and always on you. Many of these quick reference books can easily be tolerable to read on PDAs.
   Examples include:
   
   i. The Sanford Guide
   ii. Griffith’s 5 minute clinical consult
   iii. Fred Ferri’s reference books
   
   
3. Med/Reference-Suites: Some companies or organizations are offering packages, which include a drug database with some key reference books. AMSA packages come preloaded with some med-suites so you can save some money on the pda and the software, while supporting your local chapter.
   
   
4. Patient-Tracking: This is up to you if you want to use this software or not, if it is not being deployed by your hospital for clinical care. The downside without hospital IT support is manual data entry. The upside is that these records are not lost, are legible, and can easily be exported to your PC for write-ups. Just make sure that you password protect and comply with HIPAA regulations. AMSA is in the process of working toward patient software designed exclusively for the medical education process.
   
   
5. Textbooks: Yes, even Harrison’s can be available on your palm. This is great for your 15 minute lunch break where you can read that chapter on Henoch-Schonlein Purpura without lugging around a 4 inch thick book. Keep in mind that Harrison’s can also be downloaded in individual chapters onto your handheld for free if your school has a site-license to Harrison’s Online. If you know you need to read that Henoch-Schonlein Purpura article before rounds, this is a reasonable option too.