Treo650 in Health Care - Page 11

NJPsycho · 04/25/2005, 10:39 PM

As a patient here are my thoughts on this subject.

I started going to a new doctor a few years ago. I asked him about me quitting smoking and about medications that are avaliable. I was very worried about side effects. I ask him about Zyban.
Now the doctor I was seeing earlier was a crotchety old man who would have gasped at the notion. An I-don't-need-any-young-kid-telling-me-different kinda guy.
So instead if having a preconcieved opinion on the subject the new doctor had no problem looking up the info on his handheld. I appreciated his open-mindedness and stuck with him ever since. I'm not sure he had a Treo (he may have even had a *gasp* Pocket PC).

Oh yeah, and I'm still smoking.

WittiDoc · 04/26/2005, 11:14 AM

So...
downloaded free trial LaucherX and installed it. Fairly simple, really. Pam from LaucherX said to move all files but Startup.prc file. Well I had to leave epStartup.prc and ePocrates.prc on the handheld ~500KB. The others I moved to the card..programs directory, easily. So I freed up some 1.5MB (I am currently using the free ePocrates version). Updates work fine.
I'm planning on purchasing the full version soon and will report back as to how that works with the card.
I'll play somre more with moving other files to the card.

Also, ePocrates wrote the following in regards to ePocrates and cards:

Subject
Epocrates on expansion card

Discussion Thread
Response (Ricco) 04/20/2005 02:35 PM
Good day,

Thank you for writing to us. Your feedback is very appreciated. I have forwarded your e-mail to our Engineers. We will also be testing expansion cards very soon. Thank you

DocGo · 04/26/2005, 04:50 PM

I really hope they will work on the expansion card soon. I have been bugging them about it for a year now about this issue since the pro/essentials version of ePocrates is a memory hog!

stringbeanie · 04/27/2005, 04:49 PM

Has anyone figured out a way to use HandheldMed books with the Treo 650? I have about 5 books including Medical Dictionary with this company and the books don't open. I get a soft reset every time that I try to open one of them. Their tech support is neither technical nor supportive.

phillydog · 05/01/2005, 08:58 AM

I am using my Treo 600 as a pager and have had no communications issues. The problem is that the built in MIDI tones are very low in volume compared to a decibel rattling pager. As MP3's are considerably louder, I have tried using those as alerts via Call Filter (only works on 600) which plays a designated MP3 via PTunes. The problem is that answering an SMS Page does not end the MP3 as answering a phone call does and the MP3 continues playing to its completion. Very embarrassing when you can't push a button to silence the pager and everybody turns around to see where the William Tell overture is originating from. Does anybody know if any of the 3rd party ringer programs (Ringo, Lightwave) have this problem?

Hotoru · 05/01/2005, 10:02 AM

Quote:

Originally Posted by phillydog

I am using my Treo 600 as a pager and have had no communications issues. The problem is that the built in MIDI tones are very low in volume compared to a decibel rattling pager.

Wow, I was really impressed by the volume of the MIDI. I have to set mine on the next to lowest setting so it does not draw attention from everyone in the area. I found some really screaching ones that seem to do the trick if you need dbs

abarreto · 05/01/2005, 11:26 AM

I am a physician with a treo 600. I am trying to collect a database of adobe acrobat files: pdf files of landmark medical studies that I can easily print for medical students. I am trying to find an application (like printboy) which will print pdf files wirelessly to a printer while on rounds in the hospital. Any suggestions?

Thanks alot

Fred Clark · 05/01/2005, 02:19 PM

I am not a doctor, but am in the medical arena. I don't understand why more doctors don't use their Treo for dictation? It is a mobile voice tool and there are some excellent dictation applications available like Audacity. It seems like it would be a natural application.

TreoDoc · 05/06/2005, 08:20 PM

Quote:

Originally Posted by phillydog

I am using my Treo 600 as a pager and have had no communications issues. The problem is that the built in MIDI tones are very low in volume compared to a decibel rattling pager. As MP3's are considerably louder, I have tried using those as alerts via Call Filter (only works on 600) which plays a designated MP3 via PTunes. The problem is that answering an SMS Page does not end the MP3 as answering a phone call does and the MP3 continues playing to its completion. Very embarrassing when you can't push a button to silence the pager and everybody turns around to see where the William Tell overture is originating from. Does anybody know if any of the 3rd party ringer programs (Ringo, Lightwave) have this problem?

I use the P tunes/TreoAlert combo as my pager for sms pages...as soon as I acknowledge the page on my 650 the John Coltrane stops :-)!

TreoDoc · 05/06/2005, 08:23 PM

Quote:

Originally Posted by Fred Clark

I am not a doctor, but am in the medical arena. I don't understand why more doctors don't use their Treo for dictation? It is a mobile voice tool and there are some excellent dictation applications available like Audacity. It seems like it would be a natural application.

Fred. I have thought about doing it. Is there an easy way to get those files to my transcriptionist (in my office). It would be great if I could email them or hotsync and have them automatically go to her. I started to look at audacity but there seemed to be a bunch of interfaces that have to be in place on both ends. Thoughts?

Fred Clark · 05/06/2005, 09:32 PM

Audacity will do just what you want. It comes packaged with a desktop application called LAM (local Audacity Manager). Just record and do a HotSync. The LAM program will take the files and automatically send them to the Transcriptionist using either email, FTP, or place on a LAN network computer. If you want to send an audio email to someone in your address book, just tap on email on the record screen; the application jumps to the address book and when an entry is selected, the email address is pulled in. When you HotSync the file is automatically sent to the selected address.

Audacity does sell a Transcriber application and there are good reasons to use it, but it isn't required. The only time the far end party really needs a special application is if the file is compressed or encrypted; then you need an application to decompress and/or decrypt it.

Hotoru · 05/07/2005, 08:54 AM

Quote:

Originally Posted by Fred Clark

Audacity will do just what you want. It comes packaged with a desktop application called LAM (local Audacity Manager). Just record and do a HotSync. The LAM program will take the files and automatically send them to the Transcriptionist using either email, FTP, or place on a LAN network ....

That seems pretty cool. What is the overhead for Audacity? Any idea how big are the sound files? I am using the Sound Recorder program now. But, I am going to delete it because the sound files are *huge*. Last night a 2 minute dictation took up approx. 7MB! May have to try Audacity.

1st I thought he was talking about the open source program that I use for windows here:
http://audacity.sourceforge.net/

But, I found it at PalmGear here
http://makeashorterlink.com/?J3724190B

Kinda pricey. What is the LAM-S you get in the professional version?

DocNusum · 05/07/2005, 01:51 PM

Has anyone here tried Dial Dictate?

For dictation we are going to try Dial dictate. $58/user license

Dial Dictate-phone-in dictation software
http://nch.com.au/dialdictate/index.html

We will install Dial Dictate on a office pc connected to a dedicated phone line.

We will also install Dial dictate and our EMR on the transcriptionist pc.

With this set up, we should be able to phone in our dictation from anywhere using a cellie or landline and control the recording like the hospital systems (FFW, REV, Pause, etc).

When the recording is complete, dial dictate should automatically upload the recording to the transcriptionist's email/FTP address.
The transcriber then directly imputs the dictation into our EMR and at the end of the day "Sync" with our server.

Since our EMR is mostly user defined autotext, to save $$ on transcription we plan to only dictate subjective, impression, plan/discussion on established patient encounters. Each provider will imput objective and coding on all established encounters. We will completely dictate all New Patients.

When we get up and running I'll post a review.

Check out the link above for more info on Dial Dictate.

Cuter · 05/07/2005, 09:17 PM

Hotoru: I have tried several record programs and Audacity has the best audio quality versus file size. Audacity has three compression modes on the 650. They have compressed 6, 12 and 24 kbps. Compressed 24 has excellent quality and a 2 minute file is about 350 k. The compressed 12 is only half that size and very acceptable for dictation. To get a 7 Meg file for 2 minutes of recording it must have been set at PCM 22 or better. My guess is the Audacity compressed 24 is nearly as good and much smaller.

The LAM is a related desktop program. You could think of it as a super conduit. It handles the HotSync processing and also automatic emailing and FTPing of the files. It also does things like deletes the files from the handheld after Syncing and archiving the files, etc. It is a very powerful companion product to the actual recorder application.

DocNusum: I tried dial dictate, but found Audacity to be superior.

paulwein · 05/08/2005, 10:28 AM

Quote:

Originally Posted by TreoDoc

A little more about me. I began using PDA's in medical school when I had the first Sharp Wizard units and stuck with them all the way to the Zaurus..had from an early age tried to push the thing past its limits...used a telephone book to store patients and patient data...bought the sidecar modem and used to fax my notes to a local fax machine at the nurses station and put on the chart (with much rebuking). Kept with the Zaurus through residency but found as a fellow when I was spending less time in scrubs and a white coat that the Zaurus was too bulky...which is when I switched to the Palm OS. Again...had wired modems and wireless modems for my Palm V and Vx and began using Epocrates and the early versions of Patient Keeper. As noted previously I have been with Treo's since the release of the 180 until my present 650. As an orthopaedic surgeon working with PA's it has really been invaluable to have them snap a pic of a fracture in the Emergency Room and send it to me wherever I am so I can decide if I need to go into the hospital or it is something that can simply be casted. As one of a few orthopaedic surgeons covering an Emergency Room to not have to rely on someone painting a verbal picture is invaluable and better care for my patients. I use Epocrates but secondary to space issues may need to move to PDR.
My office utilize both the SMS capability and Verichat too keep in touch with me throughout the day and out of the office. Verichat is more of a real time interface that does not depend on needing to enter in an email address each time my administrative assistant wants to send me a message...
What finally brought me to the Treo (previously was using a Nextel Blackberry...pager (as the blackberry was not loud enough nor did it have the capability to nag with a repeat beep if I missed a call or page) and a Sony Clie UX50 (still the best dedicated PDA IMHO) ), was the availability of "push email". Versamail was not soon enough nor flexible e nough...I use Chatter which pushes email to me directly without the need and interval of VersaMail or other clients which require periodic logging on. Chatter is a wonderful program with a very responsive and responsible developer.
I have found HandDbase to be invaluable as a database of patient interactions...I have made my own cpt/icd dropdown lists and have created one database that allows me to record patient phone calls...clinical consultations in the hospital/ER and tasks that need to be followed...very flexible database and really allows you to customize to what Y OU as the caregiver feels they need.
I utilize MDCoder to track and bill my surgeries...a very well written piece of software that automatically chooses the correct icd9 codes for a cpt code chosen...would like it to have a few more data fields but all in all is the best of what I have seen out there for charge capture.
I use Docs To Go...to keep patient handouts/post-op protocols...which allow me to easily email to the patient or print out via IR or wi-fi network and hand to them directly...patients love feeling that their doctor has so much info at hand :-)! My assistant keeps my non-patient schedule in ACT! and I purchased companion link which allows me to sync meetings etc to my T reo but I can choose which categories to NOT SYNC so alot of my personal data does not make it to the ACT database and it all can be transferred to my home computer.
Recently purchased Bluetooth dongle for my work computer so my PA can easily send to me any new consultations to either the Treo or my computer (from our HandDbase database) so that I can review them after a night on call.
TreoAlert has allowed me to get rid of my pager as it allows the treo to continually to annoy after a missed sms message/email or phone call until you recognize it and of course the Treo does a much better job of tracking info/msgs than most pagers. I recently added voicedialing so I can dial on the road via my bluetooth head set..Sony HBH660. TreoTechnician with Pocket Tunes has allowed me to add some levity to my day as my phone ringer is now an MP3 as is my pager...at least now when it goes off while seeing a patient (oops forgot to put on vibrate) the dulcet tones of John Coltrane or Miles Davis come through vs some evil Midi or built in ringtone. Also use PocketTunes for streaming Audio via Shoutcast...like having satellite radio on the cheap :-)!!!!
Wish list...a 1.strong interface for an EMR...I am purchasing EClinicalworks EMR (actually will lease to make sure I like it)...have also purchased 2 Motion Computing tablets to work with the EMR looking forward to having the Treo work with them. Would love to have an EMR that had a small program for the Treo for charge capture that could sync via bluetooth to the main database.

2.Voice recognition software that works...

3.A simple not FEE BASED prescription program integratedwith one of the prescribing databases...that would work via a fax server to the pharmacy...
All in all I love the unit and truly believe it has helped me to be a better doctor....
PS: The bolds do not imply endorsement but as I rambled aimlessly wanted to make it easy for folks to find key software/hardware that I utilize..Thanks!

I just joined this chat room since I only started using the treo 650 recently when Cingulair became available. I am a cardiologist and have used many of the same devices you listed. My last d evice was the sonly clie and before that the Plam Vx.
I started with a Sharp wizard and moved to the Palm III.
Memory stinks on the treo and I have had a lot of problems running out of memory. I rely on Epocrates and synch with Outlook which over the past few years have become very large and eats up the memory.
I need to find better ways to utlize my memory and have found that versamail does not fully delete when i resynchronize. I only use 1 POP 3 account through optonline (Cable).
How do you use the treo as a pager? I would like it to keep beeping until i answer it. Is that an option that I am missing? I have given up my beeper but always look for new messages.
With regard to the use of other programs, that is academic until I can get more memory. Too many of the important programs will not run on the expansion card. Any advice will help.

TreoDoc · 05/10/2005, 05:21 AM

Paul. Greetings and welcome. I assume your Treo already had the update from Palm that many people have found provided up to 50% more memory? I keep a great deal of software on my Treo and have not had memory problems as yet. Curious as to what else you are using. Regarding pager...I use a program called TreoAlert which will cause the Treo to continue to beep or buzz until you acknowledge it (like a pager). Obviously functionality as a pager lies greatly in where you spend most of your time vis a vis signal quality. The only place I do not have a good signal is in the OR and usually anything urgent gets called there anyway so u sing it as a pager has not been an issue. You might want to check out Chatter email or one of the other mail clients. Chatter will "push" the mail to your device and is not the memory hog of Versamail.

DocNusum · 05/10/2005, 12:35 PM

Cuter-

How can Audacity be "superior" to Dial dictate???

Is Audacity a "phone-in" dictation program...

If not... why the comparison???

Do you work for Audacity????

Cuter · 05/12/2005, 08:29 PM

Doc, No, Audacity is not a phone in dictation system,but it does transfer the file to the Transcriptionist automatically so I got confused. I checked a little further and discovered the program I was referring to is Palm Dictate, not Dial Dictate. I really didn't like the Palm Dictate application. I haven't tried Dial Dictate.

tomchan79 · 05/17/2005, 10:28 PM

Hi, Skyscape apps don't seem to work well with the Treo 650.

I was wondering if anone has noticed a pause between when you type a letter and when it shows up on the screen. It significantly slows down how long it takes to lookup a term.

This problem seems to just affect my treo 650, even after fresh erase and re-install. My tungsten C works fine.

Does upgrading the ROM fix the problem?

Thank you so much for your help!

Thomas

Physician User · 05/21/2005, 03:40 PM

Processor speed. The Tungsten C is fast and is probably running about 400Mhz or more. The Treo 650 runs at about 312Mhz even though they are the same processors! This pause defeated the purpose of using a PDA for quick information look ups.

Anyhow, do a search for "PXA Clocker" or "lightspeed" and "Treo 650." PXA Clocker is free and I used it to clock up to 507Mhz my Treo 650. Now I'm actually running perhaps faster than the Tungsten C. Research the risks and benefits though. In my case, its been flawless and I anticipate using it through my Treo 650's planned life.