PDA Proposal for Life Flight

Life Flight could benefit from the purchase of a personal digital assistant (PDA). The main benefit would be increased efficiency of the crew in flight and on scene due to faster access to the protocols and drug information. The PDA would also decrease the weight of equipment carried by the aircraft crew on missions.

We believe a moderately priced PDA using the Palm operating system (OS) with eight megabytes (MB) of memory best fits the requirements for accessing clinical information. We found the Handspring Visor Deluxe to be functionally equivalent to the Palm Pilot IIIxe. At $249, these devices offer the best combination of memory, features and price. With the addition of the RhinoSkin ShockSuit hard case, the PDA easily meets all the criteria set by Life Flight crewmembers and administrator. Either PDA is an excellent choice for Life Flight.

Life Flight wishes to explore the feasibility of using a handheld computer to transport and display their protocols. Written by Life Flight's medical director, these documents serve to outline the expected standards of practice for the flight nurses and paramedics. Although the flight team memorizes the protocols, a reference copy is transported in the helicopter.

Our group will research and analyze the capabilities and cost effectiveness of available devices and provide counsel to the Life Flight Program Manager regarding purchase and utilization of a device in the helicopter. The protocol reference carried on the helicopter is a notebook that contains 82 pages and weighs seven pounds. Weight is a significant concern in Life Flight's aircraft. Saving weight in the equipment of the helicopter translates directly to increased ability to carry patients and staff. In addition, the written reference is difficult to read in low light situations. It is also susceptible to substantial abuse because paper is not a very durable material.

Life Flight crewmembers carry Palm Pilot brand personal digital assistants (PDA's) and have transferred the protocols to their devices. In addition to the protocols, each crewmember uses the free software application ePocrates to view updated drug information on the Palm Pilot.

Life Flight crewmembers who carry Palm Pilots as a reference device on the helicopter find value in its use. Because not all crewmembers have purchased the device, it is not consistently used with every crew. Both the crew members who have their own device and those who do not own a PDA have voiced the opinion that Life Flight should purchase, configure and use a PDA owned by the service and available to every crew.

Crewmembers are also interested in the new Pocket PC devices from Compaq, Hewlett Packard and Casio. They have questioned how these devices compare with the Palm Pilots.

Interviews with the program manager, three RN's and two paramedics yielded the following Life Flight crew requirements for a Personal Digital Assistant.

These criteria yielded the following five questions, which directed our collection of data:

The notebook weighs seven pounds and the PDA's each weigh around 1/2 pound. As weight is a significant consideration in Life Flight's helicopter, the PDA offers an advantage.

The ease of access to the information and the degree of information the PDA can contain also appear to be advantages for the device.

However, the reliability of the PDA when compared to the notebook appears to be a disadvantage. Failure of the device in field conditions could leave the Life Flight crew in an uncomfortable position.

If a PDA is to be evaluated, there are two principal choices in operating systems (OS): Windows CE and Palm OS. We will evaluate each for reliability and ease of use.

The Life Flight crew has identified the need to read the protocol documents and use of the ePocrates drug information software as the primary purpose of the PDA. Having determined the software requirements, we will match the hardware capable of fulfilling this mission. Our analysis will also include the expected purchase price for each device.

We know that Life Flight crewmembers are already using the Palm Pilot in the field setting with considerable success. We can learn from their experiences and those of others operating in helicopter emergency services. We will use crew interviews and a Flightweb listserv posting to gather this information.

Are any of the currently available peripherals appropriate for Life Flight's use?

We will evaluate the peripherals against the purchase of a stand-alone device that serves the same function.

We will seek out peripherals for the Palm Pilot and investigate the new Springboard modules for the Handspring. Springboard is the add-on slot for peripherals used by the Handspring Visor PDA's.

The companies producing PDA's (Casio, Palm, Hewlett-Packard, etc.) have Internet sites describing the capabilities of their products. Additionally, the university library carries many periodicals on current technology. We will search these sources for information. Paul Hudson is a part of the Life Flight team and has access to its members and others in the industry. He has ascertained what the team needs through conversation, and interviewing. He can further discuss the use of PDA's with those who currently use the devices, and access other helicopter EMS professionals though the FlightWeb listserv to obtain data related to the set criteria.

The five companies that have PDA's on the market each produce between two and five models. Not all models will be considered because cost concerns will dictate which models we evaluate. In addition, the Windows CE models are not compatible with the existing devices (five crewmembers already have Palm Pilots). Therefore, they were excluded from the scope of this project.

In response to the crew's inquiry about peripherals for the Palm PDA, we will evaluate the Kodak digital camera for the Palm Pilot. We will also evaluate the Handspring Visor eyemodule digital camera peripheral. We will focus our attention on models that are capable of providing images appropriate for web page graphical requirements. We will also examine the global positioning satellite (GPS) peripherals.

We will use two authoritative technology-oriented web sites, CNET.com and Zdnet.com, for product comparisons of PDA's and recommendations for devices appropriate for the tasks outlined in the criteria.

Using the World Wide Web to explore manufacturer, retail, and magazine sites, we have accumulated data that addresses our questions of operating systems, suitability to task and features. This material, coupled with information from the Flightweb listserv and interviews with the Life Flight crew, will form the basis for our analysis and recommendation.

The PDA offers the ability to transport and display a greater amount of information than the notebook using a device that weighs less. The issue of purchase price and reliability are addressed in the features section.

Currently, the Windows CE and Palm operating systems (OS) dominate the handheld market. Windows CE is based on the popular Windows family for desktop computers. This includes the familiar "Start" button to access applications. Most people are familiar with this interface, as Windows owns about 90% of the desktop computer market.

The Palm operating system is much simpler, however. The applications are divided into folders. For example, using the folder "Protocols", the Life Flight crewmember would tap on a protocol name using the PDA stylus and open that document. The Protocols icon would be prominently displayed on the desktop and available for immediate use when the device was turned on.

Additionally, the Palm OS is very stable. This OS does not crash. Unfortunately, Windows CE is not as stable. One of our sources, Phillip Marsh, told us that within two hours of buying with his new Windows CE device, it crashed and continues to do so on a periodic basis. This could be a life-threatening occurrence for Life Flight when attempting to save a patient.

In addition, the Windows CE devices are not compatible with Palm devices. They do not meet the criteria of being compatible with existing crewmembers' PDA's. Given these weaknesses, we have chosen not to collect any data or review any PDA's using the Windows CE operating system.

The PDA customer can choose color or grayscale screen, two to eight megabytes of RAM, Palm or Windows CE OS, a variety of peripherals and software.

Having chosen Palm OS as the superior operating system, we will analyze this family of devices.

Model	RAM	Features	Price
Palm IIIXe	8 MB	Expandable	$249
Palm V	2 MB	Lightweight	$279
Palm Vx	8 MB	Expandable, Lightweight	$399
Palm IIIC	8 MB	Color	$395
Visor Handspring	2 MB	Expandable	$179
Visor Handspring Deluxe	8 MB	Expandable	$249

Each of the five crewmembers interviewed enthusiastically endorsed Life Flight's purchase of a PDA. As Palm Pilot owners, they expressed the opinion that Life Flight should also purchase this brand. Two of the crew were familiar with the Handspring Visor, but had not seen or used this brand.

Two crewmembers were using their third version of the Palm Pilot, having upgraded to newer versions as they became available. These individuals were particularly sensitive to the need for expandability and reserve capacity in the device Life Flight chooses to purchase. RAM was the primary rationale for each upgrade and the crewmembers counseled us to purchase the device with the greatest RAM available.

Respondents from the listserv were uniformly positive in their recommendation of the Palm Pilot and spoke highly of its suitability in the field environment. One respondent specifically recommended the RhinoSkin ShockSuit for increased protection and we altered our investigation accordingly.

Since the crew expressed interest in add-on devices (peripherals), we investigated two digital cameras and one GPS (Global Positioning Satellite).

The digital cameras investigated were the Kodak PalmPix for the Palm Pilot and the eyemodule for the Handspring Visor. Although they look quite different, their price and performance are similar. We found both devices' performance unacceptable, considering the high price. For example, the eyemodule digital camera for the Handspring Visor has a very weak picture resolution of 320 x 240 and costs $149. The BarbieCam, a digital camera marketed to children, offers a picture resolution of 640 x 480, at a price of $79.

The GPS model we reviewed offers interesting features associated with its interaction with Palm Pilot models, such as the ability to provide latitude and longitude coordinates on the Palm Pilot screen. Its positive attributes are overshadowed by its hefty price tag and cumbersome size and shape. A less expensive non-peripheral GPS offers many of the same features and places them in a very usable hand-held package.

The peripherals have a certain "wow-factor" associated with them because of how they can be integrated with a PDA. However, their high cost and low level of performance render them inadequate. In addition, the purchase of these items is not warranted based on the criteria set for this analytical report. If devices such as a GPS or digital camera were to be considered by Life Flight in the future, the non-peripheral devices would definitely be the best value.

We had not considered a hard case for the PDA until we came across a review on Life Flight's listserv. This review gave a very positive image of a hard case manufactured by RhinoSkin. It made us strongly consider a PDA's resistance to abuse.

Electronic devices are, by nature, not durable. Because PDA durability was a very important criteria set by the audience, we felt prompted to investigate the field of PDA hard cases. Given the fact that any hard case used by Life Flight would need to be not only durable, but also very easy to use (not requiring the PDA to be removed from case for use, easy to open), we quickly narrowed our data collection to two RhinoSkin models: The ShockSuit and Titanium Slider

After reading fifteen reviews for each model, we found that the opinion of them was unanimously positive. However, the price of the Titanium Slider nearly triples that of the ShockSuit. Titanium is an expensive metal with incredible resistance to stresses. When we considered the set criteria and task, we determined that a case of this quality and expense was unnecessary. This naturally lead to the conclusion that the RhinoSkin ShockSuit would be a very suitable addition to any PDA to significantly increase its durability in adverse situations.

After interpreting all of our data, we have concluded that the Palm Pilot IIIxe and Handspring Visor Deluxe PDA's are best suited for Life Flight's needs. Based on the data we collected and by personal testing, we determined that these devices are functionally equivalent. Their superior Palm operating system lends itself to rapid learning and fast operation. At 8 MB, memory is currently not a concern. This amount of RAM, combined with the expandability provided by their computer interfaces, makes each a very versatile PDA. In addition, the $249 price falls in the middle of the prices of PDA's considered, making each a good value for the features offered. With the addition of the RhinoSkin ShockSuit hard case, both easily meet all the criteria set by the Life Flight crewmembers and administrator.


Palm Pilot IIIxe	RhinoSkin ShockSuit	Handspring Visor Deluxe

We feel the Palm Pilot IIIxe or Handspring Visor Deluxe are the right PDA's for the job. When used in conjunction with the RhinoSkin ShockSuit, these PDA's will be very reliable and resistant to the continual wear and tear experienced by Life Flight equipment. We recommend that Life Flight choose and obtain this PDA and protective case. In addition, we would like to recommend having a back up PDA on board the helicopter. That way, in the unlikely event that the primary PDA is damaged beyond immediate use, there would be another PDA to take its place.

Thank you for considering our recommendation. We are confident our data will convince you that our analysis was correct, and that our choice of PDA and protective case are the right models for the active role of Life Flight equipment.

ePocrates - ePocrates is a program for the Palm compatible devices. It contains information for medical personnel on drugs.

Lithium ion - This battery is never changed. It is recharged periodically by placing on a base that is plugged into an AC outlet. These batteries generally last 12-36 months.

MB (Megabyte) - A computer term that represents a capacity. It is approximately a million bytes (a byte is eight bits and a bit is just a one or a zero). A compact disc can hold about 660 MB. A 3½" diskette holds 1.44 MB.

Monochrome - It is a single color. Generally, a monochrome screen is black on a white background.

MHz (Megahertz) - This is a measure of speed in computing devices. It tells how fast a computer can process numbers. Handheld devices generally run around 16 MHz whereas laptops run about 500 MHz and desktop computers run up to 1000 MHz. The reason for the vast difference in speed is that handheld devices are not meant to handle Microsoft Office or 3D games, while desktop computers have to handle these programs.

OS (Operating System) - The operating system is the program that runs other programs. When a computer starts up, it first loads the operating system, which in turn tells the computer how to handle files and run other programs. Typical examples of this are Windows 2000, Mac OS, Linux, Palm OS, and Windows CE.

PDA (Personal Digital Assistant) - This is a handheld device that is meant to keep track of information and to be taken anywhere. Many use PDA's for scheduling meetings, keeping appointments, and holding phone numbers. They can also have applications that do various convenient tasks (such as ePocrates).

Peripheral - An accessory device attached to the PDA that provides increased functionality. Examples include digital cameras, additional memory, global positioning satellite systems and voice recorders. Handspring models use the Springboard slot for peripherals.

RAM (Random Access Memory) - This is the storage (often measured in megabytes) in which active programs are held. It is more commonly referred to as memory. On a PDA, this is the only type of storage available to the user, and all programs are stored there. Once the RAM is filled, the device will not accept any more information until some RAM is freed.

Stylus - A pen-like object used with touch screen computers such as PDA's for input. They serve as a replacement for the mouse on desktop computers.