marlof
05-02-2003, 05:00 PM
Finally, ePocrates for the Pocket PC! It's about time. What took them so long? Read this collaborative review between Pocket PC enthusiast and medical student Jude Defensor, and Palm refugee and OB-GYN resident Francesca Valerio, MD. Was it worth the wait? Does it work? Did she like it? Did he hate it? Do you even have to ask? It's ePocrates!<br /><br /><img src="http://www.pocketpcthoughts.com/images/web/epocrates_indications.PNG" /><br /><!><br /><i>Everybody with a Pocket PC and an MD is going to need and want this program. Vexing installation and update troubles, a lack of enhancements, and a few minor quibbles aside, ePocrates is the very definition of an essential application for those in the medical or related fields.</i><br /><br /><span><b>OS Switcher, Killer App</b></span><br /><b>Francesca:</b><br />As a Palm user since my medical school days, I often though of switching to a Pocket PC with all the improvements it seemed to offer. But one of the reasons I held back was the fact that ePocrates was not available in this platform. There were many programs that were available as an alternative but none of them provided the ease of use, functionality or comprehensiveness that I had grown to depend on with the ePocrates program. Fortunately, ePocrates is now available for the Pocket PC platform and as soon as I heard this news, you can bet that (with Jude's help) I wasted no time in acquiring myself a Pocket PC.<br /><br /><b>Jude:</b><br />I was never much of a Palm user. I'd just occasionally play around with my friends' Palms back when they were your only choice for a PDA. And everybody had (and still does have) ePocrates on their Palms. Even if everybody doesn't really use it all of the time, it has sort of become like a security blanket for medical folk. For years it was a big juicy morsel for Palm OS stalwarts to wave in the faces of those who've switched to the Windows CE camp. I've been trying to persuade Francesca to cross over for a while now, and although she admired everything else the Pocket PC OS had to offer, it took ePocrates to finally convince her. And I'm sure that there'll be a lot more conversions among the medical community from now on. In the medical software category, ePocrates has always been a “killer app" on the Palm, and it retains that designation for the Pocket PC. In fact this program is such an institution that it's already critic-proof, and reviewing it would be little more than going through the motions really.<br /><br /><span><b>First, Do No Harm</b></span><br /><b>Francesca:</b><br />To start off, installing the software was similar if not identical to the installation process on the Palm version. The process was fairly easy and straightforward. However, it took a pretty long time installing on my dial-up connection (30-40 minutes) as well as on my Cable connection (10 mnutes) and I think required me to give a lot of information that although was probably necesary for secruty reasons, I was uncomfortable with. Another thing I noticed though is that there is no option to install the program on a memory card. Instead, the program will install itself directly into the handheld's memory.<br /><br /><b>Jude:</b><br />I used a dial-up as well and the download and installation process was something of a hassle. The ePocrates team should be a bit more understanding of the fact that not all of their customers might have access to broadband, and that almost all of their prospective customers have limited time on their hands. Maybe there should be a bit more streamlining of the download and installation process. I didn't mind giving out my personal information, but their having to confirm through a database search if I had truly been enrolled in my professed medical school before my registration could be approved had sort of an Orwellian vibe to it.<br /> <br />Whereas ePocrates could feel like a huge space-occupying lesion when residing in a Palm OS machine and their 16 megabytes and less of RAM, it's barely a blip on even the more spartan Pocket PCs. It would be nice to be able to install onto a memory card, but I believe that it's worth installing in RAM, maybe even ROM if your device has any extra.<br /><br /><img src=http://www.pocketpcthoughts.com/images/web/epocrates_drugs.PNG border="1"><br /><i>Figure 1: Drugs table</i> <br /><br /><span><b>Differential Diagnoses</b></span><br /><b>Francesca:</b><br />On opening the program, I immediately noted that the interface was again nearly identical to the Palm OS version. It does look much nicer though on my brightly lit, high resolution color screen. Still I think it lacks color and is a bit too bland. You'd think with the thousands of colors available on the pocket pc, the developers would at least use more than three. Aesthetics aside though, the program has the same features except for Doc Alerts and Epocrates ID. The developers have assured us that these will soon be available.<br /><br /><b>Jude:</b><br />I actually found ePocrates' no-nonsense black-white-and-red color scheme to be quite functional, refreshing even. But frivolous though it may seem, it'd be great to be able to change color schemes or fonts. All as long as it won't affect performance of course. Cleartype or some other form of text anti-aliasing (ala uBook) would also be attractive. <br /><br /><b>Francesca:</b><br />Using the program, looking for drugs is fairly easy with an option of looking them up by generic name, brand name or by class. In additon there is an option to input either the generic or brand name of the drug in the Lookup box which will then produce a screen with clickable results. It even has a separate section that lists alternative drugs. I appreciated the fact that it provided not only the generic drug but also combination drugs which had this particular drug as a component. Once the drug name is on the screen a single tap will lead you to a page where pertinent information such as indications, dosing (both adult and pediatric), interactions, adverse reactions, cost estimates and other info can be accessed easily.<br /><br /><b>Jude:</b><br />It has been 2 years since I last used ePocrates on the Palm but I got the hang of using it again in no time. For such a large database of info, it was appreciably fast and snappy, with the swirling ball of colors barely ever putting in an appearance. As a real test of its user-friendliness, I also let my brother-in-law check it out. He's a cardiologist and has almost no experience working with PDAs in any form. I gave him a quick primer on the basics and in a few minutes he was up and running. I then couldn't pry him away from my iPaq and ePocrates for the next few hours. He was totally mesmerized by it. I then showed it to my sister, a rheumatologist and a decided non-techie. It took her a bit longer to figure out, but she was soon looking things up. They both commented on how up-to-date it was, as they noted that several drugs which had been launched only a few months ago were already in the database.<br /><br /><img src="http://www.pocketpcthoughts.com/images/web/epocrates_multicheck.PNG" /><br /><i>Figure 2: Perform a Multicheck</i><br /><br /><b><span>Chief Complaints</span></b><br /><b>Francesca:</b><br />I still do have some quibbles about this program. First off, there's that annoying auto-update screen that turns up whenever I sync my Pocket PC. I do realize it's there to keep the program as up to date as possible but sometimes when I'm in a hurry, having to wait by my pc to cancel the update is a bit of a hassle. Not only that, if you suddenly interrupt the sync in the middle of the update, all the databases get corrupted and the program is useless until you next sync it. Unfortunately, this happened to me once too often while I was testing the program having used it while I was on call. Maybe an option that lets you set how often the program updates would remedy this slight annoyance. <br /><br />Oh and did I mention the lack of color?<br /><br /><b>Jude:</b><br />To prove the point that just because a program is popular doesn't mean it's perfect, ePocrates displayed a few slightly disappointing flaws. Here's one example: You do a search, the results of your search appear and you tap on one of the items to view it. I would think that tapping on the back button would take me back to the search results, but it doesn't. It dumps you straight back to the homepage. There appears to be no way to be able to re-view your search results short of executing another search. The drug listings also tend to have a bias toward American generic names and even brand names. Case in point, it's common knowledge that acetaminophen and paracetamol stand for the same drug, but it would be more proper to include both names in the listing aside from just the American one. There are also a few curious omissions in the database. There is no listing for Vitamin E (or tocopherol) for example, just because it's a relatively benign substance doesn't mean it doesn't have contraindications or interact with other drugs. The reason why these little faults in the main drug database are all the more glaring is because ePocrates also includes a very rich database of alternative meds. And in my opinion, although the alternative meds section is very welcome and useful, I would have preferred it if they had focused their resources on providing an even richer and expansive main drug database (if that were possible).<br /><br />As Francesca pointed out, the autoupdate feature can also be quite a nuisance. There's no way for you to set just how often you want to receive updates. So unless you turn it off, ePocrates will check for and download updates everytime you sync, even if your last sync was only a few minutes ago. And if you disconnect your device in the middle of an update, the databases get corrupted and you can't use the program until your next sync-and-update. And there's nothing you can do about it while you're away from your desktop. The autoupdate synch utility is independent of Activesync, so your settings for Activesync don't apply. This wouldn't be much of a bother if the updates don't take too long. But depending on your connection and the size of the incoming update, you can get stuck waiting for it to finish longer than you would want or can afford to. While running, it also interferes with other tasks you might want to do while connected, like retrieving mail, transferring files, and installing programs. The situation wasn't helped by their server being somewhat dodgy for the past week or so. Again, not something busy, harried people would appreciate. It got annoying enough that I resorted to turning autoupdate off on both my desktop and Pocket PC, which is a far from ideal solution.<br /><br /><b><span>Prognosis</span></b><br /><b>Francesca:</b><br />As an OB-GYN resident, I find it particularly useful that ePocrates indicates if precautions should be taken during pregnancy and lactation as well as provide info on pregnancy risks for drugs. It's hard enough having to remember drugs, what more all their pregnancy risk info, so this is somewhat of a lifesaver for me. Not only that, it helps to easily find alternative drugs to use for my patients when I find that a drug is not ideal. Another useful function is the multidrug interaction check which includes not only all the drugs in the database but also those in the alternative medicines section. Practicing in a country in which alternative drug use is almost as ubiquitous as regular drugs, I have lost track of how many times this feature has helped me modify my patients' drug regimen.<br /><br /><img src="http://www.pocketpcthoughts.com/images/web/epocrates_tables.PNG" /><br /><i>Figure 3: Tables tab</i> <br /><br />In addition, the Tables tab provides data which I may not usually need to remember but is useful for those occasional "information emergencies" such as vaccination schedules, antidotes and ACLS protocols. I would appreciate it if this section had a look-up feature as well since there are times when finding the info you are looking for can be quite cumbersome.<br /><br /><b>Jude:</b><br />As a student and intern, you can never be too sure of your proposed drug combinations and dosages. You <i>are</i> supposed to know all of this stuff in your head , but it's both comforting and emboldening to have a sort of “electronic brain" one can refer to in a pinch. The wonderful thing about ePocrates is that it's both a tool and a learning aid. You tend to find out more about the drugs you look up as you use it, until eventually you get to develop your own personal drug database in your head. <br /><br /><span><b>Where To Buy</b></span><br />The software can be <a href="https://www.epocrates.com/catalog.do?catalogmethod=showProduct&product=3&node=Epocrates">bought online at ePocrates</a> for $49.99/yr.<br /><br /><span><b>Specifications</b></span><br />ePocrates Rx Pro PPC needs a device running the Pocket PC or Pocket PC 2002 operating system, Activesync 3.5 or higher and a USB and serial connection to your desktop. Devices based on a MIPS processor are not supported. The program requires 4.0 MB of RAM and as stated, installation on storage cards is not supported. Check the <a href="https://www.epocrates.com/sysReq.do">requirements page</a> for the full system requirements. <br /><br /><b><span>Conclusions</span></b><br /><b>Francesca:</b><br />• Identical to the Palm OS version. No need to adjust if you are a long time Palm OS user who just transferred to Pocket PC. Same functionality and features but on a faster platform<br />• No glitches identified so far.<br />• May not be as comprehensive as the PDR but provides enough info for everyday use.<br />• Needs a bit more color and enhancements to fully take advantage of the Pocket PC platform<br />• Faster installation would be nice.<br /><br /><b>Jude:</b><br />• Easy to figure out and find uses for. Impressively comprehensive and up-to-date.<br />• There should be more controls and settings for autoupdate, preferably it should be integrated into Activesync, like Outlook or AvantGo.<br />• We should be able to re-view search results.<br />• Inclusion of non-American generic and brand names for drugs would be welcome.<br />• One last huge question mark: Are Pocket PC users going to get a free version of ePocrates too?