PDA Extinction? Not a Chance

According to a recent post by technology website, Ars Technica, (“PDA Sales Drop by 40 Percent in a Single Year — Vendors Bolt for Exit”), PDAs are a dying breed. In fact, “PDA sales have been dropping for years” and “Smartphones have eclipsed PDAs,” says Ars blogger, Nate Anderson.

We beg to differ, at least when it comes to healthcare professionals.

The Journal of Medical Internet Research in May 2006 published some interesting results from a survey conducted for a paper titled “Who’s Using PDAs? Estimates of PDA Use by Health Care Providers: A Systematic Review of Surveys” (JMIR). The survey found that, based on a systematic review, “the current overall adoption rate for professional use of PDAs among healthcare providers, namely physicians, is 45% to 85%... the adoption rate is now at its highest rate of increase according to a commonly accepted diffusion of innovations model.”

“Once you’ve used a Smartphone, it’s really hard to go back to a ‘regular’ cell phone,” says Nancy Tice, MD. “Having the two together let’s you do all kinds of wonderful things like add a phone call to your contacts, have the name of who is calling announced, link the contact to meetings, etc.”

“[Anderson] tries to separate out the Smartphone from the PDA, but you can’t because they function the exact say way,” says Tice. “You install the Palm software the same way, the Palm desktop looks the same, the Outlook conduit functions the same way if you chose to synch with Outlook, buying and installing programs is the same, using programs is the same. Why carry a Dell Axim PDA and a phone when you can carry a Treo 755W with Windows or Cingular’s 8525, which is a dream to use. Or another Windows Smartphone? Each carrier has it’s equivalent. Why carry a Palm if you’ve got the 700p or 755P? This article is incredibly misleading.”

Doctors have been way ahead in terms of the palm PDA for years. There has always been a ton of medical software for the Palm; Pocket PCs weren’t even out yet. Doctors have been carrying Palms for a long time (this was before the era of the great software companies like Skyscape and Unbound.

“As time went on, more programs became available for Windows mobile devices, but Palm was still preferred by a lot of physicians,” says Tice. “Now, with Microsoft so involved in the healthcare industry, there are more medical programs available for the Pocket PC.”

We gave our Editorial Board members the opportunity to respond to both postings, as well. Their feedback is below.

“As heathcare info increases, we need a lot more than the human brain to store and process information. Up to now, the medical care system has been in the hands, primarily, of private practitioners across all areas of medicine. Since most are involved in going between office and hospital and a lot of practices didn’t have work stations with computers, the PDA filled—and still does—the void. There are now ‘hospitalists’ that are taking over the primary care arena. (Look for our September 2007 issue of MDNG: Hospitalist Edition.) They have one place that they work. Guess where? If the hospitals have computer stations all over with easy access, there becomes less need for the PDA. That also keeps the primary care doc in his office, where they also have access to full computers. This may be some of the pressure against use of PDAs, at least in primary care. Specialists are still on the run, but may have access to computers in the hospital as well as in their offices, thus decreasing the need for the PDA.

I do think that a lot of physicians are still using [PDAs], however, they may now be in the form of one device, such as the Blackberry, Treo, and iPhone. I am not sure what the future holds, but one thing is for sure: the human brain must interact with an e-brain. It’s the form of the latter that will be determined in time.

- E. Roy Berger, MD, FACP

“I would agree that from the data posted it appears that sales of PDAs are probably dropping. However, this does not necessarily disagree with the published review article on PDA use in the JMIR. Physicians that already own PDAs are not necessarily discarding them. Also, it is entirely possible that physicians may continue to find PDAs very useful even if other market segments may not find them as useful.”

- Joshua Fogel, PhD

“One trend that is definitely hurting PDAs is the trend towards moving ‘data,’ such as calendars and contact lists from devices to the Web. I use Google Calendar to manage my calendar so that it is not just on one device—but is easily available from any computer that I use. Furthermore, by having only one canonical version of my calendar on the Web, I don’t have to worry about synching my devices and I don’t need to worry about having multiple versions of my calendar that are not synchronized.”

- Daniel B. Hier, MD, MBA

“I do not know the data, however, my impression is that higher-speed wireless access devices may obviate the need for conventional PDAs in the near future. Moreover, to the degree that PDAs are not wirelessly updated in ‘real time,’ they always run the risk of containing outdated or inaccurate data. If the device we use to access information wirelessly is called a ‘PDA.’ That, in fact, I would think will increase use over time.”

- Clifford A. Hudis, MD

“I just upgraded from a Dell Axim to a new top-of-the-line HP iPaq last week and have already stocked it with medical resources. I wouldn’t want to practice without it. Having said that, PocketPC Magazine (which recently changed its name to reflect the growth of Smartphones relative to the declining interest in PDAs), has written of concern of Pocket PCs ‘going the way of the dinosaur.’

- G. Stephen Nace, MD

“It’s really a silly distinction, in my opinion. The natural evolution of a handheld computer is from a device that just connects to a full-size computer towards one that connects with the Internet using wireless communication networks. As the price of these devices and the connections they require drops, users will trade in their PDAs for connected devices (Smartphones). Smartphones perform all of the functions of standalone PDAs, but also are able to be used as communication devices and to connect to the Internet. The IDC study really just documents the shift from disconnected to connected devices. Using different names for the devices may be useful for some, but tends to cause confusion. With time, most devices we use will be connected to the IP network.”

- Daniel Z. Sands, MD, MPH

“What is a Treo? Smartphone, PDA, or hybrid? Will the iPhone do all things for all people, or live up to its potential only for a handful of buyers? I think this is indeed a mixed message. For one thing, Palm dropped the ball a number of years ago, has only recently reacquired all rights and may be back on the right track. For medical use, it still can’t be beat. E-prescribing also seems to be using this platform. Another thing is reliability. My Palm 515 still works; my RAZR died after only 18 months. I have had to replace the battery and I even blew out a charger because it is so old it could not adjust to international current. Still, I have found a way to keep it working despite significant software updates on my computer operating system. My Palm kind of runs like my 1994 Toyota Camry—though not that old!”

- Eric G. Tangalos, MD, FACP, AGSF, CMD

The PDA is shifting to a combined device for logical reasons: most people prefer to carry one device. As a blogger on Anderson’s discussion board pointed out, you’re always going to have your cell phone on you; you’re more likely to leave your PDA at home. If they are one device, you will always have it with you. Having the two combined allows you to do more things.

The PDA is not going anywhere. Yes, the “name” itself might be shifting. Call it what you will: a Smartphone or a PDA with a phone. Whatever you call it, it’s still a PDA.

Look for more on the topic in our October 2007 issue.