Medical student develops ‘Wombat’ app to triage, track patients

By Sarah Marshall

Cole Denkensohn is a wiz with computers. While most medical students practice yoga, meditate, exercise, run, play music or video games, go to church, spend time with friends or pursue other avenues to help relieve the stress of medical school, Denkensohn creates apps. And his latest venture has not only helped alleviate those academic pressures, it may have found a future supporting role in Uniformed Services University’s premier medical field practicum, Operation Bushmaster.

This annual two-week field exercise takes place in October in a remote part of Pennsylvania just north of Harrisburg. Fourth-year medical students, along with students from USU’s Daniel K. Inouye Graduate School of Nursing and a dozen or so international medical students, run through numerous reality-based medical missions as part of a mock deployment and must quickly triage and treat their “patients.” This is their final exam in the Department of Military and Emergency Medicine’s Military Contingency Medicine (MCM) course at USU, and is designed to challenge and test their knowledge of military medical practice as well as their leadership skills.

Just two nights before heading up to the exercise, Denkensohn, a Navy ensign and fourth-year student in USU’s F. Edward Hébert School of Medicine, came up with the idea for an app to track casualties in the field. He bounced it off his classmate/wife, Army 2nd Lt. Madeline Fleit, who agreed it could be helpful. He also ran it by his Bushmaster platoon leader, Army 2nd Lt. Thomas Powell, who also liked the idea. Denkensohn went straight to work, coding an app that allows users to enter patient names and some basic information about the patient to analyze the data and triage patients more efficiently. It would then list patients in rows to make it easy to retrieve, edit, and track their information.

After about 10 hours of programming, Denkensohn had a working version. He asked his classmates to test it out each time he completed a feature within the app, making sure it made sense and was intuitive. In addition to making sure it was easy to use in a fast-paced environment, he also took into account battery life, and the possibility that the Wi-Fi would be spotty, or non-existent in the area, which is surrounded on a couple of sides by a small mountain range. He made sure the app used mostly simple code, with a black theme to use less battery power. It also would not use communications technology (i.e. no cell service), which would also make it much more energy efficient. He gave it the name “Wombat PAD,” named after his Bushmaster platoon, the Wombats, and those who would use the app, the patient administration, or PAD, officers responsible for collecting and analyzing patient data.

Then, it was time to put the app to use in the field. The platoon brought two tablets that had Wombat PAD installed on each, along with two back-up batteries. They also made sure to put a durable case on the tablets, which had folding keyboards for those who preferred to type that way, as opposed to touch typing.

The Wombat PAD app for patient triaging and tracking, was designed with a black theme/background to make it more energy efficient, less likely to drain the tablet’s battery as quickly. (Courtesy of ENS Cole Denkensohn)

Denkenson and his platoon-mates used the app from sunup to sundown, he said, and still had 50 percent battery life remaining on the tablets each day.

“It ended up working better than anyone could have imagined, myself included,” Denkensohn said. “It was easy to use, even under Bushmaster conditions, and the layers of contingencies I built in meant that it was extremely reliable.”

When it was Denkensohn’s turn to serve as PAD officer during a scenario, he was excited to put Wombat PAD to work in the field himself, he said. But then, faculty members grading the students decided to put the technology to the test.

“Bang – your tablet broke,” he was told, as they pretended to shoot his tablet. “So, I said, ‘Can I go get my second one?’”

A group of USU’s fourth-year medical students developed and used an app, Wombat
PAD, to track and triage “casualties” during this year’s Operation Bushmaster.
(Photo by Sharon Holland)

The faculty told him, “Your battery is also dead.” He replied that he had two external batteries on hand, and two spare charging cords. The faculty member in turn said that the enemy destroyed their communications. Denkensohn started to explain how he intentionally programmed the app to not use far-field communications that could be interrupted, but then he got the hint that it was a test to develop a paper-based system on the fly, instead of relying on the technology. The platoon did just that, developing a tracking mechanism on paper. The next day, they were back to using the tablet.

Air Force Maj. (Dr.) Kevin Semelrath, course director for MCM and Operation Bushmaster and assistant professor in Military and Emergency Medicine at USU, said that this was the first time an app was used for the patient tracking system during the field exercise, to his knowledge.

“I thought it went brilliantly, and it was well organized,” Semelrath said.

Semelrath added that there were several mock patients that they were specifically tracking during the exercise, and the Wombat platoon was able to track those and treat them quickly.

“It shows real ingenuity on their part,” Semelrath said. He plans to see whether the app could be used in the future, and possibly gain live access, allowing faculty to offer real-time feedback on their patient tracking.

Prior to developing Wombat PAD, Denkensohn helped develop another app called the μBio, or Micro Bio, a quick reference and high-yield framework designed specifically for medical students looking for information on bacteria, viruses, protozoa, and other microbes. The Micro Bio app, which he created last year, is available for free at the App Store and is a quick reference for more than 200 of the most common bugs encountered by medical professionals.

Denkensohn said he hopes Wombat PAD can be used in future Bushmaster classes, so long as it makes their job easier, as it did for his platoon, and helps relieve some of the stress of the exercise.