As modern technology evolves, the medical professions are following suit thanks to the hard work of practitioners like Vrushali Angadi, PhD, CCC-SLP. Angadi, a speech-language pathologist and assistant professor with the communication sciences and disorders program at the College of Health Sciences—with the assistance of her colleagues Drs. Ming-Yuan Chih and Joseph Stemple—is developing a smartphone app that extends the reach of specialty medical care‑—specifically that of voice therapy. 

“My research interest has always been in outcome studies for patients with head and neck cancers,” she said. When the University of Kentucky offered Angadi a position in their department, she couldn’t turn it down.

“This is the perfect place for me,” she continued.  “One of our clinical sites for the UK Voice and Swallow Clinic is within the Markey Cancer Center and we work very closely with our head and neck surgeon colleagues. This has given me the opportunity to continue my work with this population. What's nice about my position is that it's part clinical and part research. There's some amount of teaching, so I get to do everything that I was trained to do and that I love to do.”

A significant amount of her research time is dedicated to the development of an app that delivers evidence-based voice therapy in an effort to improve both accessibility and adherence. “One of the barriers our patients encounter is a lack of accessibility,” Angadi explained. “A lot of our patients come to us from eastern Kentucky. They’re driving three hours to see us which is not cost or time-efficient. This app makes delivering services and care more accessible.”

The app isn’t only geared towards rural patients, though. “I think people in the urban population need this app just as much as the rural population,” Angadi added. “Patients with hectic schedules may not be able to attend voice therapy every two weeks. Using the app gives patients the convenience of receiving care where they are and when they need it.”

“The other objective of developing the app was also to improve adherence to voice therapy,” Angadi continued. “We know voice therapy works, but like any other behavioral therapy there is around a 65 percent dropout rate. We want to see that rate decrease.”

The app has a user-friendly interface that integrates all the components of the traditional delivery method. In addition, it also includes an accurate method of recording home-practice, unlike the traditional method of delivery.

Traditionally, patients would be sent home with a log sheet and be asked to fill out their vocal exercise attempts. “It’s very easy, though, to mark that you did the exercises five minutes before you go in for therapy,” Angadi said. “So, what’s nice about the app is that when patients perform their home practices, they have to record their attempts. It’s a foolproof method of measuring adherence.”

The question then was whether the app could in fact improve adherence. To answer this question, Dr. Angadi and her research team successfully completed beta-testing the app in November 2018.  The beta-testing phase involved comparing adherence rates between the traditional delivery methods to the app delivery method.

Results demonstrated that the app actually improved adherence by about 50 percent,” Angadi said. “The traditional group missed an average of about fifteen sessions over six weeks. Our app group missed about six sessions.”

The app is now being rolled out to patients in UK’s Voice and Swallow Clinic, and although it hasn’t yet been commercialized, Angadi and her team agree bringing the app to the public is the next step. They are working closely with the UK Office of Technology and Commercialization to guide them through this process, and Angadi also received a 2018 Jacobson Innovation Award to support her work on this project.

“Our goal is to make the app available for clinicians across medical centers and private practice alike,” she said.