Capturing the potential of digital health tools to democratise healthcare - with Dom and Saira

Welcome to the first episode of the Digital Health Passport podcast - Up, Up & Away. Well, you can't have a hot air balloon for a logo and not get a little carried away!

The Up Up and Away podcast, hosted by Dom Burch, kicks off with Saira Arif as the special guest, exploring personal experiences and journeys within the digital health sector. Saira shares her unconventional path from the legal field to digital health, emphasising the significance of her work with the NHS and the development of digital health strategies. Her story transitions from legal beginnings, through NHS project management, to her current role in digital health innovation, particularly focusing on asthma management through technology.

Saira's journey highlights the evolution of digital health, from concept to practical application, and the impact of personal experiences on health management innovation. The podcast delves into the creation and development of a digital health passport, an app designed with and for users, aiming to address real-life health management challenges. It explores the app's features, such as symptom tracking and air quality alerts, illustrating how technology empowers patients to manage conditions like asthma more effectively.

The conversation also covers broader implications for digital health, including expanding the app's utility to other conditions and the importance of reaching underserved communities. The discussion underscores the potential of digital health tools to democratise healthcare access and improve patient outcomes by enabling self-management and proactive care.

As the podcast series progresses, Dom and Saira aim to bring in more voices from the digital health landscape, including clinicians, patients, and innovators, to share their insights and experiences. The goal is to illuminate the advancements in digital health and its transformative potential for healthcare delivery and patient empowerment.

Subscribe to the podcast as we begin our exploration of digital health's impact through personal stories, highlighting the intersection of technology and healthcare as a pathway to improved health management and equity.

Transcript

Dom Burch: 0:10

Welcome to the first ever up, up and away podcast with me Dom Burch. And today my very special guest, Saira Arif. This is the podcast where we get to speak to influential thought leaders from across the digital health sector, and find out their personal experiences and their stories and what led them to being in this amazing field. And I'm absolutely delighted this week to welcome Saira to the podcast, a fellow digital health passport member of the team colleagues, Saira, no less Welcome, welcome. Welcome.

Saira Arif: 0:45

Hi, Dom thank you so much for having me.

Dom Burch: 0:47

Now, isn't this exciting? We've been talking about doing this podcast for what feels like ages, probably only a matter of days or weeks because things move fast in this world.

Saira Arif: 0:54

Ya know, it's been it's been a while since you've been kind of putting all these ideas together. And it's great to finally actually be in front of the screen doing this. So amazing,

Dom Burch: 1:02

isn't it just now you're over there in Dubai. I'm over here in Bradford. So we're both in our own respective worlds in the centre of the universe, where it's really kicking off and happening. But before we get going, right, give me a bit of background. Now I know you but for the lovely listener, tell me a bit about you. How did you end up where you are today working for digital health passport, what was your route to where you are now

Saira Arif: 1:22

I actually started off not in the health or tech or digital health field, I actually started off in the legal field, surprisingly. So I did a law degree I went in to do my postgraduate kind of went down that solicitor route. And then when I finished my qualification, that's when I figured out actually I don't think I want to be in this field anymore. It was a shock to everyone. But I actually started my own company just after I qualified. And it was really for advocating so advocating for community members are filling out forms acting on their behalf, things like that things where, you know, I wasn't given legal advice, because I wasn't really allowed to at that age, but also just kind of help my fellow man basically, with with what I can, that led me down a whole different path into sort of health care. So my, my dad, who is my inspiration, he used to work in the NHS, he told me about all the projects going on and things and I thought, You know what, that sounds really interesting. And it's, you know, I always thought NHS was just the doctors and nurses, I see you every day, you know, that kind of thing, the frontline stuff. But actually there was a whole like, kind of bubble behind the scenes, what goes on this project managers, directors, people actually putting strategy together, and I found it amazing that was going on. So I said to my dad, I said, Well, if there's any openings coming up, let me know. Because you know, I'd love to sort of dive in deep into that field, see where that takes me. And you know, lo and behold, I think was a few months after that conversation. My dad said, Oh, well, there's a, you know, a local CCG. At the time in Brent, basically had had an opening for a multidisciplinary coordinator. When I heard that I was like, I don't know what the hell that is. But, you know, I applied anyway, because I fit the bill. And it was really just kind of getting people organised getting doctors and healthcare professionals around the table so that they could discuss really complex patients, it was really just kind of organising that and they had this new term or this new pilot phase, they were going through this is back in like 2012 They're talking about integrated care. So integrated care, as we know, it now is the way forward, but back then it was a brand new concept. And it was all about how we start joining up different parts of our healthcare system. So you know, as a patient going in to see a doctor, your GP and are always at the hospital will have your notes on hand or the your social worker bit who's involved perhaps doesn't have you know, your information. So it was kind of joining up this fragmented NHS that we knew about back then I thought that was quite awesome. And I thought that you know, what a challenge that would be, but went in as a part time sort of role and ended up staying there for like, a good few years. And then eventually, yeah, eventually, I found myself working for GP practice. So actually, frontline as frontline, or you can get as the business practice manager. And that opened my eyes up to all the challenges that, you know, frontline staff face, you know, capacity budgets, etc. And then there was a opening soon after that in the first ever digital programme for northwest London CCGs. And I thought to myself, wow, like I love tech anyway, but imagine like health being all digital, you know, that would be interesting. So I got involved, essentially, I was like the project manager for an arm of the digital PMO, which was sort of digital innovation digital citizen. So it's all about how we bring people on that digital journey. So you know, you've got the NHS, sort of putting out all these amazing techniques and tools, you know, how to in terms of how to access your health and things like that. But I'm in a how do we bring those patients along on that journey? Because not everyone knows how to use, you know, phones or apps and smartphones and things like this. So it's how we kind of put training programmes into place. How do we empower them to use this digital tools and my family stuff on like panels and doing discussions and things like that. And I actually met Greg and Matt at this event. And it was a thing as a digital health London event. They came up to me after the panel, and they, you know, they had heard that I have asthma. So I was talking about my own experience. And they said to me, Oh, well, we're working on this this amazing first app, you know, so it's a first of its kind. And it's all about asthma. Like, would you like to have a have a goal, basically? And I said, Yeah, of course, I've got nothing on my phone to do with my asthma, everything's all paper, and everything's all you know, just kind of the way it's always been. So this was really exciting kind of project. And I thought, Wow, this sounds really good. I'd love to try out. And, you know, if I can give my feedback on things as someone with asthma, I'd love to. And lo and behold, I was the first user of the digital passport, which is the app, obviously, we're what we're working on now. I'm really proud of the team. Actually, I think it's, you know, it's been such a journey, you know, being sort of a person with kind of lived experience testing the product, to now being the product director. And yeah, it's been a whirlwind, honestly done, but it's yeah, it's good to be here.

Dom Burch: 6:06

I mean, what a brilliant blend as well. So starting in GP role, you know, what we're talking 12 years ago, and when, yeah, that sense of bringing together different stakeholders and trying to integrate care. And, you know, then seeing how that's developed over the last sort of decade or so and how many frontline services are being delivered, you know, even through the pharmacies, through the GP, through, you know, might be small operations, it could be procedures that typically you had to go to hospital for. So that's, you know, that world really changed. And then the grounding in being in digital health in a part of London that was really pioneering I guess, some of those things. And then here we are now, you know, you kind of blending all those things together. It's amazing, really good. And isn't it great that like, you know, you're the product director for a product that you were the first asthma user of? I mean, that in itself is a lovely symmetry, isn't it? Yeah. So let's just rewind a little bit them. So you know, and let's talk about how you ended up here. We are, like eight years on from when digital health passport was first really being iterated? And it is one of those, you know, it's quite easy, isn't it? When people see an app, or they get used to using their phones in different ways. They sort of think, oh, yeah, this thing is just been invented overnight. But the process that you have to go to, and really have people at the heart of the development so that it's useful, it has utility, it's better than what goes before. And it's something that because the real effort, whenever any sort of new technology that you want somebody to have on the phone is right? Well, one, you've got to encourage them that they need it, then they've got to download it, and then when they've downloaded it, they've got to go through the whole process of being on boarded. And then you're going to hope that it's just not one of those apps that sits on their phone and never gets used again. So and it doesn't happen by accident, just help people understand how that happens. And the kind of work that has to go on behind the scenes to make sure that it's, you know, secure and relevant and all those things, but, but actually is user friendly.

Saira Arif: 8:00

It is a journey. And you know, you have to start somewhere, you know, in my experience, I've seen that, you know, often in other companies that I've worked with, you know, you sort of just push out a product and say, right, we've designed this amazing thing, right, people are going to use it. And there's that assumption that people will use it, it's really important, right at the start to ensure that you're designing your product, with the actual user in mind, and you're actually trying to solve a problem. So you know, it's okay, it's really easy to just go ahead and design a product because you think it's fantastic. And you know, it's gonna have all these great features. But if it's not solving a problem for someone, or if it's not relevant to that person, then you're not going to get the usage that you're that you're wanting. So I think the great thing and the great position that we're in is that we've co designed this product with actual users. So we talk to the Ask my users, we talk to people with asthma, young people with asthma are parents of children with asthma. And we you know, we also as questions we asked things, like, you know, what, what, what's the thing that you'd like to see on this, you know, what would make your life easier, someone with asthma and, and it's those kinds of responses that we see, and we take back and then we kind of iterate the product, and we make it better and, and I think having a mindset where you're not just saying that this is a product, this is the end of the development, you have to have that kind of mindset where you are constantly growing. So you want you want to get rid, you want to get feedback, you want constructive criticism, you want the bad and the good, and the ugly kind of thing. You know, you want everything because that's what will make your product good. And that's what will help you really spread the message of the product. I think what's been quite quite difficult, but also quite easy, as well as obviously having the two founders who are very NHS background, you know, and very relevant to the NHS. So Martin was a systems developer, in the NHS, numerous she has an interest. And then obviously Greg is an emergency doctor as well. So having that mix of leadership also is really helpful, because you get that kind of perspective from them and you get the relationships that they've built. and which, which kind of makes it easier to kind of spread the message, if you will.

Dom Burch: 10:03

And working with different parts of the country, and really working with some of the respiratory nurses in those areas working with GPS themselves. And, you know, not being afraid to do the tried and tested things, right of going in and sitting with people and talking to them, and then building, you know, creating a flyer or a poster for Doctor surgery, and seeing what works and what doesn't, in terms of supporting people to understand how to get something like this onto their phone, and why it's better than having a paper based annual asthma plan, even if they you know, because somebody might not even have a plan, right? Just so maybe just sort of bring to life some of that stuff. Because it's really important, isn't it when you've got these benefits of these tools, and these things like, Yeah, that's great. But actually, at the heart of all of this is people it's either people who are caring, or people who you know, actually have something like asthma as an example, and would really benefit from even just knowing how to really use their own inhaler in the right way.

Saira Arif: 11:00

One thing that I've always thought about is looking at my own journey, and sort of comparing that to what happens now. But if I went into my asthma review, which is meant to be annually, as you go in and you sit there and your faces, obviously you're facing the the nurse or the practitioner who's doing the review with you, they're looking at their screen, they're going through a bunch of questions on a on a system, and at the end of it, you're given a piece of paper, you're given a piece of paper. And if that if you aren't given a piece of paper, you're lucky. I mean, I've had experience where I've never been given a care plan until this year. So you know, I don't know if everyone get does get a care plan, but essentially, what the standard should be, you should be getting a piece of paper, that document everything that you've gone through with your nurse or with your practitioner in that in that session. So once you get that piece of paper, you literally just put it in your bag, or you take it away. And you know, for me, I just kind of put it in my file somewhere. And that's it, I don't touch it. I'll go on holiday, I don't have it with me, you know, and it's it's kind of looking at those problem areas. So if I was abroad, which I am now, and I didn't have a copy of my action plan, what would I exactly do? I mean, I'd be quite, I'd be quite stuck, right? You know, the doctor who the clinician who's looking after me, how would they know what to do? Or, you know, if I'm staying with someone, how would they know what to do if I had an asthma attack? You know, they wouldn't know because there's no action plan. So that in itself as a problem. So to solve that, you have to think about well, how is this app? And how is this technology going to help alleviate that problem? That's how our thinking goes on, I guess behind the scenes is, is looking at those problems and trying to find practical problems, things that actually are happening, and sort of trying to say, Well, how's this app going to help, and using that, that kind of golden nugget and saying, Well, this is this is a selling point, this is almost a promotional bid, this is how we get the doctors to be influenced in a way that you know, this is, this is the way forward, this is what we should be telling our patients to you know, to download an app to save the action plan on their phone so that their phone is always with them. And then they can take it anywhere they want.

Dom Burch: 13:06

And building that advocacy actually out with, you know, people who are on the frontline. And Greg, who obviously worked as a, he will see firsthand, as will nurses in GP surgeries and all the rest of it see firsthand when somebody who hasn't been able to keep their asthma under control or hasn't been able to self manage, you know, the consequences of that can be really, really serious. And actually just knowing you know what your triggers are and knowing what can cause you to need to have your prevent, or whatever inhaler, you've got personal experience obviously have that the benefits of just being able to track symptoms and know that pollen is high or that air pollution in your areas. I mean, those are kind of like, and they're readily available, but having them alerted to you on your phone in the same way you might get an alert, you've had a new email or whatever, come on. Yeah, I mean, it's, it's simple stuff, but it can really, really benefit and change your life for the better.

Saira Arif: 14:00

We have a symptom tracker on the app. And I mean, I call it a diary more than a tracker. For me, it's like, you know, logging those days that you know, I've had a bit of a bit of a wheeze, you know, a bit of a chesty, cough or, you know, my I feel like my my lungs are, you know, really kind of restricted in some way. And, and I tried to log that because I feel like I need a bit of a diary. So I can go back and say, well, actually, you know, this week, what did I do, that made perhaps triggered my asthma in that way? Or, you know, if I was presented in front of a doctor, you know, I could actually show a calendar view of all the kinds of the times that my asthma was slightly triggered. And so once you know working out, well actually what works for me and what doesn't work for me, what's triggering me What can I do better? And when you have that sort of insight about yourself, you know, working towards managing your your asthma much better. And that's the whole premise of the app. Really, it's it's how to improve yourself management. Because if we don't improve ourself management and we always rely on, you know, clinicians to tell us what's going on. Then you know, we're gonna be waiting a long time. And before you know it, you might even have an asthma attack in that time. So it's actually trying to prevent things from happening in the first place. And anything unnecessarily in hospital, the location feature on the app is brilliant. So I'm currently in Dubai, although I'm based in London, you know, London, it will tell me whether there's air is polluted, or come to Dubai. And it's actually now seeing as hazardous outside because of the sandstorms that we sometimes have. And so when I have these alerts coming through, you know, for me, it's important to know, Well, should I be going out at the moment? Should I be standing outside for a long period of time? You know, is that going to affect my asthma, and I can kind of plan my day, you know, around my asthma, which makes my life easier, because then you don't come home thinking, Oh, what did I do today? And why is my breathing so heavy, you know, so it makes life really easy. And I love the fact that air quality alerts are, you know, they're set in for me, I've set them up. So every morning, when I wake up, I that's the first thing I see is my air quality alert. And I see whether you know, all my triggers gonna be triggered today, or am I gonna be, you know, having a good day, and I just, you know, I plan around it. And I think this, this sort of tool makes your life so much easier, because if I, if I didn't have this, I'd be going out, you know, even in those hazardous days, and coming home really thick, but now I can avoid that, you know, and that's the whole idea of that.

Dom Burch: 16:19

In terms of just like your own well being it must like, just take that stress down a notch or two, I'm gonna guess you were always slightly anxious, aren't you? You know that you know, it, you know, you might have an attack or whatever, but, or you've forgotten your inhaler, or you know, all those things, right, a background noise, I'm sure somewhere in the back your mind. You go, Yeah, I've got my phone, I've got my inhaler. But yeah, prepared every day. And also having that medication reminder. So you know that you're staying on track, you're not gonna miss a dose, you're able to avoid those triggers. And I guess, for a lot of young people, particularly right, and, you know, we don't use this phrase to be hard to reach anymore. And I loved it when Greg was talking about young people who are hard to reach. And he says, Well, they're not that hard to reach, or they McDonald's, find them easy to get ahold of. And so the shock, right, so they're there, right, and they've got their phones on them. And they're looking at the phones a lot. So if you can encourage somebody to see what the benefits are of having this on their phone, and actually, you're going to really improve their skills, their knowledge, but importantly, their confidence, right?

Saira Arif: 17:21

Yeah, definitely. I think it's actually quite a motivating thing to have. Because now that I feel like I'm a bit more well managed with my asthma, and I can rely on kind of my app to sort of tell me when to take medication. I know in the future, we'll have it and just log in. And that will help be reminded when my asthma medication is running out. Because that's another thing, forgetting your inhalers one thing, but actually forgetting you're forgetting to actually renew your prescription is another one because that you feel like you've got inhalers at home. But you actually don't. You know, there's there's little things like that where I think this will make your life easier. And yeah, well being I think touches on any condition, I think well being is always that thing at the back as well. If you're off your mind, you want to be well, you want to feel like you're getting better. And I think having a technology like this really will help enable that.

Dom Burch: 18:11

Absolutely. Couldn't agree. Couldn't agree more. Couldn't agree more. Now, it's a good pivot point. Right? Because, you know, we've been talking a lot here about asthma. Right. And that was the starting point. You yourself, Syrah are the starting point. But there's some really interesting developments coming on there. Because asthma is one bit of and there's huge NHS priorities, particularly around young people. But there are other things aren't there, where if you had information to hand and you're and that was dynamic information, digitally held information, and it was really personal to you, and that you could track your symptoms, young people with epilepsy as an example.

Saira Arif: 18:45

This is the great thing about the the way we've created the app. Although we started with Asper, we're sort of expanding our work into the areas of epilepsy, sickle cell, and obviously, general well being etc. And I think is great, because as someone with a condition who fairly firstly gets diagnosed at that point, or when you get diagnosed, whether you're a child, or whether you're an adult, it can be quite, you know, can be quite, quite depressing at times. And I think, having somewhere to go and not just kind of googling random symptoms and thinking, you know, should I ask doc to talk about all these things, and then getting even more anxious when you when you see the results, you need one at one place to go where you can get trusted information, you can get resources, you can get techniques, you can, you know, and there's there's also like that kind of, you know, the symptom tracking the diary and, you know, small practical ways of trying to manage your condition. I think this is this is a way forward really, I think, if there wasn't this what else would there be? Would it just be a google google my symptoms and sort of guess how to make your life work? You know, there's so much you can you can say on that, but I really feel like being having something like technote LED technology like this, an app like this will help so many other condition Shouldn't and I mean, we're just getting started, aren't we we're just asthma, sickle cell epilepsy is just the start of it, you can expand this into so many different conditions, so many different elements that I really feel like will benefit a lot of people, regardless of age.

Dom Burch: 20:13

One of the things that really is motivating them, like makes you proud part of the company, is that we're really trying to reach people that quite often there's a lot of health inequality, and that they are from a community or they're a young person with a particular condition or medical complication, and that they're not necessarily the priority that or they've been missed, or they haven't been given the tools or been given the access to the kind of health care that everybody deserves. Right. And, and one of the things that's so nice about working in this field is this real sense of sort of democratising actually, really good health care, and but you're putting the power back into that person's hands, you're giving them the ability to actually self manage and to look after themselves in a way that just is so much more rewarding, right? Because it means one, they're going to be in much, much better health, but also, they don't have to then end up in hospital, which is just, you know, nobody wants to end up in hospital.

Saira Arif: 21:13

Yeah, that's it. No one No one does. And I think, you know, when it comes to those sort of more vulnerable community members, and sort of looking at the assumption that of elderly people don't don't know how to use phones, but I think that's, that's all a myth, I think, what you have to look at who you want to work with, and I think with us, because we're focusing on children, young people, we already know, and there's that assumption that children all have phones, they know how to, you know, access things quite quickly online, that that generation, and you as you said, you have to continue to empower them in different ways. Because I think the next the way that the way we're working towards health and health care's there is, you know, we have to be really honest with ourselves, NHS, the way it's operating at the moment is that capacity is you know, people are very tired in the NHS because of the pandemic we just came out of, and, and all the things that we see on the news, and we want to we want to look at alternative ways of how we make ourselves better. And I think having digital having technology to help enable that is sort of the way forward. And I think we're just looking at practical ways of how we're doing this, you know, when we look at communities from you know, ethnic minorities, for example, you know, we have to sort of take a step back and think well, okay, accessing them is, it's not, it's not the problem, but I think we as a system, make it quite difficult for them to access us. So how do we then infiltrate like their communities? How do we go into their communities and start influencing them in a in a more positive way? And so we've got a big, diverse population in London, as you know, different religions, different faiths, different ethnicities, looking at, well, what what do What does these communities go to? So we've got like Muslim communities, we've got Hindu communities, you know, they all go to their religious temples and mosques and synagogues and things like that, how can we go go to them and allow them to understand what this app is and get them to kind of feel empowered to use it, you know, is looking at those ways of communicating with them, as opposed to sort of just handing out a leaflet to the NHS, for them to then hand out to whoever they want to hand out to, you got to look at different ways of accessing communities. And I think that's something that we're starting to pick up on.

Dom Burch: 23:17

Listen, it's been an absolute pleasure catching up with you, sir, on the podcast. I mean, I know we catch up all the time, but a lovely listener has doesn't get to listen into our conversations normally. And also, you know, like, we've called the podcast up, up and away, we are Up up and away podcast number one is out the door, and it can sail off now into the sunset. But it's been really, really good fun. Now, we should say to the lovely listener, that from now on, this is going to be a podcast with at least three voices on because Syrah is now my podcasting partner in crime. And we are going to be looking to speak to thought leaders, to clinicians, to patients, to young people, basically, we're going to try and bring to life this whole notion of digital health and find out through people's personal experiences, their lived experiences, what that actually means in the real world. And also look at who's innovating in this space, and where that technology is going to be because you know the thing that we haven't really gotten to today and we'll get onto in the next episode is in our hot air balloon, what can we see coming over the horizon that maybe other people can't quite see? Or haven't got that same perspective? So thank you so much, Saira, once again, thank you, Dan, for having me. was a pleasure. I mean, I'm not having you anymore. You've got the keys to the podcast just like I have. And, and with that, we will say goodbye now if people want to learn more about digital health passport, I mean, you can just go to all the usual searches and find us but I will call it out. Anyway, it is digital health. passport.co You'll find us there. You can also find us on Tik Tok because yeah, we are down with the kids aren't we? Sorry.

Saira Arif: 24:46

Yeah, see, I feel I'm big kid anyway, so yeah.

Dom Burch: 24:50

My days of being a kid. I mean, I never grab it but I am 49 and three quarters so I need to wake up to that. But But anyway, for the time being thank you so much for coming on to the podcast. Up, up and away!