Jess Russell, asthma practitioner, on the role of digital tools in supporting better health outcomes

In this episode of the podcast, host Dom Burch sits down with Jess Russell, an experienced asthma practitioner, to discuss practical strategies for managing asthma, the importance of patient education, and the role of digital tools in supporting better health outcomes.

Key Themes and Highlights:

• Empowering Patients Through Education and Self-Management 

Jess emphasises the critical role of education in empowering patients to manage their asthma effectively. She shares insights on how patient education goes beyond simply understanding asthma as a condition—it involves teaching patients the skills and confidence needed to manage their symptoms daily.

"It’s not just about knowing what asthma is; it's about understanding how to live with it every day, recognising triggers, and knowing when to use medications appropriately," Jess explains.

• Importance of Personalised Asthma Action Plans 

A major point Jess makes is the value of personalised asthma action plans. She highlights that these plans are tailored to each individual, taking into account their specific triggers, symptoms, and lifestyle.

"Asthma action plans are essential because they provide a clear roadmap for patients and their families. It’s about having that step-by-step guide that empowers them to act confidently, especially in emergency situations."

Jess also discusses how these plans can be integrated into digital platforms, making them more accessible and easier to update as needed.

• Role of Digital Tools in Asthma Management 

Jess and Dom delve into how digital tools like the Digital Health Passport (DHP) are revolutionising asthma care. Jess underscores the benefits of having a digital tool that allows patients to monitor their condition, track medication use, and stay informed about their health.

"Digital tools like the Digital Health Passport provide a convenient way for patients to keep track of their asthma. It’s not just about logging information; it’s about giving patients a sense of control and involvement in their care," Jess states.

She also points out that digital tools can facilitate better communication between patients and healthcare providers, ensuring that everyone is on the same page when it comes to managing the condition.

• Community and Support Networks 

Jess discusses the importance of building a strong support network for asthma patients, which includes not just healthcare professionals but also family, friends, and peers.

"Asthma management isn't something that should be done in isolation. Having a support network that understands the challenges and can offer support is invaluable," she says.

She highlights how digital platforms can also serve as a community space where patients can share experiences and support each other.

• Advocacy and Raising Awareness 

Throughout the interview, Jess is passionate about advocating for greater awareness around asthma and the need for continuous education and resources.

"There’s still a lot of misunderstanding about asthma. We need to continue raising awareness and ensuring that everyone—patients, families, and even schools—have access to the right information and tools," Jess emphasises.

Conclusion:

Jess sheds light on the multifaceted approach needed to manage asthma effectively. From patient education and personalised action plans to the integration of digital tools and the power of community, Jess highlights the key strategies that can make a real difference in the lives of asthma patients. 

Transcript

Dom Burch: 0:00

Dom, welcome back to the Up, Up and Away podcast from Tiny Medical Apps. My name's Dom Burch, and today I'm delighted to welcome on to the podcast Jess Russell. Now Jess is an asthma practitioner focusing on children and young people, and is a member of the North East London healthcare team. Jess, welcome to up, up and away.

Jess Russell: 0:30

Thanks very much. Thanks for having me today.

Dom Burch: 0:32

No absolute pleasure. Now, tell us a little bit about you. Then, how did you end up in this part of healthcare? How did you end up in healthcare at all and and how come asthma sort of drew you in? What was your what's your journey to where you are now?

Jess Russell: 0:42

Well, actually, it's a bit of a convoluted journey. I'm not sort of as straightforward as some other people, actually. And I sort of got into healthcare a little bit late. So I originally studied Sport and Exercise Science at university, so that was my first degree, and that was just sort of off the back of loving sport and loving exercise, and not really sure what I wanted to do with my career going forward. So thought I'd do something that I really enjoyed and loved. But then when I graduated, which I really enjoyed my degree, I graduated, and then didn't really know where I wanted to go and what I wanted to do previously. I thought healthcare, great profession. Enjoy working with people really like the sort of the biology side of the sports science degree. So that's when I decided to do my masters in physio. So I worked a little bit in the healthcare industry while I sort of got some experience. And then I went on to do my masters. So I did postgrad, pre registration, physio master's degree, and then I started working as a physiotherapist. So again, probably not sort of where you where you might expect the journey to go to where I am now, because when you think you think of physios, everyone thinks the sore backs and, you know, knee pain and rehab after operations and stuff. But I did a placement in children's respiratory absolutely loved it. And then that was that from from there on in, and I really wanted to follow a career in children's respiratory so I did. I've worked for a few trusts across London, and then ended up working at the Royal London Hospital in acute children's respiratory, which I loved. And then the job that I'm currently in now was sort of a little bit more niche. So I had had some asthma experience, but more in an acute setting. And then this job came up, and I thought that would be really fantastic. It gives me sort of that community long term condition management of a long term, term condition experience, also a little bit of working from a strategic point of view. So working a little bit more in the ICB, but also having that patient facing aspect, which I really enjoy, and that's obviously a huge reason for why I'm in healthcare anyway. So I thought I'd go for it, and sort of 18 months later, here we are working as an asthma practitioner with a colleague who's a nurse. So I obviously bring a different sort of set of skills being from a physiotherapist background, but yeah, I think we complement each other really nicely, and that's how I've how I've ended up where I am today.

Dom Burch: 3:12

And what was it about respiratory that when you first had that sort of first, I don't know, experience of it, you weren't Oh, yeah, this is for me. What was it that? Because I always think this is interesting when I talk to sort of health professionals and I go, I professionals, and I go, oh yeah. And I worked in A and E, and as soon as I was in A and E, I thought, oh yeah, this is for So, what was it about respiratory? Then it's sort of like, you know, just made you go, Yes, this is the this is the right place for me. Well,

Jess Russell: 3:33

I think what it is about respiratory is that you get some really quick and really satisfying returns on sort of the care that you give sometimes in different aspects of particularly physio or different sort of healthcare jobs, things can be a lot longer and a lot slower, and that's, you know, great if you're you're into that type of care, and you don't mind seeing those returns over a long period of time, like months and years, For example, but for me, it was that instant gratification of somebody's really unwell, they've got a respiratory problem, they've turned up. They need some help, and I can help them right here, right now and in the next half an hour, hopefully, I would have, you know, turned their life around and made it a lot easier for easier for them to breathe, or giving them some really good tips to then be able to go forth and do all the things that they want to do, in terms of hobbies and activities, of daily living and things like that. So I felt that it was that sort of instant gratification that really got me hooked, which I loved. Also, not many people like phlegm and sputum, but for some reason, I just really, really enjoyed helping children clear their chests and feel so much better afterwards. So Strangely, I really enjoy that that side of it as well, and that sort of pushed me forward to go into respiratory physio and more specifically, probably the acute side of it, rather than the sort of chronic side of it. Although now I am sort of working in the community, which I'm really enjoying. So actually, it's, you know, turned it turned around a little bit for me there, but definitely respiratory is my bag,

Dom Burch: 5:11

and those quick wins, I think that's really interesting. So being able to sit with somebody, particularly a young person then, and, you know, I guess, really understand what it is that's going on for them, and then be able to guide them, signpost them, offer them some tips, some helpful advice, and to see the impact of that actually make a noticeable impact quite quickly. And, you know, isn't that the truth then for lots of other things that we've been working on, because obviously, you've been helping us with, you know, getting the digital health passport into people's hands, and I was chatting to a couple of researchers last week on the podcast, and actually saying that just getting people through the onboarding process and guiding them through that process and asking all the obvious questions. Think Laura said, you know, do you know how to use your inhaler as an example? Or, do you know, what's the difference between your inhalers some of these assumptions that we make about somebody and their health and how they can manage their own health. I mean, just talk us through some of those examples, because I guess that's the kind of stuff that you're bumping into on a daily basis. You know,

Jess Russell: 6:11

like me that instant gratification is where a lot of my patients how they want to receive their care as well. You know, it can be quite labor intensive when you're asking somebody to do exercises three times a week for the next six months, the motivation goes up and down, and you need a whole new sort of skill set for those types of patients. But when sort of patients come to me and, you know, they present to me with a problem, the whole sort of respiratory aspect of it, and the instant gratification and the quick resolving of an issue is something that they can really get on board with. And I think they really do appreciate so it's those sort of small bits of advice that really can actually change somebody's life and significantly improve improve their quality of life. And that's what I that's what I really love, knowing somebody sort of left my clinic, and they've, you know, powered with the tools to hopefully improve, even if it's the next few days, the next few weeks, or make it easier for them to do something that they really want to do. And I find that one of the main motivators for the reason I do my job, and then being able to direct people to some of the tools and the resources that we have, again, is really handy. So as you mentioned, things like inhaler technique, being able to direct somebody to a video that's going to show them there and then how to do it. They don't have to trawl through papers on the internet or, you know, articles or blogs to try and I understand what they should be doing. You know, we can show them. We can back it up with a video they've got that then at home for whenever they need it, and you just feel a lot more confident that that patient has the tools that they need going forward to keep on top of their disease and the symptoms that they might experience and other things like, I think some, one of the things that are most useful, and actually the digital health passport does do this is those alerts that people Get for pollution and pollen counts on a daily basis, and that's really fantastic, because you know that that just appears on your screen when you wake up in the morning, and you can you can take steps there and then before you even left the house, that will mean that your day will be significantly better, and the effects from your disease and the environment, hopefully will be lesser. And that child will be able to get on with their life. They'll be able to go outside and play, just maybe in a different way, maybe not, you know, in the park, if the pollen Count's really high, they'll still be able to walk to school, but maybe just they'll take a slightly different route. Yeah, so it just means that they can do all the things that they want to do when they've got sort of tools and tips or tricks at their fingertips, which, yeah, I love directing people too, and just seeing that improvement in their quality of life. It's

Dom Burch: 8:45

really easy, isn't it to say about, you know, like, empowering people to be in charge of their own health, but, like, that's the that's bringing it to the real world, isn't it? When you're saying to somebody, you're like, actually, how do you keep a peak flow diary? But rather than scribbling it on a piece of paper, you can actually do it, you know, on your phone, and then seeing those recordings, and then seeing the difference that that might be having, or the pollen alert might mean that you know you need to take your inhaler that morning, or reminding you that, Oh, I do have an inhaler. I better take it with me if I'm off to the gym. Those little things are just like arresting back that sense of control, and that's really what's going on in terms of empowering a patient or empowering a young person, it's giving them what they need to feel like they're in charge, a little bit of their own destiny.

Jess Russell: 9:27

Oh, yeah, absolutely. And what we really don't want to see is we don't want to see situations where children feel out of control, or they do they feel undereducated, because that's when panic sets in. That's when anxiety sets in, and then we get a whole different sort of host of other mental and emotional well being concerns that come with sort of a physiological disease as well. And that's absolutely something that we want to avoid, because we want to make the impact of a respiratory disease as minimal as possible on on those children and young people. But you know, that is the reality. Of the world that we're living in, isn't it? You know, the technology at your fingertips and being and people being able to find information that they need really quickly. So we need to keep up with that, and we need to be providing those opportunities for children to be cashing in on, on sort of those digital advancements, I think, which I think we are, we are doing, and we're listening to our patients and trying to develop every sort of way that we can to give them what they need to manage their disease and their health going forward.

Dom Burch: 10:27

And what for you found works, you know, in terms of trying to change somebody's behavior and positively impact them. And, you know, it's easy, isn't it? We just say, well, we've built this sort of digital tool like, Great, okay, but how do you actually get somebody to feel like that's relevant to them, you know, and actually go to the bother of downloading it in the first place? Because, you know, downloading, it's one thing, and then it's just another app in a sea of apps on a phone, so like, actually making it relevant, what, you know, just in real, practical senses. What, what do you do as a team to try and help people through that process?

Jess Russell: 11:00

Oh, wow. I sort of feel that you've hit the nail on the head a little bit with your question, because actually, it's about unpicking and finding out what what is important to that patient. So what is relevant to that patient? I can sit here all day long and talk about, oh, you know, pollen count and how important it is for you to understand if they're high, if there's high pollen on a certain day, and actually, if that's not a trigger for our patients, and if they don't experience an issue in response to pollen, then they're not going to be interested. So actually, it's about unpicking what is important to that patient, delving in and then providing the advice and the resources around that so quite often, a conversation would need to start, you know, really colloquially, not about health. Maybe it's about what that child likes doing, or what they've done on their summer holidays, to really try and get an idea about who that child is, what their family setup is, what they enjoy doing, and then from there, you can delve in a little bit more and try and understand their needs and what's relevant to them. And I think we have such a wide range of resources at the moment that there will never be a situation that we can't point somebody to something that's relevant to them. So even if they don't find that they have any issues with pollen or pollution, it might be really important to them to track their symptoms, and as you say, something like a peak flow diary, so that they feel that they can manage their condition, and they feel that they have an understanding of it. Or it might be that they find it really hard to regulate their breathing correctly when they're exercising. And it might not be an asthma related symptom with exercise. It might be more of a breathing pattern disorder. And if that's what they feel that they want to be able to do, then, then we need to be able to provide them the tools to to go and investigate that a little bit more, to manage that at home, and then to be able to ask us health professionals and more in depth questions. And then we can, we can advise further on that. So yeah, I really do think, in on a day to day basis, really, actually, first port of call is getting to know that child and what it is that they they are, what they want to do, what their goals are, their likes and their dislikes. And it's building on that type of picture. And because that's, that's what's important to people, isn't it? You know, you know, can they do what they their friends do? Can they do what they want to do? Can they can they go out with family? And ultimately, that's what we're enabling people to do. Yeah,

Dom Burch: 13:28

we spoke a few months ago, and you and Laura kindly, sort of did this Q and A with us. And you were talking about, there was a young male patient in clinic who had poor inhaler technique, and you know, you went to the trouble of demonstrating the correct technique to him and his father, I think it was. And then when he returned, it hadn't improved, but his parents spoke limited English, so you got them to download, you know, the app, and then actually walk them through and show them some of those inhaler technique videos and have them to hand. And that thing of like being in a support system with might be you and a parent or you and a health professional or you and a peer, frankly, somebody else who might have the same sort of condition as you, feeling like there's a sort of team approach and that everybody has access to this information and that you can learn together, but also that just that safety net, that sort of reassurance that there is really important information to hand and people Know where to get it from. Yeah,

Jess Russell: 14:22

it really does take a village to manage somebody's health. Quite rarely would you ever find a single person, and particularly a child, managing their own health on their own, without sort of the support of their family and or various different healthcare teams and healthcare professionals. It really does take a village to manage a condition correctly, and that's where we all need to pull together to make sure that our children and our patient have the things that they need. So from a healthcare perspective, and we need to be making sure we're making the right referrals. Are they supported in the community enough, and not just from their health? Healthcare point of view, but from a social and a well being point of view, because obviously, working in North East London at the moment, it's a fantastic place to work. Can come across so many different challenges every day,

Dom Burch: 15:12

and I'd imagine quite a lot of health inequalities that are just a reality of the demographics of poverty of you know, English not necessarily been a first language, and those, those are barriers, aren't they? That in addition to somebody's own health, they have to overcome those barriers as well.

Jess Russell: 15:27

Yeah, exactly. Huge barriers. So we have, you know, lots of people that don't speak English as their first language, they are huge barriers. And when we're considering how a child is going to manage their condition going forward, we have to consider these other issues as well, and how we're going to overcome them and work around these barriers. And that's where things like visuals coming handy diagrams and flow charts and things like that that aren't sort of just long paragraphs of prose that we're expecting our children and their parents, because it takes, you know, the whole family to understand and interpret and then be able to put into practice as well. So, you know, convert what they've read and what we've told them into actual and taking their inhaler correctly, and, you know, doing the things that we've asked them to do in the way that we've prescribed it. And, you know, the other thing that is sort of frustrating, and in the job that I'm in currently, I don't have so much of an of a problem with but it is the time, time pressure that a lot of people do have in the NHS. So clinics need to run to time quite often that they don't, but patients and their families do, do need the time, as much time as we can give them, to make sure they understand what we're asking them to do, and then we avoid situations like them coming back, and whilst we told them, you know, their inhaler technique wasn't quite right, they didn't quite grasp it, and they'd come back and it's not really improved. So time is obviously a huge barrier, although I'm very lucky in the job that I'm in now that it's it's not so much of an issue for me, luckily, but I know it's a huge barrier for so many different other healthcare professionals,

Dom Burch: 17:04

and it's, you know, it's unfair, but if you did have a magic wand, what would be? Where would you want to sort of sprinkle that magic dust? Because it must be frustrating when you're part of a system, a health system where you know that early interventions, better education, you know, giving people time and allowing them to improve things like their inhaler technique or whatever else it is to be in charge of their own sort of destiny, more, and also the positive impact that has on their own well being and mental health as well as their physical health, is going to stop, you know, people ending up in A and E further down the line, or or worse, you know, and and actually, The cost to society, and the cost to them is huge. And if only we could, kind of, like, get ahead of ourselves and put some of that in at the start rather than at the end. I mean, it must be a constant friction point within the system that you can see that, and it's obvious, but you know, it's hard to do something about it. Oh yeah,

Jess Russell: 17:58

it's really frustrating. And if I had a magic wand, you'd target so many different areas and so many different sort of settings to try and fix the whole thing. But it's just, it's just not possible. I think, at the moment, in the job that I'm in, you know, having moved from the acute trust so working, you know, with people who turn up to A and E really unwell, needing an intensive care admission and sort of being really reactive to that situation, having moved from that job that I was into this sort of more community based, strategic, collaborative, more of a collaborative job. And I really do understand the importance of being a bit more proactive that rather than being reactive, and actually, I'd love to, you know, spend a little bit more time and have a little bit more resource for more community setting and maybe trying to to work out some of these health inequalities, because I think that's a huge issue, especially in the area that I'm working now, but I know it is across the country as well, having spoken to colleagues who are doing a similar role, there are pockets of inequalities absolutely everywhere. And if we could try and iron out some of those inequalities and go to some of these communities and engage them, then I really do think we would then see a change in and it would trick along through primary care and secondary care and tertiary care, and it would have a positive impact later down the line. You know, there's probably efficiencies to be worked out in all of all of those different settings, but I do think that's somewhere that we really, we are definitely trying to target, but it is really difficult to target these communities when, you know, we're not quite sure how, or we're not quite sure how we go about it, or, you know, their different types of needs, and it's something that we're trying to understand. But I think if we were able to put in a little bit more resource still, we might see some some changes further down the line. And it's something that, you know, North East London really can come up against. But as they say, it's a national, a national. Problem, but that's where I'd love to spend a little bit more of my time. And love to maybe think about that in the future, you know, there might

Dom Burch: 20:06

be somebody listening who's in a different part of England and kind of bumping into similar things and kind of going, Gosh, I wasn't even aware that you've been doing this work, or that there's digital tools or whatever it is. What would your advice be to sort of other professionals like yourself who might be working in the same field, but just, you know, in a different part of town or a different part of the UK.

Jess Russell: 20:24

Well interestingly we've been doing some work recently with accessible resources and easy read materials. And, you know, I think I was potentially a little bit ignorant before, but I you know, you think that you're writing in a really clear, concise manner, and you think that you're writing something and a patient facing leaflet that most people would be able to understand as long as they could sort of read basic English. But actually, having done a few workshops with patients who do require easy read materials, I was surprised to see how off the mark I was and how actually I'm writing things in a way that I think is simple to understand, but it's definitely not for people who have additional needs and they're not going to be able to understand it at all. So I have really felt the impact of doing a workshop with the patients that we're actually targeting and again, time and resource and getting these people on board, usually not for any sort of financial or, you know, any type of payment from from them is really tricky to do, but the value in it is huge. So that would be sort of one thing I'd really consider and but also to think about those, those sort of lesser known communities, like the easy read materials, isn't something that I'd spent an awful lot of time thinking about whereas you do, I think think about getting materials translated into other languages. I think that's, you know, really quite at the forefront of a lot of people's minds, because we speak so many different languages in this country, and we need to make sure that we're catering for everybody. So it's thinking about those sort of lesser known groups of people, like the people who do need the easy read materials, or who have visual impairments or hearing impairments, and they need some accessible resources too. Yeah, it absolutely opened my eyes as to how much more I can do for these, these communities that are slightly harder to reach, but need a lot of support.

Dom Burch: 22:16

One last question then so, I mean, it sounds like you still got loads of energy and motivation for this role, right? You know, this is you're definitely in the, you know, you're still in that sweet spot. What is it that is around the corner that you're either excited by or, frankly, it's still frustrating you and you're on a mission to try and solve it? What are the things that are kind of burning at the top of your to do list?

Jess Russell: 22:37

Yeah, absolutely. And I think every single time we start with a piece of work, and we sort of really delve into the nitty gritty of it. You realize then how much more you could do and how much further you could go with it. Every time you open that that door, suddenly, you know, the floodgates open, and you think, oh, you know. And we could do this, and we could translate this, and we could make a video into this. Then we should, you know, get patients in, in this situation, in this setting, and honestly, there is so much more that I think this job could do, and people that I would allow me to reach, and patients would be able to help. But from my personal point of view, I've been working on asthma and allergy for any school. So again, sort of a bit more of a proactive measure, rather than reactive measure, where we're looking at trying to help support schools become asthma and allergy friendly, and so it's just to be a safer environment for children with asthma and allergy hopefully across the whole of North East London, and then if they did experience any asthma attacks, staff will be really well trained, and they'll have protocols in place. They have emergency kit to treat children who have anaphylaxis or asthma attacks at school. So that's something that I'm working towards, and that is something I will continue to do, and would love to sort of take, take forward to the next level. We're getting sort of initial schools being interested in that, which is really fantastic. But actually the goal is to have absolutely every single school across North East London. So, you know, 500 odd schools all asthma and allergy friendly. And that's really that would be, that's a huge aspiration, and that would be a huge win if we were able to sort of implement that in a community setting, not only for for children, but for staff awareness. So even out in the community, you know, trained staff would be aware of signs and symptoms of these children being really unwell. So the reach is huge, and that's where I'm hoping to see this job unfold and see some progress in that area.

Dom Burch: 24:31

Brilliant. Well, I look forward to keeping track of how many of those 500 schools sign up, but it sounds like a worthy mission, but for the time being, Jess Russell, an asthma practitioner here looking after children, young people in North East London. Thank you so much for coming on to Up up and away.

Jess Russell: 24:45

Thanks for having me.

Dom Burch: 24:53

You've been listening to the Up up and away podcast with me, Dom Burch for tiny medical apps, if you'd like to be a guest on the show. Then please get in touch. You can find us@tinymedicalapps.com or you can look up digital health passport, or you just Google us. I'm sure you'll find us there. You.