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The online solutions for managing diabetes that could be found in your pocket

Digital Communities Wales is working with an increasing number of organisations in the health and social care sectors, as the links between digital inclusion and work in these areas becomes ever more relevant.

This can include people using technology to improve their health in hospitals or care homes, in some cases they could be supported by digital volunteers; organisations improving access to health information online; and people using digital technology at home, to improve their own health and wellbeing.

In this blog we look at the work of PocketMedic, an online tool that has been developed in Swansea to help people manage diabetes. Right now there are 177,000 people in Wales living with diabetes, and estimates suggest a further 70,000 have diabetes but are either unaware or have no confirmed diagnosis. Another 540,000 people in Wales could be at high risk of developing diabetes, and the numbers are rising every year.

We’ve spoken to Kimberley Littlemore who is the brains behind PocketMedic.

Q: What is the background to PocketMedic?

A: Many years ago I was working at the BBC, producing Comic Relief – you know all those appeal films that broke your heart, and made you reach for your credit card on Red Nose Day, as we shared the story of a mum in Ethiopia or a dad in Kenya, for example, facing up to some of the challenges of living in extreme poverty. When you are in a tough situation and something hits you, it can be really hard to cope and harder again to recover. Most of those stories were about health, be it HIV and Aids as an adult or a child, neglected tropical diseases, malaria or malnutrition. I was making films about health plus international development issues – trying to contextualise what was happening and why, with the hope that your cash could make a tangible difference.

I left the BBC five years ago and was trying to work out how I could make films specifically about health for those living in the developing world, to help people better understand and self-manage common conditions, because I realised that lack of understanding about health was often making difficult situations even worse. I was aware too that there were films available about common acute conditions like malaria, maternal health, HIV and Aids management, but very little about other chronic conditions like type 2 diabetes and heart disease. I was discussing this with a clinician in West Wales and telling him of my ambition, and he shared his frustration about trying to reach his patients in Wales with supporting information about their diabetes management.

“Before you head off to Africa and India to make films, do you think you could work with us in Wales to reach the hundreds of thousands of people living with type 2 diabetes?” he asked me. And that really, was the beginning of PocketMedic.

Q: What is Pocket Medic designed to do?

A: It is designed to bring people in contact with other people like them. I have just been listening to ‘You and Yours’ on the radio with Winifred Robinson and a lady living with obesity said that she wanted to join a group of people like her, so that they could support each other to address their weight and their emotional relationship with food. If you live in a remote part of the country and feel geographically isolated, if you live in a busy city and feel emotionally isolated, if you live in a busy family but feel isolated because there is no one sharing your battle around you then we are trying to build that community of people for you to meet – albeit in a film – but at least it allows you to see that you are not alone and have some time to learn more about your condition.

If you have heart failure, diabetes, depression and anxiety, chronic pain, COPD, lymphoedema … we have a series of films featuring people who are reaching out to share their experiences with you. They are digging deep, sharing their hopes and fears, telling it like it is and offering their story to show that there is someone like you out there in the world, and probably only a few miles down the road. We have filmed in North, South, West, East and Mid Wales gathering stories, sharing the expertise of doctors and nurses to explain what is happening to your body when you have a hypo or a hyper, feel persistent pain, when you want to go on holiday and are worrying about how to manage your lymphoedema, or want to know what exercises are appropriate from your chair…expert patients and expert clinicians address all aspects of a chronic condition and share it with you, the patient, in an accessible, visual, engaging way.

Q: How do people use Pocket Medic?

A: We share series of links to the films that give you access to all the films in that particular collection. We are trying to find the most effective way to share them – we are sharing the links in a letter or they can be sent to patients in a text. Currently, GPs and Practice Nurses can distribute the links. The diabetes content is part of the Designated Enhanced Service provision in NHS Wales and so there is every incentive for clinicians to share it with their patients. The lymphoedema content is available nationally. The COPD content is available in Hywel Dda University Health Board and the Wellbeing content in Abertawe Bro Morgannwg University Health Board. The cost is very low – pennies per patient population – to contribute towards the cost of distributing and updating the films. We’d like more Health Boards/chronic condition groups to subscribe to the other series. The more subscriptions we have, the more content we can make.

Q: Why do you think it’s important that people can use online tools like PocketMedic, conduct internet searches and use apps, to help manage their health?

A: If you read about things like Self-Determination Theory or the Patient Activation Measure, the evidence points to people who are engaged with their health being healthier or more able to manage their health effectively. There is a LOT of stuff out there online – if you Google diabetes there are about a million search results that come up. So it’s not just about quantity or ease of access – it’s about quality. We wanted to make CURATED content – stuff that you can be sure that is signed off by the NHS – has the gold seal of approval. You don’t have to be wondering whether a bit of advice is right or wrong.

Q: What more do you think needs to be done to help people use digital technology for health reasons? For example, do you think older people or people who are socially isolated require more support?

A: The challenge with digital technology is getting it to people. We have made some lovely, engaging, empowering films but I wonder sometimes if we will be able to get them to all the people who should see them. How can we be sure that they are being shared, prescribed, and offered to those who can benefit from them? That is our big challenge. If you are a patient then please ASK your GP or practice nurse for the PocketMedic films – that would be really helpful. Tablets are great bits of tech for people of all ages to use. Clearly it can be challenging to adopt something new but if you use something regularly or in a group, or are prepared to join a group in your library or community centre to learn how to use your tablet to access films, then there is often support to be had. And of course you can ask any young person… they seem to know instinctively how to do things mobile phone or computer-related!