Parables of Care: A Q&A with Dympna O’Sullivan

the Centre for Human-Computer Interaction Design, City, University of London.

Dr Dympna O’Sullivan, Senior Lecturer in Health Informatics at the Centre for Human-Computer Interaction Design, City, University of London.

Dr Dympna O’Sullivan is a Senior Lecturer in Health Informatics at the Centre for Human-Computer Interaction Design. Dympna’s research is in the area of health informatics, clinical decision support systems and evidence-based medicine. She is interested in managing the large volumes of data generated by today’s digital healthcare environments and in developing intelligent software systems to bridge the gaps between clinician’s information needs and the computational resources available to meet them.

Dympna participated in the Parables of Care workshops held at City in the spring. I asked Dympna some questions related to Parables of Care.

An important part of your work focuses on finding solutions to developing sustainable healthcare. In your view, what is the role that ‘graphic medicine’ (the role that comics can play in the study and delivery of healthcare) could play in finding these solutions?


Dympna O’Sullivan: A hugely challenging aspect of developing sustainable healthcare models is finding ways to engage patients and service users in health and social care. An important aspect of patient engagement is looking for new ways to communicate with patients and service users and new ways of providing meaningful and actionable information to then. I believe graphic medicine can play an important role in getting this kind of health information to patients and service providers in a new way.

Further, the modality has the potential to address issues of low levels of patient education and health literacy which are commonly observed in patients lacking engagement. Persons with low health literacy are also often at high risk for poor health.

Health and healthcare are complex constructs and the graphic medicine medium has the potential to decompose complicated information. By using characters, graphic medicine can also add humanity to information by lending a human face to health information. Graphic medicine could be particularly pertinent for public health messaging as it may be combined with existing media like pamphlets and booklets. This also has the potential to engage new audiences, for example younger patients, in health.

We employed User Centred Design activities in the development of Parables of Care. Why is user-centred or person-centred healthcare important?

DOS: User-centred healthcare design brings together patients, healthcare staff, families and communities to explore and understand the real-life experiences of healthcare. These experiences can be very different, thus requiring diverse functionality, services and even systems for each group of end users. Healthcare is a complex web of organizational, environmental and ergonomic factors all of which influence the use of computer technology in a healthcare setting. From a clinical perspective, involvement of users assures developed systems will be fit for purpose and operationally optimized for the environment in which they will be used. From a patient perspective, personalizing medicine using user centred approaches to develop technology, has been shown to engage patients in their healthcare more effectively and to improve outcomes.
Dr Dympna O'Sullivan and Dr Simon Grennan at a Parables of Care workshop at City, 8 March 2017

Dr Dympna O’Sullivan and Dr Simon Grennan at a Parables of Care workshop at City, 8 March 2017

Parables of Care adapted cases from Care’N’Share. How difficult is it to get the public interested in evidence-based healthcare?
DOS: Public access to evidence based health is generally facilitated by public health bodies such as Public Health England. Although methods for communicating evidence based health have developed and expanded rapidly due to new technologies, the scope of public health messaging remains rather narrow generally focusing on changing individual behaviours such as smoking, alcohol, exercise and eating habits.
While there are undoubtedly some issues concerning a lack of public interest in evidence based healthcare, a greater issue is the lack of knowledge on the part of the public, that other types of health evidence apart from those typically made available by Public Health England exists. Very few initiatives have had the focus of Parables of Care to make data from an existing health dataset available to the public and particularly in such an accessible format.
Public Health England logo

What were your thoughts on Parables of Care as a publication?

DOS: Parables of Care is an exceptional publication, thoughtful and simple, yet grounded in established academic practices for communicating information.  It works on many levels, making good practice information available to clinicians, formal and informal carers as well as patients themselves. It is accessible for wide ranges of literacy and health literacy, an important consideration in the care industry. Finally it specifically focuses one of the grand health challenges of our time, dementia, which despite its huge burden is chronically underfunded and thus any attention on the condition is welcome.
Parables of Care - cover

Health Informatics and comics: what’s next?

DOS: I return to my original points on patient engagement which is one of my active research areas. I believe there is huge potential for graphic medicine is this space. Patient engagement was recently described by Forbes Magazine as “The Blockbuster Drug of the Century”! 

Patient engagement is composed of a number of dimensions all of which can be facilitated very effectively by the graphic medicine format. First by providing an understanding of the importance of taking an active role in one’s health; Second by imparting knowledge, teaching skills and providing confidence to manage health conditions; And thirdly by providing guidance on how to perform specific health-promoting behaviours. All while offering a human face to the information, something that is generally not present in the many apps being developed in this space.

I believe this is an exciting interdisciplinary research area where health informatics, comic artists and behavioural scientists can provide some much needed solutions.

Parables of Care can be downloaded as a PDF file, under a Creative Commons Attribution-NonCommercial 4.0 International License, from City Research Online:

If you live in the UK you can request printed copies at no cost here.

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