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Understanding safety-critical interactions with a home medical device through Distributed Cognition

Rajkomar, A; Mayer, A; Blandford, AE; (2015) Understanding safety-critical interactions with a home medical device through Distributed Cognition. Journal of Biomedical Informatics , 56 pp. 179-194. 10.1016/j.jbi.2015.06.002. Green open access

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Abstract

As healthcare shifts from the hospital to the home, it is becoming increasingly important to understand how patients interact with home medical devices, to inform the safe and patient-friendly design of these devices. Distributed Cognition (DCog) has been a useful theoretical framework for understanding situated interactions in the healthcare domain. However, it has not previously been applied to study interactions with home medical devices. In this study, DCog was applied to understand renal patients’ interactions with Home Hemodialysis Technology (HHT), as an example of a home medical device. Data was gathered through ethnographic observations and interviews with 19 renal patients and interviews with seven professionals. Data was analyzed through the principles summarized in the Distributed Cognition for Teamwork methodology. In this paper we focus on the analysis of system activities, information flows, social structures, physical layouts, and artefacts. By explicitly considering different ways in which cognitive processes are distributed, the DCog approach helped to understand patients’ interaction strategies, and pointed to design opportunities that could improve patients’ experiences of using HHT. The findings highlight the need to design HHT taking into consideration likely scenarios of use in the home and of the broader home context. A setting such as home hemodialysis has the characteristics of a complex and safety-critical socio-technical system, and a DCog approach effectively helps to understand how safety is achieved or compromised in such a system.

Type: Article
Title: Understanding safety-critical interactions with a home medical device through Distributed Cognition
Open access status: An open access version is available from UCL Discovery
DOI: 10.1016/j.jbi.2015.06.002
Publisher version: http://dx.doi.org/10.1016/j.jbi.2015.06.002
Additional information: Copyright © 2015 The Authors. Published by Elsevier Inc. This is an open access article under the CC BY license (http:// creativecommons.org/licenses/by/4.0/).
Keywords: Distributed Cognition, Home Hemodialysis, Ethnography, Safety-Critical System, Patient Experience, Interaction Design
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Cancer Institute
UCL > Provost and Vice Provost Offices > UCL BEAMS
UCL > Provost and Vice Provost Offices > UCL BEAMS > Faculty of Engineering Science
UCL > Provost and Vice Provost Offices > UCL BEAMS > Faculty of Engineering Science > Dept of Computer Science
URI: https://discovery.ucl.ac.uk/id/eprint/1469263
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