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Publication Detail
Exploring medical device design and use through layers of distributed cognition: how a glucometer is coupled with its context.
  • Publication Type:
    Journal article
  • Publication Sub Type:
    Journal Article
  • Authors:
    Furniss D, Masci P, Curzon P, Mayer A, Blandford A
  • Publication date:
    02/2015
  • Pagination:
    330, 341
  • Journal:
    J Biomed Inform
  • Volume:
    53
  • Status:
    Published
  • Country:
    United States
  • PII:
    S1532-0464(14)00271-8
  • Language:
    eng
  • Keywords:
    Blood glucose meter, Distributed Cognition, Ethnography, Glucometer, Human–computer interaction, Socio-technical system, Algorithms, Artifacts, Blood Glucose, Blood Glucose Self-Monitoring, Cancer Care Facilities, Cognition, Data Collection, Diabetes Mellitus, Equipment Design, Equipment and Supplies, Medical Informatics, Medical Oncology, Research Design, Software
Abstract
Medical devices are becoming more interconnected and complex, and are increasingly supported by fragmented organizational systems, e.g. through different processes, committees, supporting staff and training regimes. Distributed Cognition has been proposed as a framework for understanding the design and use of medical devices. However, it is not clear that it has the analytic apparatus to support the investigation of such complexities. This paper proposes a framework that introduces concentric layers to DiCoT, a method that facilitates the application of Distributed Cognition theory. We use this to explore how an inpatient blood glucose meter is coupled with its context. The analysis is based on an observational study of clinicians using a newly introduced glucometer on an oncology ward over approximately 150h (11days and 4 nights). Using the framework we describe the basic mechanics of the system, incremental design considerations, and larger design considerations. The DiCoT concentric layers (DiCoT-CL) framework shows promise for analyzing the design and use of medical devices, and how they are coupled with their context.
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