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

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

Non Expectations and Adaptive Behaviours: the Missing Trade-off in Models of Innovation

We explore the modelling of the determination of the level of R&D investment of firms. This means that we do not tackle the decision of being an innovator or not, nor the adoption of a new technology. We exclude these decisions and focus on the situations where firms invest in internal R&D in order to produce an innovation. In that case the problem is to determine the level of R&D investment. Our interest is to analyse how expectation and adaptation can be combined in the modelling of R&D investment rules. In the literature both dimensions are generally split up: rational expectations are assumed in neoclassical models whereas alternative approaches (institutional and/or evolutionary) generally adopt a purely adaptive representation.Bounded rationality, learning, expectations, innovation dynamics.

Deriving Information Requirements from Responsibility Models

This paper describes research in understanding the requirements for complex information systems that are constructed from one or more generic COTS systems. We argue that, in these cases, behavioural requirements are largely defined by the underlying system and that the goal of the requirements engineering process is to understand the information requirements of system stakeholders. We discuss this notion of information requirements and propose that an understanding of how a socio-technical system is structured in terms of responsibilities is an effective way of discovering this type of requirement. We introduce the idea of responsibility modelling and show, using an example drawn from the domain of emergency planning, how a responsibility model can be used to derive information requirements for a system that coordinates the multiple agencies dealing with an emergency