Page - 85 - in Applied Interdisciplinary Theory in Health Informatics - Knowledge Base for Practitioners

is more accessible through the articulation of its concepts and constructs, and the need for such theories in health informatics and other domains is rising due to growing complexity of joint social and technical systems, distributed cognition is ready and relevant for grappling with twenty first century issues. Following Halverson’s [19] four categories for assessing the utility of theory: we believe distributed cognition provides descriptive power (e.g. DiCoT helped describe and make sense of activities through distributed cognition concepts and principles); rhetorical power (e.g. in terms of argumentation DiCoT-CL helped frame and articulate how macro level decisions were having negative downstream impact on the haematology ward); inferential power (e.g. we infer that patients who are most likely to use PHIMed would be those who experience complex and fragmented healthcare services); and application power (e.g. targeting PHIMed interventions towards patients with complex and fragmented care could have a higher likelihood of impact and changing the configuration of the pre-alarm on the haematology ward could have a positive impact on staff and patients, both of which could be tested). Teaching questions for reflection 1. What tools and artefacts related to health informatics exemplify how an individual’s cognition extends into the environment? 2. What complex sociotechnical systems can you describe that have important aspects of health informatics within them? 3. How would a research project evaluating electronic health records look different when planned from a traditional individualistic perspective versus a distributed cognition perspective? 4. What are the strengths and weaknesses of distributed cognition theory? Funding This work was supported by Pharmacy Research UK grant [PRUK-2016-PG2-2-A], by the UK Engineering and Physical Sciences Research Council [EP/G059063/1] and by the National Institute for Health Research (NIHR) grant [12/209/27], from the Health Services and Delivery Research (HS&DR) stream. The research is also supported by the NIHR Imperial Patient Safety Translational Research Centre. The views expressed are those of the authors and not necessarily those of Pharmacy Research UK, the NHS, the NIHR or the Department of Health and Care. References [1] E. Hutchins. Cognition in the Wild. MIT press.1995 [2] J. Hollan, E. Hutchins, D. Kirsh. Distributed cognition: toward a new foundation for human-computer interaction research. ACM Transactions on Computer-Human Interaction, 7(2), (2000), 174-196. [3] D. Furniss, A. Blandford. Understanding emergency medical dispatch in terms of distributed cognition: a case study. Ergonomics 49 (2006), 1174–203. [4] N.V. Flor, E.L. Hutchins. Analysing Distributed Cognition in Software Teams: A Case Study of Team Programming during Adaptive Software Maintenance. Reading in Groupware and Computer supported Cooperative Work. San Mateo, CA: Morgan-Kaufman. 1991. D.Furniss etal. /DistributedCognition:UnderstandingComplexSociotechnical Informatics 85