title: Distributed cognition: an alternative model of cognition for medical informatics.
abstract: BACKGROUND
  Medical informatics has been guided by an individual-centered model of human cognition, inherited from classical theory of mind, in which knowledge, problem-solving, and information-processing responsible for intelligent behavior all derive from the inner workings of an individual agent.
  
  
  OBJECTIVE
  In this paper we argue that medical informatics commitment to the classical model of cognition conflates the processing performed by the minds of individual agents with the processing performed by the larger distributed activity systems within which individuals operate. We review trends in cognitive science that seek to close the gap between general-purpose models of cognition and applied considerations of real-world human performance. One outcome is the theory of distributed cognition, in which the unit of analysis for understanding performance is the activity system which comprises a group of human actors, their tools and environment, and is organized by a particular history of goal-directed action and interaction.
  
  
  CONCLUSIONS
  We describe and argue for the relevance of distributed cognition to medical informatics, both for the study of human performance in healthcare and for the design of technologies meant to enhance this performance.
authors.affiliation: Center for Health Research, Kaiser Permanente Northwest, Portland, OR 97227, USA. Brian.hazlehurst@kpchr.org
authors.forename: Brian
authors.initials: B
authors.lastname: Hazlehurst
authors.forename: Paul N
authors.initials: PN
authors.lastname: Gorman
authors.forename: Carmit K
authors.initials: CK
authors.lastname: McMullen
mesh_terms: D003071:Cognition; D019336:Cognitive Science / Q000639:trends*; D003195:Computer Communication Networks; D006801:Humans; D008490:Medical Informatics / Q000639:trends*; D008954:Models, Biological; D011591:Psychology, Medical / Q000639:trends*