Cognition, Technology & Work

, Volume 16, Issue 3, pp 337–348 | Cite as

Coping with complexity in home hemodialysis: a fresh perspective on time as a medium of Distributed Cognition

Original Article


The existing literature on Distributed Cognition (DCog) mostly presents the temporal distribution of cognition in terms of system evolution that happens over time. In this paper, we illustrate how cognition can also be distributed through time in more immediate ways, through four principles we developed while studying how renal patients cope with the complexity of home hemodialysis. These principles are temporal assignments to tasks to aid prospective remembering; temporal arrangement of tasks to help deal with anticipated problems; temporal distribution of a task plan to avoid omission of steps; and temporal re-arrangement of tasks to reduce peak complexity. Like the physical environment, the time continuum is an external medium that can support distributed cognitive processes, serving as a representation for task reminders and allowing actors to organize the order, duration, and spacing of tasks to reduce complexity in cognitive work. These principles can highlight problems and opportunities in the design of socio-technical systems, by explicitly considering time as another medium that can be used to support DCog in short-term activity.


Distributed Cognition Time Temporal Ethnography Home hemodialysis 



We are grateful to all participants for the time, expertise, and experiences they shared with us. We also thank all the reviewers, whose comments helped improved this paper. This research is funded by the UK Engineering and Physical Sciences Research Council grant EP/G059063/1.


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Copyright information

© Springer-Verlag London 2013

Authors and Affiliations

  1. 1.University College London Interaction CentreUniversity College LondonLondonUK
  2. 2.Department of OncologyRoyal Free NHS TrustLondonUK

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