Lisa deBettencourt, MS HFID

Human factors and human-centered design should not be considered a nice-to-have in healthcare. This is a high risk environment where errors could mean death. Safety considerations are not optional so all physical, cognitive, and environmental conditions must be evaluated and accounted for in the design.

As with any design project, you need to start with gathering information. Are you assuming or perceiving lack of respect and trust or do you have actual data that proves it? Question the hypothesis and talk to your peers to understand how they feel working with you and what they believe are your strengths, weaknesses, and opportunities for improvement. Only with that insight can you determine where to make adjustments for improving relationships and building more trust with your teammates.

There must be a concept exploration phase prior to any "design the solution" work. What are all the possible ways in which we can meet the requirements and success metrics? These concepts should be put in front of target users/customers for feedback and discussion. Which concepts work the best and why? Only then once a direction has emerged should design refinement begin.

After research we should be sifting through the findings to determine which are relevant to the solution provider. We often uncover tons of issues, workflow bottlenecks, etc., that have nothing to do with the business's mission. Those need to be filtered out so we can focus on what's important AND relevant to solve for. After that, we need to dig in and explore what is happening and why. We should be reframing the problem through critical thinking - possibly even some further inquiry - and not just diving straight into requirements; that is a very business-first approach to solving problems for humans. Finally, we should be defining goals for what a successful experience would be like. Only then should we be writing requirements.

Health IT solutions live within a broader ecosystem of technologies and the users of these solutions must work within the constraints and incentives of their larger health system. Therefore, it's crucial to take a systems approach to understanding the context in which a new solution will need to exist. Focusing only on the users for a product or service is too narrow a scope for this phase. During research, one must investigate the social, organizational, business, and technical infrastructure as well to truly understand user/customer needs, goals, motivations, and incentives.