What is Human Factors Engineering?

Human factors engineering (HFE) is the science of understanding the properties of human capabilities and limitations and applying that understanding to the design, development, and deployment of systems. It is a multidisciplinary field incorporating contributions from industrial engineering, cognitive psychology, industrial design, statistics, operations research and anthropometry. Human factors involves the study of all aspects of the way humans perform and they way in which they interact with the world around them, with the aim of improving operational performance and safety.

How Does HFE Apply to Healthcare?

HFE is applied to healthcare to design processes, devices, and systems that support the work of care givers. Specific benefits of HFE applied to healthcare include:

• Efficient care processes;
• Effective communication between care providers;
• Better understanding of a patient’s current medical condition;
• Reduced risk of device use error;
• Easier to use (or more intuitive) devices;
• Reduced need for training;
• Easier repair and maintenance;
• Cost savings through mitigation of adverse events;
• Safer healthcare working conditions; and
• Improved patient outcomes

HFE should take place early in the system development process. It should include tools such as work domain analysis, function allocation, probabilistic risk assessment, usability testing, among others.



Growing Innovation

Intersectional Thinking

What is our Innovation Center?

Course on Design Thinking

Girl and stickies board

Design is often referred to as a plan to get from the current state to the desired state. Design Thinking encompasses the cognitive processes and tools that allow us to accomplish this in an effective manner.

How can design thinking lead to innovation in healthcare? 

The MedStar Institute for Innovation has produced a web-based course with videos from leading experts from the field of Design Thinking. The videos explain in detail what design thinking is, how to conduct design research and prototype, and how to apply these skills to challenges in health care.

The course was produced by Doug Solomon (Senior Fellow at MI2), Mik Pietrzak (Senior Fellow  at MI2), and Brittany Singhas-Weinberg.

  • Design and Thinking
    A fun 2.5 minute video by Muris Media to give you a sense of Design Thinking
  • What is Design Thinking?
    An overview of the Stanford/IDEO concept of Design Thinking

The Process of Design Thinking with David Webster, Partner, IDEO

Putting it all together -- David Webster of IDEO describes the overall Design Thinking process. He is joined by Steve Kinsey, Director of MedStar Inventor Services and our Course Guide Brittany Weinberg to discuss how inventors can leverage the IDEO Design Thinking process to catalyze innovation in the healthcare environment. IDEO is a leading design and innovation consulting company.

This session reflects on the parallels between the IDEO process and our work at MedStar.  However, some key differences exist.  For example, at MedStar our designers are our frontline people and often have the “empathy” (user understanding) needed to begin the design.   The discussion helps identify some differences and clarifies how to apply Design Thinking in healthcare.

Thinking with Barry Katz, Fellow, IDEO

Success in design is rarely achieved without understanding what made others succeed (or fail) in the past.  The rich history of design thinking and its impact on the industrial age provide abundant examples. Barry Katz, a renown expert of Design Thinking and author on the subject, explains how Design Thinking as we know it today was developed over a century ago when designers were innovating approaches to the new age of mass production. Barry, who works with IDEO, California College of the Arts, and Stanford University, provides insight into the definition of Design Thinking, the drivers for the emergence of design thinking and lessons learned from history.

Brainstorming with Doug Solomon, IDEO Fellow and Senior Fellow at MI2

Doug Solomon pulls us into the world of brainstorming - an important way that design thinkers generate ideas – lots of ideas. 

Brainstorming, when structured properly, can be applied as a tool generating ideas addressing a design problem. Though not a panacea, it is a supplemental tool to quickly create numerous ideas for consideration. Doug Solomon explores individual and team brainstorming – providing an understanding of the advantages of different techniques. A special focus on methods used at IDEO will guide innovator through this process.


Design Research with Lucie Richter, IDEO alumna and Adjunct Professor at California College of the Arts

“Did anyone ask the people who would be using this?” A question we seem to frequently ask ourselves. One of the most important parts of the Design Process is the early informative research that is (or should be) accomplished before product or service design begins. This process informs the fundamental “empathy” for the projected users of the intended product. Great products and devices reflect a true understanding of the users.

Lucie Richter was a key member of the IDEO team designing medication delivery systems for insulin dependent diabetics and also patients with severe arthritis for the pharmaceutical industry.  Her expert insights will enhance your ability to gain important information for the design process through keen observation and interview techniques. Her vignettes of real cases bring key points to light.

Design for Behavior Change with David Featherstonhaugh

Can design thinking make a difference to our patients? David Featherstonhaugh provides key insights for the application of design thinking to behavior change including:

  • How to even start thinking about designing for behavior change?
  • How behavior change and design thinking relate?
  • How to effectively measure behavior change?

Rapid and Nimble Prototyping With Andre Yousefi, Co-founder, Lime Lab

Andre Yousefi shares how:

  • Prototyping is informed by design research and brainstorming.
  • Rough prototypes made from rudimentary materials have multiple advantages.
  • 3D printing from CAD programs has transformed rapid prototyping and is likely to be even more of a factor in the future.

Although this session is focused on physical prototyping, we will learn that prototyping can also be used for many other nonphysical things, such as concepts, software, movies, processes, and problem-solving in general.

Prototyping – Beyond the Physical with Kara Harrington

Prototyping is a key element of the innovation process. It allows us to see and sometimes feel something tangible and helps us communicate ideas. Prototyping is not only for physical objects, but also for project ideas, services, software, and other nonphysical products – such as the “story board” before filming a movie. Kara Harrington discusses the application of prototyping techniques focusing on non-physical concepts. 


Health for America Fellowship

Health for America (HFA) at MedStar Health, a past fellowship program embedded in the MedStar Institute for Innovation (MI2) from 2015 to mid-2018, engaged early career professionals in distinctive learning experiences centered on health, design, entrepreneurship and leadership. It challenged them to create an innovative solution in an assigned domain during an 11-month program, sometimes among other work. Past HFA blog posts tagged with design showcase the importance of design thinking to the fellows’ learning and contributions.

Each year the fellowship started with an exploration phase that deeply immersed the fellows in understanding the assigned domain (e.g., diabetes, telehealth). A key activity of the exploration phase was simulation. Grounded in the principles of design thinking, HFA simulation activities were tailored to build the fellows’ empathy for the patients and/or survivors with whom they would design their solution. Defined as the ability to understand and share the feelings of another, empathy is a useful tool for innovators who seek to create a solution that is both novel and relevant to the end user.

For the 2016 to 2017 program, the HFA fellows were challenged to create a novel solution that improved stroke care. The creative simulation experiences they developed were described in a report to hopefully inspire other healthcare professionals to create and conduct their own simulation exercises as a means to further encourage patient-centered care and innovation. Read the MI2 HFA report, “Simulating the Stroke Patient and Survivor Experience: Designing Solutions with Empathy.”

Resources on Design Thinking

White Paper on Integrative Medicine

Date:     June 10, 2016

From:    Mark Smith, MD
              Chief Innovation Officer, MedStar Health
              Director, MedStar Institute for Innovation (MI2)

Dear Colleagues:

I am pleased to send you the MedStar Institute for Innovation’s White Paper on Integrative Medicine.

In its role to catalyze innovation that advances health, the MedStar Institute for Innovation has been investigating the potential application of Integrative Medicine (IM) within MedStar. IM is the seamless union of standard Western medicine with established approaches from other healing traditions (e.g., acupuncture, yoga, meditation) to relieve suffering, reduce stress, and enhance well-being and resilience. This review of the evidence on IM and its current state of practice within the US is the first product of that work, and I am excited by the possibilities that it reveals for us.

I was surprised, and I think you may be also, at the range of conditions for which there is good evidence for the effectiveness of IM approaches. IM enables us to do more to address health, wellbeing, pain, the suffering sometimes associated with treatment, and a variety of specific medical conditions. I urge clinical colleagues to review this evidence just as they would a new drug or procedure to see if these approaches might be suitable additions to the treatment plans for their patients.

I was also surprised to learn that roughly one-third of Americans are already using various IM approaches and spending roughly $12 billion annually on provider-based services. Further, some health systems are offering these services to patients for free, based simply on the impact they have seen them have on patient satisfaction and hospital ratings. There is a huge opportunity for mutual benefit here. Unfortunately, we also learned that local competitors have begun moving into this market ahead of us.

While it was not the focus of this research, I am also personally struck by another, very serious, angle on this topic—clinician burnout. Recent reports indicate that this phenomenon has reached epidemic proportions, and I suspect that you can see it in the faces of our front-line, care-giving colleagues, just as I can. There is good evidence that IM practices can also play an important role in an overall program to support clinician self-care, wellbeing and resiliency. A case could be made to invest in the development of IM services for this reason alone.

I am proud to put this product of MI2’s efforts into your hands. As you might guess, I played only a minor role in its production. Full credits are documented in the Acknowledgements section, but I would be remiss not to single out the report’s main author, Emily Ratner MD, to say a warm “thank you” for her tremendous effort. A quick skim of the 24 pages (!) of references will give you a good feel for the effort, and rigor, behind this report.

The time has come for MedStar to give serious consideration to approaches from Integrative Medicine. We should not and cannot ignore the evidence. We now know that we can do more to relieve suffering, reduce stress, and enhance well-being—among our patients… and our colleagues.

As you’ll see, it doesn’t matter so much where we start, only that we start.





-Mark Smith, MD
Chief Innovation Officer, MedStar Health
Director, MedStar Institute for Innovation (MI2)

Download the pdf of the White Paper here 
Note: This document is for your internal use only as it has not yet been finalized according to MedStar brand and style guidelines

MedStar Institute for Innovation Intake Form

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National Center for Human Factors in Healthcare Team

Raj Ratwani, PhD
Acting Director and Scientific Director, National Center for Human Factors in Healthcare
[email protected]

Rollin (Terry) Fairbanks, MD, MS, FACEP 
Founding Director, National Center for Human Factors in Healthcare
Associate Director, MI2 
[email protected]

A. Zach Hettinger MD, MS
Medical Director and Director of Cognitive Informatics, National Center for Human Factors in Healthcare
[email protected]

Grace Tran, MS
Director, Human Factors Safety Integration
[email protected]

Lawrence Wolpert, PhD
Director, Usability Services
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Angela Thomas, MPH, MBA
Executive Director, Health Services Research Administration, MHRI
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Allan Fong, MS
Research Specialist
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Natalie Abts, MS
Senior Program Manager, Usability Services
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Katie Adams
Research Assistant
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Erica Savage, MHA
Project Manager
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Kathryn (Kate) Kellogg, MD, MPH
Associate Medical Director
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Amy Will
Research Coordinator
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Daniel Hoffman
Research Assistant
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Jessica Howe, MA
Research Specialist
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Natalie (Nat) Benda, MS, PhD
Senior Research Fellow
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Nicoleta Parau
Business Manager
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Josh Puthumana
 Research Assistant

AnnKatherine Hoobler
Administrative Coordinator
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Rebecca Butler
Usability Specialist
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Lucy Stein, MS, OTR/L, CAPS
Clinical Human Factors Specialist
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Bidisha Roy
Research Assistant
Usability Services
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Tracy Kim
Tracy Kim
Research Assistant
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Ross Filice, MD
Ross Filice, MD
Clinical Informatics Scientist
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Joseph Blumenthal, BA
MI2 Clinical Informatics Developer
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Lisa Calkins, MS
Usability Specialist
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Thomas Scheurich, MS
Usability Specialist
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Rachel Wynn
Rachel Wynn, PhD
Post Doctoral Fellow
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Deliya Wesley
Deliya Wesley, PhD
Health Equity Scientist
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Kristen Miller
Kristen Miller, DrPH, CPPS
Senior Research Scientist
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Danielle Mosby
Paula Royster
Project Coordinator
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