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Believe, Build, and Boost: How to Adopt HCD Approaches for Digital Modernization in Health Programs

By Wendy Harman, Customer Experience Director, ICF

Government health operations as we know them were established in an analog world. When digital technology gained momentum and government programs started developing websites and online forms, many of the same processes were translated online without reimagining how the technology itself might be used to improve the experience of interacting with federal health agencies.

Twenty-three years into the 21st century, however, many of these legacy systems across agencies like the U.S. Department of Health and Human Services and the U.S. Food and Drug Administration are undergoing modernization. The systems that support the delivery of health programs and services now have the opportunity to be reimagined for our digital world. In response, federal health agencies are adopting agile development practices to release smaller chunks of working software much more frequently, instead of waiting for years on an enormous new system release.

Recently, the phrase human-centered design (or HCD) started buzzing through the public sector as well, carrying with it the promise that by designing systems from the outside-in, we can create service delivery that solves the real challenges and meets the real health needs of the people.

HCD is exactly what it sounds like: a mindset to be relentlessly people-focused in the design of all systems, programs, services, processes, and organizational structures. Effective HCD also requires establishing relationships between the designers and the people who will use the design.

The idea of integrating the HCD mindset into government is not new. After all, President Lincoln referred to a government of the people, by the people, for the people in his Gettysburg Address in 1863, and community engagement is a cornerstone of our democracy. And, as the U.S. determined its COVID-19 response, the clear value proposition for human-centered design came into focus across our health institutions in the public, non-profit, and private sectors. Understanding the motivations and information needs of a diverse array of priority populations helped design more effective and efficient digital services—whether for access to information about COVID-19 and mitigation strategies, finding testing sites, or learning about clinical trials.

So how can leaders of federal health programs adopt HCD approaches in their ongoing digital modernization efforts? Start with these 3 Bs: believe, build, and boost.


…or be willing to try something new. The first step to adopting a human-centered approach to your digital modernization efforts is to understand human-centered design’s role as a mindset and toolset that empowers teams to be hyper-focused on solving for the highest-impact challenges.

When digital modernization leaders support the use of HCD methods, your team becomes free to integrate HCD into the modernization effort as a core part of the delivery process:

  • Understand who uses the system(s), what they need, and how they feel
  • Identify opportunities to ease the experience
  • Prototype solutions
  • Test, iterate, and test again

When leadership is open to trying HCD, a modernization team is empowered to talk to and design with the people who actually use the system, prioritizing their highest value needs, and translating those needs into digital solutions that increase effectiveness and efficiency for everyone. Your organization benefits with each pilot project and each training in becoming a more human-centered, service delivery-oriented culture.

Federal health program leaders have an opportunity to embrace HCD and to empower your teams to talk with the people served by your program—whether that’s healthcare professionals, researchers, patients, or healthy members of the public—to better understand their goals, motivations, and pain points. As flu season continues and COVID-19 remains a constant presence, programs are wise to invest in understanding the underlying drivers and barriers for healthy behaviors—to work with populations who haven’t actively sought health services so you can identify actions and digital services that meet people where they are and improve their health outcomes.


…and start to use HCD in the work. As Tom Chi of Google X says, “Doing is the best kind of thinking,” and that means it’s almost always fastest to learn by experimentation and iteration. Surround your team with HCD practitioners who can facilitate best practices and pass along techniques and tools for applying HCD to digital modernization efforts.

  • Increase comfort in deploying HCD techniques. Make sure your team knows some foundational HCD methods through both training and applied projects.
  • Identify a relevant challenge for a proof-of-concept pilot. Immerse your team, including your modernization leaders, in applying HCD methods to solve a known challenge.
  • Create interdisciplinary HCD teams so that different program and service areas are exposed to HCD in action.

While proof-of-concept pilot teams immerse themselves in human-centered methodologies, your organization can establish baseline metrics for customer experience and, over time, identify opportunities for change or improvement to better meet the needs of your priority populations. Throughout digital modernization efforts, both health program leaders and CIOs benefit from establishing tight feedback loops that inform and shape the work of your digital modernization teams.


…and develop the structure to sustain HCD adoption. Once your organization decides to adopt human-centered approaches to digital modernization, create support structures to help sustain the effort, such as:

  • Centralize resources, tools, and training to build capability
  • Decide who will lead HCD efforts and where they fit into your organization
  • Define how the roles and responsibilities of everyone involved in digital modernization and service delivery are impacted by HCD adoption
  • Determine the funding model that will support HCD
  • Find support from HCD practitioners with experience

As your organization gains experience using HCD, the next phase is to establish frameworks and processes that help everyone understand how they apply HCD to your digital modernization efforts. HCD is not a method best left to a centralized few, but as part of every program, service delivery, and digital modernization effort. Identifying some shared services around HCD can be helpful as your programs and agency matures in the application of HCD. That way you can help ensure that repeatable, scalable discover-design-deliver processes can be rapidly created and improved over time—always keeping the human right at the center.



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