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Since the early 1980s, human factors professionals have leveraged macroergonomic approaches to build and design complex systems. Macroergonomics is of increasing relevance and interest to modern human factors experts working to address societal and organizational problems. New questions within existing domains necessitate development of new macroergonomic methods. Additionally, modern research needs drive the development of novel approaches in new domains. In this session, panelists will provide expert perspectives on the dynamic evolution of systems analysis, innovative implementation of participatory ergonomics programs, new hazard recognition approaches based on cognitive mnemonics, new applications of improvisation that enhance team performance, and a synthesized method seeking to elucidate micro to macro systems components. After each panelist has presented, we will then facilitate a discussion with the audience and panelists about the responsibilities and opportunities to derive human factors tools and methods that address the challenges and limitations of modern macroergonomics.

For people living with chronic medical conditions, the activities of patient work are often performed by multiple actors. These actors may be formal supports (i.e., paid, professional) such as clinicians in formal clinical settings, in-home nursing and therapies, school nurses, and respite care; or informal supports (i.e., unpaid nonprofessional) such as family and friends. Although often critical to the performance of patient work, the patient work network poses many methodological challenges. The five panelists will provide prepared remarks regarding a methodological approach to studying care networks and provide a discussion of the challenges and opportunities related to using the approach. These presentations will be followed by a discussion with the panel and the audience, moderated by the chair. This discussion will be focused on eliciting further discussion on opportunities, strategies for addressing potential challenges, and additional potential approaches to studying care networks including data collection tools and analytical methods.

Exploration of patient work through the lens of the Patient Work System model (PWS) has typically concentrated on clinical tasks, noting only how broader contextual factors shape these tasks. The purpose of this research was to use the PWS to begin to explore patient work originating directly from these broader contextual factors, referred to as the social determinants of health. Transportation access to maternal health services was used as a topic for a case study. Semi-structured interviews with eight health care and human services professionals were analyzed through deductive and inductive processes. The results reflected the main factors of the PWS and identified unique sub-factors under person, physical environment, and organizational environment. This preliminary work demonstrates that there is potential to use the PWS to examine patient work arising from SDoH.

Objective: By reducing barriers to accessing health services and by supporting health management, consumer health informatics has the potential to reduce health disparities. Yet, technologies are still being designed without considerations for racial and ethnic minoritized populations. This paper reviews consumer health informatics research within this population to assess for whom and how such technologies are being designed. Methods: We searched four databases from January 2020- December 2021 for literature focused on consumer health informatics and racial and ethnic minoritized populations. We extracted information about the study population, geographic location, stage of the design lifecycle, culturally tailored approaches, community engagement strategies, and considerations for the social determinants of health. Results: Twenty articles were included in the review. Most of the included literature were original research articles that tested health management interventions focused on one racial or ethnic minoritized population primarily within a confined geographic area within the United States. Seven studies described the extent to which an intervention was culturally tailored, including modifying the content, interface, functionality, and platform. Community engagement strategies varied, but few articles employed robust approaches. Lastly, seven studies detailed considerations for the social determinants of health, including providing hardware to access interventions and incorporating information about community-based resources within an intervention. Conclusions: There has been moderate progress in consumer health informatics focused on racial and ethnic minoritized populations and many opportunities remain for these technologies to be used as an approach to address health disparities. Future research should utilize community engagement strategies to design interventions that are attune to multiple racial and ethnic minoritized populations across geographic regions in addition to numerous intersectional identities and multiple co-morbidities.

There has been a significant increase in using social media for academic research and there is an opportunity for human factors professionals to incorporate these platforms into their research. Social media platforms provide a rich space to study extant data on health information communication, behaviors, and impacts and to recruit study participants. In this session, panelists will discuss using social media to study health-related topics including health management, gender-based violence, disaster response, self-harm, patient ergonomics, and secondary impacts of the COVID-19 pandemic. They will share how they have collected and analyzed data and recruited study participants from social media platforms such as Twitter, Reddit, and Facebook. They will also speak to the benefits and challenges of as well as ethical implications for using social media for research. There will be space for a moderated discussion to identify ways social media can be leveraged for human factors research in health care.

As the Human Factors and Ergonomics Society Diversity, Equity, and Inclusion Committee enters its fifth year, it continues to encourage the society, annual meeting attendees, and human factors professionals to improve diversity and equity within the field. At the center of this field are humans and their widely varying needs and abilities. While HFE professionals devote themselves to these needs, their details are often overlooked in order to design for what is assumed to be a majority of users. These assumptions can then lead users to be rejected by products, systems, or objects. This rejection indicates a lack of accessibility, which affects millions worldwide. In this panel, experts in the areas of universal design, healthcare, and accessible design will discuss how to “do” accessibility while demonstrating that accessibility should be considered a required component of usability.

Human Factors/Ergonomics (HF/E) is a systems discipline focused on jointly optimizing human well-being and overall system performance. Societal problems, including but not limited to health inequity, racism, poverty, and (lack of) sustainability, are inherently systems problems that involve humans, and so recent work has argued that HF IE can and should contribute to addressing these issues. This panel will bring together leaders of the Human Factors and Ergonomics Society (HFES) to discuss if and how HFES can encourage and support responsible, timely, and participative ergonomics to address societal issues. The session will be highly interactive as the organizers will moderate discussion to reflect on the progress the science and Society (i.e., HFES) have made in this space, identify areas for improvement, and creatively consider future actions to ensure our science and Society are responding to these issues in an ethical manner.

The COVID-19 pandemic has once again highlighted the ubiquity and persistence of health inequities along with our inability to respond to them in a timely and effective manner. There is an opportunity to address the limitations of our current approaches through new models of informatics-enabled research and clinical practice that shift the norm from small- to large-scale patient engagement. We propose augmenting our approach to address health inequities through informatics-enabled citizen science, challenging the types of questions being asked, prioritized, and acted upon. We envision this democratization of informatics that builds upon the inclusive tradition of community-based participatory research (CBPR) as a logical and transformative step toward improving individual, community, and population health in a way that deeply reflects the needs of historically marginalized populations.

Cancer care is becoming more complex each year, making the patient’s path to, and through the care continuum confusing and daunting. Patient-navigation programs for cancer patients have grown in recent years, but their navigation support is fragmented in many ways and often incomplete, lessening their effectiveness. Digital tools to support the cancer patient navigator can make them more effective and allow more patients to receive navigation support. A multifaceted analysis of the needs for such tools is presented. The analysis methods include literature review, domain analysis, and qualitative interviews with a sample of ten cancer patient navigators.

There is an increasing need and interest for Human Factors and Ergonomics (HFE) professionals to apply our discipline to a larger context. HFE researchers are starting to conduct research outside of traditional settings, focusing their efforts on complex societal challenges; however, this type of work is still in its infancy and there is a need to define how HFE can be used in broader contexts, outside of formal institutions. In this panel, we begin a formalized conversation of how our field can scale its impact. Each panelist will introduce a societal challenge they are addressing and discuss how HFE can be adapted to this context. The topics of this panel will span elections technology, sustainability and climate change, universal access to mental healthcare, social isolation in older adults, and food insecurity. This session will conclude with a moderated discussion between the panelists and audience to brainstorm specific societal challenges that HFE can address as well as how methods can be adapted to this context.

In health and healthcare, patients, families, and other stakeholders increasingly participate in designing, executing, and evaluating initiatives likely to affect them. Stakeholder participant roles include: (1) Advisors, as in patient/family advisory councils; (2) Co-Designers, as in participatory design team members; (3) Citizen Scientists, as in community-based participatory research; and (4) Peers, as in peer reviewers of proposed research or decisions regarding the ethics of a planned research study. This panel assembles leading US and UK human factors experts to discuss how stakeholders can be and have been involved as participants in the design, implementation, or evaluation of health or healthcare related initiatives. Panelists describe: (a) how they have involved stakeholders, describing their methods, strategies, and results; (b) associated benefits they have observed; (c) needs that have surfaced and must be addressed for successful stakeholder participation; and (d) recommendations for human factors professionals planning to involve stakeholder participants.

For vulnerable patient populations, such as children with medical complexity (CMC), the patient journey is fraught with challenges. By providing a range of perspectives including clinicians, a family caregiver, and Human Factors/Ergonomics (HF/E) experts, the present panel will describe the unique opportunities for HF/E to design jointly optimized systems for CMC and their family caregivers, including an explication of some of the specific challenges and complexities related to studying the work of and designing systems for this population. We will also highlight the ways in which HF/E could help in the design of solutions to improve outcomes for families.

The Diversity Committee of HFES has led sessions at the Annual Meeting for the past three years focused on improving diversity, equity and inclusion in the society as well as providing support to human factors and ergonomics (HF/E) researchers and practitioners who aim to apply HF/E knowledge and principles to improve diversity, equity and inclusion through their work. In this panel, we bring together researchers actively engaged in designing technology and systems by considering issues of diversity, equity and inclusion to share insights and methods. Topics include the thoughtful design of sampling strategies and research approaches, alternative and participatory methods to understand the impact of automation and technology on equity, scoping design problems to be inclusive and equitable through interdisciplinary partnerships, and the application of sociotechnical system design and team science to develop interdisciplinary teams. By sharing our experiences, we hope to prepare others to successfully approach these topics.

In a panel format, four systems researchers who are also patients described their experiences navigating their care continuum in relation to human factors topics. Getting inside the heads of researcher-patients is an opportunity to elicit unique perspectives on healthcare, which may not be captured through research alone. Researcher-patients may navigate and observe their care continuum with a lens attuned to identifying research questions, as well as gaps and opportunities for interventions that support patients in health-related work, clinicians in decision making, and a culture shift towards effective patient-clinician teaming in service of improved safety and quality. We provide detailed recommendations, as well as a concise take-away tool intended for healthcare organizations.

Objectives: To provide an overview of recent work at the intersection of Biomedical Informatics, Human-Computer Interaction, and Ethics. Methods: Search terms for Human-Computer Interaction, Biomedical Informatics, and Ethics were used to identify relevant papers published between 2017 and 2019.Relevant papers were identified through multiple methods, including database searches, manual reviews of citations, recent publications, and special collections, as well as through peer recommendations. Identified articles were reviewed and organized into broad themes. Results: We identified relevant papers at the intersection of Biomedical Informatics, Human-Computer Interactions, and Ethics in over a dozen journals. The content of these papers was organized into three broad themes: ethical issues associated with systems in use, systems design, and responsible conduct of research. Conclusions: The results of this overview demonstrate an active interest in exploring the ethical implications of Human-Computer Interaction concerns in Biomedical Informatics. Papers emphasizing ethical concerns associated with patient-facing tools, mobile devices, social media, privacy, inclusivity, and e-consent reflect the growing prominence of these topics in biomedical informatics research. New questions in these areas will likely continue to arise with the growth of precision medicine and citizen science.

In the 4th panel on the topic of The Patient in Patient Safety, we highlighted topics of current relevance and facilitated a reflection session. The objective was to highlight the ways in which the COVID-19 pandemic has impacted patient ergonomics research and work, with particular focus on safety. After a topic overview, panelists presented their work on overcoming challenges to human subjects research created by the suspension of face-to-face activities during the COVID-19 pandemic. A facilitated reflection and brainstorming session using Miro followed. We used questions to elicit examples of patient and caregiver roles in safety during the pandemic and research strategies and challenges. These questions were also distributed on social media prior to the event. The panel served as an opportunity to share lessons learned.

The active involvement of citizen scientists in setting research agendas, partnering with academic investigators to conduct research, analyzing and disseminating results, and implementing learnings from research can improve both processes and outcomes. Adopting a citizen science approach to the practice of precision medicine in clinical care and research will require healthcare providers, researchers, and institutions to address a number of technical, organizational, and citizen scientist collaboration issues. Some changes can be made with relative ease, while others will necessitate cultural shifts, redistribution of power, recommitment to shared goals, and improved communication. This perspective, based on a workshop held at the 2018 AMIA Annual Symposium, identifies current barriers and needed changes to facilitate broad adoption of a citizen science-based approach in healthcare.

The HFES Diversity Committee is entering its third year following many years existing as a task force. We have built a series of annual meeting content over the past years, with panels introducing the task force and then the committee; last year, we shifted focus to highlight examples of HFE research advancing diversity, inclusion and social justice. We continue to build off of previous years’ sessions – last year concluded with several questions seeking practical, concrete advice and suggestions to advance DISJ through HFE research and within the society. Therefore, this year we present an alternative format session that will function as a group of mini-workshops: two focused on research, one on broadening participation in HFE and one of inclusive excellence within HFE training and education. Session participants will develop “how to” knowledge and leave with a network of likeminded peers, colleagues and potential collaborators.

The 2019 Town Hall gathers stakeholders in the human factors and ergonomics (HFE) community who share an interest in applying HFE to study and improve patient work, an area called “patient ergonomics.” The objective of this town hall is to communally scope, prioritize, and develop applications of HFE for patient work. Whereas the 2018 Town Hall was primarily an initial community gathering, the 2019 Town Hall is envisioned as a space for further developing a community of practice in this area. The central activity of the 2019 Town Hall is a public commentary period, with live scribing, inviting attendees to address the (1) scope of patient ergonomics; (2) prioritization of future efforts; and (3) proposals to lead future development efforts.

Phenylketonuria (PKU) is a lifelong condition resulting from impaired metabolism of the amino acid phenylalanine (Phe). To avoid neurological damage, patients must adhere to a low-Phe diet that severely limits natural foods. Due to the complicated nature of the diet, this study aimed to identify the self-management tasks performed by adults with PKU and assess the need for a technological solution to aid diet maintenance. Participants were recruited via Facebook for semi-structured interviews conducted remotely with two investigators. Eligible individuals were adults 18 years or older diagnosed with PKU. The eight interviewees consisted of two males and six females between the ages of 23 to 40 years located in the US, UK, and Canada. Interviews were transcribed and coded for common themes under the categories of illness-related, articulation, everyday life, biographical, sentimental, and technology work. General interview themes demonstrated a desire for the development of PKU specific mobile health applications.

The growing field of patient ergonomics is built on an understanding that patients and their social network members increasingly play a key role in managing their health and healthcare across a wide range of settings including the home, workplace, and community. Over the last several years, we have traced, explored, and debated emerging research in this area, including the theories, methods, and strategies for implementation that are needed to support this new area of human factors and ergonomics. In this current panel, we begin a new dialogue in this space, one that is inspired not only by our previous discussions but also by recent conversations in our community about the need for human factors and ergonomics to consider issues of inclusivity, diversity, and social justice. To that end, each of our five panelists will present the patient ergonomics research they are conducting within a historically marginalized community or population and highlight lessons learned from their experiences. This presentation of work spanning considerations of gender, age, race, geographic setting, educational background, and disability will serve as a foundation for a wider discussion with the audience about how patient ergonomics as a field can prioritize and support this type of work.

Patients and families play a role in the safety of care provided across clinical settings, highlighting the need to understand clinician perspectives and experiences related to their engagement. Through a panel discussion entitled, The Patient in Patient Safety: Clinicians’ Experiences Engaging Patients as Partners in Safety, we elicited clinician perspectives that have implications for human factors relevance in both, research and solution development/evaluation. We provide an overview of the panel including participants, format and content, and the resulting discussion.

Health promotion is defined by the World Health Organization as “the process of enabling people to increase control over their health and its determinants, and thereby improve their health.” This is different from the bulk of formal healthcare processes, which are characterized by the treatment of an established disease. Much important human factors research and practice has been done to improve the healthcare delivery process and increasingly human factors professionals are also involved in work on health promotion. Such work has included examining the use and usability of wearable fitness tracking devices, studies of online health information seeking by healthy individuals, and human factors research on social robots for older adults, to name but a few examples. We discuss human factors applications in health promotion, focusing on examples from technology-related research.

Patient ergonomics is the application of human factors and ergonomics (HFE) or related disciplines to study or improve patients’ and other nonprofessionals’ performance of effortful work activities in pursuit of health goals. This chapter argues that as the science of patient ergonomics develops, it is imperative to account for the diverse settings in which patient work takes place and populations who engage in patient work. Given that human factors and ergonomics researchers and professionals are trained to account for individual variation and context, they are well positioned to tailor their efforts to the diverse places and people associated with patient ergonomics. In this chapter, we highlight results from a recent mapping review of patient ergonomics with particular attention to the settings and populations that remain relatively untapped opportunities for application of patient ergonomics. The chapter concludes with remarks on the purpose and contents of The Patient Factor, the first ever handbook on patient ergonomics.

Background Diet and nutrition management is an integral component of Crohn disease (CD) management. This type of management is highly variable and individualized and, thus, requires personalized approaches. Consumer health information technology (CHIT) designed to support CD management has typically supported this task as everyday life work and, not necessarily, as illness work. Moreover, CHIT has rarely supported the ways in which diet and nutrition management requires coordination between multiple forms of patient work. Objective The purpose of this study was to investigate diet and nutrition management as biform work, identify components of articulation work, and provide guidance on how to design CHIT to support this work. Methods We performed a qualitative study in which we recruited participants from CD-related Facebook pages and groups. Results Semistructured interviews with 21 individuals showed that diet and nutrition management strategies were highly individualized and variable. Four themes emerged from the data, emphasizing the interactions of diet and nutrition with physical, emotional, information, and technology-enabled management. Conclusions This study shows that the extent to which diet and nutrition management is biform work fluctuates over time and that articulation work can be continuous and unplanned. The design guidance specifies the need for patient-facing technologies to support interactions among diet and nutrition and other management activities such as medication intake, stress reduction, and information seeking, as well as to respond to the ways in which diet and nutrition management needs change over time.

BACKGROUND Diet and nutrition management is an integral component of Crohn disease (CD) management. This type of management is highly variable and individualized and, thus, requires personalized approaches. Consumer health information technology (CHIT) designed to support CD management has typically supported this task as everyday life work and, not necessarily, as illness work. Moreover, CHIT has rarely supported the ways in which diet and nutrition management requires coordination between multiple forms of patient work. OBJECTIVE The purpose of this study was to investigate diet and nutrition management as biform work, identify components of articulation work, and provide guidance on how to design CHIT to support this work. METHODS We performed a qualitative study in which we recruited participants from CD-related Facebook pages and groups. RESULTS Semistructured interviews with 21 individuals showed that diet and nutrition management strategies were highly individualized and variable. Four themes emerged from the data, emphasizing the interactions of diet and nutrition with physical, emotional, information, and technology-enabled management. CONCLUSIONS This study shows that the extent to which diet and nutrition management is biform work fluctuates over time and that articulation work can be continuous and unplanned. The design guidance specifies the need for patient-facing technologies to support interactions among diet and nutrition and other management activities such as medication intake, stress reduction, and information seeking, as well as to respond to the ways in which diet and nutrition management needs change over time.

Healthcare systems are complex and dynamic in nature and are driven by many interactions between system factors and processes to shape outcomes. Much of the complexity can be attributed to the interactions between system elements that influence healthcare delivery. In this chapter, we describe several conceptual frameworks that have been developed specifically to study and analyze interactions in healthcare systems. Many of the frameworks are supplemented with examples to illustrate successful use cases. Additionally, we provide various analytical and design tools that may be employed independently or collectively to identify barriers and facilitators to achieving desired outcomes with healthcare processes in complex systems.

Patient ergonomics is, simply put, the science (and design) of patient work. Patient work is the effortful, goal-driven, and consequential health-related activity performed by patients, families, and others independently or in concert with healthcare professionals. Patient work is hard work, occurs in context, unfolds as a journey, is a team effort, is distributed, goes beyond disease, can be invisible, and is not experienced invariably. Patient work, whether occurring in hospitals, homes, communities, or other settings, can benefit from the application of cognitive, physical, and organizational human factors theories and methods.