Welcome to embedded, an online publication packed with timely content about all things human-centered design!

Published bi-monthly, embedded will now be delivered directly to your inbox. Each issue will encompass articles, videos, and interactive content concentrating on a central theme. You’ll learn about theme-related Human-Centered Design (HCD) methodologies, case studies, best practices, insider tips, and even applicable personal experiences presented by your colleagues in CCSQ.

The theme of this inaugural issue is “EMPATHY.” Inside you’ll find:

In addition to valuable theme-related content, you’ll discover upcoming HCD training and coaching opportunities; industry events; bios of fellow HCD practitioners; how-to videos; and access to practical HCD tools and resources.

Start flipping through the pages of embedded right now. Enjoy!

User research provides a critical design strategy foundation that allows you to understand and empathize with customers to design valuable products and services. Something this important does not come easy. At times, conducting user research can feel as though it is full of barriers, but it can be easier to manage with some upfront organization.

Join us for a case study of how the recently centralized Quality Payment Program’s (QPP) human-centered design team learned to be effective by scaling and streamlining the research processes. Highlights will include lessons learned when setting up a user research panel in Salesforce, creating a research repository in EnjoyHQ, and measuring the experience with a modified version of Forester’s Customer Experience Index.

Experience Research Lead Eva Floyd and Researcher and Designer Kiel McLaughlin from Agile Six, and HCD Researcher Christina Brandon from Huge will share their excitement, challenges, and frustrations to get it all set up for quality insights.

The session will include:

  • Strategies to create a steady stream of research panel participants.
  • The legal and ethical considerations that affect our governance process, from consent forms to handling personally identifiable information (PII).
  • Tips for connecting the dots between multiple research studies using a user research repository.
  • How the Customer Experience Index can help make a more holistic choice.

Register now.

Service design for Hospital Quality Reporting_Service blueprint and journey maps

Join us on Friday, June 25, for a case study about understanding Hospital Quality Reporting (HQR) as a multifaceted service.

Service design requires understanding the customer experience and how an organization’s resources (people, processes, and systems) affect the customer journey. Two critical service design tools are journey maps, which visualize a customer’s experience of a product or service from their vantage point, and service blueprints, which allow you to understand and imagine all the intricate components that make up the service.

In this joint presentation, three HQR Human-Centered Design User Research team members will share the service blueprint and user journey maps they created to understand how healthcare providers and quality improvement stakeholders experience CMS’s HQR system.

Human-Centered Design Lead Lesley Humphreys with Bellese Technologies and UX Researchers Fan Huang and Tyreek Houston from Ad Hoc will describe what they learned, what they are still curious about, and how this work can influence product process, goals, and decision-making.

The presentation will include:

    - Why service design methods are essential.

    - Their service design process.

    - How service design can integrate with SAFe processes and a product mindset.

Register now.

Leveraging Human-Centered Techniques in Root Cause Analysis

Many organizations—including government, business, and healthcare—use root cause analysis to identify the fundamental reasons for an incident or failure so that they can improve future outcomes. Within product management and development, root cause analysis can lead to the source of an issue, allowing teams to enact corrective measures.

Root cause analysis often stops short at what and who instead of the systemic why, which can lead to a culture of blame without lasting improvement. 

What if tools from human-centered design, engineering, and psychology can lead to an improved understanding of why incidents occur and identify optimal solutions?

On Friday, May 28, join the CCSQ HCD Community of Practice for a high-level review of leveraging human-centered approaches for structured root cause analysis efforts.

Our guest presenters from ManTech’s Health Division — Edward O’Connor, Director, Architecture and Janie Gittleman, Ph.D., Executive Director, Global Health Innovation — will share real-life stories, review outcomes from the analysis process, and discuss how human-centered techniques can lead to better results. The presentation will cover different root cause analysis techniques and additional concepts from cognitive science, epidemiology, and machine learning.

Register now.

Behind the Glass: Introduction to Interview Techniques for Non-Researchers

"Where were you on May 1 at 10 PM?" is not the way to begin a user interview when looking to innovate products, services, or policies. While it may work in a dark, smoke-filled room with one swinging bulb, there are more effective means to get the information you need to understand your customers and their challenges.

Interviewing is a foundational HCD research method that people often assume they already possess. Everyone can ask questions, right? Isn't this just talking to people? If you want to move from gathering data to uncovering compelling insights, interviewing is more than a conversation or verbal exchange.

Join the CCSQ Human-Centered Design Community of Practice on Friday, April 30 at 1 PM ET. Senior Design Strategist Malaika Simmons from Tantus Technologies will share Behind the Glass: Introduction to Interview Techniques for Non-Researchers. Malaika will: 

  • Uncover the impact of interviewing,
  • Provide best practices for formulating questions, 
  • Introduce other ethnographic methods, and
  • Facilitate breakout sessions so you can experiment with ethnographic techniques.

Register today to join the discussion and to collaborate with a community of professionals. Attend via Zoom.

What Three Heuristic Evaluations Taught Us About Iteration CCSQ HCD Community of Practice on March 26 at 1 PM ET.

What Three Heuristic Evaluations Taught Us About Iteration

Learn how a design team at CMS uses heuristic evaluations to improve the user experience during the CCSQ HCD Community of Practice on Friday, March 26  at 1 PM ET.

Register now

A heuristic evaluation involves examining a digital product's interface to determine its compliance with established usability principles. A group teaming with the Office of Information Technology will discuss three heuristic evaluations and iterations to make improvements. 

The program will include:

  • Examples of heuristics.
  • How a cross-functional team can contribute to success.
  • How to approach evaluations from novice and expert skill backgrounds.
  • Lessons learned on conducting remote collaborative heuristic evaluations, including forming, scoring, and reporting results.
  • How to leverage and modify Excel spreadsheets and TestRail suite formatting to fit various needs.

The panel will include:

  • Ann Aly, UX Researcher, Agile 6
  • Amanda Beall, UX Designer, Fearless
  • Mike Brown, Scrum Master, Agile 6
  • Marisa Grotte, UX Designer and Researcher, Fearless
  • Daedriana Harvey, UX Designer, Fearless
  • Antoine Wright, UX Lead, Fearless

Join the discussion and collaborate with a community of professionals. Attend via Zoom.

Register today on Eventbrite with this link:

The Content Audit: Agony and Ecstasy

Join CCSQ HCD Community of Practice on Friday, February 26 at 1 PM ET.

Content strategy—the planning, creation, delivery, and governance of content—often entails generating new content but understanding the strengths and weaknesses of existing content is just as important. Performing a content audit is an excellent place to start.

A content audit can be time-consuming and often detailed and tedious work. But the thrill of evaluating and identifying opportunities to help improve your organization's content and ultimately customer experience makes it undoubtedly worth it.

Join the CCSQ Human-Centered Design Community of Practice on Friday, February 26 at 1 PM ET, as we welcome guest speaker Senior Content Strategist Julie Stromberg from Fearless, currently teaming with the Center for Medicaid and CHIP Services. Julie will share:

  • Why content audits matter.
  • Case studies.
  • How to get started.
  • Analysis and connecting content to organizational goals.

Register here:

Join us for the CCSQ HCD Community of Practice on January 29, 2020.

Incorporating Web Analytics into Your Design Practice

Join us for the CCSQ Human-Centered Design Community of Practice on Friday, January 29, at 1 PM ET.

Web analytics is the collection, reporting, and analysis of website data ( This data can be used to measure the progress of organizational goals, and in turn, drive strategy and improve user experience. And yet, accurate, actionable, and data-rich web analytics can often seem out of reach or overwhelming with possibilities.

Join us for a discussion with guest speaker Tim Lowden, Manager of the Digital Analytics Program (DAP) at the U.S. General Services Administration (GSA), on user-centered design and web analytics. This session will focus on how web analytics metrics, dimensions, reports, and configurations can assist you with user-centered design.

Tim will also detail the DAP structure and benefits, which offers aggregated web analytics across 6,000 federal government sites. See and for more information.

Register today to join the discussion and collaborate with a community of professionals. Attend via Zoom.

Eventbrite for registration:

HCD & COVID-19: A Panel Discussion

Join the CCSQ Human-Centered Design Community of Practice on Friday, December 18, at 1 PM ET for a panel discussion about HCD & COVID-19.

In one way or another, every individual and organization has been affected by the COVID-19 pandemic. Developing products and implementing human-centered design (HCD) research and other best practices has been uniquely challenging in the government sector. Likely more so for CMS when the healthcare delivery system is stretching to new limits and priorities shift to focus on the urgent matter at hand.

The work must continue despite a changing research environment, and we must navigate accordingly. The pandemic has only increased the need for HCD as we observe behavioral and psychological shifts within user groups and communities facing new challenges of their own.

The CCSQ HCD Community of Practice is assembling a panel moderated by Strategic Planning Lead and Enterprise Agile Coach Ali Tobolsky with Tantus Technologies and the LACE to discuss questions like:

  • What is the new normal and what does it mean?
  • How might we be more resilient and leverage the latest constraints to our advantage?
  • What have teams tried to do in response to these challenging times? What worked? What has not yet worked?
  • What shifts are we seeing with user groups or communities?

The panel will include:

  • Kisha Coa, Social Science Research Analyst, CMS Office of Communications, Strategic Marketing Group, Division of Research.
  • Erik Connors, Research Lead, Huge and primary researcher for the Quality Improvement and Evaluation System (iQIES).
  • Ian Lowrie, Lead User Experience Designer with Ad Hoc and currently teaming with Hospital Quality Reporting (HQR).
  • Sarah Tully, Product Manager, CMS Office of Enterprise Data and Analytics (OEDA), Data and Analytics Strategy Group (DASG).

Register today to join the discussion and collaborate with a community of professionals. Attend via Zoom.

CCSQ World Usability Day
Explore The Event Site & Register Now!

CCSQ will celebrate its 2nd Annual World Usability Day on November 12, 2020. With an exciting line-up of speakers and engaging topics, this is a virtual conference you will not want to miss!   

World Usability Day is a global celebration to focus on the importance of design. This year’s theme, Human-Centered Artificial Intelligence (AI), sounds futuristic—but in reality, it is all around us. During our virtual open-house event, we will explore the unique design challenges of AI.    

Highlights will include morning and afternoon plenary sessions:  

Visit the event site to register, review the schedule, and learn about our speakers

Join us for the HCQIS Human-Centered Design Community of Practice on October 30th!

HCD Community of Practice on Friday, October 30, 2020_Researchers Don't Let Friends Use Unreliable Task Ratings

Usability studies often include tasks for participants to complete, which are then ranked for perceived difficulty. However, these rankings are often subjective and non-standardized across studies conducted within the same team.

To learn how we might improve task ratings' reliability, we will welcome a special guest speaker Ann M. Aly, a social scientist and UX researcher. Ann will share a 5-level rubric her team created to assess task difficulty for task factors contributing to (non)completion. Interrater reliability testing used Cohen's Kappa (which measures the agreement between raters) to ensure rigor and consistency in rankings.

The presentation will include best practices and practical tips, like:

  • How to make task assessments less subjective
  • How to keep ratings rigorous, eligible for quantitative assessments, and increase research maturity among team members
  • The benefits of a standardized rubric across studies and the importance of developing a shared language into a cross-functional team
  • Using detailed task ratings to justify which domains or features require the most resources before release, like a mini heuristic evaluation
  • A how-to guide for conducting a quantitative assessment and sample rubric

Ann M. Aly is a social scientist and mixed methods UX researcher at Agile 6 Applications. She is currently teamed with Fearless Solutions to support Human-Centered Design at CMS' Office of Information Technology. Ann firmly believes in keeping the social in social science by centering the perspectives of those whose research her work serves and by making her insights accessible to non-specialists. Before joining Agile 6, Ann conducted research and consulted on higher education, bilingual communities, skill acquisition, and culturally relevant healthcare applications. Ann enjoys caffeinated beverages, remote beaches, and entry-level woodworking when not lost in a spreadsheet or transcript.

Register today to join the discussion and to collaborate with a community of professionals. Attend via Zoom.

Join us for the HCQIS Human-Centered Design Community of Practice on September 25!

Many people are confused or uncertain about the term design. With so many different design types—graphic, user experience, interaction, user interface, animation, industrial, architecture, and the list goes on—it is no wonder that misunderstandings persist. To further complicate matters, good design is often a combination of different types of design.

Join the Human-Centered Design Community of Practice on Friday, September 25, to explore the challenges of Working at the Intersection of Graphic Design and Human-Centered Design. Sr. Design Strategist Brian Flaherty will delve into:

  • Graphic design and its place with human-centered design
  • Design as a craft and way of thinking
  • The future of design

The program will include a presentation, small group activities, and a group Q&A.

Register now to join the discussion and to collaborate with a community of professionals. Attend via Zoom.

July’s Human-Centered Design (HCD) Community of Practice (CoP) on accessibility and user experience began with a quote attributed to Judy Hueman, a lifelong advocate for the rights of disabled people, who said, “for people without disabilities, technology makes things convenient, whereas for people with disabilities, it makes things possible.” A very powerful statement that aligns with Tim Berners-Lee’s, W3C Director and the inventor of the World Wide Web, view that an essential aspect of the Web is its accessibility by everyone regardless of disability.

Web accessibility improves people’s lives by enhancing social inclusion for people with disabilities, as well as others such as older people, people residing in rural areas, and people in developing countries. Businesses also benefit by offering best practices for mobile devices, device independence, multi-modal interaction, usability, design for older users, and search engine optimization (SEO).

Today, we hear reference to the ADA and Section 508, but what exactly are they referring to and what do they do?

The Americans with Disabilities Act or ADA, which was enacted in 1990, and subsequently amended in 2010, prohibits discrimination against individuals with disabilities in all areas of public life, including jobs, schools, transportation, and all public and private places that are open to the general public. 

Because of the ADA, employers are required to make reasonable accommodations for employees with disabilities in the workplace; businesses are required to make reasonable modifications to ways in which they serve people with disabilities, and telephone and Internet companies are required to provide interstate and intrastate telecommunications relay services that allows individuals with hearing or speech disabilities to communicate over the telephone. 

Section 508 refers to the Rehabilitation Act of 1973. This Act prohibits discrimination based on disability in programs conducted by Federal agencies, in programs receiving Federal financial assistance, in Federal employment, and in the employment practices of Federal contractors. In 1998, Section 508 of the Act was amended to require Federal agencies to make their electronic and information technology accessible to people with disabilities. Although Section 508 only pertains to Federal agencies, the W3C established the Web Accessibility Initiative (WAI) to develop standards and support materials to help web designers understand and implement accessibility. Brinda Large, CMS Program Analyst/Contracting Office Representative/Section 508 Clearance Officer, provided additional insight regarding 508 compliance as it relates to the Centers for Medicare and Medicaid Services.

After discussing the fundamentals of accessibility and user experience (UX), iQIES team members Htet Htet Aung, a UX designer, and Sandra Clark, a front-end developer, explained how designers work to make a website accessible. Although designers may check the boxes to comply with the required standards, it does not mean that the website is accessible. Different types of disabilities need different types of design and code.

The four principles or measures of accessibility are perceivable, operable, understandable, and robust. Automated testing or special tools can address objective issues, such as if inputs have associated labels, if images have alt text defined, if the color contrast is enough for the font-size, and if the code is well-formed. Understanding a user’s needs requires a subjective approach, which is accomplished through the development of user personas. A persona helps designers understand a user’s needs, experiences, behaviors, and goals. The key to creating a viable persona is that it is based on real data collected from multiple individuals.

This discussion made me think of a 60 Minutes segment from 2019, which was re-aired in July, about Chris Downey, an architect from San Francisco who lost his sight following surgery to remove a brain tumor. A decade after his surgery, he had developed a new specialty, making spaces accessible to the blind. Chris Downey was able to bring his needs, experiences, behaviors, and goals to design buildings that aid a blind person in navigating a physical site. He mentioned that he was able to “hear” buildings with his heightened sense of sound. This ability allowed him to design office interiors that were visually appealing to sighted workers and audibly appealing to blind or visually impaired workers. He certainly used real data to create accessible design.

Examples were provided of the different types of disabilities that designers must consider when developing a site. Designers are familiar with addressing the needs of blind or deaf users but may not immediately consider the needs of someone with attention deficit disorder, anxiety, dyslexia, or seizure disorder. An accessible website or system brings equity through design that achieves a fair outcome for all users. The goal is to develop a system or application that is flexible enough to accommodate the broadest range of users, regardless of their age or disability.

Similarly to what was stated during last month’s HCD CoP regarding content strategy, accessibility and Section 508 compliance should be considered at the beginning of a project and not as an afterthought. For the designer, it should not be viewed as a burden or detractor to creativity. Instead, accessibility requires the designer to think outside the box and innovate new ideas. For the business or site owner, it provides a cost benefit in not having to rework the site to meet 508 compliance.

As more designers and developers receive positive results from employing accessibility guidelines, these practices will become standard. As Clark states, “accessible design is universal design.” Whether a convenience for some or a necessity for others, accessibility benefits everyone.

Please refer to the HCD CoP Confluence page to review the presentation or video from this program or materials from past programs. In addition, the PM3 Communications Team offers a HCQIS Writer’s Toolkit on its HCQIS Communications Confluence page that includes guidelines, templates, and checklists to ensure 508 compliance.

Written by Susan Pagan. Originally published in PM3 Connect, September 2020.

Join us for the HCQIS Human-Centered Design Community of Practice Event on August 28th!


Tree testing is a research method that allows you to understand how people navigate and discover information with a website or app. It sounds simple, but you can learn a lot by presenting a text-only version of the hierarchy of a website and asking people where they expect to find a piece of content.  

Tree testing includes plugging in existing information architecture to make iterative improvements to a live experience, and even answering critical questions before creating a prototype:  

  • Do the naming conventions make sense?  
  • Is content grouped logically?  
  • Can people quickly find what they need? If not, what is blocking them?  
  • What are the most common paths taken to complete critical tasks?  

Join the HCD Community of Practice on Friday, August 28, at 1 PM with Senior UX Researcher Mike Eng from HQR, who will share a recent tree testing study and findings.   

Following a presentation, HQR team members Lead User Researcher Ian Lowrie and Content Strategist Stephanie Warren will join Mike on a panel. Senior Design Strategist Chelsea Hunt, from the HCD Center of Excellence, will participate as the moderator to discuss:  

  • How the study informed future information architecture and reporting infrastructure decisions
  • The broader navigation approach for HQR 
  • Background on how they completed the test, including communication and recruitment conversion 

Register now to join the conversation and collaborate with a community of professionals.

Let the Brainstorming Begin!

My first thoughts of brainstorming conjure an image of folks sitting around a restaurant table with pen in hand scribbling ideas on a cocktail napkin. The point being ideas are best conceived in a relaxed environment where all parties and suggestions are weighted equally. As more organizations establish space to spark creativity and problem solve, I was eager to attend Brainstorming Better hosted by the Human-Centered Design (HCD) Community of Practice to learn how this method could be conveyed to a business environment without stifling spontaneity.  

The guest speaker was Natalie W. Nixon, a creativity strategist and president of Figure 8 Thinking. Natalie’s background is impressive, leading companies such as Comcast, Bloomberg, Vanguard, and Living Cities in applying creativity and foresight for transformative business results.  With a background in anthropology and fashion, she brings an interesting perspective toward helping a team or organization to see, interpret, and innovate differently. 

My registration confirmation email asked that all participants bring three blank sheets of paper and a Sharpie, pen, or pencil for use in a virtual brainstorming exercise. Being an introvert, the mention of interacting with the group was a trigger for me to proceed with caution. But my concerns were unfounded, as Natalie put me at ease from the start. She is a dynamic speaker, and her enthusiasm of the topic and incorporation of exercises worked to reinforce what she presented, and it was fun! To paraphrase Natalie, “play is actually very important; when we are having fun, lesson’s stick.”  

Not only was the hour-long event fun, it was also informative. Brainstorming is a form of play that provides a method of discovery. As with all play, there are rules that provide a framework to get you started. It starts with a problem to define or a need to find, but then what? How do you proceed? Natalie offered several rules to brainstorming—the first to use time as a constraint for creativity, and then provided hands-on exercises to demonstrate how to quietstorm, questionstorm, and use the SCAMPER method.  

Our first exercise focused on quietstorming. With a 90-second time limit, we were asked to list 20 uses of a paperclip—any size, any number. Natalie emphasized the value of quantity over quality, by suggesting we think as our 8-year-old self, not as our current adult self as we create our list. We weren’t to judge the feasibility of the use, but simply to suggest it. My list included a slingshot, a shovel, a hair barrette, a bookmark, a game piece, a spoon. It was interesting to hear the similarities as well as differences of ideas. The lists provided a variety of uses from which to choose, which is the main point—quantity over quality with no judgment. Quietstorming has three components: thinking quietly to yourself, pairing off with the person next to you if in a workshop or group scenario, and then sharing with the larger group, or in simpler terms: think, pair, share.  

Our second exercise focused on questionstorming. Over the years, I have heard there is no such thing as a stupid question, but I liked Natalie’s take on the phrase based on what she learned from Warren Berger, “asking questions is a way of thinking.” It puts a more positive spin on the desire to learn or be more curious. Through his research to understand why innovative companies were successful, Berger developed three questions as a method toward defining a problem or finding a need. These questions ask why, what if, and how. To show us the process, Natalie walked us through these questions using a pen. Starting with why—why is the pen plastic; why does the pen have a cap; why is the pen round. Moving on to what if—what if it was made of wood; what if it was a different shape; what if it had multiple colors. And finally, converging these questions into how— how might we make it multiple colors; how might we change the shape; how might we make it out of wood.  

To make the exercise CMS-centric, we were given 30 seconds for each question as it relates to customer experience at CMS. I thought this was a more difficult task but was able to write several questions for each. It was interesting when several participants shared their questions, to learn how similar they were.  

The final exercise was the addition of another constraint defined by the acronym SCAMPER, which represents seven different actions to generate new ideas through the ebb and flow of divergence and convergence. The seven actions are Substitute, Combine, Adapt, Modify, Put to other use, Eliminate, and Reverse. Using one of our “how” questions from the previous exercise, we were first given an action word (mine was eliminate), and then we were divided into smaller groups. Within the group, we presented our “how” question and then indicated how we would apply the action word. I went from “How can we interact more directly with customers?” to “Create interactive chat on the web to eliminate the delay in response.”  

This hour provided great insight on techniques for better brainstorming, whether with a group or individually. I learned that it is not the physical space that sparks creativity and problem solving, but the rules that provide a framework allowing you to play and discover new ideas. If you were unable to attend the event, a recording is available on the HCD CoP Confluence page. 

Article by Susan Pagan . Originally published in PM3 Connect on July 7, 2020.