Using a Critical FMEA Approach to Identify Equity-Related Failures in Usability Evaluations of Health Technologies

Design issues that affect the usability of health technologies for marginalized populations may lead to further exacerbating health inequity. To address this concern, we propose the use of failure modes and effects analysis (FMEA) to systematically identify potential inequities that result from usability evaluation methods. This new application of FMEA grounds the traditional FMEA in critical theory and introduces two key concepts: the equity failure mode and reflexivity. To test our approach, we engaged 13 usability practitioners with expertise in healthcare in a series of four workshops. We found that when participants located themselves reflexively in their practice of usability evaluation, they were able to identify more nuanced equity failure modes. Through reflecting on our experience using this method, we aim to illustrate that the critical FMEA is a viable approach human factors practitioners and researchers can use to anticipate equity failure modes in design and evaluation methods.