This document provides guidance on building high quality health IT systems through a user-centered design methodology. It recommends conducting user research to develop applications together with users, frequently visiting users and consulting with different types of people. It emphasizes the importance of user motivation and using techniques like cameras, research methods, visual storytelling and prototypes. Systems should be continuously measured and improved based on stories from the frontlines. The overall message is to design health applications with and for users through an iterative process of evaluation and enhancement.