The Harmony 680 can be operated with only one hand, ergonomically designed to fit comfortably. Setup is accomplished by connecting the remote to your computer with the included USB cable and selecting your home theater components from the Logitech database. Windows Media Center compatibility comes pre-configured with all the necessary buttons being available. If the online setup can't detect all of your components, or fails in some way, then there's the backup mechanism of manual programming.
The one touch programming is accomplished through using Logitech's Smart State technology that lets the remote remember which devices are in the on and off state, and can toggle them accordingly.