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A helping hand

Massachusetts puts families at the heart of mental health.

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Case study
Case Studies
Strategic Futures
Breakthrough Products
Health
Technology

The urgency of attending to our children’s mental health cannot be overstated.

Concern about their well-being was already on the rise in the decade prior to the pandemic. Alongside social inequity, the COVID era has seen soaring rates of depression, anxiety, trauma, loneliness, and suicidal thoughts. Knowing that mental health is influenced by numerous systemic factors, we met with families of all income levels and heard from practitioners throughout Massachusetts. In some communities, mental health is candidly discussed, in others it remains a taboo subject. Through these conversations, we learned that mental health requires both individuals and their families to be educated, supported, and empowered.

HandholdMA.org helps families find services that work for them and gives them easy access to information on a range of mental health topics. It allows parents to learn from and support one another as they navigate the landscape of mental health together. We took special care to make resources feel approachable for those in communities of color, and curated new resources for everyone from preschoolers to teens—because mental health challenges do not discriminate.

In 2020, a coalition of the nation’s leading experts in pediatric health issued an urgent warning that the mental health crisis among children had become a national emergency.

The percentage of emergency department visits for mental health crises rose by 24% for children between the ages of 5 and 11, and 31% for those 12 to 17, compared with 2019.

87,000

site visits to to HandholdMA.org since launch

223,000

people reached in bilingual social media campaign
The world and its woes are putting incredible pressure on families, including our kids. Children’s mental health is being tested in ways we could never have expected. While many parents and caregivers are worried, they aren’t sure where to turn for information or help. IDEO partnered with the Massachusetts Department of Mental Health, the Office of the Child Advocate, and the Executive Office of Health and Human Services to create HandholdMA.org, a family-friendly digital resource designed for parents of school-age children. Parenting when all is well is hard enough. When it’s not, everyone can use a helping hand.
Raising awareness and curating resources so parents feel better enabled to help their kids.
Raising awareness and creating resources to enable parents to help their kids.
Massachusetts Department of Mental Health
North America
Massachusetts Department of Mental Health

Evolving to meet young consumers

Accelerating vivo’s transformation journey to connect with China’s young consumer.

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Case study
Case Studies
Strategic Futures
Technology

To help shift vivo’s thinking from a focus on products to a focus on brand-building, IDEO set out to help the company understand how young consumers experience fun—a core tenet of the vivo brand. The new concept store needed to convey joy and fun in a meaningful and memorable way. The project was about more than just designing the space; it was also about piloting into vivo’s future brand systems.

To kick off the project, the IDEO team conducted user research in four different cities in China, then shared the stories of young Chinese consumers with the vivo team. Their interviews revealed that young people value experiences that enrich their lives and create a feeling of positive personal transformation. They seek opportunities to discover new experiences, express themselves in different ways, expand and deepen their social connections, and build knowledge and skills. By leaning on this definition of “enjoyment,” IDEO helped vivo identify the value proposition of the concept store, helping consumers express themselves in new and different ways. The store would allow every visitor to see something unique and find a fresh perspective.

The vivo team took that value proposition into a design brief and later built out the space and interactive experiences. The second floor of the store is dedicated entirely to interactive experiences using photo booths, sound recording, and lighting technology, designed to provide consumers with the kind of enjoyment they seek. vivo launched the concept store in Shenzhen on March 22, 2019, marking an important milestone in vivo’s transformation from a smartphone maker to a consumer brand.

China consumes roughly 30% of the world’s smartphones—which presents a tremendous market opportunity for brands looking to capture young consumers’ loyalty.

Top 1

in China's smartphone market, topping both shipments (sale-in) and retail sales (sale-out), in the first half of 2024

260M active users

within two years of vivo Lab's official opening, with 70% of them young users
As one of the world’s leading smartphone manufacturers, the Chinese brand vivo is widely known for its exceptional technological innovation, and a reputation as a leader in photography and gaming hardware. But in an increasingly-saturated phone market, vivo understood that it wasn’t enough to lead the pack by relying solely on technological excellence. To win the hearts of young Chinese consumers, the company needed to become a beloved consumer technology brand. To get there, vivo wanted to design a complete brand experience beyond the devices themselves—one that would express its joyful spirit through services and retail. vivo came to IDEO for help creating a concept store and new experience that expresses the vivo brand, and resonates with China’s young people.
vivo and IDEO accelerate its journey from a smartphone manufacturer to a beloved tech brand.
vivo's transforms from a smartphone manufacturer to a beloved tech brand
vivo
China
vivo

Transformation through creative leadership

Tsinghua University launches China’s first leadership course focused on design thinking.

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Case study
Case Studies
Creative Capabilities
Learning & Work

The program Tsinghua and IDEO created together consisted of six modules focused on creative leadership: Rediscover Design, Build Design as a Core Competency, Creating the Conditions for Creativity, The Financial Levers for Innovation, Designing for the Fourth Industrial Revolution, and Leading for Tomorrow. 73 Chinese and foreign experts helped teach the modules, including former Forbidden City Palace Museum director Shan Jixiang, the father of Japanese industrial design, Masayuki Kurokawa, and Jake Knapp, author of the book Sprint.

The program’s first cohort included more than 30 entrepreneurs from 20 different industries across nine cities. Participants completed the courses throughout the year, taking full advantage of holistic, interactive teaching and the opportunity to share their own practical experiences. Their feedback consistently demonstrated how the course had given them fresh approaches to problems their companies faced, whether improving internal communication or helping them see the clients they serve from a new perspective.

Liu Feng, the founder of a fast growing tourism development company, was particularly inspired by the Creating the Conditions for Creativity module’s six pillars of corporate transformation concept. Using these pillars, he not only refined the mission and value of his company, but also launched a series of measures to improve all aspects of its operations, from customer service to annual company gatherings. With a newly empowered team, he significantly increased the agility of the organization.

Ting Zhihong, the chairwoman of China’s leading logistics technology company, managed to double its profit during the course. She said her biggest takeaway from the course was how important it is to empower the team. Her company has now set up several platforms that give employees more room to experiment, create, and take part in frontline decision-making, bringing them closer to the company’s management.

Hu Chao, founder and CEO of China’s largest e-commerce platform for childcare goods, found that while other executive courses simply teach knowledge, Lead a Creative China taught him the importance of placing people at the center of what his company is doing.

The first cohort of the program graduated in December 2018. On April 8th, 2019, the Lead a Creative China program received an honorable mention in the education category as part of Fast Company’s 2019 World Changing Ideas Awards, becoming the only award-winning Chinese project in the category.

After 40 years of rapid change, China has reached a pivotal point in its growth trajectory. Across the globe, traditional drivers of economic growth have slowed down, creating opportunity define the new economy.

The Chinese government has laid out a wide range of ambitious policy plans to ensure that China successfully manages this transition, and that the country continues to grow and lead.

Honorable Mention

education category, Fast Company’s 2019 World Changing Ideas Awards
After 40 years of rapid change, China has reached a pivotal point in its growth trajectory, leaving space for innovation and exciting new approaches to define the new economy. This opportunity will require a new generation of business leaders equipped with the collaborative, creative mindset necessary to spearhead path-breaking change. Tsinghua University, one of China’s top higher education institutions, has always prioritized the cultivation of innovative Chinese talent. As the school looked to support a new generation of creative leadership, it approached IDEO for help understanding how to use the principles of design and creativity to tackle some of the world’s most complex challenges. In 2018, Tsinghua and IDEO created the Lead a Creative China program, a year-long leadership course aimed at nurturing Chinese C-level executives in the fresh approaches that will lead to solutions for systemic change in China.
Tsinghua University and IDEO create a course focused on design thinking to support the next generation of Chinese leaders.
Tsinghua University creates a leadership course focused on design thinking.
Tsinghua
China
Tsinghua

Human-centered hospitality via a tech-forward app

Huazhu Hotels Group translates its renowned hospitality brand into a seamless digital ecosystem for guests.

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Case study
Case Studies
Breakthrough Products
Hospitality
Technology
AI & Emerging Tech

China’s digital landscape is dominated by highly integrated mobile apps like WeChat and Alipay that seamlessly combine messaging, shopping, bill payment, and finance management. This shift toward digital-first interactions that are hyper-convenient, personalized, and intuitive has significantly shaped consumer expectations for experiences like finding, booking, and staying in a hotel. To stay competitive and meet—or exceed—young guests’ expectations, Huazhu needed to redesign its Membership App 3.0 to prioritize guest needs across all touchpoints of the hotel journey.

Through in-depth research and member feedback, IDEO discovered the true pain point the Huazhu membership app needed to address: seamlessly integrating the hotel brand’s online and offline experiences. The Huazhu Membership App 3.0 adopted “simple, stable, and real” design principles, simplifying user operations, optimizing the interface, fixing lingering experience issues, maximizing page load speed, and reducing crash rates.

The IDEO team discovered users have different functional needs. Sometimes, users want to search for hotel information quickly. Other times, they prefer to explore and browse content slowly. To meet both needs, the app needed to be optimized for efficiency and exploration. So, the IDEO team upgraded the interface of the Huazhu Membership App, adding quick operation modules and information blocks on the main page, as well as a downward scrolling interface that gradually slows the experience, offering channels for detailed exploration.

Customers also had different needs at different points in their travel journey: before, during, and after their stays. IDEO designed the language and user interface to provide personalized service information for each stage, from booking to post-stay. The app’s content adapts to the user’s travel phase, showing the most relevant service experiences at each point. The content displayed on the app also changes based on user habits, helping the app flex to meet their needs. The design aligns with the Huazhu Hotels Group’s mission to provide personalized service to a diverse clientele.

The team also worked to inject Huazhu’s brand characteristics by offering an upgraded experience in booking, stay, dining, and member benefits and adding features like a 30-second, automatic check-in experience. These thoughtful, personalized updates integrate Huazhu Hotels Group’s meticulous service philosophy, providing customers with a welcoming, human-centered hospitality experience. The updated Huazhu Membership App 3.0 is now available in major app stores, shaping a new generation of user experiences for Huazhu Hotels Group.  

Young travelers in China expect the first touchpoint with a hotel brand to be digital.

5% increase

in monthly active users after the launch of the App's 2.0 version in 2021
Huazhu Hotels Group is one of China’s largest and most influential hotel groups, leading the industry in revenue. The chain has 4,000 hotels in more than 400 cities nationwide and a portfolio of more than 10,000 hotels across 18 countries globally. But it still faces intense competition in China, where savvy digital-first consumers—and millennials in particular—expect hotels to provide seamless, comprehensive, and intuitive “super app” experiences that bring together loyalty programs, mobile check-in, digital room keys, concierge services, and personalized offers in one convenient place—at their fingertips. Recognizing the need to fully upgrade and revamp its app to bridge the digital/physical hotel experience and better serve young travelers’ needs, Huazhu Hotels Group partnered with IDEO to redesign its digital ecosystem. Leveraging human-centered design practices and user insights, the Huazhu Membership App 3.0 is a more personalized, welcoming, intuitive, and engaging extension of the acclaimed hospitality brand.
Huazhu Hotels Group creates a seamless, user-centered hospitality “super app” to meet savvy young travelers’ needs.
Huazhu Hotels Group builds a human-centered digital ecosystem that syncs with guest needs.
Huazhu Hotels Group
China
Huazhu Hotels Group

Shattering the echo chamber

How human-centered thinking unlocks growth in mature categories.

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Article
Articles

For leading fast-moving consumer goods (FMCG) companies, one way to escape the echo chamber is to adopt a human-centered approach—to actively listen to consumers and reconnect with the realities of their lives. It’s about more than bringing them in at a certain stage of the project. Their needs have to be considered from the very beginning. 

What follows is a story from IDEO Shanghai about what happens when a prominent consumer company returns to its customer-centric roots and discovers new growth in one of its most established categories.

What happens after a company hits the category ceiling?

China’s FMCG sector is known for its intensity. Even the most established companies cannot afford to relax; the competition is genuinely fierce.

In China’s major metropolitan cities and regional hubs, competitors launch new products at a rapid pace, all in pursuit of increasingly diverse consumer needs. Beyond these cities, smaller and lesser-known brands are making moves, constantly experimenting, and fighting hard for consumer attention through social media platforms.

Before coming to IDEO, our client had already made significant investments in consumer research to maintain its competitive edge. After the project started, its leaders showed us an elaborate chart filled with rows of consumer identity tags, behavioral patterns, and usage preferences, all organized by data dimensions and densely packed across different quadrants. Years of accumulated consumer insights had informed their product development and marketing strategies, helping them achieve significant commercial success.

And yet, despite all these efforts, they seemed to have hit a wall. To spur new growth in one of their flagship categories, for example, they had tried various strategies, such as conducting research in smaller cities, launching new products aligned with mass-market trends, and attempting to keep consumers engaged by offering more choices. None of it was enough to break through.

What else could they try? That question prompted the company’s senior leadership to come to IDEO. They were looking for a perspective that differed from their usual approach—one that could reveal new possibilities on top of everything they had built.

Illustrations by Fiona Feng

A revelation from consumers

Even though the client already had detailed data, we decided to conduct in-depth consumer interviews during our design research phase. Our goal was to start from a more fundamental place—to understand how people lived day to day and the role these products played in their lives.

From the client’s perspective, this seemed like a wasted effort. They struggled to understand why we wouldn’t simply begin with their assumed starting point: “Why do consumers choose our brand, and what do they expect from our flagship category?”

But the way consumers actually choose products revealed the “why” behind that question.

Whether they were “core consumers” who already frequently purchased the brand’s products, or “extreme consumers” whose preferences were well outside the mainstream, the decision-making process for buying these products was the same.

It started with a broad desire, for instance, “I want to try something different.”

From there, their life stage, immediate circumstances, and emotional state shaped that desire into a more specific need: “This is the type of product I’m looking for.”

Only then did consumers consider: “Which brand should I buy?”

In contrast, the client’s original framing—“Why do consumers choose our brand?”—treated the endpoint of the consumer’s decision journey as the starting point.

From a consumer’s perspective, this might seem obvious; it’s something we all do instinctively every time we shop.

But what is intuitive to the consumer is rarely intuitive to the brand.

Mapping out a consumer’s actual decision-making process provides significant value for a brand. It establishes a consumer-centered through line that helps leaders navigate innovation in a mature category with greater precision.

Several elements naturally align along this through line: the deeper needs of various consumer types, the moments and motivations that trigger a purchase, the opportunity areas where a mature category can effectively meet specific consumer needs, and the competitive strengths the brand should build on to fulfill those needs. Not only do these components become clearer, but they also create interconnections among them.

The core insights from our design research defined those triggering moments and illustrated the map of how consumers actually make decisions. This clarity, in turn, helped the brand’s leaders determine where to focus their efforts in order to revive a mature category.

Building system-wide alignment from a human-centered insight

We took everything we’d heard from consumers, distilled the decision-making processes behind them, and translated everything into visuals on a series of boards, which we then brought into the client’s meeting room.

Step by step, we walked through the consumer’s chain of logic, highlighting what each need meant for the brand’s approach to category innovation. When we finished, a C-level executive at the company looked at the boards and said, This is a billion-dollar idea.”

The insight disrupted the default reflex of category leaders, who often claim to prioritize consumer needs while unconsciously starting every decision from their brand’s own business priorities.

At first glance, taking a human-centered route may seem like a detour. In practice, it helps companies avoid the wasted investments that come from acting on incorrect assumptions. A clear understanding of what consumers truly need allows a brand to recognize which of its existing strengths to double down on, and which emerging opportunities are genuinely worth pursuing.

After that meeting, the direction for category innovation quickly took shape. The key insight regarding consumer needs and decision-making became a powerful anchor. The insight unified early-stage product development, mid-to-late-stage packaging design and manufacturing, and the marketing communications that followed the launch.

Beyond charting a new course for the client’s flagship category, the project established a framework for cross-functional teams to build a shared understanding and work toward a common goal.

In the end, the collaboration was successful because everyone involved in the project maintained a primary focus: human-centered thinking.


“The Making of...” is a series of behind-the-scenes articles written by IDEO Shanghai designers about our innovation methods and work with major clients across industries in China.

Success can create its own echo chamber. The more a company achieves, the easier it is to rely on familiar ways of seeing the market—often without even realizing it.

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6 ways to improve at-home health monitoring

How to reduce anxiety, build trust, and increase adherence.

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Article
Articles

Healthcare was once centered on the doctor’s office. Today, it’s moving into the home. Since the pandemic, demand for at-home testing has surged, with 82 percent of older adults saying they’re interested in taking medical tests at home, and many preferring to age in place. From at-home influenza tests and COVID-19 swabs to cervical cancer collection kits and continuous health monitoring, people are taking a more active role in managing their care, with tools that enable both testing and tracking from home.

Designing for this shift means supporting people without medical training—who may struggle to interpret data, who might be nervous about collecting samples, or who might wonder about the efficacy of a test they perform themselves. In my work at IDEO, I’ve identified six principles for creating home-use diagnostics and monitoring tools that are more intuitive, reliable, and easier to use.

Art by Jeremy Chen, with the help of GPT Image 2.0.

1. Design for emotion

Medical tests can evoke powerful feelings: fear of receiving bad news, memories of lost loved ones, or general anxiety. As a designer with a background in social science, I recognize that emotions often drive behavior. Our role as designers is to anticipate these emotional responses and design solutions that support them.

On a cancer screening project, for instance, we found that some users postponed testing not because they didn’t understand how to use the tests, but because they were afraid of the results. To address this, we softened the typography, refined the color palette, and shifted the messaging to focus on taking care of one’s health rather than screening for illness.

On a separate project, we discovered a completely different emotional pain point: clunky health monitors can be perceived as a sign of aging, making people feel self-conscious about wearing them. Which is a fair point. Medical devices often look outdated compared to sleek consumer technology. This disconnect can be emotionally jarring—and socially stigmatizing. To rectify this, we focused on portability and aesthetic improvements. The goal wasn’t to turn a home heart monitor into an iPhone, but to make it feel like a tool for enhancing well-being rather than just surviving an illness.

Time and again, we see that providing patients with a premium-feeling device or thoughtfully designed packaging can transform a medical experience from being a source of embarrassment into a moment that reinforces confidence and self-care.

2. Make use of the unboxing moment

First impressions of medical devices matter. If users can’t immediately see components or have to dig through packaging material, they may assume that the testing process is complicated or time-consuming, too. 

During one at-home cancer screening project, we discovered that many people opened the box, took a quick look, and decided to postpone the test because it looked too overwhelming. By redesigning the unboxing experience to make the components and instructions more visible, participants reported feeling more confident and in control.

With some thoughtful changes, the unboxing moment can feel like an act of empowerment. Blank spaces on boxes can be valuable real estate for reassuring messages or simple diagrams, ensuring that essential information isn’t left buried in the instructions.

3. Keep it familiar

At-home screenings are a relatively new concept, and can feel intimidating. People often worry they won’t be able to perform the tests correctly—or worse, that making a mistake could invalidate their results. Thoughtful design can help alleviate these fears by leaning into familiarity and clarity.

When an IDEO team collaborated with Teal Health on an at-home cervical cancer test, they designed the testing wand to resemble a tampon—a form and function that many users were already familiar with and comfortable using. 

Similarly, for an at-home stool collection kit for another client, we designed components that mimicked the contours of a toilet bowl, making the overall experience feel more intuitive.

4. Make data relatable

Designing at-home health monitoring systems requires a careful balance between what patients want to know and what healthcare providers need to see. Providing too much information can overwhelm patients, while too little can leave them feeling powerless. To drive adoption and adherence, designers must connect the data to patients’ real needs and challenges, empowering them to navigate their health effectively. 

Recently, an IDEO team was designing an implant to monitor organ health. Data from the implant would go directly to the physician for review, but patients also wanted to see the results themselves. In today’s world, where smartwatches can track heart rates and sleep cycles, people expect feedback from health tools. When devices withhold information, it can feel as if they’re keeping secrets. To address this, we recommended a simple, intuitive interface: a stoplight notification system (green = all good, yellow = contact your doctor), along with the option to view a trend graph over time. Patients had the agency they desired, while more complex data remained accessible only to physicians. 

In another project focused on at-home bladder monitoring, we discovered that a device that indicates bladder fullness was life-changing for patients who struggled to empty their bladders. People who felt homebound by the fear of embarrassing accidents or infections reported that the device would help them gain the confidence to plan their days and reclaim their lives. Even though the device would require surgery, the possibility of increased freedom was so appealing that patients felt it was worth the risk. The quality-of-life improvements the data enabled—not the monitor itself—motivated them to embrace this new device. 

5. Lean into visual instructions

More words don’t always equal more clarity. In fact, overly detailed, multi-page instruction packets can discourage people from engaging and may give the impression that a test is too technical, even if the language is at a fourth-grade reading level. 

In one project, we simplified an 11-step test guide into a user-friendly design with three main steps. We reduced the amount of text, emphasized illustrations, and broke down the process into manageable parts to make it feel achievable. This visual-first approach not only made the instructions easier to follow but also reduced user anxiety and improved accessibility for people with reading disabilities and those who speak English as an additional language.

6. Look to family and caregivers

While we typically think of patients as individuals, it’s important to recognize that they exist within complex networks of family, friends, and communities that support and supplement their abilities. When we do research for at-home devices and monitors, patients often request to be interviewed alongside their caregiver, or vice versa. Successful at-home medical monitoring and testing must take into account the motivations and needs of everyone involved in the patient care ecosystem. 

Product teams may assume that older patients will not want to use even basic technology. This might not be true, and even when it is, it’s worth remembering that the end user might not always be the patient. At times, a caregiver might be more invested in the outcomes of monitoring or testing than the patient themselves, and could be more open to embracing digital and tech-forward solutions. 

It’s this kind of health ecosystem thinking that becomes crucial as at-home testing and tracking grow more prevalent. What we have now may feel revolutionary compared to the pre-pandemic era of mandatory in-person care. Many innovations that once felt like futuristic fantasies—such as headsets that help treat depression and saliva-based hormone tracking to support conception—are now available for home use. Still, the potential that lies before us is far greater. 

But only if designers get it right. By keeping human needs—across patient, caregiver, and providers—at the center, we can build more advanced solutions that help people take action on their own health.

Need help designing some at-home experiences of your own? Get in touch.

“Providing patients with a premium-feeling device or thoughtfully designed packaging can transform a medical experience from being a source of embarrassment into a moment that reinforces confidence and self-care."

Health

It's time to tame the monsters of healthcare

How health organizations can overcome obstacles to improve outcomes.

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Article
Articles

In our healthcare work, we’re constantly partnering with clients to solve big, seemingly intractable problems that prevent them from delivering the care patients need. Bad UX. Tangled bureaucracy. Stigma. Disinformation. Systems that were never designed to communicate with one another or effectively serve people. These barriers ultimately decide who gets better and who doesn’t.

Over the decades, we’ve learned it’s easier to tame these monsters if you name them. So we’ve turned them into creatures to help people identify and defeat the obstacles that prevent them from delivering the healthcare experiences and outcomes that patients (and employees) truly deserve. 

Here are five bogeymen we keep encountering in our healthcare work, and some projects that have taught us how to vanquish them.

The Abominable Experiences Monster

Many medical procedures are more uncomfortable than they need to be. Women’s health, in particular, is full of experiences that feel a little medieval—painful, invasive, and undignified. Each one nudges patients toward skipping their next appointment.

The Abominable Experience Monster devours appointments. It also gobbles up early diagnoses, follow-up care, and long-term relationships between patients and clinicians that fuel good healthcare.

This is particularly true when it comes to cervical cancer screenings. When detected early, this form of cancer is completely preventable. But one in four American women is not up to date with their screenings. To address this issue, we partnered with Teal Health to reinvent the screening experience, focusing on much more than just the speculum.

Together, we designed a method for patients to collect their own samples at home, one-handed while standing, with clear instructions and welcoming packaging. In 2025, the FDA authorized the device. During the trial, 87 percent of participants reported that the new in-home experience made them more likely to stay current with their screenings. 

Taming this monster starts with a question that isn’t asked often enough in healthcare: “Does it need to feel like this?”

The Entrenched Complexity Monster

This monster stymies progress. Departments operate as fiefdoms. A patient’s record sits inside three different systems. A small change requires six committees. Clinicians who want to improve the patient experience run out of energy trying to fight the system.

Newton-Wellesley Hospital came to us because they saw an opportunity to drive better patient outcomes through cultural and organizational change. We worked together to imagine a different future for the hospital, then prototyped it in phases.

The team at the Women’s Imaging Center kicked things off by reimagining the mammogram experience. They defined the principles for the experience they wanted to create and designed prototypes to gather patient feedback. Then, they became ambassadors, helping other departments take on their own monsters. Patient-centered ideas soon spread, including a practice that the hospital integrated directly into its medical records: a method for flagging each patient’s communication and care preferences, allowing providers to meet them in ways that made them most comfortable.

The Entrenched Complexity Monster is tamed one project at a time. Each time a department demonstrates that change is possible, the monster shrinks a little more.

The Ingrained-Barriers Monster

For a teenager seeking mental health support, there can be multiple barriers to care: from parents who don’t believe in therapy and months-long waitlists, to school counselors who are overwhelmed with the needs of 400 other students and the high costs of treatment. Combine these challenges, and you’re dealing with a juggernaut. 

The Ingrained-Barrier Monster festers in the gaps between systems that were never designed to support the people who need them most—especially young people.

Our solution? Design with them. We partnered with Kooth, the California Department of Healthcare Services, and hundreds of young Californians to create Soluna: an app featuring evidence-based behavioral health tools, free coaching, and resources designed by the people who will eventually use them. Soluna is now available for free to six million young people across California. 

The Fragmented Systems Monster

For a working family in Lima, Peru, accessing routine healthcare services is a patchwork experience. Affordable, comprehensive care can be extremely hard to find. The Fragmented Systems Monster thrives in these cracks. It costs patients both time and money and, at times, leads them to miss appointments altogether.

Intercorp wanted to build something different: clinics specifically designed for Peru’s emerging middle class, rather than modifying existing models that weren’t intended for them. Before launching a real clinic, they constructed a full-scale prototype—a fake clinic—where patients could experience every aspect of their visit: registration, waiting room, examination, and pharmacy. Afterward, patients provided feedback on what was and wasn’t working. That feedback shaped Aviva, a clinic that opened in 2019 and now offers over 30 specialties. Since opening its doors, Aviva providers have performed more than 3,000 surgeries and assisted with more than 5,000 births.

Taming the Fragmented Systems Monster begins with a counterintuitive idea: quickly build a tangible, rough version of connected care, allowing patients to guide you in getting it right.

The Convoluted Comms Monster

Today’s parents receive a lot of information from their pediatricians, but they also turn to wellness influencers, online forums, and screenshots shared by people in their networks. By the time they’re in the doctor’s office, their opinions on care have been shaped by numerous sources, not all of which agree with each other.

The Convoluted Comms Monster flourishes in this noise, derailing even the most critical conversations, such as those a pediatrician must have with a concerned parent about a new immunization or vaccine.

When Sanofi prepared to launch Beyfortus—the first-ever RSV immunization for infants—the biopharma company approached us with a big question: How might we help pediatricians communicate clearly with worried parents across languages and cultures and amid the swirl of misinformation surrounding new medical developments? Together, we created materials to facilitate these important conversations. Beyfortus successfully launched in time for the 2024–2025 RSV season. Demand was so strong that Sanofi tripled its manufacturing capacity, and the immunization has been shown to reduce infant hospitalizations by 82 percent.

Taming this monster is about providing clinicians with clear, human-centered resources to cut through the noise, ultimately helping the parents in front of them and the children who depend on them.

Taming what’s blocking the way

At their core, these monsters arise from human decisions, organizational habits, and inherited assumptions. While technical issues may exacerbate the problems, strategy or software alone cannot resolve them. 

The work is to find the monster, name it, and begin taming it by focusing on cultural behaviors and ways of working; in other words, prioritizing people, not just products.

We’ll be at HLTH Europe in Amsterdam later this month, on the lookout for more monsters. Bring us the obstacles in your work that feel too big, too tangled, or too entrenched for you to face. We’ll help you name them. And then we’ll help you tame them.

Have a monster of your own? Get in touch.


Special thanks to Ellora Jaggi and Tanya Kar for their work making the monsters come to life.

Here are the five bogeymen we keep encountering.

Health

“Building the last piece of software"

Lovable’s Nad Chishtie on designing at the frontier of AI.

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Tucked away behind the brightly-colored restaurant fronts of East London’s Brick Lane is Second Home, a co-working space housing the design team of “vibe coding” company Lovable, one of the fastest-growing start-ups in history.

Founded in 2023 by Swedish software engineers Anton Osika and Fabian Hedin, and currently valued at $6.6 billion, Lovable’s mission is to make software development accessible to everyone, not just the 0.6 percent of the planet who are professional developers. The firm talks about their goal as “building the last piece of software.”

Nad Chishtie, Head of Design at Lovable, discovered his passion for building through his childhood obsessions with music, online gaming, and computers. Initially drawn to coding at the age of 8, he later “fell into design by accident” when he discovered he preferred problem-solving to programming. After stints at two hypergrowth companies, Cmune and Element, he had an epiphany. “With the launch of OpenAI’s GPT-3, I was able to do 70 percent of the coding work of seven full-time developers. I thought, ‘Everything's going to change.’” This realization led Chishtie to seek out the most ambitious people in this space, which ultimately led him to Lovable co-founder Anton Osika.

I spoke with Chishtie at Second Home about the skills people need to design with AI, Lovable’s unique culture, the pros and cons of collaborating with agents, and why humans—and optimism—will always matter. 

Art by Mark del Lima, with the help of GPT-5.5 Thinking and Adobe Firefly.

Ed White (EW): We’re increasingly hearing about a newer discipline called “design engineering” at companies like Lovable. What does that mean in practice?

Nad Chishtie (NC): It's essentially applying design thinking to code. Depending on your technical skills, design engineering could focus more on front-end development, microinteractions, or the architecture needed to support multiple initiatives. 

An interesting example of a design engineer is Niklas, who joined us as the team’s second designer and has a background in industrial design. Until last year, he hadn’t written code professionally. Now, he’s the third-largest contributor to the Lovable codebase. That’s because today there are two paths: Path A involves ideation, creating comps, and managing stakeholders, while Path B is about directly translating ideas into code with 100 percent fidelity. Path B wins a lot. It’s why Niklas’ learning curve was just a couple of months.

It’s difficult to find people with this skill set, but a single person with this shape can be as valuable as an entire team. 

Path B also means that, in design, we can drive initiatives forward without needing technical support or advocating for inclusion in the engineering roadmap. We can just implement ideas directly. 

Initially, some of the engineering leaders questioned why the design department was hiring engineers. But after we became productive, their response changed. Now, it's one of the most requested roles within our company.

EW: What mindsets or skills are required to be a successful design engineer?

NC: You need to be a very strong systems thinker. Instead of focusing on a specific solution, you’re developing the system that enables that solution to exist.

In classic lean startup methodology, the focus has been on specializing both people and products. With AI, you need to do the inverse and adopt a generalist mindset—for two reasons. First, it’s more challenging to constrain AI models than to let them operate freely. Second, by allowing models to evolve and get better without constraints, your product improves, too. By thinking like a generalist, your product expands its footprint in tandem with AI’s growth. To design at the frontier of AI, you need to invert your perspective.

EW: What’s different about designing with LLMs?

NC: When you design software as a service (SaaS), the main task is to design constraints that make the system more deterministic. With AI, the goal is to develop something that is somewhat deterministic and also truly generative. Because if it isn’t generative, then it’s not truly intelligent; it just mimics patterns or picks templates in the background. This marks a shift in design from focusing on hard constraints to providing a broader design direction, while maintaining certain guardrails. 

EW: How is working with these models changing design?

NC: From a technological perspective, we’re ruthlessly trying to reduce the time between having an idea and making it tangible. This applies to Lovable as a product and also to our internal practices. For instance, in our development pipeline, we’re trying to streamline processes as much as possible. If someone here has an idea and is curious about its viability, they can quickly tag an agent and receive immediate feedback. Today, it’s standard for a tech company to spend minutes, hours—even days—testing out a single part of their code base. Our goal is to reduce that time to zero. 

In terms of people’s time here at Lovable, there are no sunk costs with LLMs. We can adopt a more experimental mindset and go from a customer insight to a tangible iteration within a few minutes. Then, we can share that with more people, gather feedback, and decide whether to double down on the idea or delete it. It's totally acceptable to pivot because the turnaround cycle was minutes. 

EW: Lovable is one of the organizations that’s early to work with agents on a daily basis. What’s that experience like?

NC: We try to think of agents as if they were people. They need to have the proper context about how our team works, what’s important to us, the principles and philosophies behind our decisions, and what constitutes a good or bad decision. We have banks and banks of knowledge and skills that codify our thought processes for ourselves and for agents. They’re like a human employee onboarding Wiki, but for agents.

EW: What do agents do in practice, and what roles do they play in design?

NC: One role is called a “Linter.” You write some code, and then a Linter will dynamically check it against our codebase. A simple example is keyboard focus. Imagine you have an application with 20 different features that need to be added at various times. Keyboard focus can be quite invisible, making it challenging to maintain coherence. We have a skill bank dedicated to keyboard focus. If you’re designing or implementing a feature, a Linter might review your work and say, “With my end-to-end view of the application, this is how we think about keyboard focus. In the specific view you’re working in, you definitely should do it this way.” 

Another role is a “Sweeper.” Whenever you propose changes in a pull request, Sweepers conduct a variety of checks. For example, a Sweeper agent might say, “You’re introducing a new mental model for the user here. Here’s a list of related mental models that you should consider. Should we extend an existing mental model instead of adding a new one?”

The final role we’ve found very helpful is the “Critic.” These agents critique your implementations as thoroughly as possible. You can even ask them to imitate experts. For instance, you could prompt, “You are [Danish usability pioneer] Jacob Nielsen. I want you to critique this from a purely UX perspective.” The models are trained on Nielsen’s entire body of work, so you’ll gain insights that reflect Nielsen’s expertise.

EW: What’s been particularly effective for you when you use these agents?

NC: Prompting Critics to ask questions rather than make statements. General-purpose AI is overly sycophantic. Having Critics ask questions flips that dynamic. It keeps you in control, which is crucial since humans are ultimately responsible for the outcomes of these systems, and it encourages you to continuously critique your thinking. 

EW: As you work more often with powerful agents, what do you think the role of humans is?

NC: Human designers must be held accountable. We must create usable, desirable products that feel cohesive. I believe that across all mediums—be it film, TV, music, food, etc.—we have an innate ability to sense whether the people behind them genuinely care and what values guide their work. Do they value speed, a sense of luxury, quality, or something more experiential? I think the same applies to software. For Lovable, the experience of using our product is always the responsibility of the humans on our team; we don’t delegate that responsibility to AI. 

EW: How are team structures changing?

NC: I keep coming back to the word “asymmetry.” We used to build teams in very symmetrical ways at tech companies: you’d have a product manager, engineers, a designer, and possibly a data analyst. This cookie-cutter approach was easy for hiring and HR purposes, but it didn’t necessarily lead to the best products or user experiences. 

Today, team dynamics are evolving. Generalists can manage the entire design process—from user insights and analyzing data to building an initial product and testing it with users. A single generalist can deliver 20 times the value of someone focused on just one part of the process.

EW: What does that mean in terms of the people you look for?

NC: The “K-shaped” economy is an apt analogy for what we look for in design engineers. We’re seeing a split between those who are “AI native” and driven, and those who are more cautious about AI and hesitate. These two types of people are diverging significantly, with compounding effects in both directions. We hire people who are optimistic about AI’s potential and are eager to learn.

We also focus heavily on the slope of someone’s career trajectory—not just where they are today, but where they could be in this quickly evolving environment. During my introductory calls with designers, I spend time discussing their motivations for entering design, major influences from past roles, and self-initiated projects rather than just work history. 

Ultimately, a company’s success comes down to its teams and the products they build. The best team is the one with the highest learning aptitude.

EW: How do you create an environment or culture of experimenting and learning?

NC: One of our core values—“våga vara annorlunda”—means “dare to be different” in Swedish. We encourage our employees to challenge norms and embrace innovation by fostering an environment where failure is acceptable. We encourage rapid experimentation and urge individuals to continually challenge their own workflows. 

Many companies believe they need to adopt a single AI tool to write more code and then deploy it organization-wide. In contrast, at Lovable, we allow everyone to choose their own tools. It’s not only fun, but as the tools evolve and our understanding of how to use them expands, our organization adapts and grows as well. 

We have a few helpful rituals, too. Every Friday, we host open demos to showcase what we’ve been doing during the week. Someone might share, “I figured out this new approach that required overhauling our development environment. If we use agents in this new way, we could be 20 times more productive.” We celebrate these achievements as part of our onboarding process, in our Monday morning meetings, and during our internal company awards. 

EW: What’s important to remember when designing with LLMs?

NC: First, the models themselves are incredibly idiosyncratic; it's almost like having different children, each with their own strengths and weaknesses. To produce truly great outcomes, you need to understand these idiosyncrasies and build around them.

Second, you need to consider the entire system. You can't evaluate models, core product architecture, and user experience in isolation. You have to understand them all and integrate them to create a cohesive user experience.

EW: Any parting thoughts for designers?

NC: Be optimistic. Every door is open right now. I feel like a kid again, discovering technology for the first time. 

“Design in the Age of AI” is a series of conversations with designers and makers from across industries and disciplines, building the future with AI, today.

“To design at the frontier of AI, you need to invert your perspective."

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Lindsey Turner

I’m passionate about building brands, products, and experiences that help organizations show up with meaning and momentum.

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I started my career in editorial and digital design, shaping cross-platform experiences and identity systems in publishing and agency environments. That foundation still shapes how I work today: I’m detail-oriented, collaborative, and overreliant on the Oxford comma. I hold a BFA in Visual Communication from the School of the Art Institute of Chicago.

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Before IDEO, I taught elementary school in East Palo Alto and spent a decade doing design work with social service organizations—where I learned firsthand what it costs people when systems are built without them in mind.

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I bring an inclusive, hands-on approach and a deep understanding of business, which enables me to consistently deliver excellence while always asking why.

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I am responsible for IDEO’s long-term success in China and working with clients to use design as a tool to enable growth. Specifically, I have helped Chinese companies design holistic brand solutions through the development of their products, communication, services, and innovation teams, and I have helped multinationals expand their presence and influence in China.

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Before joining IDEO, I worked at Philips Electronics and the Electrolux Group in Italy, the Netherlands, and Singapore on a number of breakthrough commercial products. I am a member of the Young President Organization in Shanghai.

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