D4V is a Tokyo-based early stage Venture Capital in partnership with IDEO. Two years ago, D4V invested in healthcare startup Ubie, which develops a service called AI Monshin Ubie. The digital service was created with the goal of reducing the burden on healthcare professionals working long hours, under harsh conditions. AI Monshin Ubie automates a number of patient registration and documentation processes through digital tools, enabling doctors to spend less of their time on manual paperwork, and to dedicate their valuable skills and attention to the patients themselves. Currently, the service is installed in 200 medical institutions in 41 prefectures across Japan.

With AI Monshin Ubie, patients fill out preliminary forms on a tablet, rather than paper, entering information about their health history and current symptoms directly into their digital medical record. As patients fill out the questionnaire, the Ubie AI generates questions in real-time according to patients’ responses, which results in more appropriate and accurate data. The patient’s responses are automatically formatted for the doctor to review prior to and during the consultation. As a result, doctor consultation times and facility operation times are drastically reduced.

With the Coronavirus raising fears of a possible health system breakdown, Ubie has made improvements to anticipate and possibly prevent in-hospital infections. Until recently, Ubie’s services have been primarily used by large hospitals; but in light of the global health crisis, Ubie approached D4V—who partners with IDEO—to help rethink the onboarding experience and quickly facilitate the introduction of AI Monshin Ubie in regional clinics across Japan. D4V and IDEO have been working with Ubie for many years to collaborate in various areas, including UX, rebranding, international research, and more. Therefore, they had a foundation of knowledge from which to build these new features.

Typically, AI Monshin Ubie has been introduced to new hospital clients through direct, in-depth instructional visits from Ubie sales staff. This approach has worked well for rolling out the product to Japan’s 8,000 large hospitals; but for the 100,000 smaller clinics, Ubie needed a more efficient onboarding method to enable staff to get set up smoothly and independently.

During research, D4V and IDEO team members engaged with many different clinic staff members, including full-time doctors, part-time doctors, nurses and receptionists. The researchers found that staff tend to react skeptically to new tools and services, with a common preconception that they will add to their workload. One clinic director’s first impression of AI Monshin Ubie was, “It looks complicated.” But once he actually used the service, he realized that it was very user-friendly.

The team quickly understood that it was important to remove preconceptions by clearly communicating Ubie’s benefits and ease of use. They created a two-minute animation and designed three separate guidebooks. The animation adopted a friendly tone and expressed empathy for doctors, staff members and patients, highlighting how Ubie can bring benefits to each of them. The animation showed how Ubie fits into the existing workflow and explained complex systems in a straightforward and accessible way.

WATCH: A short video clip explains the benefit of their product and service to avoid the users’ concerns in advance.

The guidebook for doctors and directors explains how Ubie’s AI smooths the patient consultation experience and greatly improves the quality of medical care. It also introduces concrete how-tos around set-up, implementation, and ideal workflow. FAQs were also included, addressing concerns about whether or not elderly people would be able to use it.

Ubie business development leader Kenji Yamada says, “D4V and IDEO have a deep understanding not only of design, but of our entire business. They provide inspiration by bringing experience and knowledge that comes from working with other industries and clients outside of healthcare. We appreciate that they can share the knowledge that they’ve obtained with our business.”

Read the Japanese-language version of the Ubie case study here.
When You Feel Unwell, Ask Ubie: Check your symptoms for free
Learn more about Ubie: Global Company Website

In the emergency room, an intervention that’s administered too slowly could cost a patient their life. With COVID-19 fueling a surge in acute respiratory conditions, intubation—a procedure that involves inserting a tube through the mouth or nose and into the airway—is more common than ever. For patients struggling to breathe, the tube can be connected to a ventilator that pumps oxygen to the lungs, keeping them alive.

While a laser-focus on the present is critical for successful patient outcomes, hospitals and physicians often don’t have time to look ahead and anticipate the future of the operating room experience. As technology rapidly improves, there is a ripe opportunity and pressing need to evolve medical equipment to be more innovative and intuitive. Verathon Medical, a global medical device manufacturer, is supporting health care providers at the cutting-edge of care.

Verathon approached IDEO to redesign the existing product system for laryngoscopies and bronchoscopies—procedures that examine parts of the throat through intubation. During these examinations, a tube with a camera embedded in the tip is inserted through the patient’s nose or mouth. The doctor can then see inside the throat on a video monitor, and therefore more easily and quickly intubate and perform the exam.

To create a groundbreaking device, the team observed over a dozen laryngoscopies, bronchoscopies, and intubations. They noticed that many anesthesiologists relied on fixed equipment during the procedures. For example, some had grown accustomed to looking over their shoulder—away from the patient—to view the monitor.

During interviews, physicians and residents expressed difficulties with the current technology, sharing that the small screens aren’t conducive to team viewing or student instruction, and they must often use a separate computer to record patient notes. Others reported frustrating workflows, needing to constantly divert their attention and move their hands between the patient, prep tray, monitor, sterile bin, and disposal bin. These inconveniences and inefficiencies are not only cumbersome, but can increase the risk of infection and fatality.

The team relied on these insights to start designing a next-generation product. Through sketching, storyboarding, and building in real-time alongside doctors and clinic staff, designers quickly teased out additional findings and validated concepts.

This work led to the creation of the GlideScope Core: an all-in-one, portable product system that supports both video laryngoscopies and bronchoscopies. The base of the device—a wheeled cart—has built-in storage units for tools and a disposal bin, offering more mobility and accessibility for medical professionals.

The product’s tagline, “see more, do more,” points to the improvements made to the video system, including a large 10- or 15-inch high-definition touch screen monitor. Displayed images can be enlarged and rotated 180 degrees for improved visualization, team viewing, resident training, and classroom demonstration. To help doctors keep both the patient and monitor in their line of sight, the detachable screen can be secured to an adjustable arm that can be positioned directly over the patient. Additionally, the monitor’s patient annotation feature gives staff access to more of what they need in one device.

The product has been especially valuable for providers and patients during the coronavirus pandemic, when it’s imperative for doctors to keep their distance from patients’ mouths and noses. The GlideScope Core’s movable, detachable, and large, high-definition monitor makes it easier to take this precaution and intubate more quickly. This usefulness is reflected in the 5-fold increase in cart-based device orders for Verathon. While most providers typically order anywhere from 1 to 20 devices for airway procedures, one hospital system requested 600 GlideScope Core systems to meet current intubation demands.

Through modern technology and a focus on human needs, the GlideScope Core supports improved patient outcomes and creates a more seamless operating experience for medical professionals. The product underlines the key but often overlooked fact that often, in order to ensure the healthcare industry is patient-centered, medical device manufacturers and hospitals must also focus on improving the experience of providers.

Healthcare is notoriously difficult to change. Rules and regulations present complex barriers; health practitioners and organizations often have entrenched ways of working; and lives are literally on the line. Despite these significant barriers, the leaders at Newton-Wellesley Hospital (NWH) boldly committed to improving patient care through a new approach.

NWH is a community teaching medical center in Newton, Massachusetts. Because of its proximity to Boston—a city known for world-class healthcare institutions—NWH needed to differentiate itself. The hospital's new president, Dr. Michael R. Jaff, reached out to IDEO for help: "I knew that providing an unparalleled patient experience would set us apart from our competitors." But, Dr. Jaff’s particular approach was unique. He and Dr. Jodi Larson, Chief Quality and Experience Offer (CQXO), saw an opportunity to drive better patient outcomes through cultural and organizational change.

"You cannot learn any more than when you get to listen to your potential patients say why they would never walk into your place." —Dr. Michael R. Jaff

IDEO partnered with NWH for a year of work together, kicked off by defining the vision for NWH and ramping up to in-hospital prototyping and the launch of several new initiatives. A pilot project with the Women's Imaging Center (WIC) focused on solving departmental and employee challenges to provide a better experience for women getting mammograms.

Fueled by this potential, the WIC team redesigned key work processes and created a set of experience principles that inspired new service prototypes. Guided by principles like "Express mutual gratitude" and "Honor every voice," the WIC team tested ways for patients to acknowledge outstanding caregivers and created tools to gather better feedback from patients and adjust quickly. The experience of designing better services inspired the WIC staff to become ambassadors for the power of design thinking across other departments inside NWH and they continue to build on the work through new prototypes and experiments.

Next, IDEO partnered with NWH’s ambulatory surgery group. They took an analogous research trip to Boston’s Logan airport to see with fresh eyes how other high-touch customer service organizations provide customer value in a complex setting. Insights from the trip were applied through live prototyping of several new experiences inside the hospital, including a pre-surgery visit summary and pre-operation care carts.

Analogous research helped us realize that we can learn from other industries and incorporate some (cool) best practices if we allow ourselves to get over the ‘that would never work in the hospital’ mentality. - Dr. Jodi Larson

One of the most impactful prototypes was Care Modes, a tool to empower the NWH care teams to tailor their approach and interaction with patients based on the patients’ unique needs, beyond simply their clinical requirements. Four distinct approaches were identified for engaging a patient before surgery—Explain, Partner, Embrace, and Encourage. The Care Mode is determined based on the provider's understanding of a patient's degree of self-advocacy and their confidence that surgery is the best solution to their issue.

Historically, care providers have been trained to deliver consistent care above all else. However, Care Modes powerfully acknowledge that patients respond differently to different types of care. The Care Modes empower the team—from surgeon to nurse to anesthesiologist—with a clear framework for how to interact with and provide care for patients so they feel most comfortable. Based on the prototype's success with patients and impact on the staff culture, NWH has incorporated Care Modes into EPIC, the hospital's electronic medical record.

The importance of being patient-centered has been central to the healthcare conversation over the past thirty years; but new explorations reveal that there’s far more potential for innovation and improvement when the provider experience is considered in tandem with the patient’s. Each enables the other, and design for both together yields stronger solutions and better outcomes. IDEO's work with NWH demonstrates this vital shift in user-centered healthcare—one can't design services and experiences for patients without designing for their providers’ culture as well. When these go hand-in-hand, meaningful institutional change in healthcare is more than possible.

The mission of Chicago's Museum of Science and Industry (MSI) is to inspire children to achieve their full potential in the fields of science, technology, medicine, and engineering. Leaders at MSI realized they needed to drive day-to-day operations and maintain historic exhibits while focusing on where to go next. To prepare for its next decade, MSI worked with IDEO to create a new business focus to support the museum’s aspirations for the future. The plan would allow MSI to respond to the demands of the marketplace and raise the funds to get there.

At the beginning of the project, MSI laid out its priorities: improve equity of access, enhance the museum experience, and create a more innovative culture. To dive into each of these areas, IDEO conducted immersive research with families, teachers, donors, and staff.

IDEO brought together 60-plus donors, board members, and staff members to engage in a design thinking exercise to unpack and address the tensions that come with choosing a new strategic trajectory. Instead of having a standard ballot vote, the IDEO team encouraged participants to get up and vote with their feet, helping the group of stakeholders physically align on the museum’s new direction.

At the end of the research and prototyping phases, MSI and IDEO developed a vision called Provoking Minds, Inspiring Futures, creating six detailed design briefs to equip MSI teams to bring initiatives forward. The briefs laid out everything from recommending a new Department of Next, dedicated to ensuring that the future is at the heart of everything the MSI does, to MSI Runway, a place for experimental, small-scale, and limited-run exhibits. The ideas were brought to life with an interactive exhibit, built quickly with everyday materials like plywood and circuit boards, to demonstrate that creating an inspiring vision of the future doesn’t have to be an expensive endeavor.

The team also focused on insights that highlighted accessibility issues some families brought up early in the design process—travel across the city via public transportation can be lengthy, and the cost of admission to special exhibits could be prohibitive. To address these concerns, IDEO came up with the Mission Accessible brief: Inspired by casino buses, MSI bus stop signs would be posted in various low-income neighborhoods, signaling a way to take kids and families to the museum for free.

During the project, the IDEO team identified some low-hanging fruit, like rethinking ticketing and improving the student field trip experience, and helped the museum create cross-functional innovation teams to apply design thinking skills towards solving those challenges. They researched, brainstormed, and pushed forward new concepts, meeting weekly to share and build on ideas. At the end of the four week period, each team prototyped their ideas—new outdoor programming, software tools for visiting tour groups—and pitched them to each other.

In 2019, two years after the conclusion of the project, the collaboration paid off. With its new strategic plan and additional resources, the museum has renewed its commitment to serving youth, and MSI’s team, including donors, are aligned on a collective vision of the future. MSI raised more funds than in any previous year, including the single largest gift in its history—$125 million, nearly half of its $380 million fundraising goal—that will help ensure the years ahead.

I met him in 2005, when he became the art director of my crafty, grassroots Berkeley magazine, ReadyMade.

In the years that followed, we laughed and wept through one of the most fruitful creative collaborations of our lives. Then, in 2011, George strapped on a jetpack, waved goodbye to publishing, and lit out to start his own eponymous juggernaut, McCalmanCo. Aside from his fertility as a creative director, illustrator, and artist, 2020 was a year of honing “Observed,” his column for the San Francisco Chronicle, into a razor-sharp instrument of cultural commentary. One of his pieces shares the backstory behind his exhibition, “Tell Me Three Things I Can Do/Return To Sender,” a collection of bold, typographic renderings of messages he received from white acquaintances in the wake of George Floyd’s murder. I caught up with George in January, 2021, to hear more about an eagerly awaited new project: Illustrated Black History: Celebrating the Iconic and the Unseen, due out from Amistad/HarperCollins in October, 2021.

In one sentence, who are you?

A polymath trying to simplify his life.

What do you do? How did you learn it?

Too many things for this format! I’m a fine artist, illustrator, art director, cultural critic, editor, writer, and professor of graphic design. I also run McCalmanCo, a design studio that does branding for companies, books, and individuals. I learned all of those things through magazine military training. I started at the peak of magazine publishing in New York and left right at the sunset in San Francisco.

One story that sums up that experience was my very last day atEntertainment Weekly. I put in an all-nighter designing the cover story on Heather Locklear at Melrose Place. I had already cleared my desk, but I needed to be there to get it done. I came in at 8 a.m. and left at 8 a.m. the next morning. I said to myself, I never want to do that again. And I never did. San Francisco offered a version of that life without ever getting to that level of insanity.

What are your 3 favorite possessions?

My home is filled with art that my friends have created. This year represents the most time I’ve spent at home, and I realized I’ve constructed my home as an altar—a totem to both friends who have passed and those who are living. So, my entire home is my favorite possession. Also, my studio. And my friendships.

What does a typical work session look like?

Communication. A lot of communication. Because every day is atypical. What is consistent in how I approach anything I do is I try to make sure I have a perspective on what I’m doing first. Whether I’m starting an illustration, painting, doing a shoot for a book, if I don’t know what I’m doing, I stop. I’ve stopped meetings, conversations, illustrations, I’m always like, Wait what am I doing, who am I talking to? It makes everything I do better.

How do you get over creative block?

If I’m having difficulty it has to do with everything outside the creative process. It’s an emotional or somatic block. When I listen to my emotions or body, all the information is there. If my body is tired, I won’t draw for a week, rather than powering through. I am prolific because I’m tuned into the lessons I’m getting from my emotional or somatic state and I don’t challenge those things. But this is not something I knew when I was younger, only in the last 10 years. I think back and my body was sending me all those signals all along.

What was the last item on your to-do list?

I’m directing a photo shoot for Bryant Terry’s new book, so I’m currently organizing a zoom call with the team. The truth is that I’m never not working—I’ve fused my personal and professional life. I learned that from James Lord and Roderick Wyllie of the landscape architect firm Surfacedesign. They are a couple who are very different people, but inseparable. They move through life with no break between work and life—they will work through a glorious dinner and while traveling—but it’s not work that’s breaking them, it’s work that’s energizing them. That joyfulness in treating their work like it’s their choice rather than their burden inspires me.

How do you see the world in 2078?

I think the U.S. will still be a messy, unsatisfying experiment. The pandemic has transformed much of this world and it will be years before we see how that’s manifested. Two words thrown around a lot are hope and optimism. That’s a very American position. I don’t really think in those terms. Do I believe we are going to make progress? Yes. But we live in a country where people don’t want the progress, so we have to figure out how to live with those who don’t think treating people of other races equally is a good idea, or that paying for the health care for everyone is a good idea, or that letting people who enter this country become citizens is a good idea. How do we reconcile these polarities? It’s not optimism or pessimism, it’s just work. My white lady friends say “I’m so hopeful now,” and I think, how wonderful for you, what a luxury that you get to be hopeful.

What's your number one bucket list item?

I’m doing it! To write and illustrate and design my own book. Much of Black history is reduced to 10 people, but the book I’m working on tells the story of 400 years of American history through the eyes of 150 Black pioneers. Their biographies are historical allegories in that you’ll see how the Black community, unlike the white community in this country, is very much a continuum of our ancestors passing down knowledge. It’s a contemporary telling, devoid of the dryness of historical writing. It’s celebratory of the sacrifices that some of these pioneers of business, film, art, writing and science made to enhance our ideas of democracy and justice. I’m treating them like they’re the Avengers. I hope everyone reads it. It’s a gift you can send to your slightly racist cousin, your republican father, and your apathetic aunt. I want it to be read by students and teenagers and 80-year-olds and also by those who don’t care about Black history.

Who are you creative crushin' on lately?

A short list of iconoclasts who are in their own lane:

• Bryan Stephensen of the Equal Justice Initiative
• The illustrator Lauren Tamaki
• New Yorker food writer Bryan Washington

‍

George McCalman wasn’t always a multi-hyphenate. The art director-writer-illustrator started out as a traditional graphic designer, earning his stripes through the “military training” of New York magazines in the aughts.

To think back on how we “prepared”—as individuals, organizations, and communities—is a lesson in hindsight. Who could have imagined the new vocabulary, behaviors, and habits we’d all acquire in one short year?

In New York and New Jersey at that time, more than 280,000 people traveled each day on the Port Authority Trans-Hudson (PATH) train, one of the region’s most important public transit systems connecting New Jersey and New York. Squeezed into metal cars, commuters scrolled through headlines suggesting that an unremarkable trip across town might be unwise, if not dangerous. Transit agencies scrambled to establish new guidelines and produce communications to keep riders safe, but the virus was outpacing people’s capacity for behavior change at this scale and speed.

By April, the pandemic had gained a threatening grip on the New York City region, and PATH ridership had fallen off by nearly 95%. Stay-at-home orders took effect, and daily commuters hung up their office attire to the sound of sirens cutting through vacant streets. It wasn’t clear at the time how the disease spread, and how safe mass transit was. All the while, essential workers continued to pass through stations and trains each day, and their lives were on the line.

Transit operators have many contingency plans, but this unforeseen crisis required quick action: at PATH, leaders quickly implemented safety protocols such as overnight train cleaning, and posted signs and messages to let riders know what was being done to protect them, and what new behaviors they'd have to adopt to make sure those protocols actually worked. Everyone’s cooperation was essential, yet not all forms of communication are equally effective.

Try, try again

Inside The Port Authority of New York and New Jersey (PANYNJ), which operates PATH, one small department specializes in thinking about innovation within the institution and—critically—in how riders engage with the system. The Office of Continuous Improvement (OCI) had already been exploring and applying design thinking strategies when they decided to call IDEO to see how a more immersive, design-led approach could yield quick, effective solutions to the challenges COVID had delivered to the PANYNJ systems.

Lisa Dewey-Mattia, who heads the small OCI team, initially connected with IDEO Director Randy Plemel to develop a plan for an immersive, rapid collaboration that might yield some new ideas for communicating with PATH riders and facilitating behavior change. “It was a time when everyone in every industry was trying to figure out, how do we adapt?” Dewey-Mattia recalls, “We had this conundrum with regard to customer confidence and safety, and the physical design of our space. We were asking ourselves, how can we best meet the needs of the agency and our riders right now?” The small team worked remotely to workshop the highest-value, shortest-term problems identified across the whole Port Authority which could fit in a two-week sprint. Plemel remarked, “The OCI team has deep connections across the Port Authority’s different units. Designing for PATH riders and operators allowed us to focus on the most acute issue—confidence in using the system—and the learnings could be transferred to other Port Authority units like the airports and the Port Authority Bus Terminal.”

Large transit agencies aren't typically known for rapid innovation, but the only clear approach to such an unprecedented challenge was a willingness to experiment. When IDEO team members joined OCI and other subject matter experts from across the agency, the product they were working toward was not yet defined. What PATH leaders were looking for was an outcome: all riders wearing their masks properly, maintaining social distance, and heeding public messaging. How to get there wasn’t yet clear. “At that point in time, what we needed was to be able to simplify our communication to our customers. We didn’t need fancy or clever,” says Clarelle DeGraffe, the Director and General Manager of PATH, “But there’s also fear of backlash from customers that it’s too simple.”

With lockdowns and distancing preventing on-the-ground research, the team had to nix in-person interviews and spontaneous conversations, instead establishing remote communication that still yielded candid, comfortable interaction. “This was a very different project for Port Authority,” explains Morgan Keane, DeGraffe’s Chief of Staff. “So much was produced over two weeks’ time, and it was really driven by people being able to collaborate with each other, even remotely.” What became clear was that riders and workers needed to feel confident and safe on the train. Boosting confidence depended on communication strategy.

Over two weeks, IDEO and PATH staff immersed themselves in a design sprint to come up with nine concepts for solving their core challenges, from masking and safety information, to operational changes to the trains, to touchless payments. The large sprint team reviewed these concepts with a panel of advisors at PATH and the greater Port Authority, then pared them down into a series of three prototypes, which hinged on the critical behavioral mandates of COVID: 1.) Stay masked up; 2.) Maintain distance where possible, and; 3.) Practice compliance with stated guidelines.

Live prototyping in a high-stakes environment

PATH and OCI approached Port Authority leadership and asked for permission to use one of the smaller train stations as a place to test ideas. At Grove Street Station in Jersey City, signs went up alerting riders that they’d be seeing some changes around the station, and QR codes on the posters invited real-time feedback as riders passed through. “At every point our customers really understood that we were doing proof of concept,” says DeGraffe, “And that turned out to be positive. Our customers took it as a reassuring indicator that we were looking to pilot new things to keep them safe, and they appreciated us looking outside the box.”

The most successful prototype was a “mask-up zone” at the station entrance, where riders could pause, outside the flow of travelers, to properly cover their faces before descending to the platform. People immediately adjusted their flow through the station to make use of this preparation area. IDEO Senior Design Lead Jeff Kessler, who led the PATH collaboration, points out that the most enduring concepts are the ones that can survive many rounds of doubt. “There’s a balance between protecting new ideas as they emerge and letting them take enough criticism to improve and work. Ultimately, the concepts that survive rounds of testing should improve the long-term operations of the system.”

Down on the platform, a concept designed to keep people apart didn’t prove as effective. Riders provided feedback that they didn’t want to comply with signs directing them where to stand while awaiting the train. Yet, many added, they were reassured to know that new safety measures were under consideration.

That insight led PATH to think beyond posters and signs, to what other means might be used to disseminate their messages. One team member, noting that there’s limited space for signs on trains, was inspired by the “I Voted” stickers people don on their shirts on election day. “Why not be a little cheeky and make stickers to hand out along with free masks? That way passengers themselves become communicators of the message.” The idea was relatively cheap to test out, and it was a sign to riders that the agency was thinking about their well-being.

Although the train is part of many people’s everyday lives, DeGraffe says it still comes as a surprise to some that train operators and leadership are truly listening to what they have to say about their experience. “Everyone thinks of it as their own little train,” says DeGraffe of PATH’s rider culture. “They post things to Twitter about their experience and we respond.” That personal, human outreach has the benefit of building trust and connection between riders and their transit system—a better way to foster adherence than by cracking down on non-compliant individuals. DeGraffe points to the increased tension around police interaction during this time. “We’d rather give out a mask than a summons.”

Lessons for the future

More than a year after COVID first rolled into New York and New Jersey, ridership on public transit hasn’t returned to pre-pandemic levels, but residents are slowly resuming routines and vaccination rates are raising a little hope into a shaken city. At PATH, the spirit of exploration and willingness to prototype have remained. In late January 2021, PATH announced a new diplomatic corps called the Mask Force Ambassadors, “a group of volunteers whose daily mission is to help keep riders masked, socially distant, and able to travel in the safest possible environment.” On those volunteers’ bright yellow t-shirts and in large lettering around the stations, riders see the simple message developed during the IDEO sprint: “Mask On. Ride On.”

PATH Chief of Staff Keane reflects on how similar adaptive responses have appeared in other areas of the city, and where she sees the impact of institutions that are slow to change and accommodate their communities. “During COVID, the streets are being taken over for outdoor eating, distanced interaction, bookstores with takeout windows. It’s interesting to think about new ways to do things,” says Keane, “And it’s important to test for the extremes: Say okay, can a really old person do this and a child do this? Can you get from an underground station to an outdoor plaza while pushing a stroller? The way to really bring this home for people is to have them walk through with a different perspective.”

That constructive empathy is exactly what Kessler hoped for from the PATH and IDEO collaboration. “This was a moment when if we got the nuances right it would keep people healthy and taking care of each other and giving each other respectful space on the train,” he says, noting how bravely PATH stepped into experimentation as a new route to safety. “It’s a good thing for design to be working on.”

Illustrations by Ran Zheng

In January 2020, news of COVID-19’s approach was building like a looming storm. That the pandemic was coming seemed clear, but when it would arrive, where it would appear, and how bad it would be, nobody could yet predict.

COVID-19 has fueled a whole new waste stream, putting additional plastics and other material into the environment and harming ecosystems, animals, and human communities as a result.

At the same time, those masks and gloves and other personal protective equipment (PPE) are critical to slowing the progression of the pandemic and keeping our front-line workers safe. They’re disposable, yet they’re indispensable—presenting us with a difficult tension between our immediate public health needs and the long-term repercussions of this massive waste problem. Gloves floating in the ocean like seaweed threaten already endangered marine species and pollute the world’s tap water, in time delivering new risks to human health.

But an apparent lose-lose situation like this can also become a rich opportunity area for human-centered design. How might we design PPE that is effective at keeping people safe without polluting the environment?

One source for models and inspiration lies in another realm entirely: coffee shops. By exploring other industries—a design tactic known as analogous research—leaders can get inspired by how others have addressed similar questions. Looking to analogs allows designers to move beyond their expertise to see issues with fresh eyes, building new levels of understanding to their present design challenge.

The to-go cup has a lot to teach about disposability, desirability, hygiene and convenience; and as a consumer product, it’s seen more sustainability-minded innovation than medical disposables. By looking at the ways the coffee cup has evolved, we can gain new insight for understanding what is possible in the heavily regulated, fast-paced, and high-pressure world of medical supplies, where safety and sustainability are both paramount.

Next-generation solutions for the humble to-go cup

As a product, the disposable cup has gone through several eras of change relative to design and behavior. Initially, to-go cups enabled convenience and efficiency. But nearly all of the to-go cups that exist today are made of a combination of materials that make them next to impossible to recycle or compost. They were designed without any thought to where they would end up after being used, aside from the landfill or incinerator.

Environmental concerns then sparked a movement encouraging consumers to bring their own reusable cup. Committed environmentalists were willing to do this, despite the personal compromise on convenience, but the trend failed to scale and meaningfully reduce waste. Some cups are now made of materials that can biodegrade or be composted, but both processes are difficult to achieve at a global scale due to cost and lack of access and infrastructure.

In 2018, OpenIDEO launched a design challenge to invite new ideas for material and processes that could lead us into a more sustainable era for to-go beverage containers. The NextGen Cup Challenge represented a new horizon for sustainability that goes beyond the product to offer a vision for a system and business model where circularity is the driving principle. Contrary to the linear “take-make-waste” model of manufacturing that has characterized industrial products for centuries, a circular economy designs waste and pollution out of the value chain, keeping products and materials in repeated use, and regenerating our natural systems.

The NextGen Cup Challenge asked the question: How might we design the next generation fiber cup to be recoverable on a global scale, while maintaining the performance standards we know and trust? The Challenge, managed by OpenIDEO, was part of the NextGen Consortium, a global initiative convened by Closed Loop Partners and founding partners Starbucks and McDonald’s. The 12 winning solutions—categorized into innovative cup liners, new materials, and reusable cup service models—have the potential to turn the 250 billion fiber to-go cups used annually from waste into a valuable material in the recovery system.

When we see masks and gloves in the gutter, we can imagine a similar trajectory for innovation. But there’s a different set of barriers—psychological, regulatory, supply chain, and safety—to contend with. The question becomes: How can we apply circular design principles in the healthcare industry to enable a more robust and resilient supply chain of PPE, which can be safely reused to become regenerative rather than wasteful? Based on the learnings from the NextGen Cup Challenge, we see two rich areas for design: redesigning PPE products to be sustainable and adopting a systems-level perspective.

Redesign or repurpose the product itself

The NextGen Cup Challenge sought manufacturing and material innovations and technologies that improved the existing to-go cup, making it more valuable at the end-of-life, whether through recycling, composting, or biodegrading. For consumers, baristas, and retailers, these new ideas would require little behavior change—they offered the same convenience of the single-use cup, just made of something new and more sustainable. SoluBlue, for example, is a winning NextGen Cup Challenge solution that produces plant-based, food-grade, and non-toxic materials that quickly biodegrade after use, and can replace some forms of single-use plastics.

The same concept is hopefully being applied to PPE: Recently, the Canadian government announced two business challenges for the private sector that offer funding for PPE that won’t end up in landfills. One calls for businesses to develop compostable surgical masks and respirators that can be mass-produced for healthcare workers. The second challenge seeks technologies for "efficient and cost-effective" PPE recycling, which can transform potentially contaminated PPE into "valuable materials that can further be used in manufactured products.”

If Solublue can make a cup that biodegrades after one use, why couldn't we do the same with a face mask or a pair of gloves? Furthermore, as we consider redesigning PPE to be safe and environmentally-friendly, there is not only an opportunity to redesign the product, but to extend its value to other products. Binish Desai, for example, is an entrepreneur and environmental activist based in New Delhi who is transforming used PPE into bricks for homes and factories. Desai installs bins outside of apartment buildings and retail shops to collect used masks and gloves, then leaves them untouched for 72 hours. The gear is then sanitized, shredded, and sanitized again. Lastly, the sanitized scraps are mixed with paper sludge and a binding agent to form various brick molds.

Good intentions must be coupled with systems thinking

Sometimes the product alone—or a byproduct of it—can’t solve the problem. We’ve had the technology to produce a compostable cup or mask since long before COVID-19. But as demand for PPE outstrips supply, it becomes critical to consider the system surrounding the product to enable recoverability and reusability. In neglecting to design for how a product fits into the larger ecosystem, we risk exacerbating the issue. When items are improperly disposed of (for example, when a compostable cup is recycled, which is common) it can contaminate the entire bin, dumpster, and truckload with byproducts that devalue the actual recyclable material. This sometimes results in full batches of recycled materials being removed from the recycling line and sent to landfills due to a single incompatible cup, as it has potentially contaminated the entire collection.

New solutions need to be designed in tandem with new infrastructure, or designed to work within the existing system. Muuse, a NextGen Cup Challenge winning idea, created a platform for reusable cups that works within restaurant networks with the goal of eliminating single-use waste. Before the pandemic, consumers could “borrow” a cup from one of Muuse’s cafe partners, such as Equator Cafe in San Francisco, by scanning the QR code on the cup. Within the designated time period, the customer returned it to any of Muuse’s 40 cafe partners in San Francisco. Muuse inspected and cleaned the cups, and collected late fees through tracking technology, seamlessly integrating into the way the restaurant system operates.

Muuse can offer inspiration for redesigning PPE to be both safe and regenerative. Most people know that doctors wear sterile gloves during surgery. But fewer realize that surgeons can be particular about the gloves they use (e.g. latex, non-latex, nitrile, vinyl). In design research, we’ve noticed that some physicians prefer specific layered combinations of gloves, such as latex over non-latex or vice versa. When we look at other trades, many professionals have their own pair of reusable, personalized gloves, like welders, chefs, and athletes, that are sustainable, help them excel in their craft, and keep them safe.

How might we enable this for doctors? What new innovations—in reusable design but also in the washing and sanitation procedures that already exist in hospitals for bedding or scrubs —might achieve safety and waste elimination, while also enhancing physician desirability and performance? To support frontline workers during the coronavirus pandemic, Ford pivoted to produce face masks, shields, and ventilators using the same air filtration technology the automaker uses to produce the ventilated car seats found in F-150 trucks, putting their existing materials towards an urgent global need. Taking a cue from Muuse, what if a new system was designed to enable frontline workers to return these masks to hospitals, and hospitals to then return them to Ford? This reusable system would be keeping key materials in use in both the auto and medical world.

A future that is designed for both sustainability and safety

Alarming photos of masks and gloves scattered on sidewalks and washed up on beaches are a reminder that COVID-19’s impact spreads far wider and deeper than we yet realize. The virus and its reverberations have touched every aspect of life on the planet. But human safety does not have to come at the expense of environmental damage and climate change.

Design encourages us to look to unlikely analogs, like the unassuming and ubiquitous to-go cup, to be inspired to create a world in which safety and sustainability can co-exist, offering protection to all.

The landscape of litter has shifted over the past year. The pandemic has made disposable masks and gloves as commonplace as plastic bottles and cigarette butts on city streets.

In between refreshing our local COVID-19 dashboards and the U.S. election map, we’re proud to have produced another year’s worth of Octopus stories. Thank you for stopping by to read our design blog. Below are the 10 stories you loved the most in 2020. And here’s to a calmer, kinder 2021.

IDEO Designers Share the Best Creative Advice They've Ever Received

There’s no shortage of inspirational quotes, but meaningful, personal advice can change a career and a life. A preview of some of the creative advice IDEOers shared in this piece: “A bad movie is better than an unfinished movie,” and, "When you feel stuck, draw a card and do whatever it says."

4 Ways to Work Together When We Can’t Be Together

Sometimes while watching TV episodes filmed before the pandemic, I get pangs of fear when people shake hands or stand less than six feet apart. Everything has changed in the last 10 months or so. This story contains early ideas on how to navigate design work during a pandemic. A question we’re still asking from this piece: “As designers, how do we design our way through this?"

24 More Things We Want to Redesign

Applying for a job. The news. Hot dogs. IDEOers want to redesign those, plus 21 other things.

How a Kid's Perspective Improves Design Research

Whether your design research is happening in a boardroom or at an amusement park, author Ben Swire argues that adding a kid’s perspective can produce better design outcomes. Although this piece is about his daughter, he is not biased at all.

4 Reasons Warm-Ups Will Fundamentally Change Your Work

Olivia Vagelos is IDEO U’s resident warm-up expert. Not only does she have an entire database of exercises, but she also designs them on the spot. Her firm belief is that every meeting deserves a warm-up—read the piece to learn why.

How Would You Reimagine Learning? 5 Visions for Our Post-COVID Future

The coronavirus pandemic has pushed an estimated 1.6 billion students out of the classroom. As teachers adjust to this remote reality, OpenIDEO asked a question: “How might we adapt to remote learning while also using this moment to radically reimagine what we need our education systems to be?” This story shares five ideas to shape this future.

10 More Documentaries That Will Spark Your Creativity

Devin Peek is a visual connoisseur, so you can trust her documentary recommendations are well-vetted. (She even saw one of these at its premiere!) This post shares 10 more documentaries to spark creativity; her first post, from way back in 2016, is one of the Octopus’ most popular of all time.

4 Exercises That Prove Listening Matters

It’s noisy out there. Drawing from Krista Tippett’s work, author Allison Press designed and adapted four exercises that dive deep into the transformative power of listening.

How Quitting Plastic Got One Designer Thrown in Mall Jail

There are some surprising benefits to quitting plastic: IDEOer Shuya Gong saved money and produced less trash. On the flip side, she almost got thrown in mall jail, so take on the no-plastic challenge at your own risk.

5 Tools to Design for Digital Confidence

Every single day, one million people use the internet for the first time. IDEO’s Jason Fund and George Joseph share a set of tools, created alongside Google and the Bill & Melinda Gates Foundation, to help designers build digital services that work for everyone—even if your user is touching a smartphone for the first time.

In last year’s top 10 stories post, my colleague Saige wrote, “We can’t wait to see what 2020 has in store.” Upon reflection, I probably could’ve used more time to prepare for what the last 12 months delivered.

I help organizations cut through complexity by shaping how they show up, through brand strategy, identity, and storytelling.

Working at the intersection of brand and business, I bring an editorial eye and a bias toward making—turning ideas into tangible experiences that people can understand, trust, and believe in.

My work spans government, healthcare, financial services, media, and consumer goods, from launching Gen Z-focused ventures to building innovation labs and reimagining legacy brands. I relish moments of ambiguity and enjoy translating across teams, perspectives, and priorities to move ideas forward.

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.

For 25 years, I've asked the same question: Who does this design exclude—and what are we going to do about it?

My work spans human-centered strategy, inclusive design, and qualitative research, with clients ranging from Microsoft, Google, and Verizon to the National Science Foundation, and San Francisco Unified School District.

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.

I am currently writing User Error, a nonfiction book about digital access and the design decisions behind it. I live in Oakland, California.

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My expertise spans brand, communication, and product design across tech, education, the arts, and social impact.

I believe great work demands both high-level vision and obsessive attention to detail, and only happens through collaboration.

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

Before joining IDEO, I worked at the brand firms Pentagram and VSA Partners. I began my career as a designer, leading teams at the School of the Art Institute of Chicago and the Milwaukee Art Museum. I hold an MFA in graphic design from Maryland Institute College of Art and a BFA in communication design from the Milwaukee Institute of Art & Design, and have taught at some of the best design schools in the US.

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.

I advise global leaders on developing China-led innovation and capabilities.

In over 15 years in IDEO Shanghai, I have worked on projects that use design to elevate the quality of the experience of healthcare products and services, streamline processes that increase productivity, create spaces and programs that promote and enable inclusive communities, and build next generation mobility solutions that are planet-positive.

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.

Most AI products today are built for work—a space with clear problems and established systems. One founder noticed a gap: personal life is messier, harder to systematize, and mostly left behind by the AI boom. So she built Cue, a personal AI that lives inside iMessage and group chats, to go where the other tools haven't.

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In this episode, Becca Carroll, IDEO's Chief Strategy Officer, talks with Sida Li, co-founder and CEO of Shared Context Lab, about staying anchored to a human need while the technology around her keeps changing shape, why she treats her business model with the same rigor she'd bring to a product, and what it feels like to build a company at this particular, disorienting moment in AI.

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The conversation also gets into how Sida makes design decisions: the language Cue uses to describe itself, the tradeoffs behind building inside iMessage instead of a new app, and a real story about a business idea that didn’t pan out.

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This is the second in a two-part series profiling founders from IDEO's Startups-in-Residence program. The first conversation is with Johannes Seemann, founder of Sooner, on designing GenAI for the emotional side of money.

Most personal financial tools are built to run the numbers and optimize towards a budget. While that works for some, most people experience money as a lived relationship that does not neatly fit into a spreadsheet. Johannes Seemann and Becca Carroll discuss why money is emotional before it is mathematical, and what a human-centered approach to building a generative AI financial product looks like in practice.

Mina Seetharaman talks with Scott Shigeoka, author of Seek and Head of Curiosity Cultivation at the Eames Institute, about what distinguishes genuinely curious leadership from performative curiosity, how power dynamics shape curiosity, and why practicing curiosity can restore energy rather than drain it.

Mina Seetharaman talks with David Epstein, author of Inside the Box and Range, about why total freedom often produces average work, how leaders can design useful limits on purpose, and what organizations such as General Magic and Pixar reveal about the relationship between boundaries and creativity.