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.

Like a gawky teen who acts like a kid but resembles an adult, many Internet-born organizations find, a few years in, that their mode of operation no longer matches their growing size. The acceptable norms of a small startup—like decision-making around a shared kitchen table—actually prevent these companies from continuing to innovate once they’ve scaled. As a result, they begin to plateau and become susceptible to disruption and competition.

Often, companies in this teen stage seek guidance in areas they've neglected during their initial growth spurt. As one CEO recently shared, she needed help “jumping the S-curve.” The following three principles can enable digitally-native companies to keep thriving and achieve sustainability—in other words, help the skinny kid fill out and establish the traits needed to become a grown-up.

Rethink team structures and incentives

When startups consist of just a few people in a room, there’s no separation between disciplines: An engineer sits next to the head of sales, who sits across from a project manager and shares a file cabinet with a designer. But as the company scales, teams often become siloed into discrete functions. When disparate groups are responsible for specific parts of the customer experience, it becomes fragmented.

In a project IDEO led with an online retail startup that had fallen into this trap, we noticed that the front-end engineers and UX designers—who were responsible for the website search interface—rarely communicated with the back-end engineers and data analysts. Because of this, the front-end team designed user search experiences that weren’t even feasible from a back-end point of view. In addition to this being a massive waste of time and effort, it represented a misalignment between teams working at the same company, on the same product, and serving the same customer. If internal teams are disconnected, the customer experience will inevitably be disconnected as well.

For organizations struggling with this, there’s an opportunity to reorganize teams around moments along the customer journey (account creation, browse or search, checkout, and so on), rather than function. Eventually, that misaligned company created an interdisciplinary search team that included designers, data analysts, account managers, customer success associates, and others. This resulted in a more consistent and functional search experience for users, which in turn led to more people finding, and ultimately buying, products on their site.

The customer experience needs to guide not only team organization, but also incentives. In early start-ups, individuals and teams are rewarded for speed and execution: The quicker features are released, the better. But this mindset only reinforces the tendency for teams to evolve into myopic silos, unable to grasp the holistic experience beyond their discrete function.

When reorganizing their teams around the customer journey, that online retail startup established new incentives and shared success metrics that encouraged the newly-formed groups to work together and focus on the customer experience, rather than speed and quantity. The new interdisciplinary search team’s incentives were tied to a customers’ success in finding the item they were looking for on the website or app.

Dig deeper into data

Internet-born startups tend to have an abundance of engineers who are experts at collecting and leveraging data. They relentlessly A/B test the product and often immediately take action based on the results: If button A is generating more clicks than button B, it’s best to go with the former.

This is where teenage companies take a wrong turn. Engineering teams rely on their same tried-and-true data and analysis methods used when they were chasing the next round of funding. But now that the company has matured and needs to become profitable, it must change its habits to match this new stage of growth. Continuing to blindly A/B test without considering the implications leads to over-optimizing their current product features. This results in feature bloat and prevents innovation beyond a hallmark product or technology.

Instead of reinforcing old habits, it’s useful for startups to ask why something is occuring—why is this button outperforming the other? Many teams skip this question. As a comparison, during qualitative research, we ask target customers open-ended questions to learn why they think, feel, or behave in a certain way. For example, a shopper may share that they prefer organic produce. But learning why—perhaps due to climate concern or wanting the best for their kids—unlocks the potential to understand how an online grocery delivery startup could innovate.

Rather than merely pushing organic strawberries on the homepage or building an “organic” product filter, the company can use this valuable knowledge to grow beyond their primary offering. They can consider questions like: Do environmental activists or health-conscious parents represent new or existing customer segments? How might we meaningfully shift our product or create a new one to serve them? The key is to follow data collection and A/B testing with qualitative research aimed at understanding why. Engineers will need to push beyond their comfort zone to ask these questions. Companies may also consider bringing qualitative research specialists onto engineering teams to help build this capacity.

For Internet-born startups, data can’t be only an optimization tool. It’s also a catalyst for deeper qualitative understanding and continuous innovation.

Embrace a new mode of leadership

When founders are used to working alongside engineers and designers, they often hesitate or struggle to step into the level of leadership required to run a company with hundreds of employees. The skills that enable someone to build a company are not always the same as those required to lead a mature and rapidly growing organization.

During a meeting with a digitally-native healthcare startup, the founder asked for a pause so he could weigh in on new illustration icons. By this point, the company had 200 employees and the founder had hired over a dozen senior leaders with deep experience managing teams and scaling mid-sized startups. But because of this CEO’s tendency to do the work (which he embraced when the startup was 10 people) rather than delegate the work, he wasn’t empowering this new talent do their jobs. Letting go, trusting others, and delegating can be particularly difficult and humbling for founders of companies in this adolescent period. But it’s essential to make these shifts for the startup to flourish.

This same founder also shared that communicating the company’s vision and big decisions to employees felt like more of a challenge than it used to. When an organization can fit inside a conference room, leaders have a simpler time with this: Small startup teams are often made up of generalists with an “all hands on deck” mindset. But with hundreds of specialists on board, CEOs must translate their strategy to multiple teams with differing expertise.

Each quarter, the founder began holding meetings with each team in addition to town halls with the entire company. Rethinking one’s communication strategy at this adolescent stage can create more of an opportunity for understanding, connection, and inspiration. This transition also reflects a new level of maturity for a leader.

Digitally-native startups initially grow and succeed due to a certain set of conditions: They’re technologically innovative, data-driven, and have leaders who can inspire early hires and investors and build from the ground up. But when these startups scale, those core conditions no longer do the trick. Evolving from a rambunctious, scrappy teen to a promising adult requires a new willingness to centralize around the customer experience, think before acting, and reach a higher level of leadership.

Special thanks to Mike Stringer, Jill Levinsohn, and Deb de Vries for their contribution to this article.

Visuals by Kate Bingaman-Burt

Startups enjoy a reputation as the bright young things of the business world. They’re digitally fluent, small enough to be nimble, and new enough to be free of legacy baggage. Yet many successful startups face a rude awakening if they make it past infancy and scale to hundreds of employees. While success is exciting, puberty is awkward. These principles can help.

Now, almost seven years and two babies later, all four of us are still in the same space. I accidentally gave birth to our second child on the apartment floor—a life-changing moment that only took up about twelve square feet. Eric calmly delivered her, while speaking to the paramedics, and our two-year-old stood in the corner.

So, our apartment has served many different purposes. With each additional human, black shirt, pair of boots, friendship, painting, plant, and piece of furniture we have had to really evaluate what stays in the apartment and what must go.

I’ve devoured all the decluttering blogs, books, documentaries, and conversations. I’ve tried a lot of the methodologies, and written “get rid of everything” on my weekend to-do list for more than seven years—and failed. But over the years, I’ve built a framework for making decisions about what to bring into my life—and our space—based on what matters most to me and to us.

I’m not sure that this is the final version of my criteria for what stays and goes, but I’m trying it out—a true IDEO prototype. I would like to think that these five principles could apply to whatever life you have—whether you have a huge space with three closets, a tiny room with no closet, or you actually live in a closet, like my daughters do.

1. Relationships

Relationships are what matter most to me. I value people. I love having them over to celebrate, I love feeding them, letting them stay overnight, hearing their stories, letting them shower, and taking meals to them. We built a Murphy bed for my husband and me to give us more space, but, mostly, so that we can have people over to talk and eat together, and develop those relationships that mean so much to us. We also built bunk bed cribs in the closet (bedroom) so that the girls would learn to share. Instead of being a constraint, I think of our tiny space as a way to share happiness, motivate us to resolve conflict more quickly, and cry and be sad—together.

2. Cleanliness

Cleanliness isn’t just about Pine-Sol and bleach—it’s also about reducing visual clutter. White walls, curated with colorful artwork and flooded with natural light, feel clean and visually calm. With a human baby for a Swiffer, I am also particularly aware of accumulating dust. And although it would be more convenient, I find it difficult to give up my duties to a cleaning person because of my high standards and weird obsession with fresh grout and shiny floors. And so, cleaning and reducing visual clutter are a family affair filled with songs, dance breaks, snacks, and high fives.

3. Long-term vs. short-term

For me, investing in things that will be with me for the long term is a balance between using my money better and producing less waste. In the short term, I will reuse something that I already have, like a hand me down click-on kid booster seat, even though I don’t like the way it looks or the exact function of it. (My kids will eventually be able to sit in a regular chair unassisted, right?) To help manage the amount of waste we produce, we also have the super luxury of curbside compost, recycling, and garbage and we have communities that will happily use things that we no longer can.

4. Aesthetics

When one thing is out of place in a small space, everything looks like chaos. To create order and balance, you need a bit of white space to breathe, and nice things to look at. To give us more storage we installed cabinets high up on the wall, out of our line of sight. We hang our laundry bags on a dowel in our front closet, hiding dirty laundry and freeing up the floor space that a laundry hamper would take up. We often rotate the refrigerator artwork to keep things interesting and curated. We make our home a place filled with things that we’re proud to talk about, look at, and live with.

5. Health and wellness

We all need space to be together and to be apart, space to retreat to and be quiet, space to move around and dance, or space to exercise or meditate. The place where you live can’t always serve all of those purposes. Creating cozy, soft places to read, moving furniture to the perimeter to make room to dance and run in circles, and hanging out in the shower just one minute longer to clear your thoughts have all helped us be a healthier family. And when it feels like everything is breaking down, we buckle the girls in the stroller and go outside. The outdoors have become our extended living room, allowing us to spread out our arms a little wider and play.

We won’t be in our tiny home forever; two growing children mean that one day our apartment will actually be too small. But we—and you—can take this methodology we’ve created wherever we go.

When you think about your own space, remember to consider the things that matter most to you, and the things that work for you. Take pride in your home and make it your own sanctuary. Learn to see the possibility in your space and in your life.

In the meantime, we’ll be thriving in our 400 square feet. If you’d like to drop by, we’d love to feed you.

It all started in 2011, with eight weeks of apartment searching, a lot of flirting with landlords, a couple of rejections (because “couples always break up in studio spaces”), and an eventual win—four hundred square feet for my husband Eric and me.

As more of our interactions with healthcare become mediated by screens, the need to design human-centric systems only increases. Digital interfaces can empower people to take control of their own health, but these systems can also amplify the sterile interactions for which the industry is all too well known.

In order for “making healthcare more human” to be more than a marketing slogan, it’s important for designers, entrepreneurs, and business leaders to keep in mind the humans they serve—especially when designing digital products. Below are five principles we use at IDEO to keep human needs at the center of everything we do.

1. Meet users where they are

Human-centered design means designing for a user’s whole life context: income, employment, food preferences, and emotions. We must also consider the expectations, learned behaviors, and technological capabilities each user brings to the table when thinking about his or her health.

At IDEO, we always try to map out the full user journey. And because that user is human, they might not always be consistent in the way they interact with the digital product or tool. For example, in the course of designing a connected blood glucose meter, we observed that many people with diabetes don’t test their glucose levels on a regimented schedule. Why? Life gets in the way.

But because certified diabetes educators (CDEs) need as accurate information as possible, they ask patients to test as regularly as possible for the two weeks leading up to an appointment. This is where designers can play a role: Because digital tools live in people’s pockets and homes, we can tailor solutions to the individual to a greater degree than is possible in the in-person clinical care environment. By observing how patients use workarounds to integrate products into their routines, we can design solutions that work within the context of their lives. It’s only by meeting users where they are that we can inspire meaningful behavior change over time.

2. Create “give-get” loops

Imagine you’re introduced to a digital product or service by a healthcare provider during a routine clinical visit. You may choose to search for the accompanying app and download it from the App Store. You’d then go through an onboarding process, create a username and password, and decide whether to accept push notifications. You may also be asked to share sensitive health information or consent for the application to access it.

All of these steps have happened before you gained any tangible value from the product or service. In the absence of clear benefit to users, it’s not uncommon to lose many at this early stage.

One way we address early user drop-off is with a “give-get” loop. This could be as simple as asking a user to enter their dietary restrictions in exchange for tailored suggestions about nutrition, or asking for an address to provide hyper-local recommendations. Ultimately, good user experience design incorporates that data to complete a cycle of action that benefits the user. When we’re able to create conditions for purposeful data gathering, we can then recognize patterns and help users discover insights that they could act upon by introducing and initiating new behaviors.

At the same time, we need to be mindful of the role we might be creating for ourselves as recipients and holders of sensitive information. That’s why we’re careful to only collect the “minimally viable data” required to create the intended user experience.

3. Design for relationships

User experience design for managing chronic disease needs to rely on more than software and technology. The relationship between the primary user and their network of care providers and community members has significant bearing on the success of the product. The user experience is part of a larger service ecosystem and must consider how the nodes in that system interact.

Today, pharmaceutical companies often use digital tools to drive adherence—to make sure that patients take their medication at the right times and in the right ways. But digital solutions can go beyond adherence: they can—and should—support holistic care beyond acute or immediate medical needs.

When digital experiences and interactions can help patients live healthier lives, they become tools for delivering better health outcomes overall, beyond any specific condition. Further, the burgeoning field of digital therapeutics is turning out digital health products that themselves stand as effective, proven interventions to treat physical, mental, and behavioral conditions.

4. Don’t be limited by the boundaries of “the device”

When IDEO began working with Bayer Diabetes (now Ascensia Diabetes Care) in 2006, people with diabetes were able to access their own blood glucose data either by logging it themselves or by showing the meter to their doctor. The Contour USB opened up new opportunities for design, enabling people to plug the meter into a personal computer and transfer all readings to a single document. Once the Contour USB launched, the next design challenge was to make it simpler and less expensive. We honed in on a feature: the color screen.

While a color screen might seem like a great new opportunity to present rich information, it was only used for displaying simple data, like meal markers, dates, and times. From a human-centered design perspective, it made more sense to eliminate the color screen and use users’ smartphones or computers instead. The meter’s color screen was adding unnecessary cost without contributing enough benefit in return.

By focusing on the outcome rather than the solution, we were able to spot our own blindspot. Just because an intervention can be solved with technology doesn’t mean it always has to be.

5. Inspire the organization to evolve

As a rule, creating digital products and services will create the need for new capabilities and processes inside the organizations that deliver them. Digital user experiences are living systems, and they require organizational investment and structures ready to support near-constant change. As soon as we’re “done” designing a digital experience, a software operating system might change, a new data privacy law might pass, or a content partner could change their rules of engagement, any of which would require additional refinement.

Today, many companies that deliver global offerings at scale work in silos that are each oriented around different targets and metrics. There are several examples where organizations are directly addressing this challenge through new experimental ways of working. Whether through a corporate innovation lab, internal incubator, or entirely separate venture, carving out a portion of the business enables efficient experimentation without detracting from core business objectives. Then, once proof-of-concepts have been successful, learnings can be incorporated into the rest of the organization.

Even within the most nimble and flexible organizations, any digital product or service will need to continue to evolve and improve from day one. It’s like that old adage about buying a car: once you drive it off the lot, it immediately goes down in value. Once a digital solution is launched, it’s essential to start planning immediately for its next update. By listening to the needs of end users, it should be clear where to begin.

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From stepping into a doctor’s office to taking a daily vitamin, each interaction with the healthcare system was designed for and by a human—and yet the industry can often feel soulless.

CEOs like Tim Cook of Apple, Julie Sweet of Accenture North America, and Larry Fink of BlackRock joined together to declare that businesses must also focus on the ethical treatment of their employees, suppliers, and the environment. In other words, organizations must rethink their purpose—a reason for existing beyond making a profit.

But establishing purpose isn’t simple, particularly for parent companies that own a variety of businesses. Mergers and acquisitions can put the purposes of different enterprises at odds with one another when they find themselves under the same corporate umbrella. Individual employees create their own goals and motivations. But beyond the structural and financial ties across entities and employees within a corporation, there often is no consistent, unifying vision.

With so much complexity in a conglomerate organization, where do leaders begin to create a purpose that functions across many businesses? The solution lies in “nested purpose”—a layered approach that starts at the business level and ladders up to the parent level. Nested purpose builds unity among all employees and businesses, making everyone feel connected. We’ve seen it shift leaders’ mindsets from “running a business owned by a parent company” to “being part of a family of businesses that are stronger together.” Nested purpose has the power to inspire new individual behaviors that in turn catalyze global impact across a corporation.

Walt Disney Company, for example, defines their “why” within their mission statement, “To entertain, inform and inspire people around the globe through the power of unparalleled storytelling.” This statement applies across nine subsidiaries, each with different audience engagement, content, and distribution. A tier down, ESPN, which is owned by Disney, describes their “why” as, “To serve the sports fan, anytime, anywhere.” This statement is more focused on the ESPN consumer and their habits, but it nests comfortably within Disney’s higher purpose, enabling the two to function in tandem toward their ultimate goal, and giving employees in the smaller section of the business a sense that they’re meaningfully connected to the parent corporation.

The following is a series of tools and exercises to help foster nested purpose, based on our experience working with a global corporation hoping to drive transformational change within their organization. Like the Business Roundtable executives, this particular CEO knew that developing purpose at the parent-company level would be both virtuous and strategic, but needed leaders from each of the businesses to be engaged, aligned, and inspired. In addition to engaging these executives, we included promising talent—from mid-level managers to vice presidents—in the work to define and activate parent-level purpose.

Begin by setting the wheels in motion

At the first session with the heads of the businesses and their employees, we introduced the Purpose Wheel: a tool designed to foster conversations about purpose. The Wheel helps teams envision the various ways the parent company might have impact in the world. Simultaneously, the Wheel builds the foundation for an eventual purpose statement. Before crafting the specifics and poetry of a purpose statement, leaders must first find common ground around the idea and how it’s nested throughout the company.

Spinning the Purpose Wheel, the group imagined what the parent company’s future might look like if their purpose was grounded in the following five underlined areas:

We exist to Enable Potential
This suggests a parent company creates impact by inspiring greater possibilities, such as Nike, whose products and services exist to motivate and empower athletes.

We exist to Reduce Friction
By simplifying and eliminating barriers, companies like Spotify make daily pleasures—like listening to music—more accessible and seamless for customers.

We exist to Foster Prosperity
Brands like Warby Parker, which donates a pair of glasses to someone in need for every pair sold, creates impact by supporting the success of others.

We exist to Encourage Exploration
This suggests that a company’s purpose is to champion discovery. Adobe, for example, offers a creative suite of tools and services that people can use to design and explore.

We exist to Kindle Happiness
Zappos purpose is “to live and deliver WOW.” The retail company creates impact by inciting pure joy.

While spinning the wheel, we posed the following questions to encourage discussion: If we exist to [ insert one of the five areas ], how might that purpose ultimately show up in our individual workplaces and in the world? What would all of us—together—have to agree to start or stop doing in order for this parent-company purpose to be true?

The Wheel’s five areas are intentionally designed to be fluid. Phrases like “enable potential” and “encourage exploration” are similar yet different. Though Spotify’s purpose is grounded in reducing friction, the company’s purpose could also be rooted in kindling happiness for its millions of listeners. This kind of flexibility is especially useful when establishing shared purpose among diverse businesses, as it enables generative conversations and more opportunity for alignment.

The Purpose Wheel also opens teams’ eyes to new possibilities: If a parent company exists to foster prosperity, for example, what innovative ideas or growth opportunities might this foundation unlock for one of its business groups? Perhaps it’s tweaking the manufacturing process to be more environmentally-friendly, developing a more human-centered customer service strategy, or instituting a new parental leave benefit for employees.

Get tangible through storytelling

Once this groundwork was laid, we broke the executives and employees into small groups and asked each member to share stories about their business that made them proud or represented their workplace culture at its best—focusing on humans and experiences, not profit or performance.

One business head talked about an entry-level employee who works at one of the energy plants her business operates. During a shift, the worker put his job at risk by persistently questioning a supervisor’s recommendation. His willingness to push authority ended up preventing an accident at the plant, one that would have put both the business and worker safety at risk. A mid-level manager shared a story about his business providing the financial resources to send a customer’s son to engineering school. After graduation, the son returned to his village to help the community learn to irrigate crops and generate food for the local area.

When asked to boil these stories down into values, the groups landed on words like bravery, dedication, trust, protection, empowerment, and generosity. Articulating these values prompted even more storytelling: Other participants began considering and sharing stories from their own organizations. Eventually, they generated a collection of stories about a particular shared value from across the parent company.

Look to the future with optimism

While stories of the past help illuminate purpose-oriented practices already in play, considering the future encourages leaders to articulate hopes and dreams for the parent company. During another workshop, we gave the team blank front covers of magazines, ranging from WIRED to National Geographic. We asked them to reflect on the purpose statement and values they’d derived from the previous exercises to imagine how their company might show up on a magazine cover in the future. What image would appear? What would the headline say?

One participant proudly taped his National Geographic cover on the board. The headline read, “Plastics Now Completely Eliminated From the World’s Oceans.” Another’s cover said, “[Parent company’s CEO] Named Time’s Person of the Year.”

When creating purpose at the parent company level—or any level for that matter—it’s helpful for tools and exercises to toggle between the accessible (sharing real stories) and aspirational (spinning the Purpose Wheel and imagining the future). This ensures that the eventual purpose statement is ambitious and inspirational, but also relatable and within a business’ reach.

Collaborate to drive improvement and alignment

To ground the group back in the tangible, we guided them through a writing session, asking them to draft three potential purpose statements for the parent company, based on the structure established from the Purpose Wheel, the values derived from their favorite stories, and the visions captured on the magazine covers.

Each team presented their favorite to the larger group, then switched tables and left their favorite purpose statement for others to inherit, build on, and improve. At the end of the rotations, every participant had contributed to five strong purpose statement prototypes to continue refining and testing with teams.

Putting purpose into practice

Nested purpose isn’t simple. Done poorly, it can confuse, distract and compound already complicated dynamics at the parent company-level. But when carefully planned and designed with both leaders and their employees, nested purpose can invigorate an organization by clarifying roles and creating cohesion across industries and countries.

Written by Kristin Kelly and Nate Carter
Visuals by Louisa Liu

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Business Roundtable, a lobbying group composed of executives from some of America’s largest companies, recently released a statement arguing that today’s corporations must do more than simply drive shareholder value.

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.

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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.

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.

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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.

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