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.

Blockchain is a relatively new technology that will soon replace the underlying structure for a lot of the applications and services we use today, including systems for managing our finances, tracking our health, and determining how we connect, transact, and communicate with each other.

So, while it’s tempting to write off blockchains as something to leave to the coders, the potential human impact is too big to ignore. There will be user experiences, communications, and other completely new elements that will need to be carefully designed.

At IDEO CoLab, we explore the potential of emerging technologies like artificial intelligence and the Distributed Web by building prototypes in quarterly sprints. A crucial part of our mission is considering human-centered values in the process of building for the future—creating things the world actually needs, not just more technology.

Here are three reasons why designers need to start thinking about blockchain technology today:

1. It’s bigger than just cryptocurrency

Many people are familiar with cryptocurrencies like Bitcoin and Ethereum. (And for those who aren’t, here’s a quick video that explains the basics.) Blockchain is the technology that forms the underlying structure for these digital currencies, and gives them the unique qualities that make them different from conventional lucre like the US Dollar. That structure includes the ability to exchange funds directly with anybody, anywhere in the world, without the need for an intermediary like PayPal, Visa, or Citibank.

But what most people don’t understand yet is that blockchain technology is about so much more than digital coins. At its essence, a blockchain is a new type of digital ledger which records information in a publicly-verified, traceable way across a decentralized network of devices. What this means is information for, say, an app isn’t just stored on a privately-owned server somewhere—it’s stored across multiple devices that communicate with each other to verify user activity, rather than referencing one central authority, like a Wells Fargo or Google.

Blockchains offer a new way of tracking information, and their applications are broad. Not only are they expected to pervade the financial industry, they’re also being integrated into global shipping, parts tracking, digital identity, healthcare, and other systems. In fact, it’s hard to think of an industry that relies on technology that wouldn’t benefit from using a blockchain.

With a potential to reach millions—even billions!—of people, designers need to start thinking about how they can use their skills to improve the user experience for all of the products and services that will be built on top of this new infrastructure.

2. It will change how humans interact with one another

Blockchain isn’t just a technology, it’s also a state of mind. Well, okay, that might just be the Californian in me talking, but all exaggeration and hype aside, blockchains are going to have a big impact on our culture too.

We’ll come to expect new things from our relationships with other people and parties, based on how blockchains manage our digital interactions. Mirroring the open, accessible code structure, people will expect the companies they do business with are open and accessible as well.

Consumers will demand more information about the goods and services they purchase. Companies will be held to a higher standard of data security.

Trust will become perhaps the most important design element in any system.

Imagine a world where all interactions are more egalitarian, transparent, and traceable—what would that look like? How might we design for this new world view?

(Check out this talk from CoLab’s Gavin McDermott to learn more about the 10 key landmarks of the decentralized web movement.)

3. Technology needs design more than ever

Our world is changing at lightspeed. As new technologies and tools are released daily, it’s easy to get caught up in the rapid pace without stopping to think about the human impact of what we’re creating.

We have a tendency to think of code and algorithms as neutral tools, but they’re not. Technology is neither good nor bad, it's how we apply it that matters. Everything we create has a human imprint on it—our assumptions, hopes, and fears are built into the systems we design (the bias in algorithms has been getting a lot of ink lately).

That’s why, moving forward, we’re going to need a group of people that advocate for the human experience—and human rights—as we develop these technologies. Especially right now, as emerging technologies like blockchain begin to take form, it’s important for designers to have a voice in that process from the very beginning.

How do you envision the designer's role evolving alongside blockchain developers? Let us know on Twitter or Instagram #blockchaindesign

Looking for ways to get started designing for blockchains? Check out this list of quick prototyping tools for emerging technologies from IDEO CoLab.

Blockchain. You’ve heard the word. Perhaps you’ve invested in a digital currency or two. But do you really know what the technology is and why it matters? It all sounds deeply technical—and it is. But it's important to understand this new tool, as it will have a big impact on our lives—radically altering how we live, work, and play.

We were joking about how Aaron's last name is pretty similar to Furby, the interactive Gremlin look-a-like toy from the late 90s. Someone suggested it would be funny if we modified a Furby so that instead of speaking Furbish (I think that's what people call the language Furbys speak?), it would repeat phrases in Aaron's voice. At first, it was just a joke, but then I mentioned I had a couple Furbys at home I'd been meaning to hack…

What’s a Furby?

For the unfamiliar, Furby was a coveted toy when it hit the market in 1998. Seriously. More than 40 million of the hamster-esque creature were sold in its first three years of production. Kids fell in love with it because of its child-like nature and the fact that it required feeding, nurturing, and constant attention. It also only spoke Furbish out of the box, developing an English vocabulary over time as kids talked to it.

Because the Furby was one of the first widely-marketed toy robots, it also appealed to the hacking community. In the early years, there were some news stories about whether the microphone inside Furby was listening in on private conversations, but thankfully, Furby does not use the microphone to record audio. Because of the ruckus over the microphone, there is a wealth of information on the internet about how to properly deconstruct a Furby, and how the Furby's insides function.

How I did it

The first step was to take Furby apart. Unfortunately, due to Furby's realistic personality, the process of deconstructing the Furby felt more like field dressing an animal. I had to delicately skin the toy so that I would be able to resurrect it later.

Once the Furby was dissembled I put together a vice to clamp down its skeleton; it almost looked like I was torturing it until it would talk...and in a way, I kind of was. With the Furby in place, I was able to access its inner circuitry and check out its voice box. After some initial probing, I turned back to the internet again and was able to find a full schematic of Furby’s insides, which meant I no longer had to guess and check what each part was used for and how they were connected. I could also disconnect the voice box.

After some reading, I decided that the best option for triggering voice playback would be to use the motors. Furby always moves and talks at the same time, so any time the motors are working, he should be talking. If I used any of its switches (belly, mouth/tongue, gyroscope, etc.) as an audio trigger, I would miss Furby’s unprovoked audio actions, the ones it does without user input. (Sometimes the Furby will start singing or fall asleep on its own.) Those actions are triggered internally, and I didn't have the time or resources to begin understanding how a Furby's brain works.

To build the the audio playback, I used a circuit board I created a few years ago that's a variation of Adafruit's wav/ogg audio fx board. My audio playback board is very similar, but it also includes the necessary circuitry for charging a connected lithium-ion battery. With this addition (and a voltage booster), I was able to power the Furby from a rechargeable source, rather than four AA batteries.

Now that most of the individual pieces were developed, it was time to play Dr. Frankenstein and connect the parts together to give Franken-Furby life.

I used the newly vacant battery holder space to store the Furby’s new guts...err circuitry. This was an ideal location because there were already holes to run new wiring up to the Furby’s body. I added a wire to break out the motor trigger line for monitoring. I was able to monitor the motor with a basic analog comparator (LM311), and use the output to trigger audio playback. I then amplified the audio output with a class D amp, before connecting to the Furby’s speaker with two more wires.

Last, but not least, I added a few clips of Aaron speaking at various events to the audio playback board. We may or may not have have played around with loading some more inappropriate vocals (i.e. creepy laughing and other Halloween-themed sounds) first for kicks, but things got a little too creepy, so that didn’t last long.

The result

We presented the Franken-Furby to Aaron at his goodbye party, and it was a hit! Unfortunately, because it was a goodbye gift, it's no longer possible to work on that Furby anymore. But I’m game to hack more Furbys. My next goal is to create a new version, perhaps integrating all the circuitry onto a single circuit board, and hopefully dig a little deeper into understanding how Furbys operate.

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Our Chicago office has a tradition of giving silly but relevant goodbye gifts to departing colleagues. The goal is to make their exit a little more light-hearted for everyone, as well as give our erstwhile colleagues a sort of inside joke to take with them. When a friend and colleague of mine, Aaron Ferber, was leaving to pursue another passion in St. Louis, we started ginning up ideas for his send-off.

Thankfully, we have smarter tech tools than ever to help us spin through these cycles at a sprint. In a recent Quora Session hosted by IDEO U, we reached out to the entire IDEO community to ask what design research technology and other trends they're excited about. Here’s what we heard:

1. Going rogue

Influenced by Jan Chipchase and The Field Study Handbook, the “pop-up studio” model for doing design research in challenging, less-explored environments is finding success. Chipchase describes a pop-up studio as “a live/work space optimized for teams working toward a shared goal ... highly suited to international research, design, and innovation projects that require speedy immersion.” He talks more about the pop-up studio model in this Co.Design piece (and excerpt from The Field Study Handbook), “How To Do Great Design Research Anywhere On Earth.”

2. Smart sensors

Though some smart sensors are still in the early stages, looking at how sensors (from FitBits to smart moodmetric rings) can help inform our understanding of users' experiences. Projects like MIT's Dermal Abyss look into a future of smart, sensing tattoos.

3. Changes in data + privacy

With the General Data Protection Regulation (GDRP) taking effect in May 2018, design researchers in the EU and beyond will have to address changes to data privacy in a human-centered way, both in how we design our research, and in terms of how we explain it to participants. Understanding what that looks like in practice is important, so we published a little yellow book of Design Research Ethics.

4. Testing concepts in virtual + mixed reality

Augmented Reality (AR) and Virtual Reality (VR) are uniquely experiential and portable, allowing you to visualize complex ideas and measure user engagement in new ways. You can fully immerse users in an experience, get their reaction, and help them co-design (or redesign) an environment or experience on the spot using mixed reality prototypes. And now ARkits allow you to fully transplant a VR experiment with optical calibration—which allows you to retain the spatial boundaries and physics of a VR-created space anywhere on your phone. It’s pretty incredible.

5. Working alongside data science + machine learning

Most of us at IDEO predict that data science will complement and enhance a deeper understanding of qualitative research. By expanding our reach into data science, we’ll be able to understand how our designs are being used during live prototyping and piloting. Rather than relying exclusively on self-reported behaviors and stories, we’ll be able to collect actual interaction data.

But perhaps more interestingly, we’ll also be well-positioned to understand, both qualitatively and quantitatively, how a new artifact is causing a ripple in the ecosystem in which it was placed. As we strive to create disproportionate impact in the world, we’ll now have insight into what’s successful, and what’s impeding success. By introducing new areas of expertise into design research—legal design, policy design, infrastructure design, organizational design, behavioral economics, urban planning, macroeconomics, and more—we can begin to shift some of the fundamental underpinnings that can cause negative and adverse outcomes at individual, group, organizational, and societal levels.

6. Neuroscience x design research

One of our design researchers who studied cognitive neuroscience notes that there is a major connection between the brain and design—and a lot that we still don't know about that connection. This Quartz article discusses how neuroscience can help us create more effective human-centered cities. “Technology has now reached the stage where we can translate decades of neuroscience and psychological research from the lab into the city,” says neuroscientist Dr. Hugo Spiers of University College London. Now when we test prototypes, we can measure behavior, cognition, emotional reactions, physiological markers, and brain activity. Here are a couple more articles on the subject, from Forbes and The Leading Strand.

7. Digital forensics x design research

As technology becomes more ingrained in our daily lives, understanding how we live our digital lives—and the digital trail we leave as we go—will help unlock insights into new behavior.

8. Ethics in the age of artificial intelligence

Artificial Intelligence (AI) changes interaction and design in a way that's dynamic and incredibly complex. Because of its scale, adoption speed, and widespread human impact, it's important that someone raise a hand and ask the question, "Even though we can create this, should we?" Not all AI models are transparent and design researchers will increasingly become the voice in the room questioning its development. This isn't any different than what we do now, but it's more important in the age of AI.

This content originally appeared in a Quora Session hosted by IDEO on November 1, 2017. Special thanks to Ovetta Sampson, Dan Perkel, Michael Chapman, Samantha Miller, Rebecca Wint, Alana Murao, Mike Peng, Geoff Schwarten, Erin Bogar, Saige Perry, and Katie Clark for their contributions!

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Understanding the human challenge we're designing for is as much about inspiration as it is about information. Design research now happens in quick loops—gathering insights, building rapid prototypes, and getting feedback—rather than in a long and rigorous discovery phase.

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We have become accustomed to relating to these interfaces, and increasingly they are able to relate to us—taking in the world around them, talking to their users, and even inferring our emotions from how our faces change shape. I call this layer an Affective User Interface (AUI), a term borrowed from the field of Affective Computing.

Affective Computing is a field of computer science that develops technology that we might consider intelligent and emotionally aware. These new interfaces present a slew of opportunities and challenges, because as Dr. Cynthia Breazeal of the MIT Media Lab points out in her book Designing Sociable Robots, when a technology “behaves in a socially competent manner” our evolutionary hardwiring causes us to interact with it as if it were human.

And once we enter into that relationship, the personas we design for these bots affect our behavior, too. I’ve heard many people say that unassertive bots often bring out the worst in kids. When there are no social checks on rudeness—bots don’t tattle, after all—children tend to be more blunt, and can even become abusive.

That lack of assertiveness also affects adults. Reporter Leah Fessler researched how female-gendered bots respond to sexual harassment. It turns out that the assistants’ permissive personas can reinforce some disturbing stereotypes about women, and allow the user free reign to degrade them at will.

If bots can have a gender, I started to wonder whether they might also have a cultural or even racial identity. Considering the fact that these products allow us to choose between various accents, it would seem that designers have created nationalities for our bots.

I'm certainly not the first person to surface these issues. This New York Times piece by AI Now's Kate Crawford about "Artificial Intelligence’s White Guy Problem" comes to mind. And there are many people here at IDEO who are thinking through what it means to be inclusive human-centered designers as we work on Augmented Intelligence projects.

To explore this further, I decided to conduct an experiment to surface the personality of these bots by interviewing them.

The key was to ask soft questions: Where are you from? How old are you? Do you have any kids? What do you look like? Even, Tell me a story.

These interactions were not actionable queries, and thus triggered purely conversational responses that revealed the “personality” that the bots’ creators had designed.

I recorded a video interview with each voice assistant and handed these over to a number of illustrators commissioned via the social gig site Fiverr. While a few of the artists had previous exposure to the bots, I was able to source English-speaking international artists in markets where Alexa and/or Siri were not available. Countries of origin included Indonesia, Pakistan, Ukraine, Venezuela, the Philippines, and the U.S. For many of them, my videos were their first meaningful exposure.

Here are the images that came back:

Drawings representing Alexa and Siri based on video interviews I'd done by illustrators who had little to no previous exposure to the assistants.

Gender came through clearly, but I would also argue that none of the illustrations depict a person of color. Whether they were intentionally designed that way is not the issue. If users perceive the bots this way, what kind of cultural pressures are they carrying into the home?

It’s something I think about a lot as a first-generation American who has worked in and around tech throughout my career. On my father’s side, I’m the second U.S.-born family member, and on my mom’s side, I’m the first. I grew up in a diverse community, and the tapestry of cultures I experienced was simply normal, everyday life.

I was aware of code-switching pretty early on; many of my friends and family had their normal voice and their “professional” voice, and they chose which to use in different environments.

Looking back, I first learned about it when my mom gave a wedding speech.

My brother was shocked; he didn’t recognize the voice that he heard. I had to explain to him this was my mother’s work voice. Code switching isn’t inherently bad—we all do it to some degree—but if we’re to design Affective User Interfaces that are truly human-centered, then we must consider that for some, the switch requires more effort.

Inclusivity is not just an issue at the bleeding edge of tech. We’re seeing a growing body of evidence that those who speak outside of mainstream vernaculars have a harder time being properly recognized by affective systems.

This represents an accessibility challenge, but one that is resultant from a cultural rather than physical challenge. In a tech industry that is known to be monocultural, we must take steps to ensure our affective systems are not just designed to be useful to their creators, but inclusive of the full spectrum of people their products will serve.

Because ultimately what’s at stake is trust. Studies have shown that when brands lose trust, they lose customers.

As designers, it’s our job to expand the usability of our affective devices to ensure they serve the rich tapestry of people, cultures, and vernaculars they will encounter.

Beyond being good design, it’s good for business, because in our affective future the products that win will be the ones that users trust.

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Behind every interface, there's a designer. More like a team of them. And those designers have a lot to consider: What should Siri sound like? What kinds of things will people ask Alexa to do? How will users expect the Kuri robot to respond when they crack a joke?

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.