Keeping diabetes in check isn’t easy. Between checking blood sugar multiple times a day, keeping a detailed activity record, and logging food intake, staying healthy can be daunting.

But a recent advance in smart diabetes management—Ascensia’s CONTOUR NEXT ONE blood glucose meter and the CONTOUR DIABETES app—can give patients more clarity and control.

The CONTOUR NEXT ONE is the latest product to spring from a multi-year collaboration between IDEO and Ascensia Diabetes Care (formerly Bayer Diabetes Care). In 2009, Ascensia and IDEO developed the award-winning CONTOUR USB blood glucose meter—the first meter to plug directly into a computer, providing patients and their doctors with instant access to blood sugar data and personal trend reports.

Buoyed by the success of the first collaboration, Ascensia asked IDEO to help design a next-generation diabetes management system (and the company’s first internet-connected device).

To help reduce the stigma of checking blood sugar in public, IDEO designed the CONTOUR NEXT ONE to look and behave like today’s modern tech devices. The highly simplified, seamless system allows patients to upload blood glucose readings automatically to the app, which helps guide informed, real-time decisions. The meter’s red, green, or yellow smartLIGHT feature gives instant feedback about whether blood sugar levels are below, within, or above the target range.

Seeing contextual data, which includes physical activity logs and photos of meals, paired with recent and historic blood sugar levels, nudges patients toward healthier lifestyle choices and better control of their condition.

For doctors, the accuracy and quantity of the data combined with the app’s easy-to-read pattern views invites more comprehensive, actionable conversations with patients.

The CONTOUR NEXT ONE hit shelves in Europe in 2016 and is now available in the U.S. Ascensia is poised to develop more products enabled by rich, personalized data to help people with diabetes live longer, healthier lives.

What if we could use the sky to provide alternative solutions to these problems, creating more space for living and transportation? What exciting future awaits us?

At JAXA’s Aeronautical Technology Directorate (ATD), researchers are conducting research and development on aviation science and technology for the future. They are working to affect positive impact through research like noise reduction of airframe and an integrated aircraft operation management system for disaster relief and crisis management.

Normally, JAXA begins their projects by examining the needs of the aircraft industry or comparing themselves against global technology standards. This approach often leads to ideas that are merely an extension of the current technology. JAXA needed a new approach in order to create radical ideas and real change.

The key question was: What solutions would emerge from prioritizing people’s needs over the most advanced technological possibility—taking a human-centered approach to tackling the most pressing societal challenges?

JAXA ATD voluntary partnered with IDEO to attempt to answer this question, identifying new research areas by envisioning people’s needs in the near future. Together, JAXA and IDEO developed four scenarios of future societies.

The scenarios do not necessarily focus on technologies. Rather, the focus is on telling stories that help readers put themselves in the shoes of the four personas. At the same time, the team worked with industrial designers to illustrate convincing demonstrations of the vehicles and machines of the future.

JAXA’s team embraces the belief that “technologies developed at JAXA should incorporate emotional aspects to blend seamlessly into people’s lives.” Driven by this philosophy, the visual design of the four scenarios used a friendly illustration style intended to be approachable and understandable for people of all ages.

In order to develop human-centered concepts from scratch, the IDEO and JAXA team first undertook research and inspiration-gathering. They skydived, observed cities from above, brainstormed with students from the department of architecture at Waseda University. They interviewed airline employees, a former Judo world champion, skyscraper lovers, a business producer who focuses on new working styles. Throughout the research phase, the team explored the possibilities of the sky as a “living space,” not just a place for transportation.

The team was surprised and excited when they learned from a former fighter pilot that old cockpit designs were inspired by the Japanese tea room, highlighting a historic precedent for taking inspiration from real life to inform new technology designs.

The team synthesized their research and developed several concepts, each informed by a different social issue or pressing concern. Each issue was brought to life through a fictional personal narrative.

How might we relieve city congestion and pollution using the sky, while still keeping it clean and blue? Floating public lights, a skyway that regulates air traffic, camouflaged planes that keep the sky blue—concepts introduced in this scenario were the closest to the technologies already being researched at JAXA ATD. They show us how the sky could become an infrastructure that supports our daily lives. Meet Ayame, a girl from Gunma prefecture, ready to begin her college life in Osaka.

How might we make travel feel easy for people of all ages, no matter how far they need to go? While the researchers at JAXA ATD are working to improve the mobility of aircraft, like reducing air friction or increasing the engine efficiency of aircraft, this scenario explored how people could travel door-to-door through the sky with or without aircraft. A day-in-the-life of Naoto, a 72-year-old man who commutes twice a month from Tottori to Tokyo for medical checkups.

How might we leverage the sky as a resource for reusable energy and economic growth? One of the criteria of JAXA’s R&D activities is to improve the environment. While JAXA has been focusing on “protecting” the environment, this scenario focused on “creating” new environments. A day-in-the-life of Toshi, who runs a “sky-to-table” farming business.

How might we help people live with peace of mind, even during a disaster? JAXA’s disaster relief technologies have been extremely valuable in countries like Japan, which frequently suffers from natural disasters. In this scenario, we approached the problem from victims’ point of view while exploiting the potential of a network of aircrafts and other flying objects. Here's the story of Yuri, a victim of an earthquake in Tokyo who reunites with her family after evacuating to the sky.

The purpose of the project website is not to present answers, but to introduce new directions towards an exciting future. By presenting JAXA ATD’s vision through these four scenarios, the team invited people from all industries and of all ages to participate in co-creating the future.

Just like movies, cartoons, and novels from childhood stimulate the imagination, this project aims to spark new conversation and vision for a radically different, positive future.

By illustrating and communicating a more human-centered future to a wider audience, Japan’s top aeronautical technology development agency may already be changing the future of the sky for the better.

The speed and scale of change in our world are unprecedented. As more people relocate to cities, our lives are impacted by urbanization problems such as pollution, congestion, depopulation of rural areas, resource, and energy deficiencies.

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For factory operators, a smart valve is a game-changer. It gathers data on how smoothly the system is running and feeds it to an app, making it easier to troubleshoot from anywhere. And when things get overheated, it can automatically shut down the machinery, avoiding a meltdown.

Georg Fischer (GF), the Swiss-based, B2B industrial manufacturer collaborated with IDEO to design that valve, along with a system that adds value for generations of engineers to come.

And there were some surprises along the way. When the team set out to interview customers, they learned a lot about their real needs. “We showed a customer a sacrificial concept of a smart valve and asked, what do you think about this?” says Laura Barrabia, GF’s Head of Corporate Design Thinking. “The customer answered, we don’t want your valve to be smart, we want to be smart. If GF is providing a smart valve, where is my value?”

For GF Piping Systems, these insights helped shape initial prototypes and guided the direction of the design to something that would tie parts together into smart systems and more efficient industrial facilities—a competitive advantage.

Yves Serra, GF’s CEO, recognized early on that his company needed to strengthen its customer-centricity and digital capacity, so he approached IDEO to begin shifting GF’s culture from engineering-led and procedural to customer-focused, multidisciplinary, collaborative, and flexible. That kicked off a decade-long relationship that would help GF take a design-based approach.

Learn what it means to move from being technology-driven to being truly customer-centric.

To help GF identify clients’ pain points and address them with new digital offers, IDEO proposed three “lighthouse” projects, one for each of GF’s divisions: Piping Systems, Casting Solutions, and Machining Solutions. Lighthouse projects (also called “Beacons”) are proofs of concept that light the way for an organization and help it shift its way of working.

For example, GF Machining Solutions built a prototype for an application that uses real-time data to help customers identify and fix problems in the machines, laying the foundation for truly predictive maintenance. Making data streams more transparent for customers also simplified life for the GF service engineers, who keep the machines running.

Learn how Georg Fischer is moving from hardware offerings to digital solutions.

For GF Piping Systems, the design team developed the GF Digital Line, a set of products, apps, dashboards, and other services that help customers plan, install, and maintain water and chemical piping systems. GF teams went back to customers to test several prototypes and gather feedback on the Digital Line and make sure it addressed current and future needs. They also built internal capabilities to support product development, laying the groundwork for future innovation.

Lastly, IDEO helped GF Casting Solutions escape the “commodity trap” of competing with foreign automotive suppliers. To better understand the pressures car manufacturers face, the design team explored the development cycles of two car manufacturers. They learned how challenging it is to implement solutions to reduce vehicle weight—essential for cutting fuel consumption. As an expert in aluminum die casting, GF was well positioned to help manufacturers meet that challenge, not just with quality parts, but also with digital engineering to deliver cutting-edge lightweight casting solutions, which are harder to replicate.

By the end of these lighthouse projects, GF had rolled out a global design thinking training program that had touched more than 1000 employees. After the training, employees throughout the organization adopted a new way of working and became passionate ambassadors. The enthusiasm spread from the R&D department to HR to finance and many other departments.

Today, GF has permanent design thinking and digital teams to continue this work. All three divisions aim to launch the first releases of their lighthouse projects by early 2019. And with every project, GF’s business—and solutions—get smarter about how to meet the needs of a fast changing world.

IHG’s ambition is to grow in service of its guests around the world. IHG’s Atlanta-based team had identified a major opportunity for hotels in the midscale space—a market segment known for its inconsistency.

Alongside colleagues at London-based forpeople, IDEO was invited to help IHG shepherd that business opportunity into a human one, by asking how IHG might reimagine the everyday travel experience for people relying on this category of hotel. What kind of offer might resonate equally with guests and with the owner/operators who’d need to buy into a new brand and bring it to life?

IDEO began by talking to travelers to better understand their lives, values, and needs—travelers who spend one or two nights on the road a few times every year; travelers who regularly take short trips to small cities or away from city centers; and travelers who live on the road, moving from hotel to hotel. These included court stenographers, medical technicians, consultants, conference-goers, and more.

Early research insights evolved into two distinct concepts for a new hotel brand, which were built out into two full-scale physical prototypes at IHG’s design center in Atlanta. Over three weeks, IDEO and its IHG partners led potential guests and hotel owners through each model, gathering their feedback on new formats for breakfast offerings, service details, booking experiences, and overall tone.

The investment in prototyping paid off with surprising and actionable insights. Despite wide variation in occupation and income, these guests are sophisticated and self-reliant; they know what’s out there, and they know what’s reasonable to expect. In fact, many describe a syndrome IDEO dubbed “anticipation anxiety:” the sense of dread that comes from not knowing whether a lower-priced hotel is going to be clean or safe, or provide a bed that enables restful sleep. Many have so little confidence in the cleanliness of hotels in this price range that they travel with their own packs of wet wipes.

IDEO, along with the IHG team, recognized these behaviors as an unanswered cry in the market. The purpose of the new brand crystallized around extinguishing that anxiety and rewarding guests with something much better. avid hotels exceeds its competition by doubling down on quality in just a few select areas: an extraordinary mattress; rigorously high standards of cleanliness; a focused, high-quality, grab-and-go breakfast and coffee experience; and an overall tone of warmth and straightforwardness.

These guests made clear that for trips like this, they aren’t interested in bells and whistles, or communication that isn’t frank or to the point. That led to an insight that upends an industry truism: for these guests—and there are many of them—choosing a hotel is rarely only about the price of the room. avid guests can often afford to stay in a more expensive place for a honeymoon or a vacation or a trip with friends; they’ll spend more when they need more. But for functional stays of one or two nights, it just feels wasteful. It goes against their values and their principles.

IHG and IDEO heard a clear call for a sense of focus and affordability—but never at the expense of quality. Guests should be able to access a simple booking process, rooms designed for sound sleep, and a quality breakfast, all at a fair price. And hotel owners ought to be able to deliver that experience with confidence and consistency, at costs that build a compelling case for their own business.

That’s what avid hotels is designed to deliver, every single time. Early traveler reviews have been exceedingly positive and have noted specifically the unique differentiating offers avid brings to the market.

Within a year of partnering with IDEO, IHG had issued 150 avid hotels licenses to franchisees in the US, Mexico, and Canada, and announced a development deal for 15 avid hotel locations in Germany over the next five years—a scale of success that came at unprecedented speed for the industry. The collaborative, inclusive design process is now serving as a model for how to develop robust, guest-centered hospitality brands that deliver where it matters for people.

When I started at IDEO six years ago, I had no idea what a systems designer was—only that I was one. Now, six years later, I have an answer, but I’m still perfecting the great-aunt-approved dinner table pitch.

The secret? It’s actually something you probably learned in your grade school language arts class: a good analogy.

If you’ve got approximately 10 minutes, I can tell you what I’ve learned about what I now proudly call my job—and how I’ve learned to explain it.

Systems and automobiles

An iPhone, the human body, buildings, cities, organizations, economies, the universe—all of those things count as systems, even though one can fit in your pocket and one is infinite. So what makes them all systems?

In a series of excellent lectures, Russell Ackoff, a pioneer in systems thinking, uses a simple analogy to explain systems: an automobile.

As Ackoff explains, a car needs to carry you from point A to point B. No individual part of a car can move you on its own—not the wheel, the axle, the seat, or the engine. But a car can. And if you take a car apart, you no longer have a car: you simply have the pieces, because “a system is not the sum of the behavior of its parts; it’s the product of their interactions.” That’s as true for a computer as it is for the universe—or any other system.

Systems design and architecture

Ackoff, a professor at Wharton Business School, criticized managers for focusing on business silos (marketing, operations, finance). He urged them to take a wider systems view—to think about the interactions that create the whole.

I couldn’t agree more. But if that’s systems thinking, what is systems design? What’s the difference?

Ackoff heralded one profession for understanding systems best: architecture. Architects begin with the needs of the client—bedroom, kitchen, living room, bathroom—but they don’t stop there. It wouldn’t make sense to design the rooms separately; they need certain adjacencies and sizes.

Importantly, Ackoff explains, the architect “will never modify the house to improve the quality of the room, unless the quality of the house is simultaneously improved.” To take this analogy a step further, think about it this way: you wouldn’t make the kitchen bigger if it meant getting rid of the bathroom. That would be a weird house.

Ahhh, so you're an architect?

Not exactly, although it’s no coincidence that I used to be a designer at an architecture firm. I think of myself as a “human-centered systems designer,” but that wouldn’t be the clearest thing to have on a business card.

IDEO is known for human-centered design, a process that takes inspiration from the needs and aspirations of people, most often end users. Human-centered systems design also starts with people, but requires looking at all the diverse stakeholders within a system—not just end users.

Let’s dive into another analogy: a school. If you’re designing a school, students are the end user. But the needs of teachers, parents, and administrators are equally important. For example, a few years ago we wanted to create a way for schools to change their culture. Since culture is intangible, it can’t be designed in and of itself. But you can design spaces, schedules, processes, roles, rituals, and incentives—tangible “levers for change” that help create culture. We zeroed in on the needs of school leaders, and developed School Retool, a professional development program that empowers principals to evolve their school culture.

When you’re designing a system with a lot of moving pieces, it’s hard to know where to start, and very easy to get lost in the “What if’s?” Design needs constraints, and focusing on human needs provides them.

But why human-centered systems design?

Let’s return to my man Russell Ackoff. He writes, “No problem ever exists in complete isolation. Every problem interacts with every other problem and is therefore part of a set of interrelated problems, a system of problems.” Ackoff even coined a term for systems of problems—he called them “messes.”

Indeed, our biggest problems—in education, health care, criminal justice, government—are systems challenges. And surprise: These are all human systems. When the parts of a system are made up of people, complexity is exponentially high because human feelings and needs are unpredictable and constantly changing. Despite good intentions, these important societal systems can be some of the least human-centered experiences we encounter today.

None of these problems can be solved in isolation, but it’s also easy to get a headache just thinking about tackling them.

Our most complex systems need human-centeredness the most. As a systems designer, I specialize in zooming in and out. I’m constantly jumping back and forth between the big picture and the details. I work with teams to bring the best of all disciplines together to design individual elements that form an integrated, cohesive experience for end-users. I ask questions like, “How might the environment support the new behaviors we’re trying to create? How might digital tools enable a new mindset?” I create intentional interactions between parts.

As the holidays creep closer and closer, I no longer dread the questions about work and career that come along with the appetizers. I finally have something my family is more likely to understand, thanks to the powerful and beloved literary device known as the analogy. Getting to this point feels like learning how to ride a bike—you pedal hard, gather speed, and finally crest the hill.

And if nothing else, I’ll just send all my family members a link to this piece. Hi, mom and dad!

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Fall has arrived in the northern hemisphere, and you know what that means: cool weather, warm cider, and sitting around the holiday dinner table with my extended family, trying to explain to them what I do for a living as a systems designer.

In the not-too-distant future, patients with chronic obstructive pulmonary disease could be equipped with a sensor that monitors their medication and inhaler use and prevents acute events. People suffering from clinical depression could be prescribed an app-based therapeutic program in place of a drug.

The digital therapeutics global market is estimated at $1.8 billion today, but predicted to reach $7.1 billion by 2025. Much of the growth is predicted to come through investment from traditional pharma, but there are several new players emerging from the tech and start-up worlds as well with the hopes of evolving into a digital therapeutic. Omada Health, which creates behavior change programs for managing chronic disease, makes its hundreds of thousands of patients feel seen and heard with personal coaching. Click Therapeutics develops software to support smoking cessation and address major depressive disorder in adults. The meditation app Headspace has convinced more than a million people to integrate meditation into their daily lives, with proven wellness benefits.

Companies like these are revealing transformative new approaches to helping patients tackle the thorny challenges at the core of chronic disease, mental health disorders, and a growing number of other diagnoses—and in the process, they’re creating and growing thriving markets where none existed before.

Might these digital products, one day soon, be prescribed by a physician who is concerned about her patients’ heart disease, diabetes, or weight? If Tesla released software that clinically validated reductions in car accidents, even for the most dangerous drivers, would that qualify as a digital therapeutic? We are just beginning to imagine and design the future of this industry.

But these products still face the age-old challenge: how to get people to actually use them. If patients don’t love and trust the experience enough to sustain engagement over long periods, many of these therapies—and products—will fail.

Any new approach needs to begin with the needs of real people, and to follow those needs toward products that are not only desirable, but also have viable business models behind them. Here are our four big takeaways drawn from IDEO’s experience working in this field, designing digital therapeutics that engage patients—and the market.

Put down the competitive landscape report

Innovations in science and health tend to be incremental, but by looking to other industries, it’s possible to identify opportunities for more radical change. Studying analogous experiences—services, products, and other offerings that deliver something tangentially related but not exactly the same—will clarify what kinds of experiences give patients a sense of meaning, delight and value.

A partner of ours in the biotech industry recently launched its first digital therapeutic, focused on helping patients manage diabetes. In piloting the experience, we encountered a big challenge: Patients were struggling to connect the at-home testing device to the bluetooth on their phones. Without it, the experience fell apart.

Instead of buying all of our competitors’ devices to look at their solutions, we brainstormed a list of organizations that were particularly good at helping people with a set of complex instructions—IKEA, ballroom dance instructors, piano teachers, NASA-to-spacecraft communications specialists, and others. We discovered that LEGO had made its first bluetooth-connected toy and—master of instruction that it is—had created instructions to guide even little kids through a simple series of steps. Inspired by LEGO, the team created a new set of instructions. Once they were integrated into the patient onboarding experience, nearly every patient was able to connect their medical device to their phones.

Prioritize the patient

It can be easy to fall into the trap of addressing the needs of payers and providers above the patients’. After all, if a digital therapeutic isn’t reimbursable, the underlying business may not be successful; and if a physician doesn’t know it well enough to prescribe it, a company can’t increase market share. These are critical pieces of the puzzle, but they need to come after the foundational concern of any new digital health venture: fitting your therapy into patients’ lives.

During early stages of design, we rely on user research to inspire countless possibilities, and revisit our insights when we need to refine (or flip) our ideas. User research informs the business model, helps define the path to market, and may also lead to other product features.

What does this look like in practice? Consider the digital mental health company Headspace. Headspace was designed to teach people the fundamentals of meditation, engaging them in an experience that might encourage practice and adherence over time. Initially, Headspace played with incentives like badges and friendly social competition, but it slowly came to understand that the most profound motivation was mental health itself. The company prompted meditators to remember why they meditate, and asked them who in their lives would be better off because they meditated. This consistent call for reflection and awareness led to higher overall engagement.

Headspace’s popularity has catapulted the company to $100M in annual revenue and more than a million subscribers. Once the company designed an experience that people loved, subscribers embraced the product and took it upon themselves to host Facebook groups, meet-ups, and events. Headspace then opened up partnerships within the formal health industry, adapting to the needs and requirements of providers, payers, and regulators. Today, Headspace is a benefit offered to employees of over 350 large companies worldwide, and providers and health systems across the globe offer it to their patients. If you design an effective product that patients love, players in the health system have incentive to offer access.

Design with and for your most extreme, hard-to-engage patients

Designing for extreme users illuminates the wide range of people who might use a product. In IDEO’s earlier days, we saw this most clearly when we designed physical products like ice cream scoopers and pizza slicers for older adults, people with arthritis, and children with limited motor skills. We ended up creating something those populations could use, but in doing so, we developed a universally easier user experience. The product design outshone its competitors and became a top consumer choice.

In the world of digital therapeutics, this approach might entail designing for patients with limited experience using digital technology, or focusing on patients living with multiple chronic conditions, or with profound barriers to accessing care. These patients can help shape a more equitable and inclusive therapeutic experience.

One of our most challenging digital therapeutic projects involved creating an app-based experience to combat depression. To engage with potential users, we traveled to the rural Rocky Mountains to an isolated community where we met Dan, a cowboy and rancher living 40 miles away from his closest neighbor. Dan had struggled with depression for most of his adult life. On a good day, it was hard for him to get out of bed. On a hard day, he struggled with suicidal thoughts.

Before talking to Dan, we considered all of the technological features that could encourage adherence, like enabling offline access and fast download speed in low-bandwidth contexts. But through talking to Dan, it became clear that the tactical challenges weren’t the biggest problem to solve. Even in more populated areas, depression itself can be isolating. Dan helped us co-design a digital tool that even he would be willing to come back to, day after day. One of the key features a digital therapeutic could offer would be connection to others—in real life—and a chance not only to receive help, but to give it. Informed by Dan’s story, we designed an experience that could connect people living with depression to each other and engage them as supporters, mentors, and advocates.

Launch a thousand prototypes

One of the biggest challenges facing health innovation today is the belief that you need to have a solution before you really grasp what people want and how they want it. That’s how the industry is constructed. You would never write a grant proposal without telling the funder exactly what you will deliver, nor allocate budget at a pharmaceutical company without a detailed plan and anticipated ROI.

For digital therapeutics, those constraints are blown wide open. Our task is to come up with as many ideas as we can and test what will actually stick. Prototypes pave the way to a solid, working product, and patient input on prototypes can be used in countless safe, thoughtful ways.

Recently, we worked on a digital therapeutic that helps people manage the tremors associated with motor disabilities such as Parkinson’s Disease. Instead of the typical treatment, which solely relies on an oral medication known to have serious side effects, we were tasked with working on a software and hardware system that delivers targeted electric pulses to the part of the brain that calms tremors. We began with a long list of open questions about what patients living with Parkinson’s would find acceptable, usable, and engaging.

When we went into the field to interview patients, we quickly realized that they had no idea what it might be like to rely every day on a digital device that’s crucial to their health. They were curious about the inner workings of the therapy, and asked questions about the technical, logistical, and philosophical implications.

Our first prototypes included a dozen hats, headbands, or pillows that a patient might wear to charge the implanted device. We also prototyped many digital interactions, from Alexa add-ons to iPhone apps, that might guide them to administer digital medication. To take advantage of bio-monitoring data, we created numerous dashboards, exports, and communication portals that might help patients, providers, and caretakers make sense of what was happening neurologically.

A lot of those ideas were failures, but the things we learned were priceless. For example, it turns out that despite the growing number of retirees on Alexa, many of our patients didn’t trust a voice-controlled app with a task this important. It also turns out that the headgear a person needed to wear could easily make them feel embarrassed, unattractive, or emasculated. One of the most important discoveries was that faster charging is not better, if slower charging meant you could fold laundry, watch your favorite TV show, or weed the garden at the same time. At the end of the day, we designed a hundred prototypes before we landed on the key value propositions, features, and usability standards that would shape the experience.

Tying it all together

Breakthrough products and experiences like Click Therapeutics and Headspace all align with the framework outlined above. But to be clear: They aren’t successful because they have a silver bullet for engagement or the best theory of behavioral economics. They are market-movers because they focused on their users and designed their products around what they found. That led to creating something people love, and success quickly followed. It’s a formula you can apply to creating your own digital therapeutics—or any product you want users to love enough to use in their daily lives.

Illustrations by Nien-Ken Alec Lu.

The next era of digital health has arrived, and it’s booming.

But in practice, when we’re making something genuinely new, we often don’t have data to begin with, nor do we even know what kind of data we will need. We’re staring at a blank canvas, so the only way to dive in is to listen, observe, and sketch.

Making ideas real didn’t just mean collecting biometrics about patients and displaying the data in a smart way. It was much more important to use data to help experts and patients build and maintain a relationship, track progress, adjust course, and figure out next steps. These elements are all an integral part of how the service operates. And in the process, I came away with a few principles for data scientists to keep in mind when using data as a medium for design.

1. Be part of research

We needed to know what experts ask their patients to help support them in their journey to self-management, and what is reasonable to ask patients for. Is it fair to ask somebody who mainly eats at restaurants to accurately track the micronutrients of everything they eat? Probably not.

It’s critical to understand people’s real needs in their context to understand what data is meaningful and feasible to collect. Qualitative field research is key in the process of developing empathy for those we design for and for getting a feel for what life challenges might get into the way of data collection. Understanding when we can collect data—and when we can’t—provides valuable information.

2. Sketch by hand and share

Informed by research and armed with crayons, we created a variety of data visuals aimed at tracking patient progress in various aspects of their day-to-day lives—basically, sketches of the features that might be helpful. Drawing is much faster than writing code. We made the visuals a prominent part of the project room to serve as a catalyst for brainstorming and discussion with other members of the team who aren’t data scientists. We explored trends of activity and sleep over time, and played around with visual ways to track mood and to inform people of healthier food options without asking them to count calories and micronutrients.

This approach allowed us to make significant progress in two ways. One, showing our sketches to experts allowed us to narrow down which metrics were useful, and to start tracking down potential data sources. Sketching in crayon versus writing in code also helps us fail faster and narrow in on the right questions to ask.

And two, sharing our sketches with the broader team, which included designers from a broad spectrum of disciplines (communication, interaction, research, software, business), made our work more transparent and helped us establish a common language. It also sparked conversations, inspiring us and helping us to gather further feedback.

3. Gather up and agree on all your data

Once we identified useful visuals, algorithms, and interfaces, we began hunting for the data that could fill them in and move us to higher fidelity prototypes. In our case, data included the client’s historical data, simulated data, and team data. We simulated data about meals and snacks and plugged it into publicly available nutritional APIs. This exercise allowed us to identify the types of data that might be suitable as input for these APIs.

We also bought a bunch of trackers for the team to explore ways we might keep tabs on activity, which showed us where a tracker might go wrong (moving your arm in a circle might count as a step, when in actuality you’re not taking a step at all) and narrowed down the types of data that are meaningful to collect (for example, movement vs. steps). By diving in with our own data, we were able to fill our communcation, interaction, and software designers in on how we would approach collecting patient info.

4. Look to the future

As we were exploring data solutions for the various components of this service, we had to keep in mind that design and development take time and resources. For example, tracking micronutrients via nutritional APIs relies heavily on the assumption that patients are willing—or will even remember—to share their meals. In reality, we didn’t know what patients were willing to share about the foods they eat, nor did we know what food-related information experts need to track a patient's progress.

Redirecting the team’s effort to a lower-fidelity solution to track these behaviors (say, allowing patients to share a food journal) can save a lot of time and effort while still informing the future development of the service.

As a data scientist, starting with people and crayons rather than data and a keyboard felt uncomfortable at first, but it made the process of identifying what’s important and doable much more efficient. Making data science a visual part of the project space also helped the data scientists on the team become co-designers from the very beginning—meaning that we could contribute a lot more to the project. Hopefully, the tips above will empower you to do the same.

A big thank you to Mike Stringer for his help shaping this piece.

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You might think the first thing data scientists do on a project is grab a bucket of data and run with it. And for good reason—that’s how many data scientists write about projects after the fact.

In business, new models and offers are further constrained by the need to satisfy current stakeholders and follow market trends. So how can you break free of present-day realities to envision a genuinely novel future?

In other words: Design can move us beyond the imagination-traps of our own experience to uncover truly new possibilities.

When I founded IDEO’s CoLab four years ago, one of our goals was to find new ways to catalyze visionary business leaders and to activate new models by assembling diverse perspectives from across industries. We frequently employ design fiction exercises with our partners to open up more exploratory approaches to tough problems—particularly the ever-changing nature and role of technology. The process helps connect the dots between an aspirational vision of the future and a business approach that can make that vision a reality.

How to apply design fiction to your business

The futures that we imagine are based on a few catalytic data or trends—“inevitables”—that serve as foundational elements of a future vision. By anchoring on these inevitable factors, we can then imagine the implications that ripple across a business, industry, or society. For example, five or 10 years ago, one might have assumed that smartphone ubiquity was inevitable and started to imagine the implications (good and bad) of everyone in the world having access to a super computer, the internet, a camera, and more. By extending from what’s already true to what might soon be true, it becomes possible to exert some agency in the way you move forward, even when you can’t know exactly what’s ahead.

The late Bill Moggridge (an IDEO founder who came up with the concept of a folding laptop) referred to this as “preferred futures.” In this view, rather than viewing the future as something that happens to you and can’t be controlled, you adopt the mindset that you can influence what happens, asking, “What future do we want to create? And how do we reverse engineer the pathway to get there?”

It sounds pretty heady—perhaps something to be left to experts—but the process of creating design fiction is actually accessible to most people by following a four-step process. This exercise is inspired by an activity from a class at UC Berkeley’s Haas School of Business called “Designing the Future” that I taught alongside two IDEO business designers, Becca Carroll and Sandeep Pahuja.

1. Pick an industry and describe its role in the consumer’s life

Let’s take insurance as an example. Insurance is a safety net for when something bad happens. But insurance customers don’t simply want protection—they also want to understand and manage risk, find the most agreeable policy to ensure support when they need it, and trust that their claims will be processed and paid. These criteria are often referred to as the “jobs to be done”—in short, they are the things the consumer has “hired” the product to do.

2. Write a story about the future, free from today’s constraints

If you focus on the “jobs to be done” (and don't get caught thinking about existing insurance companies and how they operate), you can begin to imagine new ways to do those jobs for customers with the help of new technologies and other shifts (behavioral, regulatory, etc.) we believe will be relevant in the future.

For example, if we take the job of understanding risk, there’s a story to be told about machine learning and the explosion of sensor data, which will allow us to create more sophisticated risk models. More sophisticated risk models could lead to a more personalized approach to assessing risk and ultimately the ability to provide more relevant products to customers. In this future, perhaps insurance companies shift from being the safety net after something happens to proactive behavior change coaches who help protect you before something happens.

When writing a story about the future, we continually ask, “What future do we want to create?” This helps us focus on the ultimate goal of creating value for people and preventing harmful consequences, not just creating new technical capabilities and hoping for the best. In this case, we answer it by imagining how the experience of insurance might take on an entirely new form and function when enabled by the tools of the near future.

3. Back out to the assumptions that would make this future real

Taking this vision of the future as possible, we can work backwards to uncover the assumptions need to be in place to support it coming to be. Our go-to provocation is inspired by Roger Martin and Jennifer Riel: What would have to be true to make this future a reality?

Asking what has to be true is a powerful tool to help you optimistically articulate the key assumptions implied by your story and connect them to your current offers and potential path forward. It’s easy to come up with a long list of reasons why something won’t work, and this often leads to risk aversion and incremental thinking. By surfacing the criteria for success you can pragmatically assess how realistic these assumptions are and design experiments or milestones to demonstrate if you’re on track. Invite your colleagues to get imaginative alongside you and uncover even more ideas.

Elon Musk famously published his master plan (and then a second) for Tesla that stepped through five key assumptions that would allow Tesla to move the automotive industry towards an electric future. These included making electric vehicles high performance and cool—a shift from the pervasive negative view of EVs’ aesthetics and functionality; and changing the notion that these cars are too expensive for average consumers, riding the scale/cost curve to reduce the price and range of vehicles, and making them more accessible to the mass market.

4. Prototype

So now you know what would have to be true. Are those things possible? Rather than speculate and debate, prototyping is your way to find out. Begin with scrappy, low-fidelity prototypes to test your assumptions and continually iterate forward, incorporating your learnings into higher-fidelity prototypes. Getting really clear on these key assumptions enables you to take an evidence-based approach to making investment decisions in risky innovation projects.

As quickly as possible, you’ll want to test your assumptions in the market. This is another sticky point where risk aversion and desire to jump to scale can grind progress to a halt. Designing in-market experiments that are right-sized and laser focused on testing key assumptions is an organizational skill that is difficult to cultivate. Successful startups often are forced to be quite scrappy in the market and increasingly, larger companies are building these capabilities. The founders of Airbnb famously tested their idea out by renting out air mattresses in their apartment during a conference. Established companies are getting into the act too, LEGO, Coca-Cola and General Electric have all market tested new products on crowdfunding site Indiegogo.

It’s unlikely that there’s only one viable solution to get to any preferred future—there are many avenues that may get you there and thus it’s important to diversify and have a number of bets. Many entrepreneurs will tell you that their current business is not exactly like their original business idea. Often, it’s pretty far from it. That’s because the steps required to go from idea to reality involve a lot of prototyping, experimentation, and openness to change along the way. Whether you work in the field of innovation, you’re an entrepreneur with a startup, or you have an idea for a business that you’re ready to explore, using the principles of design fiction and cross-organizational collaboration can help.

Hear more on design fiction and cross-organizational collaboration in this episode of IDEO U's Creative Confidence podcast.

Illustration by Mark Conlan.

There’s no such thing as a truly original idea, or so the saying goes. Even the most imaginative inventors and artists are limited by the boundaries of their own experience, and every fresh idea is derivative of something that came before.

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.

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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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