To bring students healthy food at school, San Francisco Unified School District had already hired Revolution Foods, a caterer that serves some of the highest-nutrition meals in the nation. But when the lunch bell rang, 72 percent of those who could afford lunch weren’t showing up; students didn’t want to wait in the long lines or rush to finish, so they headed off-campus to eat.

Working alongside more than 1,300 students, parents, union leaders, nutrition staff, board commissioners, principals, teachers, and community groups, IDEO and SFUSD redesigned school lunch. Together, they developed recommendations for three age-appropriate dining experiences, from communal eating to student-designed spaces to new technology platforms, and worked to develop a robust business model.

In September 2013, the San Francisco Unified School Board expressed unanimous enthusiasm for IDEO’s work, clearing the path for this new vision of student-centered lunch to take root.

You can learn more about the cafeteria, and hear firsthand from the students, in this immersive, interactive story.

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Steelcase and IDEO have been collaborating for more than 25 years. The relationship has influenced furniture design across a range of environments, from work spaces to hospitals to schools, and has resulted in numerous design awards for iconic pieces like the Node Chair for classrooms and the innovative modern office chair Leap WorkLounge.

At the heart of the relationship lie trust and a spirit of collaboration, said IDEO founder David Kelley, allowing the space for innovation. “It has to be the collaboration between our inherent innovation capabilities and their extraordinary internal knowledge about the market and what they do best,” Kelley said. The way IDEO began working with Steelcase decades ago has influenced the way they continue to work today, involved in all areas of the business, from design and engineering to strategy and marketing.

The first collaboration in 1989 was for a new Steelcase division called Details, and featured desktop products to go along with its already successful line of office furniture. From the beginning, IDEO founder David Kelley and a group of designers were involved in helping Steelcase with decision-making on every level of the new division, from product strategy to hiring and everything in between. The particular blend of strategy, design, and engineering used to help Details become successful actually became the prototype project for the future IDEO, and is the blueprint for how IDEO works today.

What followed were a series of projects in which Steelcase and IDEO explored moving away from the traditional office cubicle toward furniture that was more architectural and open. More than 10 years ago, Steelcase noticed that the way people worked was changing from static work in offices to more fluid environments that were technology-enabled with laptops and mobile phones. This insight led to two collaborations, Room Wizard and media:scape, design efforts that captured this changing landscape by extending intelligent work to be supported by digital products, not just physical ones.

Jim Hackett, former CEO of Steelcase, said that an early brainstorming exercise in IDEO’s Palo Alto studio made him realize the power of a human-centered design approach. “They asked me to come to Palo Alto for a brainstorming exercise, so I went through the literal exercise that IDEO was having clients do at the time,” Hackett said. “As I was cutting foam core on the floor of one of the studios, I was thinking: I would never work the same way again after doing this. Not just designers should work like this, but anybody who is a knowledge worker should work like this.”

The collaboration’s many successes had a profound impact on Steelcase, and on Hackett personally: “I’m so humbled, I can’t even express it. I can’t tell you how many waves of joy come over me when I’m at IDEO. It’s just an extraordinary part of my life.”

Over the years, the two companies have been in nearly daily communication, a practice that has informed the work of both. While Hackett brought Steelcase’s perspective of corporate boardrooms and running a global company, Kelley and IDEO were working in the most innovative place in the world, saturated in design. Both companies agree that neither would be the same today without the experience gleaned from the other.

Some of the projects include:

RoomWizard
Aiming to connect the convenience of digital technology to physical spaces, the teams designed RoomWizard, a web-accessible touch-screen display that provides the real-time status of shared meeting rooms, simplifying the process of reserving and managing those spaces.

Leap WorkLounge and Ottoman
Building on their earlier work on the Leap Chair, the teams created a work chair with the comfort and style of a classic club chair, a luxury Leap Chair that takes work away from the desk.

i2i Chair
In researching the needs of a growing number of collaborative settings, Steelcase identified an opportunity to combine task and lounge seating. Named for the collaboration it enables, the i2i chair supports a variety of postures, including sideways, reclining, perching, and leaning. Winner of the Spark Gold Award, 2010, and the IDEA Silver Award, 2009.

Amia Chair
Steelcase and IDEO designed a task chair with modern ergonomic capabilities that accommodated a wide range of body types at a lower price point. Winner of the IDEA Bronze Award from IDSA and BusinessWeek, 2009.

media:scape
Steelcase asked IDEO to help evaluate and design a “walk up and connect” experience that merged furniture and technology to help teams access and share information. Designed to look light, open, and inviting, media:scape used a pedestal table with cleverly embedded hardware and interactive technology to foster group work. Winner of the IDEA Bronze award for Office & Productivity, 2011.

Node Chair
IDEO collaborated with Steelcase to design a platform for improving the classroom experience. The final product, dubbed the Node chair, has received praise for promoting student collaboration, allowing educators to reconfigure classrooms to fit different teaching styles, and enabling institutions to save money by making spaces more flexible and accommodating for varied uses. Winner of five design awards.

Watch: A love letter to Node.

A great healthcare experience shouldn’t be a luxury. It should be available to everyone, regardless of who they are, where they live, or what they need.

Planned Parenthood health centers have opened their doors to every woman and man for 100 years with this core conviction, offering services ranging from pap tests, cancer screenings, and breast exams to contraception, treatment for sexually transmitted infections, counseling, and education.

As the healthcare landscape continues to shift, Planned Parenthood is evolving to lead the progress. For the past year, the organization worked side by side with IDEO to rethink and prototype a patient and employee experience that elevates individuals and their health and well-being.

Together, the teams designed a number of patient and employee interactions and corresponding prototypes that address different patient needs: education, personalization, connection, and support for any decision.

Concepts in Development

These concepts are being rolled out across health centers around the country:

Welcoming Waiting Areas
To help set the right tone for patients from the time they enter the door, the teams designed waiting rooms that offer different types of environments for different needs. The Hub is an area that transforms the passive waiting room experience to a greeting area that’s staffed by knowledgeable guides who help orient patients, and quiet nesting spaces for reflection and privacy. Patients can spend time with friends and family in a social, kid-friendly common area, and those who want to get involved to support Planned Parenthood’s mission can learn about health and advocacy information. This modular design toolkit can adapt to the individual buildings, budgets, and community needs of any existing Planned Parenthood health center.

Restorative Recovery Rooms
For women who are recovering from surgical procedures, small thoughtful details have a magnified positive impact. Redesigned recovery rooms have been separated into semi-private spaces, accommodating loved ones who want to join patients after a procedure. Soothing colors and soft, warm fabrics create a comforting environment, and service gestures including cards with words of support and encouragement from staff reinforce Planned Parenthood’s promise. A take-home kit provides clear information about what to expect during recovery and recommendations for follow-up care.

Unifying Employees
Because the heart of Planned Parenthood is its dedicated employees, we developed and launched an engagement and training program that provides staff with the tools and support they need to do their best work. In This Together, an employee engagement training, prepares staff to work with a vastly diverse community, reduce stigma around health choices, and empower patients to take control of their care. It’s based on a clearly defined set of workplace values and service standards, common goals that help employees across the global organization work together to provide top-notch experiences at every location.

Vision for the Future

These concepts are in varying stages of development, with plans to launch coming soon.

Patient-Physician Tool and Educational App
Visit Companion is a prototype for a suite of digital tools that help patients learn about their reproductive health choices and create personalized plans with their clinicians. While they wait, or anytime before a visit, patients can learn the answers to common questions related to their appointment and see side-by-side comparisons of their care options. The app uses familiar language and symbols to describe symptoms and side effects, and it provides a record of what was discussed during the visit as well as reminders for follow-up appointments.

Simplified Medical Forms
For the 2 million-plus patients who visit Planned Parenthood health centers, there’s an opportunity to make appointments more convenient and straightforward. Currently in prototyping stages, Friendly Forms is an easy-to-understand, interactive digital questionnaire written in simple, conversational language that was designed by replicating how Planned Parenthood clinicians speak to their patients. The forms adapt as patients answer questions, giving only the prompts that are relevant. Patients will be able to complete Friendly Forms any time before their appointment, so it’s easier to complete the forms accurately.

Holistic Women’s Health Care
Women who rely on Planned Parenthood for their sexual and reproductive healthcare can benefit from having trusted clinicians guide their care throughout their lifetime. Through the Well Woman Plus program, Planned Parenthood will connect women to trusted providers for care beyond physical exams and birth control consultation. Clinicians will use interactive digital and physical tools to map out lifelong health care milestones and help patients think proactively about their future, from family planning to preventive screenings.

To learn more, go to PlannedParenthoodExperience.org.

Find out more about Planned Parenthood's approach to creativity in this Q&A with executive vice president and chief brand officer Dawn Laguens.

La Victoria Lab (LVL) is a group of designers, anthropologists, architects, and entrepreneurs working on improving the lives of the Peruvian middle class. Founded in 2014, LVL is the Innovation Lab of Intercorp, an economic group of 35 companies spanning banks, malls, cinemas, schools, health care clinics, and more. Intercorp was founded by Carlos Rodríguez-Pastor, one of Peru’s most successful entrepreneurs, employs more than 90,000 people, and accounts for almost 4 percent of the country’s gross domestic product.

Peru is one of South America’s fastest growing economies, with a healthy 6 percent year-on-year growth from 2007 to 2017, on average. That rising economic tide, along with government policy, has created extraordinary social mobility: Between 2005 and 2017, the share of poverty fell from 55% to 22%, of a population of 32 million.

Know The Customer

As Peruvians’ lives have improved, the new middle class's needs and aspirations have changed: They’re entrepreneurial, expect great services, and want the best for their children. That challenge and opportunity led Rodríguez-Pastor to enlist IDEO to bring our empathic approach to the construction of Innova Schools, a new school system, and to redesign Interbank's customer experience"

Success in these two projects bred ambition. Intercorp, Rodríguez-Pastor realized, needed to build two capabilities: a deep, bedrock understanding of the new middle class, and an innovation capability with which his companies could create new products, services, and experiences. “I want a little IDEO,” Rodriguez-Pastor said, and the germ of LVL took root.

A Lab Takes Shape

In early 2014, as contractors broke ground on the Lab, its founders set about hiring an eclectic team from across the globe and undertook their first project: to deeply understand the needs, desires, hopes, and dreams of the emerging middle class.

Three months of ethnographic research was followed by three months of bringing their insights to life. LVL’s team surrounded themselves with mementos of people’s lives: toys, products, ads, as well as video interviews with families, to help Intercorp’s executives literally step into the lives of their prospective customers.

Solutions and Skills

Powered by those insights, La Victoria Lab has brought human-centered problem-solving to a variety of Intercorp’s companies, including new retail ventures, and improving the cinema-going and banking experience.

In 2015, the Lab began scaling its efforts to build innovation capabilities across all of the portfolio companies by using IDEO’s innovation readiness assessment, Creative Difference. Each company received a report of their strengths and improvement areas, and as a result, LVL facilitated workshops and community groups focused on building essential capabilities.

"Creative Difference is the first tool that has allowed my team and the organization to have a precise picture of where we are in the spectrum of doing truly innovative work. Now, we can identify our strengths and areas of improvement, we can develop work plans and actions based on data, and can start to really dig deep into innovation,” says Aurelia Alvarado, Director of Innovation, Innova Schools.

La Victoria Lab’s experiments are catalyzed by Intercorp’s scale, reach, and national ambition. Innova Schools, for example, is now Peru’s biggest private school network (read more about Innova here). And Interbank’s new retail experience rolled out to more than 180 branches nationally.

As LVL matures, its focus is changing, says Hernan Carranza, Chief Innovation Officer, Intercorp. “There's a transition taking place at La Victoria Lab, from a studio undertaking typical design projects, to a platform for impact-led journeys that start at pipeline discovery, defining key performance indicators, all the way to implementation and stewardship."

Just as important as the projects it delivers is the wider intent of LVL. The aim is for IDEO’s role within La Victoria Lab to wane, as Intercorp’s waxes, and the company’s internal Innovation capability and culture strengthen. LVL’s ventures range from mindset-changing initiatives, such as curating Peru's largest innovation festival, to deeply transformative endeavors targeted at reinventing the core value propositions of Intercorp's insurance, drugstores, and medical services. It envisions massive cross-organizational transformation.

“Innovation,” said Rodríguez-Pastor, “is too important to be outsourced.”

Keep up to date with the latest projects from La Victoria Lab: lavictoria.pe

"For the latest developments on our work with Intercorp, head to "The Possibilities Business: An Oral History of Organization Transformation"

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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