Life Technologies, a global biotech company that supplies scientists with products and services, needed to grow big, from a $4 billion to a $10 billion enterprise. So it hired IDEO to help seed innovation across the company.

"When we started out, it was an R&D thing for driving innovation in new products. Now it’s not just R&D; user-centered innovation is a central part of our culture. It’s what we do throughout the organization," said Amy Cuneo, Associate Director, Customer Insights.

Over a three-year engagement, IDEO helped transform Life Technologies’ corporate culture through the introduction of User-Centered Innovation (UCI), an optimistic, experiential approach to problem-solving. Far outperforming its ambitious goal, Life Technologies is now a $13.6 billion company and uses UCI to inspire innovation throughout the 10,000-person organization.

After working with Life Technologies, IDEO designers came up with three products that have gone to market, including, a new bottle that showcases superior handling and storage, easier identification, and additional room for supplements. And Life Technologies has transformed from a company that aspires to focus on customers to one that truly does.

Unplanned pregnancies are a big problem in the US, especially among unmarried 18- to 29-year-olds. Seven in 10 pregnancies in this demographic are unplanned, a statistic that applies to women of all ethnicities and socioeconomic levels. Complicating matters are the social tension between abstinence-only and contraception-inclusive education, and the difficulty and expense associated with obtaining prescription birth control.

Since 2009, IDEO has worked closely with the National Campaign to Prevent Teen and Unplanned Pregnancy, a nonprofit NGO, to address this pressing social challenge. One of the first insights on the project was identifying the need for comprehensive birth control support. Designers looked at ways to transform birth control from a prescription (a piece of paper that is handed to you by a doctor) into a subscription (a program that ensures you start using birth control, use it correctly, and migrate to more effective methods).

Given the complex and potentially overwhelming subject matter, the IDEO team interviewed women in the target demographic; talked with doctors, counselors, and other experts with varying opinions about birth control; and hosted roundtable discussions. They developed several concepts and scenarios that allowed members of the National Campaign to see sex and pregnancy through the eyes of the young women they’re working to reach.

Research and prototyping efforts led to the design of Bedsider, a multi-touchpoint birth control support system with a carefully crafted sex-positive brand, which is uncommon for the healthcare industry. Bedsider focuses on five key areas (awareness, motivational drivers, digital offerings, services, and loyalty) and acts as a vehicle for behavioral change that’s flexible, with room to grow into a much larger movement.

The Ad Council and the National Campaign debuted a multiyear, multimedia public service campaign in November 2011. The Bedsider website offers comprehensive education about existing birth control methods. This includes opt-in reminder services, personal stories from women across the country on why they chose a particular method, a phone service that provides information in both English and Spanish, features such as “Fact or Fiction” (hilarious animated clips debunking popular myths), a “Frisky Friday” newsletter, and more.

Bedsider has launched nationally with the help of an Ad Council campaign that drives sexually active women ages 18–24 to Bedsider.org. The multimedia Public Service Announcement effort includes television, radio, print, web, and nontraditional advertising, as well as an integrated social media program.

“We hope that Bedsider will be a useful tool for women to learn about their birth control options, better manage their birth control, and in the process avoid getting pregnant until they’re ready,” said Planned Parenthood of South Florida and the Treasure Coast in its monthly newsletter. Planned Parenthood and Philliber Research Associates joined forces with the National Campaign to Prevent Teen and Unplanned Pregnancy to help test and evaluate Bedsider.

Through a social media campaign called #ThxBirthControl, people are voicing their thoughts about what birth control has made possible for women, men, families, and society. It’s all part of Thanks, Birth Control Day, launched in November 2013 as part of a continuing initiative to encourage positive conversations and more consistent use of birth control by the National Campaign to Prevent Teen and Unplanned Pregnancy. To celebrate the movement, IDEO wrote, scored, and performed an animated musical featuring condoms and pill packs dancing the cancan.

According to an independent evaluation of the program, Bedsider is the first digital intervention in reproductive health in the U.S.—with adults as an audience—that has shown to prevent unplanned pregnancy. Turns out that when women and men have the ability to plan, prevent, or space pregnancies, they’re more likely to finish school, achieve their goals, and ultimately have healthier families, according to the nonprofit organization.

Chicago’s federally funded, citywide bike-sharing service, called Divvy, makes a fleet of bicycles available to commuters and tourists 24 hours a day. Alta Bicycle Share (which runs bike-sharing systems in Boston, the Bay Area, DC, and New York City) collaborated with IDEO to spread Divvy’s message, “Divide and Share!” to the cyclists and would-be cyclists of Chicago through the brand.

The new brand would appear on its bikes, stations, company vans, member fobs, and website—and it needed to be ready to hit the streets in just six months. IDEO partnered with local brand strategy studio Firebelly Design to collaborate on a solution. IDEO led the early research, conceptual brand development, and naming phase of the project; the Firebelly team led the visual design and developed the brand guidelines.

The brand has become a functional and fun part of Chicago’s transportation landscape and has been embraced by Chicago commuters. Just three weeks after it launched, the City of Chicago called the Divvy Bikes program the busiest bike-sharing system in the world. Six months into the service, enthusiastic cyclists have racked up over 780,000 trips and 1.7 million-plus miles, and over 12,000 Chicagoans have become members.

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After watching her husband suffer from cancer, Tomoko Namba, founder of Japan’s leading mobile internet company, DeNA, wanted to empower people with better health information to aid them in making medical decisions. DeNA partnered with IDEO to help with the design of a genetic test that had mass-market appeal.

Together, IDEO and DeNA designed all the consumer touchpoints from the ground up for the expanding new business, called MYCODE. The aim was not only to create a functioning, usable product, but also to introduce the notion of genetic testing in a privacy-sensitive country that for the most part, hadn’t yet considered it an option. What would make MYCODE resonate with mass-market Japan? How could genetic testing results be shared in a way that was accurate but also actionable and motivating?

The team worked with doctors, nutritionists, medical governing bodies, and more, setting up fast, iterative cycles, and conceptualizing and prototyping almost every aspect of MYCODE in just 16 weeks. Data design, home testing experience, purchase flow, and how the service would be used over the long-term were all considered, along with traditional branding elements, like name, logo, and visual identity.

The result is a product that puts reliable genetic information into the hands of Japanese consumers, helping them to make more informed healthcare decisions. MYCODE went to market in August 2014, just nine months after the engagement with IDEO began. Not only did MYCODE fulfill Namba’s mission, it helped the company find new ways to grow: Upon announcement of the new service, DeNA’s share price jumped 6.7 percent.

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.

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

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

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

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

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

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

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