
A blueprint for transforming pediatric obesity care
Charting a healthy path for children and families on Medicaid.
Obesity exists at the complex intersection of a clinical condition and a cultural force. Clinically, it comes with a diagnosis and treatment plan. Culturally, it is influenced by beliefs, identity, and self-worth, making it deeply personal and often taboo. Families, healthcare providers, and experts tend to avoid the fraught “o-word,” opting for euphemisms instead. For families on Medicaid, these challenges are even more pronounced. Award-winning health-tech startup Clarity Pediatrics, together with designers from IDEO, IDEO.org, and with support from Rise Together Ventures, sought to uncover the obstacles to healthier lifestyles and create a free report for US pediatricians who want to bend the curve on the childhood obesity epidemic.
Research with kids and parents on Medicaid in Dallas, Texas, and California’s Bay Area, along with interviews with healthcare providers and experts across the country, uncovered stories of stigma and frustration. Parents spoke of the daily challenges of balancing multiple jobs, sourcing affordable healthy food, and finding time to make necessary lifestyle changes. They described rushed pediatric visits that left them with unclear next steps and feelings of blame. Provider conversations echoed these struggles, noting time constraints and limited follow-up options.

Ultimately, food had become a daily torment for these families. Eating was unavoidable and also one of the few affordable indulgences low-income parents were able to provide. Once kids left their own homes, they were surrounded by unhealthy temptations, making it feel impossible for parents to maintain control. The popularity of costly new weight-loss medications and surgical procedures added another layer of complexity for families who had been underserved by—and therefore distrustful of—America’s healthcare system. With so much of the responsibility placed on parents to self-direct care, inequities deepened, adding to the burden of families already at a breaking point.
To design a path forward, IDEO and IDEO.org mapped a family’s needs before, during, and after pediatric visits. This work revealed critical parts of the journey where families needed more support: recognizing early signs of obesity, navigating provider conversations, and sustaining healthier habits at home.

These insights informed a theory of change framework that provides actionable guidance for stakeholders involved in obesity care. Grounded in three opportunity areas along the patient journey—building awareness, confidence, and capacity—the framework highlights how trust, dignity, and systemic support can lead to lasting outcomes.

IDEO and IDEO.org also developed 10 user-centered concepts spanning digital, physical, and service offerings to reduce stigma and empower families to sustain healthier lives. These ideas address dignified diagnoses and structural inequities, among other pressing issues. Complementing these concepts, IDEO created a short documentary of a mother discussing her family’s experience navigating childhood obesity to help pediatric providers—many of whom have had very different lived experiences from the families and patients they serve—better understand the realities of the daily struggles of many families on Medicaid.
Designed for the public good, the interactive website and free downloadable report, Reimagining Childhood Obesity, contain research findings, design recommendations, and a theory of change framework. The goal: provide practical, actionable guidelines for pediatricians, educators, healthcare organizations, and innovators to meet families and kids where they are and support them as they move toward a healthier future.
21% of US children are obese. 40% of Latino youth are either overweight or obese.
26% of kids on Medicaid experience childhood obesity, compared with 11% on private insurance.
525,600 minutes: Total time per year parents spend caring for their children. 17 minutes: Average time a pediatrician spends with a child during their annual exam, a small window to address a complex chronic condition such as obesity.
10
user-centered ideas to help pediatricians reduce the stigma of childhood obesity in an accessible report
3
opportunity areas for building trust with young patients and providing family support


Building Acer’s Climate Lab
How a consumer electronics giant is turning sustainability into an engine for growth.
With its reach, Acer saw an opportunity to power positive choices in the billions.
But new products and services won’t succeed if consumers don’t want them, no matter how sustainable they are. A few years go, the Harvard Business Review’s report, "The Elusive Green Consumer," found that about two-thirds of those surveyed said they wanted to buy brands that advocated sustainability. But only a quarter actually did.
Meanwhile, the market for climate era products is only growing: In 2022, Forbes found that nearly 90 percent of the Gen X consumers they surveyed said they’d be willing to spend more on sustainable products, compared to just over a third two years before. The desire was only higher among Millennials and Gen Z; they just didn’t like what was on offer.
To drive sales and growth, and meet its sustainability commitments, Acer needed to capitalize on desirability, deepening the connection between Acer’s sustainable options and consumer needs, lowering the barrier to purchase. To that end, Acer and IDEO created the Acer Climate Lab, a cross-organizational team and initiative, to launch the company on a transformative journey to deepen the connection between Acer's conscious technology and the realities of people's lives and needs across four strategic areas.
Together, the combined team conducted extensive research to better understand consumer attitudes and behaviors toward sustainable products, and identified everyday areas where Acer’s conscious technology might be able to have the most significant impact: living, working, moving, and learning.
- Living: Envisions homes as hubs of energy efficiency and climate resilience, leveraging technology to optimize energy use, enhance air quality, and enable proactive climate management. These concepts include technologies like smart energy systems, adaptive air solutions, and integrated home management platforms explore how technology can support sustainable daily living.
- Working: Reimagines the workplace with flexible, sustainable technology solutions that prioritize resource optimization and circular practices. Concepts such as Acer Loop could provide a subscription-based model that ensures access to the latest technology, supports remote work, and reduces electronic waste through effective recycling and rehoming practices.
- Moving: Focuses on the transformation of urban mobility by integrating technology into systems that promote sustainable transportation. Concepts could include e-mobility hubs that highlight how urban spaces could offer seamless access to shared, low-emission travel options, reducing reliance on traditional carbon-heavy methods.
- Learning: Explores pathways to sustainable education by imagining environments where technology supports circularity and accessibility. This includes ideas like refurbished devices for students, repair and reuse programs, and educational spaces designed with climate-positive principles, nurturing eco-conscious habits in future generations.
Together with Red Peak and Sid Lee, the team launched the culmination of the work at COP28, the United Nations Climate Change Conference in Dubai, positioning Acer as a pioneer in climate positive technology. The exhibit included immersive experiences and interactive displays demonstrating how Acer's sustainable solutions seamlessly integrate into everyday life. Visitors could engage with scenarios depicting sustainable living, working, moving, and learning, emphasizing the practical benefits of Acer’s innovations.
Acer's journey through the Climate Lab project underscores a commitment to sustainability that goes beyond mere compliance. With this new cross-business team tackling the real-world barriers faced by consumers, Acer is paving the way for a more inclusive, sustainable future. This initiative not only aligns with global climate goals, but also sets a precedent for the tech industry, demonstrating that with the right approach, sustainability and innovation can go hand in hand.
In a survey, 65% of respondents said they want to buy brands that advocate sustainability, yet only about 26% actually do.
Nearly one in two consumers say they either don’t know what information to trust, or that nothing can influence how much they trust a business’s commitment to sustainability.
1 cohesive strategy
for climate era products across 6 different fields


A better way to teach writing, with AI
Ethiqly empowers time-strapped teachers to provide feedback at scale.
With the introduction of generative AI, Ethiqly and IDEO saw a unique opportunity to help teachers, by cutting down the time it takes to provide each student with feedback on their writing assignments. But to get there, they had to learn from the experts themselves. To kick off the project, the team headed into the classroom to co-design with students and teachers.
One of the first problems they discovered? Traditional methods of grading essays are laborious and inefficient for high school teachers, who are already notoriously busy and overworked. What teachers really wanted was to spend time giving each student the personalized feedback that helps them grow. Meanwhile, students really struggled to get started on their writing assignments, overwhelmed by looking at a blank page.

Together, the team started to think about how it could harness AI to make personalized instruction more accessible for all students, helping teachers provide better feedback at scale, and giving students the support they need to not only get started on their writing assignments, but improve their work.
With insights directly from students and teachers, the IDEO team built working prototypes, allowing them to beta test the product in schools, and demonstrate value to investors. They also developed a brand identity and style guide for launch, which came to life in a pitch deck, landing page, and other brand expressions.

The resulting product is a sophisticated blend of AI technology and user-friendly interfaces that empower teachers and inspire students. The goal isn’t just to get to a finished essay, but to assist students in developing critical thinking skills. Ethiqly's tools help students organize their thoughts and get writing by providing contextual prompts and suggestions—without doing the work for them. And the AI assistant supports teachers by suggesting comments based on evaluation criteria they have set, and teachers choose which feedback is relevant for their individual students. Students never see it without teacher approval.
As one teacher told the team, “With leveraging AI more in education, there’s this fear that it’s deprofessionalizing the field or it’s a direct replacement of a teacher in a classroom. I think it gives us meaningful data, so that we can actually teach the way that we want to in order to support our students.” Now, Ethiqly is in use in classrooms in 25 countries, positively impacting students across the globe.

Teachers know 1:1 interaction is key to student success, but an EdWeek survey found only 46% of teachers’ time is spent teaching, while 25 hours/week goes to other tasks like grading and making lesson plans.
25 countries…and growing
Ethiqly’s reach in classrooms around the world


Designing a park for generations to come
Frisco, Texas, imagines an ambitious city park for an evolving community.
Designing a piece of a city, like a park, doesn’t start with a blank slate. There are always traces of the past and the present, and the lived history of its residents.
To create a full picture of that story, the IDEO team built workshops for the community centered around questions about the unique experiences of living in Frisco. They invited them to reflect on the communities they grew up in, the city of today, and the public spaces that have played formative roles for them.
From their answers, a common value emerged: heritage. Frisco is a rapidly growing city, with residents whose families have lived there for centuries living side-by-side with more recent neighbors from diverse cultures and ethnic groups. Participants shared a vision of Grand Park as a unifying, shared space, a backdrop where many families can form foundational memories in Frisco.

Next, IDEO brought in multisensory design prompts to help participants further conceptualize the park. How did they want it to feel, sound, and smell? In the built-up, suburban city of Frisco, residents imagined a space that was less planned, enabling guided wandering and exploration. They also hoped that the park would inspire loved ones and descendants to feel a sense of curiosity and wonder.
At the end of workshops and sessions with community groups, the IDEO team took Polaroids of participants, asking, “What’s one word you want to describe Grand Park in the future?” Those words informed the collective vision that IDEO delivered to the city of Frisco, which included spatial concepts, user journeys, and branding for the park, all designed to showcase its unique landscapes. In January 2024, Frisco City Council approved the vision statement, and officials expect to break ground in the second half of 2025.
The population of Frisco is growing rapidly; its population is up 516% since the year 2000.
At more than 1,000 acres, Grand Park in Frisco is even larger than Central Park in New York City.
Less than 1% of Blackland Prairie soil remains in the region, and some of it is in Grand Park.
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Frisco residents were engaged in the process, from City Council members to high school students
200+
respondents shared anonymous feedback on what they imagined the park should be


Opportunities in the hidden costs of caregiving
Hard-won lessons from a designer supporting her father.
He had taken a disability leave from work to prepare for the removal of a tumor on his spine. The drives to his appointments had become routine, each trip a reminder of how much his body was changing—and how much he now relied on me. He said, “I’m going back to work after my surgery.” Despite my uncertainty, I didn’t argue. The surgery gave him a 50 percent chance of walking again, and for him, that was enough. But the probability alone was not enough to prepare me for what came next.
At 22, I came face-to-face with the hidden costs of healthcare when my father became paraplegic. Since then, I’ve become his sole full-time caregiver. This role has profoundly shaped my perception of the healthcare system—not only exposing the many gaps in healthcare but also the massive opportunities to improve how care is designed and delivered.
Today, alongside my role as a caregiver, I am an interaction design fellow at IDEO, where I spend my days collaborating with other designers to shape and refine human-centered experiences. Part of our job is to listen with empathy to user pain points to craft useful solutions that foster trust and understanding. As both a caregiver and a designer, I deeply understand these pain points and how we can design solutions that ease the burden on the 24 million caregivers in the US alone—whether it’s creating clear, comprehensible medical bills or developing devices that help prevent further health complications. Here are four massive opportunity areas I believe we need to solve for.

Mitigating enormous burnout
The first few years were by far the most difficult. My peers were embracing the newfound freedom of adulthood, while I was responsible for everything from dealing with insurance companies to daily cleaning and bandaging his stage-four wounds. I was in and out of the hospital, drowning in paperwork and trying to make sense of my father’s condition, his medications, new routines, and medical bills. I spent countless hours battling with insurance reps, demanding appeals, chasing down unreliable case managers, and pushing charge nurses to advocate on my father’s behalf. The burnout was debilitating. But there are so many opportunities to lessen that load.
Technological tools that patients and their families can trust can help close the gap in an inequitable healthcare system. Already, AI tools like Hyro AI and SICURA by Nohold are taking on some of these pain points by reducing the complexities of dealing with insurance, treatment options, and medical jargon. Hyro AI is even integrated into many electronic health record systems, allowing patients easy access to their personal health information to understand and manage treatment.
But what if AI patient advocates could take things a step further, flagging biases, challenging questionable denials, and assisting with appeals? As insurance companies increasingly use AI to deny claims, such a tool could help level the playing field, ensuring that vulnerable patients aren’t silenced by the very systems meant to support them.

Navigating the system
My father was hospitalized for over a year following his surgery, moving between the ICU, skilled nursing facilities, and acute rehab centers. Each stay brought hefty bills, frequently arriving months later with little clarity about their origins. They were outrageously expensive, and I struggled to understand what we actually owed—or why we owed it in the first place. Between the maze of Medicare, state programs, and private insurance, determining financial responsibility was completely overwhelming, and cost transparency was non-existent.
What if medical bills were as clear as itemized receipts, with straightforward descriptions alongside hospital codes? Originally designed to prevent fraud, medical billing systems rely on cryptic codes like “ICD-10” and “CPT”—effectively standardizing claims but making them nearly impossible for patients to decipher. While these systems serve the industry, they often do so at the expense of patient transparency and accessibility. An app that translates these complex codes into a simple, easy-to-read breakdown would be invaluable.
Beyond that, there’s an opportunity to design a visual progress tracker or dynamic dashboard, helping caregivers and patients manage payments, track processing status, and reduce the financial guesswork that adds unnecessary stress to an already difficult journey.
As a young adult learning to manage my own financial responsibilities while taking on my father’s, I found myself in need of a financial “buddy”—someone who understood my situation and had the expertise to guide me. While some companies, like the AI app Cedar, are tackling this issue, there’s still significant potential for innovation in this space.

Providing physical care
Whenever my father developed a stage-four bedsore, I had to administer IV antibiotics every six hours for eight to 12 weeks. During these times, I was stuck at home, bound by the six-hour window, having to reposition him every two hours to help the wound heal and prevent new sores from forming.
When you care for someone with limited mobility, bed sores are one of the most challenging issues. In the US alone, nearly 60,000 people die from bed sore complications annually. They emerge shockingly quickly and can go from the size of a nickel to so deep you can see bone. For caregivers, the physical toll of lifting and repositioning their loved ones can be overwhelming; it often left me physically drained and emotionally exhausted.
After dozens of hospital trips and many sleepless nights, I decided to invest in a specialized bed that could handle repositioning. But insurance doesn’t cover them. And they range from $2,000 to $15,000. A pressure-relieving mattress adds another $500 to $3,000, and professional assembly—often required—can cost an additional $200 to $500.
Imagine if there was a smart, modular bed for paraplegics that automatically adjusted using an AI-powered scanning app to track movement and prevent pressure sores. It could offer personalized configuration by allowing users to add or remove features as needed, enabling customization at home. Additionally, an affordable smart mattress that monitors sores and relieves pressure could greatly benefit both the caregiver and the patient. Accompanied by an AI-powered scanning app, the bed could track movement and prompt timely repositioning. Companies like Tidewave and Arjo already use technology to help mitigate bedsores, and the ForeSite Intelligent Surface (IS) by XSENSOR uses AI to monitor the real-time emergence of sores. However, these solutions are largely limited to hospital settings. If a company could create an affordable version for home use, it could significantly improve the lives of millions of patients and their caregivers.

Accessing home modifications
When my father was discharged from the hospital, it was up to me to find a wheelchair-accessible home in the Bay Area. Whether it was too-narrow doorways, steps, or tight corners, none of the homes I toured had the necessary modifications for him to navigate in his power wheelchair. The home we finally found had enough space to meet his mobility needs, but we still had to pay out of pocket for ramps, touchless light switches, and other accessible features. Even now, he can’t leave the house on his own. He can’t reach the door handle from his wheelchair, and the ramps are too narrow for him to safely navigate alone, leaving him at risk of getting stuck—something that has happened more times than I’d like to count.
Instead of having to tour each house with a tape measure in hand and the wheelchair measurements stored in my phone, it would have been incredibly helpful to have an app that could instantly tell me if a wheelchair would fit through the doorframe or if adding a ramp was feasible.
Imagine if that app connected to stores like Home Depot or Amazon, curating a list of items I could purchase directly, without the hassle of checking measurements myself. Or, what if real estate or rental apps had a special section for homes that had already been modified or were built with accessibility in mind? With the right tools in place, I could have avoided much of the uncertainty and frustration, making the journey to find an accessible home much smoother for both my father and me.
What began with inexperience and uncertainty has evolved into a journey of growth and adaptation, both as a caregiver and a designer. Together, my father and I have learned a lot about how to live our new life—and each other. It has not been easy. And there is so much opportunity for insurance companies, healthcare providers, and startups to alleviate the unnecessary stress for caregivers and their loved ones. As the caregiver population continues to rise, the need for innovation is clear—without it, millions will continue navigating these challenges alone. As designers, we’ve only scratched the surface—there is so much more that we can do.
As my father and I prepared to head to Stanford for yet another doctor’s appointment, I remember asking him, “Are you prepared to never walk again?”


Meaningful resistance
The transformative power of designing for friction.
As you play, your job is to move a circle from one side of a line to the other. At each level, you have to wait one more second before you can cross the line. It’s both easy and increasingly boring—until you up the level of friction. The harder you make it, the more obstacles fill your path, and the more points you score. The higher the friction, the greater the fun, sense of accomplishment, and meaning.
This is a principle that’s true across play. Think about it: You could walk to the kitchen to grab a glass of water, or you could pretend your kitchen floor has turned to gooey molten lava, and hop from chairs to rugs to the sink to get what you need. You could sit around at home mindlessly watching TV on a Friday night, or you could pay money to be locked in a room with your friends, forced to solve puzzles to earn your collective freedom.
As the Executive Managing Director of IDEO’s Play Lab, I lead a team of toy inventors and designers who use play to create effective and joyful products and experiences. Rarely does our work involve making things seamless. It’s usually about inserting obstacles, adding layers, and crafting challenges to help motivate and delight players, employees, and customers alike.
And yet, as technology accelerates at an unprecedented pace and becomes intertwined in all aspects of our lives, from dating to healthcare to managing our time, we’re constantly trying to remove as much friction as possible. Digital tools promise to streamline our calendars, show us the shortest routes to destinations, enable us to make purchases with a single click, and even facilitate our relationships with each other.
But at a moment when technology promises frictionless living, we have to ask: What are we losing when everything becomes too easy?
Lessons from Gen Z
Gen Z is our first generation of digital natives, people roughly between the ages of 14–28, who have known digital technology and the internet for their entire lives. They have also seen the downsides: cyberbullying, superficial relationships, and broken attention spans. In many ways, they understand the costs of tech better than the rest of us.
Last year, we tested early prototypes of creative and relationship AI tools with a group of young people to gain a deeper understanding of what they truly want from technology. They were universally clear: They’re happy to use AI tools that can make them more efficient, but they don’t want to get rid of the messy parts of life. As one of them told us, “I want to go on a date for myself. I want to go on a bad vacation. You know what I mean? I want to experience things and be like, ‘Oh, I hated that.’”
There are numerous videos on YouTube featuring young people questioning the value of tech making their lives more convenient. Some are going so far as to turn back the clock, embracing flip phones, embarking on digital detox journeys, and becoming digital minimalists. On YouTube, Jess Farnham shares how intentional tech breaks help her feel more grounded. Sakura Opal explains her switch to a flip phone as a return to intentional living. JV Scholz paints a picture of the creative rebirth that comes with limiting your screen time.
The comments on their videos reveal a growing groundswell: Consuming mountains of content is becoming overwhelming. These young people want to return to creating content through activities they loved as children, like writing stories and drawing. They’re also recognizing that our brains have lost the ability to sit with our thoughts or commit our full attention, factors that can be contributing to our growing loneliness epidemic, because intimacy requires time, focus, and effort.
Young people aren’t the only ones—brands are responding, too. Bottega Veneta shut down its social media channels to focus on in-depth, slow storytelling. Heineken and Bodega created the “Boring Phone,” a tongue-in-cheek device that encourages users to step away from digital distraction. Merriam-Webster’s 2023 Word of the Year? “Authentic.”
Designing for meaningful friction
Instead of assuming that we should always design for efficiency, we should look for opportunities to design for deliberate friction, perhaps making our lives a little bit slower and maybe even more challenging.
As human-centered designers, friction has long been a part of our toolkit. And not just recently with the proliferation of AI. In 2011, we partnered with the beloved nonprofit Sesame Workshop to develop Elmo Calls, an app that allows preschool-age children to call Elmo to hear advice, educational stories, songs, and jokes. Going to the doctor for a shot? Need help going potty? Call Elmo for support and a positive message about the challenge ahead! The app’s purpose was never to have kids glued to a screen, though. Together with Sesame Workshop, we made a decision: Elmo will show up for a few minutes when kids need him most, and when the call is over, he will hang up.
We did something similar when we designed a VR version of the classic ViewMaster with Mattel. The toymaker asked that we purposely design it without a headstrap, so that kids could interact with incredible scenes enabled by the new technology for a reasonable amount of time, but would put the device down when their arms grew tired. This purposeful friction moderates usage and ensures that kids can experience the fun while encouraging most of their playtime to be in the real world, with real people.
Can you imagine if our phones weighed as much as bricks? Our lives would be very different.
Maintaining the rewarding parts of work
Recently, we’ve been involved in several AI projects where the initial impulse is to outsource work to tools that can automate tasks, generate content, or make decisions on behalf of users. But, there is a danger in outsourcing all our work to AI, because not all work is created equal. True, there’s burdensome work that you don’t want to do, but there’s also rewarding work that you wouldn’t want AI to take away from you.
When an early-stage startup approached us for help designing an AI-powered writing hub for high school students and their teachers, our research quickly made it clear that both students and teachers value the process as much as the result. As one student said, “I feel like writing kind of helps you learn more about yourself, and I feel like just having a computer do that for you...you don’t really get to tell your own story.” Their teacher told us, “It isn't just about the strict grade that I’m giving them, but also making sure that their writing connects to them as a human being. It gives me a peek into who they are as a person.”
Writing isn’t just about writing. It’s testing ideas and practicing critical thinking. The effort that goes into it is well worth it if it lets us share our thoughts with others, gives us a sense of accomplishment, and enables us to learn more about ourselves and each other.
So, rather than create a tool that makes writing easier, Ethiqly was born out of the question: What if teachers could give individualized writing instruction to every student? The product we designed with our clients guides students through the steps of developing their own creative thoughts—surfacing topics they are excited about, providing the right prompts to draw out ideas, and helping them craft a story that feels authentic to who they are. It also helps teachers provide individualized feedback at scale. It’s not about having AI replicate our work; what we want is for technology to help us do our work better so that we can continue to learn and feel the exhilaration that comes with that accomplishment.
Designing a more rewarding future
If, at this point, you're rolling your eyes at my proposal to purposely add friction, don't worry. I’m not suggesting we slow everything down. AI is poised to bring incredible enhancements to our lives. There are many things we want to do as quickly as possible, from curing diseases to predicting natural disasters. Even mundane everyday moments, like finding directions quickly when we’re running late, benefit from AI’s frictionless speed. There’s plenty of drudgery we can get rid of, too. But we need to be thoughtful about where we apply efficiency versus just creating efficiency wherever we can.
Imagine if instead of watching videos at 2x speed, they automatically paused and invited us to explore the content in more depth, allowing us to click on elements that catch our eye so that we can learn more about an object, person, location, or event. It could even compel us to reflect and comment on what we're seeing. What if our map apps didn’t automatically take us on the shortest route between points A and B, but instead offered a discovery mode option when he have the time for a more inspirational route? What if we abandoned endless scroll for a feed interrupted by challenges that prompt us to put our phones down and go interact with nature? What if it offered us rewards for time away from our screens, like a coupon for a cup of coffee at the cafe down the street?
Technology will keep evolving. AI will keep getting smarter. And there will always be new temptations to make life easier. But human-centered design has never been about making everything effortless. It’s about knowing when to embrace the effort—to design for friction, for complexity, for depth. Because it’s in those deliberate moments of challenge that life becomes more meaningful, more social, more joyful. Imagine what the world could look like if we design for meaning, not just for speed.
Looking to design for friction in your own products and services? Get in touch. We're here to help.
(This article was adapted from Michelle Lee's main stage talk at Config '25. You can watch the full talk here.)
Recently, my colleague Takashi Wickes designed a deceptively simple game called wait. wait.. wait…


Why futurists start with a backward glance
Forget predictions; we’re using lessons from history to design our preferred futures.
“What might be” was suddenly overshadowed by “what must happen now.” The pandemic disrupted every aspect of our healthcare ecosystem and forced us to adopt an entirely virtual primary medicine model, something most health systems had previously only experimented with. It felt like everything was urgent, and getting anyone to focus on the future seemed impossible. Surrounded by all that chaos, I decided to look back to see what history could tell me about major shifts in this industry during other periods of great uncertainty.
The past is filled with patterns of human triumphs, mistakes, and missed opportunities. These moments can give us a strong sense of how humans, governments, markets, and organizations might react to profound change. A century before COVID-19, the 1918 influenza pandemic similarly upended global healthcare, exposing the limitations of existing care delivery systems. Looking back at this period offered significant insights into how a crisis catalyzes transformation. In that era, patients received healthcare in their homes, by general practice doctors who were also members of their community. Just as COVID-19 forced a rapid transition to virtual care, the devastation of the 1918 pandemic led to the expansion of healthcare systems, the professionalization of medicine, and public health reforms. Despite the realities of the moment, the feelings of fear and uncertainty people felt in public settings in 2020 were eerily reminiscent of the fears that marked the 1918 influenza crisis.
Each decade of our past tells stories about how change develops. The Industrial Revolution demonstrated how rapid technological advancements could reshape economies; the Space Race of the 1960s highlighted how global competition could fuel scientific breakthroughs; and September 11 proved how tragedy could bring a country’s diverse communities together in a shared purpose. Adding the context of examples from human history brings rigor and believability to the futuring process, upping the likelihood that people can understand potential opportunities and consequences in tangible ways.
But how do futurists do this? How do we pick which pieces of the past apply to what we’re trying to solve for, and how do we arrive at tangible takeaways? Here are three ways history can help you understand what could be.
1. A frame for ideation
History doesn’t always offer clear predictions for how change might unfold, but it can provide a scaffolding or starting point for the imagination. A historical lens anchors storytelling, making speculative futures more relatable and actionable by drawing on connections to known human experiences.
In 2023, IDEO partnered with LeadingAge California to explore a fundamental question: What does it mean to age well in a world of rapid change? Through a series of workshops, we examined how traditional older adult care, long centered on institutionalized models, could be reshaped by shifting demographics, emerging technologies, and evolving cultural expectations. We started by grounding our work in historical precedent to add credibility. Then, we crafted six bold, forward-looking narratives that reimagined aging as a deeply human-centered experience, one defined by purpose, autonomy, and connection rather than decline. These stories introduced new possibilities for older adulthood, where updated mindsets on aging, advances in AI, regenerative medicine, and assistive technology redefine what it means to grow old, allowing people to maintain their physical and cognitive health in previously unimaginable ways. Using the past as a framework clarified how services for this population could be reimagined to evolve in response to social and technological change. Within these constraints, we designed futures that felt not just visionary but entirely within reach, creating a roadmap that could help bring these ideas to life.
2. A way to stress-test plausibility
History helps make future scenarios more credible by grounding them in familiar patterns and contexts. This thought experiment requires thinking critically about the past. What factors spurred a particular phenomenon? What kinds of decisions shaped action, and by whom? What decisions did people decide not to make? By examining these dynamics, we gain insights into how similar forces might unfold under new conditions and use them to inform our stories. A backward glance at the mental health impact of isolation during 2020 could provide insights into the potential effects of remote work and virtual schooling on future communities. When we think this way, the past becomes a launchpad rather than a limitation.
These methods were extremely useful in 2023, when we partnered with the DC Federal City Council to reimagine the future of downtown Washington, DC, a city with both a storied past and a future that can change radically every election cycle. To generate bold, forward-thinking ideas for revitalizing downtown neighborhoods, we convened over 100 stakeholders. We asked them to identify the past and present to surface patterns of transformation and areas of opportunity in the city. With that foundation in place, the teams developed plausible future narratives, layering ideas such as new pedestrian zones, green spaces, and artist live/work zones onto physical maps of each neighborhood. These activities helped them create stories of the future that didn’t just feel aspirational but were deeply rooted in the city’s identity, its people, and the existing infrastructure. By looking to history, the workshop unlocked new pathways for action, moving closer to the goal of a thriving, community-driven urban future.
3. A method for predicting outcomes
The future is about identifying strategic choices that will shape the future we want to build. History reveals how communities, industries, and organizations responded to change, offering a glimpse into potential outcomes that could have a significant impact.
IDEO’s 2024 collaboration with San Francisco public television and radio station KQED explored how public media will have to evolve to remain relevant and essential in a rapidly shifting landscape. In a day-long workshop, the IDEO team guided the KQED board through a method developed by futurist Sohail Inayatullah called “The Futures Triangle,” which examines the weight of the past, the push of the present, and the pull of the future. By discussing these different forces, we surfaced a key tension: In an era of hyper-personalized content and decentralized media consumption, KQED’s legacy of trusted journalism and civic storytelling can be both a powerful foundation and a potential constraint. So, how will these existing forces shape the future? With this insight in mind, participants crafted stories and created artifacts from the future that drew a picture of a public media ecosystem more deeply embedded in community life, one that reaches audiences through interactive, on-demand, and participatory experiences. They explored how KQED could expand even further as a multimedia organization and community convener to become an agile, responsive, and dynamic force for engagement across generations and platforms. By analyzing the historical forces pushing and pulling the public news source, the group identified key strategic choices KQED could make today to shape the desired outcome of a more inclusive, innovative, and community-driven future for public media.
To build bold, forward-looking futures, we must look backward—not to recreate the past, but to navigate the future with intention. History provides more than context; it offers structure for creativity, a stress test for credibility, and a mirror through which we anticipate consequences. When we weave these insights into our foresight practice and design efforts, we can imagine futures that are rigorous, plausible, and transformational, drawing on the past to shape scenarios that inspire action and meaningful change. Years from now, when futurists look back on today, they will be reading the signals we left behind.
At the end of 2019, I embarked on a project exploring the future of primary care medicine, looking ahead a decade to imagine stories about innovative home diagnostics, expanded virtual care, and transformative shifts in delivery models. Then came COVID-19.


Busting the myths of gamification
And methods for tapping into the deeper power of game design.
But somewhere between unlocking a new badge and being reminded that your streak is on the line, you wonder, “Am I actually getting healthier—or just getting better at this game?”
Gamification, the technique of borrowing principles from game design to nudge behavior, promises motivation wrapped in fun. It has taken hold for a reason—it works. At least in the short run. Our products now nudge us at every turn. Fitness apps keep us running (literally) after digital rewards; loyalty programs make us strategize our coffee orders like it’s the Olympics; and even financial markets have started to feel more like Vegas, where winning means flipping assets before the music stops. But the important question isn’t whether gamification works. It’s who is it working for?
When game mechanics are used for product strategy without understanding consumers’ deeper motivations, it breeds fatigue, churn, and mistrust. It’s not just bad design, but rather a larger risk to customer loyalty and long-term growth. Gamification strategies that emphasize winning can also unintentionally encourage overconsumption, while attempts to gamify health, community engagement, or sustainability risk reducing meaningful behavior change to shallow, performative tasks.
In a well-designed game, the relationship is symbiotic—you play because you love the experience, and in return, the game designer thrives as more players buy in. But gamification can sometimes feel like a system imposed upon you, where participation is required to unlock basic functionality, avoid penalties, or simply keep up. When this happens, gamification starts feeling more like an obligation—or worse, a trap. The game stops being something we choose to play—it plays us instead.
So how do we harness gamification’s immense promise in a more productive way?
At the IDEO Play Lab, we leverage game design to help businesses drive deep, sustainable engagement. Because most successful products don’t just lean on gamification’s surface sparkle—they dig into the sturdy mechanics of game design itself.
Here are some of the myths of gamification and real ways thoughtful game design can lead to better products.

Myth 1: To make an experience sticky, just add points or badges!
Reality: The deeper opportunity lies in leveraging game thinking to make transformative experiences.
Reducing game design to points and leaderboards sells it far too short. True game-thinking involves designing systems that embody the foundational mechanics of games—like challenge, choice, feedback, and progression—to create deeply engaging, motivating, and transformative experiences.
One example: We were partnering with an organization to develop a digital platform to support the mental health of people aged 14-25. We could have simply added a point or reward system to make the app engaging for this young audience—after all, social media and other apps do just that. But we knew that the benefits of working on one’s mental health aren’t tied to those types of metrics; in fact, employing them can have the opposite effect. Instead, we ran game design workshops to explore specific mechanics and principles that would tap into users’ intrinsic motivations, then used those as a springboard to explore compelling—and beneficial—new features. One of the simplest—and most popular in testing—was a fidget drawing board, where users could make little finger drawings on a starry background that would fade after a few seconds. This playful interaction was a compelling feature that drew our testers back again and again. No leaderboard needed.

Myth 2: Make an experience feel like a game with competition!
Reality: Games do not have to be zero-sum.
Games often have a winner and a loser—one person’s success comes at the expense of another’s. But not always. Over the last two decades, we’ve seen a big rise in new kinds of gaming experiences—cooperative games, cozy games, storytelling games, and more. Games like these leverage game mechanics to build community, encourage expression, or even intentionally lower the stakes to design for new kinds of emergent experiences
On a recent project, IDEO worked with a client that was looking to introduce generative AI workflows into employees’ day-to-day work. They told us that the team responded well to competition and recommended leaning into that to motivate and incentivize participation. So, we split the group into two teams and started tracking achievements to see which team could achieve the highest overall score each week. At first, the teams enjoyed tracking points and competing. But when we introduced a challenge where harder tasks earned more points, participation collapsed. Some tried, but after high scores hit the leaderboard, they felt embarrassed to share lower ones. Others skipped it entirely, assuming they couldn’t measure up.
So, we changed course. Instead of rewarding skill, we gave points for effort and encouraged mentorship over competition. Participation rebounded immediately.
Dialing in the right mechanics for a leaderboard is trickier than you might think. Done poorly, you might discourage the very behavior you’re hoping for. Ultimately, gamification should encourage progress, not perfection.

Myth 3: Gamification works because it’s fun.
Reality: Motivations are much more complex than just fun, and game elements work best when they are tied to more meaningful values.
Fun is suuuuuper subjective. It’s not even helpful to say it’s a motivation. It is an outcome. Some games create fun through storytelling and narrative explorations (think Dungeons & Dragons); other games offer fun through the satisfaction of strategic or tactical problem-solving (think chess). Game designers look at these deeper, more nuanced motivators when they shape an experience.
When we designed the initial prototype for Ethiqly, an AI-powered writing platform for teachers and students, we began with a fundamental belief: motivation goes deeper than fun. Ethiqly is built to support the writing process, not replace it. We applied a play-centered design methodology to uncover intrinsic motivators at every stage. Students don’t just complete tasks—they explore writing voice, style, and critical thinking. Meanwhile, teachers take on the role of game designers, shaping the learning environment through challenges, feedback, and progression systems. Instead of automating away the parts of the writing process that bring users satisfaction and purpose, like students building confidence and skill in developing their point of view, we built experiences that work with their intrinsic motivation. Just like in a great game, the platform gradually increases difficulty, offers meaningful choices, and delivers helpful feedback that sparks growth. Gamification, in this case, works because it isn’t just icing on the cake—it’s a deliberate system for sustained engagement, where technology augments human creativity rather than bypassing it.
Many of the industries that are leaning into gamification—exercise, eating habits, medicine, education—tap into motivations that are similarly complicated. Organizations need to take care to align the ingredients for fun with the criteria for other meaningful outcomes.

Myth 4: Gamification has universal best practices.
Reality: You can’t slap any old game mechanic onto any experience and expect to improve it.
Picture what would happen if you added dice rolls to chess—a game that is deliberately devoid of randomness. You’d change the very essence of it. Similarly, you can’t just add badges to a workout routine and assume it will make the workout better. You might even ruin the original, desired experience.
IDEO once helped design an FDA-approved program to help people quit smoking. The team made early games that were fun to play, but something didn’t feel right. So, we took a cue from roguelike games, a genre that uses repeated failure to make players’ eventual success more meaningful. (After all, the journey to quit smoking can often include repeated failures.) Some roguelike games even require you to fail in order to level up. Inspired, we applied this kind of game psychology to design a core loop, providing feedback that users could reflect on, understand, and apply on their next attempt. The setup gave users a reason to continue and ultimately succeed.
Layering game elements onto existing activities requires intention and design to dial in the right experience.
When done well, leveraging game mechanics isn’t about points, competition, or chasing fun; it’s about designing experiences that tap into deeper human motivations. The best games can shape how people engage, learn, and grow. But getting it right takes more than a leaderboard—it takes thoughtful design.
At IDEO, we apply play and game mechanics to complex challenges, designing experiences that empower rather than manipulate, motivate rather than pressure, and create lasting impact beyond the next dopamine hit. If you’re looking to build experiences that go beyond the surface and truly engage, let’s talk.
Imagine this: You’re halfway through your fitness challenge, hitting milestones with satisfying progress bar updates and an occasional trip up the leaderboard.


Lindsey Turner
I’m passionate about building brands, products, and experiences that help organizations show up with meaning and momentum.
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.


Rachel Young
My work helps organizations see who their products aren't working for—and build the will and the tools to do something about it
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.


Brian Pelsoh
I lead with craft, ensuring our work is creatively excellent: rooted in deep human insight and imagination, while also grounded in the realities of business and technology.
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.


Tony Wong
I am responsible for IDEO’s long-term success in China and working with clients to use design as a tool to enable growth.
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.
Building a personal AI for the messiness of life: Sida Li
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.
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.
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.
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.
Designing GenAI for the emotional side of money: Johannes Seemann
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.
The curious leader's edge in uncertainty: Scott Shigeoka
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.
How constraints make us more creative: David Epstein
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.
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