For more than 40 years, Sage has helped businesses of all sizes navigate complex business environments. While many of its larger customers have the means and the structure to support climate initiatives, many of its smaller customers do not.

Sage wanted to help its SMB customers get ahead of future climate regulations and meet consumer expectations. And building carbon-footprint evaluation and mitigation tools would also dovetail nicely with Sage’s own climate aspirations: cutting its own emissions in half by 2030. Together, Sage and IDEO investigated how the company could leverage the data in its platform to calculate its customers’ emissions, both direct and indirect, and how that information could spur action as they aim to hit net zero.

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To get started, the design team went deep with customers running all kinds of businesses—from a taxi company to a champagne bar to a falconry center. Business owners shared that their focus often has to be on the day-to-day, a series of small decisions that, when added together, lead to business success. For many, tackling a problem as complex as climate change felt overwhelming. IDEO and Sage synthesized those insights and began working across verticals and products, bringing together experts from marketing, technology, sustainability, and operations to build out new concepts. With the help of two carbon accountants, the team worked to figure out how existing data could inform customers about both their direct and indirect emissions, which can be harder to track. Given how tight SMBs’ margins are, they focused on how that knowledge could fuel emissions-cutting changes that also save money, giving businesses extra incentive to take action. Together, the team created a roadmap of customer outcomes and experience guidelines to help shape future products.

Sage has taken that work forward, launching Sage Earth, a platform that aims to help businesses measure, manage, and mitigate emissions—even across supply chains. With carbon accounting now built directly into all Sage Accounting and Sage for Accountants products in the UK, Sage has made climate action practical and accessible for millions of SMBs. By automating emissions measurement and reporting, Sage Earth removes barriers of cost and complexity, empowering business owners and their accountants to stay competitive in supply chains where up to 95 percent of emissions occur. 

From co-developing the UK Voluntary SME Carbon Reporting Standard to launching a Carbon Accounting API, which gives banks, fintechs, and other platforms access to Sage’s Carbon Engine, Sage is embedding sustainability into the systems people already trust—helping hundreds of thousands (and rapidly increasing) small businesses turn climate ambition into everyday action.

Small- and medium-sized businesses—companies with fewer than 500 employees—make up about 90% of the world’s businesses, according to U.N.-backed SME Climate Hub.

Two thirds of small businesses don’t know how they’re going to reach net zero, and lack the resources to do so, according to a recent survey by SME Climate Hub. Still, the majority reported they want to act on climate, recognizing it can help them become a more resilient business.

Large companies may be the biggest emitters of greenhouse gasses, but an estimated 80% of those emissions come from supply chains—often made up of smaller enterprises.

Scaling rapidly

in the three years since the launch of Sage Earth, which is now being used by hundreds of thousands of businesses

World's 1st

open-source hybrid emissions factors dataset, Carbon Commons, led by Sage, helps SMBs calculate carbon footprints using existing data

Menopause is much more than a biological transition—it is a profound shift that often arrives just when people experiencing it start to feel invisible. Because it has long been shrouded in darkness as an unmentionable female affliction, those going through menopause often feel unprepared and alone.

Recognizing that its customer demographic makes QVC uniquely positioned to surface conversations and provide support to those dealing with menopause, the video commerce retailer partnered with IDEO to figure out how it could not only meet customer needs, but also flip the conversation on midlife. To learn more, a team of female design researchers held in-depth interviews with folks experiencing it firsthand. The people they spoke to had limited information about what was going on with their bodies, and in some cases, it took years before they understood that symptoms they were experiencing were related to menopause. Respondents also reported that midlife brought a change in social status and the feeling of being boxed in by stereotypes.

QVC and IDEO worked together to design an integrated suite of offerings that could give customers a safe space to discover and share more about menopause. That included an on-air programming series called “Menopause Your Way,” where QVC could support those going through menopause in the privacy of their own homes, a digital landing page with useful solutions, and social media campaigns to help women share and learn more about each others’ experiences. Because people experience menopause and choose to manage it in many different ways, the team wanted to create an integrated ecosystem of content that women could access according to their unique journeys. The new offering helped QVC  reach its core audience with solutions and relevant products, and created a space where menopause is out in the open and part of an ongoing conversation. And in the process, QVC evolved to become a more customer-centric company, putting its audience and their needs at the heart of its offerings.

9/10 of British menopausal women say society and brands overlook them.

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1 in 2 women in the UK admitted they didn’t know what was happening to them during perimenopause.

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Nearly 40% of menopausal women are being prescribed antidepressants to help manage their symptoms, despite 4 out of 5 describing the treatment as “inappropriate.”

Season 2

a series focused on menopause is now in its second season

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Healthcare is a complex web of institutions, interaction, relationships, and services. In England, the National Health Service consists of thousands of separate organizations spread across the country. This fragmented structure means that rolling out digital tools and using them to their full potential can be difficult.

NHSX approached IDEO and Public Digital, IDEO’s sister company, for help designing user-centered resources that would empower Children and Young People’s Mental Health (CYPMH) practitioners to use digital tools more effectively, shifting service design from a reactive to a proactive process, and allowing each regional organization to create the best digital services for their children and young people.

The team took a human-centered approach, tapping into the perspectives, challenges and needs of NHS practitioners and leaders across the system over months of research. They then designed a set of accessible, straightforward online resources, courses, and templates that would enable a practitioner to start their own local service transformations. These included everything from practical advice on improving users’ experiences of CYPMH, to teaching methods for service design, to content focused on achieving digital transformation at scale.

The resources were easy to implement and replicate, allowing mental health practitioners across the country to seamlessly integrate physical and digital, create firebreaks in the system, and better bridge the gap between seeking care and receiving it. They were designed to evolve over time, and the work is replicable across the NHS, with the potential to touch millions of lives.

By empowering practitioners to utilize these digital tools to ease the burden of care, NHSX plans to create a positive ripple effect across the entire NHS, its partner organizations, and the country at large.

In a study undertaken in July 2020, the first summer of the COVID pandemic, the NHS found that clinically significant mental health conditions amongst children had risen by 50% compared to three years earlier.

More options, more access

digital resources are helping children and young people access more options for their mental health care

It’s not easy to shift the paradigm for an entire industry. But when a company comes along that promises to reinvent air travel, it opens up a blue sky of opportunities. That’s the flight path for Boom Supersonic, which is thinking big about how passengers arrive at their destination not only faster, but also with a greater sense of wellbeing.

To really comprehend the experience of flying in the unique contoured profile of this ultrafast jet, and to help Boom make key decisions about the design of the plane, the IDEO team believed that you had to go beyond algorithms and schematics—you needed to actually board it.

Using a “build-first” approach, the team quickly constructed a full-scale mockup of the fuselage from plywood and foam core. That became a prototyping platform to test multiple seating configurations, galley and lavatory size and placement, luggage storage solutions, and other concepts that would differentiate and add value to the passenger experience. For the first time, the Boom team was able to set foot in its own aircraft and truly understand the experience from the perspective of its clientele. The exercise allowed the Boom team to confidently make decisions by comparing multiple cabin configurations and options in full-scale.

Throughout the project, Boom and IDEO invited future travelers aboard to interact with the prototype and offer feedback. That input culminated in a more refined model, with augmented windows, moonroof, in-flight entertainment screens, and sound design—all further augmented by a Virtual Reality component to allow our future travelers to fully immerse in this new experience.

Together, Boom and IDEO brought a sneak peak to the Farnborough International Airshow, a biannual exhibition for the aerospace, aviation, and defense industries. The event was an opportunity to give the industry and potential customers a preview of Boom’s innovative new jet. In collaboration with the client, an exhibition architect, and a digital production agency, the team created an immersive environment designed to make the Overture experience feel tangible, eliciting the wonder of this revolutionary plane.

Boom’s presence at Farnborough not only underscored the Overture’s progress but provided an inspiring glimpse into the future of air travel. During the air show the company announced the production Overture design, a market-expanding alliance with Northrop Grumman, and agreements with tier one suppliers Collins Aerospace, Safran, and Eaton. Not long after, Boom received its largest order to date, this one from American Airlines. 

The prospect of getting to London in time for dinner just got a little closer.

Boom plans for Overture to get from New York to Frankfurt in just over four hours instead of the eight hours spent on a commercial jet today.

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The Overture supersonic jet has a cruising speed of Mach 1.7, about twice as fast as today’s commercial planes. Overture is built to fly on 100% sustainable aviation fuels (SAF).

20 Overture deposits

made by American Airlines, joining current customers United Airlines and Japan Airlines

When we prototype, we embrace what we call the three Rs: rough, rapid, and right. We keep prototypes rough, so that the people we design with feel comfortable providing honest feedback. We move rapidly, getting in as many reps as we can to open up creative possibilities, learn from each iteration, and avoid falling in love with the first ideas that pop into our heads. And we work very hard to get it right, creating lo-fi designs that test for just one variable at a time, so that, for example, a beautiful design doesn’t distract from a less-than-ideal experience. As AI makes it easier to generate polished renders with minimal effort, we see more people celebrating the ease and speed of design. But beautiful images aren’t design. In fact, they can seduce us into thinking an idea is fully baked, stopping us from asking the most important questions, the ones that uncover the insights that help us truly meet human needs. 

For decades, the three Rs have kept us grounded, reminding us why we prototype and ensuring that we get the most out of the design process. They apply to everything we design—from physical products to AI-enabled systems and digital tools. One of our most memorable prototypes was for a digital product for Sesame Workshop. It involved a simple cardboard cutout of an iPhone and a bit of role-play. One colleague pretended to be a preschooler, standing in front of the board, pointing to elements on the improvised screen. Another stood behind the board, impersonating a furry monster that introduced a new dance move whenever our “preschooler” tapped the invisible screen. It did exactly what a prototype is meant to do: It drew people in, sparked a discussion with our partners at Sesame Workshop, invited valuable feedback, and could be easily adjusted and improved, giving us numerous opportunities to make it into something kids and parents loved. The video we recorded became so popular that professors still show it in design schools today.

As we integrate AI tools into our prototyping process, it’s crucial that we use them thoughtfully and intentionally, so we don’t lose the methods that have enabled us to create category-defining innovations that meet real human needs. We have to maintain the three Rs to expose knowledge gaps, invite real feedback, build belief, and give us confidence that a concept is worth developing and investing in. They help us make space for surprising turns, illuminate opportunities for joy in the design process, and even let us embody and fully engage with our ideas. Here’s a deeper dive into why each R matters, and how to integrate them while embracing AI tools.

Rough: A strategic incompleteness

Early prototypes aren’t finished or even pretty. That’s on purpose—it gives the people we test with permission to dive in and co-create with us. It also keeps us from becoming overly attached to our initial ideas, making it easier to pivot if we see a better way forward. 

When our toy inventors created the first prototype of the Aerobie Rocket Football, for example, it featured a small pedestal glued to the bottom of a foam football. The goal was to create a football that could stand upright, allowing kids to practice place-kicking without someone holding the ball. The pedestal was clunky and awkward, so we replaced it with fins. Nothing fancy—just four fins cut from a sheet of foam then hot-glued to the ball. It was better, but still incomplete. The next iteration included a ball with two curved parting lines running from the nose to the tail. Taking advantage of this feature, we attached the fins along the ball’s curve, creating a helix. The design compromised stability, and the ball immediately toppled when we tried to stand it up. But when we picked up the ball and threw it, it flew through the air with a perfect spiral. We had accidentally made something better than what we were aiming for—a toy so successful that it’s been selling for decades.

How can you intentionally introduce roughness into your prototypes when your tools automatically default to high fidelity? One approach IDEOers use is to roll them back to earlier versions, such as Midjourney 1.0, where figures are rendered with multiple fingers and other noticeable flaws that indicate a work in progress. You can also ask AI to create sketch-level or monochrome outputs rather than full-color rendered ones, leaving things visibly incomplete, annotate prototypes with open questions, or present multiple competing directions side by side, ensuring that no single option feels like the answer. The goal is to signal to collaborators and users that their input is still welcome and that the design has room to evolve.

Rapid: More cycles, questions, and opportunities to learn

We don’t want to spend too much time on a single round of prototypes. The goal is to iterate as quickly as possible, giving us multiple opportunities to share our ideas with users and to grow and morph our designs into something that resonates functionally and emotionally. By addressing challenges and responding to feedback, we reduce risk and build confidence with each iteration.

For example, when we prototyped a new voting booth for Los Angeles County, we wanted to incorporate tactile and audio interfaces for individuals with visual impairments. Instead of fully coding the experience and pre-recording audio clips to respond to testers’ actions, we hired a voice actor and improviser. He was hidden in an adjacent room with one of our designers, who had taped a flowchart to the wall. When our “voter” tapped the keypad to navigate the voting process, the designer would point to a phrase on the flowchart, prompting the voice actor/improviser to read it into the microphone. The audio was then relayed to the voter via headphones. Throughout the research session, our designer could make last-minute adjustments and explore different paths on the flowchart, enabling him to quickly test which scenarios provided the best experience for our voters. The flexibility of the prototype—combined with the voice actor’s improvisational skills—allowed us to modify not only the flow of the interaction, but also the wording, pacing, tone of voice, and more, on the fly.

There’s no doubt that AI accelerates output, but that’s only valuable if the time saved goes back into more cycles, more questions, and more variations. How do you make sure AI’s speed translates into more iterations rather than locking in your design too early? Show your prototype to various stakeholders to solicit their feedback. Listen closely and incorporate what you’re hearing. If you’re working on a digital design, for example, and the people you’re testing with don’t like the size or placement of a button, or how an interaction works, consider how you might alter the UI. Does moving the button over a tad solve the problem, or is there something else that isn’t working? With AI, you can make changes and test them almost immediately, even if you don’t have a coding background. However, be sure to keep your updates focused on the feedback you’re hearing rather than on testing a completely new design. 

Right: Testing one variable at a time

“Right” means building a prototype early in the process to answer a specific question, rather than showcasing the entire vision. When too many variables are included in one prototype, it can be hard to discern what is working and what is not. Do people love it because the ergonomic shape feels great in their hand or because they like the color or texture you chose? Or do they dislike it because of how it functions mechanically or digitally? Splitting these attributes apart allows you to learn about each element separately before bringing them all together into a cohesive prototype in the later stages of refinement.

An example of this is Flipslide, an electronic game that we designed and licensed to Moose Games. The toy was inspired by the fidget craze, which includes items like fidget spinners, chew beads, pop-its, and the resurgence of the Rubik’s Cube. Recognizing this trend and wanting to create a challenging gameplay experience without a screen, we came up with a game concept in which pieces flip, slide, and click into place as players manipulate them to match tiles that light up and change color. We built our first prototype to test the movement of our design and understand what it would take to create a mechanical toy with shifting components. The initial model was made of foam core and rubber bands. Next, we wanted to create a fidget toy that felt satisfying to hold and transform, so we made a prototype with more bulk, incorporating machined plastic parts held together with tension springs that provided just the right amount of resistance when moving the pieces around. By refining this model, we created a prototype that felt particularly satisfying to hold and manipulate. It also made a fantastic clicking sound as pieces fell into place. 

After we solved the mechanical elements, we moved on to gameplay. We started by taping a stack of 2 x 2-inch laminated color grids onto the front. Each grid had a different color pattern, representing rounds of gameplay. To complete a round, rectangular wings had to be rotated, flipped, and moved into place to match the colors on the grid. Once the colors matched, we’d yell “ding!” and pull off a grid to represent the next round, initiating another flurry of rotating, flipping, and sliding to match the new color scheme. Satisfied that the gameplay felt fulfilling, we added electronics to bring sound effects, music, pacing, and more advanced gameplay into the test. Soon after Flipslide hit the market, we had an award-winning game and fans around the world.

Don’t get caught "boiling the ocean”—using AI to address every question in one prototype. Instead, build discrete prototypes for discrete questions. Before generating anything, ask, “What am I trying to learn? Who needs to weigh in?” AI is exceptional at producing artifacts, but you need to direct it to give you artifacts that teach you something. You want to create prototypes that you can bring into research and put in front of users to understand what resonates with them and why. That’s easier to do when you know what you’re testing for.

Maintaining joy and discovery

It’s easy to use AI tools to manage a creative process. Some are even designed to do parts of it for us. But as designers, it’s crucial to invest in our own learning by doing. When we get our hands dirty, we learn to recognize what’s right, engage our imaginations and deep thinking, and energize ourselves and our teams. That practice is how we achieve great outcomes, for ourselves and our clients. It’s also how we keep it human—putting ourselves in the shoes of the people who will live with these designs every day and experiencing them ourselves.

There’s no question that AI is a game-changer for designers, and one that we’re happy to embrace. But it’s crucial to use these tools to support the best of design, rather than replacing the methods that have led to some of the world’s most important innovations. Building prototypes that enable you to co-design with users, test assumptions, and iterate with new learning leads to better results. Experiment with different tools, including the latest that AI has to offer. Once you understand each tool’s strengths and limitations, you’ll better understand what combination you need to engage not only others, but also yourself. Because ultimately, prototypes and great design will always need human creativity, imagination, and judgment. And the three Rs are a great way to get there.

“For decades, the three Rs have kept us grounded, reminding us why we prototype and ensuring that we get the most out of the design process.”

For leading fast-moving consumer goods (FMCG) companies, one way to escape the echo chamber is to adopt a human-centered approach—to actively listen to consumers and reconnect with the realities of their lives. It’s about more than bringing them in at a certain stage of the project. Their needs have to be considered from the very beginning. 

What follows is a story from IDEO Shanghai about what happens when a prominent consumer company returns to its customer-centric roots and discovers new growth in one of its most established categories.

What happens after a company hits the category ceiling?

China’s FMCG sector is known for its intensity. Even the most established companies cannot afford to relax; the competition is genuinely fierce.

In China’s major metropolitan cities and regional hubs, competitors launch new products at a rapid pace, all in pursuit of increasingly diverse consumer needs. Beyond these cities, smaller and lesser-known brands are making moves, constantly experimenting, and fighting hard for consumer attention through social media platforms.

Before coming to IDEO, our client had already made significant investments in consumer research to maintain its competitive edge. After the project started, its leaders showed us an elaborate chart filled with rows of consumer identity tags, behavioral patterns, and usage preferences, all organized by data dimensions and densely packed across different quadrants. Years of accumulated consumer insights had informed their product development and marketing strategies, helping them achieve significant commercial success.

And yet, despite all these efforts, they seemed to have hit a wall. To spur new growth in one of their flagship categories, for example, they had tried various strategies, such as conducting research in smaller cities, launching new products aligned with mass-market trends, and attempting to keep consumers engaged by offering more choices. None of it was enough to break through.

What else could they try? That question prompted the company’s senior leadership to come to IDEO. They were looking for a perspective that differed from their usual approach—one that could reveal new possibilities on top of everything they had built.

A revelation from consumers

Even though the client already had detailed data, we decided to conduct in-depth consumer interviews during our design research phase. Our goal was to start from a more fundamental place—to understand how people lived day to day and the role these products played in their lives.

From the client’s perspective, this seemed like a wasted effort. They struggled to understand why we wouldn’t simply begin with their assumed starting point: “Why do consumers choose our brand, and what do they expect from our flagship category?”

But the way consumers actually choose products revealed the “why” behind that question.

Whether they were “core consumers” who already frequently purchased the brand’s products, or “extreme consumers” whose preferences were well outside the mainstream, the decision-making process for buying these products was the same.

It started with a broad desire, for instance, “I want to try something different.”

From there, their life stage, immediate circumstances, and emotional state shaped that desire into a more specific need: “This is the type of product I’m looking for.”

Only then did consumers consider: “Which brand should I buy?”

In contrast, the client’s original framing—“Why do consumers choose our brand?”—treated the endpoint of the consumer’s decision journey as the starting point.

From a consumer’s perspective, this might seem obvious; it’s something we all do instinctively every time we shop.

But what is intuitive to the consumer is rarely intuitive to the brand.

Mapping out a consumer’s actual decision-making process provides significant value for a brand. It establishes a consumer-centered through line that helps leaders navigate innovation in a mature category with greater precision.

Several elements naturally align along this through line: the deeper needs of various consumer types, the moments and motivations that trigger a purchase, the opportunity areas where a mature category can effectively meet specific consumer needs, and the competitive strengths the brand should build on to fulfill those needs. Not only do these components become clearer, but they also create interconnections among them.

The core insights from our design research defined those triggering moments and illustrated the map of how consumers actually make decisions. This clarity, in turn, helped the brand’s leaders determine where to focus their efforts in order to revive a mature category.

Building system-wide alignment from a human-centered insight

We took everything we’d heard from consumers, distilled the decision-making processes behind them, and translated everything into visuals on a series of boards, which we then brought into the client’s meeting room.

Step by step, we walked through the consumer’s chain of logic, highlighting what each need meant for the brand’s approach to category innovation. When we finished, a C-level executive at the company looked at the boards and said, “This is a billion-dollar idea.”

The insight disrupted the default reflex of category leaders, who often claim to prioritize consumer needs while unconsciously starting every decision from their brand’s own business priorities.

At first glance, taking a human-centered route may seem like a detour. In practice, it helps companies avoid the wasted investments that come from acting on incorrect assumptions. A clear understanding of what consumers truly need allows a brand to recognize which of its existing strengths to double down on, and which emerging opportunities are genuinely worth pursuing.

After that meeting, the direction for category innovation quickly took shape. The key insight regarding consumer needs and decision-making became a powerful anchor. The insight unified early-stage product development, mid-to-late-stage packaging design and manufacturing, and the marketing communications that followed the launch.

Beyond charting a new course for the client’s flagship category, the project established a framework for cross-functional teams to build a shared understanding and work toward a common goal.

In the end, the collaboration was successful because everyone involved in the project maintained a primary focus: human-centered thinking.

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“The Making of...” is a series of behind-the-scenes articles written by IDEO Shanghai designers about our innovation methods and work with major clients across industries in China.

Success can create its own echo chamber. The more a company achieves, the easier it is to rely on familiar ways of seeing the market—often without even realizing it.

Healthcare was once centered on the doctor’s office. Today, it’s moving into the home. Since the pandemic, demand for at-home testing has surged, with 82 percent of older adults saying they’re interested in taking medical tests at home, and many preferring to age in place. From at-home influenza tests and COVID-19 swabs to cervical cancer collection kits and continuous health monitoring, people are taking a more active role in managing their care, with tools that enable both testing and tracking from home.

Designing for this shift means supporting people without medical training—who may struggle to interpret data, who might be nervous about collecting samples, or who might wonder about the efficacy of a test they perform themselves. In my work at IDEO, I’ve identified six principles for creating home-use diagnostics and monitoring tools that are more intuitive, reliable, and easier to use.

1. Design for emotion

Medical tests can evoke powerful feelings: fear of receiving bad news, memories of lost loved ones, or general anxiety. As a designer with a background in social science, I recognize that emotions often drive behavior. Our role as designers is to anticipate these emotional responses and design solutions that support them.

On a cancer screening project, for instance, we found that some users postponed testing not because they didn’t understand how to use the tests, but because they were afraid of the results. To address this, we softened the typography, refined the color palette, and shifted the messaging to focus on taking care of one’s health rather than screening for illness.

On a separate project, we discovered a completely different emotional pain point: clunky health monitors can be perceived as a sign of aging, making people feel self-conscious about wearing them. Which is a fair point. Medical devices often look outdated compared to sleek consumer technology. This disconnect can be emotionally jarring—and socially stigmatizing. To rectify this, we focused on portability and aesthetic improvements. The goal wasn’t to turn a home heart monitor into an iPhone, but to make it feel like a tool for enhancing well-being rather than just surviving an illness.

Time and again, we see that providing patients with a premium-feeling device or thoughtfully designed packaging can transform a medical experience from being a source of embarrassment into a moment that reinforces confidence and self-care.

2. Make use of the unboxing moment

First impressions of medical devices matter. If users can’t immediately see components or have to dig through packaging material, they may assume that the testing process is complicated or time-consuming, too. 

During one at-home cancer screening project, we discovered that many people opened the box, took a quick look, and decided to postpone the test because it looked too overwhelming. By redesigning the unboxing experience to make the components and instructions more visible, participants reported feeling more confident and in control.

With some thoughtful changes, the unboxing moment can feel like an act of empowerment. Blank spaces on boxes can be valuable real estate for reassuring messages or simple diagrams, ensuring that essential information isn’t left buried in the instructions.

3. Keep it familiar

At-home screenings are a relatively new concept, and can feel intimidating. People often worry they won’t be able to perform the tests correctly—or worse, that making a mistake could invalidate their results. Thoughtful design can help alleviate these fears by leaning into familiarity and clarity.

When an IDEO team collaborated with Teal Health on an at-home cervical cancer test, they designed the testing wand to resemble a tampon—a form and function that many users were already familiar with and comfortable using. 

Similarly, for an at-home stool collection kit for another client, we designed components that mimicked the contours of a toilet bowl, making the overall experience feel more intuitive.

4. Make data relatable

Designing at-home health monitoring systems requires a careful balance between what patients want to know and what healthcare providers need to see. Providing too much information can overwhelm patients, while too little can leave them feeling powerless. To drive adoption and adherence, designers must connect the data to patients’ real needs and challenges, empowering them to navigate their health effectively. 

Recently, an IDEO team was designing an implant to monitor organ health. Data from the implant would go directly to the physician for review, but patients also wanted to see the results themselves. In today’s world, where smartwatches can track heart rates and sleep cycles, people expect feedback from health tools. When devices withhold information, it can feel as if they’re keeping secrets. To address this, we recommended a simple, intuitive interface: a stoplight notification system (green = all good, yellow = contact your doctor), along with the option to view a trend graph over time. Patients had the agency they desired, while more complex data remained accessible only to physicians. 

In another project focused on at-home bladder monitoring, we discovered that a device that indicates bladder fullness was life-changing for patients who struggled to empty their bladders. People who felt homebound by the fear of embarrassing accidents or infections reported that the device would help them gain the confidence to plan their days and reclaim their lives. Even though the device would require surgery, the possibility of increased freedom was so appealing that patients felt it was worth the risk. The quality-of-life improvements the data enabled—not the monitor itself—motivated them to embrace this new device. 

5. Lean into visual instructions

More words don’t always equal more clarity. In fact, overly detailed, multi-page instruction packets can discourage people from engaging and may give the impression that a test is too technical, even if the language is at a fourth-grade reading level. 

In one project, we simplified an 11-step test guide into a user-friendly design with three main steps. We reduced the amount of text, emphasized illustrations, and broke down the process into manageable parts to make it feel achievable. This visual-first approach not only made the instructions easier to follow but also reduced user anxiety and improved accessibility for people with reading disabilities and those who speak English as an additional language.

6. Look to family and caregivers

While we typically think of patients as individuals, it’s important to recognize that they exist within complex networks of family, friends, and communities that support and supplement their abilities. When we do research for at-home devices and monitors, patients often request to be interviewed alongside their caregiver, or vice versa. Successful at-home medical monitoring and testing must take into account the motivations and needs of everyone involved in the patient care ecosystem. 

Product teams may assume that older patients will not want to use even basic technology. This might not be true, and even when it is, it’s worth remembering that the end user might not always be the patient. At times, a caregiver might be more invested in the outcomes of monitoring or testing than the patient themselves, and could be more open to embracing digital and tech-forward solutions. 

It’s this kind of health ecosystem thinking that becomes crucial as at-home testing and tracking grow more prevalent. What we have now may feel revolutionary compared to the pre-pandemic era of mandatory in-person care. Many innovations that once felt like futuristic fantasies—such as headsets that help treat depression and saliva-based hormone tracking to support conception—are now available for home use. Still, the potential that lies before us is far greater. 

But only if designers get it right. By keeping human needs—across patient, caregiver, and providers—at the center, we can build more advanced solutions that help people take action on their own health.

Need help designing some at-home experiences of your own? Get in touch.

“Providing patients with a premium-feeling device or thoughtfully designed packaging can transform a medical experience from being a source of embarrassment into a moment that reinforces confidence and self-care."

In our healthcare work, we’re constantly partnering with clients to solve big, seemingly intractable problems that prevent them from delivering the care patients need. Bad UX. Tangled bureaucracy. Stigma. Disinformation. Systems that were never designed to communicate with one another or effectively serve people. These barriers ultimately decide who gets better and who doesn’t.

Over the decades, we’ve learned it’s easier to tame these monsters if you name them. So we’ve turned them into creatures to help people identify and defeat the obstacles that prevent them from delivering the healthcare experiences and outcomes that patients (and employees) truly deserve. 

Here are five bogeymen we keep encountering in our healthcare work, and some projects that have taught us how to vanquish them.

The Abominable Experiences Monster

Many medical procedures are more uncomfortable than they need to be. Women’s health, in particular, is full of experiences that feel a little medieval—painful, invasive, and undignified. Each one nudges patients toward skipping their next appointment.

The Abominable Experience Monster devours appointments. It also gobbles up early diagnoses, follow-up care, and long-term relationships between patients and clinicians that fuel good healthcare.

This is particularly true when it comes to cervical cancer screenings. When detected early, this form of cancer is completely preventable. But one in four American women is not up to date with their screenings. To address this issue, we partnered with Teal Health to reinvent the screening experience, focusing on much more than just the speculum.

Together, we designed a method for patients to collect their own samples at home, one-handed while standing, with clear instructions and welcoming packaging. In 2025, the FDA authorized the device. During the trial, 87 percent of participants reported that the new in-home experience made them more likely to stay current with their screenings. 

Taming this monster starts with a question that isn’t asked often enough in healthcare: “Does it need to feel like this?”

The Entrenched Complexity Monster

This monster stymies progress. Departments operate as fiefdoms. A patient’s record sits inside three different systems. A small change requires six committees. Clinicians who want to improve the patient experience run out of energy trying to fight the system.

Newton-Wellesley Hospital came to us because they saw an opportunity to drive better patient outcomes through cultural and organizational change. We worked together to imagine a different future for the hospital, then prototyped it in phases.

The team at the Women’s Imaging Center kicked things off by reimagining the mammogram experience. They defined the principles for the experience they wanted to create and designed prototypes to gather patient feedback. Then, they became ambassadors, helping other departments take on their own monsters. Patient-centered ideas soon spread, including a practice that the hospital integrated directly into its medical records: a method for flagging each patient’s communication and care preferences, allowing providers to meet them in ways that made them most comfortable.

The Entrenched Complexity Monster is tamed one project at a time. Each time a department demonstrates that change is possible, the monster shrinks a little more.

The Ingrained-Barriers Monster

For a teenager seeking mental health support, there can be multiple barriers to care: from parents who don’t believe in therapy and months-long waitlists, to school counselors who are overwhelmed with the needs of 400 other students and the high costs of treatment. Combine these challenges, and you’re dealing with a juggernaut. 

The Ingrained-Barrier Monster festers in the gaps between systems that were never designed to support the people who need them most—especially young people.

Our solution? Design with them. We partnered with Kooth, the California Department of Healthcare Services, and hundreds of young Californians to create Soluna: an app featuring evidence-based behavioral health tools, free coaching, and resources designed by the people who will eventually use them. Soluna is now available for free to six million young people across California. 

The Fragmented Systems Monster

For a working family in Lima, Peru, accessing routine healthcare services is a patchwork experience. Affordable, comprehensive care can be extremely hard to find. The Fragmented Systems Monster thrives in these cracks. It costs patients both time and money and, at times, leads them to miss appointments altogether.

Intercorp wanted to build something different: clinics specifically designed for Peru’s emerging middle class, rather than modifying existing models that weren’t intended for them. Before launching a real clinic, they constructed a full-scale prototype—a fake clinic—where patients could experience every aspect of their visit: registration, waiting room, examination, and pharmacy. Afterward, patients provided feedback on what was and wasn’t working. That feedback shaped Aviva, a clinic that opened in 2019 and now offers over 30 specialties. Since opening its doors, Aviva providers have performed more than 3,000 surgeries and assisted with more than 5,000 births.

Taming the Fragmented Systems Monster begins with a counterintuitive idea: quickly build a tangible, rough version of connected care, allowing patients to guide you in getting it right.

The Convoluted Comms Monster

Today’s parents receive a lot of information from their pediatricians, but they also turn to wellness influencers, online forums, and screenshots shared by people in their networks. By the time they’re in the doctor’s office, their opinions on care have been shaped by numerous sources, not all of which agree with each other.

The Convoluted Comms Monster flourishes in this noise, derailing even the most critical conversations, such as those a pediatrician must have with a concerned parent about a new immunization or vaccine.

When Sanofi prepared to launch Beyfortus—the first-ever RSV immunization for infants—the biopharma company approached us with a big question: How might we help pediatricians communicate clearly with worried parents across languages and cultures and amid the swirl of misinformation surrounding new medical developments? Together, we created materials to facilitate these important conversations. Beyfortus successfully launched in time for the 2024–2025 RSV season. Demand was so strong that Sanofi tripled its manufacturing capacity, and the immunization has been shown to reduce infant hospitalizations by 82 percent.

Taming this monster is about providing clinicians with clear, human-centered resources to cut through the noise, ultimately helping the parents in front of them and the children who depend on them.

Taming what’s blocking the way

At their core, these monsters arise from human decisions, organizational habits, and inherited assumptions. While technical issues may exacerbate the problems, strategy or software alone cannot resolve them. 

The work is to find the monster, name it, and begin taming it by focusing on cultural behaviors and ways of working; in other words, prioritizing people, not just products.

We’ll be at HLTH Europe in Amsterdam later this month, on the lookout for more monsters. Bring us the obstacles in your work that feel too big, too tangled, or too entrenched for you to face. We’ll help you name them. And then we’ll help you tame them.

Have a monster of your own? Get in touch.

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Special thanks to Ellora Jaggi and Tanya Kar for their work making the monsters come to life.

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Here are the five bogeymen we keep encountering.

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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.