D4V is a Tokyo-based early stage Venture Capital in partnership with IDEO. Two years ago, D4V invested in healthcare startup Ubie, which develops a service called AI Monshin Ubie. The digital service was created with the goal of reducing the burden on healthcare professionals working long hours, under harsh conditions. AI Monshin Ubie automates a number of patient registration and documentation processes through digital tools, enabling doctors to spend less of their time on manual paperwork, and to dedicate their valuable skills and attention to the patients themselves. Currently, the service is installed in 200 medical institutions in 41 prefectures across Japan.

With AI Monshin Ubie, patients fill out preliminary forms on a tablet, rather than paper, entering information about their health history and current symptoms directly into their digital medical record. As patients fill out the questionnaire, the Ubie AI generates questions in real-time according to patients’ responses, which results in more appropriate and accurate data. The patient’s responses are automatically formatted for the doctor to review prior to and during the consultation. As a result, doctor consultation times and facility operation times are drastically reduced.

With the Coronavirus raising fears of a possible health system breakdown, Ubie has made improvements to anticipate and possibly prevent in-hospital infections. Until recently, Ubie’s services have been primarily used by large hospitals; but in light of the global health crisis, Ubie approached D4V—who partners with IDEO—to help rethink the onboarding experience and quickly facilitate the introduction of AI Monshin Ubie in regional clinics across Japan. D4V and IDEO have been working with Ubie for many years to collaborate in various areas, including UX, rebranding, international research, and more. Therefore, they had a foundation of knowledge from which to build these new features.

Typically, AI Monshin Ubie has been introduced to new hospital clients through direct, in-depth instructional visits from Ubie sales staff. This approach has worked well for rolling out the product to Japan’s 8,000 large hospitals; but for the 100,000 smaller clinics, Ubie needed a more efficient onboarding method to enable staff to get set up smoothly and independently.

During research, D4V and IDEO team members engaged with many different clinic staff members, including full-time doctors, part-time doctors, nurses and receptionists. The researchers found that staff tend to react skeptically to new tools and services, with a common preconception that they will add to their workload. One clinic director’s first impression of AI Monshin Ubie was, “It looks complicated.” But once he actually used the service, he realized that it was very user-friendly.

The team quickly understood that it was important to remove preconceptions by clearly communicating Ubie’s benefits and ease of use. They created a two-minute animation and designed three separate guidebooks. The animation adopted a friendly tone and expressed empathy for doctors, staff members and patients, highlighting how Ubie can bring benefits to each of them. The animation showed how Ubie fits into the existing workflow and explained complex systems in a straightforward and accessible way.

WATCH: A short video clip explains the benefit of their product and service to avoid the users’ concerns in advance.

The guidebook for doctors and directors explains how Ubie’s AI smooths the patient consultation experience and greatly improves the quality of medical care. It also introduces concrete how-tos around set-up, implementation, and ideal workflow. FAQs were also included, addressing concerns about whether or not elderly people would be able to use it.

Ubie business development leader Kenji Yamada says, “D4V and IDEO have a deep understanding not only of design, but of our entire business. They provide inspiration by bringing experience and knowledge that comes from working with other industries and clients outside of healthcare. We appreciate that they can share the knowledge that they’ve obtained with our business.”

Read the Japanese-language version of the Ubie case study here.
When You Feel Unwell, Ask Ubie: Check your symptoms for free
Learn more about Ubie: Global Company Website

In the emergency room, an intervention that’s administered too slowly could cost a patient their life. With COVID-19 fueling a surge in acute respiratory conditions, intubation—a procedure that involves inserting a tube through the mouth or nose and into the airway—is more common than ever. For patients struggling to breathe, the tube can be connected to a ventilator that pumps oxygen to the lungs, keeping them alive.

While a laser-focus on the present is critical for successful patient outcomes, hospitals and physicians often don’t have time to look ahead and anticipate the future of the operating room experience. As technology rapidly improves, there is a ripe opportunity and pressing need to evolve medical equipment to be more innovative and intuitive. Verathon Medical, a global medical device manufacturer, is supporting health care providers at the cutting-edge of care.

Verathon approached IDEO to redesign the existing product system for laryngoscopies and bronchoscopies—procedures that examine parts of the throat through intubation. During these examinations, a tube with a camera embedded in the tip is inserted through the patient’s nose or mouth. The doctor can then see inside the throat on a video monitor, and therefore more easily and quickly intubate and perform the exam.

To create a groundbreaking device, the team observed over a dozen laryngoscopies, bronchoscopies, and intubations. They noticed that many anesthesiologists relied on fixed equipment during the procedures. For example, some had grown accustomed to looking over their shoulder—away from the patient—to view the monitor.

During interviews, physicians and residents expressed difficulties with the current technology, sharing that the small screens aren’t conducive to team viewing or student instruction, and they must often use a separate computer to record patient notes. Others reported frustrating workflows, needing to constantly divert their attention and move their hands between the patient, prep tray, monitor, sterile bin, and disposal bin. These inconveniences and inefficiencies are not only cumbersome, but can increase the risk of infection and fatality.

The team relied on these insights to start designing a next-generation product. Through sketching, storyboarding, and building in real-time alongside doctors and clinic staff, designers quickly teased out additional findings and validated concepts.

This work led to the creation of the GlideScope Core: an all-in-one, portable product system that supports both video laryngoscopies and bronchoscopies. The base of the device—a wheeled cart—has built-in storage units for tools and a disposal bin, offering more mobility and accessibility for medical professionals.

The product’s tagline, “see more, do more,” points to the improvements made to the video system, including a large 10- or 15-inch high-definition touch screen monitor. Displayed images can be enlarged and rotated 180 degrees for improved visualization, team viewing, resident training, and classroom demonstration. To help doctors keep both the patient and monitor in their line of sight, the detachable screen can be secured to an adjustable arm that can be positioned directly over the patient. Additionally, the monitor’s patient annotation feature gives staff access to more of what they need in one device.

The product has been especially valuable for providers and patients during the coronavirus pandemic, when it’s imperative for doctors to keep their distance from patients’ mouths and noses. The GlideScope Core’s movable, detachable, and large, high-definition monitor makes it easier to take this precaution and intubate more quickly. This usefulness is reflected in the 5-fold increase in cart-based device orders for Verathon. While most providers typically order anywhere from 1 to 20 devices for airway procedures, one hospital system requested 600 GlideScope Core systems to meet current intubation demands.

Through modern technology and a focus on human needs, the GlideScope Core supports improved patient outcomes and creates a more seamless operating experience for medical professionals. The product underlines the key but often overlooked fact that often, in order to ensure the healthcare industry is patient-centered, medical device manufacturers and hospitals must also focus on improving the experience of providers.

Healthcare is notoriously difficult to change. Rules and regulations present complex barriers; health practitioners and organizations often have entrenched ways of working; and lives are literally on the line. Despite these significant barriers, the leaders at Newton-Wellesley Hospital (NWH) boldly committed to improving patient care through a new approach.

NWH is a community teaching medical center in Newton, Massachusetts. Because of its proximity to Boston—a city known for world-class healthcare institutions—NWH needed to differentiate itself. The hospital's new president, Dr. Michael R. Jaff, reached out to IDEO for help: "I knew that providing an unparalleled patient experience would set us apart from our competitors." But, Dr. Jaff’s particular approach was unique. He and Dr. Jodi Larson, Chief Quality and Experience Offer (CQXO), saw an opportunity to drive better patient outcomes through cultural and organizational change.

"You cannot learn any more than when you get to listen to your potential patients say why they would never walk into your place." —Dr. Michael R. Jaff

IDEO partnered with NWH for a year of work together, kicked off by defining the vision for NWH and ramping up to in-hospital prototyping and the launch of several new initiatives. A pilot project with the Women's Imaging Center (WIC) focused on solving departmental and employee challenges to provide a better experience for women getting mammograms.

Fueled by this potential, the WIC team redesigned key work processes and created a set of experience principles that inspired new service prototypes. Guided by principles like "Express mutual gratitude" and "Honor every voice," the WIC team tested ways for patients to acknowledge outstanding caregivers and created tools to gather better feedback from patients and adjust quickly. The experience of designing better services inspired the WIC staff to become ambassadors for the power of design thinking across other departments inside NWH and they continue to build on the work through new prototypes and experiments.

Next, IDEO partnered with NWH’s ambulatory surgery group. They took an analogous research trip to Boston’s Logan airport to see with fresh eyes how other high-touch customer service organizations provide customer value in a complex setting. Insights from the trip were applied through live prototyping of several new experiences inside the hospital, including a pre-surgery visit summary and pre-operation care carts.

Analogous research helped us realize that we can learn from other industries and incorporate some (cool) best practices if we allow ourselves to get over the ‘that would never work in the hospital’ mentality. - Dr. Jodi Larson

One of the most impactful prototypes was Care Modes, a tool to empower the NWH care teams to tailor their approach and interaction with patients based on the patients’ unique needs, beyond simply their clinical requirements. Four distinct approaches were identified for engaging a patient before surgery—Explain, Partner, Embrace, and Encourage. The Care Mode is determined based on the provider's understanding of a patient's degree of self-advocacy and their confidence that surgery is the best solution to their issue.

Historically, care providers have been trained to deliver consistent care above all else. However, Care Modes powerfully acknowledge that patients respond differently to different types of care. The Care Modes empower the team—from surgeon to nurse to anesthesiologist—with a clear framework for how to interact with and provide care for patients so they feel most comfortable. Based on the prototype's success with patients and impact on the staff culture, NWH has incorporated Care Modes into EPIC, the hospital's electronic medical record.

The importance of being patient-centered has been central to the healthcare conversation over the past thirty years; but new explorations reveal that there’s far more potential for innovation and improvement when the provider experience is considered in tandem with the patient’s. Each enables the other, and design for both together yields stronger solutions and better outcomes. IDEO's work with NWH demonstrates this vital shift in user-centered healthcare—one can't design services and experiences for patients without designing for their providers’ culture as well. When these go hand-in-hand, meaningful institutional change in healthcare is more than possible.

The mission of Chicago's Museum of Science and Industry (MSI) is to inspire children to achieve their full potential in the fields of science, technology, medicine, and engineering. Leaders at MSI realized they needed to drive day-to-day operations and maintain historic exhibits while focusing on where to go next. To prepare for its next decade, MSI worked with IDEO to create a new business focus to support the museum’s aspirations for the future. The plan would allow MSI to respond to the demands of the marketplace and raise the funds to get there.

At the beginning of the project, MSI laid out its priorities: improve equity of access, enhance the museum experience, and create a more innovative culture. To dive into each of these areas, IDEO conducted immersive research with families, teachers, donors, and staff.

IDEO brought together 60-plus donors, board members, and staff members to engage in a design thinking exercise to unpack and address the tensions that come with choosing a new strategic trajectory. Instead of having a standard ballot vote, the IDEO team encouraged participants to get up and vote with their feet, helping the group of stakeholders physically align on the museum’s new direction.

At the end of the research and prototyping phases, MSI and IDEO developed a vision called Provoking Minds, Inspiring Futures, creating six detailed design briefs to equip MSI teams to bring initiatives forward. The briefs laid out everything from recommending a new Department of Next, dedicated to ensuring that the future is at the heart of everything the MSI does, to MSI Runway, a place for experimental, small-scale, and limited-run exhibits. The ideas were brought to life with an interactive exhibit, built quickly with everyday materials like plywood and circuit boards, to demonstrate that creating an inspiring vision of the future doesn’t have to be an expensive endeavor.

The team also focused on insights that highlighted accessibility issues some families brought up early in the design process—travel across the city via public transportation can be lengthy, and the cost of admission to special exhibits could be prohibitive. To address these concerns, IDEO came up with the Mission Accessible brief: Inspired by casino buses, MSI bus stop signs would be posted in various low-income neighborhoods, signaling a way to take kids and families to the museum for free.

During the project, the IDEO team identified some low-hanging fruit, like rethinking ticketing and improving the student field trip experience, and helped the museum create cross-functional innovation teams to apply design thinking skills towards solving those challenges. They researched, brainstormed, and pushed forward new concepts, meeting weekly to share and build on ideas. At the end of the four week period, each team prototyped their ideas—new outdoor programming, software tools for visiting tour groups—and pitched them to each other.

In 2019, two years after the conclusion of the project, the collaboration paid off. With its new strategic plan and additional resources, the museum has renewed its commitment to serving youth, and MSI’s team, including donors, are aligned on a collective vision of the future. MSI raised more funds than in any previous year, including the single largest gift in its history—$125 million, nearly half of its $380 million fundraising goal—that will help ensure the years ahead.

I was there as part of the IDEO Play Lab’s ongoing work to leverage design to create digital spaces that help people thrive. We believe that thoughtful digital design is critical, especially as advocates argue there is a correlation between unregulated social media platforms and an ongoing mental health crisis. (In 2021, the CDC found that 42 percent of high school student respondents “experienced persistent feelings of sadness or hopelessness,” a rise from 28 percent in 2011.)

‍At the event, I was really struck by what Khoa-Nathan Ngo, a psychology major at UCLA and a member of #GoodforMEdia, a youth-led group at the Stanford Center for Youth Mental Health & Wellbeing, had to contribute to the conversation. “You really can’t talk about youth, mental health, and well-being in this day and age without also talking about our relationship to social media,” he says. Ngo and his peers advocate for informed social media use and regulation; They’ve created tool kits for parents, led workshops at schools, and testified to support the Age-Appropriate Design Code Act in California. And they also regularly advise private companies and industry leaders, bringing student voice into the design process. After the event, Khoa-Nathan and I reconnected to talk about the importance of co-designing with youth to create a healthier future that includes digital tools and social media.

Michelle Lee: Nathan, you’re incredibly passionate about your work around social media and mental health. What drew you to this space?
Khoa-Nathan Ngo: During the Covid-19 pandemic, I realized that online, pushback against misinformation mostly happens within English-speaking spaces. In my Vietnamese community, and in Spanish- and Chinese-speaking communities, misinformation around where Covid-19 came from and the safety of the vaccine was rampant. That obviously has huge implications for health outcomes. I realized that what I was seeing on social media affected the health of my community and the nation. I couldn’t ignore that.

ML: We met at an event on digital thriving at the Stanford Internet Observatory, where you were part of the youth panel. Why is it important for companies in the private sector and advocacy groups to involve the youth voice in co-design?
KNN: The best argument for the importance of youth participation in co-design is when you look at what happened when they weren’t part of the process. Youth weren't considered in the social media design process at all, and that led to the situation we’re in now. Youth were only considered consumers, a demographic to engage and profit from. Technology could have been created to promote our well-being and interconnectedness, but what we value wasn’t centered in the design process, which has created a major crisis in terms of our mental health.

ML: You mentioned that the legislative work is very rewarding for you. Tell us more about that.
KNN: In our conversations around social media and mental health, there’s a lot of condemning individuals: Kids are addicted to their phones and they don’t know how to hold a conversation, or parents should control privacy settings. But at the legislative level, we’re able to have bigger conversations: How are these tech companies collecting data? How do they design these products to be addictive? How do they radicalize kids by exposing them to echo chambers? How should children’s data be stored? You can really only have those conversations at the policy level.

ML: What are your thoughts about policymakers? What advice do you have for people in positions of governmental power?
Khoa-Nathan Ngo: My advice is to bring in experts who so badly want to be a part of this conversation. The Age-Appropriate Design Code Act in California did that — part of the policy involved bringing together people from fields including computer science, mental health, and children’s rights to figure out a shared vision. This is a complex problem, and it deserves comprehensive solutions that involve going after companies and their practices directly, not just empowering parents and protecting kids. 

ML: I’ve heard you talk about the difference between privileges and rights in the digital space. Can you explain that distinction?
KNN: Of course. Because we all have these apps on our phones, social media platforms can feel like a public and shared space. But at the end of the day, these are private companies, and they can choose what they want to show us. If they privilege popularity-driven content over factual content, that’s their right. The opposite is also true: If their algorithm doesn’t privilege your post, you were not denied your First Amendment right. If you want to post something on your personal account, you have that right, but you don’t have the right to my attention. You have the right to speak, but it’s a privilege to be listened to.

ML: One word that came up repeatedly at the Stanford event was “nuance.” While many focus on the harms of digital media, there are also good things that come out of social media and digital presences, and I’d love for you to touch on that. If I were to say, we’re going to take away all social media, what would your response be?
‍KNN: If you remove social media because of the harm it has caused, then you’re indicting the people who use social media rather than the people who created these platforms to be addictive. No one said that the most popular content needs to be Photoshopped images or Breitbart. That comes from the platforms’ design, and shutting down social media puts the blame on individuals when it should be on companies. Don’t compromise our ability to politically mobilize, or for marginalized youth to find community. There are so many young people who find joy and love on social media—I don’t think that removing it is better than reforming it.

ML: Given how deep you are in this space, what are your thoughts on flipping social media from a tool that can cause harm to one that can lead to self-acceptance and more authenticity? What are some ways that we could approach that?
KNN: I really like this question, because I like to talk about concrete solutions. I think the biggest way we can make social media a place for self-acceptance rather than self-harm is to give autonomy to the users. Let people determine if they want their feed to only consist of people they actually follow, or only show their close friends. Let people determine what healthy social media looks like for them, and give them the ability to design social media for themselves. We know better than anyone else what’s good for us. We should have the ability and tools to act on that knowledge. 

ML: But there’s a certain level of education that goes along with that, to help people be more informed as they make these decisions for themselves, right?
KNN: Definitely. We need to regulate social media, but we also need to teach media literacy. It starts with making sure that mental health education is available in all schools, where children learn about how to protect their emotional health, including on social media. There are ways that we can make social media a better place, but at the end of the day, we also have to communicate to kids that having social media is a massive responsibility.

ML: What might tools to help youth understand that responsibility look like?
KNN: I think it’d be great if there was an online resource that helped parents and kids determine what level of vulnerability they have to online harm. Do I feel connected to my community? Do I feel understood by my peers? Have I developed interests and hobbies of my own? Maybe that can give a measurement that helps kids understand whether they should be online, based on how vulnerable they are to online addiction and harm. 

There also need to be conversations that happen at school. When students learn to navigate research online, we need to teach more than, “Don’t use Wikipedia, kids.” I’m really a fan of assigning an essay and asking students to cite five sources—one of those sources has to be from Twitter, Instagram, or TikTok, and you have to verify it as a credible source. What are the credentials of this TikToker? Are they an MD, are they trying to sell you something? Did they cite anyone in their video? We need to train media analysis and literacy to include social media platforms. 

ML: If you were a parent, what would you do to set rules or guidelines for your kids?
KNN: If I were a parent in this day and age, I would be a bit more humble about how social media is affecting kids’ brains, because it’s rewiring adult brains as well. Our parents say don’t believe everything you read online, but then they believe Facebook conspiracies. Social media addiction is very different from other types of addiction. Gen X and Boomers have seen alcoholism, drug abuse, and the opioid epidemic. My parents can talk to me about that and draw on a rich body of experience. But all of us are experiencing social media at the same time. They don’t have a wealth of experience to draw from. How do you warn kids about sexual predators, if you don't know that is happening online? Or warn them about becoming radicalized? My job is not to inform my child, but to be informed with my child. We’re in this messy digital world together. Can we work together? Can we share tips and tricks about how to have a healthier relationship with social media? 

It definitely has to be a much more egalitarian partnership than it used to be before. It has to be an equal partnership. We’re all going through it together at the same time.

ML: What advice would you give to designers in this space?
‍KNN: If you’re designing a product that will be used by or affect youth, then you should engage youth. That requires a special skill set, because for a young person, it can be really intimidating when an adult asks for your thoughts on an issue. You need to engage them, ask the proper questions, and make them feel comfortable being vulnerable. That’s a different skill set than being a good UX designer or engineer, so if that ability isn’t on your team, think about bringing in people who have experience with youth participation.

Are you asking the right questions about digital thriving? How are you working to understand Gen Z? Tell us how we can help.

A few weeks ago, I attended an event at Stanford University held in collaboration with the Biden-Harris Administration’s Kids Online Health and Safety Task Force.

Only 13 percent of women in Pakistan have a bank account, so they designed their product to be easier to use than traditional banks. Still, many women struggled to use the service, especially low-income women and first-time internet users.

What was happening? Why was it so hard to connect with customers?

The answer was always in front of them: male defaults.

The invisible made visible

Even though Oraan was built by women, for women, the startup struggled with the pervasive problem of male-centered norms. 

Male defaults reflect biases deeply ingrained in our society. They allow institutions to build products to fit the way men inhabit the world: the kinds of jobs they have; how they use phones; their available free time; and even their ability to move around in public. At best, this hinders women's access to financial systems, forcing them to jump over extra hurdles. Often, it means low-income women must rely on men as proxies, having to ask a husband to save money in his bank account, and then needing his permission to access that money. At worst, it excludes women from the financial system, robbing them of opportunities entirely.

Male defaults aren't just bad for women, they're bad for business. Globally, women are 31 percent more likely to have an inactive financial account than men, and banks and fintechs wonder why. Are women just not interested in saving money? Are they not educated enough to understand new products? Are they stuck in the past? Attempts to adapt existing bank products to appeal to women have often fizzled, and many new women-centered products have tried and failed to reach product-market fit. 

Why is this problem so hard to solve? It’s difficult to fix what you don’t see—and male defaults are so prevalent that they’re nearly invisible unless you know how to look for them. Anyone who has set up a bank account or used digital financial services has probably encountered them:

• Account sign-up processes that require customers to fill in their occupation in the first few questions (something mothers, caregivers, and the unemployed may not have, and can lead to dishonest answers)
• Marital status (which can can disadvantage or raise stigma for women who are single, separated, divorced, or widowed)
• Property ownership (which can disadvantage low-income women who rent, live with family, and women who do not have deeds or documents in their own names) 
• Mobile number, especially for account verification (which can immediately cut off women who don't own a mobile phone or share one with family members) 
• Annual income (which can make it very difficult for informal workers with multiple income sources to open a financial account or qualify for a loan)

With gender-intentional design, IDEO is pushing back against these practices, and challenging the reign of male defaults. Already, we’re starting to see how even small shifts can create outsized impact for women. 

An addressable opportunity

Today, more than half of the world’s 1.4 billion unbanked adults are women. At IDEO Last Mile Money, we believe the solution to filling this enormous gap in financial agency and social equity lies in better design, with products and systems made for and with women, not just adapted after the fact. 

Over the last five years, we’ve brought together gender experts, banks, institutions, and fintechs to co-design what women-centric financial products should look like.

Together, we’ve uncovered male-default design patterns and developed design principles to disrupt them. We’ve updated our Financial Confidence Playbook with a new section dedicated to women and finance, with examples of products, features, and best practices for designing for underserved women. It’s all in service of helping teams question and ditch male defaults.

Here are three key shifts that can help companies build products designed for women:

1. From invasive to inclusive

If you sign up for any financial service, you’ll often see the same standard questions. While they are meant to build a user profile and increase security features, diving straight into these questions about occupation, income level, or home ownership can quickly make underserved women feel unwelcome, and push them to abandon the process altogether. 

Luckily, small design changes can transform the experience. In Pakistan, we explored how to make a rigorous financial account sign-up process more inclusive. We asked Oraan: What is the information you actually need? How might we reframe data requests in ways that feel empowering for underserved women? This helped Oraan rewrite those standard questions, from “What’s your occupation?” to “How do you spend your days?” Simple, but effective: 50 percent more women signed up for Oraan’s service. And the changes also reduced the load on Oraan’s back-end systems. Because Oraan articulated its requests more clearly, women submitted higher-quality documents, which meant Oraan’s team spent less time on follow-up calls. Win-win.

2. Let’s get ‘phygital’

For women at the last mile, the journey to adopt digital finance begins long before they pick up a phone. Yet, many new products default to engaging customers via digital-only channels. So, we propose going “phygital,” connecting physical and digital experiences to meet women where they are. 

Why? Many underserved women live in a world that’s mostly person-to-person and not very digital. They’re more likely to share a smartphone, and  they juggle so many responsibilities as mothers, caregivers, and informal workers, they have limited time and bandwidth to try and learn new digital services. 

These factors affected product use at Wagely, a startup that digitizes wages for women factory workers in Asia. Many women in Bangladesh had signed up for the service, but their accounts became dormant quickly. In a country where just 21 percent of women own smartphones, Wagely needed a phygital approach. 

Together we expanded its service blueprint to include a few key physical touchpoints. Our goal was to increase trust in Wagely’s service by showing up at familiar spots like community centers, building tangibility with physical collateral like membership cards, and creating a reward system that’s tailored to women’s everyday purchases like groceries and health items. 

Designing for phygital might seem less cost-effective than going digital only, but it opens doors for female customers, can supercharge usage, and improves long-term retention. 

3. No pink products

We believe that to truly include women in finance, their needs have to be prioritized from initial research all the way through to the future roadmap.

In partnership with Mansi Gupta at UnConform, a women-centric design consultancy, we created a Gender Evaluation Framework to help companies build a more gender intentional strategy that guides teams from discovery all the way to outcome measurement. With four pillars—Intent, Capability, Commitment, and Impact—teams can use our  prompts to reflect on their own gender practices throughout the product cycle. 

Last year, we also used the framework to choose which of the more than 300 startups that applied to Last Mile Money's 2023 gender and finance accelerator to accept. Our portfolio startups took the Framework a step further to generate insights and ideas to improve everything from product features to strategy for the future, as well as how to measure their impact on women's lives.  

We’re sharing these design principles in hopes that financial institutions around the world will reconsider how they are designing their products, and include women’s needs in the process from the start—whether they’re unbanked women at the Last Mile in emerging markets, or women who have been kept out of financial systems in the U.S. Not only is it the right thing to do, it’s a way to reach the next billion women coming online. 

Already, Oraan is seeing the benefits of the shift it has made to center the needs of women in Pakistan. With 50 percent more women accessing digital financial services through their platform, IDEO and Oraan are demonstrating that gender-intentional design benefits both financial providers and underserved women themselves.

‍

Dive deeper into the Women x Finance section of the Financial Confidence Playbook.

In 2023 the team at Oraan, a women-led fintech startup in Pakistan, was facing lower signup rates than they expected.

Now let’s say some massive global event comes along and disrupts everything, everywhere, all at once. (Not hard to imagine, is it?)

That’s what leaders at Imaginable Futures faced in 2020. The actions it took in that moment put it ahead of the curve as a new world emerged. The impact was concrete and meaningful, with Imaginable Future’s work inspiring others to fund more than a million dollars’ worth of related initiatives and educational moonshots.

For 40 years, IDEO has helped the world’s leading organizations make the future, sometimes with startling prescience. Our work in strategic futuring has been informed and inspired by our client partnerships, but also by generations of futuring practitioners, to whom we’re indebted.

Now imagine that you're the CEO of a company navigating an uncertain future. Perhaps you already are. You might know your customers today, but you can’t see who they'll be in a decade, or what they’ll need by then. Current industry norms might no longer apply. Today’s buzzy trends will be long forgotten.

How do you make your future?

‍1. Your vision should be an inspiring anchor, not an empty gesture‍

Strategy is action: it’s not about what you say; it’s entirely about what you choose and then do. The future presents seemingly limitless choices for a leader—more the further out you look. Possible futures must be narrowed to probable futures, and from there to preferred futures. And that’s what effective visions of the future bring to life.

A great vision is inspiring and suffused with imagination. But it also enables leaders to focus on the right choices, in service of where they want to go, and to make such choices with confidence.

Not long ago, the CEO of one of the world’s leading consumer electronics companies asked, “If we could do anything in the next five years, what would it be?” Partnering closely with their team, IDEO developed seven visions of the future they could touch today, each of them optimistic, and each of them grounded in rigorous research.

Each of these future worlds provoked ways the company might respond to it: hundreds of ideas and concepts it could potentially bring to its future customers. The CEO chose three to take forward, and you might have even seen a Superbowl ad about one of them.

In another project, we also helped a global athletics brand take a jog in the future by creating a series of immersive "day in the life” stories, complete with billboards for fictional versions of major sporting events.

Creating tangible objects, stories, and experiences that invite you directly into the future is one of the ways we blend imagination and rigor in our work: It makes real the effect of intangible forces, and helps people grasp and distill what's most critical for their own work.

All of that helps move organizations to action.

‍2. Leap beyond the distraction of today's disputes‍

Infinite futures are possible, but not all are likely. Even fewer are desirable. And more often than not, the best futures—the ways we want things to turn out—can only happen as a result of deep collaboration: People need to agree on what matters, and then work toward it.

But getting aligned is hard work. In many organizations, team members are distributed across the world or engaged in work that defies simple distillation or storytelling, so getting on the same page can feel like an insurmountable obstacle. People have different goals and are accountable for different things. Over time, conversations can surface stark differences of opinion. Before long, you’re stuck.

Strategic futuring is helpful here, too. Creating future visions together before deeper strategy work begins is a way to discover what’s desirable and magnetic for everyone.

For example, to unlock a new scale of impact, the global environmental non-profit Conservation International (CI) needed a strategy that could unite its country offices on the African continent. Each had its own priorities, norms, goals, and personalities—a huge source of strength for the organization, but a barrier to scale. To create space for a new approach, CI jumped decades years into the future. Partnering with IDEO, CI experts and teams developed a set of short stories set in the year 2050, exploring future possibilities in sequestration research, satellite monitoring technologies, and more.

That futuring work created a shared language, goal, and frame of reference for the country offices. And the work accelerated the subsequent strategic decision-making and investment. The resulting goal? To expand the protection of grasslands, savannah, and scrublands in a transboundary area across six African countries. It's an effort that's now scaling Conservation International's successful Herding for Health model as a mechanism for partner-driven community climate resilience, targeting the protection of at least 10 million hectares by 2030 in partnership with a continent-wide NGO.

3. Remember: No business or organization is an island‍

To thrive in the future, organizations must also think about all the forces beyond their control—from climate events or cultural changes (both seen and unseen) to the deployment of emerging technologies. And they must even consider the potential effects of forces seemingly unrelated to their line of business. Because they might just matter.

That’s a lot to take in; making sense of it all can feel impossible. And a giant research document might just make it feel worse. Here again, strategic futuring offers a way forward. Rigorous speculation, informed by signals and data, picks out what’s most relevant from the noise—even if it’s unexpected. Distilling that informed speculation into imagined scenarios, and then into concrete experiences, can move leaders to reflect with urgency and clarity, and make choices with confidence.

At IDEO, we sustain an ongoing signal scanning practice, taking notice of what’s shifting across industries and cultures. We blend that informed sense of what’s coming with our client partners’  insights and data to build a rich tapestry of foresight. And then we employ all the crafts of design—from engineering and environments to software development and storytelling—to give life to the visions of the future that result.

When people step into a wide-angle view of what might be coming, they see what’s possible and discover new motivations to act. We used an AI-enabled process we developed to create a pocket viewfinder for D.C. residents to help them visualize the future of their city while standing in their own neighborhood.

Games can take that kind of immersion a level deeper. Recently IDEO helped global enterprise software company Sage investigate how the company might support businesses working to achieve net zero emissions. We designed a choose-your-own adventure story that asked people to play characters navigating business demands in a climate-impacted 2030; it generated empathy for future users, which led to support for the launch of the pioneering Sage Earth platform.

Sometimes, the outputs of strategic futuring work are entirely physical and can take over whole spaces. At the Ellen MacArthur Foundation’s 2023 circular economy summit, we staged a home from the year 2050 populated with the personal items and detritus that might shape our daily lives if access to natural resources were to change, and if environmental regulations were to evolve as a result.

And at COP28 in Dubai, we built three distinct worlds from our collective climate future, traversing continents and culture, economic realities, and societal roles. We invited people to step directly into these futures—into spaces suspended deliberately between reality and possibility.

Do you want to make your future?‍

Strategic futuring is a powerful tool for solving significant, far-reaching business challenges.

You may be a leader striving to distill many levers of change affecting your organization. You may be part of a team that needs to find positive, energized alignment around what to do to set up your next era of growth.

Or you might be a leader determined to understand how your business may be transformed by forces far beyond your influence.

Wherever you are today, strategic futuring can help you make your own tomorrow.

Let’s say your job is to transform the entire landscape of learning and education. For the world.

In that room, we built an "Idea Catcher" wall, where employees could use Post-its to share ideas, questions, and answers with each other and with management.

We knew from previous studies that tough calls have a negative impact on employees for hours afterwards, and that constant monitoring can make call centers tricky places to work. But still, this Post-it showed up on the wall: “There’s positives in each call we take!” The energy that this space created showed us how involving agents in designing their jobs was a meaningful way to learn and grow.

Many of us spend much of our lives at work. We want it to be good and meaningful. But too often, workers don’t have the agency or satisfaction for that to be true. As work is increasingly monitored and automated, it’s critical that we design technology and tools to support workers' well being and sense of purpose. Over the years, we’ve pulled what we’ve learned from various projects into a set of four principles for designing good jobs.

1. Use new tools to encourage a sense of purpose 

Involving employees in creating the tools for their own work provides an opening for them to act on their own values, and reflect on what they like (or don’t like) about their jobs. During the mortgage project, our design team worked with call center agents and homeowners to understand both the “front stage” and the “back stage” of service delivery. For the agents, being able to make a personal connection with the caller was important to their sense of agency—their perception of their own capacity for making change and being creative at work. With that in mind, we prototyped a customer dashboard with a scripted conversation, along with customized cards that prompted agents to infuse their own words and experience into the interaction. Inspired by Brian Eno’s Oblique Strategies, the cards included questions like: “What’s the best advice you’ve ever gotten from someone else on your team?” and “Who is your role model? How would they handle the next call?” The prototypes addressed the tension between scripting and creativity, without burdening agents with additional oversight. Agents appreciated that the prompts recognized and supported their expertise and passion to engage with customers in a professional but personal way.

2. Design for values and emotions

Autonomy and creativity are foundational to high job satisfaction. Technologies like customer dashboards, time and task tracking, and software systems shape how we spend our time at work, what tasks we get to do and how, and fundamentally alter how we feel about and experience work. By designing for people’s values and emotions, new tools and systems have the potential to make work better. But that wasn’t the case when we first started working with a cruise line.

Employees (and also potential customers) thought that booking a vacation felt difficult, and compared the repetitive experience to the movie Groundhog Day. They constantly took their own notes, because the system didn't always log their entries, and had to search online to answer questions about their own services. To fix their frustration, the design team created a new dashboard that aggregated the information they were missing or currently keeping track of with pen and paper. By eliminating redundancy and cognitive load, the dashboard also made agents feel confident and informed—in their own eyes, as well as customers’. This marked a stark contrast to the earlier phase of work, in which agents had to look up the latest products and offerings on the company’s website, which gave them no more specialized knowledge than the customers calling in, deflating their image of themselves as confident service professionals.

The agents’ managers had a different problem: They hated using this tool on a desktop. They preferred to walk around and coach agents face-to-face. It was actually one of their favorite parts of the job. So, the designers moved the tool to a tablet, in order to preserve it.

3. Keep the work ecosystem in mind

Work is a true ecosystem; no worker or technology functions in isolation. Bonnie Nardi and Vicki O'Day, social scientists formerly at AT&T Labs and Xerox PARC, define an information ecology as “a system of people, practices, values, and technologies in a particular local environment.” It’s extremely effective for thinking through how technology can’t be implemented in a vacuum. Instead, technology should be deployed in service of individual and group goals. In the mortgage project, we were also responsible for creating a brand new role that combined service and sales. Since sales roles were mainly based on commission, and service roles on efficiency-based metrics, there was not a lot to incentivize collaboration and a new approach to homeowner relationships. Because agents had a sense of fulfillment that came from growth and financial success based on their personal skills and charisma, which was baked into the compensation structure, it was important that they be comfortable with new metrics and incentives. So, the team designed the new role to encourage long-term customer relationships by increasing base pay and the weight of customer experience metrics, along with more typical efficiency measures like length and volume of calls.

4. Co-create with employees to build trust

Trust is foundational to ethical research and successful design. By working side-by-side with employees to co-create their roles and the impact of technology on their day-to-day work, companies can model openness during times of change. In a project to redesign the patient experience for a new hospital building, the design team identified a key technology in need of innovation: appointment and medication scheduling software. Making custom medications accurately and on time in a hospital environment is crucial, because a small mistake can be fatal, and delays can be painful.

At the time, medications could only be processed in the order in which they were received—not by the level of urgency. For pharmacists, being able to process medications to fit patients’ schedules would improve workflow and ease stress. For patients, it would mean more visibility into upcoming care, and less pressure on families to keep track of medications. The lack of information between departments forced family members to play the role of mediator, communicating vital information in terms they weren’t familiar with. Pharmacists were motivated to provide the best care, but the siloed operating systems that governed appointment and medication schedules created a disconnect. So, the designers created a software refresh that would provide visibility into patients’ schedules, making the pharmacists’ relationship to the software more mutual and rewarding. They no longer felt they were missing the information they needed to do their jobs well. The ability to have a more holistic view into a treatment and current state of health also allowed them to better connect with the patients, one of the most meaningful parts of their job.

Designing for job satisfaction isn’t just a nice to have; not only is it the right thing to do, it leads to increased performance and lower attrition, and employees that are better able to deliver high-quality services to customers.

Rethinking roles, or how new technologies might affect jobs at your company? Get in touch to hear how IDEO can help.

A few years ago, when I was working on a project to help a mortgage company improve the work experience at its call centers, we created a living-room-like space we called "The Oasis," a live prototype of a space to take a break and reflect between calls.

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.