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.

In some cases, we knew nothing about the people we were trying to reach, so addressed them with the default direct marketing salutation, “Dear Valued Customer.” Finding the target audience was like being spun around blindfolded, then praying you were walking in the right direction.

Thirty-seven years later, we know virtually everything about everyone. Thanks to data mining and feeble privacy laws, we can pinpoint your exact location, health status, consumption habits, and, troublingly, what makes you laugh, cry—even think. All of that data is now being poured into the greased pan of generative AI where—we are promised—it will bake the most delicious cake, made just for us.

From direct marketing to AI-driven personalization, I’ve witnessed a transformation in how businesses reach their customers. We've never known so much about people, and yet we've rarely understood them less. In my view, using data alone to understand people has the same flattening effect as “Dear Valued Customer.”

But there is an antidote: Human-centered design.

Goodbye “Dear Valued Customer”‍

Once, at an international conference, I heard a speech by someone who worked for a large social media company. The premise of the talk was that a person’s “likes” could mirror their answers on a personality test. The more likes the social media company could analyze, the better they could predict a person’s personality—and to a level of accuracy that could beat what your friends knew of you; beat your family; and maybe know you better than you knew yourself.  

With that kind of knowledge, companies are able to design user experiences that feel like intimate conversations. But are they, really? Or is it only the illusion of intimacy—the hackneyed output of a data-driven predictive power?

It made me wonder: Is how we appear online—even to ourselves—who we really are?

Of course not. People are not reducible to their preferences. People contain multitudes. People change their minds, regularly and often. They respond to things that feel authentic and responsive to their experiences and identity—especially if they have historically been written off, underrepresented, or marginalized. 

The new customer, if we can imagine them in their infinite richness, has in recent times slogged through a global pandemic; discovered the unwelcome uplands of hiked interest rates and housing shortages; and likely contended with some form of professional burnout. Human lives are necessarily messy: You can’t rely on troves of data and canned messages to reach them, let alone persuade them. People can smell a door-to-door algorithm from a mile away. 

‍The best organizations are able to stretch how they think about their customers. The most successful businesses are able to understand and reflect back to people things that they don’t even know about themselves. ‍

‍The power of starting small ‍

In China, a client once questioned IDEO’s decision to root an entire concept in the preferences and needs of a small group of people. But when the product was delivered, the client recognized a level of human understanding that data alone could not achieve.

My time at IDEO has shown me that understanding people requires research at depth. For us, that often means ethnography, and you don’t have to have thousands or hundreds or even 50 people in the room to do it. What you need is a small sample of people with a diversity of lived experiences whom you get to know very well. 

Starting small requires designing with people and communities rather than for them, too. Innovation doesn’t spring from our heads as Athena from the forehead of Zeus; it's uncovered through the careful and considered use of tools, mindsets, and methods which we share with teams and communities.

‍Great organizations recognize that the work of understanding their customers is never complete. They continuously challenge themselves to listen and respond to what their customers are telling them, not only through data, but also by including them as co-designers.

The brutality of perfection‍

I once had a custom suit made for me for my wedding. To appear cool and unconventional, I asked for a red lining. The tailor wondered if I would still be fond of that red lining in 10 years. A simple question based on lots of experience. Upon a moment of honest self-reflection, my answer was, no, I would not. So, I followed his advice. I still wear that suit today; not once have I wished for a red lining. Of course, a company selling that same suit to me based on tracked preferences would’ve gladly hawked me any lining I wanted. But I am not sure I would trust that company again. I’d move on.

‍The organizations that will endure will be the ones that stretch their ability to deliver long-term, unexpected value to their customers.‍

I am thrilled by the possibilities of generative AI. IDEO’s experiments with emerging technology are as fervent today as they’ve ever been. And one of the qualities of which I’m most proud is our collective hunch that the most interesting opportunities lie in the messiest places.

That runs counter to the brutal attraction of data and AI in the current moment: an implied promise that an objectively “right” answer is within reach. Much of what we love in the world is so wrong it’s right. Perfect is not interesting, it’s not personal. In our pursuit of the spotless and ideal, we lose the essence that makes us human. The truth is, we value imperfection over perfection. 

New customer, new organization, new baselines ‍

I believe we’ve now reached an inflection point where many of us are experiencing a similar moment, only all at the same time. The last few years have changed how we work, how we socialize, how we spend our money, and how we think about our time. And we are being pushed to rethink how we do business, too. 

One of the baselines affecting us all is the arrival of the Climate Era. The planet reminds us daily that we have entered into a new normal. July was the hottest month on human record, impacting anyone who works outside or without AC—such as the drivers and  workers delivering boxes upon boxes to our doorsteps.

We can expect increased absenteeism and reduced efficiency, much more disruption to supply chains, and customers moving away from known polluters and toward brands that reward their conscience and their wallet. Climate regulation is coming too: The EU is working to impose tougher rules on  production and consumption in fast fashion.

Yet, while two-thirds of businesses are affected by climate change, few are doing enough to prepare for it. If we’re to avoid catastrophe, we’re going to have to redesign everything. And, if we want people to adopt Climate Era behaviors, we’re going to have to make things that are irresistible to them.‍

That means creating sustainable products and services that are simply better than the competition. By stretching to meet new and emerging customer needs, organizations can create products that people love and that are fit for the Climate Era.

When the instinct is to contract, great leaders stretch ‍

The SF adman Howard Gossage had this saying: “Nobody reads advertising. People read what interests them. And sometimes it’s an ad.” After 36 years as an advertising executive, I know better than anyone that we can’t always predict what will interest people.

But now, as the leader of an extraordinary community of designers, I know we have ways to help organizations figure it out. Creative, mind-bending ways that leaders and their teams can stretch to meet their markets and the new customer.

How? By continuously reassessing and expanding our understanding of what people want and need, with care, imagination, and sensitivity. We owe that to people, and we owe it to the planet all of us call home. 

Because in the end, the things that make our time here on Earth worthwhile are the things no algorithm can come up with on its own, no matter how much of the internet it’s ingested. They’re the irreducible things that make us who we are.

Early in my career, I worked on direct marketing mailers for British Telecom’s high-value customers.

Every week, she makes a hefty interest payment to her suppliers without knowing how much of that loan she still has to pay off. She tried using smartphones to allow customers to pay her via QR code, but her uncertainty about the process and a few cases of fraud scared her off.  Like many aspiring to a more prosperous future for their families, Swati dreams of expanding her shop and opening a factory. But due to limited formal banking history and lack of confidence navigating digital financial services, people in Swati’s position find their options limited.

And her story is the story of a billion others living in emerging markets.

Every week, around the world, millions come online for the first time. Of all the experiences these new users face, financial services are among the most complex and high-risk.

Pulling hard-earned wages out from under the mattress and putting them into an abstract financial app or virtual wallet is a daunting task for the 1.4 billion unbanked adults globally at the last mile of financial access. Mobile phones and data connectivity are reaching more of the poorest people, but a lack of digital financial confidence continues to hold them back.

“Last mile” refers to physically remote communities as well as traditionally excluded users who lack access to the digital economy, due to lack of internet and formal bank accounts. There’s a lot that can go wrong in trying to adapt services to reach and serve people at the last mile. To solve for the needs of last-mile users like Swati, who make up about 30 percent of adults around the world, we need to redesign our financial services to be not just accessible but also inclusive, valuable, and equitable for everyone.

But building for everyone means more than just airlifting in products that have worked in the West. Here are some key factors in designing products that help build financial confidence for everyone.

‍

PLAIN LANGUAGE, NOT PERCENTAGES

In India, rural women often struggle with formal banking. Yet, the same women deftly manage family resources to ensure there’s money for weekly expenses as well as future goals. Ask one of these women how, and she might say, “I earn 50 Rupees for every 1,000 Rupees I put in my savings group. By the end of the year I’ll have enough to buy a TV.”  Banking terms have never been in their vocabulary, but they’re experts of their finances in concrete terms.

Financial communication at the last mile needs to work differently, building on intuitive mental models people are used to, rather than expecting them to adopt new ones.

In Pakistan, the startup Finja offers credit in the plainest language possible: It shows credit terms in absolute numbers and the lending rate as a fee. Knowing some are skeptical, the startup  offers a calculator to try out different terms. Finja illustrates how small shifts can make a complex financial product more aligned with people’s mental models and easier to trust: In its first year, 25,000 merchants signed up for Finja’s app, which served 16 million customers.

‍

TYPE SHORTCUTS

For new digital users, smartphones can be intimidating: Screens are small, text is tough to read, and on-screen keyboards are hard to use. The fear of a typo in a financial transaction can stop them in their tracks.

Last-mile users have a range of textual and digital literacy, and products need to offer multiple ways for users to engage, based on their comfort and capability.

NOW, a digital-first bank in UAE, breaks the text-only interaction model for its low-income users who send money back home to their families, by offering data input via voice, 11 in-app languages, and photos of receipts, reducing time and errors, to help users send remittances confidently and securely.  

HANDS-ON HELP

Many last-mile users need help using their accounts. Assistance often comes in the form of agents—local merchants who provide services from banks, startups, and other organizations. These agents  also provide strategic guidance as trusted proxies to formal financial services.

Yet, most financial apps are designed for one user and one device only.  What happens when a user needs to share their password with their agent because they forget their PIN? Or when a husband needs to review a financial decision with his wife? We need to design high-tech with high-touch moments of human support to truly include last-mile users.

In India, Haqdarshak made hands-on help a core feature. Knowing many were already sharing passwords and handing over their phones to strangers just to access emergency relief, Haqdarshak  introduced a secure network of agents. They explain government benefits, run eligibility screenings, and help people make informed decisions.  These agents opened up access to government benefits to millions of people through a hands-on, assisted experience, where a single-user experience would have failed.

‍

BUILT-IN PAUSES

For last mile-users, speed can be the enemy of comprehension. App performance is often measured in the fewest taps in the fewest seconds to complete a task—making it easy to lose money or sign up for a product a user isn’t ready for.

For users with limited income, one wrong move can feel like a slip on a tightrope. Financial products need to give users moments of pause that help them regain balance when things start to feel shaky, and safety nets when a misstep does occur.

bKash and FiMoney are proving that slower is better. Their apps use “swipe to confirm” and “press and hold” to give users more control as they confirm a big financial decision. A few extra fractions of a second greatly increase a user’s sense of control in a new financial experience. For bKash, designing for financial confidence helped it grow into one of the largest mobile-money operators in the world, with 70 million users.

‍

NO DARK PATTERNS

In Deceptive Patterns, Harry Brignull  identifies the “dark patterns” that  interlace today’s digital products, sometimes leading users to decisions they never meant to make.

Products with dark patterns can harm vulnerable users even when they are built with good intentions overall. Offering multiple credit options to unbanked people, for example, can land them in a vicious credit cycle that they are unable to maintain. But thoughtful design can help users explore the benefits and risks of new financial options, make informed decisions, and slowly build their financial capacity.

In Uganda, the startup Opareta has created a responsible loan-ladder model: It makes the first loan small in size, rewards payments made on-time (or early), and enables users who demonstrate responsible behavior to apply for bigger loans. Opareta embeds education along the way and helps customers understand the why behind each credit decision. This prevents users from taking on too much risk and Opareta from over-leveraging. Opareta trades short-term gains for long-term relationships with customers and paves the way for building financial literacy and confidence, one step at a time.

Connecting last-mile users to digital financial services takes many hands, so we put together a Financial Confidence Playbook to help any organization design products for this demographic. As for Swati, with the help of her local bank agent, and the right financial tools, she was able to double her sales and set up food stalls. She even bought her own phone, which she now uses with confidence. Actualizing her dream of a better future for her family no longer feels out of reach.

‍

Reprinted with permission from Fast Co.

In a small town in India, Swati runs a popcorn and peanuts kiosk. She doesn’t trust banks, so she saves cash and buys supplies on credit.

“She” was supposed to serve as a 24-hour counselor for people dealing with eating disorders. Instead, psychologists and activists found Tessa was offering dieting tips.

In the me-first race to adopt AI and push new products out into the world, there are headlines everywhere that freak us out. Some 1,400 leading technologists are imploring companies in this technology arms race to pause. Sam Altman, CEO of ChatGPT maker OpenAI, has recommended the formation of a global consortium on the level of the International Atomic Energy Agency (IAEA) to avoid the catastrophic outcomes that could result from the misuse of AI.

All of us are wondering what our future is going to look like, and companies aren’t quite sure where to draw ethical and legal lines around how to use these very new technologies in their own operations and offerings. (Some organizations have placed an all out ban on them.) The decisions we make today will shape our world and have reverberating impacts for generations to come.

At IDEO, we know that tools aren’t inherently good or bad—it’s about how they are designed. Our designers have been using these tools for years, and our clients are already experimenting with them. Instead of distancing ourselves from AI, we knew we needed to set clear guidelines, to pave the way for experimentation that aligns with our values. Rather than waiting for our future with AI to be imposed upon us, we’re choosing to intentionally design it.

This isn’t new for us. For more than a decade, IDEO has integrated data science into our design process. Early on, we created the AI Ethics Cards as a foundational element of how we practice algorithmic and product design when it comes to AI systems. And through initiatives intended to help us become more inclusive, equitable, and responsible, like our Inclusive Design Collective and a workshop to break down the potential unintended consequences of our work (the psychological and human rights impact, for example), we work to help designers think through the ethical considerations of choices we make and artifacts we create.

With the proliferation of generative AI, it was time to create more tools to guide our exploration. We dove into design research to understand how generative AI was showing up in our work and how we might make it both legally compliant and caring—built for healthy individuals, healthy relationships, and healthy communities.

Knowing that the rules are yet to be written for much of the legal precedent in this domain, we relied heavily on our technologists and the Inclusive Design Collective for recommendations. Their research informed this set of considerations, which also anticipate potential future legislation.

Next, we did a go/no go exercise, vetting the most popular tools to decide which types of data  can or cannot be used, for what reason, and at which stage of our design process. And finally, we made sure that our guidelines included everyone at IDEO, from early adopters to those who are opposed to using generative AI at all. Here’s where we landed:

Download a free PDF of the Gen AI Legal & Ethical Framework cards here.

To make this line of questioning even more tangible, we offered some common ethical watchouts, and some ways that designers can offset negative effects.

For example:

Ethical Concern:

Images or content produced by AI might be mistakenly taken as factual or truthful and consequently cause unintended harm.

Mitigate with:

• Give credit when you are using AI-generated content, and put the prompt next to the artifact where appropriate.
• Validate factual information through a third-party source.

Guidelines for this rapidly-evolving technology are not a set-and-forget kind of exercise—they represent a snapshot in time. Likewise, it’s not possible to cover every scenario. We plan to regularly revisit and revise.

With these guidelines in place, we dug into the documentation of generative AI offerings from multiple companies. And to further mitigate risk, IDEO built its own “AI playground” tool to access a version of ChatGPT that complies with our policies and launched it to everyone in the firm—unleashing a tidal wave of AI-powered design that we’re using ourselves and bringing to clients.

Interested in testing out some of these tools and frameworks? We’d love to talk: ai@ideo.com

Download a free PDF of the Gen AI Legal & Ethical Framework cards here.

Thank you to: Esha Reddy, Evan Burton, Zoey Zhu, Graham Gardner, Jeremy Sallin, Jenna Fizel, Nohemy Stella, Tom Antony, Jeremy Chen, Alireza Karduni, Ilene Palacios, Kate Schnippering, and Bo Peng for your contributions to the guidelines.

The information provided in this article and on our toolkit cards does not, and is not intended to, constitute legal advice; instead, all information, content, and materials available on this site are for general informational purposes only. Information provided may not constitute the most up-to-date legal or other information. Readers should contact their attorney to obtain advice with respect to any particular legal matter. All liability with respect to actions taken or not taken based on the contents of this article are hereby expressly disclaimed. The posted content is provided "as is;" no representations are made that the content is error-free.

In June, the National Eating Disorders Association decided to shut down an AI-powered chatbot called Tessa.

Reprinted from the SHRM Executive Network’s People + Strategy journal.

Derek Robson, our CEO, and Tim Brown, our Chair, believe that the fundamental role of leadership teams has changed.

The fundamental role of the C-suite has changed. In the past, the leadership team's job was to keep the existing machine humming, optimizing for efficiency and profitability. But now the challenge goes beyond delivering business results to driving transformation—in effect, building a new machine that will thrive in the future and, ideally, the present.

And the demands placed on most senior leaders of organizations have grown exponentially. Not only are they required to be constantly reinventing the company, but they must also navigate the growing expectations of employees, investors, and other stakeholders who believe that corporations and their leaders should play a larger role addressing broader issues in society that historically fell outside the purview of business. And the demands these leaders face will only increase given that relentless disruption and uncertainty are now facts of life.

Who can live up to this superhuman job description? It's time to start contemplating a mindset shift and possible reimagining of how the C-suite operates. We see four fundamental shifts that can help executives teams evolve.

How might we shift from answers to questions?

It used to be that chief executives were expected to have all the answers to any question, as if they were Athena, the goddess of wisdom. But in our conversations with CEOs over the last few years, many share the opinion that the primary role of chief executives has to shift to being constantly curious rather than all-knowing.

In a sense, the CEO needs to move from being chief executive officer to chief inquiry officer. The ability to ask the right questions is arguably more important for the CEO than having the right answers. That's because questions provide long-term focus for companies, whereas the right answer in one context can quickly become the wrong answer amid shifting contexts.

That then raises the question of whether one person can realistically be expected to be able to have all the knowledge, expertise, and insight required to explore new territory and create those questions. The answer to that is almost certainly no, and that creates a bit of a dilemma for the CEO.

Where do they get the help to be constantly curious? It may be too much to expect that support from their direct reports, given that their primary responsibility is to execute the strategies that emerge from those questions. The board may not be much help, either. Boards, for the most part, are not expert enough. They have an important role to play, and maybe some board members can play that role. But it's not something that boards are generally set up to do. They are governance mechanisms more than knowledge-seeking mechanisms.

One possible solution for providing more support to CEOs is for them to have a small set of peer advisors around them to help them figure out what the right questions are. For this to work, the CEO would need to be able to treat that group as true peers. And they not be on the payroll of the organization, so that the CEO doesn't have to also worry about the motivations of employees who might be looking to be promoted.

In most of their day-to-day interactions, CEOs have to be concerned about side agendas and ulterior motives. And for this advisory group to work, it would have to have a singular goal of helping the CEO think through challenges and questions, in the same way that U.S. presidents have assembled "brain trusts" to offer guidance on issues. The goal for the group would be to provide a series of perspectives on a problem, rather than trying to provide the answer, and help the CEO build their confidence and courage for navigating uncertainty.

How might we create more fluidity in executive roles?

This question underscores a fundamental tension in the role of the CEO and other members of the C-suite. At a time when people expect more of their CEO and their leaders—authenticity, humanity, inclusivity, greater visibility, constant communication—these senior executives also need more time away from the office to simply think, to calm the noise and figure out what questions they should be asking but aren't. And there's no way to do that other than being either intensely disciplined about it or by sharing the load. That thinking time is crucial, even if it is just to step back and ask yourself whether you are making progress on the big goals that you've articulated for the organization.

In theory, the responsibilities of leadership in organizations should be shared and spread across the other executives. One challenge there, as we mentioned earlier, is that the C-suite is primarily focused on executing the strategy, rather than contemplating new strategies.

In addition, those roles themselves are facing their own existential crisis. Not only are the responsibilities of each traditional role expanding rapidly with the complexity of the world, but we are seeing more C-suite leaders wearing multiple "chief" hats.

For example, many chief human resources officers are now also responsible for real estate, given that the future-of-work policies they are devising have enormous implications for their requirements for office space. As if that weren't enough, they are also taking on responsibility for communications—both internal and external—since it makes sense for them to be aligning corporate messaging with efforts to recruit and retain employees.

As new issues come up, responsibility for handling them will likely fall on the shoulders of the existing leadership team. But this model isn't set in stone, and it should be revisited.

We can look for lessons on fluidity from outside the world of business. Some years ago, we worked with the government of Dubai to create new ministries—including establishing the Ministry of Possibilities—and merge existing ones to address the evolving challenges and issues that society faces. Should businesses start to think the same way? Should we start to imagine C-suite leadership roles that are more agile and can be continuously restructured to deal with the challenges of the moment while also considering the future?

What's the strategy? Does the organizational structure match it? In many cases, it doesn't. You kind of drift away one degree every year, and suddenly you're a long, long way away from delivering against what you've set out for your shareholders and for the company itself.

How might we balance performance with regeneration?

As we contemplate the future of C-suite roles, another question arises: Can we structure the jobs so they aren't so reliant on people who have a tremendous amount of stamina and energy, or those who have the capacity to work constantly?

It's almost as if a requirement for the job now is to be able to score well in the equivalent of an NFL "combine," where potential draft picks are tested in various speed, skill, and agility drills. To sign up for these C-suite jobs requires a certain amount of internal drive but also pure physical endurance.

Is it possible to imagine doing this job without requiring that level of relentless physical and mental effort? Sports are often used in useful ways as a metaphor for business, but there is a key difference between the two. In sports, you don't spend all your time just playing the game. You spend a lot of time training. And the same is true for other pursuits like dance and music—you are practicing most of the time and performing for a relatively small amount of time. But in the workplace, we don't have that concept, and so we assume that leaders can both practice and perform at the same time all the time. And if you really want elite performers, that may not be humanly possible.

We may be expecting simply too much out of human beings to have them be practicing and performing to extremely high levels for thousands of hours a year. So, what can be done about that?

Organizations have to spread the load so leaders can regenerate some of the time and perform some of the time. But businesspeople are not very intentional about how we regenerate today. We are quite intentional about it in the world of sports, where there is a whole science around what it takes for an athlete to regenerate both physically and mentally. Could we be intentional in the same way in the world of business, rather than having leaders run so hard all the time that they're not giving themselves time to recover?

There are no easy answers to these questions, but they need to be asked now, before the C-suite becomes unsustainable. Rather than worshipping at the altar of the CEO, organizations need a more collaborative approach as we look to the future. Ultimately, the goal would be to create more of a collective leadership body, rather than relying on one person, the CEO, or their direct reports.

Reprinted with permission from SHRM, ©2023. All rights reserved.

Given the growing demands on leadership teams, particularly the CEO, the current structure for leading companies may no longer be sustainable.

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.

‍

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.