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Designing a better onboarding experience for an AI symptom checker at clinics

Enabling doctors to spend less time on paperwork and more on patient care.

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Case study
Case Studies
Breakthrough Products
Health
AI & Emerging Tech

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

Enabling doctors to spend less time on paperwork and more on patient care.
Enabling doctors to spend less time on paperwork and more on patient care.
Ubie, Inc.
North America
Ubie, Inc.
Designing a better onboarding experience for an AI symptom checker at clinics, infection prevention, hand hygiene, Ubie, Inc, healthcare, health innovation, patient experience, AI, artificial intelligence, emerging technology, AI strategy, AI product design, responsible AI, designing with AI, healthcare design, digital health, patient-centered care, understanding user needs, how to use AI, innovation, strategy, product design, research, startup, rebranding

An improved airway intubation system that helps physicians save more lives

The GlideScope Core offers elevated visibility and a seamless workflow for intubation, allowing doctors to better conduct routine procedures and respond to health crises.

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Case study
Case Studies
Strategic Futures
Health

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.

Designed around a high-definition, touchscreen monitor and comprehensive workstation, the GlideScope Core delivers elevated visibility and improved workflow.

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.

Verathon Medical
Verathon Medical
An improved airway intubation system that helps physicians save more lives, Verathon Medical, healthcare, health innovation, patient experience, systems thinking, systems design, service ecosystem, healthcare design, digital health, patient-centered care, innovation, mobility

Transforming a community hospital from the inside out

Designing for caregivers to create world-class care for patients.

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Case study
Case Studies
Creative Capabilities
Breakthrough Products
Health

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.

The pop-up design studio, dubbed Project Phoenix, was centrally located on the main thoroughfare of the hospital.

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

A team of surgeons, anesthesiologists, nurses, and hospital executives headed to JetBlue seek out inspiration around analogous themes of teamwork, coordination under pressure, and customized pathways for patients.

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.

The team produced several live prototypes in the hospital, gathering feedback and learnings directly from patients and staff. The first prototype launched was a series of experience kits selected by patients at check-in. Each kit represented a different mindset for patients—productive, serene, or enlightened—and a visual cue to signal different scripting and pathways from care providers.

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.

Designing a clear framework for caregivers to interact with and provide world-class care for patients.
Designing for caregivers to create world-class care for patients.
Newton-Wellesley Hospital
Newton-Wellesley Hospital
Transforming a community hospital from the inside out, Newton-Wellesley Hospital, healthcare, health innovation, patient experience, business transformation, organizational transformation, culture change, healthcare design, digital health, patient-centered care, innovation, design thinking, research, prototyping, transformation

Helping a historic museum prepare for the future

Using design thinking to improve access, experience, and culture.

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Case study
Case Studies
Strategic Futures
Breakthrough Products
Learning & Work
Public Sector

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.

Museum of Science and Industry, Chicago
Museum of Science and Industry, Chicago
Helping a historic museum prepare for the future, voting experience, voting machine, accessible voting, Museum of Science and Industry, Chicago, education innovation, learning experience, future of work, public sector innovation, government services, civic innovation, human centered design, design thinking, customer centricity, future strategy, strategic futures, designing for the future, innovation, strategy, research, prototyping, transportation, education, learning, government

The future is already here

Is your organization prepared for it?

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Articles

From flexible working conditions to the coexistence of both physical and digital experiences, COVID-19 has accelerated the trends and behaviors that have been rearing their heads for some time, and pushed them to the forefront of our everyday lives.

Indeed, the future is already here. How might we fully step into it with creativity and resilience?

Recently, a group of IDEO designers in Tokyo convened a creative project to brainstorm and design for the implications of the pandemic on the future of Japan. Called “Emergent Futures,” the goal of the work—accessible below—was not to predict the future, but to prepare for the possibilities it may bring.

To envision these “emergent futures,” we started where we always do: with people, and by observing ourselves, our families, and communities. For each future, we describe what it looks like and what behaviors prevail, the evidence we see for this future already emerging, and what design opportunities exist for Japan-focused businesses.

For example, the first emergent future we explore is Leftover Spaces—the idea that physical spaces will become more dynamic due to public health concerns around occupancy. With this, business opportunities related to rent, consumer preferences, space design, and co-ownership emerge. We explore and ground this emergent future through Kei, an IDEO designer and blossoming curry chef, whose needs inspired us to prototype a pop-up system concept—the Kei Truck. Our research reveals how some businesses are already prototyping this future, including restaurants operating as corner stores and Hoshino Resorts, who is leveraging data tracking to keep guests safe. These examples provoke key takeaways for leaders, from the need to develop a more entrepreneurial, adaptable workforce to using data in a human-centered way.

Though Emergent Futures is a collection of provocations about the state of Japan post-pandemic, the value of this futuring exercise and framework is universal, especially now. For Japan and other parts of the world to meet the challenges and opportunities we face post-COVID—from how to safely utilize physical spaces to how to remain competitive in a changing job market—our response must be human-centered, innovative, and imaginative.

Please share the work far and wide. We hope to spark the global collaboration required to ensure the future is evenly distributed, so we can step into it with confidence and creativity, together.

Download and share Emergent Futures here.

“The future is already here—it’s just not very evenly distributed.” Though attributed to essayist William Gibson nearly 20 years ago, the quote could not be more relevant today.

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the future is already here, futures thinking, strategic foresight, innovation strategy

Widening the pathway to a career in design

A new fellowship program for underrepresented young designers.

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Articles

It was a result of her own tenaciousness, her creativity, and the support of RepresentED, a small organization with a big mission to prepare students for careers in industries where they are underrepresented. The organization uses a human-centered approach to diversify the next generation of leaders through training, mentorship, and internships. RepresentED’s founder, Rashida Hanif, met Cisneros when she was a transfer student at UC Berkeley. Hanif notes that transfer students—particularly Black, Indigenous and People of Color (BIPOC) young adults—are missing out on what she calls the “hidden curriculum of life.”

Cisneros immediately saw the opportunity to help other Black and Brown transfer students like herself attain university education and gain visibility into concealed opportunities for their futures. Cisneros first learned about RepresentED in 2017, when she applied to join the first cohort of fellows. As part of the fellowship, she participated in a design thinking workshop led by former IDEO designer Scott Shigeoka. Later, she and her team competed in OpenIDEO's Future of Higher Education Challenge and designed an app that connected transfer students with much-needed community and resources. The experience and process introduced Cisneros to an industry she had never considered before. “Learning about design was absolutely pivotal for me,” she says.

Making change from within

After the competition, Cisneros was encouraged to apply to IDEO, and was hired as a recruiting coordinator before being promoted to her current role. Today, she leads Color by Design (CxD), which she helped launch in the wake of the rise in activism for social justice last year. She also helps facilitate internal programs at IDEO like business and inclusive leadership trainings, which seek to support IDEO’s senior leaders (and eventually all employees) to better understand how to create a culture of belonging. “In these trainings, we’re going to provide tangible leadership skills which help build awareness of where people are in their own personal journey,” she explains.

Shifting the power dynamic

This month RepresentED and IDEO are opening application submissions for the fall session of CxD. The program is open to all BIPOC students from backgrounds that have been historically underrepresented in design.

“It was important to shift away from the typical ‘company-intern’ power dynamic,” said Hanif. “It’s about an equal exchange of value that shifts the long-held power dynamics between the company and the fellow.” Following a bootcamp in design thinking, the cohort will receive placement on a six-month full-time IDEO project and have the opportunity to pursue a career at IDEO. Whether they decide to continue a design career or not, fellows will leave the program with a deeper understanding of design that they can apply to nearly any line of work.

Fellows will also be trained holistically for entry into culturally white-dominated industries, preparing them for challenges that are likely to come up, like imposter syndrome. “Having the ability to name things like imposter syndrome enabled me to step into my own authenticity,” explains Cisneros, “while understanding that institutions need to do their own work in order truly create a culture of belonging.”

A signal to the industry

Looking forward, there’s a lot of potential for programs like CxD to drive lasting change within other companies and industries. “This isn’t just a pipeline program, it’s a signal to the industry,” Hanif notes. Companies that have more diversity in their staff will have a greater competitive edge, and the design skills fellows bring to the table can be applied to more than just traditional design work—they can be used anywhere.

“It's not about checking DE&I boxes,” she adds, “When you build products and services, you want the people who buy those products to be represented in the design process—there’s a real business case for that.”

The first cohort has been invited into IDEO in January 2022 for a 6-month period, and an iteration of the program will launch by the end of 2023. We will share more updates as we get closer to the recruitment season. If you have any questions, please contact cxdinfo@ideo.com.

For Jordan Cisneros, a Senior Specialist on IDEO’s Global Learning and Development Team, access to a career in design was not a given.

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widening the pathway to a career in design, learning, design careers, creativity

These two designers published a visual guide to gender fluidity

It’s about more than bathrooms and pronouns, but the freedom to choose how to identify.

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Many people share these same questions but are afraid to ask. They don’t want to be rude or make a misstep—which can generate more missteps and even cause harm simply due to being uninformed.

Solving this issue is exactly what IDEOer Stuart Getty set out to do with their new book, How to They/Them. Stuart, who uses they/them pronouns, wanted to create a guide that answered a lot of the questions they commonly get asked, and find a way to educate people in a friendly way. Far from being a niche topic, gender is an important part of the human experience and its landscape is ever-expanding as we learn new ways to describe our most innate identities. It’s important to realize that everyone has a gender identity—not just those whose identity diverges from traditional norms. In Stuart’s brilliant words, “Gender is for everyone and we all get to decide who we want to be in this world.”

We sat down (virtually) with Stuart and Brooke Thyng, a former IDEOer who helped bring Stuart’s story to life through illustration, to talk about the book—the role of humor in the story, the pair’s collaboration process, and why the timing of the book was so important. Read on for a peek behind their creative process.

This book approaches talking about gender from both an educational perspective, as well as through humor. Why was that balance so important?

Stuart Getty: There's a hidden audience with this book and for me, it's my mom who's in her 70s and lives in Kentucky. I think that jokes are what get her to be like, “Oh, okay! I'll keep reading.”

Stuart Getty: I think that people get really uptight when these kinds of subjects around gender are being talked about. People are worried they’re going to mess up and use the wrong words like “transgendering,” for example. What I'm saying is, I like to add a little levity, because it makes people relax into the learning process. It’s about access to the information.

Brooke Thyng: I wanted to follow Stu’s lead and make sure that everything that I created was in service of their message. So as much as I wanted to make myself laugh, as a cis-person, it was important for me to come to this project very humbly and with the utmost respect.

The whole time, we’d ask, “Is this pushing people, but in a way that's authentic and respectful, and not just doing it to be a jerk?” There's a time and place for joking around. And I think it was clear that Stuart’s message wasn't a joke, but that it needed to come across with some levity, or just some openness.

I was really conscious of finding that nice balance of, yeah, it’s not a joke and we're fighting for rights and we're fighting for exposure and visibility, but at the same time, when we take ourselves so seriously I think we block out people from coming into the message. And so I really wanted to use humor as access, and use the visuals as access.

How does this book connect to what’s going on in our society right now?

Stuart Getty: If you look at the stats for Gen Z, 35 percent of them know someone who uses they/them pronouns, and something like 20 percent of them also identify as gender neutral, even if they don't use they/them. People are stepping into these places of breaking binaries, and I think the binaries of sexuality have been crumbling over the last couple years. People are now asking, “Why do we have to be only gay or straight?”

What I also love about this book is it means cis-people get to look at their gender and the way that they've been told to be a man, a woman, an American, a human, whatever—and decide what they actually believe and what they actually want to be. And I think that is the thesis statement of the whole book. “They” is for me, and I want to explain it to you, but also, gender freedom should be for all of us.

Tell us more about what your collaborative process was like.

Stuart Getty: I came to Brooke with pages that looked like this, and then we would sit down and go page by page. I do think that I had a really good idea of the story, but it was on a level seven or eight when I turned it to Brooke, and then she kicked it up to the, “It's a 10, everyone!” She just made it such a better story.

Brooke Thyng: Stuart came with all of these pages printed out, and I would meet up with them at IDEO. We’d sit in the communal area and we'd go through the pages, and they'd be like, “Oh, I was thinking about this here. And this is sort of what I meant here.” I would just take notes and try to take it in.

I'm always so taken aback when Stuart asks me to be a part of things like this. I really felt like I was helping make the vision come to life, like I was Stuart's visual hands for this project. I just wanted to amplify the text that was written. As I read through their draft, it was an immediate, “Oh, this is what it's making me think of.” Either I am slightly out there and can just see weird images come to life, or Stuart is really good at crafting their words. I think maybe it's both.

Want to read How to They/Them and learn more about gender identity? Get your hands on a copy here, or wherever books are sold!

Animations by Louisa Liu and Devin Peek

Ever wondered what “nonbinary” and “gender nonconforming” really mean? Or if it's grammatically correct to use “they” as a singular pronoun? You’re far from alone.

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these two designers published a visual guide to gender fluidity, spaces, experience design

The line between work and play is garbage

What rock stars have taught me about my job.

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A founding member of the alt-rock band Garbage, Steve Marker had generously agreed to an interview on one condition: that he could read an advance copy of my book, Two Beats Ahead, before we talked. This made me sweat, not because he was a rock star—my co-author and I had spoken to many of them while writing—but because he was the first rock star reading the book about the inventive mindsets of musicians. It was like waiting on Julia Child for feedback about the omelet you just served her.

“I’m enjoying your book so far,” Steve said. My shoulders relaxed.

I first heard Garbage on college radio in the mid 90s. The band had an unmistakable sound—a combination of shoegaze, hiphop, and electronic dance, with the pouty attitude of the Cure reinvented by a feminist fatale. It was an unexpected direction for the band given that Butch Vig, another founding member, had rocketed to fame as the producer of Nirvana’s major label debut, Nevermind. Grunge—as that Seattle sound was called—was nowhere to be found on Garbage’s debut. And it turns out, that was by design, or as Steve implied, maybe an un-design.

“You know, it was interesting reading about the intention that so many artists have had in making their music,” Steve told me. “It wasn’t like that for us. We didn't have a written-out plan or even something we really talked about that much. It was just a combination of everything that we loved.” He shared a story about Butch seeing My Bloody Valentine in New York and being blown away by their white noise and pop melodies. He mentioned Public Enemy and their gritty noise loop samples. He talked about 60s rock.

“Garbage could have turned into a totally pop thing. Or it could have turned into a noise experiment that would have been an interesting album to listen to once or twice. Luckily, we found a combination that worked for us. A lot of that had to do with Shirley [Manson], as she brought this whole other thing into the mix that we couldn't have planned. The combination of all our different influences is what the band became.”

Well, maybe there wasn’t a plan, but there was definitely a principle of designing the conditions for creativity and letting the outcome emerge from that. Steve and the band had figured out how to bring together all the things they loved, and at the same time, reject all the things that were popular in the mainstream. They chose a new path, which became their own path to mainstream success. Their debut sold 4 million copies in its first 12 months.

As I reflected upon how this happened, I was thinking about the numerous client teams that I’ve worked with under rapid deadlines and inflated expectations.“We want to be the next iPod of banking!” they say. The bygone days of Bell Labs open briefs feel like business mythology now. And yet, that was exactly the situation Garbage had. “We were lucky enough to have somebody say, ‘Okay, go make a record,’ mainly because Butch had a great reputation. We had the luxury to take as much time as we wanted to figure out what we were going to be.”

In Two Beats Ahead, Panos Panay and I interviewed Imogen Heap and Steve Vai about music and product breakthroughs they had in their own careers. We also spoke with folks at Amazon’s PillPack about launching their startup idea. What ties these stories together are mindsets of curiosity and learning. Experimentation wasn’t confined to any single part of a workflow or to particular roles. It was more like a cultural attribute, the water they swam in. For Garbage, that culture looked like persistent play. Steve illustrated this with a story about making Garbage's first record.

At the time, they were often just sampling other people’s songs to find elements they liked. During one session, he grabbed a handful of CDs looking for a beat and happened to play “Train in Vain” by the Clash. “Right there, we had a good four-bar loop to use as a click track...I put down a bass line and that was the foundation of the song right there.”

The next day, Butch came up with the lyrics:

you stupid girl
pretend you’re high
pretend you’re bored

“It can take minutes or months to make a song,” Steve continued, “and you’ve just got to stay open to letting it make its own path.”

I can imagine someone reading this and thinking to themselves, “So that’s it? The secret to innovation is to try a bunch of random stuff until it works?” But remember, this wasn’t just any band coming up with songs. This was Garbage. And this led Steve and I to an interesting discussion about team dynamics and experience.

“I guess we were lucky that we all worked with bands for 10-15 years before Garbage. We were in dozens of bands that hated each other. You learn by doing that.” He went on to talk about fluidity, respect, and vulnerability—the essential chemistry of the band.

It would be misleading to suggest that musicians somehow have a more natural ability to collaborate than others. It's not about an inherent gift. We all know the stories of a band breaking up over creative differences, sometimes with incredible public meltdowns. The reason musicians have so much to teach us is that the conditions in which they work are the ideal classroom for these mindsets.

Great creative talent is in every company, but the structures and social norms of the organizations often dictate who is permitted to collaborate. I’ve been in situations where clients have asked me not to talk to their colleagues because they didn’t trust them. I’ve seen departments make competitors of one another because they were incentivized to do so. I’ve been in buildings that have rooms dedicated to innovation rather than cultures committed to it. To get the best teams, it's often left to the creativity of the project leader to work around these organizational constructs and find the ideal contributors, no matter where they are in the organization.

Garbage set themselves up without defined roles—except for Shirley, who always sings. Otherwise, roles and contributions are left up to the person with the best ideas. “Being in a band is the most fun thing I can imagine doing. It's a dream come true from when you were a kid. And I've done it as a job, as my livelihood for a long time. It's amazing,” Steve shared with a smile.

Those words, “I’ve done it as my job,” have stuck with me because they really are the premise of Two Beats Ahead. We often don’t see the musician’s life as a job. And yet the mindsets that Steve and Garbage bring to work are the mindsets that we are regularly striving for in the corporate world. We’ve categorized the rock star life as something else. But on my best days, I’m working just like those legendary musicians, pursuing curiosity, building on new ideas with my teammates, and trying to get the video lighting just right.

Two Beats Ahead: What Musical Minds Teach Us About Innovation, by IDEO partner R. Michael Hendrix and Berklee College of Music Senior Vice President for Global Strategy and Innovation, Panos A. Pany, will be available worldwide in April.

Preorder in the U.S. here and the UK here.

Steve was supposed to be in bright colored lights on stages across the U.S. along with Liz Phair and Alanis Morrisette. Instead, he was on a video call with me, trying to find a camera angle that didn't make him look like he was in witness protection.

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the line between work and play is garbage, play, creativity

Lindsey Turner

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

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Leader
Leaders

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.

My tween twins teach me more about technology and gen-alpha than the last decade of trend reports.
Making things that matter
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Rachel Young

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

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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.

The greatest project to which I’ve ever contributed is raising my two daughters with my husband.
Uncovering unmet needs
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Brian Pelsoh

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

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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 love a good crit.
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Tony Wong

I am responsible for IDEO’s long-term success in China and working with clients to use design as a tool to enable growth.

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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.

I have a thing for antique maps.
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How to use AI as an editor, not a writer

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Ed White shares how he uses AI as an editor—not a writer—to sharpen storytelling, rehearse ideas, and preserve the productive friction that makes creative work better.

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Ed White has a rule he's tested on his own writing: hold yourself as the writer, and let AI be your editor. Ed is a Senior Design Director at IDEO's London studio, where he co-leads the firm's AI portfolio across Europe. Before IDEO, he spent 12 years as a writer and editor at the Financial Times, Wired, and Contagious. So when he talks about when to use AI for storytelling and when not to, it comes from two decades of crafting his storytelling skills.

In this episode, Mina Seetharaman talks with Ed about two specific tools he uses to keep AI in an editor's seat: a "roasting agent" prompted to critique his drafts without any sugarcoating, and a simulated audience he rehearses pitches on before the real thing. They also get into what Ed is hearing from design leaders at Anthropic, Lovable, Shopify, and Google Creative Lab about how creative work is changing, and why he thinks the friction of writing something yourself is worth protecting rather than automating away.

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Building a personal AI for the messiness of life: Sida Li

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Becca Carroll talks with Cue co-founder Sida Li about designing a personal AI for the messiness of everyday life—not just work. They explore how Sida stays anchored to human needs while navigating fast-changing technology, product tradeoffs, business-model experimentation, and the realities of building an AI company today.

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

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

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

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

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Designing GenAI for the emotional side of money: Johannes Seemann

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Designing financial tools around the feelings that shape money decisions.

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

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The curious leader's edge in uncertainty: Scott Shigeoka

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How genuine curiosity helps leaders navigate uncertainty with greater confidence.

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

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