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.

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.

Yun believes the purpose of food is more than sustenance. Every dish is a cultural story and an ode to generational resilience.

Yun is one of hundreds of women entrepreneurs San Francisco’s beloved food business incubator La Cocina ( "The Kitchen" in Spanish) has supported over the last decade. Graduates from La Cocina have scaled industry barriers to establish restaurants and factories around the Bay Area, served millions of nutritious, multicultural meals, and generated tens of millions of dollars in sales. Yun’s story is one of success for one woman, but also for her family, her culture, and for a business that supports community health.

Business and community health can form a virtuous flywheel. Businesses thrive when their employees lead happier, healthier, and more productive lives. Communities thrive when the businesses that serve them support their health holistically. However, despite considerable investments in the healthcare system, the cycle has sputtered and stalled: every year, $2.6 trillion of productivity is lost to chronic disease. Businesses could play a broader role in addressing these inefficiencies and inequities, but investments in health have largely been limited to the traditional healthcare system and ignored where people live, work, learn, and play—in the space we call The First Mile of Health. By “First Mile Health” we mean making a deliberate effort to design for the patterns of everyday life that keep people well—emotionally, physically, financially, and socially. First Mile Health means creating and investing in businesses that provide compounding health benefits like intergenerational housing, food cooperatives, insurance to combat loneliness, and digital technologies that enhance trust and social cohesion.

What do we mean by the first mile? First Mile Health looks at people living their full life—not just their diet, exercise, insurance—not just things in isolation.

Animation by Claudio Fresneda

Building blocks for First Mile Health exist at the interpersonal, community, and city level.

Interpersonal: Nurture lasting relationships

The first mile of health is built on a basic human need: to relate with each other. As a species, humans rely on each other to survive and thrive. In today’s world where so much of our lives are digitally-mediated, it’s critical that our digital relationships foster mutual care and support.

If social media is the modern public square, today’s digital technology remains far from the agora of Athens or Central Park, places where people from diverse backgrounds gather and build shared understanding. Most social tech is still new in the grand scheme of things, and there's ample opportunity to develop them in a health-centered way. If we are to avoid the “social recession”—a loneliness epidemic exacerbated by COVID—digital experiences must help people spend meaningful time together, moving away from doom-scrolling and toward lasting relationships.

One positive example of this appears in IDEO data science research supported by the Robert Wood Johnson Foundation, which revealed that social media posts tagged as “inspiration” strongly correlate with posts about health. This signals that health can be a unifying topic that catalyzes positive conversation and builds social cohesion. Talking about health can lift people up, motivate them, and activate them toward taking care of their own well-being, sometimes just by giving the words to describe how they feel.

Health is also strongly correlated with personal identity, especially among younger people still in the process of learning and affirming who they are. When the pandemic hit, the social innovation organization Hopelab had been working on a tool called Nod, an intervention for loneliness among young people. At first, they determined that getting young people off their devices was the top intervention for tackling loneliness—but when COVID happened, they took a step back and asked, “What are the underlying principles of social connection?” and, “How can we build a tech-mediated intervention that will catalyze meaningful social connection digitally?” Nod shifted from a tech-centered framing—get kids off devices—to identity-centered framing based on principles such as positive psychology and mindful self-compassion to equip young people with the skills to nurture meaningful connections both online and offline.

How might digital products and services better support positive self-awareness and well-being?

How might we create digital experiences that feel like being in proximity with those we love? And importantly, how might we foster connections among those we don’t already know?

How might we design policies and regulations to ensure that digital experiences create reciprocal value for people and businesses?

Communities: Support local economic resilience

An inclusive local economy supports health: grocery stores that stock fresh produce, shared bikes and scooters to help people get around the neighborhood, small businesses and local services that connect and convene community members, and more.

Co-investments build strong, resilient local communities. Organizations that share economic power with communities at the local level are, in turn, more resilient themselves. Through co-investment, organizations and communities form a virtuous cycle. In the aftermath of the 2008 financial crisis businesses that diversified their community of co-investors were not only able to weather shocks, they were better set up to support the health and economy of the communities in which they operate in the long-run.

Businesses new and old are now taking part in a cooperative renaissance. Project Equity, a member of the Ashoka network of changemakers, is helping businesses transition to employee-ownership. Start.coop, a national accelerator for cooperative entrepreneurs, is advancing new business solutions addressing all of the social determinants of health. From creating affordable housing to increasing access to nutritious food, cooperatives have equity built into their DNA. These are examples of businesses that engage their community members beyond pure consumerism to become active decision-makers and co-designers of their local economies.

This cooperative renaissance is part of a bigger conversation to imagine a political economy that’s not centered on short-term value extraction but rather community health and wealth. From Platform Cooperative to Zebras Unite to RadicalxChange, the movement to build a new economy grounded in steward-ownership and long-term purpose is gaining momentum around the world.

How might we supercharge local entrepreneurship, starting with women and minority-owned businesses?

How might large businesses build local enterprises and steward-ownership models into their ecosystem in ways that create value for all?

How might innovations in the distributed web and decentralized governance enable alternative ownership and exit models?

Cities: Build multi-city coalitions

American cities are places of extremes: the most diverse places in the country and also the most unequal—a deadly intersection as shown by the disproportionate impact of COVID. Over the past few years, an experiment has been in the works in Stockton, California, the most diverse city in the country. For two years, Stockton’s former mayor, Michael Tubbs, gave $500 per month to 125 randomly selected residents living with low income. As the Stockton Economic Empowerment Demonstration (SEED) website describes it, “the cash was completely unconditional, with no strings attached and no work requirements.” Two years later, the data collected on the project has been released, and among other striking findings, one stands out: recipients of the funds were “healthier, showing less depression and anxiety, and enhanced well-being.” COVID demonstrated the compounding effects of an economic crisis on top of a public health crisis. In showing a way forward that solves for both, Stockton’s success story has catalyzed a coalition of mayors to launch guaranteed income pilots in 29 cities across the country. When decisions center on the diverse voices of those who live closest to the problem, cities can rise the tide and lift the health and wealth of all of their people.

Cities are effective units of change, where people could work on challenges that are big enough to matter and small enough to make things happen. When diverse partnerships of organizations rally around a shared purpose, cities become containers for collective imagination. One example of this shows up in Cities Changing Diabetes, a 36-city network advised by Gehl that conducts research, crafts strategy, and collaborates across cultures and geographies. The coalition creates neighborhood-level strategies for health that are unique to local conditions but offer lessons that can be applied across the network.

The 2020 census revealed the faces of a changing nation: a pronounced aging population and an increase in diversity among Millennials and Gen Z. Already home to eight out ten people over the age of 65, cities are the ground zero of these macro demographic shifts. Aging is a main risk factor of chronic diseases and COVID has made race-based health inequities abundantly clear. If business-as-usual persists, we will face a grave prognosis: an aging population burdened by chronic disease will be catastrophic for the American economy. The solution is as simple as it is inevitable: just as chronic diseases like diabetes and obesity are risk multipliers that devastate the economy, First Mile Health could be a resilience multiplier for both people’s health and the economy.

How might we create pathways for economic mobility for those who face the biggest barriers of systemic inequities?

How might we build trust between governments, businesses, and residents?

How might networks of cities unite across divisions and heal together?

Every business leader should see an opportunity in First Mile Health

First Mile Health is an “and” to all the work being done today. It’s shifting the mentality from fixing to designing. And we can only do that by seeing one another fully.

Depending on where you stand, you might see a different path toward First Mile Health. Healthier communities make better customers, making them and the businesses who serve them more resilient to unexpected threats such as pandemics; improved mental health and well-being generate higher levels of engagement; extended healthy lifetimes increase the talent and customer pools available to business; healthy family and work life encourages a sense of belonging, which in turn builds organizational knowledge; and lower health costs benefit all. All of these outcomes are examples of First Mile Health.

This week marks the grand opening of La Cocina Municipal Marketplace, the first women-led food hall in the country. This 7000 square foot development in the heart of the Tenderloin will give entrepreneurs who follow in Nite Yun’s footsteps an even bigger platform to innovate, while offering affordable, healthy food to longtime local residents. La Cocina Municipal Marketplace is an exemplar of First Mile Health: it serves as an inclusive gathering space for the community, a catalyst for business leadership from the ground up, and a demonstration project for health-centered economic development to inspire cities around the country.

Runners know that the first mile is always the hardest. When you start out, your body has to adjust to the new demands of physical activity. But as you run, your body adapts and the experience naturally starts to get easier. The same is true for First Mile Health: while the first mile might be the hardest, it will create many happier and healthier miles down the road. As Mark Twain said, “The trick to getting ahead is getting started.”

We wish to thank Steve Downs at Building H for his thought partnership and collaboration that helped shape First Mile Health.

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While having a bowl of soup on a trip to Cambodia, Nite Yun, who was trained as a nurse and is now the chef-owner of the award-winning restaurant Nyum Bai in Oakland, realized that eating could be a way of healing.

This is done by leveraging human-centered design as a tangible skill set for building useful products and services for diverse communities. Students are introduced to internships, professional roles, and entrepreneurial opportunities as trained professionals contributing to positive social change in the marketplace.

Color by Design (CxD) is RepresentEd’s newest fellowship program designed for BIPOC (Black, Indigenous, people of color) in partnership with IDEO that is invested in transforming the boundaries of design. This program provides participants with the necessary professional development skills, mentorship, and on-the-job training to make impactful and empowering career decisions in design. Additionally, fellows will participate in seminars, workshops, and networking events that will expose them to professional designers from various fields who will share their knowledge, provide instruction on design components and support them in successfully completing CxD projects.

It is a 9-month program spanning September 2021 to June 2022.

The 9 months include a 3-month part-time professional training course (September - December 2021), followed by a 6-month paid full-time Fellowship with IDEO (January - June 2022). The Fellowship will have an opportunity to convert to a permanent full-time role after 6 months.

Update, May 6th 2022: We’d like to share our decision that we are postponing the next cohort of the Color by Design program in partnership with ReprentEd Leadership until 2023.

We are about to wrap up our pilot program and we want to take the time to debrief and learn from the experience of our current Fellows and take those inputs into the design of the next cohort. In particular, we want to consider if and how to scale the program to a broader set of design disciplines beyond design research and the impact this will have on the curriculum design, and how to best place Fellows in different communities within IDEO to ensure the most productive experience.

Based on this review, we intend to iterate on the next Color by Design program and launch it by the end of 2023. We will share more updates as we get closer to the recruitment season.

We hope that this has not caused any inconveniences and please know that we welcome your feedback and suggestions as we work to build the next version of the Fellowship.

If you have any questions, please contact cxdinfo@ideo.com.

RepresentEd Leadership builds pathways for college students of color who are harnessing their power as socially conscious leaders.

This month marks the one-year anniversary of the World Health Organization's designation of COVID-19 as a global pandemic. In the past year, we've changed our routines and behaviors, and many of us have established a new normal that's not terribly different from the old one. Except...with so much less entertainment, interaction, and spontaneity. With options narrowed, it helps to ask others what they're doing to keep things joyful. At this strange milestone, we asked IDEOers around the globe how they’re designing for more moments of joy these days. Here’s what they had to say.

Write down three good things each day

One thing that has personally helped me a lot is an exercise that was recommended to me by a friend and also recently mentioned in a TEDx talk by Lucy Hone as an important technique to become more resilient. It’s brutally simple: No matter how hard your day has been, you jot down three good things that have happened to you, that you learned, or that you are just grateful for. Nothing negative. It’s all about switching your attention to the good. It is a really powerful way to remind you there is always something to be thankful for.

—Pierre La Baume, Senior Interaction Design Lead, Munich

Find time to play

Something that really has helped me is shifting into a more playful mindset. Especially early on during shelter-in-place, when I felt like I was drowning in self-development recommendations for all my “free time,” I found peace in reverting to hobbies I enjoyed when I was younger that I hadn't gone back to in awhile. For me, this meant diving deep into the games I enjoy (such as SpyParty, Team Fortress 2, Into The Breach,Tetris 99, Raji, and Among Us) for months even, as opposed to playing many games “quickly” to learn more as a game designer. It meant spending more time, even an entire day, re-reading comforting books (such as Pride and Prejudice, Tuesdays With Morrie, Dune, Sapiens: A Brief History of Humankind, Shingeki No Kyojin, and more) without feeling guilty about it. It meant more doodling, daydreaming, and giving myself moments in the day that didn't make me feel like I had to be “productive” to make up for all the quiet, reflective commute time and socializing that was no longer happening regularly.

—Ridima Ramesh, Play Lab Game Designer, Palo Alto

See life through a child’s eyes

Observing how my three-year-old daughter sees the world has taught me a lot in these dark times. She always lives in the moment, and what she feels right now is not affected by the pandemic situation. Even after a rough day, she jumps up and down with a big smile for every little thing that happens around her, such as finding a butterfly or bumping into her friend on the street. For adults, although we may have a joyful moment, it’s often swallowed up by the overflowing information and chaos at the end of the day. We see more complexity in the world than children do, but my daughter has made me try to be more present, see the world with fresh eyes like she does, and embrace a moment of joy so I can stay positive.

—Kayoko Watanabe, Marketing, Tokyo

Be in your body

Exercise is helpful—especially dance! The brain is cool in that our limbic system is often more able to process emotions and stored energy via movement, than the prefrontal cortex (the thinking mind, which is in charge of executive functions). Moving your body is a consistent hack to shake off the heaviness of this moment in time. One silly (or serious!) dance party a day encourages me not to take myself too seriously.

—Alex Nana-Sinkam, OpenIDEO Community Lead, New York

Invest in yourself

2020 has been an interesting year to say the least. First off, condolences to the lives lost from the past few months; it has not been easy. As the year has moved along, I’ve been running some checks and balances on my life: investing in myself by practicing my skin routine, working out, investing money, and learning new skills. I’m very focused on protecting my energy. I've found myself giving less and less energy to various media outlets; I'm tired of seeing this political battle, police brutality, and pandemic talk. Staying in touch with friends and family is major. I’ve been to more virtual parties than real parties this year!

—Preston Tilghman, Leadership Coordinator, San Francisco

Actively pursue work-life balance

I've started to look after my health more, and have actually started to turn the thought of “work-life balance” into action (though I'm still seesawing more than balancing right now!). I go to morning workouts as early as 6:45am to start the day on a positive note, and have started to incorporate more essential oils into my life: dribbles into my baths (also taking more baths!), dabs onto my wrists or temples, and mixed into my diffuser. I'm taking different routes on my bike rides to and from work to add variety into my days, and am especially enamored with biking under the shade of large leafy trees. I've begun going on day or overnight trips outside of Shanghai, turning weekends into adventures. I've also enrolled in an improv workshop for the month of November, and we will have our first showcase in December!

I think in general this year has forced me to think about how fleeting and fragile life can be, and has prompted me to be more courageous about trying new things. For me, the moments of peace have been rare, but joy hasn't.

—Kiko Zang, Business Operations Lead, Shanghai

Get inspired by other creative people

I wish I had a silver bullet for “feeling good” this year that reliably works not only for myself but for others as well. However, each thing I've held as foundational that I could trust to inject “good vibes” into my life has been challenged, and many haven't made it into 2020 unscathed. That said, there are a few things I've found myself doing that may not make me laugh so hard I need to throw myself out of frame during Zoom calls, but do bring much desired comfort and quiet when I most need it.

One of those things is Jon Bois. It seems strange to point to someone who you only know through their online output and say, “This dude's videos are what's gonna get me through this,” but it's a gamble I'm willing to take. Jon Bois is a video producer for SB Nation, a sports website I don't read, and he mostly makes videos about weird and niche stories that primarily center around sports I don't watch or know much about. He's a superb writer and a masterful filmmaker, though I'm only calling him those things because there isn't an accurate term to describe exactly what he's doing. He's in the middle of releasing a sequel to his defining work Football 17776 called Football 20020—a multimedia speculative fiction story that follows three extraterrestrial entities watching and commenting on people playing exaggerated football on a post-scarcity, post-death, post-war Earth, where humans are defined by play. It's joyous and there's truly nothing like it. I have an ongoing though incomplete watch guide for things made by Jon Bois for those interested.

—Zachary Clemente, Senior Tech Admin, Cambridge

Share vulnerability with co-workers

The ability to build trust with a team to a point where you can be vulnerable in front of each other has been very important on my projects—being able to slump onto the couch with the team for the twelfth hour of Zoom calls or pull out a pint of ice cream at 3pm when you just really need it. I think it’s also really valuable to leave space to talk about how we're feeling during stand-up or anytime during the workday. With major events surrounding racial injustice, scary wildfires, the political environment, challenging immigration issues with COVID, or generally just feeling low energy—it's not a normal time, and it’s not realistic for us to always “be optimistic” these days. The joy I find with my team is that I feel I'm not in this alone.

—Amanda Amyx, Design Lead, San Francisco

Get in costume

When the pandemic hit and suddenly I was separated from my colleagues by entire continents, we needed new rituals for remote working. As a creative warm-up, my teammate George Joseph suggested a theme and asked that we all dress up, grab a prop, or put on a virtual background relating to that theme for the next meeting. It was so much fun! We decided to do it every morning—and so the “Extras Daily Zoom Theme” came to be.

The night before the meeting, or even early that morning, someone from the team would come up with a new creative theme for us to explore. Most people would find a fun Zoom background, but since I had an old computer that wasn’t able to use virtual backgrounds, I had to come up with a prop or costume to go with the daily theme—often with only five minutes warning! As the themes became progressively challenging and abstract (from animals, fruits and colors, to adverbs) I got more and more into it. Some highlights: For the “recreate a piece of art” theme, I looped in my mom for help dressing as The Two Fridas, and for Halloween, I dressed up as a campfire with s’mores. Every morning my team members would watch for what new invention I would come up with. This was truly an injection of daily joy into my life, and one that brought joy to others, too.

—Arianne Orillac, Design Lead, IDEO.org

Design new rituals

Since April, I have had a new ritual on Friday nights. After my daughter goes to sleep, I pour a glass of wine and sit in front of my computer to virtually meet six of my college friends who call in from Tokyo, London, and Melbourne. Our weekly call has been set up as a recurring event with no end date. You feel no pressure to attend if you’re busy or tired because you know that there is always “next time.” At the same time, we’ve been able to use our meeting as an opportunity to check in with each other. The pandemic happened when many of us were already facing new challenges: becoming a mom, moving overseas, working from home with kids. We needed a place where we could be vulnerable, support each other, and laugh together to keep our sanity. I have never felt them so close despite the physical distance. 2020 has been hard indeed, but having this regular opportunity to stay connected with my friends brings so much joy and peace into my life.

—Kayoko Watanabe, Marketing, Tokyo

Notice the little, beautiful things

The pandemic sent me and my family into the lake-and woods-filled Poconos, Pennsylvania. Quickly settling into a new routine, each day, my two-year-old and I would walk up and down our yard and back and forth the stretch of our street. As my mind circled the themes of the day—the state of the world, the uncertainties of our plans, work—my son observed our surroundings: the sticks in the yard, a squirrel running up the tree, the plane flying far overhead, each passing and pausing bird. It took me weeks to pause myself. I suddenly wondered: How had I never noticed how beautiful birds are? The variety of colorful coats and the stunning range of voices. I soon found myself tracking a particular bright yellow-coated bird on the branches near the lake; each time I caught it perched for an extended moment I felt a simple joy.

Neither the beauty of nature nor the power of mindfulness is a new discovery, of course. But reaping their benefits requires a constant remembering. I am grateful for the presence of my toddler—both his remarkable ability to be present and his presence in my day to day. At two and a half, he is himself transforming and learning about the world at an astonishing pace, while also teaching me everything that I've forgotten.

—Alice Kogan, Business Design Lead, New York

Illustrations by Jenice Kim

Now that the answer to “How are you?” is “Pandemic-fine,” how do we answer the question, “What brings you joy?”

I help organizations cut through complexity by shaping how they show up, through brand strategy, identity, and storytelling.

Working at the intersection of brand and business, I bring an editorial eye and a bias toward making—turning ideas into tangible experiences that people can understand, trust, and believe in.

My work spans government, healthcare, financial services, media, and consumer goods, from launching Gen Z-focused ventures to building innovation labs and reimagining legacy brands. I relish moments of ambiguity and enjoy translating across teams, perspectives, and priorities to move ideas forward.

I started my career in editorial and digital design, shaping cross-platform experiences and identity systems in publishing and agency environments. That foundation still shapes how I work today: I’m detail-oriented, collaborative, and overreliant on the Oxford comma. I hold a BFA in Visual Communication from the School of the Art Institute of Chicago.

For 25 years, I've asked the same question: Who does this design exclude—and what are we going to do about it?

My work spans human-centered strategy, inclusive design, and qualitative research, with clients ranging from Microsoft, Google, and Verizon to the National Science Foundation, and San Francisco Unified School District.

Before IDEO, I taught elementary school in East Palo Alto and spent a decade doing design work with social service organizations—where I learned firsthand what it costs people when systems are built without them in mind.

I am currently writing User Error, a nonfiction book about digital access and the design decisions behind it. I live in Oakland, California.

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My expertise spans brand, communication, and product design across tech, education, the arts, and social impact.

I believe great work demands both high-level vision and obsessive attention to detail, and only happens through collaboration.

I bring an inclusive, hands-on approach and a deep understanding of business, which enables me to consistently deliver excellence while always asking why.

Before joining IDEO, I worked at the brand firms Pentagram and VSA Partners. I began my career as a designer, leading teams at the School of the Art Institute of Chicago and the Milwaukee Art Museum. I hold an MFA in graphic design from Maryland Institute College of Art and a BFA in communication design from the Milwaukee Institute of Art & Design, and have taught at some of the best design schools in the US.

I am responsible for IDEO’s long-term success in China and working with clients to use design as a tool to enable growth. Specifically, I have helped Chinese companies design holistic brand solutions through the development of their products, communication, services, and innovation teams, and I have helped multinationals expand their presence and influence in China.

I advise global leaders on developing China-led innovation and capabilities.

In over 15 years in IDEO Shanghai, I have worked on projects that use design to elevate the quality of the experience of healthcare products and services, streamline processes that increase productivity, create spaces and programs that promote and enable inclusive communities, and build next generation mobility solutions that are planet-positive.

Before joining IDEO, I worked at Philips Electronics and the Electrolux Group in Italy, the Netherlands, and Singapore on a number of breakthrough commercial products. I am a member of the Young President Organization in Shanghai.