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.

What do we stand for in this moment when education is being disrupted, inequities are being exacerbated, and we feel more isolated than ever before?

Knowing we couldn’t answer those questions alone, we hosted listening circles earlier this year to learn how educators were navigating their personal and professional lives as the pandemic surged.

Those sessions surfaced questions like these:

• What can we do to increase students' and families' joy right now?
• Can we build safer and more inclusive spaces for school communities?
• How do we make sure we prioritize—not just accommodate—the needs of marginalized students?
• How might we be healers of a broken system?

These gnarly, complex issues can’t be addressed by any single person or organization, and making progress requires more than repurposed solutions delivered by outsiders. As we’ve learned through our work with teachers and principals, navigating these types of challenges depends on school communities being supported to co-design the future for themselves. As one teacher in Fremont, California told us: “Teaching and innovating have to go hand in hand right now.”

With that in mind, we developed a method for educators to take a co-design approach to driving better outcomes for their schools and the students and families they serve. The Co-Designing Schools Toolkit is a collection of 40 activities, frameworks, and research-based practices designed by The Teachers Guild and School Retool programs, supported by and in collaboration with Riverdale Country School, the Deeper Learning network, Liberatory Design, the Stanford d.school, and the input of educators, local collaborators, and coaches.

At its core, the toolkit is about designing for equity. It complements an approach we developed nearly 10 years ago, the Design Thinking for Educators Toolkit, encouraging educators to focus on equity issues in their schools as part of diverse design teams. The toolkit focuses on the needs and lives of students furthest from opportunity, helps teams explore their members’ personal identities, and guides educators in articulating equity goals for their schools. Taken together, these components aren’t just boxes to tick off, but a set of principles that guide the entire change process.

Designing with students, not for them

Myron Long, Principal of The Social Justice School in northeast Washington, DC, says the co-design process has pushed him to fundamentally rethink the role of his students. “We ask for their feedback,” Myron says, “but we actually have to listen to them and then act on it.” For example, rather than assuming his students are always eager to take on justice issues, he asks them, and recalls a student replying, “Can’t we just play dodgeball, too?” Myron urges his colleagues to regularly invite students to be co-designers, and to build in “time to pause, listen to, and design with our students, not just for them.”

Meet parents where they are

Another example of co-design comes from across the country in South County San Diego, where a team of Special Education leaders hosted co-design workshops. Inviting families in was crucial to the team’s efforts to bridge gaps in understanding between parents and the countless people who provide support for students with special needs.

But to ensure that caretakers of children with special needs would be able to show up as collaborators, they knew they’d have to offer some basic support, like hiring professional translators and lining up child care. “The parents felt so respected, valued, and part of the process,” said Olivia Rivera, a team member. Knowing their children would be taken care of during the workshops gave parents the time and space they needed to “share from their hearts.”

Meet 4 educators who are co-designing solutions for their school communities.

We know that no single strategy or process can solve all the complicated issues facing schools. But with roots in design, equity, and community, the Co-Designing Schools Toolkit can support schools and families as they navigate complexity and look ahead to building a collaborative environment in which all students thrive.

Learn more about co-designing a more equitable future for your community at www.codesigningschools.com.

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Along with educators and families around the country, those of us at IDEO who work in education have been asking ourselves, “Where do we go from here?”

Creating a new business is a little bit like being a sea turtle mom—you want to know your environment and create many versions of your offer to increase your odds of success.

When it comes to making sure those sea turtle babies—I mean, uh, your business ideas—thrive, there are two methods that can help: Design thinking is the approach for discovering which of your eggs has the best chances of survival. Once that baby sea turtle has made it successfully into the ocean, the Lean Startup methodology can improve its chances of successfully reaching adulthood.

During a recent project, a client asked me about the difference between the two methods. While these techniques have been around for years now, it’s a question I hear a lot—many folks in the world of business think they should know the difference, but in all honesty, I don’t blame them for being confused. The methods are distinct, but they can (and should) be used in tandem. Businesses could benefit from them both.

Back to the client question—what’s the difference? I started by explaining the difference between the two methods more broadly, laying out what you see in the chart below.

Both approaches are about building new concepts and products, learning as much as possible from users, and from what’s happening in the market. And both methodologies employ an iterative approach that consistently seeks feedback and understanding from customers in the market.

Knowing the difference is one thing—knowing when to use one or the other is just as important.

Design thinking helps teams come up with many new ideas for new offers they then test before settling on the one that is most desirable, feasible, and viable. When applying design thinking, once we’ve uncovered user needs, we create a slew of options that might solve those needs. Each one is intentionally distinct from the others so we can learn what works best. In visualizing design thinking for our curious client, I sketched something like this:

On the other hand, the Lean Startup method helps teams drive toward a better version of an existing or new concept. It’s great if you have a product in-market that you want to tweak so it performs better. That end product may vary significantly from the original, but with the Lean Startup approach, you will be able to trace a path from Version A to Version Z. If I were to sketch it, it looks something like this:

Now that we have the two distinct methods visualized, we can look at applying them. A hypothetical challenge: Let’s imagine we’ve been asked to create a new concept to upend the fact girls are called on less, given less teacher attention, and given fewer opportunities to speak in mixed-gender science classrooms.

As design thinkers, our first step would be to talk to girls, boys, and their science teachers. We would talk to psychologists and sociologists. We would explore the mixed-gender education experience in other cultures. After our research, we’d distill our findings into opportunities for improving the classroom experience. For example: How might we immediately reward girls for participating in class? How might we enable teachers to see the disparity?

Based on those prompts, we would brainstorm a slew of ideas. For example: What if classrooms had a voice monitor that recorded the amount of time that boys spoke versus girls spoke? What if there was an online instructor’s portal with exercises for how to draw out girls in every classroom session? What if there was an app that quizzed students who are girls daily to increase their familiarity and confidence with science material?

We would then take this array of ideas and create prototypes—rough, inexpensive, tangible expressions of the new concepts—and test them. Based on feedback, the next round of prototypes might look something like this:

Maybe the voice monitor didn’t affect teacher behavior, but it did sufficiently frustrate the girls in the classroom—so much so that the next prototype was a wall-mounted display to show a live tally of student input. Because of the diversity of ideas and prototypes that come from a design thinking approach, there’s no clear throughline from Version A to Version Z.

Based on knowing that we are now going to build a voice-activated wall display, we would also use design thinking to build and test the accompanying business model and the product’s visual language. We would think about, build, and test options for how the display will get in front of buyers (the distribution channel), who pays for them and how much (the revenue and pricing model), and which entities might help to expedite our success (partnerships). As we explore the most viable business model, we’re still refining the concept.

Once those designs have been sufficiently evolved, we can plan for a limited launch to test the assumptions behind the products. With a refined concept and business model in hand, we can begin in-market testing.

This is when you want to lay 100 eggs, because only a very few will meet the bars for user desirability, the company’s ability to implement it, and the crucial feature of being financially lucrative for the business. In general, using a design thinking approach for a limited launch of a new concept will reduce risk, while using the Lean Startup methodology during in-market refinement will improve the chances of success.

Sometimes, when a team launches a new product but skips the user-centered design process, they find it may be necessary to pivot. That’s a good time for a team to turn to design thinking to explore why the concept isn’t working, and to find new ways to make it meet user needs.

A sea turtle lays more than 100 eggs each nesting season, but only a handful will successfully hatch and survive the journey into the ocean.

I first saw Sharon during a workshop she delivered for Black Minds Matter. Sharon discussed the creative process as essential to mental health and considered the white dominance of the mainstream art world, all while making an original, delicate art piece with a scalpel and fine magazine paper. (I know—“multi-talented” doesn’t even cover it, right?)

In a session she later ran for IDEO, she created such a warm space while inviting us into the intimacy of her signature collaging process. She inspired us to see what it is when someone dictates the rules of their own art, career journey, how they define and are defined.

The pieces evolving from her “Seeing Ourselves” collection explore identity, representation, portraiture—when the ‘we’ and the ‘our’ are represented in art, education, media. Who is omitted from that narrative and how can art reclaim it?

Sharon is currently exhibiting at the Black Art Matters exhibition. She took a few minutes out of her day to answer some questions I had for her.

In one sentence, who are you?

I am an artist, currently creating work using handmade collage, and an educator who is passionate about changing predominant narratives of underrepresented, marginalized people.

What does a typical work session look like?

I work from a new home studio which I set up a couple of days before lockdown in March 2020. I recently resigned from my part-time job of 4.5 years in a London museum to work as a full-time artist. I am working on several different projects and I find joy in the varied nature of my work.

My work varies greatly from one day to the next: I am currently working on a project with a national museum; I have been commissioned to create a few bespoke collages; I curate creative programs for organizations; and I deliver workshops and create hand-assembled collages. Creating the collages helps me to relax, and in parallel, explore identity and representation of Black womxn.

Does sharing your process while creating such personal work ever feel too intrusive or voyeuristic?

I absolutely love sharing the process of creating my very personal art. My background includes the delivery of teaching sessions in political literacy, also known as citizenship education. I have also taught art workshops and have delivered self-esteem, getting back into work and personal development workshops to women who have lost confidence after a period of unemployment. I have worked with people of all ages from children to the elderly. Sharing my process is a further extension of this highly invigorating work.

How has your work and career evolved?

My career has evolved organically; there hasn’t been a linear route towards my current working life.

My work has been varied, but today, I can now see how so many of these seemingly disparate strands connect to inform my present practice. Early on after my first degree, I worked in recruitment sales and was a headhunter. The skills I gained there have made me feel less awkward when selling my work; I am not afraid to speak to new people.

Training teachers and people of all ages has given me the confidence and skills to deliver creative workshops both online and in person; it is something I absolutely love doing! I am passionate about connecting and communicating with others.

For much of my life I worked with marginalized groups in a variety of settings, ranging from boys in young offender institutions and the elderly living in sheltered housing to underrepresented museum audiences. This work all feeds into my current series entitled “Seeing Ourselves” which focuses on the underrepresentation of Black women. My projects all encourage others to “take up space” in environments where they may be unseen and to use our voices to create positive change and impact.

What does it mean to you to do what you love at this stage?

It feels so wonderful to be doing what I love at this stage! I have wanted to be an artist since I was a child. For many years it felt like I would not make it, but deep down, I did not give up hope.

Money wasn’t available for me to pursue my dreams in my teens, but as a mature student, I got a second degree in Fine Art. I took “the scenic route” and with hindsight I am glad I did. Things are happening exactly when they are supposed to.

What was the last item on your to-do list?

To contact a collector who has commissioned a bespoke, hand-cut collage.

How do you see the world in 2078?

Wow! This is a huge question, which immediately saddens me; in reality it’s unlikely I’ll still be around. It immediately makes me think about the world I would like my children to be living in. I would hope there would be less disparity of wealth and greater visibility and distribution of power across diverse groups.

What’s your number one bucket list item?

To return to Barbados for a holiday someday soon; it is my mother’s country of birth and I have not visited it for 11 years. Despite being born in London, Barbados also feels like "home."

Who are you creative crushin’ on lately?

I am creative crushin’ on Sheena Rose who is a phenomenal, multidisciplinary, Barbadian artist. Her work spans drawings, hand-drawn animations, performance art, paintings, and new media. I am particularly inspired by Sheena’s vast creative works with powerful overarching themes.

When I first came across Sheena’s work on Instagram, she was creating amazing pieces from her bedroom which inspired me to return to creating after a long time. Through seeing Sheena working in this way, I began to believe it was possible for me to do the same without the luxury of a studio at the time.

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Experiencing Sharon Walters’s work is like being given a comforting, personal gift.

How’d we end up on this culinary carousel, from learning about kelp’s role in addressing climate change to understanding the significance of seeing kernza, an unusual perennial grain, in the cereal aisle by 2040? We spend our days working in the food world, hearing about its challenges: Hunger is rampant, but so is food waste, and the food system is responsible for 25 percent of global carbon emissions. This leads many to believe that the system is broken. But it’s not broken—it was designed this way. And if it was designed this way, then it’s time for a redesign. That’s what IDEO’s new narrative podcast, Food by Design, is all about.

The experts featured are living proof that we can create a system that’s nourishing for people and the planet. Below are some of the new ideas, staggering statistics, and inspiring stories they generously shared with us. Let’s dig in.

A human-centered approach that prioritizes equity is required

The food system is inherently about food, but without humans, the system doesn’t work. Improving a system that’s been ravaged by multilayered crises—health, racial injustice, climate, and economic—depends on how we value those doing the actual labor in it. The role and importance of human-centeredness and equity (and the current lack of both) can’t be ignored.

We spoke with Saru Jayaraman, a professor at the University of California Berkeley who leads the Food Labor Research Center and founder of the non-profit One Fair Wage. In episode seven, she explains how the legacy of slavery still impacts how much money restaurant and food service workers make today—sometimes as low as two dollars and thirteen cents an hour—despite the cruel irony that the industry is the largest and fastest growing in the U.S.

Dr. Ricardo Salvador, Director of the Food and Environment Program at the Union of Concerned Scientists, adds to Saru’s perspective in a later episode: “We've been creating people that are affluent and at the same time we've been creating people that are poor,” he says. “All of that is a direct consequence of the way that the agricultural system in the United States was born. The system of slavery did not completely disappear. It has been transformed.”

We need both individual and structural change—it’s not an either/or situation

We’ve been told that individual action is enough, but we’ve also been told that it isn’t—we need bigger changes. Eating red meat is often the subject of this debate, as animal agriculture is the second-worst contributor to greenhouse gases after fossil fuels. But here’s the thing: we need both individual and structural change to design a better food system.

While doing research for our second episode, we met Lisa and Loren Poncia of Stemple Creek Ranch, cattle ranchers who now consider themselves carbon farmers. Through practices like rotational grazing (which allows pastures to rest and regenerate), they actually sequester carbon into the soil, keeping it from being released into the atmosphere where it contributes to greenhouse gases that cause climate change. When we recorded the episode, Stemple Creek Ranch was sequestering enough carbon to offset 285 passenger vehicles per year, and that number is growing.

With additional incentives, like those baked into the Federal Farm Bill, even more ranchers like Lisa and Loren might adopt these practices. “I wish that the federal government would jump on board and subsidize carbon and carbon sequestration instead of corn and soy,” says Loren. “In a very short amount of time, we'd have a lot of carbon stored in our soil.” (That’s a good thing.) In our sixth episode, we talk about how producing red meat conventionally can create nearly 10x the emissions of vegetables. But if individuals buy regenerative red meat from carbon ranches like Stemple Creek Ranch, it could help shift the rest of the industry this way and lead to more structural policy changes, having a huge impact on the health of the entire system.

Another example of the need for both individual and structural efforts comes from Karen Leibowitz and her partner, who established a climate-minded restaurant in San Francisco. Every detail of the Perennial aimed to minimize carbon emissions, from using recycled appliances and napkins meant to be fed as compost to worms to hydroponically-grown vegetables.

But just one business can't change the system. Armed with this insight, Karen and her partner closed the Perennial to scale their ambition across many restaurants—creating a more effective way to fight climate change. Their nonprofit Zero Foodprint asks restaurants to add a one percent charge to their bills and use those funds to fight climate change.

Embrace mental “flips” and blank slates...or cardboard boxes

Again and again, the individuals we interviewed shared that in order to create a better food system for all people and the planet, we must build something entirely new—whether reimagining the restaurant business model, altering what we believe is edible, or redefining the meaning of sustainability.

We talked to chef and restaurateur Camilla Marcus in our seventh episode, who is rethinking the power dynamic that gave rise to the harassment and racial and gender inequities in the restaurant industry. Her restaurant west~bourne turned the “front-of-house, back-of-house” hierarchy—which Camilla describes as a caste system in disguise—on its head. During an intensive training program, every team member becomes fluent in all areas of the business, from dishwashing to wine tasting. “If you envision a world a different way, you have to start from the beginning and be willing to redesign how everything is done,” says Camilla. “You can't just hope for a different outcome and keep using the same process and system.”

Like Camilla, Mr. Lyan—a professional moniker for Ryan Chetiyawardana—is another food visionary. Mr. Lyan was crowned world’s best bartender in 2015, and his bar Dandelyan, now reopened as Lyaness, was named the world’s best bar in 2018. He’s known for experimenting with “closed loop cocktails”—any waste from the production of these drinks is used as ingredients for future drinks. For instance, he pressure-cooks leftover citrus and uses the resulting flavorful stock to create fruit jelly desserts. He doesn’t stop at fruit: Mr. Lyan even boils down cardboard delivery boxes with lemongrass, chamomile, sugar, and water, then strains it and turns it into a syrup. “People saw it as an affront,” he tells us. “So much of what we faced was this idea that the world that we were inhabiting—you know, luxury food and drink—was at odds with the idea of sustainability.” (Until, of course, a restaurant critic said that the drinks were the best he’d ever had in the city.)

Nearly a year before we found ourselves professing our love to baby kelps, we were carpooling home from IDEO’s San Francisco studio to our homes in Oakland. As our conversation quite naturally ping-ponged from an upcoming CSA delivery to methane-producing cow burps to Indigenous agriculture to aquafaba (a chickpea byproduct) to workers’ rights, a creative lightbulb went off. And the idea for Food by Design was born.

We wanted to connect the dots across all these topics and better understand the potential opportunities for design. So we set out to explore the question: How might we build a climate-positive food system that favors the many instead of the few? We hope the array of voices and stories shared on Food by Design not only demonstrate the breadth, interconnectedness, and gaps of the food system, but just how many people depend on it being sustainably and equitably redesigned, and can help us do this, together. Listen to some of their stories today on Apple Podcasts, Spotify, or wherever you tune into your podcasts.

On a chilly December morning, Bri Warner gave us a tour of her kelp facility in Saco, Maine. The room was filled with giant tanks of seawater containing thousands of baby kelps. “We change their tanks constantly,” said Bri. “We play them music. When nobody's looking, I'll lean over and be like, ‘Hi, babies.’” On another occasion, we spent an entire afternoon chatting up Larisa Jacobson of Soul Fire Farm, a BIPOC-centered community farm committed to ending racism and injustice in the food system.

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.