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.

My “partner” that day was a technology called GPT-3 from OpenAI. You may have heard of it already; if not, you can think of GPT-3 as a really good autocomplete. Like, shockingly good. Once I shared some of the output of my brainstorm with others on Slack, there were plenty of 🤯reactions—and honestly, our minds are still blown. But clients and design teams will need to tread carefully and watch their ethical compass as they imagine inspiring, human-centered applications for this new tool. As with any new technology, there are new risks to account for. Here's how I started my experimentation.

How to run a virtual brainstorm

In order to work with a so-called “transformer model” such as GPT-3, you feed it a pre-written prompt, then the model uses everything it's seen before (in this case, a substantial portion of the internet) to guess what should come next.

I wrote some context: This is an IDEO brainstorm, which follows our 7 Rules of Brainstorming, including “encourage wild ideas.” I gave GPT-3 a real client challenge from a past project: The team is developing a new app for a bank to encourage millennials to better utilize savings accounts. Then I wrote a brainstorm prompt: How might we help young people turn saving money into a lifelong habit?—and fed it five example ideas.

As soon as I pressed submit, the model began churning out new ideas. Not all of them were gold, but many were perfectly good brainstorm concepts. After all, the rules also tell us to “defer judgment” and “go for quantity.” Without cherry-picking too much, here's a sample of some of the ideas it generated:

• Allow the user to share their saving goals with friends and have a community of people who will cheer them on or challenge them if necessary
• Reward the user with real money if they don't spend money at all in a month
• Allow the user to set up “fun budgets” (aka “triggers”) to save more money, e.g. whenever they go to Target, they'd get a pop-up asking if they'd like to put $5 towards savings
• Similar to the Future View idea, show how much more could be saved if the user decides to forgo a coffee every day or splurge on new sneakers instead of taking an extra vacation

In the last example, you can even see the model “build on the ideas of others”—another rule of brainstorming—by riffing on an idea called Future View that I had given in the prompt.

This stuff is on par or better than some of what I've seen from humans. Some [of it] is worse, too. But that anything is better is wild.

An IDEO Director on GPT-3's brainstorming output. Watch out, humans.

Another colleague suggested we tweak the prompt we gave GPT-3 to encourage it to use analogous inspiration, which primed the model to produce some truly wild ideas:

• Have “clowns” jump out of ATM's, making it less fun to withdraw money
• Create a virtual reality experience where users are in an arena full of savings monsters, and need to slay them by depositing money into savings
• Create a “Savings Monster” similar to those featured on Chinese lottery shows where viewers have to guess the amount saved in order to win money

“I'd love to know what a Savings Monster is,” I mused on Slack, and a colleague responded, “Why don't you ask it?” Of course! After the brainstorm, I started a Q&A session with the model (my prompt is in bold):

Q: Quick question: What exactly is a savings monster? You mentioned it twice.

A: I'm glad you asked! This was just an idea that emerged from the brainstorm. A savings monster is a physical manifestation of your savings goal. For example, let's say I want to save $500 by the end of next year. If I deposit $10 every day, that will get me pretty close to my goal at the end of the year, but what happens if one day I don't have $10? Now my savings monster is underfed, and he starts to throw a tantrum (eg. negative cash flow notification).

A: Yes, this is an idea inspired by Chinese lottery shows (and World War Z). We thought it might be fun for users to have a physical manifestation of their goals that they could feed (ie. save more money) when they meet their goals, and starve (ie. spend more money) when they fall short. In order for this idea to work however, the savings monster would have to be very cute, and a bit terrifying.

As it turns out, the model doesn't skip a beat when you change up the input’s format. So I decided to try my luck: In my next prompt, I asked GPT-3 to choose its favorite idea from the brainstorm and create a script for a promo video. Thankfully my virtual brainstorm partner selected the Savings Monster concept. The resulting script was so good that I found an animator to bring it to life.

So what is this good for?

As exciting as this technology is, GPT-3 is not Artificial General Intelligence, and it was interesting to find the edges of its abilities. For example, this model can easily summarize a news article, or turn it into a fairy tale. But it's surprisingly difficult to get it to remove references to a specific person, or change the subject of a certain paragraph.

To put this in human-centered design terms, these large transformers are an extremely valuable way to augment the team during divergent moments in a project, when we're creating choices. The tech struggles, however, in convergent moments, when we're making choices. Thankfully, humans are still required to synthesize massive amounts of information about human needs into concrete human-centered design decisions.

Gotchas

There are two other issues we have to confront when considering transformer models for our prototypes and design recommendations: toxicity and bias. These models are trained on big chunks of the internet, and optimized to produce output that looks like the input. The result is that the model can reproduce the language of a scientific paper just as easily as it can mimic an internet troll. You get the good with the bad.

My experiments sparked a conversation with Jess Freaner, an IDEO Data Scientist with a special interest in ethics and AI. “Though the rules governing how it all works might not be explicitly written on the wall,” Jess told me, “being a product of our world as it exists now and in our past (the internet is an excellent, incomplete archive) we need to consider what GPT-3 reinforces and when it can reveal what needs to be subverted about society.”

Problems with toxicity and bias are not unique to GPT-3. OpenAI is working on both—they have built-in tools to manually and automatically flag output as toxic. They’re also working on the issue of bias, but it’s a thornier problem. These models literally encode a snapshot in time, and are inherently biased to reproduce the status quo. Companies and designers will need to question and problematize the output of these models with the same rigor that we are learning to bring to our human interactions.

Future possibilities

Despite the challenges, it's clear that in the past 12 months, natural language models have crossed an invisible threshold of usefulness, in the same way that speech recognition was frustratingly terrible for decades—until one day it wasn't. Early proof of concept prototypes demonstrate how this type of model can transform a description of an interface into functional UI code. Talk about “declarative programming.” Imagine a future in which the job of a UI designer is to write a description of the interface rather than laying out each button and label by hand. The same description might result in totally different visual expressions or interactions depending on the individual user's needs, interests, or current context.

As transformer models improve, I'm inspired by a future where people are literally in conversation with their software. Users might be able to easily adapt the same app to become a widget in their AR glasses, a quirky voice assistant, or an animated character. Because who knows: for some people, the perfect solution just might be a Savings Monster.

Illustrations by Katie Kirk

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Back in early August, I opened my laptop and kicked off a remote brainstorm. Immediately, my partner started generating a huge number of ideas—a perfect blend of wild, hilarious ideas and pragmatic solutions. That's not unusual at IDEO, but what made it remarkable is that my partner wasn't just remote—it wasn’t human at all.

In 2020, everything has been turned upside-down, and all budgets are starting from scratch. Planning for the coming year will be more ambiguous and uncertain than ever. It’s time to ditch the carry-over mindset, which can’t solve the complex and often competing challenges faced by business leaders today. What we need now is to broaden our perspectives and use imagination to project into the future.

Back in the spring, when it became clear that coronavirus would reshape the entire world in short order, we began tracking principles to help us focus on understanding context as it evolves, having a clear vision for successful recovery, rebuilding for resilience, and designing through collaboration.

As we spoke to clients and business leaders within and outside of IDEO, we saw the opportunity to develop a tool that would help leaders plan with imagination for the tumultuous road ahead. We were inspired by the Early Recovery principles used by the United Nations to respond to crises or natural disasters. Early Recovery helps people and societies "build resilience and establish a sustainable process of recovery from crisis."

We’ve adapted this concept into a framework for organizations to use in planning the coming 12 months. The Build Back Bolder canvas offers a simple template for reflection, and a series of short exercises designed to help set strategic priorities and initiatives, and to uncover opportunities for growth and impact in the midst of fluctuating conditions. Build Back Bolder is a straightforward, two-page tool that business leaders can run alongside their own planning processes. It can help leaders and teams make sense of the present, get out of analysis-paralysis, and move towards action. Simply put, the Build Back Bolder canvas helps you think, and that helps you plan.

Circumstances don’t get much more ambiguous and uncertain than the ones we’re living through now. In moments of crisis, when markets are redefined, imagination rarely leads the day. But this instability calls for a more varied and experimental suite of tools. Change is inevitable, but using imagination is not. By choosing an imaginative approach, we can plan for a more resilient, bold, and sustainable 2021.

Download the Building Back a Bolder 2021 tool here.

Illustration by Charlota Blunarova

In typical years, there’s a continuity to the annual planning process. Changes are incremental. Many budgets that were approved the previous year are simply carried over. Not so this year.

To fix big, systemic problems like inequality and climate change, many called for rethinking how companies generate value and who they generate it for—from shareholders, employees, and customers to partners and the planet itself. This wasn’t just a moral argument that business ought to “do the right thing.” The movement was anchored in an existential understanding that radical forces are changing not just the rules of the game for business, but the game itself.

The multilayered crises we face today offer a powerful moment of reckoning for purpose-led businesses and leaders: will we make good on this rallying cry for a reimagined capitalism or not? The pandemic put stakeholder capitalism to the test: a report funded by the Ford Foundation found that companies that had signed on to the “Statement on the Purpose of a Corporation” fared no better than other top companies in prioritizing worker rights. Though there is clearly the opportunity and will to rethink the purpose of business to address systemic problems, the way forward is often less apparent. Understanding where to begin can help us realize the more equitable promise of stakeholder capitalism.

I’ve long been curious about how forward-looking companies have jumped over this hurdle, so I’ve spent this year learning from dozens of movers and shakers already in the thick of tackling systemic changes, from professors and CEOs to founders and non-profit presidents working across sectors and industries. They’ve shared with me the first steps that helped them break the initial inertia of business-as-usual—and, importantly, the mindsets they’ve adopted to sustain new kinds of activity. I hope their wisdom will be as inspiring for you as it has been for me.

First steps

Set bold targets and innovate your way to reaching them
Even if they don’t know where to start, the changemakers I’ve talked with have put a stake in the ground and set bold targets. But they don’t rely on a big PR splash and then move on: alongside these bold goals is a commitment to a process of brave experimentation and innovation.

The Swedish furniture retailer IKEA, for example, has committed to becoming a fully circular company—one that is restorative and regenerative by design—by 2030. To make good on this future, they’ve invested in a range of experiments, prototyping smaller-format shops in city centers that rely on fewer resources, electric vehicles for home delivery, new products like home solar systems, and buyback and rental programs to reduce waste, among others. Taken together, these many activities are moving IKEA closer to their ambitious goal. But they’ve also enabled fast learning and iteration, so that when the company chooses to scale any of these solutions they have the greatest impact for their investment.

From this example and others, a common method is emerging for how companies can use their scale to unlock change at a systems level: commit boldly to an outcome, design a number of experiments, learn and iterate quickly, and scale what works. Spoiler alert: It’s not going to be one thing.

Create a coalition of partners around a tipping-point problem
From homelessness to climate injustice, our challenges demand unprecedented collaboration across sectors. The UN Sustainable Development Goals provide a powerful framework to rally around, but there are other emerging partnership models that leverage the capital investment, innovation muscle, and ability to scale that corporate partners often uniquely bring to the table.

Take the NextGen Consortium, for example. Managed by Closed Loop Partners and powered by OpenIDEO, some of the most powerful food and beverage companies (including Starbucks, McDonald’s, Wendy’s, the Coca-Cola Company, Yum! Brands, Nestlé, and WWF) are collaborating to create a new cup that will curb the 250 billion fiber cups piling up in landfills each year. The approach of this coalition has been to enable many breakthrough solutions, working directly with founders and stakeholders in the system, to take root in the market.

There are many other examples of convenings—whether official or unofficial—and the power of rallying partners around a shared challenge. Founded by Sam Polk, Everytable is on a mission to bring healthy, affordable food to communities that do not have readily available options. Polk grew Everytable to eight locations and delivered 160,000 meals just a few weeks after launching. Through a philanthropic initiative led by the California government, Everytable partnered with a hotel offering shelter and protection to the homeless during COVID to provide food, eventually facilitating additional partnerships with elder care homes. Everytable is now on track to deliver a million and a half meals, and they’ve added jobs along the way. As Jacqueline Novogratz, CEO of Acumen, shared with me, this is an example of business, government, philanthropy, and individual volunteers, leaders, and donors uniting and busting siloes to address hunger.

Define key performance indicators (KPIs) for stakeholder groups
Despite its recent buzziness, the stakeholder perspective—a fundamental commitment to all stakeholders, including customers, employees, suppliers, communities, and shareholders—is not a new idea. Many companies already consider multiple stakeholder interests in their decision-making. But the problem with stakeholder capitalism as it exists today is that it doesn’t offer a clear compass for how to make decisions in complex scenarios where win-win outcomes for all parties are rarely possible. This brings us to the elephant in the room: not all stakeholders are created equal. Leaders are often forced to pick favorites, and at the end of the day, we know who will always win.

To address this, companies like Airbnb are beginning to hold themselves accountable to new stakeholder-centric metrics. Airbnb sees their stakeholder community as made up of guests, hosts, communities, shareholders, and employees. Their design challenge—Rob Chestnut, Airbnb’s Chief Ethics Officer, told me—was to create a company that measures itself against the value it creates for each. Airbnb began by listening to these groups, establishing principles and metrics reflecting the needs of each. For example, they have committed to treating hosts like partners, and measure their delivery of this through survey data evaluating hosts’ satisfaction and earnings over time, among other things. Airbnb reports their progress and continues to update their corporate governance and compensation to reflect delivery against these KPIs.

This approach isn’t perfect. But doing the work of measuring the value you create with and for stakeholders and institutionalizing accountabilities for delivering that value is certainly a step in the right direction.

New mindsets

Allies over heroes
When it comes to business’ role in the big problems society faces, they are often cast as either heroes or villains. Some see capitalism as society’s savior, especially when governments have seemingly abdicated their responsibility to serve citizens’ best interests. Others see capitalism as society’s villain, the cause of many of its major problems like climate change and inequality.

The leaders I’ve interviewed reframe the discourse entirely. They know that systems change requires bringing together key actors—local communities, nonprofits, governments, businesses, donors, and others—to address unjust systems and solve social problems at scale. So, they see their organizations as meaningful allies in the work of change-making, adopting a partnership-as-leadership approach to their engagement in these issues.

“Greyston’s founder Bernie literally started pulling people off the streets to work for a small cake-baking business he had started to address the problems he saw in Southwest Yonkers...Just as the bakery started growing, [Greyston’s founder] Bernie met two guys named Ben and Jerry. Our relationship with Ben & Jerry’s started out as a serendipitous one, but it’s held steadfast as a strong partnership over the years and has enabled us to employ more folks who would normally be deemed excludable, non-employable.”
—Joseph Kenner, President and CEO, Greyston Bakery

“Cooperation among investors is a key to this progress. More than a third of the world’s invested capital—about $19 trillion—is controlled by the world’s hundred largest asset owners…In principle these investors have enormous power to move the entire economy in more sustainable directions. All they have to do is find a way to cooperate...The rumor is that they look at each other and say, “You go first.”
—Rebecca Henderson, Professor, Harvard Business School and author of Reimagining Capitalism in a World on Fire

Gardeners over architects
As the pandemic unevenly distributes pain and suffering across our society, it’s ever more clear: true systemic change requires a shift in power. That means that a top-down approach to change just won’t work to produce the equitable outcomes we need. We need new voices with new ideas to reimagine our economic system. Personally, I’m inspired by the small business owners who have reimagined the role businesses might play in neighborhoods through creative pivoting—like restaurants now offering CSA boxes and large family meals while their dining rooms are closed. Or Black communities that were forced to develop regenerative economic strategies decades ago, long before these concepts penetrated white-dominated corporate worlds.

These are the imagineers of a more resilient, inclusive, and sustainable society for everyone, and the leaders I’ve learned from believe this, too. Their job, as they see it, is to find the seeds of ideas and nurture them. They play the role of gardener, but instead of a green thumb they have a green ear, tuned to listen and learn.

“We were open to new ideas from anywhere and created new mechanisms to source them. Part of our mantra was the conviction that all the good thinking doesn't come only from people sitting on Fifth Avenue in New York City. We ran competitions, we did global innovation challenges, and we learned a lot from what was going on on the ground.”
—Judith Rodin, Former President, The Rockefeller Foundation

“Purpose is obviously about how a company acts, but it’s also about how they listen.”
—Maryam Banikarim, Chief Marketing Officer, Nextdoor

“And so it's going to be up to the rest of us in the conversation to hold those people’s feet to the fire—to make sure that as we are reimagining capitalism we are reimagining it to actually work for all. And part of that is by creating systems that are actually inclusive and equitable and regenerative because only those things will dismantle a version of capitalism that is just for the elite.”
—Andrew Kassoy, Co-founder and Global CEO, B Lab

An audacious question over an assumption about the answer
Rather than start with an assumption about the right solution, these leaders begin with an audacious question. What, for example, would it look like to be a fully carbon neutral company by 2030, asks IKEA? Melinda Gates’ Pivotal Ventures asks what would a future look like if women’s power and influence was equal to that of men?

By starting with a question instead of an answer, these individuals are searching for far more imaginative solutions. This is how radical breakthroughs happen.

“Business has a huge role to play in designing our future. They can do this by first, stepping back and asking, what are the problems that need to be solved? And how can we make that the purpose of our business? Start with that problem. Then, look at the different stakeholders you engage with and rethink how we might come together around that problem...This is moral imagination—the humility to see the world as it is and the audacity to imagine what it could be.”
—Jacqueline Novogratz, Acumen’s CEO

“For the big briefs we face, we need questions that open up new possibility. We don't need the obvious questions — we’ve got plenty of those. We need questions that reframe how we think about some of these systems, ones that change our perspective.”
—Tim Brown, Chair and former CEO, IDEO

The work of changing systems is hard. Taking any of these first steps might require you to flex new muscles, fit yourself into a mold that isn’t quite perfect, or develop new collaborations that might not go seamlessly. Likewise, adopting any of these mindsets might clash with your business-as-usual culture and process. It’s not for the faint of heart. And yet, we can’t move forward—on equity, on the environment, on social cohesion—unless we roll up our sleeves, start redesigning our organizations, and make room for the voices most affected by these systems. So let’s take some first steps, and prototype them together to help push this work forward.

Before the coronavirus pandemic, the promise of a reimagined purpose for business—one that serves a diverse set of stakeholders and society more broadly—had bubbled into mainstream industry discourse. From boardrooms to business schools, a growing chorus argued that our economic system is not only unable to respond to the world’s most urgent challenges, but has excluded many people from the prosperity capitalism promises.

Well, not complete strangers. They had shared an unusual experience, designed by IDEO, over the previous five weeks: The Department of Super Secrets.

When COVID-19 shut down elementary school buildings, it shut down opportunities for young students to build soft skills like empathy. It also severed personal contact between seniors and other human beings, leaving many confined and lonely.

Alongside teachers and students at Mineola Union Free School District in Mineola, New York, IDEO took on a project to design a program that would help 4th graders build empathy by connecting idle students with isolated seniors. We thought it would be a simple, playful opportunity, but in the end, we found a powerful tool for connection that might be scaled to bridge any number of social divides.

What’s the key? Well, that’s a secret.

Connections grown in isolation

The IDEO team decided that instead of trying to compensate for the limitations of quarantine, we would embrace those constraints and make them the centerpiece of the experience.

People can’t meet face-to-face? Perfect. We’ll beat quarantine at its own game. Neither partner will know anything about the other. No names, no ages. They’d have no clue about the other’s most basic biographical information, like age, race, gender; instead, this would simply be two human beings building a connection by sharing stories of their hopes and fears. A relationship built on meaning rather than appearance.

Thus, the Department of Super Secrets was born—an IDEO twist on the pen-pal relationship. Our heroes picked secret super aliases and we paired them up: one student with one senior citizen. Over five weeks, the partners were prompted to share five specific secrets designed to be low stakes, but highly personal, carefully crafted to spotlight character, values, and feelings. This was a delicate tightrope walk, asking them to offer up something meaningful without being invasive or uncomfortable. We designed the prompts to build on each other, gently establishing a bond through vulnerability and reflection.

Every secret was shared in two ways, with words and images. We wanted the partners to spend energy reflecting on their own lives so they could benefit as much from the telling as the receiving.

You know what was so wonderful about it—I had been cheated all these years not remembering that image of my brother and I playing under the table. I wouldn’t have [remembered it] if we didn’t do this.

MARVELOUS MUSEUM MAVEN, SUPER SECRET SENIOR

The secrets were exchanged through actual mail, not email. This slower method gave the partners time to explore their memories, express themselves deliberately, and—in a situation where days begin to blend—gave them something to look forward to. The tactility of cards filled with handwritten words and pictures turned them into a gift; it made the receiver a caretaker, safeguarding moments of someone else’s life.

Friendship across distance and decades

We wanted our participants to build a connection, not just exchange information. This was not about grown-ups humoring kids, or kids humoring grown-ups—this was about two experiences at either end of a spectrum, sharing a window into their point of view.

As part of the final exchange, each partner used what they’d learned about the other to create and send a gift to their anonymous pal: a superhero mask based on the shared secrets. And then the Department of Super Secrets hosted a reveal party. Partners came together on a video call, each wearing their newly gifted masks. Although they had been exchanging stories for weeks, this was the first time they saw the face behind the feelings. This was the first time Super Potato met Fantastic Fixer, and it was lovely.

Visit the Department of Super Secrets to meet the 4th graders and senior citizens behind the masks

Before and after their experience, we asked the partners to answer a few questions meant to gauge their empathy. Turns out the numbers support the anecdotes: Their time with the Department of Super Secrets seems to have genuinely increased their empathy scores, especially their ability to put themselves in someone else’s shoes.

So what went right? We built the Department of Super Secrets by combining three key elements:

1. Anonymity: character vs. characteristics

No one in the world is more perfect for you than the mysterious stranger sitting alone in the coffee shop. The less we know about someone, the easier it is to dress them up and see them exactly as we wish. That’s why we sidestepped the introductions, the descriptions of hair color, and the family history. We wanted each side to begin by speaking across the mysterious absence created by anonymity to someone they assumed was a kindred spirit, ready and excited to connect.

We’ve all seen enough awkward hugs and pinched cheeks between kids and elderly relatives to know these two groups don’t always dance to the same beat. If the relationship began with the mental shorthand of “old” and “young,” there would be silent assumptions on both sides. Confirmation bias would run wild.

We used the freedom of anonymity to create rapport so partners would speak their truth honestly without tailoring it to their audience.

2. Story: introductions from the inside out

My name Is Ben. I once had my heart broken.

Which of those two offerings is more likely to create a bond between us? Ironically, the things that shape us most distinctly—our stories—are also the things most of us have in common. At the very core, we all share the same stories, but told in our own unique ways. Your parents may not have named you Ben, but you probably know what it is to cry into your pillow.

We used story as a sneaky back door to help Super Secret partners appreciate each other's identities once we dropped the anonymity. By the reveal party, they had connected enough through the shared stories that when they discovered each other’s identity, it enriched their idea of who a young or old person could be.

3. Play: lighten the mood, deepen the conversation

As I’ve written elsewhere, play is powerful. It lowers the bar for self-judgment; it can function like oven mitts for handling sensitive subjects; it can encourage us to stretch our everyday thinking and see possibilities we might have otherwise missed. Fun is a fuel.

We could have said, Hey, this is a school project to build empathy. Bo-ring. Instead, we led with the language of secrets, superheroes, and surprise to elevate it to something memorable, meaningful, magical.

Play allowed the partners to share vulnerable stories in a safe way. One prompt—"Share the secret of your most embarrassing moment"—became a funny way of sharing values, fears, and anxieties. Because underneath the slipped bathing suits or milk-spewing nose is the nature of what you find embarrassing, and that tells a lot about a person. Is it failure? Public or individual? Loss of control? Misunderstanding? Fear itself?

Sharing a moment you wish had never happened is an act of trust and bravery. Receiving someone else’s story is a way to remember you are not alone in the world as a flawed human being.

Play allows you to do both with a smile.

The next adventure…?

While this began as a way to enrich the lives of kids and seniors, it turned out to be a powerful way of sneaking behind the unrecognized biases, the mental shortcuts that are the unacknowledged guardrails of our day-to-day thinking. What if we expanded the experience to bridge other divergent points of view related to politics, race, economics, gender, geography, or religion?

We’d love to find situations to use the Department of Super Secrets to help people hear each other in a new way. Our hope is that this combination of anonymity, story, and play can help any two strangers find common ground whether they be superdelegates or super potatoes.

*Names and details have been changed to protect secret identities

When Super Potato* met Fantastic Fixer* for the first time, she asked if Fantastic Fixer’s puppy was feeling better. Fantastic Fixer wanted to know about Super Potato’s recent birthday. There were no awkward silences, despite the fact that Super Potato was nine and Fantastic Fixer was closer to 79 and they were, until this very moment, strangers.

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.