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.

Six months ago, Dawn announced she’d step down from Planned Parenthood, having successfully helped transition the organization from the leadership of long-time president, Cecile Richards. Instead of hurling herself straight into leading at another large organization, Dawn decided to dedicate a year to experimentation and discovery as expert-in-residence at IDEO.

Dawn is now working with teams across IDEO and IDEO.org to find new ways to catalyze change. In particular, she wants to uncover how best to use data and technology to improve service delivery and support movement-building. Coming to IDEO, she says, “I saw an opportunity to ask, How do we use human-centered design principles, entrepreneurship, and data and technology to transform how we are reaching people and working alongside them?”

Not one to be daunted by ambitious goals, the first official project Dawn is helping to launch is The Billion Girls CoLab—an initiative aimed at harnessing new coalitions and diverse expertise to develop innovative solutions that will support young women’s power and health worldwide. This joint effort between IDEO.org and IDEO CoLab will bring together cross-sector collaborators to think about reproductive health in new ways. Dawn sees this work as a chance to create impact at scale, but also as a means to continue empowering others to become leaders.

“I think established leaders are afraid to leave their roles and what they know,” Dawn reflected recently. “But if we're talking about diversity, equity, and inclusion, some of us who have been privileged to lead—especially as leaders of a certain age—have a real opportunity to move and make space and build up a cadre of new leaders. They need room to lead.” It can be scary, she acknowledges, “but you just have to say to yourself, ‘Well, I'm going to step off this diving board into the unknown, and what can I report back from the other side?’”

Dawn sat down with Whitney Mortimer, IDEO CMO and partner, to talk about what the other side is like, how her perspectives on creative leadership are evolving, and what she hopes to build in the near term to support a healthy, empowered generation of future leaders.

Whitney: Let’s begin with the work you’re doing with CoLab, where you’ve been deeply immersed. You’ve said that the CoLab model, which brings disparate groups and experts together to collaboratively solve problems, aligns well with your vision of how to work better on women’s health.

Dawn: We’re building a cohort that is not just people in the sexual and reproductive health field, but also others who are thinking about adolescent girls from very different perspectives and industries, including the for-profit corporations. The idea is a cohort that is domestic and global, which is something kind of new for the sexual and reproductive health ecosystem. We’re trying to catalyze a very different kind of conversation and output, researching and designing in close collaboration and asking what would it look like to build something that unlocks the power of a billion girls who are coming to adolescence around the globe over the coming decade? And what would that change for our world?

[When I was at Planned Parenthood], as much as we all tried to promote that kind of ‘fail-fast’ culture, we mostly lived in a fail-never culture, because the stakes were so high. And yet we know we’re going to have to experiment some to figure out what is going to catapult us to the next level.

Whitney: How is this approach to work different from how you were working before?

Dawn: I have to constantly remind myself, it's only been six months since I left [Planned Parenthood]. I really had to learn to live without a grenade as my metronome. Our days were so driven by constant distractions and firefights, even though I feel like we made real progress and built real things. So now [at IDEO] I’m gaining a different way to approach problems—to step back and have time to be more thoughtful. I'm more convinced than ever that this is not just a narrow fight. We now clearly have a global set of forces at play.

Whitney: You've always been clear with everybody that what got us here won't save us—we have to be looking ahead to the next thing. You're sitting on that horizon now, asking how does technology and everything we're learning about healthcare play out in a world that has such unequal access? As a creative leader, what do you need? What helps you shape something completely new, as opposed to just wanting to fall back into the matrix of an organization that already exists and will tell you what its priorities are every single minute of every day?

Dawn: Many people called me in the days after I announced and said, ‘Hey, do you want to apply for this job? Can we put you forward for that?’ They were all amazing opportunities, many in the progressive health and rights arena. It was hard to resist going to another similar operation, because of the urgency and the real difference that those organizations are making in this moment. But that urgency can get in the way of stepping back and thinking differently about how to work most effectively. [When I was at Planned Parenthood], as much as we all tried to promote that kind of ‘fail-fast’ culture, we mostly lived in a fail-never culture, because the stakes were so high. And yet we know we’re going to have to experiment some to figure out what is going to catapult us to the next level.

Whitney: Something that you do very naturally and fluidly, is you find analogous examples out in the world that makes sense inside your world. I'm wondering, as you look at scaling something new, what other kinds of methods or mindsets from the designer's toolkit are you able to tap into?

Dawn: There are just these amazing ways to step back and actually use a designer’s approach to think about how companies, organizations, movements could actually be building and thinking more about the early and upstream inputs to get the outputs we want to see later.

With a designer’s mindset, we would ask how to more thoughtfully shape the waves of cultural nurture that will carry these generations to the shores of the future.

Recently I’ve been thinking a lot about nature versus nurture. And then I jumped to this bigger idea with the folks at IDEO, thinking about the idea of cultural nurture: What larger cultural wave was I riding that I couldn't see then, but which shaped me—and not just me, but a generation of people?

For example, when I was in third grade, I started a student council because the playground rules were unfair to girls. Exactly around that same time was when Title IX passed. All of a sudden there was a mandate for equality in education—in sports in particular—for girls. I benefited from that immediately but I could not see the profound impact it would have. I would have been radically different had I not been told, “You get to play basketball. You get to run for whatever school office.”

I think about how powerful those forces are, and yet we don't respond to them and leverage them as well as we could. With a designer’s mindset, we would ask how to more thoughtfully shape the waves of cultural nurture that will carry these generations to the shores of the future.

Whitney: Can you see those moments now that are shaping the next generation?

Dawn: I'm thinking about it a lot around the climate and depletion of the planet, with younger people getting messages both of fear, and also of preciousness. We're also looking at stigma. There is a lot of exciting shame-busting going on in the culture right now, which of course is why I think there's so much pushback in our politics.

Whitney: How has your identity and orientation as a leader shifted? How does that alter your sense of your capacity and what you need in order to have the impact you want to see?

Dawn: As they say in IDEO fashion, I'm diverging before converging. What I have tried to do is not converge on a solution or direction too quickly, because by nature that would be what I’d do—solve the problem as quickly as possible. In my previous life you could not sit around and admire the problem for very long. But I’m learning to be in love with the problem for a bit longer. I’m asking, can data and technology unlock a different paradigm of care? Is it stigma or rights or both that are foundational to solving the problem of abortion access? And what is it that I’m best equipped to do and help lead people toward?

Whitney: When you were at Planned Parenthood, you were early to see the potential, say, to use VR as an engagement and empathy-building tool. What technologies are you seeing as most critical and exciting now, as you're exploring what will be the new paradigm for reproductive health and healthcare?

Dawn: Well, I know augmented intelligence is the phrase of the year, but it really does have amazing potential. For example, take the idea of personalized prescribing and apply that to contraception. We know contraception is a game-changer, a life-changer, a life-saver. But we also know that when people get hormonal contraception, some people are going to have side effects. That means they’re either not going to keep using it or they’re going to want to switch. And that’s when there is more risk of getting pregnant. Imagine if we could harness AI to look across all of the prescription data sets and provide doctors with the tools to better match individuals with the product or formulation that suits them best. What if you could, by orders of magnitude, improve the ability of women to get a prescription or method of their choice that works for them right from the get go? That’s one example of how we might use new capabilities to create impact at scale.

Whitney: With the political climate being what it is, and an election on the horizon with unknown outcomes, how do you think about the challenge of something like improving access to and adherence to contraception or of empowering a billion girls around the world, irrespective of what may happen politically in the US and elsewhere?

Dawn: The one thing I 100% believe is you can’t think of anything completely outside of politics. It's just so clear what a powerful shaping force politics and government policy are. At the same time, there is a narrowness to the political lens. And when you start to think of these other actors and other ecosystems, you realize there's a lot that is possible—there’s potential to organize, to employ tools we're not fully utilizing. Part of what I want to do now is build out the progressive toolbox so that we're able to better work over or under or around the political obstacles, even while we recognize they cannot be ignored. The CoLab model has a lot to offer in leveraging many sectors and approaches and drawing them together to power solutions.

Whitney: What is the role of brand in that scenario?

Dawn: I actually think it is very important—not to create a name or brand a product, not that kind of thing—but the idea that we could use the principles of brand to communicate the power of girls to change the world. The idea that we can impress upon people the importance of raising up generations of girls, giving them the tools and the freedom to make their mark. That, I think, is something we need to capture and tell to the world.

We have to do everything we can to connect girls and to empower them and to make room for them. We have to get over some of our false distinctions and start to help them see that there’s a kind of global sisterhood that’s powerful, and that they have the opportunity to save the planet. That’s the small task we're going to hand off to them.

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When Dawn Laguens looks back on her eight years leading brand and public strategy at Planned Parenthood Federation of America, she describes a typical work day as “catch grenade, throw grenade back, run two steps forward.” To be sure, the years from 2010-2018 were eventful for everyone, and particularly for people like Dawn, who were on the front lines of vicious political conflicts, while simultaneously doing the daily work of advocating for accessible and effective healthcare solutions for women worldwide.

Spring in London vibrates with the tweeting of birds and the drilling of construction excavators. It’s a surreal symphony of nature and gentrification.

I was late for work and speeding up my usual way when I got detoured by a few meters of plastic barrier. As I walked around the construction equipment, I heard one worker shout to another.

"I'll pick up my gloves and be right back," he said. He walked by me and leaned towards a hole in the temporary barrier where his gloves were neatly stored.

"Excuse me," I started with my typical nosey flair. "Why do you keep your gloves in there?" He must have a locker, I thought to myself, or even a pocket where to store them on site.

"I work on different areas of the site,” he said, “and I need different gloves based on the job. These barriers crack very easily, so they provide the perfect storage space when I need it and where I need it."

As I looked at his hiding spot, I thought about designing for the end of life of products, like construction barriers, mailboxes, and or a simple shoebox. It was the first time I considered the new use cases that can come from deterioration and change.

As he walked away, he smiled tightly; I had acknowledged his hidden creative side.

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Human-centered design requires us to observe human behavior with beginner's eyes, so that we can spot the innate ways people interact with the world around them. We call these intuitive and unconscious reactions Thoughtless Acts, and IDEO designers collect photos of them to inspire their work.

1. What a Computer Learns From Watching Hours of Cartoons

Find out what happened when an IDEO CoLab designer tried training a neural network to generate its own cartoons—and what he learned about the danger of bias in training data. Read the story!

2. Inviting Algorithms to the Design Team

Your future design partner may be an algorithm. Here’s what emerged from an experimental collaboration between a graphic designer, a data scientist, and an algorithm. Read the story!

3. To Design a Better Future, Embrace the Uncomfortable

How can we explore the future of technology? By prototyping it. Check out the 5 near-future concepts that came out of a new IDEO exploration called The Discomfort Zone. Read the story!

4. No Beards Allowed: Exploring Bias in Facial Recognition AI

One IDEO designer created a facial recognition AI game that helps users understand how machine learning models are trained—and subtly hints at the areas where bias could creep in. Read the story!

5. We Built a Bot to Assign Parking Spots. It Fought Back.

When IDEO Cambridge moved into a new studio with a too-small parking lot, they built a bot to manage traffic... but the bot fought back. Here’s what this rogue AI taught the team about “raising” a bot—and how they tamed it. Read the story!

Bonus: Check out the follow-up post where a design researcher explores how his colleagues' interactions with the bot signaled shifts in studio culture.

6. Training a Computer to Find Shapes in the Clouds

The average 25-to-34-year-old only spends 13 minutes a day relaxing. Here’s what happened when one IDEO intern tried "outsourcing" some of her leisure time to a computer. Read the story!

7. What the AI Products of Tomorrow Might Look Like

How can designers leverage the power of AI to build a better future? To explore this question, we created an award-winning speculative design exhibition called HyperHuman. Read the story!

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As designers, we help build the future we want to see. So when a new technology emerges, we're always eager to take it for a test run, push its edges, and see how it fits into visions of the future. When it comes to AI, the opportunities are endless, but the stakes are high—our work can have serious implications that affect the lives of real people at unprecedented scale. Designers at IDEO are constantly working on cutting-edge experiments that explore the possibilities—and potential pitfalls—of a future where humans and machines are ever more entangled. Read on to explore a few of those experiments and the lessons we’ve learned along the way.

But the painful reality is that most corporations don’t enjoy the conditions necessary to enable true startup behaviors. The DNA of a large, established business looks far different than that of a fledgling company. And just like with actual startups, creating new ventures is hard, risky, and doesn’t always pan out.

So how, exactly, can you design the conditions for success?

If you have a big company’s DNA, you need to catalyze strategic changes—small mutations that make it possible for a startup model and mindset to thrive inside a much different species. Sometimes, it happens naturally. If a legacy company hits an acute adapt-or-die moment, there’s no choice but to change (à la Netflix or Microsoft). But for companies where transformation is inevitable but not immediate, it’s entirely possible to engineer the conditions that generate pressure for a controlled shift. Here are three ways senior management can provoke the conditions for success.

1. Question your business model

Many legacy companies have been successful because they’ve focused on their core business, while many startups have flourished by routinely abandoning theirs. The key is to do both: Keep the core business running while a new venture pursues something entirely different.

Recently, American Family Insurance was looking to innovate outside of its traditional business model while staying true to its mission to help working families. One of its customers' biggest pain points was an inability to save enough money for an emergency. A $400 surplus—a cushion to get through a medical crisis, for example—was beyond many people’s reach.

Initially, American Family thought budgeting tools might provide a solution, but from the very first research interview, it was clear that budgeting wasn’t the barrier—cash-strapped people budget masterfully. The problem was having enough income to put away a little extra.

So, the insurance company embraced a radically new opportunity, creating a service to help families living on the edge bridge the gap between their paychecks and their security threshold. The company built a new business venture called Moonrise—a platform that would allow businesses to tap into an on-demand workforce, and allow people to access short-term work when they found themselves on shaky financial ground.

The solution was outside the scope of the legacy company’s core offering, but by moving outside of its business model, American Family Insurance was able to create an entirely new venture that helped its core customers solve a chronic, unaddressed problem.

2. Be an early adapter

It’s nearly impossible for an entire corporate organism to pivot rapidly in response to what’s happening around it, but startups have the innate superpower to move fast and get in early. When an emerging need or trend appears on the horizon, they can leap to create new products—or even new markets—far more quickly than large corporations. To achieve speed and adaptability, the new venture must be carved off and treated as its own autonomous, responsive entity.

Take the case of the 150-year old financial company that decided to widen the scope of its business to meet the growing desire for socially-responsible investment options. The company recognized early signals that the consumer desire for Environmental, Social and Governance (ESG) investing and impact investing was increasing rapidly, especially among younger generations, with whom they didn’t have many relationships. Chasing a high-growth opportunity for a new market segment, they set out to create a digital-first product that focused on socially-responsible investing.

To get started, the company didn’t simply announce a new division, or task an existing team with creating something new. Instead, they hired a founder and an outside startup team of 10. They built a company and a culture that was totally separate from their parent company’s offering, allowing the venture to take risks, prototype early and often, and above all, move fast. Throughout the venture’s development, the team continuously evolved the experience and business model by pushing prototypes to potential customers, adapting and pivoting until they reached product-market fit. By creating a team with the impetus and the culture to hit the ground running, the venture launched in just 18 months—and put its product in the hands of its consumers before its competitors.

3. Select for resilience and relentlessness

No matter the industry, startup leaders tend to have a few shared qualities that are more common among the entrepreneurial set than among seasoned CEOs. For a new venture to really work, the people behind it need to be driven by curiosity and insight, and have the skills necessary to prototype and iterate their way toward a tangible outcome. They can’t carry the static burden of “the way we do things around here.”

Intercorp, a massive Peruvian economic group of more than 30 companies, including banks, malls, cinemas, and schools, sought to build and design an innovation studio. Instead of solely relying on the business units to drive their own innovation processes, the company opted to create a central entity that could solve problems across its offerings, focusing on the needs of Peru’s rising middle class.

Intercorp purposely built La Victoria Lab in a middle-class Peruvian neighborhood—outside the walls of the corporate HQ—to immerse the team in the human-centered problems it’s trying to solve. The company also put together an interdisciplinary team of resilient and relentless talent, and set it up to embrace design thinking, identify new opportunities, and constantly prototype new value propositions. This talent stays close to the customer in order to shape new ventures in development, works through rapid digital-first prototyping, and operates within constrained timelines to get results. To drive disruptive new growth opportunities, small, cross-functional teams work quickly to design and launch digital businesses that compete with Intercorp’s core companies. Through La Victoria Lab, Intercorp’s leadership is intentionally creating urgency and applying positive pressure to disrupt its own businesses and remain competitive.

As a leader of an established company, you can’t ignore its history or DNA—nor would you want to; it’s what made the company successful in the first place. But you can constructively provoke necessary changes that allow new ventures to flourish. By openly embracing new business models, pursuing (and possibly creating) new markets, attracting and empowering entrepreneurially-minded talent, and even imposing a few artificial constraints like tight timeframes or lean budgets, companies can begin to fundamentally evolve not only what they do, but also how they do it. It’s the only way to ensure long-term market leadership—and sometimes even survival.

The tricky part of all of this, is that true venture-building, much like innovation itself, cannot be a corporate hobby. It cannot be wedged into spare time and pursued only when employees have white space on their calendars. It has to be modeled from the top, by senior leadership. One of the things that makes startup entrepreneurs effective, and ultimately successful, is their grit, determination and dedication to creating lasting change in the face of all obstacles. It's why others join them on their mission. Make it one of the reasons that others join you.

Visuals by Elin Svensson.

As tech valuations rise, and more and more unicorns are born, legacy businesses everywhere hear the message that they need to act more like startups. If you want to innovate, stay relevant, and grow, the advice goes, then you have to take risks, be nimble, and throw money at potential solutions.

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.