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.

I’m grateful for Chicago’s trains—even amid the crush of people jammed into the morning’s rush hour commute and the thought-clouding clatter and clank that pervades every metal car. It’s a marvel that these hulking workhorses of public transport coordinate at all, and are generally safe, on time, and comfortable. And yet I often notice fellow train-goers challenged, like myself, by something basic: What do we do with our stuff? In my time as a commuter, I’ve seen myriad workarounds. Legs became walls propping up clothes and bags; thighs became resting ports for big headphones. And then there was the man who transformed his suitcase handle into a coat rack. Human ingenuity: It’s one more thing I’m grateful for during my commute.

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.

Tim Brown, CEO of IDEO, shows how the techniques and strategies of design belong at every level of business.

The myth of innovation is that brilliant ideas leap fully formed from the minds of geniuses. The reality is that most innovations come from a process of rigorous examination through which great ideas are identified and developed before being realized as new offerings and capabilities.

In this revised and updated edition of Change By Design, Tim Brown reintroduces design thinking, the collaborative process by which the designer’s sensibilities and methods are employed to match people’s needs with what is technically feasible and a viable business strategy. In short, design thinking converts need into demand. It’s a human-centered approach to problem-solving that helps people and organizations become more innovative and creative.

Change by Design is not a book by designers for designers; it is a book for creative leaders seeking to infuse design thinking into every level of an organization, product, or service to drive new alternatives for business and society.

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Know someone who might love this book? Purchase Change By Design here.

Our checklist made all the difference when the Wellcome Trust tasked us with designing a way to cut down on unnecessary antibiotics use in middle-income countries. The world’s antibiotic misuse has staggering implications: By 2050, antimicrobial resistance is expected to kill 10 million people every year. That’s more people than we lose annually to cancer.

What became known as Project Marvelous took us to Kenya and India, where we encountered patients who self-diagnose and prescribe for themselves and their friends, community health workers with very little training, and pharmacies that dole out antibiotics without a prescription in order to make a sale.

As far as complex systems challenges go, it was an extreme one, but after testing several rounds of concepts rooted in behavior change, we found an intervention with real potential. Smart Prescriptions, as we called it, was an endpoint that varied drastically from where we began. The original hypothesis was that the intervention should be designed for pharmacists. But after following the checklist, we found we had to start with doctors.

Here are the five steps we followed to address this complex systems challenge:

1. Define your ecosystem

We can’t claim to have reached an understanding of the whole ecosystem by a longshot—the sheer number of stakeholders involved is what makes it such a complex problem. So at the outset, we defined our ecosystem, drawing a line at pharmaceutical companies, which seemed beyond the scope of the design challenge Wellcome had set. We then set out to interview antibiotic users, doctors, and pharmacists. In doing so, we realized there was a category we had overlooked: India’s tens of thousands of registered medical practitioners (RMPs). They typically aren’t licensed to prescribe antibiotics but have studied Ayurvedic medicine. Being willing to pivot and expand (or contract) the ecosystem is key: We began interviewing RMPs after realizing the huge impact their population has on antibiotics consumption.

2. Adopt a beginner’s mindset

In interviews, we positioned ourselves as people who didn’t know much about the topic. We were there to learn about them as people—their motivations, their struggles, their day-to-day. We listened. We made sure our questions were free of judgement and left our assumptions at the door. What we came to understand is that a primary motivator for doctors is to succeed as a business. They depend on patients coming back.

This insight made it through to the final design. Smart Prescriptions is, at its core, a tool to improve the doctor-patient relationship. Features like automated advice for patients and medication reminders increase the personal interactions doctors have with patients. The antibiotics recommendation is a Trojan horse, tucked inside the features doctors were really clamoring for.

3. Lead with empathy

Continually put yourself in your user’s shoes and make sure you’re seeing the situation from their perspective. We quickly came to understand, for instance, that many people working in pharmacies aren’t actually pharmacists, and that their financial motivations eclipse any duty of care. They dole out antibiotics without a prescription because refraining from doing so means sacrificing a sale and possibly losing a customer to a rival. Rather than slapping a “bad” behavior label on this, we accepted it as their reality and used it as a design constraint.

4. Consider your language

Systems challenges are often as sensitive as they are complex (consider homelessness or mental illness). As designers we are outsiders, so in designing Smart Prescriptions, we needed to make sure doctors were upheld as the experts. We weren’t creating a diagnostic tool, but rather an intervention that offers a recommendation based on their diagnosis. The tool doesn’t actually change the way they prescribe, it just offers guidance. It’s tough to remember every antibiotics guideline, especially as they update. The language that was used was consciously designed to be light and supportive of their expertise.

5. Generate unlimited ideas, then co-create

Don’t fall in love with your first good idea. Every assumption we made was challenged in our first trip, which ended up being more exploratory than we expected. We made a point to talk to every stakeholder and actor about our sacrificial concepts—early ideas we put in front of people to spark reactions. We gauged whether they had a positive or negative response, then iterated accordingly. After the discovery phase, we came up with seven concepts to test with participants and gauged their reactions. Smart Prescriptions was the clear standout, generating the most interest and excitement. We refined the concept back home, then returned to India and Kenya to gather more feedback. This allowed us to design something that spoke to doctors’ primary motivation, and to add features that the doctors felt would make it even more useful.

Unlike pilots, we don’t have the benefit of a known destination. Our checklist doesn’t just guarantee a smoother ride, it plays a major role in mapping the route itself. When the ecosystem is unfamiliar and the complexity is vast, it is a must.

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Every time we board an airplane, we assume our pilots aren’t going on instinct alone. They’ve worked their way through a checklist—fuel levels reviewed, the flap setting confirmed—to ensure the plane is ready for takeoff. They may be pros, but they’re human, and the complexity of the job makes it easy to forget a step.

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While I occasionally geek out over numbers, I spend most of my time going deep with clients, sketching business models, and building prototypes to test our ideas with real people.

I’m currently working on a project to create a new taxi experience for Japan. We’re working to help our client, a taxi equipment supplier, stay relevant when taxis themselves are being disrupted.

There’s really no typical day for me at IDEO, but here’s a little peek at what a recent one looked like.

8:30am: Commute

On nice days I walk to work through Yoyogi Park, one of Tokyo’s largest. It’s hard to believe that I live in a concrete jungle with views like this! Most days, though, I take the train. It’s exactly 16 minutes to get to work. (Perk of living in Tokyo: Trains run like clockwork.)

10:00am: Team stand-up

Our team has daily morning and evening stand-ups. We’re supposed to plan the day, but we get sidetracked and spend most of it playing with our taxi prototype.

10:30am: Business model review

I sketch out our current idea using our Business Model Tiles. They’re a quick, visual way to bring our plan to life, and they make it easy enough for anybody to come in and iterate with me. (The team liked this version.)

12:00pm: Monday lunch meeting

The entire studio gets together every Monday for lunch. The food is amazing—we have different caterers provide freshly cooked, seasonal dishes every week. Usually, we share silly photos from the previous week and studio/project updates. Everybody takes a turn as host, and shares personal inspiration. This week it's Ryo, introducing one of our new D4V (Design for Ventures) portfolio companies, Tabi Labo, to the studio. (More on that later!)

1:00pm: Crash course in graphic design

Outside of work, I run a pop-up curry shop with some friends. We make curry with a Japanese twist, using seasonal ingredients or flavoring that you might not usually find in curry. I’m lucky to be surrounded by talented graphic designers who helped me transform my very analogue potato stamp logo into a digital masterpiece.

2:00pm: Video shoot

We’re making a short user journey video to showcase what our taxi service might look and feel like. As a business designer, making things tangible is important, because it makes the service feel real, and empowers clients to take risks and launch new businesses. Our client got really into it, and even starred in the video as the taxi driver!

5:00: Design sprint

IDEO Tokyo is co-located with D4V (Design for Ventures), our in-house venture capital fund. I really enjoy working with the startups, which have different needs from our typical clients, and move really fast. Here, we’re helping Famzon (a company that makes shoes with interchangeable heels) create its first pop-up store in the Haneda Airport.

6:30pm: Heading home

It’s been a long day. Can’t wait to go home, eat dinner, and recharge for tomorrow.

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When people ask me what I do for a living, I say, “I find innovative ways for companies to transform and grow.” I think a lot about the intangible parts of creating a new service. How do we make money? Who do we partner with? What resources do we need to begin?

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.