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.

Growing up with a Jetsonian vision of push-button dinners and automated cleaning, I imagined coming home to a house managed by a trusty humanoid helper. In hindsight, that glimpse of the future wasn’t a bold vision of what could be in 2040; it was a 1960s dream.

In our pursuit of future-forward thinking, we often find ourselves recycling outdated paradigms. This phenomenon, known as the “used future,” refers to the adoption of established ideas and models without critical examination of their current relevance or efficacy. First introduced by Sohail Inayatullah, a pioneer and leading voice in the field of futures studies, “used futures” are ideas about the future that we inherit without criticism, ideas that resonated in the past but are no longer fit for our emerging realities. The image of a humanoid robot tidying the home is just that—a nostalgic picture of tomorrow that distracts us from the more systemic innovations we need today. Which, given our current context, should look more like redesigning entire systems for living, rather than just one gadget for individual efficiency.

As a futurist, I am fascinated with the concept of the used future. Many leaders and organizations I work with unintentionally operate on autopilot, constantly recycling old beliefs and assumptions about what people want, what good or better looks like, or what technology should enable. Even futurists unthinkingly adopt concepts developed in different contexts and timelines, leading to solutions that are inappropriate or even detrimental to current needs. ​Designers who go after used futures are at risk of building yesterday’s dreams without realizing they're already stale. This is evident in many of the “redesigned” systems we see in today’s world:

• Urban planning that continues to favor car-centric infrastructure despite growing awareness of the benefits of pedestrian-friendly and sustainable transportation.
  
  
• Educational systems that still mirror the industrial revolution's factory model, emphasizing standardization and conformity over creativity and critical thinking.
  
  
• Healthcare that focuses on acute, episodic care, neglecting holistic, preventative, and community-based wellness and public health approaches.
  
  
• Office designs that prioritize “modernized” cubicles and centralized workplaces, overlooking the potential of hybrid models and third spaces, and ignoring costly commutes and work-life balance issues.

Each of these systems carries the DNA of an older future that doesn’t fit the reality we’re living in or the expectations we have for the future. Most attempts to redesign or evolve these systems and so many others are myopic and incremental at best—more akin to remixing previous fixes than driving paradigmatic change.

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It’s an easy mindset to slip into. Over many years of doing futuring work with clients and graduate students, I’ve returned to the same exercise. I ask them to close their eyes and  “imagine the year 2040.” Almost invariably, their minds leap to the familiar—flying cars, corporate dystopias, and neon-lit cityscapes of sometimes decades-old popular culture. The futures they could imagine are limited by inherited visions of what could be.

To break that loop, I’ve started changing the prompt. Instead of “What does 2040 look like?” I ask, “What does your birthday in 2040 feel like?” Suddenly, the answers are different. They talk about who they hope would be there, where they would be, and what they would be doing. The future becomes grounded in something personal, emotional, and ultimately, human.

And that’s where real futures thinking begins. The key is to notice when you are repeating someone else’s vision of tomorrow and get curious enough to imagine your own. But how, exactly, can you sidestep the used future?

Here are five techniques I use regularly that can help transcend the limitations of the used future:

1. Identify emerging signals

‍Looking past today’s dominant narratives means tuning into faint signals of the future, early indicators of change that hint at what might be plausible tomorrow. These signals are not trends yet; they’re provocations, cultural artifacts, early-stage experiments, or subcultures operating at the edge.

Consider IDEO’s Future of Automobility project from 2015. Introduced long before autonomous vehicles hit city streets, this work mapped a world where vehicles were shared, adaptive, and integrated into a broader urban ecosystem. It didn’t ask, “How do we make cars better?” It asked, “What happens when we stop designing around car ownership?” By interpreting early shifts in technology, social behavior, and city planning, the team envisioned new mobility platforms that anticipated today’s transformations in transportation infrastructure. Witnessing the most recent “carriage-style” entries into the autonomous market in the Bay Area, it’s impossible to miss the similarities between what IDEO imagined mobility could be and where it is today.

To avoid the trap of the used future, we need to be less obsessed with forecasting with certainty of what will happen and far more courageous in noticing signals for what is possible, no matter how speculative it feels.

2. Question the framing

Used futures often sneak in through the front door, via projects that frame the problem to be solved using assumptions, categories, or language that come from the past. That’s why it’s critical to ask: Is this work going after incremental improvement or transformational reimagining? “Better-than-today” efforts may optimize the status quo, but “future of” briefs open the door to strategic reinvention.

IDEO’s collaboration with Conservation International initially focused on protecting biodiversity hotspots. Through reframing, the team moved from traditional conservation messaging toward building a new cultural paradigm: helping people recognize nature as a source of emotional, physical, and spiritual well-being. This new context led them to think of nature as their client, shifting the way conservation is valued and communicated in human-centered terms. It was a significant reorientation of purpose rather than just a new message.

3. Prototype tangible futures

It’s hard to unlearn the futures we’ve inherited unless we see, touch, or experience alternatives. Prototyping tangible futures helps us push beyond habitual thinking and brings speculative ideas into experiential form. This might mean creating speculative artifacts like newspapers from the future, designing future rituals like a daily huddle with your AI agent, or simulating entirely new systems.

At IDEO, teams often use tangible futures techniques to prototype new products, new services, and new ways of behaving. When teams work on “future of health” projects, prototypes might include a mock clinic that embodies an alternative care model, a future policy pamphlet, or the interior of an autonomous ambulance. These prototypes for interactions are tools for stress-testing assumptions and unlocking insights  creating momentum that stakeholders can react, iterate, and imagine together. You don’t need a time machine to imagine what could be; you simply need a prototype.

4. Create human narratives

Too many future visions center on technology, markets, or efficiency and miss the beating heart of change: human lives. Human-centered narratives illuminate the values, desires, tensions, and trade-offs that define meaningful futures. They help us imagine what the future brings as well as what it will feel like to live in it.

In several IDEO projects that reimagined the future of aging, teams resisted the common narrative of decline and dependency. Instead, they co-created stories with older adults that ranged from reimagining retirement as an opportunity to engage in lifelong purpose to redesigning death to helping the elderly live with intention, right up to the end. These future narratives inspired new product and service ideas and reshaped social attitudes and policy conversations.

Narrative is a strategic tool. By telling stories of a preferred future where people thrive in just, inclusive, and life-affirming ways, we can build the collective resolve to make them real.

5. Design nascent paradigms

Sometimes it’s not enough to design for a new future; we also have to design the conditions and new thinking that make shaping nascent paradigms possible, reorienting how we define progress, value, and success

In the Beyond the Bag Challenge, IDEO worked with startups and major retailers to help define what it means to design solutions that restore and renew natural systems rather than deplete them. The collaboration led to a range of alternatives to single-use plastic bags, including biodegradable options and systems for recirculating bags. Within months, several prototypes were launched in major retailers and key markets.

Avoiding the used future in design means embracing techniques that encourage not just imagining transformative futures, but also those that help us surface and question possible outdated visions as well. If we don't notice the used future, we risk creating innovation theater, polishing legacy ideas instead of surfacing the truly new needs, emotions, and possibilities. By consciously moving beyond these old visions of what’s possible, we open ourselves to a broader spectrum of possibilities, enabling designs that are not only innovative but also deeply attuned to the evolving context of our world.

‍Looking to bring futuring into your own work? Get in touch.

I’ve been waiting for a housekeeper robot since I was a kid.

The question tossed out at checkout has become such a common refrain that it can feel like background noise. Perhaps you say no—worn down by membership fatigue, especially for stores you rarely visit. Or perhaps you say yes, lured by a one-time signup perk, only to join the 35 percent of shoppers who say they belong to a loyalty program they’ve never used.

Nearly 80 percent of Gen Z and millennial consumers believe a high-quality digital experience is essential for loyalty programs. But these reward systems, typically built around points, discounts, or tiers, rarely reflect what the brand actually stands for. And when the behavior being rewarded feels disconnected from the brand’s promise, it creates a subtle but powerful disconnect. We think of this as brand dissonance: a type of cognitive friction between what a company claims it values and how it invites people to engage.

When we design loyalty programs at IDEO’s Play Lab, we begin by recognizing that a brand exists at the intersection of what it says about itself and how people experience it, across hundreds of small, accumulated interactions. Done well, loyalty programs don’t just reflect a brand’s values—they embody them, shaping how people experience the brand in the countless moments that add up to brand loyalty.

On a project with JetBlue, for instance, we were tasked with introducing a new premium service that could compete with first-class perks—but without undermining their mission to “bring humanity back to air travel.” Rather than replicate a tiered status model, we grounded the work in a different philosophy: speak to modes of travel, not travel classes.

We designed for different player types—offering “power-up” benefits like faster security, better access to overhead bins, and higher quality food and beverage options. These upgrades honored JetBlue’s inclusive ethos and resonated more with the airline’s loyal passengers.

The result? The new offerings, introduced in 2011, drove its EvenMore line of perks, generating $230 million per year, with a 30 percent annual growth rate, and increasing revenue per customer by 20 percent. That success didn’t come from gamification for its own sake—it came from building a loyalty experience that reflected JetBlue’s values and aligned with travelers’ intrinsic motivations.

Designing for the next generation of consumers brings added complexity, as brands must account for shifting behaviors, rising expectations, and evolving definitions of loyalty. Programs that feel overly transactional or inaccessible often fall flat. Younger, digitally native audiences are highly discerning and research nearly every product online before buying—not just to find the best deal, but also to assess whether a brand aligns with their values and feels worth supporting. They gravitate toward brands that feel authentic, expressive, and purpose-driven. Think REI Co-op or Trader Joe’s. Earning their loyalty means creating experiences that reflect who they are and who they aspire to be—rather than how much they spend.

That’s where game design offers a powerful blueprint. The best programs go beyond transactions, building ecosystems of engagement that give people agency, align with their intrinsic motivations, and evolve over time. Not to be confused with basic gamification, which adds a superficial layer of points, badges, and leaderboards as a way to incentivize customers, game-inspired programs can go deeper and reward engagement in ways that are rooted in brand values and reflective of real-life consumer behavior and identity. Here are three ways we could design a more sophisticated game approach to loyalty programs across three industries: retail, restaurants, and hospitality.

Pokémon Go for retail

Imagine the goal for your brand is to tap into self-expression, identity, culture, and community through your loyalty program. Your app could include an AR feature that lets users scan physical environments—like storefronts, catalogs, or product tags—to reveal hidden offers, collect digital rewards, or unlock exclusive quests. Shoppers could level up based on their interests or shopping style (e.g., “Sustainable Shopper" or "Sneakerhead"), earning rewards that reflect their values and deepen their connection to the brand. Think Pokémon Go meets personalized product discovery.

Gamify the wait at restaurants

Every parent dreads the restless stretch between sitting down at a restaurant and the food arriving. It’s often when screen time rules go out the window—and then backfire when the meal arrives and a tantrum ensues as you try to pry the screens away. Now imagine you operate a chain of family-friendly restaurants. When families are seated, they can scan the table to unlock secret menu items or interactive mini-games that reward adventurous eaters (“no repeat dishes for two weeks”). Better yet, what if your kids could feel like they’re helping prepare the meal through a restaurant simulator game, synced to the real-time cooking process—turning wait time into a playful, immersive experience that reinforces family connection and the fun of dining out together?

Turn hotel stays into an open-ended travel adventure

Let’s say you run a hospitality brand that caters to travelers who care about connection, creativity, and belonging—not only price or convenience. Imagine if guests could earn recognition beyond the number of nights they stay, reflecting how they make travel a part of their lives. Like the cozy game of Animal Crossing, rewards are given to players for consistently returning and doing small, meaningful things over time—earning recognition for sending postcards, documenting hidden gems to help fellow travelers, or simply enjoying breakfast in bed. Each stay becomes a chapter in their story, where they can log snippets of music, photos, journal entries, and even scents as mementos to savor and relive later. Over time, their loyalty profile becomes a rich, emotional artifact of their journey and identity as a traveler—not just a status tier.

Gaming culture has reshaped how people shop, connect, and stay loyal to brands. The most effective loyalty programs operate like games: they offer agency, build a sense of progression, and create emotional resonance. Grounded in a brand’s core promise, they reward behaviors that reflect what the brand truly stands for and show up in the everyday moments that matter. And while they’re inspired by game design, they don’t need to look like games to make people want to keep playing.

So let’s build something better. Let’s co-create the future of loyalty—one that feels like a game your customers actually want to keep playing.

“Are you a member of our rewards program?”

On the one hand, product development processes are built for good reason: They bring structure, reduce risk, and ensure that what goes to market is feasible and viable. I’ve seen this firsthand across various industries, including mobility, real estate, home goods, and consumer products. Rigor is essential when you’re investing in a launch.

But here’s the rub: Those same processes that build confidence often constrain the ambiguity and risk that innovation demands. Design thinking is often touted as the solution, a concise methodology to inject creativity. But how does that square with a stage-gate model built to de-risk and control?

Is it a matter of choosing one or the other? Or is there a way to bridge the gap?

Here’s how one team figured it out.

The familiar question

“How can we integrate design thinking into our product development process?”

It’s a question I’ve heard many times in my career, and this time, it came from an engineer I was coaching on the R&D team at the headquarters of a globally renowned retailer in China.

The team leader had an ambitious vision: leverage their proximity to China’s robust supply chain and dynamic consumer market to build the world’s leading retail R&D center. A critical step was enhancing the engineers’ creativity and critical thinking skills, moving them beyond task execution toward collaborating more closely with their cross-functional partners to design solutions that meet real consumer needs.

That’s where IDEO came in. Building on an earlier innovation project, we embedded designers as advisors and coaches directly into their product development process.

In one of our sessions, the engineers had mapped out their four key development stages on a whiteboard:

• concept discovery
  
  
• product development
  
  
• product qualification
  
  
• launch
  
  

They had also been taught that design thinking contains four key steps.

“Maybe there’s a one-to-one match?” one engineer asked, hoping I could align each development stage with a corresponding design thinking step.

It was a reasonable guess, but not quite how design thinking works.

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Getting past process

That day’s focus was prototyping and testing. At first glance, it seemed to align with the third stage of their product development process: product qualification.

“How does IDEO do prototyping and testing?” they asked. “At what stage should we use it? What role does it play?”

Instead of jumping into an explanation, I suggested an experiment.

“Let’s forget about process labels for a moment,” I said. “Write down all the questions you want to explore through prototyping, regardless of which stage or methodology they supposedly belong to.”

Before long, each engineer had a handful of sticky notes with their questions written on them.

“Now map these to your actual development stages based on when you’d naturally ask them.”

When they placed their questions across all four stages of their product development process, something clicked. They could suddenly see that design thinking wasn’t competing with their process.

“Can this product store spices?” belonged in the early concept discovery phase, where prototyping could help define the product.

“Does the product stay stable during movement?” fit into the product qualification phase, where prototyping could test structural performance.

Prototyping was clearly valuable across all stages. 

The same is true for all the other so-called steps of design thinking: finding inspiration in consumer needs, translating needs into design opportunities, and generating concepts. They’re not fixed stages to complete in order; they’re ways of thinking and working that help teams ask better questions, explore possibilities, and make informed decisions, regardless of where they are within their own internal processes.

A mindset shift, not a process replacement

Back to the original question: “How can we integrate design thinking into our product development process?”

The answer, it turns out, isn’t about fitting one process into another.

Through the sticky note exercise, the engineers understood that design thinking and product development aren’t competing methodologies. Design thinking could add value by bringing curiosity, questioning, testing, and making ideas tangible throughout their existing process.

This insight shaped our collaboration model: embedding consultation sessions into real projects rather than trying to overhaul their established ways of working. We weren’t disrupting cross-department collaboration or the high-stakes requirements of mass production. We were expanding the potential for innovation and experimentation within their existing framework.

The results are still unfolding, but the engineers are already applying design thinking mindsets to ask meaningful questions, explore solutions, and test ideas, helping them think more expansively, make thoughtful trade-offs, and push concepts further.

That’s the bridge between structure and creativity: not new processes, but new ways of thinking within the ones you already have. Practiced over time, those habits make innovation both sustainable and rigorous.

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“The Making of...” is a series of behind-the-scenes articles written by IDEO Shanghai designers about our innovation methods and work with major clients across industries in China.

As companies grow and their internal processes mature, the concept of innovation can start to feel like a contradiction.

Over the past decade, particularly through two pregnancies and deliveries, I have learned to navigate and deeply appreciate the complex network of healthcare providers and services that comprise the NHS.

I am far from alone in that deep appreciation. In England, the NHS is a national obsession. It determines election campaigns, shapes the budget, and perhaps most importantly, colors how we think about and act on our health. But alongside that feeling of national pride is an understanding that the institution is under far too much strain. There are currently 6.34 million people waiting for NHS treatment. Cutting waiting lists by making better use of the private sector is front and center of the Prime Minister’s latest NHS proposals. It is a top priority for the government as it looks to deliver on a promise to ensure that 92 percent of patients in England wait no longer than 18 weeks for treatment.

Over dinner recently, a close friend asked me: “You’re a designer. If you were going to fix the NHS, where would you start?”

My answer: “Anywhere but the NHS.”

The NHS is a world-class problem fixer. An emergency and acute care service that kicks into gear when we need it most. However, the NHS cannot purify the air we breathe, encourage us to move more, improve our relationships with others, help us develop healthy working patterns, or change the food we eat. To preserve our health, we need to address the causes of preventable lifestyle diseases like obesity, diabetes, and heart disease at their source.

That means turning to the spaces where our health must be built, maintained, and nurtured. Our workplaces, our schools, our communities, our supermarkets. That’s why the best way to improve the NHS actually lies outside of it.

Rethinking the way we generate health in the UK might sound ambitious, but for a designer who has focused on health for 20 years, it is very clearly the right brief.

So, where might we start?

1. Paint a new picture of health

My mentor, IDEO founder David Kelley, used to say, “Paint a picture of the future with your idea in it.” This is where design excels. We need to imagine a future where health thrives outside of healthcare settings, a future where preventable illnesses are dramatically reduced, and people live longer, healthier lives.

Imagine a future where waiting lists for heart surgery are a thing of the past, not because the NHS has magically become more efficient, but because fewer people need surgery in the first place. Or where at-home cancer screening frees up time for healthcare workers, and gives patients more control over their own health. One of our clients, Teal Health, partnered with us to create safe and accurate cervical cancer screenings that would allow patients to collect their own samples at home, giving them more agency over their own health.

Or consider mental health. Across the UK and the US, children and young people are in crisis. In California alone, more than 284,000 youth cope with major depression. Sixty-six percent of kids with depression do not receive treatment. Between 2019 and 2020, the suicide rate for kids ages 10-18 increased by 20 percent. These numbers are shocking. Imagine a future where children, their families, and schools had easy access to tools designed to combat those mental health challenges. This was the vision driving IDEO’s collaboration with Kooth, the State of California, and cohorts of young Californians to create Soluna, a digital mental health resource kids could access anywhere, anytime.

To drive a step change in the state of our health in the UK, we must allow ourselves to rethink the ways in which we keep ourselves and our families healthy. The National Health Service cannot be our sole partner in this endeavor.

2. Break taboos and engage in hard conversations

Taking health beyond the hospital will require us to confront awkward topics—conversations which we have become used to leaving at the door of the doctor’s office. We need to learn how to talk about menstruation, aging, mental health, and—dare I say it —poo, out in the open.

By normalizing these discussions and listening with empathy, we can begin to uncover the human challenges that impact our health, opening up opportunities for new products and services that improve health and drive economic growth.

Menopause is a great example. In our work with QVC, we learned that nearly 40 percent of menopausal women are being prescribed antidepressants to help manage their symptoms, despite four out of five describing the treatment as “inappropriate.” We also heard that nine out of 10 British menopausal women feel society and brands overlook them. Recognizing that its customer demographic makes QVC uniquely positioned to surface conversations and provide support to those dealing with menopause, the video commerce retailer partnered with IDEO to determine how it could not only meet customer needs but also flip the conversation about midlife, reframing it as a time of vibrancy and exploration.

3. Fix incentives to combat health pollution

The true financial cost to society of excessive sugar, saturated fats, and pollution is largely hidden. The sticker price is nothing compared to the cost of lost productivity, medicines, procedures, and NHS waiting lists they create.

Policy makers need to inspire innovative new alternatives and reward manufacturers who can create attractive products that do not come at the expense of our health.

In the US, an organization called Eat Real is working to scale access to nutritious, sustainable foods through healthier meal programs in public schools. Almost 30 million children in the US rely on public school lunches for more than 50 percent of their daily caloric intake, but these meals are often comprised of ultra-processed, unsustainable foods. IDEO collaborated with Eat Real to develop its branding and messaging in order to reach a new set of food philanthropists and scale their impact.

4. Be radically collaborative

Once we relinquish the notion that the healthcare system is solely responsible for our health, we are free to design a new system of collaborative forces to promote, maintain, and foster good health. What opportunities might we unlock if we brought together food producers, educators, employers, city planners, tech leaders, and content creators to co-design a new approach to health with policymakers? Already, some public/private partnerships have led to change. A few years ago, IDEO partnered with the NHS’s health tech unit and a company called Public Digital to create a suite of digital resources that enabled organizations across the NHS to transform their own services, allowing them to provide mental health support for the most vulnerable children and young people.

The opportunities extend far beyond the NHS

A healthier society is more productive and pays more taxes. It requires less healthcare funding and is less poverty-stricken. It can help us all to live happier, more fulfilling lives.

The tensions getting in our way—the short-term incentives to sell unhealthy products, reduce environmental regulations, and the challenge of breaking unhealthy habits—do not necessarily require a revolution in medical technology or vast sums of money to resolve.

They require a designer’s toolkit. A willingness to imagine a different approach to health in the public and private sectors, the courage to talk about health in the open, a realignment of incentives, and the willingness to experiment.

They also present a huge opportunity for any organization interested in building a business centered on improved health outcomes.

It’s time to take our health out of the hospital.

When I relocated from the US to the UK ten years ago, one of the biggest differences I experienced was my sudden access to the publicly funded National Health Service (NHS).

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.