All moms want to give their babies the best start in life, and for many, that means nourishing their babies with breastmilk. However, breast pumping is often inconvenient and uncomfortable. Tethered to the wall, undressed, and surrounded by cords and dangling bottles, most mothers who pump are interacting with technology that hasn’t fundamentally changed in more than 25 years.

Passionate about solving this challenge, the startup Willow set out to completely re-imagine the breast pumping experience. The team at Willow envisioned a “dream pump” that would deliver what moms want most: mobility and discretion.

The Willow team approached IDEO to be a close partner in bringing their product to life. As a cross-disciplinary team of researchers, industrial designers, and mechanical engineers, IDEO, Willow, and Function Engineering worked together seamlessly to identify mothers’ unmet needs and resolve engineering complexities with a simple and elegant design.

The resulting product, Willow, is the first all-in-one, wearable breast pump that cuts the cords, ditches the mess of bottles, and fits easily inside a bra. Mobile, discreet, and hands-free, Willow allows women to achieve their breastfeeding goals without pressing pause on their own lives.

The final design of Willow was informed by research and in-person interviews with dozens of mothers, ranging from first-time to experienced pumpers. Insights about their personal routines, challenges, and workarounds guided the design team as they built more than 60 physical prototypes to understand how Willow could best fit into mothers’ lives. Learnings from those prototypes helped the team to define the size, shape, color, and materials of Willow, as well as each step in the pumping process.

One key design element that emerged from this iterative process was the simplicity of Willow’s architecture, which makes the pump easy to use, assemble, and clean. The pump contains just a few basic parts that snap together, and only two parts that need to be cleaned (both are dishwasher-safe).

Considering how personal the breast pumping experience is, the team aimed to help the pump feel less like a stark, mechanical device and more like a considered, modern, and personal accessory—a goal ultimately achieved through the pump’s colors, texture, and finish.

Because of Willow, mothers no longer need to plan their lives around pumping—it can happen anywhere, at anytime. Willow gives moms back their time and freedom and gives them choice; now moms can play with an older child, work, or enjoy precious relaxation time at home. With Willow, pumping breastmilk finally fits seamlessly into women’s active everyday lives.

More than 50 million people worldwide suffer from schizophrenia, yet only half receive psychiatric treatment. When they do, it usually involves medication and one-on-one therapy to treat the most visible symptoms, including hallucinations and paranoia. But the disease can also cause debilitating symptoms that medication can’t easily treat, such as social anxiety and isolation, lack of motivation, and memory deficits.

For people living with these symptoms, what might seem like simple activities—socializing, spending time outdoors, exercising—can sometimes feel overwhelming. And if patients aren’t given effective care, they can become even more isolated, and their physical health and quality of life suffer. They’re far more likely to let the rest of their treatment regimen slip, skipping medication or therapy sessions.

To help address these challenges, a digital health research group at the University of California, San Francisco (UCSF) approached IDEO with an idea to supplement the longstanding medication-and-therapy model with a tool to alleviate hard-to-treat symptoms, and more importantly, improve patients’ quality of life. It would require identifying unmet needs among patients and determining which kinds of interactions could have the greatest impact on young people with mental illness.

The outcome of that collaboration is PRIME, or Personalized Real-time Intervention for Motivational Enhancement, a digital platform that empowers young people with schizophrenia with the tools, motivation, and community of support they need to achieve their goals.

The simplicity of PRIME belies its deep functionality. The easy-to-use mobile app helps patients stay motivated to stick with behaviors that boost their health, social skills, and productivity, and it provides motivational coaching from trusted professionals and social connections with other patients.

How It Works

The PRIME app lets users set daily goals based on their particular needs. There are more than 500 small challenges to try—from inviting a friend to play basketball to spending time with a family member—and users can see their progress tracked through incremental successes over time.

Whenever users need help, trained motivational coaches are on hand to provide cognitive behavioral therapy coaching, encourage patients to achieve their goals (and to push beyond their comfort zones), and support their interactions with other users.

Tapping into its vibrant social network to help patients feel less isolated, PRIME prompts users to snap photos of happy moments, highlight important events in their lives, and share challenges they’re proud to have accomplished. Unlike Facebook, which can be overwhelming for some patients with schizophrenia, PRIME is a closed community where users can talk freely about their challenges with others who are just like them.

Click above to hear our audio story, or listen on SoundCloud.

To measure the efficacy of PRIME, UCSF and IDEO combined traditional metrics, such as Patient Health Questionnaire scores and time spent in the app, with new metrics evaluating patients’ quality of life. For example, they studied the pictures of things that made users happy before and while using the app, and measured the frequency, depth, and quality of patients’ social interactions in the app based on word choice and punctuation.

Learnings from these human-centered metrics helped the team iterate further on PRIME’s design, so that the platform would generate even higher levels of engagement and stronger improvements in patients’ motivation and social functioning. In this 2016 peer-reviewed, clinical study, 80 percent of patients with schizophrenia achieved their daily goals, and users logged into the app an average of 4.5 times a week, far more than the expected rate of once a week.

PRIME has also made an impact on patients and their families on a personal level. The mother of one research participant was thrilled with the results. She told IDEO, “I wish you could have witnessed my daughter’s first response to seeing the faces and profiles on her phone. She looked at me, smiled, and said, ‘Everyone looks normal. Everyone looks like people you see every day.’ It was as if she looked into a mirror that reflected possibility and hope.”

Human-Centered Design

The PRIME platform is an example of how the human-centered design process can lead to first-of-its-kind innovations in the field of mental health care. PRIME designers conducted comprehensive interviews that led to a deep understanding of patients as whole people, not just conditions or sets of symptoms.

For Dr. Danielle Schlosser, lead researcher on the PRIME project at UCSF, collaborating with IDEO and applying design thinking to her research on mental health was illuminating. "[It] showed us that in order to engage our users, we needed to provide a safe and supportive community that directly catered to their needs. The insights we gained enabled us to create an experience that inspires patients to improve their quality of life by emphasizing their strengths. Working with IDEO helped us make powerful, creative leaps in our process, and build a digital health platform that’s already deeply impacting patients’ lives.”

The success of PRIME in treating schizophrenia has led to additional federal research funding, and the platform is now being expanded to treat a wider range of mental health conditions.

For example, in this recent, peer-reviewed study, PRIME helped patients with moderately severe depression experience a 50 percent reduction in symptoms, with a noticeable difference in just two weeks—far faster than the average of four to six weeks it takes for traditional medication and therapy to yield improvements. By the end of the depression study, 90 percent of participants said they had achieved their treatment goals, such as to “become happier” or to “feel less lonely.”

Numerous patients with schizophrenia and depression have already benefitted from PRIME’s unique offering, and the team is exploring ways to commercialize and scale PRIME to reach more people with mental health conditions.

New Yorkers are a tough lot, but damaging coastal storms will continue to test their resilience. More than 400,000 people live within the city’s floodplain and are at physical and economic risk. In the face of both natural and manmade challenges—from superstorms to confusing insurance regulations—many New Yorkers are not aware of their flood risk, or even that they should be thinking about it at all.

The Center for NYC Neighborhoods‚ a nonprofit that champions affordable homeownership for middle- and working-class families and communities, engaged IDEO to create a resource that could help New Yorkers keep their homes and finances safe. Launched in September 2016 with funding from New York State's Governor's Office of Storm Recovery, FloodHelpNY is an expansive platform that dismantles the complexity surrounding flood insurance and gives homeowners clear and simple guidance for assessing their flood risk and taking action toward resiliency.

Facing the complexities of insurance policy, shifting flood regulations, climate change, and citizen engagement, the design team began by engaging two vastly different groups of New Yorkers—those who had been battered by past storms and those not yet affected. Homeowners in the first camp were angry and frustrated by a system that had let them down after Superstorm Sandy. Homeowners in the second camp were simply unaware of their risk and had little idea of what might happen. The right design solution needed to encourage both groups to take action and learn about flood risk and insurance regulations, while also addressing divergent levels of need and preparedness.

To co-design solutions with homeowners, IDEO set up pop-up stations at neighborhood meetings in Canarsie, Red Hook, and Gerritsen Beach, and had flood-affected residents create paper prototypes of the resources they wanted in place the next time a storm hit. The team learned how residents contextualized their individual risk, which information they prioritized, and how their frustration could inform a better outcome. In Lower Manhattan, where residents are less aware of flood risk, the team set up a pop-up station with virtual reality viewers that simulated water rushing into the surrounding streets, a visceral wake up call that got them talking about flood recovery.

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Less than a month after launch, FEMA began promoting FloodHelpNY as a key resource for building flood resilience. The platform helps all New Yorkers learn what flood zone they’re in, or will be in, how that affects their insurance rates, and what steps they can take to mitigate their risk. It features a first-of-its-kind flood insurance rate calculator that can help homeowners get a rough idea of the costs they could face as insurance prices go up. It is also the main conduit to apply for the Home Resiliency Audit, a New York State-funded program that equips at-risk homeowners with vital documentation valued at over $800 that confirms their actual elevation and insurance costs—all with the personalized assistance of an engineer and housing counselor team. In the coming months, FloodHelpNY will expand further to offer homeowners free backflow valves that reduce the chance of sewers backing up during flooding, as well as access to more existing benefits for resiliency.

The New York City floodplain, which is expected to grow as tides continue to rise, threatens neighborhoods that are among New York’s oldest and most historic. The people who live there make the city work: teachers, police officers, subway operators. Many of these homeowners will watch their flood insurance premiums surge, year over year. It’s a troubling future, but one that FloodHelpNY is designed to help New Yorkers face, by guiding them toward greater resilience and assuring them that they aren’t alone.

Athletes looking to score big on game day could hit the gym, but they’d probably be better off hitting the sheets instead, according to Rise Science, a sleep analytics startup. Harnessing the latest sleep science, Rise helps players significantly improve reaction time and decrease false starts, lapses, and injuries, among other benefits.

While attending Northwestern University, the co-founders of Rise Science created a simple sleep app and light-touch coaching service, which they prototyped on the school’s Big Ten football team with positive results. They came to IDEO to optimize their customer experience and scale the business, and joined IDEO’s Startup in Residence program.

While observing coaches and players using Rise, IDEO saw the opportunity to better integrate the digital and hardware experiences and design a more robust, intuitive, and service-heavy on-boarding experience during the first few weeks using the system, when breaking old habits and incorporating new ones are most challenging.

At the end of the residence program, Rise left IDEO with a rebranded and optimized sleep training system. Here’s how it works: Players and coaches receive a short, in-person introduction to sleep coaching by a Rise employee. Players who opt in to the service receive a sleep-training kit that includes the Rise Coaching App; adaptive sleep plans tailored to their chronotype, age, game schedule, and training load; a part-human, part-machine sleep coach that continuously supports each player, monitors progress, and gives timely feedback; in-context education that provides daily and weekly sleep insights; and products like UV glasses, sleep mask, and bed sensor. In just a week of using Rise’s full sleep program, 97 percent of players report getting 54 more restorative minutes of sleep per night.

Recently, Rise Science added the Chicago Bulls, Miami Dolphins, and the University of West Virginia to their sleep-training roster, enhancing their performance, one good night’s sleep at a time.

“Coming into IDEO, we knew our service was letting customers down. When we left, we had the blueprint for the next version of Rise. We were able to solve and optimize sleep at a much larger scale,” said Jeff Kahn, co-founder and CEO of Rise Science.

In the not-too-distant future, patients with chronic obstructive pulmonary disease could be equipped with a sensor that monitors their medication and inhaler use and prevents acute events. People suffering from clinical depression could be prescribed an app-based therapeutic program in place of a drug.

The digital therapeutics global market is estimated at $1.8 billion today, but predicted to reach $7.1 billion by 2025. Much of the growth is predicted to come through investment from traditional pharma, but there are several new players emerging from the tech and start-up worlds as well with the hopes of evolving into a digital therapeutic. Omada Health, which creates behavior change programs for managing chronic disease, makes its hundreds of thousands of patients feel seen and heard with personal coaching. Click Therapeutics develops software to support smoking cessation and address major depressive disorder in adults. The meditation app Headspace has convinced more than a million people to integrate meditation into their daily lives, with proven wellness benefits.

Companies like these are revealing transformative new approaches to helping patients tackle the thorny challenges at the core of chronic disease, mental health disorders, and a growing number of other diagnoses—and in the process, they’re creating and growing thriving markets where none existed before.

Might these digital products, one day soon, be prescribed by a physician who is concerned about her patients’ heart disease, diabetes, or weight? If Tesla released software that clinically validated reductions in car accidents, even for the most dangerous drivers, would that qualify as a digital therapeutic? We are just beginning to imagine and design the future of this industry.

But these products still face the age-old challenge: how to get people to actually use them. If patients don’t love and trust the experience enough to sustain engagement over long periods, many of these therapies—and products—will fail.

Any new approach needs to begin with the needs of real people, and to follow those needs toward products that are not only desirable, but also have viable business models behind them. Here are our four big takeaways drawn from IDEO’s experience working in this field, designing digital therapeutics that engage patients—and the market.

Put down the competitive landscape report

Innovations in science and health tend to be incremental, but by looking to other industries, it’s possible to identify opportunities for more radical change. Studying analogous experiences—services, products, and other offerings that deliver something tangentially related but not exactly the same—will clarify what kinds of experiences give patients a sense of meaning, delight and value.

A partner of ours in the biotech industry recently launched its first digital therapeutic, focused on helping patients manage diabetes. In piloting the experience, we encountered a big challenge: Patients were struggling to connect the at-home testing device to the bluetooth on their phones. Without it, the experience fell apart.

Instead of buying all of our competitors’ devices to look at their solutions, we brainstormed a list of organizations that were particularly good at helping people with a set of complex instructions—IKEA, ballroom dance instructors, piano teachers, NASA-to-spacecraft communications specialists, and others. We discovered that LEGO had made its first bluetooth-connected toy and—master of instruction that it is—had created instructions to guide even little kids through a simple series of steps. Inspired by LEGO, the team created a new set of instructions. Once they were integrated into the patient onboarding experience, nearly every patient was able to connect their medical device to their phones.

Prioritize the patient

It can be easy to fall into the trap of addressing the needs of payers and providers above the patients’. After all, if a digital therapeutic isn’t reimbursable, the underlying business may not be successful; and if a physician doesn’t know it well enough to prescribe it, a company can’t increase market share. These are critical pieces of the puzzle, but they need to come after the foundational concern of any new digital health venture: fitting your therapy into patients’ lives.

During early stages of design, we rely on user research to inspire countless possibilities, and revisit our insights when we need to refine (or flip) our ideas. User research informs the business model, helps define the path to market, and may also lead to other product features.

What does this look like in practice? Consider the digital mental health company Headspace. Headspace was designed to teach people the fundamentals of meditation, engaging them in an experience that might encourage practice and adherence over time. Initially, Headspace played with incentives like badges and friendly social competition, but it slowly came to understand that the most profound motivation was mental health itself. The company prompted meditators to remember why they meditate, and asked them who in their lives would be better off because they meditated. This consistent call for reflection and awareness led to higher overall engagement.

Headspace’s popularity has catapulted the company to $100M in annual revenue and more than a million subscribers. Once the company designed an experience that people loved, subscribers embraced the product and took it upon themselves to host Facebook groups, meet-ups, and events. Headspace then opened up partnerships within the formal health industry, adapting to the needs and requirements of providers, payers, and regulators. Today, Headspace is a benefit offered to employees of over 350 large companies worldwide, and providers and health systems across the globe offer it to their patients. If you design an effective product that patients love, players in the health system have incentive to offer access.

Design with and for your most extreme, hard-to-engage patients

Designing for extreme users illuminates the wide range of people who might use a product. In IDEO’s earlier days, we saw this most clearly when we designed physical products like ice cream scoopers and pizza slicers for older adults, people with arthritis, and children with limited motor skills. We ended up creating something those populations could use, but in doing so, we developed a universally easier user experience. The product design outshone its competitors and became a top consumer choice.

In the world of digital therapeutics, this approach might entail designing for patients with limited experience using digital technology, or focusing on patients living with multiple chronic conditions, or with profound barriers to accessing care. These patients can help shape a more equitable and inclusive therapeutic experience.

One of our most challenging digital therapeutic projects involved creating an app-based experience to combat depression. To engage with potential users, we traveled to the rural Rocky Mountains to an isolated community where we met Dan, a cowboy and rancher living 40 miles away from his closest neighbor. Dan had struggled with depression for most of his adult life. On a good day, it was hard for him to get out of bed. On a hard day, he struggled with suicidal thoughts.

Before talking to Dan, we considered all of the technological features that could encourage adherence, like enabling offline access and fast download speed in low-bandwidth contexts. But through talking to Dan, it became clear that the tactical challenges weren’t the biggest problem to solve. Even in more populated areas, depression itself can be isolating. Dan helped us co-design a digital tool that even he would be willing to come back to, day after day. One of the key features a digital therapeutic could offer would be connection to others—in real life—and a chance not only to receive help, but to give it. Informed by Dan’s story, we designed an experience that could connect people living with depression to each other and engage them as supporters, mentors, and advocates.

Launch a thousand prototypes

One of the biggest challenges facing health innovation today is the belief that you need to have a solution before you really grasp what people want and how they want it. That’s how the industry is constructed. You would never write a grant proposal without telling the funder exactly what you will deliver, nor allocate budget at a pharmaceutical company without a detailed plan and anticipated ROI.

For digital therapeutics, those constraints are blown wide open. Our task is to come up with as many ideas as we can and test what will actually stick. Prototypes pave the way to a solid, working product, and patient input on prototypes can be used in countless safe, thoughtful ways.

Recently, we worked on a digital therapeutic that helps people manage the tremors associated with motor disabilities such as Parkinson’s Disease. Instead of the typical treatment, which solely relies on an oral medication known to have serious side effects, we were tasked with working on a software and hardware system that delivers targeted electric pulses to the part of the brain that calms tremors. We began with a long list of open questions about what patients living with Parkinson’s would find acceptable, usable, and engaging.

When we went into the field to interview patients, we quickly realized that they had no idea what it might be like to rely every day on a digital device that’s crucial to their health. They were curious about the inner workings of the therapy, and asked questions about the technical, logistical, and philosophical implications.

Our first prototypes included a dozen hats, headbands, or pillows that a patient might wear to charge the implanted device. We also prototyped many digital interactions, from Alexa add-ons to iPhone apps, that might guide them to administer digital medication. To take advantage of bio-monitoring data, we created numerous dashboards, exports, and communication portals that might help patients, providers, and caretakers make sense of what was happening neurologically.

A lot of those ideas were failures, but the things we learned were priceless. For example, it turns out that despite the growing number of retirees on Alexa, many of our patients didn’t trust a voice-controlled app with a task this important. It also turns out that the headgear a person needed to wear could easily make them feel embarrassed, unattractive, or emasculated. One of the most important discoveries was that faster charging is not better, if slower charging meant you could fold laundry, watch your favorite TV show, or weed the garden at the same time. At the end of the day, we designed a hundred prototypes before we landed on the key value propositions, features, and usability standards that would shape the experience.

Tying it all together

Breakthrough products and experiences like Click Therapeutics and Headspace all align with the framework outlined above. But to be clear: They aren’t successful because they have a silver bullet for engagement or the best theory of behavioral economics. They are market-movers because they focused on their users and designed their products around what they found. That led to creating something people love, and success quickly followed. It’s a formula you can apply to creating your own digital therapeutics—or any product you want users to love enough to use in their daily lives.

Illustrations by Nien-Ken Alec Lu.

The next era of digital health has arrived, and it’s booming.

But in practice, when we’re making something genuinely new, we often don’t have data to begin with, nor do we even know what kind of data we will need. We’re staring at a blank canvas, so the only way to dive in is to listen, observe, and sketch.

Making ideas real didn’t just mean collecting biometrics about patients and displaying the data in a smart way. It was much more important to use data to help experts and patients build and maintain a relationship, track progress, adjust course, and figure out next steps. These elements are all an integral part of how the service operates. And in the process, I came away with a few principles for data scientists to keep in mind when using data as a medium for design.

1. Be part of research

We needed to know what experts ask their patients to help support them in their journey to self-management, and what is reasonable to ask patients for. Is it fair to ask somebody who mainly eats at restaurants to accurately track the micronutrients of everything they eat? Probably not.

It’s critical to understand people’s real needs in their context to understand what data is meaningful and feasible to collect. Qualitative field research is key in the process of developing empathy for those we design for and for getting a feel for what life challenges might get into the way of data collection. Understanding when we can collect data—and when we can’t—provides valuable information.

2. Sketch by hand and share

Informed by research and armed with crayons, we created a variety of data visuals aimed at tracking patient progress in various aspects of their day-to-day lives—basically, sketches of the features that might be helpful. Drawing is much faster than writing code. We made the visuals a prominent part of the project room to serve as a catalyst for brainstorming and discussion with other members of the team who aren’t data scientists. We explored trends of activity and sleep over time, and played around with visual ways to track mood and to inform people of healthier food options without asking them to count calories and micronutrients.

This approach allowed us to make significant progress in two ways. One, showing our sketches to experts allowed us to narrow down which metrics were useful, and to start tracking down potential data sources. Sketching in crayon versus writing in code also helps us fail faster and narrow in on the right questions to ask.

And two, sharing our sketches with the broader team, which included designers from a broad spectrum of disciplines (communication, interaction, research, software, business), made our work more transparent and helped us establish a common language. It also sparked conversations, inspiring us and helping us to gather further feedback.

3. Gather up and agree on all your data

Once we identified useful visuals, algorithms, and interfaces, we began hunting for the data that could fill them in and move us to higher fidelity prototypes. In our case, data included the client’s historical data, simulated data, and team data. We simulated data about meals and snacks and plugged it into publicly available nutritional APIs. This exercise allowed us to identify the types of data that might be suitable as input for these APIs.

We also bought a bunch of trackers for the team to explore ways we might keep tabs on activity, which showed us where a tracker might go wrong (moving your arm in a circle might count as a step, when in actuality you’re not taking a step at all) and narrowed down the types of data that are meaningful to collect (for example, movement vs. steps). By diving in with our own data, we were able to fill our communcation, interaction, and software designers in on how we would approach collecting patient info.

4. Look to the future

As we were exploring data solutions for the various components of this service, we had to keep in mind that design and development take time and resources. For example, tracking micronutrients via nutritional APIs relies heavily on the assumption that patients are willing—or will even remember—to share their meals. In reality, we didn’t know what patients were willing to share about the foods they eat, nor did we know what food-related information experts need to track a patient's progress.

Redirecting the team’s effort to a lower-fidelity solution to track these behaviors (say, allowing patients to share a food journal) can save a lot of time and effort while still informing the future development of the service.

As a data scientist, starting with people and crayons rather than data and a keyboard felt uncomfortable at first, but it made the process of identifying what’s important and doable much more efficient. Making data science a visual part of the project space also helped the data scientists on the team become co-designers from the very beginning—meaning that we could contribute a lot more to the project. Hopefully, the tips above will empower you to do the same.

A big thank you to Mike Stringer for his help shaping this piece.

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You might think the first thing data scientists do on a project is grab a bucket of data and run with it. And for good reason—that’s how many data scientists write about projects after the fact.

In business, new models and offers are further constrained by the need to satisfy current stakeholders and follow market trends. So how can you break free of present-day realities to envision a genuinely novel future?

In other words: Design can move us beyond the imagination-traps of our own experience to uncover truly new possibilities.

When I founded IDEO’s CoLab four years ago, one of our goals was to find new ways to catalyze visionary business leaders and to activate new models by assembling diverse perspectives from across industries. We frequently employ design fiction exercises with our partners to open up more exploratory approaches to tough problems—particularly the ever-changing nature and role of technology. The process helps connect the dots between an aspirational vision of the future and a business approach that can make that vision a reality.

How to apply design fiction to your business

The futures that we imagine are based on a few catalytic data or trends—“inevitables”—that serve as foundational elements of a future vision. By anchoring on these inevitable factors, we can then imagine the implications that ripple across a business, industry, or society. For example, five or 10 years ago, one might have assumed that smartphone ubiquity was inevitable and started to imagine the implications (good and bad) of everyone in the world having access to a super computer, the internet, a camera, and more. By extending from what’s already true to what might soon be true, it becomes possible to exert some agency in the way you move forward, even when you can’t know exactly what’s ahead.

The late Bill Moggridge (an IDEO founder who came up with the concept of a folding laptop) referred to this as “preferred futures.” In this view, rather than viewing the future as something that happens to you and can’t be controlled, you adopt the mindset that you can influence what happens, asking, “What future do we want to create? And how do we reverse engineer the pathway to get there?”

It sounds pretty heady—perhaps something to be left to experts—but the process of creating design fiction is actually accessible to most people by following a four-step process. This exercise is inspired by an activity from a class at UC Berkeley’s Haas School of Business called “Designing the Future” that I taught alongside two IDEO business designers, Becca Carroll and Sandeep Pahuja.

1. Pick an industry and describe its role in the consumer’s life

Let’s take insurance as an example. Insurance is a safety net for when something bad happens. But insurance customers don’t simply want protection—they also want to understand and manage risk, find the most agreeable policy to ensure support when they need it, and trust that their claims will be processed and paid. These criteria are often referred to as the “jobs to be done”—in short, they are the things the consumer has “hired” the product to do.

2. Write a story about the future, free from today’s constraints

If you focus on the “jobs to be done” (and don't get caught thinking about existing insurance companies and how they operate), you can begin to imagine new ways to do those jobs for customers with the help of new technologies and other shifts (behavioral, regulatory, etc.) we believe will be relevant in the future.

For example, if we take the job of understanding risk, there’s a story to be told about machine learning and the explosion of sensor data, which will allow us to create more sophisticated risk models. More sophisticated risk models could lead to a more personalized approach to assessing risk and ultimately the ability to provide more relevant products to customers. In this future, perhaps insurance companies shift from being the safety net after something happens to proactive behavior change coaches who help protect you before something happens.

When writing a story about the future, we continually ask, “What future do we want to create?” This helps us focus on the ultimate goal of creating value for people and preventing harmful consequences, not just creating new technical capabilities and hoping for the best. In this case, we answer it by imagining how the experience of insurance might take on an entirely new form and function when enabled by the tools of the near future.

3. Back out to the assumptions that would make this future real

Taking this vision of the future as possible, we can work backwards to uncover the assumptions need to be in place to support it coming to be. Our go-to provocation is inspired by Roger Martin and Jennifer Riel: What would have to be true to make this future a reality?

Asking what has to be true is a powerful tool to help you optimistically articulate the key assumptions implied by your story and connect them to your current offers and potential path forward. It’s easy to come up with a long list of reasons why something won’t work, and this often leads to risk aversion and incremental thinking. By surfacing the criteria for success you can pragmatically assess how realistic these assumptions are and design experiments or milestones to demonstrate if you’re on track. Invite your colleagues to get imaginative alongside you and uncover even more ideas.

Elon Musk famously published his master plan (and then a second) for Tesla that stepped through five key assumptions that would allow Tesla to move the automotive industry towards an electric future. These included making electric vehicles high performance and cool—a shift from the pervasive negative view of EVs’ aesthetics and functionality; and changing the notion that these cars are too expensive for average consumers, riding the scale/cost curve to reduce the price and range of vehicles, and making them more accessible to the mass market.

4. Prototype

So now you know what would have to be true. Are those things possible? Rather than speculate and debate, prototyping is your way to find out. Begin with scrappy, low-fidelity prototypes to test your assumptions and continually iterate forward, incorporating your learnings into higher-fidelity prototypes. Getting really clear on these key assumptions enables you to take an evidence-based approach to making investment decisions in risky innovation projects.

As quickly as possible, you’ll want to test your assumptions in the market. This is another sticky point where risk aversion and desire to jump to scale can grind progress to a halt. Designing in-market experiments that are right-sized and laser focused on testing key assumptions is an organizational skill that is difficult to cultivate. Successful startups often are forced to be quite scrappy in the market and increasingly, larger companies are building these capabilities. The founders of Airbnb famously tested their idea out by renting out air mattresses in their apartment during a conference. Established companies are getting into the act too, LEGO, Coca-Cola and General Electric have all market tested new products on crowdfunding site Indiegogo.

It’s unlikely that there’s only one viable solution to get to any preferred future—there are many avenues that may get you there and thus it’s important to diversify and have a number of bets. Many entrepreneurs will tell you that their current business is not exactly like their original business idea. Often, it’s pretty far from it. That’s because the steps required to go from idea to reality involve a lot of prototyping, experimentation, and openness to change along the way. Whether you work in the field of innovation, you’re an entrepreneur with a startup, or you have an idea for a business that you’re ready to explore, using the principles of design fiction and cross-organizational collaboration can help.

Hear more on design fiction and cross-organizational collaboration in this episode of IDEO U's Creative Confidence podcast.

Illustration by Mark Conlan.

There’s no such thing as a truly original idea, or so the saying goes. Even the most imaginative inventors and artists are limited by the boundaries of their own experience, and every fresh idea is derivative of something that came before.

In the 70s and 80s, Cey’s earliest work was exhibited next to Jean-Michel Basquiat and Keith Haring; later, as the founding creative director of Def Jam Recordings, he developed the visual identities for the Beastie Boys, LL Cool J, and more. Recently, you may have also seen his collaboration with Pabst Blue Ribbon and Levi’s. He may not admit it—he's too humble—but Cey has definitively shaped hip-hop culture, design, and beyond.

When I met Cey through a mutual friend, I was immediately taken by his uniquely bold style and refreshingly humble spirit. I asked him if he’d work on a creative project at the IDEO New York office. After the completion of Revolution Solution, we sat down to talk about his creative journey, why he left and then returned to New York, and what it means to be, as he says, “an artist without a blueprint.”

Diana: Let’s start with how you got into hip-hop, working with Russell Simmons and Def Jam.

Cey: When I met Russell in the early 80s, the term hip-hop wasn’t even coined yet—it was just rap music. A photographer had given me Russell’s business card, and I went down to his office to show him my portfolio. All I had were photos of car washes and commercial walls I had painted. But he said, “Okay, we can find something for you to do.” There wasn’t a long-term contract, but to me it might as well have been one. I’m laughing now, but the best thing about being young is that you don’t know enough to feel empowered. You just know they’re not saying “no.”

Did your graffiti art influence your hip-hop design?

To me the responsibility was always how to transform a language everyone was familiar with into something else. You see graffiti on the subway, scrawled on the walls, but I knew it was bigger than that. My question was how to elevate graffiti and keep its integrity.

Was there a breakthrough moment when someone said, “Now I see the power of what you’re creating”?

You know what? I never really heard that. At the time, nobody had formal training so it wasn’t like they understood the power of graphic design. It wasn’t until LL Cool J’s record Mama Said Knock You Out hit number one that I felt that recognition. The album cover was a beautiful black and white photograph of LL shot by famed photographer Michel Comte, and that was when everyone finally saw it as art.

What are you most proud of from that chapter in your creative life?

I think about the artists more than the creative pieces. It’s a little embarrassing to say, but sometimes I’ll dream that it’s 1987 again and we’re on the Together Forever Tour with Run-D.M.C and the Beastie Boys. We’re reliving everything as adults, and we’re all so much more appreciative. Then I wake up and realize it’s just a dream, and Adam Yauch is gone and Jam Master Jay is gone, but I realize I was actually there. During that time I learned about the power I had that I didn’t even know I had.

You went on to art direct the book Hip-Hop: A Cultural Odyssey, which captures the essence of the hip-hop era. What came next?

That book is synonymous with hip-hop itself. The fact that the publishers were convinced to make a book so huge is wonderful! The design of that book was completely my vision, I got to experience every creative idea I’ve ever wanted in that book.

Around 9/11, I realized none of this stuff mattered in the same way anymore. I got disillusioned with the business and the misogyny. I knew I couldn’t change how everyone thought, but I could take myself out of the equation. By that time, I’d designed as many albums as I needed to and wanted to try something else.

After spending a few years in Hollywood doing film titles, I moved back to New York to get my hands dirty. I missed making things so I began painting again and learned silk screening. After I made a few pieces, Adidas commissioned me, Shepard Fairey, and a handful of others to make original works for a clothing collection celebrating the life of Muhammad Ali. Working with Adidas was my first major corporate partnership. That got me thinking, maybe partnering with major brands isn’t the worst thing in the world.

At the time, I was also teaching art to high school students at Brooklyn Academy of Music. Over a ten-week course, I had to create dozens of lesson plans. I came up with every possible creative scenario to challenge their notion of what art could and should be. I stumbled into working with collage then.

That was a small start of something big. Tell us more about your work with collage.

For one of my lessons, I cut out a giant letter and had each student pick a color and fill in a small area of collage. The letter was broken up so nobody knew what it spelled. At the end of the project, we’d have a family sharing moment and present the final piece. The students would line up holding letters that spelled “FREEDOM” or “JUSTICE.” It was such a powerful way to communicate. I realized that collage combined what I learned as a graffiti artist with my love for letterforms.

This makes me reflect on a conversation we had at the beginning of our collaboration when you decided to create the number “25” for the IDEO NY mural. We had lots of discussions around bravery and creativity. At one point, you quietly offered that “maybe it’s not about a word.” Tell us why letters and numbers are so important to you.

There’s a simplicity working with letters and numbers. They break down barriers. The process of making collage is so involved that I don’t want the design to get too busy. Letters and numbers let the design be bold and simple, but the execution is always complex.

Speaking of murals, can you tell us about the One Nation mural you created for the new National Museum of African American History and Culture?

When I was invited to make a piece for the ribbon-cutting ceremony with President Obama, I said yes immediately. The whole thing was surreal. Just the existence of the museum was something I’d been waiting a lifetime for. The only guidance they gave me was to make a piece of art that the community could contribute to. A collage was the perfect vehicle to do that. People could contribute to creating a piece that was bigger than themselves. That’s the beauty of collage.

Trusted Brands came next, which brought together your graffiti work and your graphic design work. What inspired the series?

As a kid in the 60s and 70s, I loved seeing huge graphics like the 76 logo whizzing by on the highway—Trusted Brands was an homage to the symbols of that period in my life. As I was working with collage, I started wondering what the next thing was going to be. After doing letters and numbers, I wanted to do a project that nodded to my favorite brands.

Just recently, I partnered with Pabst Blue Ribbon to reimagine their signature 12oz can and launch National Mural Day. Like Trusted Brands, I wanted to pay tribute to the brand’s history and iconography.

Looking back on all of these chapters, is there a specific approach or ritual in your creative process that is the “Cey Adams secret”?

I always try to make work that is positive and uplifting. Even if it’s all black, I’m thinking about how to make something that will make someone feel good.

While you were creating the IDEO NY mural, we had three and a half months of your lovely presence in our studio. What was it like to be with us at IDEO?

One of the coolest things was creating in the lobby. I thought I’d be in a project space, but being in a community space that you can’t control was the best thing I could've done. Had I done it another way, I might've reached the same results visually, but I wouldn’t have had the same experience interacting with people in the moment.

I have such an appreciation that an organization like IDEO exists because it’s so nurturing to creative talent. Even at the age that I am now, I crave it so much! Not that I need to be patted on the back everyday, but it’s refreshing, that feeling of love and support is foreign to me.

A peek into Cey Adams' creative process. Video produced by Ian Gittler.

You might not have realized it in the moment, but you’ve seen Cey Adams’s art—on album covers, gallery walls, and the streets of New York City.

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.