In 1987, the three companies that would later form IDEO worked together with Microsoft to create the world’s first ergonomically designed mouse. IDEO’s human factors research suggested a small but significant change: Moving the location of the mouse ball forward, from under the palm to under the fingertips, enabled more precise control and resulted in measurable performance differences compared with earlier models.

The industrial design effort examined and tested dozens of shapes in comfort and aesthetic studies that led to the famous “Dove Bar” form, a significant advance over the boxy mouses prevalent at the time. The resulting clean appearance, enhanced control, and improved reliability created enormous consumer appeal that replaced all earlier versions, and Microsoft sold more than 2 million units in its first two years.

With approximately 55,000 Americans waiting to receive kidneys and a list that could double in the next 10 years, there is an acute and urgent need for new technology to increase the quality and number of organs available for transplant. Using the conventional method of organ storage and transportation—a cooler filled with ice—doctors and nurses needed to accompany the organ to ensure proper handling.

IDEO and Organ Recovery Systems created the LifePort Kidney Transporter to provide a new high-tech alternative. The LifePort gently perfuses, or pumps, the kidney with a cold liquid solution to improve its condition before transplantation, which can nearly double storage time and may increase the number of usable kidneys and improve patient outcomes. The device also provides critical data to monitor and evaluate kidneys during transport.

Organ Recovery Systems believes that perfusion has the potential to remove tens of thousands of patients from the waiting list and dialysis, and save the healthcare system more than $1 billion annually. In 2006, the LifePort Kidney Transporter was used to transport 350 kidneys per month in 12 countries, and was included in the permanent architecture and design collection at the Museum of Modern Art in New York City.

Pediatric healthcare system Nemours provides primary, hospital, and clinic-based specialty care, prevention and health information services, and medical education programs in Delaware, Florida, New Jersey, and Pennsylvania. When Nemours wanted to strengthen its brand, it faced two challenges: Empowered patients had more access to information and choice than ever before, and new players—alternative-care centers, retail-based care clinics, and urgent-care centers—were entering the marketplace, diverting market share.

Nemours approached IDEO for help in creating an innovative, differentiated, and patient-centric experience for a new hospital in Orlando, with the goal of establishing Nemours as a destination care provider and industry leader. Together, they identified and clarified both family needs and key experience touchpoints in the patient journey, resulting in the state-of-the-art-designed, 60-acre, $400 million Nemours Children’s Hospital in Lake Nona Medical City, Florida. “The design team’s approach to defining key moments in the patient journey was highly instructive,” said Dr. David Milov, chief of clinical informatics at Nemours. “They captured insights otherwise unavailable to us.”

Concepts that were realized in the hospital’s final design include:

• Care Team Room ID: Patients and families are introduced to each member of their care team to ensure continuity of care.
• Floor Greeters: Concierge-like greeters welcome and orient families and answer questions.
• Family Lounges: Private dining rooms have kitchenettes, so families can cook and eat together.
• Emergency Department: Patients are greeted, sorted by medical condition, and immediately checked into rooms.
• Patient Information Screens: Doctors and nurses can access patient information prior to entering an exam room to enable informed conversations and build trust.
• Smart Bracelets: Personalized RFID-enabled bracelets keep track of the care team.
• Smart Rooms: Triggered by the Smart Bracelet, Smart Rooms “welcome” the patient upon entry.

To arrive at these designs, IDEO sought inspiration via analogous kid-friendly environments, such as museums, schools, toy stores, and zoos. Designers also conducted in-context interviews with patients, parents, families, doctors, nurses, support staff, and outside physicians. One key insight that led to the final design: Patients and families came to Nemours with varied levels of experience—first-timers, occasional visitors, and those who were chronically ill—but the hospital treated them all the same.

To address these needs, the team created an experience blueprint focused on welcoming, guiding, and supporting patients and families through unique environments, integrated service moments, and market-differentiating spaces and tools. To test the look, feel, and value of the designs, designers built full-scale foam core prototypes of welcome stations, waiting lounges, and exam rooms.

The results appeal to patients, families, and caregivers. According to Dr. Lane Donnelly, Nemours chief medical officer, “all the amenities at Nemours focus not only on the child but their parents and families as well.”

The hospital won two awards at the International Interior Design Association’s 2013 Best of the Best Gala (Georgia Chapter), one for the Healthcare Design category and one for best overall out of all 11 categories. Parenting.com writer Shawn Bean noted, “Set amidst a wooded expanse of central Florida, with theme park roller coasters peppering the horizon, Nemours Children’s Hospital is arguably the new high water mark for pediatric care in the United States.”

Designer turned educator Kiran Bir Sethi wanted to blur the boundaries between school and life to help young students become aware, enabled, and empowered to effect change in the world. In aiming to spread her message to millions of children across India , Sethi tapped IDEO and the d.school at Stanford to help create a design contest for youth that would show them that they could make a difference in their community.

Together with the d.school, IDEO designed a competition for middle school students called the Design for Change Contest. Adapting the human-centered design approach into a simple process that 10- to 13-year-old kids could follow on their own, the contest included rules, tools, and platforms that would be accessible to children and teachers throughout India regardless of their previous exposure to design.

The team shaped the rules so that students could learn core design-thinking skills such as empathy, brainstorming, collaboration, and reflection through the process of participating in the contest. And together, the group developed a toolkit to walk students through the simple four-step process.

The biggest challenges to the contest were overcoming the lack of infrastructure, language barriers, and a discrepancy in school resources. There was no national database of schools for easy outreach, so Riverside built relationships with NGOs across India to distribute the contest toolkit to more than 30,000 schools.

The contest receives about 2,000 entries from groups of youth in India each year. They have been addressing challenges such as illiteracy, pollution, traffic safety, care for the elderly, alcoholism, and the environment.

As of 2015, the Design for Change Contest has scaled far beyond India, and is being run in 30-plus countries, with millions of children participating. Each contest entry shows that kids really can make a big difference in the world.

While we designed a new family of acoustic amps for Fender, we squeezed into an Airstream for two months to better understand the touring musician lifestyle. And when we wanted to better understand the environmental impact of the things we design, we visited a sewage treatment plant to see what happens when a product can't be recycled.

We go after big problems that have never been solved. And by going all in on the unfamiliar and uncomfortable, we’ve come up with creative solutions that we might not have imagined before.

As an industrial designer, I’m a builder. I experience the world with all my senses and apply my tangible building skills to make experiences and systems. Technology inspires me because it's always been an important vehicle to advance our current state. With technology racing forward at an ever increasing pace, some advancements can impact us on an unprecedented scale. As shapers of the future, we must strive to understand the consequences and implications of emerging technology. We do this by asking ourselves uncomfortable questions about possible outcomes during the design process in areas like healthcare, the future of work, and the circular economy.

In order to better understand how emerging technologies could affect our day-to-day life, my colleagues from multiple design disciplines—industrial design, data science, communications, interaction design—and I embarked on an internal IDEO project that could give us some clues. We got curious and asked ourselves, How might the way we’re communicating with each other change with new technology? How might we collaborate together in the future when we can show up in different realities? What could be possible if the digital and physical world blend seamlessly into each other? How will we protect our privacy if we can teach devices our most personal preferences, and what will happen to our data?

We named our project The Discomfort Zone.

In order to explore these uncomfortable, out-there questions, we had to experience them ourselves, and to experience the future we had to build it. Here are the tools that we built:

Personalized Intelligence: by building a camera that can be taught to take the best self portraits based on individualized feedback, we experienced the idea of actively teaching machines our preferences. The user trains it on their ideal lighting, placement, composition, head tilt, and facial expressions. While it may seem like a trivial thing to create, teaching machines to see us how we see ourselves can show us the path to building other devices—like health devices—that the user can teach to adapt to user preferences and feedback.

Complementary Media: a device that can be taught to recognize facial expressions and emotions, then generates an appropriate, customized emotional expression for each user—like a personalized emoji—helped us imagine more depth and expressiveness online using artificial intelligence. This tool can communicate real human emotion, which could lead to improved communication among children, for example.

Shared Realities: a tool, bridging the physical and virtual, that allows workers operating in VR to sense the presence and movements of colleagues around them as if they are on the same plane. An exploration of how virtual and augmented technology might improve collaboration, it allows people to respond to virtual coworkers’ cues without fully disrupting work in the virtual environment.

Network Empathy: code that enables a user to anticipate how large social or interconnected user networks will react to messages before they are posted, bringing deeper understanding and empathy to online communication. With cues from large online networks, smart technology becomes even smarter and empathetic interaction online becomes easier—especially when it is applied to high-profile communications, or at mass scale among networks that might be discussing politics, health, or education.

Meta Identity: code that is invisible to naked eye can be embedded in an object to make it readable by a machine—not unlike a barcode—and give it meaning online. Branding and production methods might evolve toward this physical tagging method, so that users easily learn about physical objects they see, and find them online. Making the physical as searchable as the Internet could further empower consumers to align their purchase decisions with their beliefs and values.

As designers, it is our responsibility to explore the discomfort zone, design holistically, and consider the full range of possibilities of what we create. For example, as much as Network Empathy was intended to be an inclusive tool, it could also be used to manipulate public opinion by predicting the reaction of large audiences. If we use Personalized Intelligence to teach our devices our most personal preferences, what becomes of this new personal data? And who is the owner of this information: the device, the platform, or the individual?

Because technology will serve us on an even more personal level, the stakes are high. Designers are uniquely stationed to be the connectors in an ever more complex ecosystem of stakeholders, and we must ensure the tool leaves the lab and enters an ecosystem with safeguards in place to have a positive impact.

We’re at the dawn of something big and unknown. New technologies are shaping the future in ways we haven’t even thought of yet. Some of them will have extraordinary benefits, while others, through unforeseen capabilities or even sinister intentions, may have unwanted consequences. But as designers, it’s up to us to explore them early, dive into the unfamiliar, and do what we can to shape the future for the better. We’d love for you to join us here in The Discomfort Zone.

The Discomfort Zone was a collaboration among many designers at IDEO. Special thanks to all involved, including the core design team: Leo Marzolf, Jochen Weber, Brooke Thyng, Christian Ramsey, and Nan Tsai.

So much of being a designer is being willing to embrace the uncomfortable. We create new products, experiences and systems for people whose needs are different than ours—sometimes really different.

In one sentence, who are you?

I am an illustrator who enjoys bringing any amount of joy to people through my creations.

What do you do? How did you learn how to do it?

I create different drawings using pencil and ink. The illustrations range from patterns to caricatures, unique creatures, and other one-off ideas. I grew up sketching and doodling and it has continued. When I moved to LA, I was suddenly surrounded by an amazing cadre of artists and creators who constantly inspire me, as well as push me to keep improving myself. That is how I learned my craft and continue to learn, because I believe you never truly finish learning.

What are your 3 favorite possessions?

Miniature Back to the Future 2 hover board; Magnum P.I. Tiki Mug; a drawing of my fiancé and me, which she drew. Not in that order.

What does a typical work session look like?

I have a running list of ideas and sketches that I pull from if I don't have an art show with a specific topic that I am working towards. Usually, I'll do some Google searches on the topic at hand and pull a bunch of reference photos for perusal during the pencil drawing stage. I sketch out the drawing inside a pre-drawn area, such as 4x6 or 5x7. Art that is easy to frame is always a goal of mine, because I love framed art and it drives me mad when I see things tacked onto a wall or cork board. After finalizing the pencil drawing, I'll usually step away for a moment or two to play a video game or watch a show. I like to do something that differentiates the time between stages. Once I come back to the drawing, I pull out all the different micron pens that I think I will use for the piece. I check the nibs, and then I begin inking. I put on dramas in the background to listen to, or things I've seen a ridiculous number of times. West Wing and Parks and Recreation are two such shows.

I don't like to start inking unless I am going to finish a drawing that night. Sometimes, a piece is too large, and I have to break it up over two nights. If that happens, I make sure the pens I've used on the previous night are away from all my other pens. I do this to achieve a consistency within the lines. Once finished, I scan the piece, put it within a predetermined frame, and pack it up for a craft fair or deliver it if it's for an art show. Rinse and repeat as necessary.

How do you get over creative block?

I used to stop drawing and just stew for a bit until it finally passed, which could take a bit of time. As I've gotten older, and ever so slightly more confident in my abilities, I push through it. I just keep drawing. Yes, sometimes the drawings are awful, but as Lauren (my future wife) always says, "sometimes you just have to pass a rat."

How do you see the world in 2078?

A lazy utopia, filled with autonomous everything. Humanity will have moved past Earth and outward into the stars while robots cater to our every whim and we become fat and happy. I could be confusing my vision of the world in 2078 with the timeline in Wall-E—who doesn't yearn for the saccharine dreams of Pixar in 2017. It is tough to image the future right now because at this moment it feels as though we are hanging by a loose wire, and any minute now someone with a spray tan is going to cut the wire and tell us all how huge his ratings are, as we all fall to our collective doom. I hope we make it to 2078, if only so that I can enjoy my hover chair and 128-ounce Slurpee.

What’s number one on your bucket list?

I should say something epic like bungee jumping off of Thomas Jefferson's nose on Mount Rushmore, but honestly, I'd like to have my own artist's studio. Some place I could retreat to and tune out the world and draw silly pictures. That to me is something I want to do before I fade out of this existence.

Who are you creative crushin’ on lately?

I've had a one-sided love affair with Dustin Harbin for a long time. I own two of his original pieces and his diary comics book. The man can use an ink nib like Aaron Sorkin can turn a phrase.

I’ve been creative crushing on Austin Salmi since I saw his doodles, patterns, and adorable characters on Instagram almost two years ago. Austin’s work, learned through practice and osmosis in his job surrounded by artists, has a giggly character about it that fits his intention to hide the ugliness of the world for a moment, and make lovely order out of chaos. I got to learn a bit more about him and his process in this installment of Creative Crushes.

We had just begun work on a project exploring how we might help a medical-liability insurance company increase patient safety by learning from past incidents. As we talked, our conversation shifted away from excitedly imagining ideas for data-driven tools toward ways our work might potentially do harm.

What if our designs ended up raising premiums for doctors and, in turn, healthcare costs for patients? What if they kicked doctors off their insurance? What if doctors stopped reporting adverse events to keep their premiums from rising? There was real potential that our work could result in reduced patient safety or increased cost of care. We could inadvertently build a tool that could be used against the very people we were trying to help.

Today, data systems and algorithms can be deployed at unprecedented scale and speed—and unintended consequences will affect people with that same scale and speed. How can we always make sure we’re putting people first when designing large scale systems? Especially when those systems will change over time and evolve without direct human supervision?

The seed planted during that bar conversation has grown into a set of principles, activities, and now a set of cards that our teams—both data scientists and designers across every other discipline—use to ensure we’re intentionally designing intelligent systems in service of people.

We’re far from the first people to ponder this. We’ve been inspired by organizations like AI Now and Data + Society, books like Weapons of Math Destruction and Technically Wrong, academic communities like FATML and CXI. In particular, we’ve been eagerly following O’Reilly’s series on data ethics (and encourage you to read their free ebook, Ethics and Data Science).

To develop our own set of guiding principles, we started with people. We talked to folks all across the globe: We interviewed IDEO teams about where they found challenges. We spoke to our clients about where they saw intelligent systems go awry. We spoke to the public about where smart designs seemed to cross lines. We observed and read about AI systems that had gone off the rails and worked to understand how this might have been avoided. We learned a lot.

We came up with an original design, iterated on them, and landed on a set of four design principles and ten activities that can help guide an ethically responsible, culturally considerate, and humanistic approach to designing with data. These activities are meant to provoke thought; they’re a vehicle for introducing new ideas and stimulating conversations around ethics throughout the design process.

To start, here are our principles:

1. Data is not truth

Data is human-driven. Humans create, generate, collect, capture, and extend data. The results are often incomplete, and the process of analyzing them can be messy. Data can be biased through what is included or excluded, how it is interpreted, and how it is presented. Unpacking the human influence on data is essential to understanding how it can best serve our needs.

2. Don’t presume the desirability of AI

Just because AI can do something doesn’t mean that it should. When AI is incorporated into a design, designers should continually pay attention to whether people’s needs are changing, or an AI’s behavior is changing.

3. Respect privacy and the collective good

While there are policies and laws that shape the governance, collection, and use of data, we must hold ourselves to a higher standard than “will we get sued?” Consider design, governance of data use for new purposes, and communication of how people’s data will be used.

4. Unintended consequences of AI are opportunities for design

Just as with any design endeavor, we know that we’re not going to get it right the first time. Use unanticipated consequences and new unknowns as starting points for iteration.

To get started with the activities, you can download the cards here. We hope that these activities provoke dialogue and provide concrete tools to help our community ethically design intelligent systems.

Thank you to the larger team who helped make these cards come to life—Ben Healy, Jane Fulton Suri, Jess Freaner, Mike Stringer, Justin Massa, Connie Oh, and KP Gupta, who designed them.

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A design researcher, a business designer, and a data scientist were sitting at a bar. It sounds like the setup of a joke, but the conversation was actually quite serious.

As a user experience and interaction designer with a hybrid art and tech background, I’ve long been a fan of the concept of using art and design as a Trojan horse to make tricky concepts accessible. Through intrigue, curiosity, and play, these experiences can bypass our biases and open the door to understanding, without requiring deep comprehension. If you’ve ever visited a children’s science museum and watched kids excitedly engaging with subjects that would bore them to tears in book form, then you’ve seen the power of experience and play at work.

Meet ERNEST

That’s why my colleagues and I created ERNEST, an installation that gives the viewer the job of training a rudimentary artificial intelligence. Using facial and emotional recognition tech, ERNEST shows the user imagery and tries to see how happy it makes them. Our goal for this project was to engage users in a game-like experience to help them understand how machine learning models are trained, and subtly hint at the areas where bias could creep in.

Fellow IDEOer Matt Visco and I wanted to make sure ERNEST didn’t look like a modern computer—we designed it to look vintage. With its old hardware and nostalgic graphics, ERNEST doesn’t feel smart on the surface. Its look is meant to evoke a time when computers carried the promise of a utopian future, prior to mass connectivity and the ubiquitous collection of personal data.

The full installation uses five monitors, two computers, and three Raspberry Pis, which power several video loops that reveal the training data behind ERNEST, and give passersby a sense of the experience even if they don’t engage directly with it.

How it Works

ERNEST uses computer vision to perceive the user ambiently through facial recognition, allowing it to detect when a user is looking at it and how far away they are. When a user gets close enough, ERNEST comes alive and asks the user to help it learn. It then shows the viewer images intended to make the user happy, and gauges their emotional reaction based on their facial expression using a pre-trained model. The facial tracking and emotional data is displayed to the viewer in real time, encouraging users to make faces at ERNEST. Viewers can then validate the accuracy of the model to help ERNEST know if it was correct or not.

(Sound complicated? The video below might make it clearer.)

We installed ERNEST in IDEO San Francisco’s lobby for a couple of months, and also brought it to the San Francisco Art Institute Fort Mason Gallery for the CODAME Intersections exhibition in November 2018.

The Results

Many participants loved to challenge ERNEST, often emoting in varying ways through numerous loops of the game. Once, a group of participants spent nearly 20 minutes playing with ERNEST, takings turns to compare how it perceived each person.

When viewers interact and play with ERNEST, we’re helping them see that machines can have almost human-like perception, reacting differently to different faces, and sometimes being uncannily accurate...or completely wrong. The wrong guesses were in many cases more interesting, and were in fact a very intentional part of the design. We wanted users to see that artificial intelligence is sometimes not as intelligent as we might think.

ERNEST is meant to be a game, but what happens when real-world AI makes the wrong guesses? Or what if those wrong guesses are uneven, indicating an unintentional bias, such as working well for some faces but not others?

We wanted people to realize that designing systems that can ambiently perceive humans without direct input is rife with ethical concerns. And already, systems like these are being deployed at scale. The Guardian predicts emotionally-aware tech is already a $20B industry. Even something seemingly benign like ERNEST causes us to wonder—if an AI is trying to make the viewer happy, who determines what “happy” is? What if bad actors train Ernest to think that disturbing content is “happy?” What if the technology is repurposed to provoke anxiety or anger? What happens if we deploy technology like ERNEST widely?

Of course, ERNEST only scratches the surface of these big ethical questions, but we hope that it helps give people insight into how artificial intelligence thinks, and the ways its thinking can be flawed. The more that we as a society can start to understand these systems, the better we can judge their quality, and work to design them to be in line with our shared human values.

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Artificial intelligence and machine learning are among the hottest topics of the tech world, but some of us at the frontier forget that many people feel intimidated—or even afraid of—these technologies. The pop-culture trope of machine intelligence gone rogue has been a part of our cultural psyche for a good 150 years. Think 2001: A Space Odyssey’s HAL 9000, The Terminator’s Skynet, and The Matrix’s... Matrix. Combine that fear with arcane tech-speak like “recurrent neural network” and “generative adversarial network,” and in addition to feeling emotionally intimidating, AI and ML can also feel incomprehensible.

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.