Change by Design Read online

  A designer, no less than an engineer or marketing executive, who simply generalizes from his own standards and expectations will limit the field of opportunity. A thirty-year-old man does not have the same life experiences as a sixty-year-old woman. An affluent Californian has little in common with a tenant farmer living on the outskirts of Nairobi. A talented, conscientious industrial designer, settling down at her desk after an invigorating ride on her mountain bike, may be ill prepared to design a simple kitchen gadget for her grandmother who is suffering from rheumatoid arthritis.

  We build these bridges of insight through empathy, the effort to see the world through the eyes of others, understand the world through their experiences, and feel the world through their emotions. In 2000, Robert Porter, the president and CEO of the SSM DePaul Health Center in Saint Louis, approached IDEO with a vision. Porter had seen the episode of ABC’s Nightline in which Ted Koppel had challenged us to redesign the American shopping cart in one week and wanted to discuss the implications of our process for a new wing of the hospital. But we had a vision too, and we saw an opportunity for a new and radical “codesign” process that would join designers and health care professionals in a common effort. We challenged ourselves by starting with what is perhaps the most demanding of all hospital environments: the emergency room.

  Drawing upon his highly specialized expertise in the ethnographic study of technology and complex systems, Kristian Simsarian, one of the core team members, set out to capture the patient experience. What better way to do so than to check into the hospital and go through the emergency room experience, from admission to examination, as if he were a patient? Feigning a foot injury, Kristian placed himself into the shoes—and in fact, onto the gurney—of the average emergency room patient. He saw firsthand how disorienting the check-in process could be. He experienced the frustration of being asked to wait, without ever being told what he was waiting for or why. He endured the anxiety of being wheeled by an unidentified staffer down an anonymous corridor through a pair of intimidating double doors and into the glare and the din of the emergency room.

  We have all had those kinds of first-person, first-time experiences—buying our first car, stepping out of the airport in a city we have never visited, evaluating assisted living facilities for an aging parent. In these situations we look at everything with a much higher level of acuity because nothing is familiar and we have not fallen into the routines that make daily life manageable. With a video camera tucked discreetly beneath his hospital gown, Kristian captured a patient’s experience in a way that no surgeon, nurse, or ambulance driver could possibly have done.

  When Kristian returned from his undercover mission, the team reviewed the unedited video and spotted numerous opportunities for improving the patient experience. But there was a larger discovery. As they sat through minute after tedious minute of acoustic ceiling tiles, look-alike hallways, and featureless waiting areas, it became increasingly evident that these details, not the efficiency of the staff or the quality of the facilities, were key to the new story they wanted to tell. The crushing tedium of the video thrust the design team into Kristian’s—and, by extension, the patient’s—experience of the opacity of the hospital process. It triggered in each of them the mix of boredom and anxiety that comes with being in a situation in which one feels lost, uninformed, and not in control.

  The team realized that two competing narratives were in play: The hospital saw the “patient journey” in terms of insurance verification, medical prioritization, and bed allocation. The patient experienced it as a stressful situation made worse. From this set of observations the team concluded that the hospital needed to balance its legitimate concerns with medical and administrative tasks with an empathic concern for the human side of the equation. This insight became the basis of a far-reaching program of “codesign” in which IDEO’s designers worked with DePaul’s hospital staff to explore hundreds of opportunities to improve the patient experience.

  Kristian’s visit to the emergency room exposed a layered picture of a patient’s experience. At the most obvious level, we learned about his physical environment: we can see what he sees and touch what he touches; we observe the emergency room as an intense, crowded place that provides patients with few cues as to what is going on; we feel the cramped spaces and the narrow hallways and note both the structured and improvised interactions that take place within them. We may infer that the emergency room facilities—not unreasonably, perhaps—are designed around the requirements of the professional staff rather than the comfort of the patient. Insights lead to new insights as seemingly insignificant physical details accumulate.

  A second layer of understanding is less physical than cognitive. By experiencing the patient journey firsthand, the team gained important clues that might help it to translate insight into opportunity. How does a patient make sense out of the situation? How do new arrivals navigate the physical and social space? What are they likely to find confusing? These questions are essential to identifying what we call latent needs, needs that may be acute but that people may not be able to articulate. By achieving a state of empathy with anxious patients checking into an emergency room (or weary travelers checking into a Marriott hotel or frustrated passengers checking in at an Amtrak ticket counter), we can better imagine how the experience might be improved. Sometimes we use these insights to emphasize the new. At other times it makes sense to do just the opposite, to reference the ordinary and the familiar.

  Cognitive understanding of the ordinary and the familiar was at work when Tim Mott and Larry Tesler, working on the original graphical user interface at Xerox PARC in the 1970s, proposed the metaphor of the desktop. This concept helped move the computer from a forbidding new technology of value only to scientists to a tool that could be applied to office and even household tasks. It was still in evidence three decades later, when the start-up Juniper Financial asked IDEO to help it think about whether banks still needed buildings, vaults, and tellers.

  In approaching the uncharted territory of online banking, we began by trying to get a better understanding of how people thought about their money. This exercise proved to be challenging in the extreme since we can’t watch the cognitive process of someone thinking about money in the way we can watch the behavioral process of someone paying a bill or withdrawing cash from an ATM. The team settled on the technique of asking selected participants to “draw their money”—not the credit cards in their wallets or the checkbooks in their purses but the way in which money played a part in their lives. One participant—we called her “The Pathfinder”—drew little Monopoly-style houses representing her family, her 401(k) retirement plan, and some rental properties, since her focus was on long-term security. Another participant—designated “The Onlooker”—drew a picture with a pile of money on one side and a pile of goods on the other. With disarming candor, she explained to the team, “I get money and I buy stuff.” The Onlooker was completely focused on her day-to-day financial situation and did almost no planning for the future. Beginning from cognitive experiments like these, the team of researchers, strategists, and designers developed a subtle market analysis that helped Juniper refine its target market and build an effective service in the emerging world of online banking.

  A third layer—beyond the functional and the cognitive—comes into play when we begin working with ideas that matter to people at an emotional level. Emotional understanding becomes essential here. What do the people in your target population feel? What touches them? What motivates them? Political parties and advertising agencies have been exploiting people’s emotional vulnerabilities for ages, but “emotional understanding” can help companies turn their customers not into adversaries but into advocates.

  The Palm Pilot was an indisputably clever invention, and it has, deservedly, won widespread acclaim. Jeff Hawkins, its creator, began with the insight that the competition for a small, mobile device was not the omnifunctional laptop computer but the simple paper diary that many
of us still slip into and out of our shirt pockets or purses a hundred times a day. When he began to work on the Palm in the mid-1990s, Jeff decided to buck the conventional wisdom and create a product that did less than was technically possible. That his software engineers could have stuffed spreadsheet capabilities, colorful graphics, and a garage-door opener into the Palm didn’t matter. Better to do a few things well, so long as they were the right things: a contact list, a calendar, and a to-do list. Period.

  The first version of the Palm PDA was a hit among tech-savvy early adopters, but there was nothing about its chunky gray plastic form that fired the imaginations of the larger public. In search of this elusive quality, Jeff teamed up with Dennis Boyle at IDEO, and together they began to work on a redesign that would appeal not just at a functional but also at an emotional level. The interface was left largely unchanged, but the physical quality of the device—designers call it the “form factor”—was reimagined. First, it was to be thin enough that it would slide smoothly into a pocket or purse—if it didn’t disappear, Dennis sent his team back to the drawing boards. Second, it was to have a feel that was sleek, elegant, and sophisticated. The team sought out an aluminum-stamping technique used by Japanese camera manufacturers and found a rechargeable power supply that even the battery suppliers doubted would work. The added development was worth the effort. The Palm V went on sale in 1999, and sales rocketed to more than 6 million. It opened up the market for the handheld PDA not because of a lower price point, added functionality, or technical innovation. The elegant Palm V did everything it promised to do, but its sophisticated look and professional feel appealed, at an emotional level, to a whole new set of consumers.

  beyond the individual

  If we were interested only in understanding the individual consumer as a psychological monad, we could probably stop here; we have learned to observe him in his natural habitat and gain insight from his behaviors; we have learned that we must empathize, not simply scrutinize with the cold detachment of statisticians. But even empathy for the individual, as it turns out, is not sufficient. To the extent that designers have one at all, their prevailing concept of “markets” remains the aggregate of many individuals. It rarely extends to how groups interact with one another. Design thinkers have upped the ante, beginning with the premise that the whole is greater than the sum of its parts.

  With the growth of the Internet, it has become clear that we must extend our understanding to the social interactions of people within groups and to the interactions among groups themselves. Almost any Web-based service—from social networking sites to mobile phone offerings to the vast world of online gaming—requires an understanding of the dynamic interactions within and between larger groups. What are people trying to achieve as individuals? What group effects, such as “smart mobs” or “virtual economies,” are taking shape? And how does membership in an online community affect the behavior of individuals once they return to the prosaic world of atoms, proteins, and bricks? It is hard to imagine creating anything today without trying to gain an understanding of group effects. Even a chair.

  When Steelcase, the giant office furniture manufacturer, sits down with its customers to help them plan the right workplace environments, the designers use network analysis to understand who in their organization interacts with whom and which departments, functions, or even individuals should be colocated. Only then does it make sense to begin thinking about desks, storage units, and ergonomic chairs. We may use similar approaches when we are designing systems to facilitate knowledge sharing within and between offices. Simply asking people to recount how they spend their time or with whom they regularly communicate can result in skewed information. Even with the best of intentions, people’s memories are faulty and their answers are likely to reflect what they think should be the unvarnished facts. Tools such as video ethnography (in which cameras record group behavior over time) and computer interaction analysis help gather more accurate data about the dynamic interactions among people and groups.

  A second set of considerations is forcing us to rethink our notions of how to connect to consumers, and that is the pervasive fact of cultural differences—a theme that has moved from bad jokes about “political correctness” to the center of our concerns as we confront the realities of a media-saturated, globally interconnected society. Clearly, Kristian Simsarian’s first-person observations of an emergency room would have yielded an entirely different set of insights if they had taken place in sub-Saharan Africa rather than suburban America.

  This reality puts yet another dent in the idealized image of the designer as the source of professional expertise that can be taught in school, honed in professional practice, and exported universally to anyone in need of a better desk lamp or digital camera. Spending time to understand a culture can open up new innovation opportunities. This may help us to discover universal solutions that have relevance beyond our own culture, but they will always have their origins in empathy.

  The movement from insight to observation to empathy leads us, finally, to the most intriguing question of them all: if cultures are so diverse and if the twentieth-century image of “the unruly mob” has given way to the twenty-first-century discovery of “the wisdom of crowds,” how can we tap that collective intelligence to unleash the full power of design thinking? The designer must not be imagined as an intrepid anthropologist, venturing into an alien culture to observe the natives with the utmost objectivity. Instead we need to invent a new and radical form of collaboration that blurs the boundaries between creators and consumers. It’s not about “us versus them” or even “us on behalf of them.” For the design thinker, it has to be “us with them.”

  In the past, the consumer was viewed as the object of analysis or, worse, as the hapless target of predatory marketing strategies. Now we must migrate toward ever-deeper collaboration not just among members of a design team but between the team and the audience it is trying to reach. As Howard Rheingold has shown in his studies of “smart mobs” and Jeff Howe has demonstrated through “crowdsourcing” (more formally known as “distributed participatory design”), new technologies are suggesting promising ways of forging this link.

  We are in the midst of a significant change in how we think about the role of consumers in the process of design and development. In the early years, companies would dream up new products and enlist armies of marketing experts and advertising professionals to sell them to people—often by exploiting their fears and vanities. Slowly this began to yield to a more nuanced approach that involved reaching out to people, observing their lives and experiences, and using those insights to inspire new ideas. Today, we are beginning to move beyond even this “ethnographic” model to approaches inspired and underpinned by new concepts and technologies.

  My colleague Jane Fulton Suri has even begun to explore the next stage in the evolution of design as it migrates from designers creating for people to designers creating with people to people creating by themselves through the application of user-generated content and open-source innovation. The idea of “Everyman the Designer” is a compelling one, but the ability of consumers to generate breakthrough ideas on their own—as opposed to replicating existing ideas more efficiently and cheaply—is far from proven. Mozilla, with its Firefox Web browser, is one of the few companies to have been able to build a significant brand using an open-source approach.

  These limitations do not mean that user-generated content is not interesting or that it may not become the Next Big Thing to roil out of the innovation cauldron. It has been argued that user-generated content is leading to far greater engagement and participation in the world of music than we ever saw during the top-down reign of mass media. Perhaps, but even the most zealous advocates of open-source design will admit that it has not produced its Mozart, John Lennon, or Miles Davis. Not yet, at any rate.

  For the moment, the greatest opportunity lies in the middle space between the twentieth-century idea that companies created new products and
customers passively consumed them and the futuristic vision in which consumers will design everything they need for themselves. What lies in the middle is an enhanced level of collaboration between creators and consumers, a blurring of the boundaries at the level of both companies and individuals. Individuals, rather than allowing themselves to be stereotyped as “consumers,” “customers,” or “users,” can now think of themselves as active participants in the process of creation; organizations, by the same token, must become more comfortable with the erosion of the boundary between the proprietary and the public, between themselves and the people whose happiness, comfort, and welfare allow them to succeed.

  We see evidence of innovative strategies meant to enhance the collaboration between creators and consumers everywhere. In an initiative funded by the European Union to look at ways in which digital technology might strengthen the fabric of society, Tony Dunne and Bill Gaver of the Royal College of Art in London developed a set of “cultural probes”—journal exercises, inexpensive video cameras—that enabled elderly villagers to document the patterns of their everyday lives. In industries more geared to the youth culture—video games, sports apparel—it is now quite common for developers to work with tech-savvy youths at every stage of the development process from concept development to testing. Sweat Equity Enterprises in New York (the term refers to contributing time and effort to a project as opposed to “financial equity,” or money) works with companies as diverse as Nike, Nissan, and Radio Shack to codevelop new products with inner-city high school kids. The sponsoring companies capture cutting-edge insights “from the street” (a somewhat more reliable source of creativity than the executive suite) while at the same time making a lasting investment in education and opportunity for underserved urban youth.