20 million premature and low-birth-weight (LBW) babies are born every year. Of these, four million will die within the first month of life. Those that survive face severe long-term health problems like diabetes and respiratory disease.

99% of neonatal deaths occur in low to middle income countries. Why? The proven treatment – the infant incubator – is cost prohibitive. At $25,000 for a single unit, this life saving device is out of reach for the world’s poorest.

The solution seems obvious – design an affordable incubator.  In 2007, Linus Liang and his team at the Stanford d.School were tasked with the ambitious objective of creating an incubator for 1% of the standard cost – a mere $250.

I recently shared this story with a friend who is an accomplished engineer and his immediate reaction was one of excitement. “It actually might not be that difficult,” he claimed, “incandescent bulbs, analog, combined with appropriate insulation would be a starting point.” A talented, visual thinker, my friend appeared to be working up the schematics in his head.

And perhaps he’s right – it might not be that hard. However as Linus and his team soon discovered, hard to design or not, an affordable incubator would have little impact because it solves the wrong problem.

Lesson One: Solve a real problem

Linus comes from a programming background – he was a Product Manager at Microsoft, built and flipped a technology start-up here in Silicon Valley, and received his Masters from Stanford’s prestigious Department of Computer Science. Since co-founding Embrace, the company that formed around his team’s d.school project, life has changed dramatically. Now based in Bangalore, India, Linus’s focus is on the complex operational issues associated with the design, manufacture, and distribution of a product in the developing world. I reached Linus in Bangalore to discuss Embrace and the meaningful work the company has planned.

Their story begins in “Design for Extreme Affordability”, the d.school’s project-based course focused on innovating for social good. Of the assignments available, Linus and his team gravitated to the incubator challenge, a project sponsored by a Nepalese NGO (Note: Nepal has the highest percentage of neonatal deaths per babies born in the world). As good design thinkers, the team’s first step was to observe users, specifically the healthcare workers in Nepal responsible for treating premature and LBW babies.

Linus journeyed to Katmandu and immediately started touring hospitals, speaking with doctors and nurses about the issue of premature births. As he walked around, Linus noticed something surprising – there were already a number of incubators, primarily older units that had been donated. Even more surprising, most of the incubators sat empty.

When Linus asked why this was the case, a doctor shared that most problematic premature and LBW births occur in rural villages, up to a day of travel away. Sadly, because babies cannot regulate their body temperature, they often die en route to the hospital. It was a powerful insight and Linus immediately recognized his team had the wrong design challenge. To evolve it successfully, he would need a completely different data set.

He canceled his remaining hospital tours and arranged to visit surrounding villages, the areas where the true need existed. He spoke with local doctors and with mothers who had lost their babies as a consequence of premature or LBW births. He discovered that geographic proximity to urban hospitals was only part of the problem; in many cases families simply couldn’t afford the travel let alone the cost of hospital care. He also unearthed several realities that would inform the design of his team’s solution: no reliable source of electricity, rudimentary local healthcare, extreme cost constraints (It became clear that $250 would be far too expensive for local adoption).

With these factors in mind, Linus’s team reframed their task. Rather than focusing on affordable incubators, they endeavored to “design an ultra low cost, portable way of maintaining babies’ temperatures without the use of electricity.” By shifting and narrowing the challenge, the team increased the likelihood their final solution would indeed have impact.

—

Lesson Two: Solve that problem well

Once back in the USA, Linus’s team engaged in a flurry of activity. First, they gathered as much information as they could on incubator technology and its methods for regulating babies’ temperatures. They were fortunate to be at Stanford where access to expertise in medicine, engineering, and materials science was readily available. Their research revealed, among other valuable facts, that a significant portion of the expense associated with standard incubators had little to do with temperature regulation.

Second, focused on their revised design challenge, the team brainstormed possible solutions. Using the brainstorming principles advocated at the d.school (including deferring judgment, building on the ideas of others, and allowing for wild ideas), they generated a large volume of potential ideas, a subset of which would ultimately influence their final solution.

Third, after synthesizing and voting on their brainstorming output, the team evolved their ideas by engaging in rapid prototyping. Using a variety of sundry items available at the d.school, the team threw together various solutions, pushing their thinking in unique directions. In just a few weeks, the team built and broke over 100 prototypes.

The path was tortuous but necessary; the resulting solution was extraordinarily elegant. Resembling a miniature sleeping bag, the product insulated a child against the cold. A side pouch accommodated the real magic – a unique, removable heating pad. After a few minutes in boiling water, the pad releases just enough heat to maintain the perfect temperature inside the sleeping bag for over four hours. As importantly, the solution had no moving parts and could be built for under $25 (that’s correct, 1/1000th the cost of a traditional incubator).

In typical business scenarios, a prototype this polished would enter into clinical testing, production planning, and finally manufacturing and distribution. Linus’s team however was determined to make sure their final product would optimally suit the intended market. So with prototype in hand, the team returned overseas seeking evaluative feedback.

The learning was fast and furious. Because there was now a tangible prototype, users had little difficulty reacting with suggested improvements.

For example, the team learned that local doctors often accompany new mothers and their premature babies to urban hospitals. When in transit, a key consideration is observing chest movement to monitor respiration. To facilitate such observation (without requiring the opening of the sleeping bag and the consequent loss of valuable heat), Linus’s team designed a rugged plastic window for the front of the unit.

Another modification fit a cultural norm. The team discovered that it is fairly common for patients to use intuition when taking medication, regardless of a doctor’s instructions. Local doctors worried that the LCD temperature strip on the exterior of the sleeping bag, which showed temperature in degrees Celsius, would invite interpretation and result in bad decisions. Using paper mock-ups, Linus’s team quickly tested a temperature gauge that had two states – a happy face to indicate the temperature inside the sleeping bag was warm enough, and a sad face to signal the need for a new heating pad. This level of abstraction was well received and has been incorporated into the design.

The “Embrace Infant Warmer” is nearly ready for market. Interest in the product has already exceeded expectations. Indeed, healthcare systems around the world have been inquiring about the unit’s availability. By solving a real problem and solving it well, Embrace is poised to do more than introduce a popular product; they will be saving lives.

Thank you for continuing to provide us with great feedback! We hope these updates result in an even better experience for you and your learners.

We heard: “Can I have learners interview the stakeholders as pre-work and prevent them from implementing tactics?”

We created an ‘interviews only’ mode that locks the Tactics, Planner, Feedback, and Debrief tabs and automatically unlocks them on the day of your session.

We also heard:

• Some learners don’t implement the “Employee Interviews” tactic because they they confuse it with interviewing the stakeholders
• Some learners are surprised when stakeholder interviews expire
• Some learners aren’t sure if their games are being saved
• Some learners accidentally accept their choices for tactics with choices like “Appoint Core Change Team”
• Some learners get tangled up in the “Identify Problem” tactic
• Some learners find it difficult to map stakeholders during the “Stakeholder Mapping” tactic because of the font used
• Some learners feel the instructions for choices tactics could be clearer

We changed the name of “Employee Interviews” to “Walk the Floor” and made some updates to instructions, fonts, and pieces of the user interface to address these issues without changing how the simulation is played.

In the past week, my son and I made balloon animals on my phone. I checked in for my Vancouver flight online and, the next day, received a reassuring text message with updated departure and gate information. Thanksgiving was saved when I learned how to make gravy on YouTube. I discovered via a podcast that “Mutually Assured Destruction” kept us safe during the Cold War, and via Facebook that my Cold War era classmate is excited about her new flatware.

We all have similar stories. Yet we’re so immersed in this rapidly evolving modernity that we can lose sight of our time’s singular truth – our worlds have become hyper accessible and interactive in ways that none could have predicted.

When today’s leaders look forward into this complexity to divine the next breakthroughs, they do so with an alarmingly high assumption-to-knowledge ratio, one that effectively undermines traditional analysis and business thinking. To quote Rita McGrath of Columbia Business School, “it is increasingly difficult to plan by extrapolating from a platform of past experience.”

So how do we prepare for a future we cannot yet fully grasp? One approach is to learn “Design Thinking”.

The design profession is focused on creating innovative solutions that are by definition outside of our experience. As a consequence, Design Thinking (and its manifest methods and tools) is optimized for the purposeful discovery of possibilities amidst complexity. Designers don’t predict the future so much as they quickly learn their way into novel solutions that are simultaneously desirable, technically feasible, and financially viable.

Start here.

© 2009 IDEO

Design Thinking has helped deliver safe drinking water in Africa, create category revitalizing products for P&G, improve the quality and accuracy of patient care in hospitals, increase commitment among casual blood donors, and much, much more.

And what’s the best way to learn Design Thinking? One must experience it.

Therefore ExperiencePoint knew we had a role to play in the democratization of Design Thinking. We sought out the leader in the field, IDEO, a global consultancy that “creates impact through design” and over the past year have worked in partnership to create an energizing game that introduces the essentials of Design Thinking.

The result is “Design Thinker”. In this workshop experience, competing teams flex their Design Thinking skills to solve a realistic and complex challenge. In so doing, they engage with the terms, techniques, and thought patterns of designers. Participants leave ready and able to affect meaningful change back on-the-job.

We are excited to share Design Thinker with the world and will be making it available in January 2010. We hope you will be among those who join us in this re-think of thinking. The world will be the better for it.

At a glance:

• U.S. case study
• Language tweaks
• Choose project team members
• More detailed debrief of individual games
• Animated change in project buy-in
• Interface updates

U.S. case study
We heard that the case study includes references to the Canadian healthcare system that may distract users from other countries. We now have a U.S. version of the case study in addition to the existing case study.

Language tweaks
We heard that some language needed to be more accurate to a healthcare environment, so we updated tactic descriptions and feedback with that in mind. We also included some explanations of jargon for learners unfamiliar with a healthcare environment.

Choose project team members
We heard that learners would build a stronger connection with the sim by hand-picking the members on the project team, so we updated the tactic “Appoint Project Team”. Learners now select project team members from the stakeholder map – as many or as few as they feel necessary.

Choose project team members

More detailed debrief of individual games
We heard that learners need more information when debriefing their decisions. Users can now click “Debrief a Game” in the simulation website to access a detailed, printable debrief.

More detailed debrief of individual games

Animated change in project buy-in
We heard that learners want to know whether they gained or lost project buy-in immediately after implementing a tactic. The change in buy-in is now front and center and appears before feedback is given.

Animated change in project buy-in

Interface updates

• We heard it can be hard to tell which questions have been answered in the Stakeholder interview window. We also heard that it can be hard to tell which question is currently being answered. The Stakeholder interview window now highlights which question is being answered and greys out questions that have already been answered. We also made the text a little easier to read.

Stakeholder Interview window

• We heard learners sometimes ask questions we’ve heard many times before. We added tips to the loading screen that answer some of our frequently asked questions, such as “Are my decisions being saved?” and “What happens when I reach 60%?”.

Tips in the loading screen

• We heard learners sometimes want to skip the debrief after a failed game to try again. We created a button on the end-game movie to skip the debrief and go back to the splash screen.

Button to skip the debrief and play again

• We heard some users with low screen resolutions (1024×768) had difficulty finding the New Game button. We integrated the New Game, Resume and Debrief buttons into the splash screen, making them bigger and more visible.

Splash screen

Our focus for this update has been to increase learner engagement and make the sim easier to facilitate. Read on to find out what’s new, but first, let’s address the big question:

What did we change?

Nothing! Well, we did tweak the descriptions of a few tactics and fix some typos… but in most respects, GlobalTech remains the same GlobalTech we’ve come to know and love. That said, we’ve added some great new features.

What’s new?

Please note: You may need to clear the cache on your browser (and on any computers running the simulation) to see the updates.

At a glance:

• Web debrief updates
• Tactic updates
• Harder difficulty level
• Animated feedback
• Animated change in company buy-in
• Introduction videos
• Interface updates

Web debrief updates

• Earlier this month, we updated the web debrief for facilitators to help explain the result of learners’ decisions and make the information easier to digest.

Tactic updates

• We heard that “Appoint Core Change Team” should be a little more impactful, so we increased the impact of this tactic.
• We heard that descriptions for some tactics could be a little clearer. We updated the descriptions for the tactics “Employee Interviews”, “Competitive and Financial”, “Appoint Core Change Team” and a few others!
• We heard that learners should see the emotional side of change. We’ve added more feedback to some tactics that shares how some Stakeholders feel.
• We heard that every tactic should have some feedback. We created feedback for the tactics “Develop Training Infrastructure”, “Professional Objectives”, “Team Site Visits”, and a few others.

Harder difficulty level

• We heard that some facilitators want to challenge their learners. We created a tougher version of the simulation. When starting a new game, learners can choose to play on the standard difficulty level or on a harder difficulty level, where buy-in is harder to come by, choosing the right tactics at the right time is essential, and change expertise is put to the test.

Harder difficulty level

Animated feedback

• We heard that learners want to see the impact of their decisions in a fun way. We created animated feedback for a select number of the tactics in GlobalTech to increase emotional impact.

Animated feedback

Animated change in company buy-in

• We heard that learners want to know whether they gained or lost company buy-in immediately after implementing a tactic. The change in buy-in is now front and center and appears before feedback is given.

Animated change in company buy-in

Introduction videos

• We heard it would be useful to have a short video walk-through of the simulation. We produced a series of short videos that correspond to each activity in the simulation. These are designed to be used by both learners as they are playing, as well as by facilitators when they are introducing the exercise.

Introduction videos

Interface updates

• We heard it would be useful to see a list of all the tactics in the “Debrief” tab. We added a “List all tactics” button to the “Debrief” tab that displays a list of the tactics.

List all tactics in the "Debrief" tab

We heard some users with low screen resolutions (1024×768) had difficulty finding the New Game button. We integrated the New Game, Resume and Debrief buttons into the splash screen, making them bigger and more visible.

Splash screen

• We heard learners sometimes ask questions we’ve heard many times before. We added tips to the loading screen that answer some of our frequently asked questions, such as “Are my decisions being saved?” and “What happens when I reach 60%?”.

Loading screen

We heard it can be hard to tell which questions have been answered in the Stakeholder interview window. We also heard that it can be hard to tell which question is currently being answered. The Stakeholder interview window now highlights which question is being answered and grays out questions that have already been answered. We also made the text a little easier to read.

Stakeholder interview window

• We heard learners sometimes want to skip the debrief after a failed game to try again. We created a button on the end-game movie to skip the debrief and go back to the splash screen.

End game movie