Inside the Design Thinking Process

The Mayo Clinic team presents its ideas at the Aspen Design Summit. From left, conference overseer, Larry Keeley, Allan Chochinov, Gong Szeto, Henry King and Dr. Jay Parkinson

Insomnia is rarely welcome. So when I woke up at 3:00 a.m. on the third day of the Aspen Design Summit, I wasn’t exactly delighted. Pesky Colorado altitude aggravating jetlag, I thought to myself, as I gave up on sleep, brewed coffee, and powered up my laptop. It was only when I realized I had spent the next hour or so feverishly typing notes and thoughts about the project I’d come to Aspen to work on that it dawned on me: I’d been, not punk’d, exactly. I’d been design thunk’d.

Design thinking has been bubbling up as a management mantra of forward-thinking executives for some time now. Its promise — to unite the left and right brains of individuals and organizations and illuminate a righteous path of business success using principles and tools of the design trade — has been preached from all sides of the design and business spectrum. Corporations such as Procter & Gamble (PG), Hewlett-Packard (HPQ), and Apple (AAPL) have adopted its principles. Consultancies such as IDEO, Continuum, and Ziba Design have positioned themselves as ready business partners, the more creative equivalents of McKinsey or Bain.

Many of design thinking’s highest-profile evangelists gathered in Aspen for this event, with executives from business, charities, and other nonprofits. Held at the end of November, the four-day summit was convened to explore how this approach could be applied to solve social problems. It was organized by design consultancy Winterhouse Institute and AIGA, a design industry organization, and funded by the Rockefeller Foundation.

An Opaque Process
The 64 invited attendees, including Tim Brown, CEO of IDEO, Chris Hacker, chief design officer at Johnson & Johnson (JNJ), and Ted Chen, director of learning and innovation at the W.K. Kellogg Foundation, rolled up their sleeves and got to work. Divided into five groups, each team was tasked with coming up with a solution to a specific problem. To try to prevent participants from being creative but impractical, the organizers told us our solutions needed to include a clear plan of action, with a goal of implementation within 24 months.

It was an enlightening few days. But perhaps the strongest takeaway was that those looking for a prescribed way to implement design thinking are destined to be disappointed. It’s a messy, opaque process that depends as much on group dynamics as intellect or insight.

I was on the Mayo Clinic team, with two representatives from the Clinic’s Center for Innovation to explain the somewhat daunting brief: to design a new health-care system for Austin, Minn., a town of some 24,000 residents whose main claim to fame is being the home of Hormel Foods, the maker of Spam. Previous Mayo Clinic research had shown that the city’s health-care system was inadequate and fragmented, a situation common in rural communities around the U.S.

What followed was four days of discussion that veered from health-care reform measures in Washington and the challenges of the insurer/doctor/patient relationship to trying to get a sense of everyday life in Austin.

Our focus, as it emerged from the swirl of intense conversations, was to avoid thinking about health care in terms of traditional services, such as emergency room visits, and think instead about ideas of wellness and community.

Falling into a Trap?
Not surprisingly, team members brought their individual areas of interest and expertise to the table. Dr. Jay Parkinson is the co-founder of Hello Health, an online network that connects doctors and patients. He was keen to use Web 2.0 principles and techniques to create a virtual community for Austin, featuring videos of local heroes taken by school children and including a diary of local wellness-themed events. By the final presentation, he had even mocked up a prototype of what the Web site might look like. It was a bewitching concept, and Parkinson put together a beautiful piece of design. It was also the idea that stopped me from sleeping.

My suspicion, as I thought about it in the middle of the night, was that we were falling into a trap. Our intentions could hardly be faulted. But without deep understanding of the community we were trying to serve, our efforts seemed doomed. After all, a brilliantly creative idea in the eyes of Aspen Design Summit attendees, most of whom live and work in large cities on the coasts of the U.S., might seem like entirely inappropriate bunk to those actually living in Austin. We didn’t know, for example, whether the area had broadband Internet connection. Moreover, many of Austin’s residents are non-native English speakers. Yet here we were, conspiring to offer them a Web experience freighted with bells and whistles?

But an interesting thing happened after I somewhat timidly voiced these heretical thoughts when we gathered bright and early the next morning. Designer Gong Szeto jumped in with some thoughtful analysis of his own, and moderator Allan Chochinov, of design resource Core77, guided the conversation to remain useful and respectful. One of the other groups, looking at the problems caused by poverty in Hale County, Ala., struggled with the same theme in a more fractious way. (There were tears, apparently, though the team did come up with an interesting proposal by the end of the Summit, and the members have now committed to traveling to Alabama as a group next year.)

Junk the Detail; Keep the Principle
Questioning and even conflict are a critical part of the design thinking process. In this system, any proposed solution can be revised or improved. By putting something, anything, into the ether or on paper — Chochinov also implored us to write or draw constantly — and by rapidly working through a series of ideas, different and better ideas can emerge. Even those that go nowhere can have value. It’s not always neat and tidy, but it’s all useful.

Later, Maggie Breslin, senior designer and researcher at the Center for Innovation at Mayo Clinic, reassured me that the process was more important than the product. “I don’t necessarily think what will move forward is the specific idea laid out for Austin in Aspen,” she said on the phone a few weeks after the group members had gone their separate ways. “But whether it ends up as a Web site with video is less important to me than the idea that people need a way to engage in multiple places within their community. You have to get to the detail to understand the larger principle — and then throw out the detail and keep that larger principle.” Now working on synthesizing the clinic’s own on-the-ground research from Austin with the Aspen insights, Breslin says that Mayo’s focus will be to build a networked community of services for the area.

What other tangible work will emerge from the four days in Aspen remains to be seen. Given Mayo’s prior and ongoing interest in Austin, success there could hardly be attributed solely to the summit. But the event did provide an intriguing model for conferences, which often gather together the brightest minds in a particular industry but often don’t capitalize on the assembled brainpower. The gathering also provided a compelling case study on the potential of design thinking, a provocative, compelling, and often messy process that keeps those involved up at night — and might just help to change the world, community by community.

Helen Walters was the editor of Innovation and Design at Bloomberg Businessweek.

This essay was published on Bloomberg Businessweek on December 14, 2009 and is reprinted here with the publication’s kind permission.