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Most products, services, and systems are designed around a composite of the “average” user. That sounds logical. If you are trying to serve the largest possible market, why wouldn’t you design for the middle?

The dilemma is that the composite often fails to reflect how people actually live or experience the world. Those differences can expose where products, services, and systems work well, and where they do not.

Design innovation comes from many places. Accessibility should be one of them. It is a powerful lens, revealing friction, hidden assumptions, and opportunities that are easy to miss when we design only for the middle. Solutions developed for people who face the greatest barriers can make products better for the mainstream as well.

Consider the familiar examples. Curb cuts were initially introduced to make sidewalks accessible to wheelchair users. They now also serve people pushing strollers, travelers with luggage, and workers moving carts. Closed captions are essential for people who are deaf or hard of hearing, and useful in noisy airports and quiet offices. Voice controls can be indispensable for someone with limited dexterity and convenient for anyone whose hands are occupied.

OXO, the maker of Good Grips kitchen utensils, offers a compelling business example. When founder Sam Farber saw his wife struggling to use a conventional vegetable peeler because of her arthritis, he recognized an opportunity to rethink an everyday product. The resulting Good Grips utensils—with their comfortable, easy-to-hold handles—addressed limited dexterity while appealing to consumers of all abilities. What began with one person’s difficulty became the foundation of a successful mainstream consumer brand.

These examples show how designing around constraints can lead to simpler, more intuitive solutions. The benefit need not stop with the people whose needs first inspired the design. A product that is easier to operate with one hand, or a service that eliminates unnecessary steps, can improve the experience for many more people. The implications extend beyond individual design decisions. Looking at familiar problems through the experiences of people whose needs have been overlooked can challenge conventional thinking, generate entirely new ideas, and reveal opportunities that might otherwise remain invisible.

Those opportunities may go well beyond improving existing products. When companies look closely at needs that are not being met, they may discover markets they have overlooked. What initially appears to be a narrow market can reveal broader demand and inspire new products, services, or business models. That is an opportunity to rethink what the mainstream market really includes, rather than assuming that existing customers represent everyone who might benefit.

Realizing that potential requires a different approach to innovation. Accessibility needs to influence the choices made at the beginning, when companies are defining the problem and imagining the solution. That means involving people with different needs and abilities in those early decisions, rather than asking them to assess a product after its basic design is settled. Their perspectives can challenge assumptions and reveal possibilities that might otherwise remain invisible. The aim is not to develop a separate product for every circumstance, but to build a richer understanding of what good design can accomplish.

There is another reason this matters now. Populations are aging. Expectations around independence and participation are changing. More customers expect products and services to fit the ways they live, rather than requiring them to adapt to rigid systems. What once seemed like a niche need may point to a much larger opportunity.

The edges of the market are moving closer to the center.

For business leaders, the choice is not between designing for accessibility and designing for the mainstream. That is a false distinction. The real opportunity is to make accessibility part of the thinking that shapes products and services from the outset. Meet needs that have too often been overlooked while creating something more useful for a broader population.

The best design begins by asking who has been left out of the design in the first place.

Gail Zauder is cofounder and CEO of AbleFly.

A group of experienced executives is discussing how the brand can “connect with Gen Z.” Everyone has a deck and an opinion. But nobody in the room is Gen Z. I’ve sat in this type of meeting more times than I’d like to admit.

We collect demographic reports, analyze trends, and increasingly ask AI to tell us who our audiences are and what they want. But this goes wrong when we allow it to replace conversations.

A generation is not a community. A community is not an individual. People born in the same years can have almost nothing in common beyond their age. Demographics describe groups, not the individuals within them.

I’m more interested in what they choose and why. What do they dedicate their time to? Where do they gather? Why do they feel like they belong there? You cannot design your way into cultural relevance without first understanding the culture.

Pep Salazar has spent more than two decades learning this lesson from another perspective. As cofounder and director of OFFF, the international creativity and design festival that began in Barcelona over 25 years ago, he has helped turn a gathering of digital creatives into an enduring international community.

When we spoke recently, Pep described the tension between knowing an audience through metrics and understanding it as people. Sponsors want attendance numbers, engagement reports, and evidence of reach. Those figures do offer important insights, but they don’t explain why someone travels to Barcelona to spend three days among fellow creatives.

For him, it’s more interesting to understand feelings rather than data. A dashboard can tell you what people clicked. A conversation can tell you why they care.

Pep wants people to spend time together and talk. But his approach goes further. He also learns by taking risks. Pep deliberately introduces new perspectives and ideas that challenge what his audience already knows and expects. Not everything resonates immediately, but that’s part of the process. As he puts it, “I understand by doing.”

That’s an important distinction for brands. Understanding your audience doesn’t mean always giving people more of what they already know and love. It means knowing when to experiment and introducing something unexpected. And learning from the response.

When inviting a target audience into the process, you don’t have to outsource every decision to them. You can develop the judgment to understand when to respond to a community, and when to challenge it with something unfamiliar.

Pep also points to another common mistake brands make when trying to connect with creative communities: Don’t show up only to sell. He has watched brands arrive at OFFF with polished corporate messaging, while missing the social dynamics of the event. His advice is simple: “Come here to understand the people and to talk to them.”

He also worries that generative AI is making corporate language more interchangeable. “When you speak similar to your neighbor, then you don’t have a soul,” he told me.

I recognize that problem from my own work. Too many brands begin by studying the competition and end up borrowing its language, aesthetics, and assumptions. The result may look professional, but it rarely feels personal and unique. People want brands with personality that speak the language of their community.

So the next time people in a boardroom start debating how to reach a particular audience, ask who is missing in the room. Invite your audience in before the strategy is set in stone. Spend time where they gather. Make room for opinions and responses that might contradict your brief and give those perspectives the power to change the outcome.

Otherwise, the empty chair at the table says more about your brand than the strategy deck ever will.

Erik Herrström is founder and creative director of STUDIO HERRSTRÖM.

The cost of delayed diagnosis in rare disease is often measured in years. It should also be measured in dollars, clinical capacity, and missed opportunities for better care.

Rare disease affects 1 in 10 Americans, and on average, the diagnostic odyssey for a patient with rare disease costs over $220,000 in avoidable medical fees and lost income. It’s significant time and money that patients and families can’t afford to lose. And it doesn’t end there.

The downstream economic impacts are also costly. Every prolonged diagnosis can trigger a cascade of additional appointments, referrals, and procedures that consume resources. Rounds of tests, specialist bottlenecks, and administrative burden intensify the longer a patient goes without a diagnosis. This reduces clinical capacity and extends wait times for patient care.

Currently, patients often navigate years of uncertainty before accessing information that could meaningfully change their care. That model is increasingly difficult to justify.

This is why a genome-first healthcare system is so compelling. A genome-first approach, where whole genome sequencing (WGS) is used as a first-line test and not a last resort, is helping redefine personalized care for patients with rare diseases. For me, this is where the field is headed. Starting with the genome gives us a more complete view from the outset. When combined with other data, it may bring us closer to answers that many families have been waiting too long to receive. It’s about using technology with purpose to move care forward for patients seeking answers.

Here’s an example of how costs may be lowered with whole genome sequencing. Consider a six-year-old with a history of uncontrolled seizures and global developmental delay. A brain MRI and EEG were performed when the child was six months old and again at three years old. These did not provide answers about his symptoms. It wasn’t until he had WGS at age six that he tested positive for a genetic change that explained his symptoms. He has SCN1A-related seizure disorder. That diagnosis provided the clarity needed to personalize his treatment plan and transform his long-term care, including both medication and dietary changes.

In this example, the total estimated costs for just the main tests performed were $12,800. Repetitive testing costs can add up fast, and it can be particularly discouraging when the testing results are uninformative. Had WGS been offered earlier in this patient’s journey, the estimated savings would have been approximately $8,900 in testing costs alone. But we also can’t forget other costs not captured here, such as medications, specialist appointments, and potentially avoidable emergency visits and hospitalizations. These additional costs can compound quickly over time.  

Increasingly, healthcare systems should question if they can afford not to use WGS earlier.

The potential benefits of doing so in patient care are clear. It can help shorten the diagnostic odyssey, minimize repetitive or uninformative tests, enable more informed medical management, and lower long-term health costs. An earlier diagnosis can also inform targeted testing for family members to understand any symptoms they may have or their own risk for that condition.

For healthcare providers and health systems, WGS can improve operational efficiency by streamlining diagnostic workflows, ultimately helping clinicians make more informed decisions sooner and minimizing unnecessary testing rounds. In acute care settings, particularly neonatal and pediatric intensive care units, rapid WGS (rWGS) can accelerate clinical decision-making and shorten hospital stays. This can generate meaningful cost savings while improving patient outcomes.  

In fact, a recent study found that rWGS as a first-line test is likely to significantly reduce the cost of acute care in a private payer system. The analysis estimated a reduction of $5.8 million to $7.8 million in inpatient payments due to rWGS results and avoided inpatient days.

Every industry eventually reaches a point where a long-standing process no longer fits its purpose. Healthcare is approaching that moment with diagnostics for rare disease. A system built around sequential testing and years of uncertainty is increasingly being challenged by a model that starts with a more comprehensive understanding of the patient. I believe the organizations that embrace that shift will be better positioned to improve outcomes, reduce waste, and deliver a more efficient patient experience.

Kengo Takishima is chairman and chief executive officer of Baylor Genetics.

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