Design shapes culture and is a part of culture. What we make is intimately tied to the culture we are part of by responding to what we see as problems, what we accept as solutions, and what we co-create to minimize the distance between the two.
This is why there is no such thing as a universal innovation. Some ideas translate well across contexts, while others are non-starters beyond their niche. It’s why we also have very few solutions to complex problems that will work across contexts. Many complex problems aren’t even solution-oriented.
However, because design and culture are so tightly linked, we can get caught up in trends. This is where design can run into problems.
Trends, Foresight, and Folly
There’s been a trend to ‘maxxing’ out things as a means of optimizing, maximizing, and capitalizing on specific qualities and attributes since the early 2010s. However, it was in the early 2020’s that the concept ‘blew up’ thanks to social media influencers using platforms like TikTok to showcase their perspectives.
Now, we have people sleepmaxxing, gymmaxxing, studymaxxing, and more.
A problem with this is that these trends tend to shape the culture toward or away from something. With the ‘maxxing’ trend, we see people optimize their routines and lifestyles to fit a particular image of what it is they are looking to represent. Like any trend, it’s likely to fade over time, but even though we might no longer do the ice bucket challenge or [insert pop culture trend here], there is a kernel of what is left. In social trends, these are things like seeking likes, reposts, and engagement on topics that are intended to represent something.
This might be a ‘vibe’, a brand, a virtue, or style statement.
We have the same thing in healthcare, it’s just we just don’t (always) put them on TikTok.
Lean Six-Sigma for health? The EHR-will-fix-everything era? Evidence-based medicine? Pay-for-performance? Pick any number of patient-focused care initiatives? Or how about the cycle of knowledge-to-action trends that yielded a panopoly of phrases like knowledge translation/mobilization/integration or learning health systems?
It’s not that any of these is necessarily problematic on their own, but they are rarely a whole-system solution, despite the promises. Very often, we see the strong adherence to them as signs of dogma, rather than innovation. To illustrate, we saw the evidence-based medicine movement focus too heavily on certain types of medicine, research, and questions that could be (potentially) answered using a randomized-controlled trial. The result was that much of what is known that produces health (e.g., social relationships, physical activities, economic security, or diet) were excluded and neglected because of the inherent complexity associated with how those factors played out in everyday life, and how they were often not suited to randomization in trials.
Right now, we’re seeing this with app-delivered, AI-driven healthcare supports. The result is, for one example, the idea that we can reduce the effects of loneliness and increase connection using a set of technologies that have been at the forefront of fostering social isolation.
Thus, we are willing to accept the design of apps and tools to treat loneliness using the very technologies that contribute to that problem. That is a design problem.
What Trend Are You Watching?
It’s impossible to discuss trends in nearly any field in 2026 without mentioning AI. It’s the ultimate trend right now. We are seeing this in the early stages of widescale adoption of generative AI tools as a means to enhance creativity and efficiency, and improve efficiency. Yet, the evidence isn’t holding up that this is happening (yet), in a manner that’s worthy of the hype.
Back-end AI use for detection, forecasting, and data analysis is far more promising. Still, the design of health systems for a technology that is still new, emerging and evolving is fraught with complications. We’ve seen it with the World Wide Web, mobile internet, EHR’s, and RFID’s for hospital product management. The tools and tech are useful, but the rollout is slow, the adoption uneven, and the outcomes are often muted, varied, or over-stated.
None of this suggests we ought not to try these things, but they can overwhelm our focus, especially if we lose track of what we’re intending to do.
Principled design is a way around this. By anchoring our design to principles, rather than trends, we can avoid the excesses of what trends produce. Don Norman’s proposed four principles that, when looked at closely, have the kind of specificity and generality that can help us avoid the trap of trends. Principles focus us on general ways of working, less on what we work on.
Design tactics, strategies, and techniques are what enable a principled-centred approaches to be enacted.
Don’t be caught in the trap of designing for what’s hot now. Health isn’t something that can be looksmaxxed or even healthmaxxed. It needs strategic design that is there for a longer term.