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Until its highly publicized downfall, Theranos was a so-called unicorn with a compelling proposition to popularize routine blood testing by making it more convenient, using a smaller sample of blood, and testing at a lower cost than conventional, often fear-inducing needles. Holmes and Theranos were reliant on the development of new technology to bring their idea to life. Instead, they became perhaps one of the most infamous examples of failed product innovation. In this article, we contend that although character failings and alleged criminal activity could not have been mitigated realistically, valuable strategic and operational lessons can be learned for future technology startups. By conducting a counterfactual thought experiment and examining Theranos through the lens of Design Innovation (DI), we provide evaluations and predictions across strategic and operational constructs from both an internal and external perspective. We use Theranos to demonstrate the value of DI to future technology-driven entrepreneurs, proposing alternative approaches to medical device startups.

The advent of design thinking as a tool for innovation has led to its adoption in a range of organizations. While proponents of design thinking continue to focus on the principles and practices of their method, little is known on the organizational conditions required for design thinking to attain a long-term impact. This article explores seven empirical case studies to identify the conditions required in organizations seeking to integrate design. It identifies four conditions-strategic vision, facilities, cultural capital, and directives-and examines their relationships.