The Old Town designs were special order -- and Old Town would also do custom designs as well on special order.
Outside stems were an option to be ordered (except they were standard on the Ideal model). They are both attractive and practical -- they do provide an element of protection to the stems. They can't really be added to a canoe built without them -- the inside stem needs to be built wider than standard to provide a base wide enough to fasten the outside stem to.
Some of Old Town's color cards are around (Benson has some), but they are old, often are faded, and so are not reliable indicators of what the colors originally were. So pick a red that you like and that fits with any other colors you use, and go to it. Sometimes a bit of original paint is found under a gunwale, if the canvas is original -- unlikely on your boat.
The time involved in a simple design (like the yellow canoe with triangles above) need not be great. When I got our OT 50 Pound canoe, it needed painting, so I experimented with a triangular design, based loosely on Old Town's design no. 4. Two years later, I changed the design a bit, still triangles, but a little less busy. Note the painted outside stem -- it was painted when I got the canoe -- the paint is now stripped, and the stems will be finished bright when re-installed on the canoe (in the process of being restore
Other designs, though, call for the work of an artist -- some builders are artists, like Jerry Stelmok (one of his Millenium canoes below), some owners are artists, and some folks hire such work out -- see the owl below.
Outside stems are often finished bright, sometimes painted over. The yellow stems of my canoe above were painted when I got the canoe -- I have stripped the paint and will be finishing them bright when I complete the restoration; they are ash, and should look good bright, though probably not as good as the mahogany ones on the 1922 Ideal:
Playing with the appearance of a canoe is, for me, one of the ways to enjoy a canoe.