Reducing social distance through co-design

Sebastian Greger

Greger, S., Hatami, Z. (2013). Reducing social distance through co-design. In: Keinonen, T., Vaajakallio, K., Honkonen, J. (eds.) Designing for wellbeing. Aalto University Publication Series, Art+Design+Architecture 5/2013, Helsinki, Finland.


The book “Designing for Wellbeing”, published by Aalto University School of Arts, Design and Architecture, summarizes a broad range of design projects carried out during the World Design Capital year in Helsinki 2012. The editors have assembled a broad range of explorations on how design can contribute to wellbeing.

In the chapter “Reducing social distance through co-design”, Zagros Hatami and I share our observations from our involvement in three co-design projects related to the provision of better public health care by utilization of information technology.

Project description

Public healthcare in Finland is based on the provision of tax-funded services, which, in times of limited public finances and an ageing population, translates into a demand that often exceeds available resources. Since municipalities are legally obliged to provide their services equally within binding time frames and at a predefined level of quality, there is a strong demand for solutions that will help cut costs, optimise the utilisation of available resources and save on expensive treatments through preventive care.

This article describes three student projects carried out with Helsinki Health Care Centre (Terveyskeskus) that address the future of health IT. The starting point for our work was to search for design solutions based on the needs of both healthcare providers and citizens. We started from desirable outcomes without being too restricted by the potential feasibility of their implementation into the existing IT infrastructure. Nonetheless, it was part of the brief to have the concepts grounded in the realities of the public health sector and its systems. Therefore, each future health IT project had a concrete starting point within on-going developments at Terveyskeskus and the solutions proposed could be implemented today with little to medium effort.

Three distances to be overcome

Our article builds on the identification of three core distances that exist between the projects’ stakeholders and how they can be reduced to the benefit of the outcome by applying co-design methods.

The multi-dimensional distances to be considered in our projects: 1) Designer-user distance, 2) system-user distance, and 3) the alienation of health care personnel and citizens.


In our analysis, we conclude that wellbeing is not created by establishing systems that chiefly support the goals of the healthcare administration. Nor would it be achieved by creating solutions that are purely based on the desires of the users of such systems, at the expense of neglecting the realities of the public healthcare system. By balancing the interests of the key stakeholders and creating a common language, designers facilitate the process of envisioning more balanced solutions. The consideration of the human actors at the heart of healthcare is an important step away from the top-down approach of interpreting wellbeing as an efficient and equitable distribution of scarce resources.

This requires an understanding and insight into the context and needs of human actors. Design, with its various methodologies, is a vehicle for bringing this understanding to various stakeholders. The co-design approach informs decision makers about the realities of both healthcare personnel and citizens, and thereby refreshes the resulting solutions with a breath of humanity through the reconciliation of the needs of all users within the requirements and constraints of the system.

The power of co-design

The three cases described in the article highlight the major benefit of co-design. While searching for an administrative solution might appear the obvious task at first, getting designers to work with all stakeholders in an integrative manner enables the utilisation of aspects that would otherwise remain undiscovered.

This will increase the likelihood of solutions being created in which the system supports the social reality of the users, thereby reducing the system-user distance. It also eliminates the risk of the alienation of healthcare personnel and citizens by keeping them as close as possible to one another.

The book “Designing for wellbeing” features nine texts on design for wellbeing and presents 34 design projects carried out during 2012. It can be purchased in Finnish or downloaded in English from the Aalto ARTS Bookstore.

This article was co-authored with Zagros Hatami, design researcher at Aalto University. The concept work described in the article was part of a broad educational project orchestrated and supervised by Professors Sampsa Hyysalo and Jack Whalen. Professor Turkka Keinonen together with Kirsikka Vaajakallio and Janos Honkkonen are the editors of the book.

This is a publication by the Aalto University School of Arts, Design and Architecture in the context of the World Design Capital year in Helsinki 2012.

I'm Sebastian, Sociologist and Interaction Designer. This journal is mostly about bringing toge­ther social science and design for inclusive, privacy-focused, and sustainable "human-first" digital strategies. I also tend to a "digital garden" with carefully curated resources.

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