Co-Designing Exploratory Paths for the Smart and Sustainable Transformation of Healthcare.

Healthcare systems are complex ecosystems facing increasing pressure to balance quality, affordability, and sustainability. Rising costs, aging populations, and climate change pose significant challenges, prompting a shift toward sustainability transformation and interdisciplinary collaboration. To address these challenges, digital technologies, including AI and smart health systems, are being leveraged to enhance efficiency, optimize resource allocation, and support sustainable healthcare models. Nevertheless, healthcare remains constrained by siloed organizational structures that hinder cross-sectoral collaboration. It is evident that the transition toward sustainable healthcare necessitates a systemic shift, integrating stakeholders from diverse sectors and disciplines. This chapter offers an overview of the various stakeholders that compose the healthcare value constellation within a Quintuple Helix framework. Following this overview, the discussion examines the role of design approaches within a participatory research context. Design has the potential to facilitate collaboration through innovative reasoning patterns and can encompass a range of 'objects of design,' including components, products, services, and systems. The chapter elaborates on existing co-creation and co-design models, outlining steps and approaches that can assist non-design stakeholders within health systems. Furthermore, it reflects on the current and future roles of smart technologies in advancing healthcare's transformation toward collaborative innovation and sustainability.