Health systems around the world are stuck. Chronic illness, mental distress, and care inequities continue to rise. Endless cycles of reform, innovation, and restructuring offer only partial fixes. Why? Because we continue to look at health and care from the outside in - through metrics, technologies, abstractions, and policies - rather than from within the messy, affective, relational ground of experience itself.

This book introduces a radical new philosophy and approach: Design with Real Lived Experience (RLX). More than a framework or method, RLX is a perceptual and philosophical reorientation. It begins not with systems, services, or stories, but with how health, illness, recovery, constraint and care are actually lived - through bodies, environments, institutions, emotions, and the forces that shape life in motion.

Drawing on over two decades of global health research and design practice, RLX challenges the prevailing logics of health innovation, including the increasingly questioned paradigm of the social determinants of health. In their place, it offers a set of 12 transformative design principles grounded in attunement, relation, intensity, and co-composition with life as it unfolds.

For innovators, clinicians, researchers, technologists, policymakers, and those with lived experience alike, this book is both a provocation and a path forward. It argues that without radically changing how we perceive and engage with experience, no amount of investment or reform will shift the conditions of health.

This is not a book about improving the patient journey. It is a call to stop designing for patients and start designing with life.

In a world saturated with solutions but starved of resonance, RLX is the future of meaningful transformation in health and care.