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The process of design encourages us to rethink what is possible in given interactions and systems. While communication design has focused on such processes as health campaigns and alternative dispute resolution, design concepts can be applied to much larger and more complex systems. This presentation focuses specifically on the design of complex health systems, exploring the relationships between health organizations, individuals, social and economic systems, and the environment. The process of design is illustrated through the work of Sir Harry Burns (Chief Medical Officer of Scotland) and his approach to fundamentally redesign the Scottish Health System, and Dr. Jeffery Brenner whose work on Hot Spotting has changed the way many medical systems approach the care of the most costly patients. Underlying both innovations are a shift from treating a disease or illness to a focus on creating health by examining the entire system in which individuals and their wellbeing exist.