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Real Lived Experience
A Radical New Design Philosophy for Health and Care
“It’s time to put real life back into health systems, tech and care”
"Real life is where health happens. Real lived experience (RLX) is how we design for it."
Summary
This book introduces Real Lived Experience or RLX as a radical and necessary reorientation for health and care design, innovation, and system transformation.
Developed over nearly two decades through Umio’s global health research and the philosophical work of its founder Chris Lawer, RLX challenges us to perceive health as something lived - dynamically, relationally, and affectively - across time, space, culture, bodies, institutions, and environments.
It offers more than a new set of tools. It initiates a shift in how we sense, engage with, and design for the complexities of illness, constraint, transition, and care.
RLX reveals the limitations of conventional health design and innovation, which tend to abstract real concrete lived experience into scores, needs, metrics, pathways, and personas. While these representations may support evaluation or system planning, they flatten the textures of life, miss subtle thresholds of change, and obscure the wider experiential field in which meaning, insight, and transformation actually unfold.
This disconnection - from the moving, emergent reality of health as lived - we call the RLX Blind Spot. And we argue that it is this perceptual and epistemic gap, more than any structural or technical failure, that explains why health systems remain unable to shift the growing burdens of chronic illness, mental distress, and systemic inequity.
Paperback, Hardback and Kindle editions. 330 pages.
"At its core, RLX asks us to see differently. It turns perception outward and inward, encouraging enterprises, innovators and designers to look beyond categories, metrics and protocols to truly attune to what people are feeling, doing, and (sometimes not) becoming."
The Problem
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.
"Amazing work and a major reframe. I hope the world responds accordingly."
"This new book from Chris Lawer and Nicki Sutton is quite possibly the most important book on tomorrow's customer experience I shall read this year. If you have anything to do with the customer experience at all, even if it is not in health care, read the book, then put it down, read it again a few days later and go for a long walk to think about its implications. I can guarantee you will not be disappointed."
"RLX speaks directly to frustrations I have had over the last quarter century working with social complexity and social emergence. Its talk of fields and ever-unfolding becoming and the associated need for design to be an ongoing process... That's all whispering sweet nothings into my ear. "
"I love how you centre the fluidity of real lived experience. Living with chronic illness means change is a constant companion - and innovation must reflect that. Life isn’t static, and neither is good design."
"RLX is a wonderful (if not divine) struggle to understand how we can promulgate understanding and practices of helping individuals as such by engaging with them more than, or even instead of, viewing them as categories of suffering to which categories of interventions can be applied."
"This is just such an important and exciting read. For those of us with trauma knowledge, the RLX approach is everything we speak about, long for and more."
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 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 the authors’ 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 real 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.