In the recent national plans for healthcare, the concept of the patient as an equal partner is gaining traction. The principal idea is that empowering the patient will lead to more effective and accurate services, with increased quality. The patient is viewed as a promising source for the type of innovation that is needed to re- organise the system. One of the greatest challenges of empowering the patients is shifting the culture and practices so that the services are organised according to the patient’s perspective. Service design, and its attentiveness to users, is gaining momentum as a preferred strategy in this shift. This thesis will investigate and compare three different projects in the field of medical specialised care that have included service design as a means for user involvement in their innovation efforts. The interest in the topic is twofold. Firstly it examines the process of service design in the healthcare context. Secondly, it will identify how design affects the utilisation of the new patient role, and how this again affects hospitals’ service innovation. This thesis takes a process perspective as it draws upon Andrew van de Vens conceptual framework for the problems of managing the innovation process. This analytical stance allows for the identification of the factors the innovation process and the implementation of innovations. The process perspective means exploring the black box of the design driven innovation process and what happens between the input of design and the implementation of new solutions, whether it is decreasing waiting time for diagnosis, making internal improvement more accessible, or raising the safety and quality of the ambulance service for psychiatric patients.