Mark Two AB

The next generation of thinking

Rebuilding Sweden’s National Healthcare Identity Service (SITHS)

Role: UX Lead / Senior UX Designer
Organization: Inera AB
Years: 2021–2023
Users: ~500,000 healthcare professionals
Domain: Digital identity · Healthcare · Security · National infrastructure

Overview

SITHS is the secure identity provider used across Sweden’s entire healthcare system. Every doctor, nurse, administrator, and public-sector health worker relies on it to authenticate, access systems, sign data, and manage their professional identity.

I led the UX work for the rebuild of this mission-critical service — from early discovery through strategy, design, validation, and delivery. The goal was to simplify a fragmented, highly technical experience while meeting strict security, regulatory, and accessibility requirements.

The Challenge

The legacy SITHS experience created friction for both healthcare professionals and IT administrators:

  • Complex, unclear flows for enrollment, renewal, certificates and card management
  • High cognitive load for users with varying digital maturity
  • Inconsistent terminology and patterns across regions
  • Accessibility gaps (WCAG non-compliance)
  • High support volume due to confusing steps and error states
  • No unified design environment or scalable design system components

The scope covered 21 regional authorities, numerous legacy backend integrations, and a user base with near-zero tolerance for downtime or failure.

My Role

I led UX for the SITHS redesign, combining strategy, design execution, research, workshops, and cross-functional alignment:

  • Defined the UX approach for the new identity & certificate lifecycle
  • Mapped end-to-end flows and created a unified IA for all SITHS tasks
  • Collaborated closely with product managers, engineers, security experts and regional representatives
  • Introduced Figma as the primary design tool and formalized a new workflow
  • Contributed new components and improvements to the Inera Design System
  • Ensured all designs met WCAG accessibility requirements
  • Facilitated workshops to align stakeholders across Sweden’s regions

Approach

Discovery

I began by mapping the full identity lifecycle for healthcare professionals:

  • Onboarding
  • Identity proofing
  • Certificate issuance
  • Card activation & PIN
  • Renewal & expiration
  • Revocation & replacement
  • Lost or damaged cards

To ground the work, I reviewed support logs, documentation, and existing flows, and conducted conversations with healthcare workers and IT administrators. This exposed several usability blockers rooted in system complexity rather than user behavior.

Alignment

Given the national scope, alignment was essential. I ran workshops with stakeholders from multiple regions to:

  • Clarify legal and security constraints
  • Harmonize differing regional expectations
  • Identify terminological inconsistencies
  • Build a shared understanding of “what good looks like”

These early conversations made later design decisions faster, clearer, and far less political.

Design Strategy

I defined a strategy focused on:

  • Reducing cognitive load through clearer decision points
  • A unified flow structure for all identity-related tasks
  • Terminology alignment across regions
  • Scalable patterns that would support future SITHS features
  • Accessibility-first design to ensure compliance from day one
  • Design system reuse, avoiding one-off solutions

This formed the backbone of the redesigned experience.

Execution

I worked hands-on throughout the project:

  • Created journey maps, IA, flowcharts, and prototypes
  • Restructured the certificate and enrollment flows into a cohesive system
  • Designed high-fidelity screens in Figma
  • Ran iterative usability tests across multiple regions
  • Reviewed designs with security teams to balance usability and compliance
  • Operationalized Figma workflows for the broader design team

A major contribution during this period was the expansion of the Inera Design System. I added several components needed for complex identity interactions, improving consistency across Inera’s products.

Key Deliverables

  • New end-to-end identity & certificate management flows
  • A unified IA and navigation model for SITHS
  • High-fidelity prototypes for all core interactions
  • New design system components and documentation
  • Service blueprint for the entire identity lifecycle
  • Accessibility-reviewed design specifications
  • Stakeholder alignment frameworks and decision logs

Impact

For healthcare professionals

  • Simpler, clearer identity tasks
  • Less confusion around certificates and PIN processes
  • Higher trust in the service through improved clarity and structure

For Inera and the regions

  • Lower support load due to improved self-service
  • Stronger alignment across regional authorities
  • Better maintainability via reusable design system components
  • Improved delivery speed thanks to a modernized Figma workflow
  • Higher UX maturity within the organization

Strategic impact

This project strengthened Inera’s national digital identity infrastructure and ensured it could scale and evolve for years ahead — while making a critical system more accessible and intuitive for half a million people who rely on it every day.

Reflections

This project exemplifies the type of work I thrive in: large-scale ecosystems with complex constraints, multiple stakeholders, and real human consequences. Balancing usability with security and regulation is challenging, but essential — and it’s where good UX creates a disproportionate amount of value.