Health systems are facing significant societal and organizational challenges that require enhancing their resilience and sustainability. The transition toward more sustainable health systems is both delicate and complex, and it needs radical changes of perspective as regards the holistic and multi-disciplinary approach to health care. Over the past years, interest in the environmental, social and economic sustainability of health care has grown globally. The present work aims at investigating the role of design towards Sustainable Healthcare, to propose, through case study experience, a systemic vision of the topic. The research methodology is deeply rooted in the framework of Systemic Design, aiming at defining how design strategies can improve the environmental sustainability of medical products, services, and systems, considering its close relationship with the social and economic aspects. Specifically, the research addressed the case study of chronic hemodialysis. In order to establish a general frame, three different dialysis units and hospitals based in different European countries (Italy, Sweden, Denmark) were compared. The comprehensive analysis of the system items making up the dialysis systems allowed to set specific guidelines for dialysis products, equipment, and treatment. The comparison of three international case studies highlighted how design should work on product and equipment to improve environmental sustainability on a global scale while addressing local systems to improve sustainability on a territorial level.