Co-design approaches have been used by different sectors, to understand end-user perspectives. They have been diversified from traditional use in product development to sectors such as healthcare environments. They put emphasis on innovation with end-users where this is seen as a source of competitive advantage, and fits with the logic of end-user-led innovation. It does however ask the question of how to enable such approaches and if digital approaches are more useful than traditional paper-based methods. We propose a digital co-design tool for environment improvement that can potentially promote user involvement. This paper reports on a comparative study on co-designing a healthcare environment using the digital tool versus a traditional paper-based tool. Discussion centers on the benefits and drawbacks of proposed approach.