Purpose To explore how converging fields of co-creation and positive deviance may increase value in healthcare. Methods Informed by research in positive deviance, patient engagement, value co-creation, and quality improvement, we propose a positive deviance approach to co-creation of health. Results Co-creation has shown to improve health outcomes with regard to multiple health conditions. Positive deviance has also shown to improve outcomes in multiple healthcare and patient community environments. Conclusion A positive deviance co-creation framework may aid in achieving improved outcomes for patients, care teams and their respective healthcare organizations.