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Palliative Care App for patients and their loves

Palliative care improves the quality of life

of patients and that of their families who

are facing challenges associated with life-

threatening illness, whether physical, psycholo

-gical, social, or spiritual. However, Palliative Care

is not only about medical. The problem of fostering communication between patients who suffer life-threatening illnesses and others is equally important because it could greatly improve the quality of life of patients and their families.

Our Design Goal:

A communication app centering the patients, empowering them with control over their communications with family, friends, and healthcare professionals. 

Design Process

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Identify Stakeholders:

  • palliative care patient

  • patient’s loved ones (aka family or friends)

  • Healthcare Professionals and caregivers

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Interview Plans:

Unfortunately, in the limited research time, we didn't find a palliative patient to interview. However, other stackholders have provided us a lot of useful information.

1. Nurse

2. Family member of the patient 

3. Medical professional (student in rotation)

4. Expert in palliative care

Interview Summary:

Medical student Emily, during her rotation at a Colorado Springs hospital, shared her insights about the communication needs of palliative care patients. 

Key Points:

  • Palliative care patients often feel unheard and desire a patient-centric approach.

  • Many patients lack family members; an app could help connect them with friends, akin to the Bumble app.

  • The app should also support family members dealing with the situation.

  • The app needs to be easy to use, accessible to all, and use clear, direct language

  • A digital diary with a forum feature could help patients feel heard and build a community.

  • Providing resources about end-of-life symptoms could make the process less traumatic.

  • The app could facilitate family members to send cards or reminders to patients.

  • Respecting patients' religious beliefs is crucial; a survey during app setup could set preferences and priorities.

  • The app should facilitate communication of these preferences to the care team.

General Research over the field:

  • Palliative Care Guidelines Plus (PCG Plus)

    • Provides healthcare professionals with guidelines for palliative care.

    • Gap: May not be directly accessible to patients and their families, limiting their understanding and involvement in care planning.

  • Serious Illness Care at Ariandne Labs

    • Aims to ensure every seriously ill patient has conversations about their goals and priorities.

    • Gap: While the program seeks to improve communication, it is not widely accessible to patients and caregivers and hard to track their wishes outside of clinical settings.

  • CaringBridge

    • A free social networking platform for patients to communicate with family and friends.

    • Gap: Focuses on communication and updates but may not offer tools for advanced care planning or decision-making support.

  • Cake

    • End-of-life planning platform.

    • Gap: I encountered some difficulties in accessing detailed reviews and specific features of Cake to fully understand potential gaps.

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  • Potential lack of access or awareness of these tools among patients and families.
  • Limited resources for comprehensive end-of-life planning that address legal, emotional, and physical care aspects.

  • Insufficient tools for patients to initiate and document their care preferences outside of healthcare settings.

  • Lack of integrated patient engagement in care planning and documentation.

VSD Analysis based on research:

(1)We face challenges engaging multiple stakeholders like family members and other networks. Some indirect stakeholders may choose not to use our app, which hinders patient connections and thought sharing. 

(2)The accessibility is mentioned by our interviewees, as some of the patients under Palliative care may need help or special assistance in using our app. 

(3)Hand-changing problem upon a patient's passing. We must safeguard their privacy while considering any potential benefits arise from the transfer case.

(4) Our app's lifespan differs since some stakeholders will use it temporarily. For sustainability, the app's enduring value and features could transition to supporting family members post-usage.

(1)Design dditional messaging pathways, such as email to allow patients to reach out to non-app users, respecting their choice not to engage with our system while ensuring they don’t miss important messages.

(2)A more inclusive user interface and experience design should be accounted for. For example, large text mode, voice input, clear and easy-to-learn modularity.

(3)A robust yet user-friendly authorization process and data cleaning service is essential. However, leave messages for in the app may be a design opportunity.

(4) Design a time capsule functionality that can help deliver messages after the patient passes. This can help the patients communicate and help the family members in their transition to being without the patient. 


*what's a concept?

Concepts are the building blocks of software. On the one hand, a “concept” means you’d expect it to mean: a mental construct that you need to understand to be able to use an app effectively. On the other hand, a concept is a coherent unit of functionality. In this sense, concepts belong to the long line of modularity mechanisms in software that include procedures, classes, abstract data types, processes, and so on.

— Daniel Jackson ’The Essence of Software’


In this project development, we use Daniel Jackson’s Concept theory to design and build the module of the software which aims to serve the user in a more modular and learnable way.

Based on a brainstorming of possible features of our app, we specilized a few concepts that could serve as the minimized module of the software. Here are some of the concepts structure docs.


User/ Websession/ Contact/ Preference/ Delay/ Diary/ Letter/ Wish/ Forum/ Topic/ Mood/ Email....

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Concept: Delay [ T ]

- Purpose: perform operation on content after a specified amount of time

- Operating Principle: after a specified time ***t**,* execute a behavior ***b*** on a piece of content of type ***T***

- State

owner: one User;

content: one Content;

type: str -> "Diary" | "Letter" | "Wish";

behavior: str -> "send" | "delete";

activation: one Date;

- Operations

create(owner, content, type, behavior, activation)





updateDelay(_id, update)




User Flow & Wireframe

Since our app centers the patient users by enable them to control the communication process, in our app, patient and non-patient users may go through different user flow with similar but different interfaces. 

User flow-4.png
User flow-4.png
User flow-4.png

User Flow

Some examples of the low-fi wireframes


account type.png
preference setting2.png
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Time Capsule.png
Add capsule content.png
Capsule Release Time.png
Contacts setting.png
WIsh Board.png
New Diary.png
preference setting3-2.png

Design Revision

A few design trade-off and revision are made during the implementation.

Concept revision during implementation:

1. Defining Non-Patient and Patient User Relationships

Our approach to connecting non-patient and patient users has evolved through several stages to better align with our design principles:

Initial Approach

  • Friend Request System: Initially, we implemented a standard friend request system. This allowed non-patient users to send requests to connect with patient users.

First Revision

  • Registration with Passcode: We modified the connection process to adhere to our 'patient-centered' design principle from P1: Impact Case. During registration, non-patient users require a passcode from the patient user. This establishes an initial connection and allows them to sign into our app.

Second Revision

  • Connection via Forum Posts: We introduced a new connection method in response to our post forum's 'public social circle' feature. Non-patient users can now view patient profiles through forum posts and request to join their contact list, enabling connections with multiple patient users.

2. Delay for Time Machine

Our concept of 'Delay' has undergone a significant transformation:

Initial Concept

  • Generic Delay Functionality: We initially planned for the Delay feature to be a generic concept applicable to various elements like Letters, Diaries, and Wishes.

Revised Implementation

  • Specific to Time Machine: After careful consideration and during the implementation process, we decided to make the Delay feature exclusive to the TimeCapsule. This decision was based on the realization that the concept of Delay is most coherent and meaningful when applied specifically to the Time Machine in our app.

  • Extend Time Machine as an option for users in “diary,” “letter,” and “wishboard.” To make Time Capsule functionality more useful in our app, we make accessible options for users when they create new diary, letter, and wish.

3. Preference Setting

The design of our Preference Setting also underwent modifications driven by practical considerations and project constraints.

Initial Concept

  • Periodically check users’ using habits and refresh their default settings

Revised Implementation

  • Specify the “preference”: Due to the time limitation of this project, we specified the preference into two main functionalities: Vision Assistance and Time Capsule activation date. The first function is designed to serve the special visual needs of our users, and the second preference function addresses and assists our main innovative concept, “delay.”


Based on the concept trade-off, some of the wireframes also change corresponding to the new features, ex: Time Machine.

Section 1.png

Refine wireframe

Time Capsule.png
Add capsule content.png

Design Hi-fi interface

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Full-Stack Prototype

The full-stack development is built on a basic architecture given by MIT which using typescript, vite, MongoDb, Vue3....

Here is two test accounts for you to experience

Patient account: 

username: Liam_J  pc: 1999

Other User account:

username: Benson_D pc:1999

or Try this flow:

1. register 

2. select a user type as patient

3. fill the information and set up a passcode

4. create a diary and set its preferences

5. create a wish

6. create a email contact in the contact page

7. send an anonymous letter to the contact

8. add a diary into the Time Machine


1. register another account

2. select a user type as other user

3. bound this new account to your previous patient account

4. view its diary (the one you just create)

5. go back to the patient account and send a letter to the "other user account"...

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User Tests

Aiming a comprehensive user test, we've created a list of tasks that cover the key concepts of your app, focusing on the concepts that are particularly unique and important to our app. Each task typically involve executing a sequence of user interaction actions. From simple one-action tasks to more complex multi-action tasks, it will test how easily the user can cross the gulfs of execution and evaluation.

Task Lists

Patient view 

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Non-Patient view

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( Each user will be assigned with both task lists of patient and non-patient user perspective to gain a coherent view of the app. )

User Test Report

Report on Patient Version:

The patient user's experience with our app was a mix of positive and negative reactions. The user found the registration process easy and intuitive but questioned the limited user settings, suggesting the inclusion of more personalized options such as religion or after-death preferences. The mood-setting feature was appreciated, but the user desired a more comprehensive pattern-tracking functionality to see mood trends more clearly while incorporating AI suggestions for negative mood trends.

The forum feature was straightforward for creating posts, but the reply functionality needed to be clearer. The user also suggested the addition of a feature to display the number of likes and who liked their post. Also, the bottom navigation menu icons could have been more intuitive, with the world and time capsule icons needing clarification about what they would lead to.

The diary feature was easy to use, but creating a topic was unnecessary. The user also questioned the option to add diary entries to the time capsule, as diaries are typically private. On some pages, the user needed to realize the home icon was a button and also expected to be able to click on their profile image on the home page.

The time machine feature was well received, but the user suggested it looked too much like an exciting present, which was conceptually odd for a concept of releasing content after death. The user also wished to add other media types to the time machine. But in general, the settings were intuitive and familiar.

Report on Non-Patient Version:

The user found the non-patient registration process easy and familiar but raised the issue of access for healthcare professionals without a patient passcode. The user found the home page icons in the mood block easy to miss but could figure out all basic functionality.

The user suggested that non-patients should also be able to add their memories of the person to the time capsule. This suggests that the app could benefit from more inclusive features that allow all users, regardless of their relationship to the patient, to contribute to the patient's time capsule.

In conclusion, the user found the app's features generally easy to use but suggested improvements for more personalization, intuitive icons, and inclusive features.

Design Flaws/Opportunities

Based on our user tests report, we detected a few design flaws and some opportunities in the future development.

  1. Enhanced Personalization (Moderate)

    • Current Issue: Limited personalization options in patient and non-patient versions, particularly regarding religious or after-death preferences and non-patients adding memories to the time capsule.

    • Opportunity: Introduce more user-specific settings and preferences to cater to each individual's unique needs and desires, enhancing the user experience and emotional connection to the app.

  2. Intuitive Iconography (Major)

    • Current Issue: Confusion caused by non-intuitive icons, such as the world and time capsule symbols.

    • Opportunity: Employ universally recognized icons or integrate tooltips to clearly convey each icon's function, thereby reducing confusion and enhancing user navigation.

  3. Advanced Mood Tracking (Moderate)

    • Current Issue: The existing mood tracking system lacks depth in recognizing patterns and providing AI-driven suggestions for negative mood trends.

    • Opportunity: Implement an AI-powered mood analysis feature to offer personalized suggestions and alerts and an expanded tracking calendar for a more insightful view of mood patterns over time.

  4. User Onboarding and Feature Explanation (Moderate)

    • Current Issue: Some of the app's features are not immediately intuitive or well-explained to new users.

    • Opportunity: Develop comprehensive tutorials or “Help” sections throughout the app to facilitate a smoother onboarding experience and reduce the learning curve for new users.

  5. Healthcare Professional Access ( Critical)

    • Current Issue: Healthcare professionals require a patient passcode to access the app, limiting its utility for professional monitoring and support.

    • Opportunity: Create a dedicated registration pathway for healthcare professionals, allowing them secure and appropriate access without patient passcodes. This would enhance the app's utility in a clinical setting and improve patient care coordination.

  6. Open Forum (Major)

    • Current Issue: The current design of the forum is unclear regarding its accessibility - whether it's exclusive to patients and their immediate circles or open to a broader audience.

    • Opportunity: Clarify the forum's purpose and access policies. Consider creating separate sections within the forum for patient-exclusive and open discussions where a wider community can participate, including interested parties, healthcare professionals, and the general public. This approach would not only respect patients' privacy and specific needs but also foster a broader community engagement and support network.

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