Co-Creating Pal: How User Feedback Shaped Our Solution

From the very beginning, we knew the only way to build something truly meaningful was to involve our users every step of the way. Understanding the gravity of the everyday challenges of our users, we didn’t want to rely just on our personal experiences. Instead, we wanted to create something that would genuinely help families everywhere.

The result wasn’t just ours—it’s a reflection of over 120 care recipients, past and present caregivers, and clinicians worldwide. It is a product of their stories, everyday challenges, wishes, and validation.

Here’s a behind-the-scenes look at that journey.

Starting with the problem

Our first step was to deeply understand the real challenges our users face. Having leaned on online caregiving communities ourselves, Reddit was one of the first places we turned to. We reached out to families and healthcare teams everywhere, inviting them to speak with us.

Over 120 individuals from 15 countries generously shared their time, ideas, and stories through surveys, emails, video calls, and in-person meetings. We had in-depth conversations with 90 care recipients and caregivers, and 30 healthcare providers—including palliative care doctors, nurses, GPs, and researchers.

One of our proudest achievements was the global scope of our research. Engaging participants from 15 countries wasn’t just about increasing numbers—it was about understanding the broader context in which our app would be used. So we deliberately sought input from families across diverse regions, including the UK, US, Netherlands, Canada, Germany, Australia, Singapore, Mexico, Hong Kong, and more.

Healthcare systems vary significantly across regions, as do caregiving roles and expectations. By tapping into this diversity, we wanted to make sure that our solution would be inclusive, flexible and scalable.

Their experiences revealed universal pain points and needs, guiding us to design a solution that truly addresses what users wanted—not just what we thought they needed.

In our conversations, we focused on:

• The challenges faced by care recipients, family caregivers (both past and present), and healthcare providers in palliative care—whether related to care location, caregiving teams, or care duration.
• The tools and technologies available to support them, and their limitations.
• The specific challenges they wanted to address with a digital tool, from urgent medical support and symptom recognition to managing caregiver burden, improving care coordination, tackling information overload, and providing conversation support.

Here’s what they told us:

“It would be great to have an option that is sensitive to the caregiver and the patient that can have shared access to information.”
Caregiver to partner

“I’m a palliative care nurse, as well as my recent experience, being an informal carer for my sister, and I would be thrilled to share this with my patients. as I know it would help them as much as it would have helped us as a family.”
Family caregiver & palliative care nurse

“Some people have more than one caregiver. I hope the app will allow one patient to have multiple caregivers on the same account somehow, so care can be coordinated.”
Family caregiver

“A section to input useful telephone numbers for the care team would be great, eg hospice team, oxygen suppliers etc. So it can be easily accessed by everyone in case of urgent need.”
Family caregiver

“After my personal experience as the primary caregiver for two immediate family members, as a palliative care doctor, I am now more aware that we often send patients and their caregivers home, to a minefield.”
Dr. Leonie Zado, Family caregiver & palliative care doctor

“Often patients don’t report their symptoms soon enough, they think it’s part of the disease. So something that could have been alleviated with a pill, ends up being a 2 week hospital-stay.”
Daisy Janssen, Palliative care physician & member of European Association for Palliative Care

Prototyping with our community

Once we identified the core problems, we brainstormed potential solutions. We built simple prototypes and brought them back to our community for feedback. To better understand their most pressing needs, we also asked for their feedback and prioritization on 9 suggested solutions.

Our initial 9 solutions were:

1. Symptom tracker for at-home symptom monitoring.
2. Medicine tracker to manage medication schedules.
3. Care contacts for easy access and instant click-to-call through the app.
4. Care planner to help family caregivers better organize care delivery and share tasks within the care team.
5. Library with practical resources to up-skill families.
6. Storybook to help record care recipients’ stories.
7. Caregiver well-being to monitor the emotional, physical, and mental well-being of caregivers.
8. Community connecting caregivers to online and offline support groups and and community events.
9. Conversation support to encourage and facilitate deeper conversations around the care recipients’ values, wishes, and advance care needs.

This is how our community ranked the solutions:

Turning feedback into features

With our community’s feedback in hand, we focused on designing the top-voted features. As the design progressed, their input continued to shape our decisions. Here are some notable insights:

• Symptom tracker and conversation support (for Advance Care Planning) were the highest-rated solutions by healthcare providers. While caregivers recognized the importance of supporting conversations about care recipients’ values and wishes, they felt that Conversation Support should be a complementary feature, introduced once core needs were addressed.
• The medicine tracker was highly requested, in line with the top 4 features, but, due to the complexity of medicine scheduling, it was excluded from the first product build.
• Care contacts was recommended by a palliative care nurse and former family caregiver in the early stages and later highly rated by others in similar roles.

These features weren’t just informed by user feedback—they were co-created with users, ensuring relevance and usability.

A product that reflects our community

By taking a collaborative approach, we designed a solution that doesn’t just solve problems—it solves the right ones. We truly believe that the best solutions are co-created with the people they’re designed to serve. User feedback isn’t just a phase of development; it’s a philosophy that drives every decision.

We believe that the best solutions come from collaboration with the people they’re meant to serve. For us, user feedback isn’t just a step in development; it’s the guiding principle behind every decision we make.

As we continue to evolve and grow, this commitment to user feedback will remain at the heart of what we do. After all, the people who use our app are the ones who inspire us to make it better every day.