ALWAYS

People who talk with their clinicians about their values and goals feel less distress and report better quality of life. Only a third of patients in their last year of life ever have that conversation, and it usually comes too late to change anything.

Clinicians agree it matters, but 71 percent say they still need a system to ask routinely. Meanwhile the most reliable handoff from patient to physician is a printed PDF, and palliative care is often read as end-of-life care, so it arrives late.

Guided by Eric Fromme (Ariadne Labs researcher and Dana-Farber physician), with a site visit to Dana-Farber. We mapped four stakeholder groups (patients, families, medical teams, the public) and four patient personas across cured, curative, palliative, and hospice care. The finding that shaped everything: what a patient wants is tied to the people they love, and patients would rather give than receive.

Three interventions on one service blueprint, each timed to a stage of illness. A digital platform turns Ariadne Labs’ Conversation Starter Guide and What Matters To Me workbook into short interactive surveys a patient can fill in while waiting for treatment.

Responses are sorted three ways: medical answers go to the care team’s portal, family answers become an illustrated memoir the family keeps, and anonymized answers feed public installations in the hospital so patients can see they are not alone.

The survey replaces form fields with gestures: plot an average day on three sliders, place the hardest things on a grid, arrange what a good day holds. Nothing reaches the care team, the family, or the public without the patient’s permission.

The tablet survey, recreated from the prototype video. Which answers reach which reader is illustrative.