Quilted Health: legacy EHR meets modern healthcare technology

As healthcare providers increasingly struggle with EHRs - with 63% reporting information overload stress - Quilted Health is modernizing maternal care workflows through an intuitive, purpose-built platform explicitly designed for midwives and birth workers.

Quilted Health represents an innovative model in maternal healthcare delivery, combining traditional midwifery with modern healthcare systems. The company operates a network of clinics that partner with local hospitals to provide comprehensive pregnancy and women's health services under the guidance of dedicated midwives. Their service scope extends beyond maternity care, including preventive healthcare, annual wellness visits, and contraception counseling. 

A distinctive aspect of its operations is its ownership of Maternity Neighborhood, a specialized Electronic Health Record (EHR) system designed for maternal and gynecological care.

Challenge: Transforming Legacy Systems for Modern EHR 

Vinta joined the Quilted Health team to support their EHR platform, a mature software product with over 14 years of continuous development. While the platform successfully delivered core functionalities, its architecture and technical foundations reflected an earlier era of healthcare software development.

Despite the platform's proven track record, limitations became increasingly apparent as Quilted Health's ambitions grew. The codebase carried significant technical debt over a decade of development. High code coupling and complex dependencies made modifications increasingly tricky and time-consuming.

The healthcare industry's shift toward new interoperability and data modeling standards further highlighted the need for change. After careful evaluation, modernizing the existing codebase proved more complex and risky than building a new solution aligned with current healthcare standards and technical best practices.

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Approach: System Rebuild Strategy

We faced a critical decision: continue patching our aging system or rebuild from the ground up. The existing stack—Python 2 and Angular 1—wasn't just outdated; it was a complex web of custom-built solutions handling everything from frontend to database ORM operations. Each piece of this homegrown ecosystem required specialized knowledge, making updates risky and new feature development increasingly challenging.

Rather than continuing down the custom development path, we chose Medplum as our new foundation. This open-source healthcare development platform offered what our homegrown solutions couldn't: a comprehensive suite of tools and services backed by an active community. For teams evaluating similar modernization efforts, our journey highlighted several crucial factors in the build versus buy decision:

1. FHIR Integration: Medplum's native support for FHIR (Fast Healthcare Interoperability Resources) ensures standardized data exchange and interoperability with other healthcare systems—a crucial requirement in modern healthcare IT.
2. Compliance Built-in: The platform's architecture inherently supports SOC 2 and HIPAA compliance requirements, significantly reducing the development overhead for maintaining regulatory standards.
3. Modern Tech Stack: Medplum's headless architecture, combined with its Mantine-based component library, provides a robust foundation for building flexible, maintainable, and scalable healthcare solutions. The tight integration between its API services and UI components streamlines development and ensures consistency across the application.

The transition from custom frameworks to industry-standard solutions streamlined development cycles and code maintenance. Medplum emerged as the selected platform, but implementing this change required careful consideration of the business impact. Starting over represented a significant investment, and stakeholder support was crucial.

Our engineering team conducted a focused one-month Proof of Concept (PoC) using Medplum's platform. During this period, we developed a basic EHR system showcasing essential features of midwifery practice. The validation proved to be a success. Within one month, we launched PoC 1.0 of the application—a practice-focused EHR featuring core charting and patient encounter functionality. 

Once this was accomplished, the team faced a new and ongoing challenge: continuing development while leading the migration effort between old and new systems.

"One of the most responsive agencies I have ever worked with. They have strong ownership and are proactive in finding ways to improve processes and make work more efficient."

– Carlos Montes

VP of Engineering

Work Assignments

When Vinta joined Quilted Health, we bridged a crucial gap in engineering. While one team had maintained the legacy system for a decade, a group of individuals brought a fresh perspective on modern development practices to the forefront.

The team we chose to implement this new approach was strategic and deliberate. Our engineering culture, deeply rooted in best practices, naturally enhanced our client collaboration. The results were immediate: accelerated engineering velocity, streamlined development practices, and more responsive product feedback cycles.

The Quilted Health VP of Engineering highlighted three key strengths of our team:

• Exceptional professional standards in all interactions;
• Anticipatory problem-solving that surpassed expectations;
• and demonstrated technical mastery across team members.

We've been going strong since day one, delivering on our core duties and taking on new ones. The seamless coordination between our product manager and developers drives our high-performance output.

What’s next in Quilted’s journey

MultiCare Health System recently acquired Quilted Health, transforming it into a not-for-profit subsidiary. This strategic acquisition builds upon their trusted partnership since 2022 and positions Quilted Health to expand its innovative pregnancy, postpartum, and gynecological care services across the United States.

Our partnership with Quilted Health continues to grow as we work on their extensive maternal care platform. The team has already achieved a significant milestone by delivering the initial Proof of Concept ahead of schedule. We're focused on implementing essential new features while executing a crucial system migration project to support their expanding operations.

Our shared vision extends beyond immediate technical deliverables, focusing on creating a lasting impact in maternal healthcare. Through this collaboration, we're helping them build robust healthcare delivery systems to serve as a foundation for their continued growth and innovation in pregnancy care services.

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‍To learn more about our development process, explore how Vinta creates and deploys MVPs.