Quilted Health: legacy EHR meets modern healthcare tech
As healthcare providers increasingly struggle with EHRs - with 63% reporting information overload stress - Quilted Health is modernizing pregnancy care workflows through an intuitive, purpose-built platform explicitly designed for midwives and birth workers.
Quilted Health represents an innovative model in pregnancy 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 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 pregnancy and gynecological care.
The challenge: transforming a legacy EHR into modern healthcare technology
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.
Even small feature requests became difficult to implement because nearly every part of the system depended on another. Outdated library dependencies further slowed development and limited the team's ability to safely evolve the platform.
The healthcare industry's shift toward new interoperability and data modeling standards further highlighted the need for change. The existing platform also lacked native FHIR support, severely limiting interoperability with modern healthcare systems.
After careful evaluation, modernizing the existing codebase proved more complex and risky than building a new solution aligned with modern healthcare technology and technical best practices. The combination of tightly coupled architecture, outdated dependencies, and minimal interoperability ultimately made a rebuild the safer long-term path.
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Our approach: system rebuild strategy for modern healthcare solutions
We faced a critical decision: continue patching the aging system or rebuild from the ground up. The existing stack, built on Python 2 and Angular 1, relied on custom-built solutions across the frontend, backend, and database layer.
Rather than continuing down the custom development path, Quilted Health chose Medplum as the foundation for their new platform. 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:
- FHIR Integration: Medplum's native support for FHIR (Fast Healthcare Interoperability Resources) ensures standardized data exchange and interoperability with other modern healthcare systems — a crucial requirement in modern healthcare IT.
- Compliance Built-in: The platform's architecture inherently supports SOC 2 and HIPAA compliance requirements, significantly reducing the development overhead for maintaining regulatory standards.
- Modern Tech Stack: Medplum's headless architecture, combined with its Mantine-based component library, provides a robust foundation for building flexible, maintainable, and scalable modern 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 delivered the first proof of concept, a practice-focused EHR featuring core charting and patient encounter functionality.
After the PoC validation, the team shifted toward a broader production effort rather than a lightweight MVP release. Because Quilted Health needed to support highly specialized midwifery workflows from day one, the product team prioritized functional depth and operational readiness before launch.
Once this was accomplished, the team faced a new and ongoing challenge: continuing development while leading the migration effort between old and new systems.
Engineering partnership and work assignments
When Vinta joined Quilted Health, we bridged a crucial gap in engineering. While one team had maintained the legacy EHR system for a decade, a group of individuals brought a fresh perspective on modern healthcare technology and development practices to the forefront. Over time, the legacy structure itself evolved, with knowledge transfer becoming increasingly centralized inside the new modernization team.
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 engagement adapted to Quilted Health's preferred Scrum-based workflow, with close coordination happening through standups, technical syncs, and collaborative engineering discussions. This helped strengthen engineering velocity, streamline development practices, and create 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 Health’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 pregnancy 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.
Current efforts are focused on achieving full feature parity with the original Maternity Neighborhood platform. Ongoing development includes educational content workflows, billing functionality, support for multiple babies in a single birth, laboratory integrations, and upcoming interoperability initiatives involving eFax and DoseSpot.
Our shared vision extends beyond immediate technical deliverables, focusing on creating a lasting impact in pregnancy care. Through this collaboration, we're helping them build robust modern healthcare solutions to serve as a foundation for their continued growth and innovation in pregnancy care services.
The modernization effort also made the platform easier to maintain and onboard into, supported by structured internal processes, living documentation, and the continued involvement of engineers who helped design and implement the system from the beginning.
To learn more about our development process, explore how Vinta creates and deploys MVPs.
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