Smart and nimble: Creating a scalable, multi-platform solution for virtual urgent care

To break new ground in virtual-first delivery, healthcare start-up CloseKnit needed pioneering technology, top-caliber talent, and a speedy build. thoughtbot’s team brings all that and more.

“It’s been a remarkable experience. The thoughtbot team really became part of our team, with great availability. It’s night and day in terms of what we’re able to deliver. I don’t have to think about the design system because it just works. It’s scalable, it’s beautiful, and it works.”

– Matt Thompson, product manager, CloseKnit

The Challenge

CloseKnit launched its virtual urgent care business with a mobile app that the company quickly outgrew.

Among the pain points: patients wanted the option to use desktop browsers to see their doctors on a larger screen and CloseKnit wanted to interact with more than one healthcare provider. Compounding the challenges were the need to bring the product to market as quickly as possible with a very small team.

Illustration for the CloseKnit brand showing a stylized doctor standing with their arms folded between two nurses.

“We were really limited with the previous architecture, it was something we built to get to market fast. All of the really fun, exciting stuff that we knew was core to the mission of our organization and would really drive a lot of value for our patients was trapped,” says Matt Thompson, CloseKnit’s product manager.

Sabrina Staedt, vice president of engineering at CloseKnit, says her company wanted the new product to be built with Ruby on Rails, the open-source web application development framework. They chose thoughtbot because its team includes some of the industry’s best Ruby on Rails developers. As a brother of one of Staedt’s UX designers said, “thoughbot? Damn, they’re legit!”

What We Did

Much of thoughtbot’s work with CloseKnit focused on deploying Hotwire, brand-new technology that allowed the web team to develop the new product while the Android and iOS teams could inherit most of the features without needing much new coding.

“It was all new and super risky. We had to rebuild our whole product and we needed to do it really fast, so there was already an exceptional amount of risk—did we really want to take on new technology at the same time? But working with thoughtbot, we knew we were working with high-caliber people. I don’t think we would have felt as confident making that call working with somebody else,” says Thompson.

Healthcare is a complex business, says CloseKnit UX developer Matt Quatrani, with many different integrations needed, from access and communication between patients and providers to billing and other administrative functions. Working with UX designers who can also code—a hallmark of the thoughtbot team—was a game-changer, he says.

“Steven Neamonitakis is the first UX developer I’ve partnered with who has experience on the design and development side. I can go straight to him about the user needs and pain points and then we can streamline that conversation with development,” Quatrani says. “I can design something to the ninetieth degree and take it to him, and I trust his development work because I’ve seen his design output and it’s fantastic.

“One of the biggest challenges in my career has been that bridge of communication between design and development. As a designer I would never pretend that I know the ins and outs of development, so I need to be able to rely on them to tell me what’s feasible and not feasible and then provide feedback. It’s very unique.”

Our chief technology officer told us, ‘These guys at thoughtbot are the best, we’ve found the best people to help us with these sorts of things’ And it was true from day one.”

Matt Thompson
Product Manager, CloseKnit

The Result

The thoughtbot team found the challenge of helping CloseKnit while trying out brand-new technology exciting.

"Working on a project that helps people address their urgent care needs is very fulfilling. Every day, I feel like I am a trusted and valued member of the CloseKnit team,” says Louis Antonopoulos, thoughtbot Development Team Lead. “Using Hotwire to dynamically update the web experience in response to events from our healthcare partner is exciting and simple.”

Stylized illustration of a man with a medical badge typing at a computer.

The new product continues to exceed CloseKnit’s expectations, its team says. “We’ve had eight to ten times improvement in our release speed over a year, and that pace only looks to continue to accelerate,” says Thompson. “It’s night and day in terms of what we’re able to deliver.”

“We have so many integrations at this point,” Qautrani says. “That’s the reality of healthcare, the integrations are not going to stop. And thoughtbot is able to just boom, boom, boom, make them happen.”

CloseKnit’s engineering team say they have gained much more than a high-caliber product. By modeling clear, thoughtful, and responsive communication, thoughtbot’s team has changed the way CloseKnit’s team interacts with each other.

“thoughtbot’s team listened more than they talked,” Staedt says. “Everyone I worked with was very conscious of their words, which is good for an engineering culture. In our industry you often find big egos, which can be very detrimental to the work. But that was not my experience with any of the thoughtbot team.”

Staedt particularly admired thoughtbot’s approach to code reviews. “That’s been the most positive impact they made. They have a write-up on how to approach code reviews. I’ve kind of adopted it for the rest of my team because I really like it.”

Thompson agrees. “The biggest change I feel from working with thoughtbot has been the level of connectivity that I feel with our engineering team and how easily they can translate things I’m saying into really excellent, usable, scalable code,” says Thompson. “That connectivity was uniquely enabled by thoughtbot, and it’s how we work now.”

I’ve worked with a lot of developers. I think the true value thoughtbot brings is that I can trust the things you guys are saying and I feel free to reach out and ask anyone questions. The open-mindedness that thoughtbot brings is extremely valuable. You make customers feel comfortable and not apprehensive to ask questions. That’s truly what made the engagement so successful.”

Matt Quatrani
User Experience Lead, CloseKnit

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