Project details
Tools:
Node.js, React, Postgres, AWS, Twilio, Auth0, OpenAI, WebSockets, Docker, CI/CD pipelines
Fertility Outreach: A text based Fertility Coaching EMR
Project Introduction
Fertility Outreach is a coaching platform built in partnership with Ferring Pharmaceuticals, one of the largest IVF treatment providers in the United States. The goal is to create a scalable system that allows fertility coaches to communicate with patients via text while maintaining structured medical records and operational oversight.
I was brought in early as Head of Engineering to lead the design and development of the entire platform. The system functions as a combined CRM and EMR, enabling coaches to manage patient conversations, document key health information, and track the full lifecycle of each interaction. Patients can text into the service and receive guidance from trained fertility coaches, while the platform records timelines of conversations, notes, and follow-up actions.
The platform ultimately supported more than 20,000 users and become a central tool for coaches to guide patients through the early stages of fertility treatment and connect them with reproductive endocrinologists when appropriate. The system and underlying technology were later acquired by Tot Squad as part of the company’s broader maternal health platform expansion.
Challenges & Technical Architecture
Building a healthcare communication platform required solving several complex engineering and compliance challenges.
The most critical requirement was HIPAA compliance. The platform handled sensitive patient information, so infrastructure, authentication, and data handling workflows had to be designed to meet strict healthcare privacy standards. This required secure infrastructure, controlled access patterns, and careful data modeling.
Another major challenge was real-time communication. Fertility coaches needed to see updates instantly as patients texted in, often with multiple coaches monitoring conversations simultaneously. To support this, we implemented a real-time socket architecture that allowed specific users to receive targeted updates without overwhelming the system.
On the product side, the CRM/EMR schema had to capture complex patient timelines, message histories, and structured notes while still allowing coaches to quickly navigate conversations and follow-up campaigns. The database design became one of the most intricate parts of the system.
Outcomes & Wins
The Fertility Outreach platform successfully scaled to more than 20,000 users and became a core operational tool for fertility coaching teams.
Coaches were able to manage patient conversations, record health information, and run follow-up outreach campaigns from a single system. Automated workflows such as welcome messages, canned responses, and structured follow-ups helped maintain a strict one-hour response time while the platform was active.
The service generated overwhelmingly positive feedback from users, with many patients sharing personal stories about how the coaching support helped them navigate fertility treatment. Most importantly, the program successfully guided a significant number of patients toward reproductive endocrinologists, helping them move from initial questions into formal fertility care. This directly supported Ferring’s goal of increasing patient engagement and connecting individuals earlier in their fertility journey with the specialists who could provide treatment.
During the company’s acquisition, I also advised leadership on the platform’s architecture and technology stack, helping position the system for integration into the acquiring company’s infrastructure.