Modernizing a Healthcare Platform on Azure Enables Scalable Patient Services

Pediatric Home Service (PHS) is a national leader in pediatric home health care, specializing in services for children with complex medical needs. Their work spans respiratory therapy, medical equipment delivery, and clinical support that helps children remain at home rather than in long-term hospital settings. Given the personalized and high-stakes nature of their services, PHS requires technology systems that can adapt to highly specific clinical workflows, caregiver relationships, and compliance requirements—needs that generic healthcare platforms often fail to meet.

When the organization began preparing for a major technology shift—transitioning to a new Electronic Health Record (EHR) platform called Brightree—they quickly realized that their existing custom software was not ready for what was to come. Their patient portal and supply ordering system had been built in-house over time, serving the organization well in its earlier stages. But as the company expanded and acquired other providers across the country, the limitations of the legacy system became more pronounced. The platform lacked modern architecture, security best practices, and scalability. Core features like user authentication, automated ordering, and cross-team workflows were difficult to maintain or expand upon. Simply put, the technology could no longer keep up with the organization’s evolving business model.

To support the Brightree rollout and modernize their infrastructure, PHS needed a partner who could refactor the legacy platform, bring it into the cloud, and ensure tight integration with their future-state EHR. They were specifically looking for a Microsoft-centric consultancy with proven expertise in enterprise application modernization, Azure cloud services, and secure DevOps practices. That’s when they partnered with Emergent Software.

Emergent Software began with a technical discovery process to audit the existing system, uncover areas of technical debt, and map out a plan for phased modernization. The assessment confirmed what PHS had already suspected: before any Brightree integration could occur, the core platform needed a substantial overhaul. Built using outdated versions of .NET, Angular, and Node.js, the legacy system also relied on deprecated Windows background services and had no automated deployment pipeline—making updates risky and time-consuming.

To modernize the application, Emergent upgraded the framework to .NET Core and Angular v11, ensuring security and long-term support. The team also performed a full audit and update of NuGet and NPM packages to resolve vulnerabilities and improve compatibility. Authentication mechanisms were replaced with Microsoft Graph API calls, enabling a secure, standards-based approach to managing users and permissions. Legacy services were refactored as Azure Functions, allowing the platform to scale more efficiently and recover gracefully from errors.

Security enhancements were also a key focus. Emergent implemented Azure Entra Managed Identity to eliminate shared credentials and centralized authentication. They restructured the ordering process to pass through Azure Service Bus queues—ensuring order requests could be processed reliably, even if downstream services were unavailable or overloaded. These foundational updates enabled the organization to deliver care with greater speed, accuracy, and confidence.

Once the application was stabilized and cloud-ready, the Emergent team shifted to focus on business enablement. PHS had recently acquired several pediatric healthcare providers across the U.S., many of which also used Brightree but lacked a unified patient-facing portal. Emergent re-architected the application to support multiple Brightree instances, allowing the organization to scale the solution across different business units without duplicating code or infrastructure.

Several key features were also introduced to improve user experience. For caregivers and families, Emergent added self-service onboarding, allowing users to create portal accounts using a patient’s medical record number and date of birth—eliminating manual setup steps and encouraging greater adoption. For PHS staff, the updated portal included secure messaging and task workflows, enabling employees to manage caregiver communications and order tracking directly within the platform. The portal was also redesigned to support more complex caregiver-patient relationships, including households with multiple children or caregivers, while maintaining HIPAA compliance and intuitive navigation.

Emergent also introduced automated CI/CD pipelines using Azure DevOps. This allowed PHS to deploy new features and updates during business hours, without the anxiety of after-hours downtime. The internal IT team gained more confidence in the platform’s stability, and developers could ship improvements more frequently.

The partnership between PHS and Emergent Software has resulted in a modern, cloud-native platform that is now foundational to the organization’s daily operations and strategic growth. With a fully modernized technology stack, PHS no longer faces the risks and inefficiencies of technical debt. The platform’s migration to Microsoft Azure has improved performance, simplified infrastructure maintenance, and enabled better monitoring, scalability, and fault tolerance.

From a business perspective, the integration with Brightree has unified order and patient data across PHS’s growing network of healthcare entities. Orders are now reliably processed, even during temporary outages, and caregivers can trust that the system will work when they need it most. Internally, staff have reported greater efficiency and clarity across workflows, while the ability to securely message with families has improved communication and service quality.

Perhaps most importantly, the caregiver experience has been significantly improved. Families can now onboard themselves without administrative delays, interact with the platform in ways that match their real-world relationships, and manage orders more easily. These enhancements reflect PHS’s broader mission: to make complex care feel more connected, supportive, and seamless.

What began as a modernization project has since grown into a long-term technology partnership. Emergent Software continues to work with PHS on strategic enhancements, helping them evolve the platform to support new services, acquisitions, and operational goals. With a secure and flexible foundation in place, PHS is well-positioned to scale its impact and continue delivering life-changing care to families across the country.