How Nurture Built a Custom Operations Platform Without a Single Developer

Nurture Prenatal, Ultrasound & Doulas Uses Knack to Replace Legacy Software and Automate Client Operations

Industry: Healthcare: Prenatal & Postpartum | Location: Cincinnati, Oh | Use Case: Practice Management, Client Portal, AI-Powered Review Automation

Running a prenatal care business means being available around the clock. Births don’t follow business hours. Neither do the questions, status updates, and coordination requests that keep a doula practice running smoothly. For Scott Paulson, CFO of Nurture Prenatal, Ultrasound & Doulas in Cincinnati, Ohio, that reality made the gaps in his existing software impossible to ignore.
Nurture is a full-service prenatal and postpartum care practice offering ultrasound services, doula support, and everything in between for expectant mothers. Scott oversees all of the systems, back-office operations, and automations that keep the business running. When the software his team had relied on for years started showing its age, he knew it was time to build something better. What he didn’t know was that he’d end up building it himself.

When Off-the-Shelf Isn’t Enough

The system Nurture had been using to manage their doula practice was, by Scott’s own estimate, roughly 15 years old. It wasn’t cloud-based. Doulas would enter data on their devices and sync later when they got back on Wi-Fi, a process that worked in theory but created constant headaches in practice.

“The system we were on was probably built 15 years ago. It worked when it worked, but when it didn’t work, it didn’t work. We were always catching up. Records out of date on some devices but not others.”

 — Scott Paulson, CFO of Nurture Prenatal, Ultrasound & Doulas

The experience led Scott to a conclusion that many small business owners eventually reach: no off-the-shelf software is going to do everything you need.

“I kind of found that all software follows that trend. Great for 80% of things, but 20% is always missing. Unless you custom-build it.”

Scott evaluated his options. Switching from one off-the-shelf system to another felt like trading one set of limitations for another. Building something from scratch with developers was expensive and slow. So he started exploring a third path: low-code, no-code platforms that would let him build exactly what he needed, on his own terms.

Finding the Right Platform

Scott’s search eventually led him to Knack. As an engineer by training, he understood what he was looking for: a relational database with solid front-end flexibility, always-on cloud infrastructure, and enough extensibility to integrate with the other tools in his tech stack.

“What first drew me to Knack was being able to have a conductor to the orchestra, to pull all the pieces together.”

—  Scott Paulson

The trial experience sealed it. Scott had looked at other platforms, including QuickBase, but found the learning curve steeper and the cost of entry higher.

“When I got my trial of Knack, I felt pretty at ease immediately getting into the system. It felt like something I could do and manage pretty well.”

He connected with mentors through Knack’s expert network who helped him learn the platform and understand the finer points of data architecture. And once they clicked, the possibilities opened up.

Building the Doula App

Scott’s first build was a doula practice management app, a back-office system for his doulas and managers to chart, track client activity, and coordinate care in real time. He started lean: no client-facing portal, no bells and whistles. Just the core operational layer his team needed.

From there, the app evolved. He rolled out a client portal, giving clients their own login and a branded experience that felt like a natural extension of Nurture’s identity, not a generic third-party interface. Clients enter their own information once, and it lives in the database permanently.

“Instead of working with emails and Voxers and text messages, we’re able to funnel all of that into one location,” said Scott.

“I’m able to build it the way I want it to operate and have alerts flow the way I want — which really streamlines our operation and lets us spend more time taking care of our clients rather than chasing down pieces of information.”

—  Scott Paulson

He also added a built-in feedback tab where doulas and staff can report bugs or suggest improvements that feed directly into how he prioritizes changes.

Today, the app runs 24 hours a day.

“Our doula app is used every day, all day, all night even because births occur all the time.”

When a client goes into labor, the status changes in the app, alerts fire, and the dashboard updates — all automatically. Multiple users are in the system simultaneously, tracking payments, checking in on clients, and logging care notes. And when something needs to change, Scott can update it himself. No developer required, no support ticket, no waiting.

“When you own your own system and you’re able to control your own destiny, you can make changes very quickly.”

Automating the Client Experience with AI

As Scott grew more comfortable with the platform, he started building beyond operations. His second major app tackled a different problem: getting more Google reviews from satisfied clients.

Nurture’s scheduling system had no way to automate review requests, and Scott didn’t want a cold, generic blast going to everyone who walked out the door. He wanted something personal. A message that actually reflected the client’s experience. So he built it.

Using Knack’s native Flows, he built an automation that syncs appointment data from Acuity Scheduling into Knack. At the end of each day, his front desk team can log the vibe of each appointment. Did the client bring their grandmother? Was it their first ultrasound? And with one click, that context gets pushed to OpenAI, which generates a personalized text message draft. The message is reviewed, edited if needed, and sent via RingCentral.

“I use a flow through Knack to take that information, push it out to OpenAI, and create an AI-based text message that is personalized to the client’s experience at Nurture,” said Scott.

“That took a process that had been entirely labor intensive and made it better. Not only a time savings, but a better experience for our employees and for the clients who receive those messages.”

 — Scott Paulson

The app also includes an escalation workflow: if a client’s experience was flagged as negative, the system automatically routes it to management with notes, context, and a resolution tracking loop built in. What used to fall through the cracks now gets handled the same day.

Built for Any Business 

Two years in, Scott is looking ahead to franchising Nurture, which means the systems he’s built need to scale beyond a single location. He’s already rebuilding the doula app on Knack’s NextGen builder, not because it doesn’t work, but because he’s learned enough to build it better.

For other small and medium-sized business owners still managing operations in spreadsheets and email threads, Scott’s advice is straightforward.

“I can’t think of a business that wouldn’t benefit from this.”

 — Scott Paulson

He’s quick to point out that Knack isn’t designed for enterprises with full IT departments. It’s designed for people like him. Business operators who understand their own workflows, who know what they need, and who just need a platform flexible enough to build it.

“Knack has a knack for fitting pretty much any kind of business operation that you’re doing.”

What’s your vision for a healthcare app? Contact us for a demo of Knack Health and see how you can build a secure, HIPAA-ready app that meets your needs.