How a Fertility Diagnostics Startup Built Its Operations Platform Without Developers

Path Fertility

Industry: Healthcare & Medical Research | Location: American Fork, Utah | Use Case: HIPAA-Compliant Operations & Patient Management

The fertility journey is one of the most emotionally charged experiences a family can face. The uncertainty, the timing pressures, the financial strain… and too often, the frustrating reality of walking away without real answers. For couples dealing with male-factor infertility, the last part is especially common. A standard semen analysis, essentially unchanged for decades, has long been the only diagnostic tool for the male partner, even as the female undergoes extensive, costly, and often emotionally taxing testing.

Path Fertility was founded in 2019 to change that. Built around the science of epigenetics — the study of factors that turn genes on and off — Path Fertility developed diagnostic tests that go beyond the standard analysis to identify infertile men who would otherwise be missed. The goal is straightforward: make the male partner an equal part of the fertility evaluation, so that couples can get answers and increase their odds of getting treatments that will work.

Today, Path Fertility offers two diagnostic tests and works with fertility clinics across the country. But with a team of just five people, a contract lab, a fulfillment center, and a network of clinics and patients to coordinate, operations could easily become the company’s biggest bottleneck. That is, until they found a better way to streamline their operations.

A Unique Workflow that Didn’t Fit Existing Software

Running a diagnostics company at the intersection of direct-to-consumer and clinical medicine means managing a lot of moving parts: An order comes in from a clinic or a patient, a kit gets shipped, the patient collects a sample and sends it to a third-party lab, and the lab processes the sample before returning raw data. 

Results then get generated, formatted into a report, and sent back to the physician — sometimes by portal, sometimes by fax. And throughout all of it, a small team is tracking status, sending updates, and making sure nothing falls through the cracks.

Derek Peterson, Program Manager at Path Fertility, and Eric Perez, Operations Coordinator, both understood the logistical and operational challenges they were up against.

“We needed a system that could track all these different things. Automate email reminders and text reminders. We weren’t just a lab, and we were not a hospital. So, we didn’t need an EMR. We needed something in between that would fit our unique process.”

 — Derek Petersen, Program Manager, Path Fertility

For Path Fertility, off-the-shelf solutions weren’t the answer. The team tried Doc Health, which worked well for its intended audience but couldn’t automate communications or separate patient records from individual orders — a real problem when patients return for repeat testing. They explored Airtable, but its per-seat pricing model made it impractical for a company that needed to give patients and providers portal access. They even tested AI-only builders, but found those tools too rigid and too dependent on getting the prompt exactly right.

“There was nothing that would work,” says Derek. “We searched for a long time trying to find something that could fit our process.”

Finding a HIPAA-Compliant Foundation

The search eventually narrowed to a specific category: low-code or no-code platforms that were HIPAA-compliant. For a company handling sensitive patient health data, like test results, diagnoses, and treatment histories, compliance wasn’t a nice-to-have, it was the baseline requirement.

“I inputted ‘low code, no code, HIPAA-compliant platform’ in Google, and Knack Health was the first option,” says Eric.

That search result turned into something more. Eric connected with a Knack representative, who built a proof of concept showing that Knack could handle the core of what Path Fertility needed. The team could see it with their own eyes: their workflow mapped onto a working app. That proof of concept became the foundation they built everything else on.

“Once we got that proof of concept, we took that and ran with it. We didn’t have that developer background, but Knack was really awesome in allowing us to make it how we wanted.”

—  Eric Perez

According to Eric, two things stood out about Knack from the start:

1. The first was HIPAA compliance built into the platform itself — not something to be configured or contracted around, but already there. 
2. The second was unlimited users. For a company planning to offer portal access to patients, physicians, and clinic staff across the country, paying per seat was never going to be sustainable.

“I was looking at all the features, and a real eye-popping one was the unlimited users. I was like, ‘What could we do with that?'” says Eric.

Building the App Without a Developer

Neither Derek nor Eric had a development background. Derek’s experience was in operations, Eric’s was in finance. And yet over a few months, working together in weekly sessions and partnering with a Knack-recommended consultant, Fine Mountain, for more complex integrations, the two of them built Path Fertility’s entire operations platform from the ground up.

The app they built tracks every step of the diagnostic process: 

• Orders come in and are logged with a linked patient profile (a feature their old system couldn’t support)
• Kits are shipped and tracked via an API integration with their fulfillment center
• Automated emails fire at each stage of the process
• Text reminders go out through a Twilio integration for patients who haven’t completed payment
• Results flow in from AWS, where Path Fertility’s data pipeline lives, via another API connection.

Without writing a single line of code, Derek and Eric transformed their operations. They went from five automated emails and more than twenty manual ones to upward of 30 automated emails—each customizable based on test type, payment method, and where the patient is in the process.

“My favorite thing so far is just how many different automated emails we can have and how customizable we can make them. Patients are going to get a customized email that will limit questions later on.”

—  Eric Perez

On launch day, the team also went live with patient and provider portals — giving patients real-time access to their order status and results, and giving physicians and clinic staff the same visibility without having to call or email for updates. It was the feature that transformed the platform from a back-office tool into something that could genuinely change the experience for everyone involved.

“We were getting a lot of requests from physicians and patients who wanted access to their information in real time,” says Eric. “Our process for that was just to update them by email. So, it was very hands-on. But now with the portal, we can give them that access.”

What Low-Code Made Possible for a Five-Person Team

For a startup running lean, the ability to build and change the app without outside help has compounding value. In their previous system, any change required scoping a statement of work, paying a building fee, and waiting. With Knack Health, Derek and Eric can make updates themselves, in real time.

“Previously it took months to get a change that we needed. Now we can just do it ourselves on the backend, quickly.”

 — Derek Petersen

That speed showed up in a telling moment shortly after launch. Path Fertility’s COO, Lorry O’Loughlin Schneider, needed a new table for her reporting work. During a working session, Derek built it — with all the right columns, filters, and structure — in just a few minutes.

“She was kind of blown away at how quick and easy it is,” says Derek. “I think that was when she first realized how quick it can be done and how useful it can be.”

That ease of use extended to the platform’s learning curve as well. Derek estimates it took about two months of part-time work — the equivalent of roughly three weeks full-time — to get comfortable with the core features. Both he and Eric note that they’re still discovering new capabilities every week.

“I don’t have any background in this,” says Eric. “My background’s in finance. So, just being able to create an app and make it useful and functional has been really fulfilling and fun.”

A Positive Impact on Both Patients and Operations 

The operational gains are already visible.  A process that once relied on more than 20 manual emails now runs largely on autopilot. Time spent tracking down payments, following up on sample status, and answering patient questions about where their results are — all of that is being absorbed by the system instead of by the team.

“I would say our operational time is probably cut in half from what we previously had to do until now.” 

—  Eric Perez

But for Path Fertility, the stakes of getting this right go beyond operational efficiency. Their patients are people in the middle of a fertility journey; hopeful, often under stress, and acutely aware of time. Every week waiting for a result, every unanswered question, every manual email that slips through the cracks carries real emotional weight.

The patient portal addresses that directly. Instead of waiting for an email update, patients can log in and see exactly where their test stands. Physicians get the same real-time visibility, which matters in a field where timing is everything.

Path Fertility processes approximately 150 orders per month across its two tests, a number that has been growing month over month. With the portal now live and automations fully in place, the team is positioned to scale without having to scale the manual effort alongside it.

A Scalable Foundation for What’s Next

The platform Path Fertility has built is already more than what they originally set out to create. What started as an effort to replicate their existing system quickly became something better: a scalable foundation for continued growth that they can shape themselves as the business evolves.

Future integrations are already on the roadmap for Path Fertility. Stripe — one of Knack’s most popular payment integrations — is next, which will automate their payment reconciliation process that currently requires manual updates. Additional reporting capabilities are being scoped for their COO. And as the rest of the team gets trained on the platform, new use cases continue to emerge.

“Knack provides all the capabilities and features to make things work for your process and your business model. You don’t have to try to fit your business into something predetermined. You can build it as you need it.”

 — Derek Petersen

For any healthcare organization navigating similar challenges, such as a unique workflow, sensitive patient data, no development team, and a need to move fast, Path Fertility’s experience offers a clear proof point. You don’t have to choose between compliance and agility: with the right platform, you can build something that’s both.

“Knack gives you the ability to create an optimized experience for all stakeholders,” says Eric. “For yourselves, and for everyone else who is either buying your product, using it, or just wants to know about it. [Knack] just gives you a tool to do that.”

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.