Fully automated loyalty program for a medical spa

The situation

Dr. Anna Guanche spent 18 years building Bella Skin Institute into something more than a dermatology clinic. Board-certified, featured on Oprah and TLC, with a trademarked procedure (the GuancheLift™) and her own product lines, her practice in Calabasas serves a clientele that expects a premium experience at every touchpoint.

The business model for cosmetic dermatology depends on repeat visits. Botox every 3-4 months. Fillers every 6-12 months. Laser treatments in series. The patient who returns is worth significantly more than the one-time visitor. But between appointments, the practice had no digital touchpoint, no way to create urgency, and no loyalty system that matched the standard she had built over nearly two decades.

The leak is not the funnel. Practices spend to fill the top while revenue leaks out the bottom: the un-rebooked guest who loved the visit, walked out, meant to call, and never did. People do not ghost a practice on purpose. They just forget. Retention is a system, not an accident.

Every off-the-shelf loyalty platform she evaluated was built for coffee chains. Too rigid, too generic, and unable to handle the specific rules her business required: 10% cash-only point earning, expiring points to drive return visits, QR-based checkout, and a premium brand experience that would not cheapen what she had built.

She came to us to build the platform from scratch. We delivered in 12 weeks. The practice owns the code outright, with no vendor lock-in and no recurring licensing fees.

What we had to solve

• Building an expiry mechanic that creates urgency without alienating patients

  Expiring points are only useful if patients are reminded before it is too late to act. Too many reminders and they become noise. Too few and the mechanic fails. We designed a two-stage system called "Pressure Points" where a 28-day reminder acts as an early nudge and a 7-day reminder creates genuine urgency. Color indicators in the app shift as expiration approaches. Push notifications are triggered at both milestones. Getting the timing and tone right required close work with Dr. Guanche's team to match the brand voice: clinical, warm, and never pushy.

• Making the admin panel fast enough for a busy front desk

  The QR code scanning flow needed to work at front desk pace: scan a patient's code, enter the transaction amount, confirm, and the points credit, all in under 15 seconds. Any slower and staff would stop using it. We also had to design the rewards management, rule adjustment, and reporting tools so that non-technical management staff could operate them without training documentation or developer help. Two very different users, the front desk processing transactions and the manager adjusting campaigns, needed the same system to feel natural for each of them.

1. Points credit in under 15 seconds, no manual entry, no reconciliation errors

   Patients open their app and present a unique QR code at the front desk. Staff scan it, enter the transaction amount, and points credit instantly at 10% of cash payments. No manual entry, no reconciliation errors. The entire transaction completes in under 15 seconds. The admin panel's scanning interface is optimized for checkout speed, not technical users.

   

2. Expiry drives return visits without requiring the practice to discount services

   Countdown timers show points expiring in 28 days and 7 days. Color indicators shift toward red as expiry approaches. Push notifications fire at both milestones. The 28-day reminder acts as an early nudge toward booking a next appointment. The 7-day reminder creates genuine urgency. Expiry drives return visits without requiring the practice to discount services.

   

3. Practice stays present during the 3-6 month gap between visits, without any manual outreach

   A before/after gallery organized by procedure type lets patients browse results from treatments they are considering. A full service catalog with descriptions and duration estimates lets them explore options and submit appointment requests directly from the app. The practice maintains a digital presence during the 3-6 month gap between visits without any manual outreach.

   

4. Front desk processes transactions, management adjusts the program, no vendor involvement required

   Front desk staff process QR transactions, correct point balances, and manage appointment requests without technical training. Management adjusts earning rules, creates rewards, sets expiry windows, and reviews redemption analytics from the same panel. All changes publish to the mobile app instantly. No vendor involvement required.

   

How it runs

Flutter

The practice needed iOS and Android apps with identical features and a consistent premium look across both platforms. Flutter compiles to native code and produces near-native performance for the QR scanning, push notifications, and real-time point balance updates the app required, all from a single codebase.

Hasura GraphQL

The point balance dashboard and transaction history needed to update in real time when a QR transaction processed. Hasura's GraphQL subscriptions push changes to the mobile app instantly, so patients see their updated balance before they leave the checkout counter.

PostgreSQL

Patient records, transaction history, point balances, and expiry schedules all needed reliable structured storage with the query performance to support live dashboards and the audit trail the practice needed for accurate point reconciliation.

Firebase

Authentication and push notifications needed to work reliably on both iOS and Android without becoming a maintenance burden. Firebase handles both at scale and powers the two-stage Pressure Points reminders that fire at 28 and 7 days before expiry.