Healthcare Checkout Failure Rescue
Case Study
The client's custom Laravel and React booking portal was crashing during peak morning hours. Patients were unable to book emergency telehealth appointments, and a previous agency had spent days trying to fix it without success. The client was facing serious reputational damage and revenue loss.
Proof Snapshot
Project Overview
A global telehealth provider's Laravel and React booking portal was crashing during peak morning hours — the exact window when patients need to book emergency consultations. A previous agency had spent days trying to fix it and failed. Kevion was brought in under an Emergency Rescue engagement and restored full peak-hour uptime the same day.
Business Challenge
The booking portal returned 502 Bad Gateway errors specifically during peak load, not randomly — a signature of resource exhaustion rather than a simple code defect. Every minute of downtime meant patients unable to reach a doctor for time-sensitive care, and the incoming team needed a root-cause fix, not another patch attempt.
- ✕502 Bad Gateway errors recurring specifically during peak morning traffic
- ✕A previous agency had spent days on the issue without resolving it
- ✕Downtime blocked patients from booking emergency telehealth consultations, not just a checkout inconvenience
- ✕No prior root-cause diagnosis — only guess-and-check attempts
Project Goals
- ✓Diagnose the actual root cause of the 502 errors under peak load, not just the symptom
- ✓Restore full uptime during peak hours
- ✓Fix the underlying bottleneck without a full platform rewrite
- ✓Deliver resolution fast, given the active patient impact
Discovery & Scoping
- 1Pulled New Relic APM traces from the exact windows the 502 errors occurred
- 2Identified that PHP-FPM worker exhaustion coincided precisely with peak booking traffic
- 3Traced the blocking call to a synchronous request to the client's external EHR (electronic health records) system
- 4Confirmed every booking request was holding a PHP-FPM worker hostage waiting on that slow external API
Before vs. After
| Before | After |
|---|---|
| Synchronous EHR API call on every booking request | EHR call handled asynchronously via Laravel Queues on AWS SQS |
| No caching on repeat static responses | Redis caching for static response paths |
| 502 errors and worker exhaustion at peak hours | Stable checkout controller, no worker starvation |
Performance Improvements
Technical Problems Solved
✕Synchronous EHR API blocking checkout
Solution: Moved the EHR call off the request path into asynchronous Laravel Queues running on AWS SQS.
✕Repeated static-response overhead
Solution: Added Redis caching for responses that didn't need a live EHR round-trip on every request.
✕PHP-FPM worker exhaustion under load
Solution: Refactored the checkout controller so a slow upstream system could no longer exhaust the entire worker pool.
Business Results
Lessons Learned
- •A checkout failure under load is rarely 'the checkout code' — it's usually what checkout is waiting on.
- •APM tracing at the exact failure window beats guess-and-check patching every time.
- •Moving a slow synchronous dependency off the request path is often a smaller, faster fix than a rewrite.
- •Emergency response speed matters most when downtime has real-world consequences beyond lost revenue.
Why Kevion Technologies
- ✦Root-cause diagnosis via APM tracing, not surface-level patching
- ✦Senior engineers experienced in Laravel queue architecture and worker-pool bottlenecks
- ✦Fast, focused Emergency Rescue engagement model built for active-incident response
- ✦Fixed the underlying architecture, not just the symptom, so the failure doesn't recur
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