Digital Commerce

A multi-brand Next.js platform.

Healthcare is a commerce business that books time.

Strip away the clinical vocabulary and a patient journey looks like commerce: discover a provider, book a slot, identify yourself, manage the relationship, and pay. Patients expect that journey to work the way the rest of their digital life does — 80% want to handle scheduling digitally, anytime — and they act on friction by going elsewhere.

At a $4B healthcare organization, that journey had grown up in pieces. Appointments were created through at least four channels — an AI chat assistant, the call center, an online scheduler, and local offices — while the patient portal sat beside them for matching patients to existing appointments, confirming, and rescheduling. Each piece worked. The spine connecting them didn't exist.

Built in chapters, each unlocking the next.

This wasn't one project — it's a platform program that has moved through six chapters, each standing on the one before it:

A storefront with no checkout.

By the current chapter, the storefront was in good shape — re-platformed, defended against fake bookings, smarter about slots, and faster to market. The deepest remaining problem wasn't any single channel — it was that the platform had no trustworthy answer to "who is this patient?":

Fix the spine, keep the estate.

The bet: treat the patient journey as one commerce spine — booking, identity, portal, billing — and invest in platform primitives instead of page rewrites. Buy the commodity layers (Auth0 for identity, Twilio Verify for MFA delivery) and spend engineering only where the domain is genuinely unusual: linking accounts to the right patient records, caretaker relationships, and claim compatibility with the existing estate.

The keystone was identity. Email became the unique account identifier, email and phone are verified during signup, and custom claims (Patient Identifier A, B, and C) ride the access token — so every existing microservice accepts the new tokens by validating a JWT and reading the same identifiers it always used. The portal itself was rebuilt from Next.js 14 Pages Router to Next.js 16 with the App Router — Server Components, streaming, route-level code splitting — so the first thing patients meet after their first real login is also a faster product.

Four ways in, one spine underneath.

Booking channels and patient clients converge on a shared GraphQL layer and microservice estate, with the Auth0 tenant issuing claims-bearing tokens beside it.

The commerce spine, piece by piece.

What it changed in the first month.

The platform launched in September 2026. These are first-month numbers from the Auth0 logs and web analytics, rounded down, next to what the architecture guarantees by construction.

More than 8 in 10 people who started sign-up finished it, and over a third of MFA enrollments chose a passkey. The rebuilt portal is faster too: mobile LCP improved by about a third, and sessions ending on an error page fell by more than two thirds.

The honest cost is the extra step. Fewer email links reach their destination now that sign-in sits in front of them, and the record-match check at signup turns some real patients away. Tuning that funnel is the current work.

And the number that mattered most inside the building: the coordination footprint. Identity touches everything, so everyone touches identity.

In healthcare, identity is the commerce platform.

Every commerce platform has a moment where the anonymous visitor becomes a known customer, and everything of value happens after it. Healthcare compresses all of its regulatory, revenue, and safety stakes into that one moment: get identity wrong and you can't bill, can't show treatment data, and risk writing to the wrong human's record. Get it right and the rest of the funnel is "just" product work.

The engineering lesson was about leverage: buy the commodity, build the domain, and never break the estate. Claims-compatible tokens let more than eight services adopt a new identity platform without a rewrite — and that compatibility trick, more than any single feature, is what made the whole commerce spine shippable.

The platform, in more depth.