Event Sourcing for Clinical Systems
Why immutable audit trails are the future of defensible veterinary medical records.
The Clinical Data Integrity Crisis
Traditional "CRUD" (Create, Read, Update, Delete) databases overwrite data. In a legal context, overwriting is destruction. Veterinary clinics face increasing scrutiny, yet their systems often fail to answer: "Who changed the dose, when, and why?"
Due to inability to reconstruct historical state.
In event-sourced systems, no data is ever deleted.
Decoupled writes and reads improve system uptime.
Why Traditional Records Fail
In a standard database, if a vet changes a weight from 20kg to 22kg, the '20kg' is gone forever unless a separate, often buggy, log is kept. Survey data from practice managers highlights the risks of this "mutable state."
🛑 The "Overwrite" Risk
"We had a case where a dog's insulin dose was updated. The system showed the new dose, but we had no proof of the original prescription when the owner claimed negligence. We settled because we couldn't defend the record."
— Anonymous Veterinary Director
Top Data Integrity Pain Points
Source: VetTech Systems Integrity Report 2024
The "Immutable Stream" Architecture
Instead of storing the "Current State" (e.g., Patient is Healthy), we store the sequence of facts that got us there. Replaying these facts allows us to travel through time.
Anatomy of a Patient's Event Stream
What Data Gets Stored?
In a veterinary hospital management system (HMS), millions of granular events are generated annually. Unlike traditional rows in a table, these events carry intent.
- ✓Clinical Observations: Vitals, subjective notes, physical exam findings.
- ✓Therapeutic Interventions: Injections given, fluids started, anesthesia logs.
- ✓Client Interactions: Consent forms signed, estimates approved, discharge instructions sent.
The "Defensible" Advantage
Comparing the operational efficiency of Legacy vs. Event Sourced systems during audits and legal disputes. Data gathered from 5 mid-sized veterinary hospitals post-migration.
The Implementation Curve
Adopting event sourcing is not free. It introduces complexity early in development ("The Learning Curve") but pays massive dividends in long-term stability and feature velocity.
💡 Tip: Start Small
Don't rewrite the whole monolith. Start by event-sourcing the "Inventory" or "Medical Records" module while leaving "Scheduling" in CRUD.
System Risk Profile: Migration Timeline
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