01 — The situation
One patient, seven desks, seven records.
Our client runs a clinic network across several branches. A single visit passes many desks: registration, consulting room, laboratory, pharmacy, then the cashier. Each desk used to keep its own record.
The result was that the same medical record number could exist in different versions at different desks, the medicine leaving the pharmacy didn't always match what the cashier billed, and the monthly accounts could only be assembled days after the month had ended.
02 — The problem
A healthcare system cannot stop to be repaired.
We arrived while the system was already running and patients kept arriving every day. There was no window to switch it off, and no alternative to use meanwhile.
Three things caused most of the discrepancies:
- Billing codes that didn't match stock codes. Medicine left the store but never appeared on the bill, or the reverse.
- One medical record number used by two different people. It happened when registration occurred at two branches at nearly the same moment.
- Revenue never reaching the ledger. The cashier recorded it, but no journal entry was created — so the accounts looked empty even though the money had come in.
03 — What we did
Closing the ways a discrepancy gets in, one at a time.
Five decisions, carried out while the system kept serving patients.
- 01
One item list, shared by stock and billing
A gap between what leaves the store and what gets billed almost always comes from two separate lists. We merged them into one source, so an item that doesn't exist in stock cannot appear on a bill.
- 02
Medical record numbers locked at the database level
Not merely checked on screen. If two branches register at the same instant, the second is refused by the database itself — rather than relying on an application check that two simultaneous processes can slip past.
- 03
Every cashier transaction writes its own journal entry
Revenue is no longer re-entered by hand at month end. The moment a transaction closes, its journal entry is created against the correct account — including separating clinic, laboratory, and procedure revenue.
- 04
The chart of accounts matched exactly to the finance team's own
We didn't invent a system version of the chart of accounts. We used the one the client's finance team already had, so the reports can be read without translation.
- 05
Repaired in stages, not in one cut
Each module was stabilised before the next was touched. Slower, but there was never a day when the clinic couldn't serve patients because the system was being repaired.
04 — The outcome
Absorbing a contract that couldn't have been taken before.
The system now holds roughly 33,000 registrations. Its busiest month recorded around 17,000 — about twenty times an ordinary month — peaking at around 3,800 in a single day.
That surge came from a large corporate health-screening contract. Work of that size could not have been taken on before the system existed: registering thousands of people, capacity per location, group invoices per company, and medical records filled in the field are not things you run on paper.
The system absorbed it without being rebuilt.
05 — What keeps it standing
What's protected isn't the features. It's the arithmetic.
In a clinic system, a mistake doesn't stop at the screen. A wrong item code becomes a wrong bill; a wrong journal entry becomes a wrong tax return. So what we guard most closely is the chain of numbers — from stock leaving, to the bill, to the journal, to the report.
Every calculation involving money is re-checked by us before it reaches formal testing. Not because testing isn't trusted, but because arithmetic errors usually surface months later, when fixing them costs far more.