Compare Scenarios

Migration Step 1

Both scenarios define a migration step at this stage. Healthcare Records Platform: triggered by 'HIPAA audit requirement exposed during external security rev'. Multi-Tenant SaaS Platform: triggered by 'Adding a second paying customer; first audit or security rev'.

Migration Step 2

Both scenarios define a migration step at this stage. Healthcare Records Platform: triggered by 'FHIR events being published to Kafka but corresponding clini'. Multi-Tenant SaaS Platform: triggered by 'Database read load growing disproportionately with tenant co'.

Migration Step 3

Both scenarios define a migration step at this stage. Healthcare Records Platform: triggered by 'Facility acquisition or merger; compliance requirement for d'. Multi-Tenant SaaS Platform: triggered by 'Enterprise customer requesting dedicated infrastructure in c'.

Audit log table growing at > 500K rows/day; INSERT p99 on audit_log > 20ms; autovacuum unable to keep up with dead tuple accumulation from UPDATE operations on the audit log's index pages

Tier 1: Audit Log Write Throughput: Audit log receiving one row per record access creates I/O contention with clinical record writes on the same PostgreSQL primary. Recommended evolution: Partition the audit_log table by month using PostgreSQL declarative partitioning; child partitions allow VACUUM to operate on bounded table segments without scanning the entire history; index each partition independently to keep index size proportional to partition row count rather than total log size .

pg_locks showing RowExclusiveLock waits on clinical_records or encounter_notes during shift-change peak hours; write p99 > 100ms; occasional deadlock errors in application logs correlated with concurrent addenda writes to the same encounter

Tier 2: Concurrent Encounter Write Lock Contention: Multiple clinical staff members writing addenda to the same encounter simultaneously, or two processes updating encounter status concurrently. Recommended evolution: Implement optimistic locking with an encounter version column; reject concurrent writes with a conflict error and require the client to reload and retry; this eliminates lock waits by failing fast rather than waiting; ensure the application presents a clear conflict resolution UI: in a clinical context, silent overwrites of concurrent edits are a patient safety risk, not just a data integrity issue .

PgBouncer pool wait queue > 0 during peak hours; application errors reporting "connection pool exhausted" or pool timeout; pool utilization > 90%

Tier 1: Connection Pool Exhaustion: Aggregate tenant connection demand exceeding PgBouncer pool_size. Recommended evolution: Implement per-tenant connection quotas at the application layer before hitting the pool; increase pool_size incrementally; identify top-N connection consumers by tenant and implement connection reuse within tenant request handlers .

pg_stat_activity shows one tenant's queries dominating query runtime; other tenants reporting p99 latency regression while their own query counts are stable; PostgreSQL shared_buffers cache eviction rate increasing

Tier 2: Noisy Tenant I/O Saturation: Single large tenant displacing other tenants' working sets from shared buffer cache. Recommended evolution: Implement pg_cgroups or connection-level resource groups if available; consider database-per-tenant for the top N largest tenants while keeping the shared schema for smaller tenants (hybrid isolation model) .