Your audit logs are about to break your database

Here's a problem nobody talks about at health IT conferences: your audit logs are growing faster than your clinical data.

The hidden time bomb

Every patient lookup. Every lab result viewed. Every medication ordered. HIPAA requires you to log it all and keep it for 6+ years.

Do the math: A mid-sized health system generates millions of audit events daily. That's billions per year. Trillions over the retention period.

And you're storing them in the same database handling patient care.

When compliance kills performance

We've seen it repeatedly: Organizations build beautiful FHIR APIs, implement perfect AuditEvent resources, then watch their systems grind to a halt under audit log volume.

The classic mistake? Treating audit logs like regular data. But audit events are write-heavy, query-rarely, and grow relentlessly. Your operational database wasn't designed for this.

The real cost

• Performance degradation as tables grow into billions of rows
• Expensive storage for data that's rarely accessed
• Slow investigations when you actually need those logs
• System risk when audit processing impacts patient care

One large EHR vendor we know had to disable audit logging during peak hours because it was crashing their production systems. Guess when most breaches happen?

There's a better way

The solution isn't more database tuning. It's architectural separation.
Purpose-built audit repositories like Auditbox handle FHIR AuditEvents separately from operational systems, ingesting millions of events per day, archiving automatically, and enabling sub-second searches across billions of records.

Think: Elasticsearch-backed, FHIR-native, designed specifically for write-once-read-rarely audit patterns.

The bottom line

Your audit logs are not regular data. Stop treating them that way.
Separate your audit infrastructure before it becomes your next production incident. Your database and your compliance team will thank you.

Want to solve this before it becomes a crisis? We're offering early free access to Auditbox for select healthcare organizations. Get early access here →