How Lakebase and Unity Catalog Are Replacing SQL Server Sprawl in Healthcare

Transactional systems supporting real-time workflows must simultaneously feed analytical platforms under strict regulatory governance. The traditional answer—SQL Server replication layered with ADF orchestration and parallel OLTP/OLAP governance stacks—means every new application adds another replication chain, pipeline, and governance gap.This session presents a fundamentally different approach: standardizing transactional storage on Databricks Lakebase, a Postgres-compatible database natively integrated with the lakehouse and governed by Unity Catalog. By moving application transactions directly into the lakehouse ecosystem, we eliminated multi-hop replication chains, removed ADF orchestration, and reduced total architecture components by 75%.We cover the governance model enabling Unity Catalog to provide lineage, access control, and audit across transactional and analytical workloads.