I'm guessing that you're updating records. So you're resolving what's "truth" during the inbound operation. (For readers: data may be received out of order, so implementers must resolve the single source of truth in near real-time.)

Our systems used to do that.

My redesign eliminated updates, did only inserts, and resolved the "truth" during the query. Greatly simplified everything.

No more "historical" table, where deltas are logged. Determining what was known when (determining liability) queries were simply date bounded. No need to "rerun the data" when a mapping or business rule changed. Etc.

No updates, no real deletes either (only virtual ones). Data about transactions is stored separately from the clinical data, in an optimised store for log data.