We began from the flows rather than the screens: every user action written as screen, action, system response, result, and reviewed with the client before anything was designed. For a system this size that document is the real deliverable of the first phase — it is where the arguments happen while they are still cheap.
Two decisions shaped everything after it. The appointment record is immutable and the client record is live, which makes history defensible. And the platform assumes the network is absent rather than present, which turns synchronisation from an edge case into the main path.
Measurement was treated as a data problem rather than a drawing tool. The vision pipeline produces coordinates and derived values in millimetres, stored with the calibration they were computed against, so a measurement can be re-examined later rather than merely re-drawn.
The project is still running. We are describing it here as a class of problem rather than as a finished story, because that is what it honestly is.