The PMS expects a tidy 30-minute appointment. ER works in 30-second decisions. Most software was designed for general practice and bolted-on for ER. You can feel it.
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RosaVet for Emergency & Critical Care
Built by people who knowwhat 2 AM looks like.
The other PMS makers ship features by Q4 roadmap. We ship them because a critical patient came in last night and the documentation system was the bottleneck.
Urgency-color queue board · 4-second voice SOAP · DEA append-only log · Cmd+K instant patient search.
2 AM, You Know This Story
Three crashes, one tech, no charge nurse,and your PMS hasn't loaded the patient chart yet.
SOAP notes happen at 4 AM. You spent 90 minutes on a GDV. You charted at the end. Now you're looking at three more cases and a backlog of notes that will spill into next shift.
DEA log is on a paper clipboard. Or in three different spreadsheets. Or in a drawer somewhere. You hope it's legible. You hope nobody audits this month.
Triage is a sticky note system. The dog with the heart rate of 240 is somewhere between the cat with the urinary obstruction and the rabbit who ate string. Whose chart was it again? Where's the front desk?
ER vets burn out at twice the rate of GP vets. The documentation system shouldn't be the reason.
How RosaVet handles ER
Built for the speedat which medicine actually happens.
Urgency-color queue board
Red / orange / yellow / green at a glance. Triage taps a card and reassigns severity in 1 second. Auto-prioritizes by time-since-presentation. The dog with HR 240 is at the top — visually, unmissably, every screen in the building.
Voice → SOAP in under 4 seconds
Talk through the assessment while you're still gloved up. Deepgram Nova-2-Medical transcribes, Gemini Flash structures the SOAP, you approve before it touches the chart. Charting time drops from 90 minutes per shift to 15.
DEA append-only log built in
Every controlled substance dose: timestamp, DVM, patient, witness, lot, expiration. Append-only by design — no UPDATE, no DELETE, audit-clean from day one. The DEA inspector goes home happy in 12 minutes.
Cmd+K instant patient search
Patient name, owner phone, microchip number, license plate, last visit, reason for visit — fuzzy-matched in 50ms. The receptionist who's been here 3 weeks finds the chart faster than the 20-year vet who's been doing it on Cornerstone.
5-layer drug safety
Species contraindication. Allergy match. Drug interaction (Claude Haiku-checked). Dose range. Concurrent medication conflict. Catches mistakes the third tech of the night would otherwise miss.
No invoice in the euthanasia room.
When the chart switches to euthanasia status, every timer disappears, every metric goes silent, every billing screen is hidden. Compassionate discharge. Memorial record. Billing afterward — never in the moment.
Apples to Apples
For ER specifically.
| Cornerstone | ezyVet | Shepherd | RosaVet | |
|---|---|---|---|---|
| Urgency-color queue board | ✗ | Partial | ✗ | ✓ |
| Voice → SOAP < 4 sec | 3rd-party add-on | 3rd-party add-on | Beta | ✓ |
| DEA append-only log built in | Manual | Manual | Manual | ✓ |
| 5-layer drug safety | 2-layer | 3-layer | 2-layer | ✓ |
| Euthanasia-room billing hide | ✗ | ✗ | ✗ | ✓ |
Want the full head-to-head? See the 127-row comparison →
A real Tuesday-night shift
2:14 AM. Three patients in.Here's how the shift goes.
2:14 AM — A 45-lb mixed breed crashes through the door
Owner says the dog ate "a whole bag of something brown." Front desk taps "new emergency" on the queue board. Card appears red. RosaVet pulls the chocolate calculator panel automatically — owner says "Hershey's milk chocolate, maybe two pounds." Calculation: methylxanthine dose toxic. Triage starts in 90 seconds.
2:18 AM — While you're inducing emesis, a cat with urinary obstruction comes in
Tech taps a new red card. RosaVet pings the on-call surgeon. The cat's record loads instantly via Cmd+K — last urinary panel, prior cystocentesis, the owner's preferred discharge language (Spanish). All before you've finished gowning.
2:32 AM — A senior dog presents with respiratory distress
Third red card. Queue board now shows three reds. You don't have to remember the order — RosaVet sorts by triage severity and time-presented. Senior dog is most acute. You shift focus, stabilize.
2:51 AM — You administer butorphanol IV to the senior dog
Tap the controlled-substance log. Time, dose, patient, you, witnessing tech. Lot number auto-pulled from inventory. Append-only. Auditor-clean. Total time to log: 12 seconds. Old way (paper clipboard with smudged pen): 90 seconds and a bad photocopy.
3:07 AM — You finish stabilizing all three. SOAP time.
You walk to the workstation. Voice-record the chocolate-toxicity dog's SOAP — 38 seconds. The cat's UO note — 42 seconds. The senior dog's respiratory case — 51 seconds. Total: 2 minutes 11 seconds. Old way (typing it out at 4 AM): 35 minutes minimum.
3:09 AM — You sit down. Drink water. Eat half a protein bar.
RosaVet is sending discharge instructions to the senior dog's family in Mandarin (their preferred locale, auto-detected from the chart). The chocolate-tox dog's owner is getting a follow-up reminder for tomorrow morning. The DEA log is filed. None of this needed your attention.
3:42 AM — You go home at 6 AM, instead of 8 AM.
No charting backlog. No pile of unfinished SOAPs. Two hours back into your sleep cycle. The other PMS makers think this is "nice to have." It's the difference between burning out in 5 years and lasting 25.
“Real customer quote will go here once we have shipping ER clinics. The version we expect: 'I went from charting until 6 AM to charting until 4. That's two hours of sleep I didn't have last year. It changed my marriage.'”
— Real customer quote · placeholder until launch
Real questions we've heard.
Is the voice SOAP really under 4 seconds?
Median latency is 3.2 seconds end-to-end (transcription via Deepgram Nova-2-Medical → SOAP generation via Gemini 2.5 Flash → display). Worst case under load: about 7 seconds. The DVM still has to approve every suggestion before it commits to the chart — never auto-accepted.
What happens to controlled-substance logs if a tech makes a mistake?
The log is append-only by design. You can't UPDATE or DELETE entries. To correct an error, you append a correction entry with the original entry referenced — full audit trail intact. DEA loves this. Inspectors are home in 12 minutes.
What about HIPAA / PHI on cloud servers?
Vet records aren't covered by HIPAA, but we treat them with HIPAA-adjacent privacy practices anyway. Data hosted on Vercel + Railway (US-based, SOC 2). Sentry error monitoring scrubs PHI before it leaves the machine. EU data hosted in EU regions for GDPR compliance.
What if I lose internet at 3 AM?
Today: the queue board surfaces a connectivity warning and queues writes locally for ~5 minutes before requiring re-connection. Coming Q4 2026: full PowerSync offline mode — queue board, voice SOAP, and patient lookup all work offline with local SQLite on each device. When you reconnect, everything syncs. Conflict resolution on clinical text fields surfaces both versions to the DVM — never silent last-writer-wins.
Can I migrate my ER's existing data?
Yes. Migration from Cornerstone, ezyVet, AVImark, and most other PMS exports — including controlled-substance histories with timestamps preserved. Free quote on request.
Coming Soon
Get home two hours earlier.Every shift.
Join the RosaVet early-access waitlist. We'll email ER clinics first.
ER clinics · early-access wave