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Can you tell us some about the technology you're using? I'm curious if a newfangled immutable database like datomic would be a good fit for medical recods. Also, do you do any schema'ing besides what's provided by your database (JSON Schema/XML Schema/etc)?

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Our data is primarily stored in postgres. We've looked into using Mongo to store FHIR-compliant documents, which is the newest standard (and best standard, IMO) proposed by HL7.

Haven't looked at that many immutable databases, but they seem interesting. Most of the time medical data does not require many writes (rarely are two doctors editing your record simultaneously), but the audit trail that datomic provides could be very useful as a built-in feature.

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