Database optimization and the level of normalization is a complex topic that varies widely based on application and workload. JSON is absolutely a valid approa

Database optimization and the level of normalization is a complex topic that varies widely based on application and workload. JSON is absolutely a valid approach to data storage when dealing with certain data structures. As is using a relational database and jsonb data types for it. Cherry picking columns gives you the advantages for both a NoSQL document storage database as well as a relational analytics database. This is a pretty common modern technique that Postgres, for example, has made easy. Go try modeling a FHIR database structure using standard normalization rules. You'll quickly discover why no one does it. Even HAPI FHIR server (the most full featured and popular FHIR server) written in Java doesn't attempt it.