With the beginning of 2022, the German government introduced an electronic prescription format for medications, comprising everything from the prescription through the pharmacy dispense to the invoice. It is described by FHIR – the global standard for exchanging electronic health data. Together with spectrumK, a service company for Germany's health insurers, we have built a platform on top of Apache Kafka and Kafka Streams that can process and approve prescriptions at large scale. In this session, we present different aspects of the platform. We highlight the benefits of our approach - converting the complex FHIR schemas to Protobuf - compared to working directly with data in the FHIR format. We further showcase how we use Kafka Streams to integrate a multitude of sources and build complex profiles of master data. These profiles are then exposed through an interplay of Kafka, Protobuf and GraphQL and among others, requested during the approval process. This complex process includes a variety of microservices. We explain how we have developed an asynchronous and synchronous mode for the process, so that the platform can support orthogonal requirements. Finally, we share our learnings on how to auto-scale such a platform.