I am running a web site that helps manage lots of information for medical clinics. Part of the application needs to upload patient files from an excel spreadsheet. The patient table has about 1 million records and an excel import needs to insert or update 10k,20k,30k patient records at a time. All the while other customers are pounding the table. Processing time is less important than reducing contention on the database. What strategies would you recommend?
I know other sites effectively do this. Salesforce allows you to upload large amounts of data at once.