Which service best provides database encryption at rest plus built-in automatic patching for a healthcare startup?

Azure SQL Managed Instance is the best choice because it offers database encryption at rest (via Transparent Data Encryption - TDE) and built-in automatic patching, which are crucial for a healthcare startup needing to meet compliance and reduce operational overhead. Azure Cosmos DB is a NoSQL database, not typically the first choice for relational data often found in healthcare, and while it offers encryption, its patching is also automatic but it's not a relational database. Azure Synapse Analytics is primarily for data warehousing and analytics, not an operational database. Azure Data Lake is a storage repository for big data analytics, not a relational database service.