Background. Clinical data warehouses (CDWs) are essential in the reuse of hospital data in observational studies or predictive modeling. However, state of-the-art CDW systems present two drawbacks. First, they do not support the management of large data files, what is critical in medical genomics, radiology, digital pathology, and other domains where such files are generated. Second, they do not provide provenance management or means to represent longitudinal relationships between patient events. Indeed, a disease diagnosis and its follow-up rely on multiple analyses. In these cases no relationship between the data (e.g., a large file) and its associated analysis and decision can be documented. Method. We introduce gitOmmix, an approach that overcomes these limitations, and illustrate its usefulness in the management of medical omics data. gitOmmix relies on (i) a file versioning system: git, (ii) an extension that handles large files: git-annex, (iii) a provenance knowledge graph: PROV-O, and (iv) an alignment between the git versioning information and the provenance knowledge graph. Results. Capabilities inherited from git and git-annex enable retracing the history of a clinical interpretation back to the patient sample, through supporting data and analyses. In addition, the provenance knowledge graph, aligned with the git versioning information, enables querying and browsing provenance relationships between these elements. Conclusion. gitOmmix adds a provenance layer to CDWs, while scaling to large files and being agnostic of the CDW system. For these reasons, we think that it is a viable and generalizable solution for omics clinical studies.