Write a review

Head to head · Patient record retrieval · October 2026 research run

1upHealth vs Medplum

Medplum scores 68.7 (B) on agent readiness against 1upHealth's 46.8 (D), and leads in 6 of 7 scored categories. Both do patient record retrieval.

Best health record and wellness data APIs for AI agents · All 63 health comparisons

1upHealth1upHealth, Inc. · HTTP API D46.8/100#903 of 1076 MedplumOrangebot, Inc. (dba Medplum) · HTTP API B68.7/100#216 of 1076

Which one, for what

1upHealth D

Best for Consumer and care apps that read a member's health plan claims and clinical data under the CMS rules, and payers meeting those rules.

No category where it leads by five points or more, and no fact that sets it apart.

Watch for

No rate limits, 429 handling or error formats documented

Medplum B

Best for An agent working inside a digital health company's own FHIR store, reading and writing patients, observations and appointments under a BAA.

Ahead on

  • Reliability, 75 against 52
  • Schema & documentation, 82 against 50
  • Agent ergonomics, 73 against 32
  • Security & auth, 74 against 63
  • Payments & pricing, 25 against 20
  • Maintenance & community, 93 against 37

Also in its favour

  • A hosted endpoint, with nothing to install
  • Open source

Watch for

The MCP fhir-request tool can delete or overwrite any resource the token allows, with no readOnlyHint or destructiveHint

Score by category

CategoryWeight this run1upHealthMedplumEdge
Reliability16%205275Medplum +23
Performance10%pendingpendingpendingnot scored in this run
Schema & documentation13%16.25082Medplum +32
Agent ergonomics13%16.23273Medplum +41
Security & auth14%17.56374Medplum +11
Payments & pricing10%12.52025Medplum +5
Task success10%pendingpendingpendingnot scored in this run
Maintenance & community7%8.83793Medplum +56
Transparency & trust7%8.87272even
Negative events≤150-2
TotalD 46.8/100B 68.7/100

Facts side by side

Fact1upHealthMedplum
KindHTTP APIHTTP API
Vendor1upHealth, Inc.Orangebot, Inc. (dba Medplum)
Hosted endpointno (local only)https://api.medplum.com/mcp/stream
TransportsHTTPHTTP, Streamable HTTP, SSE (legacy)
AuthOAuthOAuth
PricingPaidFreemium
x402nono
LicenceProprietary service under 1upHealth's Terms of Service (effective 1 August 2024)Apache 2.0 for the server, SDKs and apps in medplum/medplum. The hosted service at api.medplum.com runs under Medplum's terms of service
Tools exposednone3
Read-only variant documentednoyes
llms.txtyesyes
MCP registrynot listedcom.medplum/mcp
Last releasenone2026-10-08
Terms last updatedno date given2023-04-11
Privacy policy last updated2026-06-252022-04-05
Customer content may train modelsnot found in the textnot found in the text
Terms restrict automated accessnot found in the textnot found in the text
Terms restrict benchmarkingyesnot found in the text
Terms or service can change without noticenot found in the textyes
Arbitration or class-action waivernot found in the textyes
Popularitynone2.7k stars, 270k npm/wk

Verdicts

1upHealth

Self-serve Dev Portal sandbox clients and a demo health plan let an app test the CMS Patient Access, Provider Access and Payer-to-Payer FHIR APIs, backed by HITRUST and SOC 2 Type 2. No rate limits, error formats or dated releases are documented, and the Patient Access OAuth step needs the member in a browser.

Medplum

Graded on the hosted FHIR API at api.medplum.com. Rate limits, a RateLimit header and a 99.99 per cent SLA are published, AccessPolicy resources allow read-only clients, and an official MCP server sits in the registry. Its main tool can delete records with no annotation, the status page could not be read, and the privacy policy dates from 2022.

Before you call either

1upHealth

  1. Hand the Patient Access sign-in to the member, who must authorise in the health plan's auth app
  2. Exchange the authorisation code within five minutes, and refresh before the 15-minute token expires
  3. Email payer-patient-access@1up.health with the client ID to get the app synced to the demo environment
  4. Expect only claims and coverage resources from some payers, and read /r4/metadata first

Medplum

  1. Use a ClientApplication with an AccessPolicy limited to the resources the task needs, and set readonly where no writes are needed
  2. Read the RateLimit header and wait for the reset time after a 429. Writes cost 100 quota points, searches 20 and reads 1
  3. Create patients with conditional create (If-None-Exist) or upsert on an identifier so a retry doesn't make a duplicate
  4. Pass paths to fhir-request relative to the FHIR R4 base, with no leading slash or /fhir/R4 prefix
  5. Use Prefer: respond-async for large bundles. Operations inside the background job don't count against the quota

Questions

Which is better for AI agents, 1upHealth or Medplum?

Medplum scores 68.7 (B) on agent readiness against 1upHealth's 46.8 (D), and leads in 6 of 7 scored categories.

Do 1upHealth and Medplum need an API key?

Both use an OAuth sign-in.

Can an agent call 1upHealth and Medplum without installing anything?

No hosted endpoint is listed for 1upHealth. Medplum has a hosted endpoint at https://api.medplum.com/mcp/stream.

Are 1upHealth and Medplum open source?

No open-source release is listed for 1upHealth. Medplum is open source (Apache 2.0 for the server, SDKs and apps in medplum/medplum. The hosted service at api.medplum.com runs under Medplum's terms of service).

Other comparisons with 1upHealth or Medplum

Machine-readable

For companies

Do agents find, use and choose your tools?

An agent-readiness audit runs our probes, task suite and eight reviewer agents against your public and internal tools, and comes back with a scorecard, the transcripts of what failed, and a fix list in priority order. From $2,500, re-run included. We never take payment to move a rank. We do help companies earn one.

Get an auditSee a sample report