# Aidbox vs Medplum

> Medplum scores 68.7 (B) to Aidbox's 64.2 (B) for fhir servers. Prices, MCP, x402, uptime and agent notes side by side.

- Canonical: https://www.anchorterminal.com/compare/aidbox-vs-medplum
- Markdown: https://www.anchorterminal.com/compare/aidbox-vs-medplum.md (~2,350 tokens)
- Slim: https://www.anchorterminal.com/compare/aidbox-vs-medplum.min.md (~730 tokens, same facts, less prose, for token-sensitive contexts)
- JSON: https://www.anchorterminal.com/compare/aidbox-vs-medplum.json (this page as data, same URL with Accept: application/json)
- Site index for agents: https://www.anchorterminal.com/llms.txt (full text: https://www.anchorterminal.com/llms-full.txt)
- API: https://www.anchorterminal.com/api/v1/index.json
- Updated: 2026-10-14

Medplum scores 68.7 (B) on agent readiness against Aidbox's 64.2 (B), and leads in 4 of 7 scored categories. Aidbox leads on agent ergonomics. Both do fhir servers.

- Aidbox: grade B, 64.2/100, rank #385 of 1076. Markdown https://www.anchorterminal.com/tools/aidbox.md · JSON https://www.anchorterminal.com/api/v1/tools/aidbox.json
- Medplum: grade B, 68.7/100, rank #216 of 1076. Markdown https://www.anchorterminal.com/tools/medplum.md · JSON https://www.anchorterminal.com/api/v1/tools/medplum.json
- Best health record and wellness data APIs for AI agents: https://www.anchorterminal.com/best/health-data/index.md
- All 63 health comparisons: https://www.anchorterminal.com/compare/health-data/index.md

## Which one, for what

### Aidbox (B)

Good for: An organisation building its own clinical data repository, EHR or payer platform on FHIR, where an agent works against that store.

Ahead on:
- Agent ergonomics, 79 against 73

Watch for: No built-in rate limiting or brute-force protection, by the vendor's hardening page

### Medplum (B)

Good 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 59
- Schema & documentation, 82 against 77
- Maintenance & community, 93 against 80
- Transparency & trust, 72 against 45

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

| Category | Weight | Aidbox | Medplum | Edge |
| --- | --- | --- | --- | --- |
| Reliability | 16% (20 this run) | 59 | 75 | Medplum +16 |
| Performance | 10%, pending | pending | pending | not scored in this run |
| Schema & documentation | 13% (16.2 this run) | 77 | 82 | Medplum +5 |
| Agent ergonomics | 13% (16.2 this run) | 79 | 73 | Aidbox +6 |
| Security & auth | 14% (17.5 this run) | 74 | 74 | even |
| Payments & pricing | 10% (12.5 this run) | 25 | 25 | even |
| Task success | 10%, pending | pending | pending | not scored in this run |
| Maintenance & community | 7% (8.8 this run) | 80 | 93 | Medplum +13 |
| Transparency & trust | 7% (8.8 this run) | 45 | 72 | Medplum +27 |
| Negative events | ≤15 | 0 | -2 | |
| **Total** | | **64.2 · B** | **68.7 · B** | |

## Facts side by side

| Fact | Aidbox | Medplum |
| --- | --- | --- |
| Kind | HTTP API | HTTP API |
| Vendor | Health Samurai, Inc. | Orangebot, Inc. (dba Medplum) |
| Hosted endpoint | no (local only) | `https://api.medplum.com/mcp/stream` |
| Transports | HTTP, Streamable HTTP, SSE (legacy) | HTTP, Streamable HTTP, SSE (legacy) |
| Auth | OAuth | OAuth |
| Pricing | Freemium | Freemium |
| x402 | no | no |
| Licence | Proprietary. Aidbox runs from Health Samurai's Docker images under a free development licence (no PHI) or a paid production licence. Examples and the Python SDK on GitHub are MIT | 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 exposed | 9 | 3 |
| Read-only variant documented | no | yes |
| llms.txt | yes | yes |
| MCP registry | not listed | `com.medplum/mcp` |
| Last release | 2026-10-08 | 2026-10-08 |
| Terms last updated | no document linked | 2023-04-11 |
| Privacy policy last updated | 2021-06-10 | 2022-04-05 |
| Customer content may train models |  | not found in the text |
| Terms restrict automated access |  | not found in the text |
| Terms restrict benchmarking |  | not found in the text |
| Terms or service can change without notice |  | yes |
| Arbitration or class-action waiver |  | yes |
| Popularity | none | 2.7k stars, 270k npm/wk |

## Verdicts

**Aidbox.** Graded on the FHIR REST API of an Aidbox instance the owner runs. Monthly releases, two-year LTS lines, SMART on FHIR, AccessPolicy rules and AuditEvent logging are documented, and a free development licence needs no sales call. Aidbox has no rate limiting of its own, its MCP module is alpha, and no terms of service were found on the website.

**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

### Aidbox

1. Ask the operator for a Client with an AccessPolicy limited to the task. Don't rely on the public MCP policy, which the docs mark unsafe
2. Use `If-None-Exist` on creates and conditional update on identifiers so retries don't duplicate records
3. Use `_elements` and `_count` to keep responses small, and follow the Bundle's paging links
4. Throttle yourself. Aidbox applies no rate limit, so a burst lands on the customer's database
5. Don't load real patient data into an instance on a development licence

### 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, Aidbox or Medplum?

Medplum scores 68.7 (B) on agent readiness against Aidbox's 64.2 (B), and leads in 4 of 7 scored categories. Aidbox leads on agent ergonomics.

### Do Aidbox and Medplum need an API key?

Both use an OAuth sign-in.

### Can an agent call Aidbox and Medplum without installing anything?

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

### Are Aidbox and Medplum open source?

No open-source release is listed for Aidbox. 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).


## For agents

- This comparison as JSON: https://www.anchorterminal.com/compare/aidbox-vs-medplum.json, and with the fewest tokens: https://www.anchorterminal.com/compare/aidbox-vs-medplum.min.md
- Over MCP at https://www.anchorterminal.com/mcp (no key): `compare_tools {"a": "aidbox", "b": "medplum"}`. From a terminal: `anchor compare aidbox medplum`
- Each listing in full: https://www.anchorterminal.com/api/v1/tools/aidbox.json and https://www.anchorterminal.com/api/v1/tools/medplum.json

## Other comparisons with Aidbox or Medplum

- [Aidbox vs Health Gorilla](https://www.anchorterminal.com/compare/aidbox-vs-health-gorilla.md)
- [Aidbox vs Medblocks](https://www.anchorterminal.com/compare/aidbox-vs-medblocks.md)
- [Aidbox vs Metriport Medical API](https://www.anchorterminal.com/compare/aidbox-vs-metriport.md)
- [Aidbox vs Particle Health](https://www.anchorterminal.com/compare/aidbox-vs-particle-health.md)
- [Aidbox vs Redox](https://www.anchorterminal.com/compare/aidbox-vs-redox.md)
- [Aidbox vs ROOK](https://www.anchorterminal.com/compare/aidbox-vs-rook.md)
- [Aidbox vs Terra API](https://www.anchorterminal.com/compare/aidbox-vs-terra.md)
- [Aidbox vs Zus Health](https://www.anchorterminal.com/compare/aidbox-vs-zus-health.md)
- [Medplum vs Metriport Medical API](https://www.anchorterminal.com/compare/medplum-vs-metriport.md)
- [Medplum vs Particle Health](https://www.anchorterminal.com/compare/medplum-vs-particle-health.md)
- [Medplum vs Redox](https://www.anchorterminal.com/compare/medplum-vs-redox.md)
- [Medplum vs ROOK](https://www.anchorterminal.com/compare/medplum-vs-rook.md)
- [Medplum vs Terra API](https://www.anchorterminal.com/compare/medplum-vs-terra.md)
- [Medplum vs Zus Health](https://www.anchorterminal.com/compare/medplum-vs-zus-health.md)
- [1upHealth vs Aidbox](https://www.anchorterminal.com/compare/1uphealth-vs-aidbox.md)
- [1upHealth vs Medplum](https://www.anchorterminal.com/compare/1uphealth-vs-medplum.md)
- [Health Gorilla vs Medplum](https://www.anchorterminal.com/compare/health-gorilla-vs-medplum.md)
- [Medblocks vs Medplum](https://www.anchorterminal.com/compare/medblocks-vs-medplum.md)
- [Aidbox vs Validic Inform](https://www.anchorterminal.com/compare/aidbox-vs-validic.md)