# Health Gorilla vs Medplum

> Medplum scores 68.7 (B) to Health Gorilla's 59.3 (C) for patient record retrieval. Prices, MCP, x402, uptime and agent notes side by side.

- Canonical: https://www.anchorterminal.com/compare/health-gorilla-vs-medplum
- Markdown: https://www.anchorterminal.com/compare/health-gorilla-vs-medplum.md (~2,350 tokens)
- Slim: https://www.anchorterminal.com/compare/health-gorilla-vs-medplum.min.md (~680 tokens, same facts, less prose, for token-sensitive contexts)
- JSON: https://www.anchorterminal.com/compare/health-gorilla-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 Health Gorilla's 59.3 (C), and leads in every scored category. Both do patient record retrieval.

- Health Gorilla: grade C, 59.3/100, rank #583 of 1076. Markdown https://www.anchorterminal.com/tools/health-gorilla.md · JSON https://www.anchorterminal.com/api/v1/tools/health-gorilla.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

### Health Gorilla (C)

Good for: US providers, labs and digital health companies that need network record retrieval and lab ordering through one FHIR API with a QHIN behind it.

Watch for: No public prices. Fees are set case by case and the sandbox is requested by form

### 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 58
- Security & auth, 74 against 66
- Payments & pricing, 25 against 5
- Maintenance & community, 93 against 63
- Transparency & trust, 72 against 61

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 | Health Gorilla | Medplum | Edge |
| --- | --- | --- | --- | --- |
| Reliability | 16% (20 this run) | 58 | 75 | Medplum +17 |
| Performance | 10%, pending | pending | pending | not scored in this run |
| Schema & documentation | 13% (16.2 this run) | 80 | 82 | Medplum +2 |
| Agent ergonomics | 13% (16.2 this run) | 72 | 73 | Medplum +1 |
| Security & auth | 14% (17.5 this run) | 66 | 74 | Medplum +8 |
| Payments & pricing | 10% (12.5 this run) | 5 | 25 | Medplum +20 |
| Task success | 10%, pending | pending | pending | not scored in this run |
| Maintenance & community | 7% (8.8 this run) | 63 | 93 | Medplum +30 |
| Transparency & trust | 7% (8.8 this run) | 61 | 72 | Medplum +11 |
| Negative events | ≤15 | 0 | -2 | |
| **Total** | | **59.3 · C** | **68.7 · B** | |

## Facts side by side

| Fact | Health Gorilla | Medplum |
| --- | --- | --- |
| Kind | HTTP API | HTTP API |
| Vendor | Health Gorilla, Inc. | Orangebot, Inc. (dba Medplum) |
| Hosted endpoint | no (local only) | `https://api.medplum.com/mcp/stream` |
| Transports | HTTP | HTTP, Streamable HTTP, SSE (legacy) |
| Auth | OAuth | OAuth |
| Pricing | Paid | Freemium |
| x402 | no | no |
| Licence | Proprietary service under Health Gorilla's API Terms of Use (updated 22 January 2026), with a signed licence agreement required before production | 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 | none | 3 |
| Read-only variant documented | no | yes |
| llms.txt | yes | yes |
| MCP registry | not listed | `com.medplum/mcp` |
| Last release | 2026-10-14 | 2026-10-08 |
| Terms last updated | no date given | 2023-04-11 |
| Privacy policy last updated | 2024-08-30 | 2022-04-05 |
| Customer content may train models | not found in the text | not found in the text |
| Terms restrict automated access | not found in the text | not found in the text |
| Terms restrict benchmarking | yes | not found in the text |
| Terms or service can change without notice | yes | yes |
| Arbitration or class-action waiver | not found in the text | yes |
| Popularity | none | 2.7k stars, 270k npm/wk |

## Verdicts

**Health Gorilla.** A TEFCA QHIN with a FHIR R4 API, OpenAPI fragments on every reference page, idempotency keys on POST and dated weekly release notes. Access is sales-led, with case-by-case fees, a sandbox by request and no published rate limit numbers, and the API terms allow access to be cut at any time.

**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

### Health Gorilla

1. Send a fresh UUID in `HG-Idempotency-Key` on every POST and reuse it only when retrying the same payload
2. Poll async operations no sooner than the `Retry-After` value and treat 454 as an expired result
3. Follow `link.relation=next` in Bundles rather than building offsets yourself
4. Expect mocked Patient360 data in sandbox unless network connectivity is enabled for the tenant
5. Log `X-HG-Request-Id` from each response for support cases

### 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, Health Gorilla or Medplum?

Medplum scores 68.7 (B) on agent readiness against Health Gorilla's 59.3 (C), and leads in every scored category.

### Do Health Gorilla and Medplum need an API key?

Both use an OAuth sign-in.

### Can an agent call Health Gorilla and Medplum without installing anything?

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

### Are Health Gorilla and Medplum open source?

No open-source release is listed for Health Gorilla. 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/health-gorilla-vs-medplum.json, and with the fewest tokens: https://www.anchorterminal.com/compare/health-gorilla-vs-medplum.min.md
- Over MCP at https://www.anchorterminal.com/mcp (no key): `compare_tools {"a": "health-gorilla", "b": "medplum"}`. From a terminal: `anchor compare health-gorilla medplum`
- Each listing in full: https://www.anchorterminal.com/api/v1/tools/health-gorilla.json and https://www.anchorterminal.com/api/v1/tools/medplum.json

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