Medplum vs Metriport Medical API

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.

Metriport Medical API

One network query pulls a patient's records from HIEs, pharmacies and labs and returns deduplicated FHIR, with per-operation rate limits, RFC 7807 errors and AGPLv3 source. Each API key has full access with no scopes, there are no public prices, and the sandbox opens only after Metriport approves the account.

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

Metriport Medical API

1. Check the errors array after Start Network Query. It returns 2XX even when some sources fail
2. Wait for network-query.* webhooks or poll Get Network Query Status before reading consolidated data, which is cached from the last query
3. Send the resource's eTag in If-Match on updates to avoid overwriting newer data
4. Keep patient creates under 15 a minute and network queries under 20 a minute per source
5. In sandbox, create patients whose first name matches a pre-defined persona to get example records