# Medplum vs Metriport Medical API

> Medplum scores 68.7 (B) to Metriport Medical's 50.1 (D) for fhir servers. Prices, MCP, x402, uptime and agent notes side by side.

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- 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 Metriport Medical API's 50.1 (D), and leads in every scored category. Both do fhir servers.

- 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
- Metriport Medical API: grade D, 50.1/100, rank #833 of 1076. Markdown https://www.anchorterminal.com/tools/metriport.md · JSON https://www.anchorterminal.com/api/v1/tools/metriport.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

### 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 45
- Schema & documentation, 82 against 65
- Security & auth, 74 against 41
- Payments & pricing, 25 against 5
- Maintenance & community, 93 against 74
- Transparency & trust, 72 against 56

Also in its favour:
- A hosted endpoint, with nothing to install

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

### Metriport Medical API (D)

Good for: US care providers and digital health companies that need a patient's network records as FHIR with webhooks.

Watch for: Every API key has full access, including destructive operations, with no scopes


## Score by category

| Category | Weight | Medplum | Metriport Medical API | Edge |
| --- | --- | --- | --- | --- |
| Reliability | 16% (20 this run) | 75 | 45 | Medplum +30 |
| Performance | 10%, pending | pending | pending | not scored in this run |
| Schema & documentation | 13% (16.2 this run) | 82 | 65 | Medplum +17 |
| Agent ergonomics | 13% (16.2 this run) | 73 | 70 | Medplum +3 |
| Security & auth | 14% (17.5 this run) | 74 | 41 | Medplum +33 |
| Payments & pricing | 10% (12.5 this run) | 25 | 5 | Medplum +20 |
| Task success | 10%, pending | pending | pending | not scored in this run |
| Maintenance & community | 7% (8.8 this run) | 93 | 74 | Medplum +19 |
| Transparency & trust | 7% (8.8 this run) | 72 | 56 | Medplum +16 |
| Negative events | ≤15 | -2 | 0 | |
| **Total** | | **68.7 · B** | **50.1 · D** | |

## Facts side by side

| Fact | Medplum | Metriport Medical API |
| --- | --- | --- |
| Kind | HTTP API | HTTP API |
| Vendor | Orangebot, Inc. (dba Medplum) | Metriport Inc. |
| Hosted endpoint | `https://api.medplum.com/mcp/stream` | no (local only) |
| Transports | HTTP, Streamable HTTP, SSE (legacy) | HTTP |
| Auth | OAuth | API key |
| Pricing | Freemium | Paid |
| x402 | no | no |
| Licence | 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 | Proprietary hosted service under Metriport's terms of use. The source in metriport/metriport is AGPLv3, with an enterprise directory under its own licence, and the @metriport/api-sdk package on npm is MIT |
| Tools exposed | 3 | none |
| Read-only variant documented | yes | no |
| llms.txt | yes | yes |
| MCP registry | `com.medplum/mcp` | not listed |
| Last release | 2026-10-08 | 2026-09-28 |
| Terms last updated | 2023-04-11 | 2024-01-01 |
| Privacy policy last updated | 2022-04-05 | 2023-02-21 |
| Customer content may train models | not found in the text | not found in the text |
| Terms restrict automated access | not found in the text | yes |
| Terms restrict benchmarking | not found in the text | yes |
| Terms or service can change without notice | yes | yes |
| Arbitration or class-action waiver | yes | yes |
| Popularity | 2.7k stars, 270k npm/wk | 793 stars, 28k npm/wk |

## Verdicts

**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.

## Before you call either

### 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

## Questions

### Which is better for AI agents, Medplum or Metriport Medical API?

Medplum scores 68.7 (B) on agent readiness against Metriport Medical API's 50.1 (D), and leads in every scored category.

### Do Medplum and Metriport Medical API need an API key?

Medplum uses an OAuth sign-in. Metriport Medical API needs an API key.

### Can an agent call Medplum and Metriport Medical API without installing anything?

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

### Are Medplum and Metriport Medical API open source?

Yes. 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). Metriport Medical API is open source (Proprietary hosted service under Metriport's terms of use. The source in metriport/metriport is AGPLv3, with an enterprise directory under its own licence, and the @metriport/api-sdk package on npm is MIT).


## For agents

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

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