# Medplum vs ROOK (slim)

> Medplum scores 68.7 (B) to ROOK's 54.9 (C) for fhir servers. Prices, MCP, x402, uptime and agent notes side by side.

- Full: https://www.anchorterminal.com/compare/medplum-vs-rook.md (~2,350 tokens) · this version ~680 tokens · JSON https://www.anchorterminal.com/compare/medplum-vs-rook.json · canonical https://www.anchorterminal.com/compare/medplum-vs-rook
- Index: https://www.anchorterminal.com/llms.txt · API: https://www.anchorterminal.com/api/v1/index.json · Updated: 2026-10-14

Medplum scores 68.7 (B) on agent readiness against ROOK's 54.9 (C), and leads in 5 of 7 scored categories. Both do fhir servers.

- Medplum: B 68.7, rank #216 of 1076 · https://www.anchorterminal.com/tools/medplum.min.md
- ROOK: C 54.9, rank #718 of 1076 · https://www.anchorterminal.com/tools/rook.min.md
- Medplum, 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 Schema & documentation, 82 against 74; Agent ergonomics, 73 against 49; Security & auth, 74 against 32; Maintenance & community, 93 against 73; Transparency & trust, 72 against 55. Also A hosted endpoint, with nothing to install; Open source.
- ROOK, good for A wellness, insurance, corporate wellness or remote monitoring product that wants normalised wearable data pushed to its backend, with plan prices it can see up front.

| Category | Medplum | ROOK |
| --- | --- | --- |
| Reliability (16%) | 75 | 75 |
| Performance (10%) | pending | pending |
| Schema & documentation (13%) | 82 | 74 |
| Agent ergonomics (13%) | 73 | 49 |
| Security & auth (14%) | 74 | 32 |
| Payments & pricing (10%) | 25 | 25 |
| Task success (10%) | pending | pending |
| Maintenance & community (7%) | 93 | 73 |
| Transparency & trust (7%) | 72 | 55 |

| Fact (where they differ) | Medplum | ROOK |
| --- | --- | --- |
| Vendor | Orangebot, Inc. (dba Medplum) | Rookeries Development Corp. |
| 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 |
| 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 service under ROOK's Terms and Conditions for ROOK services |
| Tools exposed | 3 | none |
| Read-only variant documented | yes | no |
| MCP registry | `com.medplum/mcp` | not listed |
| Last release | 2026-10-08 | 2026-10-07 |
| Terms last updated | 2023-04-11 | 2026-08-01 |
| Privacy policy last updated | 2022-04-05 | 2026-05-28 |
| Terms restrict benchmarking | not found in the text | yes |
| Terms or service can change without notice | yes | not found in the text |
| Popularity | 2.7k stars, 270k npm/wk | none |