Documentation

Get to a responsible first integration faster.

A guided path through local evaluation, safety boundaries, supported configurations, and the small adapter contract behind Last EHR.

Start here: the protocol

Approval-Gated Agent Writes on FHIR (v0.1 draft)

Proposal → Decision → Commit → Audit, extracted from two running bindings.

Test the claim

Protocol Conformance Suite

Drive any implementing MCP server with a scripted reviewer and independent FHIR verification.

Start locallyBrowse source

Press ⌘ / Ctrl K to search the guide library. Search stays in your browser.

The shortest path

See the full approval loop, without a model key.

This explicitly limited local mode starts HAPI FHIR, seeds only synthetic data, and runs one fixed Maria Garcia / 72 bpm observation proposal. It does not read arbitrary charts or call an external model provider.

  • No account or .env.local required
  • No external model request
  • One visible approval before the synthetic write
ZERO-KEY EVALUATIONlocalhost:3000
$ npm install
$ npm run demo:local
01

Start

Docker Compose brings up HAPI and Postgres.

02

Seed

The repository creates its synthetic records.

03

Review

The scripted agent stops before the write.

Choose a path

Start where your architecture actually is.

01Evaluate locallyRun a synthetic HAPI stack and a deterministic, approval-gated walkthrough without a model key.Continue02Inspect MCP locallyPrepare fixture-restricted HAPI data and connect two read-only tools without FHIR credentials.Continue03Run the Safety EvalGenerate a scrubbed synthetic report for proposal, approval, denial, association, and cleanup mechanics.Continue04Integrate MedplumConnect the authenticated path, bring your own model provider, and rely on backend access policy.Continue05Extend a backendStart from the executable adapter starter and prove the FHIR contract against synthetic data.Continue

Reference library

Documentation organized around real decisions.

Each guide states the scope, the verification path, and the caveats needed to make an informed call, not just the happy path.

Start and orient

Get the operating context first

View Markdown source
QuickstartHosted demo, Medplum integration, and the local HAPI path.Support statusSupported, local-evaluation-only, and unverified configurations.ArchitectureHow the route, FHIR tools, and backend boundary fit together.

Understand the safety boundary

Know the limits before adding capability

View Markdown source
Approval-gated writesWhat the proposal-and-review pattern protects, and what it cannot prove.Threat modelTrust boundaries, prompt risks, and deployment assumptions.MCP serverRead-only by default (Medplum or local HAPI) with an opt-in human-approved write profile, plus a fixture-restricted checkout Local Lab.FHIR Agent Safety EvalA scrubbed synthetic workflow report for the web agent's approval mechanics.

Operate and contribute

Take it from reference app to your environment

View Markdown source
DeploymentEnvironment variables, Docker, rate limiting, and public demo hardening.Backend adaptersContract harnesses, an executable bearer-token starter, and verification steps.Adoption metricsMeasure OSS usage without sending chart content to analytics.

Support at a glance

The product boundary is part of the documentation.

Configuration
Status
What that means
Medplum, hosted or self-hosted
Supported
Authenticated path with backend identity, policy, and audit controls.
Included HAPI Docker stack
Local only
Synthetic, single-tenant evaluation, not a general deployment path.
Other FHIR R4 backends
Adapter wanted
Start from the contract harness and document the auth and verification story.

Read the complete support matrix before choosing a deployment path.