MCP Server

@lastehr/mcp is the smallest installable Last EHR surface: a Medplum-only, read-only MCP server for searching patients and opening a chart. It is deliberately separate from the web app, where writes are proposal-shaped and approval-gated.

Install and connect

npx -y @lastehr/mcp init

The command prints a portable MCP configuration. Add a least-privilege token, then place the result in your MCP client's configuration:

{
  "mcpServers": {
    "lastehr": {
      "command": "npx",
      "args": ["-y", "@lastehr/mcp"],
      "env": {
        "MEDPLUM_ACCESS_TOKEN": "<replace-with-a-least-privilege-token>"
      }
    }
  }
}

For Claude Code, print the registration command instead:

npx -y @lastehr/mcp init --client claude-code

The process inherits MEDPLUM_* variables from your shell or MCP client configuration. Start it directly with npx -y @lastehr/mcp when you want to test a stdio connection yourself.

Auth

The package uses Medplum credentials:

MEDPLUM_CLIENT_ID=...
MEDPLUM_CLIENT_SECRET=...

or:

MEDPLUM_ACCESS_TOKEN=...

Set MEDPLUM_BASE_URL for self-hosted Medplum.

Tool surface

The published 0.1.x package exposes exactly two tools, both marked with MCP's readOnlyHint:

• search_patients
• show_patient_info

There is no environment switch that exposes write tools. A write-capable MCP surface would need a proposal protocol and a separate safety review before it is considered for a future release.

Data and support boundary

Read-only does not mean low-risk: show_patient_info can return PHI-rich chart data. Use the smallest Medplum AccessPolicy that meets the task, confirm that your MCP client and model provider are appropriate for the data, and do not treat this package as an authorization layer.

@lastehr/mcp supports hosted or self-hosted Medplum authentication today. It does not claim generic FHIR, HAPI, SMART launch, or browser-approval parity. See the support matrix for the complete boundary.

From a checkout

The repository includes the same package for contributors:

npm run mcp

This builds @lastehr/mcp and starts the two read-only tools using your local Medplum environment variables.

Roadmap

• Better read-tool coverage where it can stay bounded and auditable.
• Proposal-shaped writes only if MCP clients support a reviewable confirmation protocol.