Medplum June 2026 Update

The headline this month: Medplum achieved HITRUST certification, a validation of our security and compliance program. June was also another busy month of shipping, with 200+ commits from 25+ contributors and nine patch releases — v5.1.14 through v5.1.22.

Scheduling saw a lot of activity. The Provider App gained a reusable inbox shell, and operation-based claim submission. SMART Health Cards and Links arrived with a QR code scanner, the Enterprise data warehouse export was released, and the AI workspace added configurable model routing. The platform also gained email-based multi-factor authentication, enforceable per project.

All of this continues to drive forward our 2026 roadmap priorities.

Features

Scheduling

Building on May's operation suite, June moved scheduling to a Beta release and tightened the rules around how appointments are booked:

• Scheduling API Beta — The appointment operation suite is now a Beta release, and the older Slot-based alpha implementations have been removed in favor of the appointment-based flow
• $book alignment enforcement — Booking now enforces scheduling alignment, and $find supports nondivisible alignment times so slots respect configured intervals
• Planning horizon constraints — Scheduling operations are now constrained by Schedule.planningHorizon, and scheduling parameters can be inherited from the HealthcareService
• Availability defaults — Availability now defaults to "always" when unset, with the requested time slot included in availability error messages for clearer feedback
• Provider scheduling flow — The Provider App streamlines encounter creation, links Appointment.slot, adds an Appointment confirm button, and moves to FullCalendar v7
• Cancelled-appointment slots — The schedule view now hides slots tied to cancelled appointments, so a cancellation frees the time back up instead of leaving a stale block

Provider App

The Provider App gained reusable building blocks and revenue-cycle improvements:

• ResourceBoard inbox shell — A new React shell that encapsulates inbox logic, providing a reusable foundation for task and worklist views
• Performing practitioner in care teams — Care team fields now support a performing practitioner, improving attribution in clinical workflows
• Operation-based claim submission — Claim submission now uses a server-side FHIR operation, and the app creates or updates the Claim during export or submit, simplifying the billing integration
• Patient documents tab — A dedicated documents tab on the patient view, with inbound faxes now stored as DocumentReference resources so they land in the chart alongside other records
• Medications in the patient summary — MedicationStatement resources appear in the PatientSummary component, and both MedicationStatement and DocumentReference now resolve to readable display strings
• Self-service registration — A Register page for the Provider App lets new users sign up directly, with the reCAPTCHA widget hidden in the app shell
• Navigation polish — Navbar visual tweaks and a HeaderDropdown refactor, plus fixes to the back button after fax loading and to autoscrolling

AI

AI work centered on the Spaces workspace — the in-app AI assistant in the Provider App — and real-time documentation:

• Configurable model routing — Spaces now supports a configurable base URL and a dynamic model list, so deployments can route AI requests through their own gateway to control cost and security
• AI real-time questionnaire form and real-time voice — A real-time questionnaire form plus voice input improvements that keep the socket active during a session
• Spaces UX — Prompt composer UI updates and grouping of each FHIR request with its corresponding response for clearer traceability

The Spaces documentation covers setup, the agent loop, and how to author the system prompts that drive its behavior.

Identity, Sharing, and Documents

• Multi-factor authentication — A new email-based MFA method, plus a project-level mfaRequired setting that enforces MFA for every member, with documentation for enabling it
• External token exchange across project memberships — Token exchange now works across project memberships, for users who span multiple projects
• Attachment handling — Inline attachments in Patient/$everything, base64 data support in <AttachmentDisplay>, and cursor pagination across patient-everything and multi-type searches
• Patient invite with RelatedPerson — The user invite endpoint accepts a Patient to support RelatedPerson, enabling caregiver and proxy access

Enterprise: Data Warehouse and Reliability

Enterprise scale and infrastructure work made the analytics export production-ready and hardened the data layer:

• Data warehouse export controls — Configuration for which tables to sync, include/exclude filters, restored ORDER BY, and DuckDB lifecycle cleanup give data teams precise control over what reaches their lakehouse
• Transaction-scoped repositories — Repository connections are now transaction-scoped, with idle-in-transaction time tracked, improving reliability under load
• FHIRPath Patch — A FHIRPath Patch utility wired into the server for targeted resource updates
• Project-level SMTP — Projects can now configure their own SMTP settings for sending email

Agent and Connectivity

The on-premise Agent — Medplum's connectivity service for legacy healthcare systems and HL7 interfaces — saw a concentrated round of reliability work this month:

• Durable HL7 message queue — The Agent now persists inbound HL7 messages to a durable queue, so messages survive restarts and transient outages instead of living only in memory
• Resilient Agent/$upgrade — A batch of fixes to the Agent upgrade flow: no more duplicated messages during an upgrade, a guard that checks for the upgrade artifact before unlinking it, and a documented upgrade bugfix, alongside a new Agent/$upgrade documentation page
• Reconnection hardening — The Agent now reconnects across a range of error states, records the acknowledgement before returning in acknowledgement-only mode, and triggers a clean shutdown before awaiting channel start
• Agent/$reload-config — A documented operation to reload a deployed Agent's configuration without a full restart
• WebSocket subscription reliability — A series of fixes recreate WebSocket subscriptions on reconnect, tear down the Redis listener cleanly on shutdown, bind the message listener before subscribing, and send a handshake on connection establishment

Compliance

Medplum achieved HITRUST certification this month — the headline of our compliance track. HITRUST is one of the most rigorous, prescriptive security frameworks in healthcare, and certification gives customers third-party assurance of Medplum's security and compliance program for their own vendor reviews. Several other pieces of the track also moved:

• HITRUST documentation — Published HITRUST documentation alongside the certification, and pointed compliance references at the Medplum Trust Center (with an updated Vanta Trust Center link)
• SMART Health Cards and Links — Support for SMART Health Cards and Links, including a QR code scanner and updates for the CMS "Keep the Card" (KTC) program, giving patients a verifiable, portable record
• Patient/$match with CMS criteria — The patient match operation now follows CMS matching criteria, aligning identity resolution with federal guidance
• Patient data access fixes — Corrected Patient/$everything pagination links and normalized C-CDA address handling, keeping patient-record exchange complete and standards-conformant
• Electronic prior authorization — Continued progress on electronic prior authorization toward the HTI-4 requirements ahead of the January 2027 enforcement date

Documentation

• Self-hosting fixes — Corrections across the Azure, GCP, and Kubernetes self-hosting guides, a Debian package fix that preserves local edits on upgrade and restores the DuckDB native dependency, and production Docker base images pinned to Node 24.18 Provider App and platform
• Shared Projects — New documentation on shared projects
• Multi-lingual FHIR support — Docs and a demo app for multi-lingual FHIR support
• Agentic engineering guide — A new agentic engineering guide and companion blog post
• AI real-time docs and Alpha/Beta feature expectations — Documentation for the AI real-time operation and a guide to what Alpha and Beta feature labels mean

Integrations

• Electronic prescribing — Expanded e-prescribe documentation, including prescriber profile setup and staging NPI creation
• Lab orders — Public docs for lab account number updates
• Clearinghouse claim submission — Claim submission documentation for clearinghouse connectivity

Bug Fixes

FHIR and billing

• Render CMS-1500 Box 24E diagnosis pointers correctly
• Prevent duplicate resources in convertToTransactionBundle
• Normalize address part text nodes in C-CDA mapAddresses

Server and async

• Stop polling a cancelled AsyncJob by returning 200 from the status endpoint, and add Accept-Encoding: identity to token exchange
• Bound the 401 retry in MedplumClient to prevent infinite retry loops
• Paginate AWS Textract results via NextToken
• Recreate WebSocket subscriptions on reconnect
• Record the authenticating ClientApplication on AuditEvent.agent[]

Releases

• v5.1.14 — June 1
• v5.1.15 — June 3
• v5.1.16 — June 8
• v5.1.17 — June 9
• v5.1.18 — June 15
• v5.1.19 — June 20
• v5.1.20 — June 20
• v5.1.21 — June 20
• v5.1.22 — June 24

Looking Ahead

June brought scheduling to Beta, made the Enterprise data warehouse export production-ready with selectable table sync, and added configurable model routing to the AI workspace. SMART Health Cards and Links, operation-based claim submission, and a reusable inbox shell round out a month focused on Provider App depth and platform reliability.