March was yet another busy month for Medplum. Three patch releases — v5.1.2, v5.1.3, and v5.1.4 — arrived alongside over 100 commits from 20+ contributors, and the work underneath the surface was just as significant as the new features. Spaces gained richer AI tooling. The communications documentation received a full suite of guides covering everything from the data model to automations. Worker infrastructure got a substantial rethink, and WebSocket subscriptions were hardened across the board. All of it continues to advance our 2026 roadmap priorities.

One of the most common questions we hear from teams evaluating Medplum is: "Can it handle our scale?" We wanted to answer that question with real data. We recently ran a formal performance evaluation against a self-hosted Medplum deployment that mirrors one of our largest production clusters, and the results speak for themselves - peak throughput exceeding 46,000 requests per second for read-only traffic and nearly 7,000 requests per second for full read/write/search FHIR workflows, with zero HTTP failures across all scenarios.

February was a productive month for Medplum. We shipped four releases — v5.0.14, v5.0.15, v5.1.0, and v5.1.1, including a minor version bump reflecting the depth of new capabilities — with over 130 commits from 25+ contributors. The biggest themes this month were WebSocket subscription stability and performance improvements, AI-powered provider experiences, scheduling refinements, and revenue cycle tooling — all advancing our 2026 roadmap priorities.

Healthcare applications require careful decisions about user authentication and access control. Whether you're building an EHR, a clinical workflow tool, or a patient portal, getting identity management right from the start will save you from costly architectural mistakes down the road.

This guide breaks down the key decisions you'll face when integrating with a FHIR-based platform like Medplum, explains the tradeoffs, and recommends approaches that work well for most healthcare organizations.

January was a packed month for Medplum. We shipped three patch releases (v5.0.11, v5.0.12, v5.0.13), published the 2026 Roadmap, and landed over 100 commits from 20+ contributors. The biggest themes this month were scheduling, the Provider app, and site reliability — all directly advancing our 2026 roadmap priorities.

As we kick off 2026, we're excited to share Medplum's vision for the year ahead. Our open-source healthcare development platform has experienced substantial growth throughout 2025:

An incredible year of growth, innovation, and community. From v5 release to expanding our developer ecosystem, 2025 marked several milestones for Medplum's open-source healthcare platform.

As part of the Medplum v5 release, we've been hard at work delivering several key improvements to our FHIR Terminology Services, which power Medplum's rich features for handling coded values:

• Supporting synonyms in ValueSet/$expand, allowing users to find codes by a number of different search terms
• Scaling our implementation of the ConceptMap/$translate operation to handle maps with over a million entries
• Updating our library of UMLS code systems with their latest release, including several new code systems around medications and supplements and a mapping between related code systems and RxNorm
• A collection of performance enhancements that speed up ValueSet expansion and code validation by a significant margin
• (In beta) The option to validate all required terminology bindings in resources on write

Below we'll discuss each of these changes in more detail and give examples of the features available in Medplum's Terminology Services today.

Slideshow: View Presentation

This is a transcript summary of the October 2025 webinar with Medplum and Unity AI. Medplum CEO Reshma Khilnani interviews Unity AI CTO Cody Hall.

Reshma: We recently hosted a webinar exploring the intersection of AI, healthcare operations, and open-source infrastructure. I was joined by Cody Hall, CTO and Co-Founder of Unity AI, to discuss how his team is solving one of healthcare's most persistent bottlenecks: scheduling, using AI Agents.

We are pleased to announce the Release of Medplum v5, the next major version of the open source healthcare developer platform.

As outlined in our preparatory post in May, Medplum v5 represents a comprehensive and necessary modernization of our core stack. This release ensures our platform maintains the highest standards of performance, security, and developer experience by aligning with the latest stable versions of our critical runtime and tooling dependencies.