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Medplum Monthly Update - January 2026

· 8 min read
Reshma Khilnani
Reshma Khilnani
Medplum Core Team

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.

Features​

Provider App: Spaces, Messaging, and Tasks​

David Yanez David Yanez

The Provider app saw major improvements across messaging, task management, and the new Spaces experience. This work advances the Provider Application roadmap goal of expanding available workflows.

  • Spaces streaming and buffered support — real-time communication with both streaming and buffered message delivery
  • Server-Sent Events bot implementation — SSE support for bots, enabling real-time AI-powered interactions
  • Messaging improvements — URL support in the inbox, participant filtering, and topic-based threading for Communications
  • Task management — auto-selection when the task list is empty, priority display for better triage
  • Navbar updates for both Medplum and Provider apps by Kevin Wadeshaw, plus a new Get Started page

Scheduling: $find and $book Operations​

Noah Silas Noah Silas

The most significant feature work this month was a ground-up buildout of FHIR-native scheduling operations. This directly supports the Scheduling initiative on our 2026 roadmap, where we committed to self-scheduling, advanced availability management, and resource scheduling.

  • $find operation for querying available slots on a single Schedule resource, now with unique slot identifiers and timezone support (scheduling docs)
  • $book operation for creating Appointments through a FHIR operation, with a first pass on the Provider UI booking flow
  • Provider Calendar refactor to support the new scheduling operations
  • Timezone support in SchedulingParams, enabling scheduling across time zones
  • New search parameters for ActivityDefinition.code, Communication.priority, and ProjectMembership.active

These operations give developers a clean, standards-based API for building patient self-scheduling and staff scheduling workflows — a capability that has been one of our most requested features.

System-Level Custom FHIR Operations​

Gonzalo Bellver Gonzalo Bellver

Developers can now define custom FHIR operations at the system level, not just per-resource. This is a key building block for the Integrations & Plugins roadmap initiative, enabling more flexible bot-powered workflows and custom API endpoints.

FHIR Operations and Terminology​

Darren Eam Darren Eam

Matt Willer Matt Willer

Site Reliability and Infrastructure​

These changes support the Enterprise Scale & Infrastructure roadmap priority of handling growing platform traffic.

Matt Willer Matt Willer

  • Reserved database connections for healthcheck — prevents health checks from being starved during high load
  • Redis failover error handling in BullMQ workers — improves resilience during Redis cluster failovers
  • Skip caching on write for AuditEvent resources — reduces memory pressure for high-volume audit logging
  • Tracing extensions on OperationOutcome — better observability for debugging production issues

Matt Long Matt Long

  • ReindexJob configuration enhancements — more control over reindexing for large datasets
  • Per-resourceType padding configuration — fine-grained tuning of array padding for storage optimization
  • Array padding calculator — tooling to help determine optimal padding settings

Noah Silas Noah Silas

  • Automatic pre/post deploy migration generation — streamlines the database migration workflow for self-hosted deployments

Security and Access Control​

  • Inactive ProjectMembership disables access tokens — when a membership is set to inactive, associated tokens are immediately invalidated (access control docs) (Matt Willer)
  • Subscription Bot execution respects ProjectMembership — ensures subscriptions run in the correct membership context (Matt Willer)
  • On-behalf-of header support with proper cache disabling (Maddy Li, Cody Ebberson)

SDK and Developer Experience​

AI and MCP​

Advancing our AI roadmap initiative:

Documentation​

A significant documentation effort this month improved coverage across the Provider app, scheduling, self-hosting, the Medplum Agent, and compliance.

Provider

Finn Bergquist Finn Bergquist

  • Revamped multi-tenancy documentation (multi-tenancy identity providers)
  • Scheduling docs: availability time zones, $find beta status, SchedulingParameters duration param (scheduling docs)
  • DoseSpot enrollment documentation: how to enroll users with the Enroll Prescriber Bot (medications docs)
  • AccessPolicy requirements for Bulk Export API (API docs)
  • Observation.valueSampledData documentation

Self-Hosting and Operations

Medplum Agent

Derrick Farris Derrick Farris

The Medplum Agent is an application that runs inside your firewall and connects to devices over low-level protocols such as HL7/MLLP, ASTM, and DICOM, bridging them to the cloud via secure HTTPS WebSocket channels. This month the Agent docs received several updates:

Additional Docs

Bug Fixes​

Forms and UI

  • Fixed repeatable items in QuestionnaireForm
  • Fixed dark mode on the visit details page
  • Fixed color inheritance issue (dark to inherit)
  • Updated diagnoses binding URL in OrderLabsPage

Server and API

  • Fixed SQL error in date array search parameters
  • Fixed search by POST issue via body-parser update
  • Fixed CCDA timezone offset conversion to FHIR format (Amanda McGivern)
  • Fixed validateResource argument merging
  • Fixed consistent storageBaseUrl generation with /binary/ path (Jim Fiorato)
  • Fixed out-of-order query results in useSearch
  • Fixed too-many-requests error re-wrapping in fetchTokens

Agent

Infrastructure

Releases​

Looking Ahead​

January's scheduling work sets the stage for the self-scheduling and resource scheduling features planned for 2026. The Provider app's Spaces and streaming capabilities are moving us closer to a production-ready provider experience. On the infrastructure side, the Redis failover handling and database connection improvements directly support enterprise-scale deployments.

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