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Authentication and Identity

Medplum supports multiple authentication configurations, with the intent to enable required compliance and integration scenarios. Implementations commonly use multiple authentication and authorization methods.

Authentication Patterns

Medplum supports three primary authentication integration patterns, summarized by the following diagram. Each has its own use case, and is supported by various authentication methods. An implementation can use multiple or all patterns for different use cases.

Client Credentials

The Medplum API uses standard OAuth2/OpenID authentication. The "Client Credentials Flow" is recommended for machine-to-machine access.

Consuming Webhooks

Many SaaS products including popular services like Stripe and Okta support Webhooks, allowing a web application to register a Medplum URL to receive notifications. When a certain event occurs in the source application, such as a new user signup or a change to a record, the source application sends an HTTP POST request to the URL registered by the destination application. This HTTP POST request contains information about the event that occurred.

Custom Emails

Some server actions send email messages to users. For example, when a user creates a new account, the server sends a "Welcome" email message. On Medplum's hosted environment, the email will include a link to "".

Domain-level Identity Providers

A Domain-level Identity Provider (DL-IDP) is a server-level configuration that sets up an external identity provider for all users from a given domain. This identity provider will be used for all Medplum applications the user logs into, including the Medplum App. Domain-level providers are primarily used to ensure that all practitioners access Medplum data via your corporate identity solution.

External Identity Providers

Medplum supports external identity providers such as Auth0 and AWS Cognito for end user authentication. This is sometimes known as "Federated Identities".

Google Authentication

Google Authentications allows users to log in to your application using their Google profile.

IP Access Rules

One valuable way to prevent unauthorized data access is to restrict access to clinical data by the user's IP address. This article will discuss the benefits of IP address restrictions and provide a step-by-step guide on configuring these settings in Medplum's AccessPolicy.


There are two different methods to "logout" and revoke access tokens:


Medplum Projects are the primary mechanism of access control. Projects are isolated containers of FHIR resources that are administered separately, and which can have different settings.

SMART Scopes

SMART on FHIR’s authorization scheme uses OAuth2 scopes to communicate (and negotiate) access requirements.

User Management Guide

This guide walks through how to create and manage users via the Medplum App and via API. Medplum supports multiple authentication options, but always maintains a representation of the user identities, and gives developers control over which authentication method to use for an identity, as well as what access controls are applied.

Using External IDs

By default, Medplum uses email address as a unique identifier for a user. When using External Identity Providers, you may instead want to use the external ID rather than email. This document describes the additional changes to use external ID.