Open source · Alpha
Search patients, read their charts, and draft notes, observations, and follow-up tasks. Review each proposed change before it is saved to your FHIR backend.
Last provides the chart tools and review workflow. Connect an assistant such as Grok Bot through MCP, or use the web app.
Browser demo: synthetic patients, no sign-up. Grok setup requires your own deployment or operator-approved pilot access.
Grok drafts. You approve. Last verifies the save.
Grok wrote the follow-up. A person reviewed it in Last, then Grok checked the saved Task. Edited from actual screenshots; the request needed a connector-name clarification. All patient data is invented. No one was contacted.
Read
The agent reads from your FHIR backend. Your backend controls access and remains the system of record.
Read results flag truncated searches, unsupported filters, and records that could not be retrieved, so the agent has context about what it has and has not read.
23 chart sections cover 25 of 27 readable resource types in US Core 9.0.0, including reference lookups. Medication and PractitionerRole remain gaps in verified coverage.
See chart coverageWrite
A request from the model is a proposal; approval is a separate step. Review in the web app, in a compatible chart MCP client, or in Last’s separate inbox for Assistant Work.
Draft a note, record a measurement, or create a follow-up task for a patient.
Check the patient and exact fields. Approve to continue, or reject to leave the chart unchanged.
An approved proposal creates a resource in your backend, subject to its permissions.
Current writes create notes, observations, and tasks. They do not edit or delete existing records. Web app and chart MCP writes carry the FHIR AIAST label. Assistant Work records the approval and a verified save receipt for its follow-up Task.
How approval worksThe approval step controls writes. In external model modes, chart reads are sent to your configured provider as context.
Use it
A chat interface with patient cards and write previews. Sign in with Medplum or launch from a patient’s chart through SMART on FHIR. Bring your own backend and model credentials.
To inspect the approval flow first, the local HAPI walkthrough uses synthetic data and needs no model API key.
Set up the web appGive Claude Code, Cursor, or another MCP client the same 4 chart-reading tools. The package is read-only by default. Enable writes separately; each proposal requires a client that supports human approval prompts.
npx -y @lastehr/mcp init --client claude-codeSupports Medplum and this repo’s local synthetic HAPI stack.
Configure MCPLet an external assistant draft a follow-up from a synthetic chart. You review the exact proposal in Last’s inbox. After approval, Last saves the Task and verifies the result; the assistant can check the receipt.
Tested with the Grok Bot desktop app over HTTPS MCP and OAuth. Self-host the synthetic lab or arrange access with the pilot operator. There is no public self-service enrollment yet.
Connect Grok BotSupport today
Last EHR is an alpha project. Medplum is the supported authenticated setup; the other adapters are for evaluation.
Read the support matrixThe repo includes an approval protocol draft and a conformance suite to test approval and persistence behavior. These checks do not establish clinical correctness or compliance.
Apache-2.0
Self-host Last EHR with your own FHIR backend and model. The source, setup guides, tests, and known limitations are public.
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