sharp-fhir-mcp

A clean-room SHARP-on-MCP compliant FHIR R4 MCP server with interactive MCP-UI clinical dashboards.

Built for the Prompt Opinion "Build the Future of Healthcare AI" Hackathon — a vendor-neutral MCP server that any SMART-on-FHIR app, agent, or LLM host can plug into without server-side OAuth, API keys, or proprietary auth flows.

Why SHARP?

The SHARP (Standardised Healthcare Agent Remote Protocol) spec describes a headers-based context model for MCP servers in healthcare:

Per SHARP §3.2, the MCP server never runs an OAuth dance itself. The agent host (e.g. a SMART-on-FHIR launch container) obtains the token and forwards it on every call. This means a single deployment of this server works against Epic, Cerner, MEDITECH, athenahealth, eClinicalWorks, ConnectEHR, HAPI, or any other FHIR R4 endpoint — there's nothing vendor-specific.

The server advertises capabilities.experimental.fhir_context_required = true on every initialise response so SHARP-aware clients know to forward those headers automatically.

What's included

🩺 Clinical FHIR tools

• fhir_get_capability_statement — discover the connected FHIR server
• fhir_get_patient, fhir_search, fhir_read, fhir_patient_everything — generic R4 access
• clinical_search_patients, clinical_get_patient_summary
• clinical_get_appointments, clinical_get_encounters
• clinical_get_problems, clinical_get_medications, clinical_get_allergies, clinical_get_immunizations
• clinical_get_health_record — one-shot consolidated record
• clinical_get_context — full visit context (demographics + allergies + meds + problems + labs + vitals + encounters + alerts) in parallel

🔬 Labs, vitals & imaging

• lab_get_results, lab_get_vital_signs, lab_get_diagnostic_reports
• imaging_get_documents — DocumentReference search

🧠 Optional persistent memory (SimpleMem)

When SIMPLEMEM_API_URL and SIMPLEMEM_ACCESS_TOKEN are set:

• memory_store_encounter — save a visit summary
• memory_store_alert — flag clinical concerns for next visit
• memory_search_history — semantic search across past encounters
• memory_get_patient_history — list all stored memories for the current patient

📊 MCP-UI visualisations

• visualize_lab_trend — Chart.js line chart of one lab over time
• visualize_vitals — multi-chart vitals dashboard
• visualize_patient_dashboard — full HTML clinical page (demographics, alerts, allergies, meds, problems, labs, encounters, immunisations + Chart.js trends)

All visual tools return MCP-UI ui:// resources that the host renders in its inspector pane.

Quickstart

1. Install

git clone https://github.com/your-org/sharp-fhir-mcp.git
cd sharp-fhir-mcp
pip install -e .

2. Run the server

sharp-fhir-mcp                     # streamable-http on 0.0.0.0:8000
sharp-fhir-mcp --port 9000         # custom port
sharp-fhir-mcp --strict-context    # 403 on non-handshake without FHIR headers

The MCP endpoint is http://localhost:8000/mcp.

Note: localhost here refers to localhost of the machine where you are running the server. To access it remotely, deploy the server (see below) or port-forward to your local instance.

3. Connect from any SHARP-aware MCP client

Send these headers on every JSON-RPC request:

X-FHIR-Server-URL: https://hapi.fhir.org/baseR4
X-FHIR-Access-Token: <bearer token from your SMART launch>
X-Patient-ID: 12345          # optional

4. Try a public sandbox without writing a SMART app

The HAPI public FHIR R4 sandbox is read-only and does not require auth — useful for kicking the tires:

curl -X POST http://localhost:8000/mcp \
  -H 'Content-Type: application/json' \
  -H 'Accept: application/json, text/event-stream' \
  -H 'X-FHIR-Server-URL: https://hapi.fhir.org/baseR4' \
  -H 'X-FHIR-Access-Token: anonymous' \
  -d '{"jsonrpc":"2.0","id":1,"method":"tools/list"}'

Deployment

Vercel (Python serverless)

This server runs as a stateless Streamable-HTTP endpoint, which works on Vercel out of the box. You can re-use an existing Next.js MCP scaffold by either:

1. Adding the Python ASGI handler — drop the app Starlette instance into api/index.py:

   # api/index.py
   from sharp_fhir_mcp.server import app  # noqa: F401
   

   plus a minimal vercel.json:

   {
     "builds": [{"src": "api/index.py", "use": "@vercel/python"}],
     "routes": [{"src": "/(.*)", "dest": "api/index.py"}]
   }
   

2. Or running it as a sidecar behind your existing Vercel front-end and reverse-proxying /mcp to a longer-lived host (Fly.io, Railway, Render).

The server respects the Vercel-injected PORT environment variable.

Local development

cp .env.example .env             # set FHIR_SERVER_URL etc. for fallbacks
sharp-fhir-mcp                   # http://localhost:8000/mcp

Docker (optional)

FROM python:3.12-slim
WORKDIR /app
COPY . .
RUN pip install -e .
EXPOSE 8000
CMD ["sharp-fhir-mcp", "--host", "0.0.0.0", "--port", "8000"]

Architecture

┌─────────────────────────────────────────────────────────────┐
│  MCP Client / Agent / LLM host (Claude, Cursor, custom)     │
│  • Knows the patient's FHIR endpoint + access token         │
│  • Sends X-FHIR-Server-URL, X-FHIR-Access-Token headers     │
└────────────────────────┬────────────────────────────────────┘
                         │ Streamable HTTP (SHARP-on-MCP)
            POST /mcp + JSON-RPC + SHARP headers
                         ▼
┌─────────────────────────────────────────────────────────────┐
│  sharp-fhir-mcp                                             │
│                                                             │
│  ┌────────────────────────────────────────────────────────┐ │
│  │ SharpContextMiddleware                                 │ │
│  │ • Parses X-FHIR-Server-URL / X-FHIR-Access-Token       │ │
│  │ • Stores in ContextVar for the request scope           │ │
│  └─────────────────────────┬──────────────────────────────┘ │
│                            ▼                                │
│  ┌────────────────────────────────────────────────────────┐ │
│  │ FastMCP tool registry                                  │ │
│  │ ├─ fhir_*           (generic R4 search/read)           │ │
│  │ ├─ clinical_*       (patient/encounter/medication/…)   │ │
│  │ ├─ lab_* / imaging_*(observations, reports, docs)      │ │
│  │ ├─ memory_*         (optional SimpleMem)               │ │
│  │ └─ visualize_*      (MCP-UI Chart.js dashboards)       │ │
│  └─────────────────────────┬──────────────────────────────┘ │
│                            ▼                                │
│  ┌────────────────────────────────────────────────────────┐ │
│  │ Vendor-neutral FHIR R4 client (httpx, async)           │ │
│  └─────────────────────────┬──────────────────────────────┘ │
└────────────────────────────┼────────────────────────────────┘
                             ▼
            FHIR R4 server (Epic / Cerner / HAPI / …)

See CLAUDE.md for detailed module-by-module notes and the SHARP compliance check-list.

SHARP compliance check-list

License

MIT — see LICENSE.