Medplum MCP
Securely access and manage FHIR healthcare data stored in Medplum.
Read a Tierward project's governance state (doctor, team-settings, arch-audit, skills) over MCP.
选择你使用的 AI 应用,然后复制设置。
通过 3/3 项检查 · 在你的电脑上运行 · ✓ 命令已检查 2026年11月13日
第一步:你用哪个 AI?
选择你用的应用,步骤会显示在下方。
可连接 Claude,但需要先准备
需要先在电脑上安装 Node.js(只需一次) · 仅限电脑上的 Claude 应用(Windows 或 Mac),网页和手机不可用
把这段话复制到 Claude 的对话里。AI 会先检查电脑,告诉你要改哪个文件,并且每次都等你同意。
请在这台电脑上为 Claude 安装 MCP server Tierward,按顺序:1) 用 node -v 检查是否有 Node.js。没有的话,请让我从 https://nodejs.org/en/download 安装,不要自己安装。2) 只使用这份配置(已通过 PopNx MCP 检查):{ "mcpServers": { "tierward": { "command": "npx", "args": [ "-y", "tierward" ] } } } 3) 告诉我要修改的文件完整路径或要运行的命令,等我同意。4) 不需要密钥。5) 按约定执行,然后确认 Tierward 的工具真的出现了。这段话不包含你的密钥。如果需要密钥,AI 会请你自己粘贴到文件或应用的输入框里。
已经装好了吗?先检查 · 打开终端,输入这条命令后按 Enter
node -vMac:按 ⌘ + Space,输入 Terminal 后按 Enter
Windows:打开“开始”菜单,输入 Windows PowerShell,然后选“打开”
还没安装: 打开官方下载页,选择 LTS 版本和点选式安装程序:Mac 用 .pkg · Windows 用 .msi。双击后一路下一步即可,不需要 curl 命令
装好后关掉终端再打开,重新运行同一条命令,应显示版本号: node -v
安装一次,所有需要 Node.js 的工具都能用
SettingsDeveloperEdit Config
{
"mcpServers": {
"tierward": {
"command": "npx",
"args": [
"-y",
"tierward"
]
}
}
}用 Tierward 告诉我你能帮我做什么,然后做一件给我看✓ 如果 Claude 说正在使用 Tierward,或回答中出现 Tierward 的工具名称,就表示连接成功
菜单名称已于 2026年11月11日 对照 Anthropic 帮助页面核实 · 你的界面可能因版本略有不同
ChatGPT 暂时无法连接 Tierward
Tierward 需要安装在你的电脑上,而 ChatGPT 只能连接在网上运行的服务器
A · 使用能连接 Tierward 的应用
B · 诊所与健康 类中能连接 ChatGPT 的其他服务器
从同类中使用较多的里挑选,仅限用地址即可连接、无需密钥的
可连接 Claude Code,但需要先准备
需要先在电脑上安装 Node.js(只需一次)
把这段话复制到 Claude Code 的对话里。AI 会先检查电脑,告诉你要改哪个文件,并且每次都等你同意。
请在这台电脑上为 Claude Code 安装 MCP server Tierward,按顺序:1) 用 node -v 检查是否有 Node.js。没有的话,请让我从 https://nodejs.org/en/download 安装,不要自己安装。2) 只使用这份配置(已通过 PopNx MCP 检查):claude mcp add --scope user tierward -- npx -y tierward 3) 告诉我要修改的文件完整路径或要运行的命令,等我同意。4) 不需要密钥。5) 按约定执行,然后确认 Tierward 的工具真的出现了。这段话不包含你的密钥。如果需要密钥,AI 会请你自己粘贴到文件或应用的输入框里。
已经装好了吗?先检查 · 打开终端,输入这条命令后按 Enter
node -vMac:按 ⌘ + Space,输入 Terminal 后按 Enter
Windows:打开“开始”菜单,输入 Windows PowerShell,然后选“打开”
还没安装: 打开官方下载页,选择 LTS 版本和点选式安装程序:Mac 用 .pkg · Windows 用 .msi。双击后一路下一步即可,不需要 curl 命令
装好后关掉终端再打开,重新运行同一条命令,应显示版本号: node -v
安装一次,所有需要 Node.js 的工具都能用
Mac:按 Command+空格,输入 Terminal · Windows:打开 PowerShell
claude mcp add --scope user tierward -- npx -y tierward应能看到 Tierward 在列表中并显示已连接
用 Tierward 告诉我你能帮我做什么,然后做一件给我看✓ 如果 Claude Code 说正在使用 Tierward,或回答中出现 Tierward 的工具名称,就表示连接成功
菜单名称已于 2026年11月11日 对照 Anthropic 帮助页面核实 · 你的界面可能因版本略有不同
可连接 Cursor,但需要先准备
需要先在电脑上安装 Node.js(只需一次)
把这段话复制到 Cursor 的对话里。AI 会先检查电脑,告诉你要改哪个文件,并且每次都等你同意。
请在这台电脑上为 Cursor 安装 MCP server Tierward,按顺序:1) 用 node -v 检查是否有 Node.js。没有的话,请让我从 https://nodejs.org/en/download 安装,不要自己安装。2) 只使用这份配置(已通过 PopNx MCP 检查):{ "mcpServers": { "tierward": { "command": "npx", "args": [ "-y", "tierward" ] } } } 3) 告诉我要修改的文件完整路径或要运行的命令,等我同意。4) 不需要密钥。5) 按约定执行,然后确认 Tierward 的工具真的出现了。这段话不包含你的密钥。如果需要密钥,AI 会请你自己粘贴到文件或应用的输入框里。
已经装好了吗?先检查 · 打开终端,输入这条命令后按 Enter
node -vMac:按 ⌘ + Space,输入 Terminal 后按 Enter
Windows:打开“开始”菜单,输入 Windows PowerShell,然后选“打开”
还没安装: 打开官方下载页,选择 LTS 版本和点选式安装程序:Mac 用 .pkg · Windows 用 .msi。双击后一路下一步即可,不需要 curl 命令
装好后关掉终端再打开,重新运行同一条命令,应显示版本号: node -v
安装一次,所有需要 Node.js 的工具都能用
用 Tierward 告诉我你能帮我做什么,然后做一件给我看✓ 如果 Cursor 说正在使用 Tierward,或回答中出现 Tierward 的工具名称,就表示连接成功
菜单名称已于 2026年11月11日 对照 Cursor 帮助页面核实 · 你的界面可能因版本略有不同
可连接 VS Code,但需要先准备
需要先在电脑上安装 Node.js(只需一次)
把这段话复制到 VS Code 的对话里。AI 会先检查电脑,告诉你要改哪个文件,并且每次都等你同意。
请在这台电脑上为 VS Code 安装 MCP server Tierward,按顺序:1) 用 node -v 检查是否有 Node.js。没有的话,请让我从 https://nodejs.org/en/download 安装,不要自己安装。2) 只使用这份配置(已通过 PopNx MCP 检查):{ "servers": { "tierward": { "type": "stdio", "command": "npx", "args": [ "-y", "tierward" ] } } } 3) 告诉我要修改的文件完整路径或要运行的命令,等我同意。4) 不需要密钥。5) 按约定执行,然后确认 Tierward 的工具真的出现了。这段话不包含你的密钥。如果需要密钥,AI 会请你自己粘贴到文件或应用的输入框里。
已经装好了吗?先检查 · 打开终端,输入这条命令后按 Enter
node -vMac:按 ⌘ + Space,输入 Terminal 后按 Enter
Windows:打开“开始”菜单,输入 Windows PowerShell,然后选“打开”
还没安装: 打开官方下载页,选择 LTS 版本和点选式安装程序:Mac 用 .pkg · Windows 用 .msi。双击后一路下一步即可,不需要 curl 命令
装好后关掉终端再打开,重新运行同一条命令,应显示版本号: node -v
安装一次,所有需要 Node.js 的工具都能用
用 Tierward 告诉我你能帮我做什么,然后做一件给我看✓ 如果 VS Code 说正在使用 Tierward,或回答中出现 Tierward 的工具名称,就表示连接成功
菜单名称已于 2026年11月11日 对照 VS Code 帮助页面核实 · 你的界面可能因版本略有不同
Claude Code
claude mcp add --scope user tierward -- npx -y tierwardClaude Desktop (claude_desktop_config.json)
{
"mcpServers": {
"tierward": {
"command": "npx",
"args": [
"-y",
"tierward"
]
}
}
}Cursor (~/.cursor/mcp.json)
{
"mcpServers": {
"tierward": {
"command": "npx",
"args": [
"-y",
"tierward"
]
}
}
}VS Code (mcp.json)
{
"servers": {
"tierward": {
"type": "stdio",
"command": "npx",
"args": [
"-y",
"tierward"
]
}
}
}这些设置是根据作者在注册中心的条目生成的。如果 README 的写法不同,请以 README 为准。
依据这个服务器的连接方式和各应用自己的文档,检查于 2026年11月10日。
在你的电脑上运行,适用于
ClaudeGooseLM StudioMsty StudioCherry StudioCursorVS Code + GitHub CopilotVisual StudioWindsurf (Devin Desktop)ZedKiroClineContinueJetBrains AI AssistantClaude CodeCodex CLIGemini CLIOpenCodenodecodeWarpLibreChatRaycast
它在你的电脑上运行;安装后,工具列表会显示在你的 AI 应用中。
我们检查的是任何人都能看到的信息;我们没有阅读代码。不适用的检查项不计入总数。 · 检查于 2026年11月15日
注册名称已通过 GitHub 账户 marcoguillermaz 验证,该账户拥有此仓库
代码最后更新于6天前
使用 MIT
它在你的电脑上运行,没有互联网端点
在你的电脑上运行,改用本地设置
它在你的电脑上运行;我们只能读取互联网端点的工具列表
OSV.dev 中没有 tierward@2.3.4 的记录
只检查这个版本的包本身,不包括所有依赖 · 检查于 2026年11月15日
提问、分享技巧或报告无法使用。按“有帮助”数量排序。
还没有评价
与注册中心里这个分类中所有活跃的服务器比较。只有当发布者拥有该仓库时,星标数才计入。
它在 3 项适用的基础检查中通过了 3 项。我们没有阅读代码。在添加密钥或令牌之前,请先看看这个服务器要求哪些权限,并使用只具备所需权限的密钥。
注册中心没有列出必需的密钥,不过有些服务器会在首次使用时要求你登录。
它在你的电脑上运行。你的 AI 应用会在需要时启动它,数据不会经过作者的服务器(除非它自己调用在线服务)。
GitHub 仓库最后更新于6天前,最新版本(2.3.4)于32天前进入注册中心。
支持 MCP 的应用,例如 Claude Desktop、Claude Code、Cursor 和 VS Code。你的电脑上还需要有 Node.js。
同一分类中有:Medplum MCP, Mirobody, Codescene MCP Server, WHOOP — MissingMCP, Marrow
同一分类、其他作者、命令已通过检查。官方的排在前面,再按星标排序。
如何看卡片:↓ 每周下载量i★ GitHub 星标i三大支柱:评价 · 检查 · 使用情况i更新 = 最新版本发布到注册中心的时间i
Securely access and manage FHIR healthcare data stored in Medplum.
Lab results to LOINC codes and UCUM units, symptoms and diagnoses to ICPC-3. Offline, no API key.
An MCP server that provides CodeScene Code Health analysis tools.
WHOOP recovery, strain, sleep and workouts in Claude via official WHOOP OAuth. Free, open source.
Marrow Health: your Apple Health data over MCP, from the free iOS app. Reads, and writes on demand.
按原文从作者的仓库复制。PopNx MCP 没有审查或背书其内容。HTML、图片和脚本已被移除。链接会离开本站。
Claude generates. You or your team decides.
A development framework that gives Claude Code a governed, phased process, so you build real software consistently and reviewably, from day one.
MCP-native: read Tierward governance state from Claude Desktop, ChatGPT, Cursor, VS Code.
Claude Code is fast. The problem it creates isn't in the code: it's in the review. When AI writes everything autonomously, you end up approving diffs you don't fully understand, catching regressions two blocks later, and losing the thread of what the system actually does.
Tierward sits between Claude and done. Teams adopt it tier by tier, from a zero-process discovery setup up to a fully governed pipeline: explicit STOP gates before implementation, audit skills that surface issues before they reach production, and a Stop hook that runs your tests when Claude says it is done and sends it back to fix them when they fail. Start at Tier 0 and move up when you need more structure.
Since v1.17.0, Tierward ships an MCP server alongside the CLI. Any MCP-aware client can read your project's doctor report, team-settings policy, last arch-audit, and skill inventory without running the Tierward CLI. See MCP server.
One thing drives Tierward: Claude Code doesn't become harder to work with because it gets less capable. It becomes harder to work with because autonomous decisions accumulate faster than anyone can review them. The pipeline enforces a review contract: scope confirmed before code, hypothesis written before a fix, tests passing before done. It doesn't slow down work that doesn't need that structure.
The tier system exists because process has a cost. A solo bugfix shouldn't pay the overhead of a team feature workflow. Two pipelines cover the range: Fast Lane (4 steps, scope-confirm) for quick fixes, Full (14 phases, 4 review gates) for team features. Both enforce the same contract: Claude works phase by phase, your team approves each step. Start at the tier that fits your current risk and add more as the stakes rise.
Built for the people who carry the result, product managers and developers alike, so the decisions stay with them, not the model.
Tierward works exclusively with Claude Code. No Cursor support, no Copilot layer, no multi-tool abstractions. That's intentional.
The enforcement mechanisms that make Tierward useful are Claude Code primitives: a Stop hook is a hard OS-level block in settings.json; a STOP gate lives in pipeline.md, a rules file Claude reads at session start; audit skills are structured programs that run inside the Claude Code agent loop. These aren't portable concepts wrapped in an abstraction layer. They're direct calls into Claude Code's architecture.
Supporting multiple tools would mean replacing these with lowest-common-denominator abstractions that strip out the enforcement layer. The value of Tierward is precisely that enforcement: the Stop hook doesn't ask Claude to run tests, it prevents Claude from completing a task until they pass.
If your team uses other AI coding tools alongside Claude Code, Tierward governs only the Claude Code sessions. The underlying principles (tests before done, requirements before code, audit before deploy) aren't Claude-specific, but the implementation is, by choice.
1. Scaffold once. npx tierward init detects your project type and scaffolds a pipeline, audit skills, security rules, and governance files matched to your stack and team size. Setup takes under two minutes.
2. Work inside the pipeline. The pipeline is a rules file Claude reads at session start. For Tier M: dependency scan before implementation, STOP gate after requirements, /simplify after writing code. You get the structure without managing it manually.
3. Run audit skills on demand. Skills like /security-audit, /arch-audit, and /systematic-debugging are multi-step programs that run inside Claude Code. Call them when you need them: before a deploy, when a test fails, after a migration wave. Each produces a structured report.
4. You or your team decides. STOP gates pause Claude to present its plan, and a commit gate blocks git commit until you have approved. On GitHub plans that support code owners, CODEOWNERS sends changes to .claude/ to a human reviewer, and blocks the merge too when branch protection requires code owner review. A Stop hook also verifies your tests pass before a task can close. No autonomous merges.
npx tierward init
The wizard detects your project state and routes setup. Three paths available:
| Path | Use when |
|---|---|
| Existing project | Add structure to a project that already has code |
| New project | Starting from scratch |
| From existing docs | Share repos or docs - Claude reads them and populates everything |
After init, open Claude Code and start working. The scaffold is active immediately.
Run context before init if you want the scaffold to reproduce consistently, with a written record of what you asked for:
npx tierward context # produces CONTEXT.md
npx tierward init # reads CONTEXT.md, scaffolds with no further prompts npx tierward context --all # one-shot: context then init npx tierward context --from-yaml file.md # bypass interview, validate + copy npx tierward validate-context # CI gate: exit 0/1 on schema check
CONTEXT.md is a schema-validated project context file. Greenfield runs a PM-friendly interview. Existing repos go through three-phase inference: algorithmic detection, LLM extraction, hybrid PM review. The first question routes you to a PM or developer flow. The developer flow reuses the technical questions from the legacy init wizards (projectName, stack, commands, scaffold options) and auto-derives tier.rationale from team size and work scope, so devs aren't asked to write PM rationale prose.
As of v1.27.0, the schema covers all four pipeline tiers: tier 0 (Discovery) and tier S (Fast Lane) for solo or bugfix work, tier M (Standard) for feature-block work with feature flags (has_api, has_database, has_frontend, has_design_system, has_prd), and tier L (Full) for complex domain projects.
One contract across four tiers. Solo bugfix or fully governed team pipeline, the rule is the same: Claude proposes, your team approves.
| Tier | Pipeline | Best for |
|---|---|---|
| 0 - Discovery | Stop hook only | First exploration - zero process |
| S - Fast Lane | 4 steps, scope-confirm | Single dev, low risk, quick fixes |
| M - Standard | 13 phases, 3 STOP gates | Feature blocks, 1-2 collaborators |
| L - Full | 14 phases, 4 STOP gates | Team projects, complex domain changes |
Start at Tier 0. Move up when you need more structure by re-running init with a higher tier (how).
The wizard also asks how changes reach main: through a staging branch (the default for web stacks), by a direct local merge (the default for native apps), or by a pull request (pr), with no staging branch and no push to main (promotion modes).
Executable multi-step programs that run inside Claude Code, not prompt instructions. Structured audit workflows with model routing (haiku for mechanical checks, sonnet for analysis).
/arch-audit, /security-audit, /perf-audit, /skill-dev, /simplify, /commit, /skill-security, /systematic-debugging/api-design, /skill-db, /migration-audit, /visual-audit, /ux-audit, /responsive-audit, /ui-audit, /accessibility-audit, /test-audit, /doc-audit, /api-contract-audit, /infra-audit, /compliance-audit, /dependency-audit, /pr-review, /skill-review, /dependency-scan, /repo-hygiene/context-reviewSkills are conditionally installed based on your project: hasApi, hasDatabase, hasFrontend, hasDesignSystem. What each skill does, when it is installed and what it needs: audit skills.
Node.js/TS, Node.js/JS, Python, Go, Swift, Kotlin, Rust, .NET, Ruby, Java - plus generic fallback. Security rules, permissions, and CLAUDE.md fields adapt automatically.
The tierward package ships an MCP server (tierward-mcp binary) alongside the CLI, version-locked, single npm install -g. Any MCP-aware client (Claude Desktop, ChatGPT desktop, Cursor, VS Code, Copilot Studio) can query Tierward governance state without the Tierward CLI running. Six read-only tools cover the doctor report, team-settings, last arch-audit, skill inventory, package metadata, and /pr-review comments. Full reference in the MCP server section below.
Tierward is also a Claude Code plugin (v1.32.0+), distributed through the plugin marketplace in this repository. The plugin adds 8 governance skills to Claude Code: commit, arch-audit, security-audit, perf-audit, simplify, skill-dev, skill-security and humanize. The MCP server isn't part of it, so install the npm package if you need that. Install the plugin from inside Claude Code (2.1.275 or later):
/plugin install tierward --marketplace marcoguillermaz/Tierward
Install individual components without a full scaffold:
npx tierward add skill security-audit # install one skill
npx tierward add rule git # install one rule npx tierward add rule security # install the security rule
Custom skills (custom-* prefix) are preserved across upgrades. See Custom Skills Guide.
your-project/
├── CLAUDE.md # Project context (<200 lines) ├── .claude/ │ ├── settings.json # Permissions + Stop hook (mechanical enforcement) │ ├── team-settings.json # Team policy: minTier / allowed / blocked / required (v1.16+) │ ├── rules/ │ │ ├── pipeline.md # Development workflow (tier-appropriate) │ │ ├── security.md # Stack-aware: web / apple / android / systems │ │ ├── git.md # Commit format, branch rules │ │ └── output-style.md # Communication rules │ ├── skills/ # Audit skills (conditional per project) │ ├── hooks/ # Governance gates and the audit log hook │ └── session/ # Session recovery (gitignored) ├── docs/ # Requirements, specs, backlog (M/L) ├── .github/ # PR template, CODEOWNERS └── .pre-commi