Wrap an EHR (FHIR R4) for a care agent

Context

A care-coordination agent needs an EHR. The MCP server exposes read tools over encounters, labs, and meds, but the only mutation is a propose_order that returns pending clinician approval — PHI stays behind the server and nothing writes to the chart autonomously.

The decision

The design decision is which resources to expose and where the write-approval boundary sits: reads are broad, the single write is a proposal a human ratifies.

What most miss

Teams expose a write_order tool 'for convenience' and quietly hand an agent chart-write authority. The boundary is the whole safety design, not a feature flag.

Stakes

An autonomous chart write is a patient-safety and liability event; a proposal queued for a clinician is not.