The biggest real distinction between Convex and Medplum is straightforward: Convex carries high lock-in while Medplum has low lock-in. Convex sits at hybrid pricing with $25/member/mo (Pro), a free tier, enterprise plan available and carries high lock-in, while Medplum sits at freemium with paid upgrades and carries low lock-in. Convex is a fit when you need mobile, teams β typical scenarios include mvp/prototyping speed. Medplum is aimed at healthcare startups building ehr or patient-facing apps on fhir with modern tooling, with workloads like open-source fhir-native ehr backend for digital health teams as the common case. The honest trade-off: Convex is explicitly not for complex custom business logic; Medplum is not intended for non-healthcare projects or teams that can't invest in learning fhir. Lock-in is the factor most teams underestimate: Convex and Medplum have different exit paths, and that shapes total cost of ownership over a two-to-three year horizon. Before committing, audit where each tool stores state, which APIs you depend on, and how painful a switch would be six months in.
Quick take
Convex is for mobile, teams; Medplum is for healthcare startups building ehr or patient-facing; decide based on how much lock-in you can accept.
High β reactive data model proprietary, no standard SQL
Migration difficulty: high
Data you keep: Via API export
API standard: Proprietary
Risk notes: High β reactive data model proprietary, no standard SQL
π‘ Plan 2-4 weeks minimum. Consider running parallel during migration
Medplum
When to choose which
Choose Convex whenβ¦
Choose Convex if your primary workload is mobile, teams and hybrid pricing ($25/member/mo (Pro)) is acceptable.
βMVP/prototyping speed
βMobile apps needing ready backend
βFaster time-to-market vs. building from scratch
Not for: Complex custom business logic
Choose Medplum whenβ¦
Choose Medplum if your primary workload is healthcare startups building ehr or patient-facing apps on fhir with modern tooling and low switching cost matters.
βOpen-source FHIR-native EHR platform
βHIPAA and SOC2 tooling built in
βSolid developer experience and docs
βSelf-host or managed cloud options
Not for: Non-healthcare projects or teams that can't invest in learning FHIR
Common use cases
Convex
βMVP/prototyping speed
βMobile apps needing ready backend
βTeams without backend engineers
Medplum
βOpen-source FHIR-native EHR backend for digital health teams
βHIPAA-compliant health record API with Postgres storage
βSOC2-certified FHIR server for US health data applications
βBuilding custom EHR workflows on open-source infrastructure
βAlternative to Aidbox for teams preferring open-source FHIR
Ready to explore?
Check each tool's dedicated page for deeper reviews, setup notes, and pros/cons.
Convex publishes an entry price of $25/member/mo (Pro); Medplum's entry price is not in our data, so a definitive comparison is not possible without a quote from Medplum.
Can I migrate from Convex to Medplum?
Migrating from Convex to Medplum is not trivial β Convex has high lock-in, which typically means data formats, APIs, or stack assumptions that have to be rewritten. Since both tools sit in the same category (Backend-as-a-Service), the conceptual mapping is closer, but you still need to validate feature parity against your specific workload. Plan migration as a project, not a script: inventory integrations, test on non-production workloads, and keep Convex running in parallel until Medplum is verified.
Which has better developer experience?
On our 0β5 developer experience scale, Convex scores higher (5/5 vs 4/5 for Medplum). The gap is one point β meaningful but not decisive, since DX is workflow-dependent. Still, score your own tasks: DX is subjective and tied to stack assumptions.
Is Medplum a good alternative to Convex?
Medplum is in the same category as Convex (Backend-as-a-Service), so it's a reasonable alternative to evaluate. Medplum is aimed at healthcare startups building ehr or patient-facing apps on fhir with modern tooling, while Convex targets mobile, teams β that difference should drive the switch decision. Note that Medplum is explicitly not for non-healthcare projects or teams that can't invest in learning fhir β if that describes your workload, it's not a viable replacement.
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