On Thursday, Trump administration officials unveiled the first wave of health tech tools as part of a push to make medical records more accessible to Medicare patients.
Since the initiative kicked off in July, more than 700 companies signed onto the agency's Health Tech Ecosystem Initiative as part of a voluntary effort, according to Centers for Medicare & Medicaid Services officials.
The initiative brings together CMS infrastructure, a new Medicare App Library, patient identity verification tools using CLEAR-backed interfaces, a FHIR-based National Provider Directory and an initial set of patient-facing applications "to move the nation beyond clipboards, fax machines and repetitive paperwork into a seamless, digital‑first era," CMS officials said in a press release.
CMS set March 31 as a deadline for companies to meet Minimum Viable Product (MVP) requirements and demonstrate tangible results from their Health Tech Ecosystem pledges.
“For too long, Americans have navigated a health system that lags behind the technology they use everywhere else,” said CMS Administrator Mehmet Oz, M.D., in a statement. “Today, CMS is bringing healthcare into the modern era—aligning innovators to deliver solutions that make care easier, more connected, and more personalized.”
On Thursday, at an event in Washington, D.C., CMS highlighted tools from more than 50 companies, many of which are already accessible or will be available to the public soon. According to CMS, these efforts represent the first real-world implementation of a connected digital health ecosystem, where patients can access, share and use their health information through trusted applications.
The digital health tools demonstrated during the CMS event included digital data access and check‑in, or tech tools to "kill the clipboard," allowing patients to securely share information with a simple scan on their phone, along with personalized health applications that offer tailored guidance on nutrition, wellness and chronic disease management.
CMS' goal is to enable patients to share their health records with providers via a QR code rather than the traditional paper clipboard for patient intake.
eClinicalWorks, an ambulatory electronic health record company, was one of the 50 companies demonstrating new tech features. The company developed a QR‑based workflow that lets patients verify identity on site and bring their health records directly into the chart at check‑in, the company said.
eClinicalWorks says it has simplified the process for practices to adopt paperless intake technology. Patients use an application designed to align with federal interoperability approaches to access their health information, first verifying their identity, which pulls their records from available sources, and generates a smart health QR code. Providers then scan the code with eClinicalMobile, and the records are available in eClinicalWorks at the point of care, the company said in a press release.
eHealth Exchange, a health information network, signed on to be a CMS-Aligned Network and is partnering with b.well Connected Health to advance patient access to health data. At the event last week, the two companies teamed up with kidney care provider DaVita to demonstrate how a kidney patient used the b.well app to securely request and retrieve their medical records from a DaVita location.
Humana, Welldoc and Noom also highlighted partnerships with b.well, aligning their efforts with the Trump administration's broader interoperability push.
The CMS Health Tech Ecosystem creates shared standards for digital health tools that enable patients to use these apps without going through their health plan, which marks an important new distribution channel.
While many industry leaders applaud CMS' ambitious goals to ease patients' access to their medical records through digital health apps and AI tools, many executives have voiced concerns about CMS' approach to lean on a voluntary tech effort and how much the initiative can move the needle without regulatory "teeth."
Hundreds of tech companies are participating in the initiative, but it is a much shorter list of providers and health systems that have signed on to the pledge, fewer than 50 organizations. There are currently no regulatory requirements that push the adoption of these tools among providers and payers.
CMS officials have made it clear that this effort relies heavily on private-sector innovation to move the needle on interoperability, digital health and patient-facing AI tools. The goal is to advance faster than slow-moving regulation, Trump administration officials said. And CMS expects patients to push the adoption of these technologies.
"All of the apps that I was talking about, like 'kill the clipboard' and conversational AI and disease management items, those should all be in the private sector so that the government is not in that business, and the government can't go fast enough and nimbly enough to build those kind of solutions anyway and make them competitive," Amy Gleason, acting administrator of the U.S. DOGE Service and strategic advisor at the Centers for Medicare & Medicaid Services (CMS), said back in November. "I think there's a great example of how the government can build some things where it makes sense to provide that infrastructure, but really unleash the power of the private sector."
Leigh Burchell, vice president of policy and government affairs at Altera Digital Health, noted that CMS will need to consider incentives to spur adoption.
"Technologists across the healthcare industry—whether EHRs, payors or consumer-oriented apps—have made very impressive progress in only a few months towards the incredibly ambitious goals outlined by the CMS Pledge program," Burchell told Fierce Healthcare.
"In order to see the new Health Tech Ecosystem functionality implemented and widely used by provider organizations, CMS will need to invest in and include in their upcoming fee schedules incentives that motivate that behavior. That provider utilization and embrace of these changes are going to be a critical last mile of this process," Burchell said.
In comments to CMS about the Health Tech Ecosystem proposal last year, the Bipartisan Policy Center noted that there needs to be "clear, predictable reimbursement pathways for high-value digital health products."
"Many of these products fail to fit into outdated benefit categories, creating uncertainty about whether and how CMS will reimburse them. Developers are hesitant to invest time and resources into innovation without clear expectations from CMS on coverage pathways," the organization wrote in its comments.
In a LinkedIn post last fall, Brian Green, a health tech executive focused on AI governance and ethics, noted that, with only voluntary commitments, the ecosystem initiative currently does not have any binding contracts, clear enforcement mechanisms or new, dedicated funding.
"No new grants or appropriations have been outlined, and resource-intensive projects may stall without future Congressional or CMS budget action," Green wrote. He also noted, "Without strong incentives or regulatory requirements, industry self-selection could perpetuate existing gaps, especially for smaller clinics, rural care, and technologies accessed by the most underserved communities."
At the end of the year, CMS announced a new 10-year payment model to encourage the use of technology to treat chronic diseases. The Advancing Chronic Care with Effective, Scalable Solutions (ACCESS) Model encourages the use of technology to treat chronic diseases, which many hoped would be a boon for health tech companies that have struggled with reimbursement. The demonstration will test the use of outcome-based payments for participating organizations in fee-for-service Medicare.
But, lower-than-expected reimbursement rates introduce the risk of negative profit margins for model participants, according to a research note from strategy firm Capstone.