Editor’s note: Seema Verma is executive vice president and general manager at Oracle Health and Life Sciences. Previously, she served as CMS Administrator during the first Trump administration.
As the CMS marks the first anniversary of its “Kill the Clipboard” initiative, it's worth reflecting on why the effort matters. The initiative recognizes a simple truth: Patients shouldn't have to repeatedly fill out the same forms or recreate their medical history every time they receive care. Delivering on that vision depends on ensuring health information moves as seamlessly as patients do.
We did the hard work of digitizing healthcare. Today, nearly every U.S. hospital uses an electronic health record, the result of billions of dollars in public and private investment over the past two decades. That transformation replaced paper charts with digital ones and created the foundation for a more modern healthcare system.
But anyone who has ever navigated the healthcare system knows there’s still a disconnect.
I experience it myself. Like millions of Americans, I receive care from physicians across multiple organizations. Some belong to the same health system; others practice independently or are affiliated with different networks. Yet, regardless of where I go, I'm routinely asked to provide my medical history, medications, insurance information and emergency contacts all over again.
Patients understandably wonder: If my records are already digital, why does every new provider seem to know so little about my care?
The answer is that digital records don’t always move with the patient. Health information too often remains trapped inside disconnected systems instead of being available where care is delivered. That means clinicians may not immediately see lab results, imaging, medication changes or consultations from another provider. Valuable time is spent searching for records that should be available, patients repeatedly answer the same questions and care becomes more fragmented than it should be.
It’s easy to think of interoperability as an IT issue. Patients experience it as delayed appointments while records are located, duplicate tests because prior results aren’t easily available and clinicians making decisions without a complete picture of their health.
When health information moves securely between physicians, hospitals, pharmacies, health plans, laboratories and patients themselves, everyone benefits. Clinicians can make better-informed decisions. Patients spend less time navigating paperwork and more time receiving care. Health systems reduce unnecessary administrative work, duplicate testing and delays that occur when critical information isn't available at the point of care.
During my tenure as Administrator of CMS, one lesson became unmistakably clear: Transforming healthcare requires changing incentives as much as changing technology.
Federal policy successfully accelerated the adoption of electronic health records. But installing software was only the beginning. Unless those systems can communicate with one another, digital records become little more than electronic filing cabinets.
That's why CMS increasingly focused on interoperability, patient access, and reducing information blocking. The goal wasn't simply to modernize technology. It was to modernize the patient experience.
We're making real progress. Standards such as FHIR-based application programming interfaces are making it easier for health information to move securely across the healthcare ecosystem. Providers, health plans, technology companies, pharmacies and policymakers increasingly recognize that information should follow patients rather than remain confined to the organization where it was created.
The need for better connectivity will only grow as AI becomes part of routine healthcare delivery. AI depends on access to complete, accurate and timely information. If patient records remain fragmented, the technology will inherit the same limitations clinicians face today.
With digital health records, a solid foundation is in place. Now, healthcare organizations must redesign existing workflows that still assume information begins and ends within their own walls. Policymakers should continue establishing clear expectations for secure data exchange while protecting privacy. Technology developers must continue making interoperability practical, scalable and intuitive for clinicians.
Patients aren’t going to judge interoperability by the number of APIs deployed or whether systems meet technical standards. They’ll judge it by whether healthcare finally feels connected. When they arrive in the emergency department, does the treating team already know their medications and allergies? When they're referred to a specialist, are their lab results and images already there? When they move between providers, does their information move with them?
When patients stop expecting to repeat their medical history every time they seek care, we'll know we've reached healthcare's next milestone.
America successfully digitized healthcare. Now it's time to connect it.
