Ending the Clipboard: Medicare’s Health Tech Ecosystem Initiative

The Centers for Medicare and Medicaid Services (CMS) is advancing a Health Tech Ecosystem initiative designed to eliminate the traditional use of paper clipboards during medical encounters. This effort aims to make patient medical records more portable and easier to transfer between providers and patients.

On April 9, 2026, Zac Jiwa, a federal Medicare official, spoke at an event highlighting the progress of the initiative. Jiwa described the effort as a eulogy for the clipboard, signaling a shift toward digital systems that remove the need for patients to repeatedly recall and manually write out their medical histories at every doctor’s visit.

The Kill the Clipboard Pledge

As part of this initiative, a group of health tech companies has entered into a company pledge known as Kill the Clipboard. These organizations commit to empowering patients to retrieve health records from personal health record apps or CMS Aligned Networks.

The pledge specifies that patients should be able to share these records with providers using FHIR bundles via Smart Health Cards, links, or QR codes. The goal is to ensure seamless and secure data exchange, and where possible, the companies pledge to return visit records to patients in the same digital format.

The initiative has attracted a wide range of early adopters and pledgees, including major technology and healthcare firms such as Google, Apple, Samsung, CVS Health, and UnitedHealth Group. Other participants include Zocdoc, Phreesia, and various specialized health tech firms like Flexpa and Fasten Health.

Technical Implementation and Integration

For the past eight months leading up to April 2026, hundreds of health tech companies have worked toward federal goals to increase the portability of patient records. A primary objective is the creation of systems that can automatically import patient data directly into the electronic health record (EHR) systems used by providers.

The integration of these tools is already being utilized by various entities to streamline the patient experience. For instance, Athenahealth has used the Health Tech Ecosystem to unify the patient experience, and the digital identity verification company Clear signed a contract with CMS in December 2025 to support the Kill the Clipboard effort.

The use of FHIR (Fast Healthcare Interoperability Resources) bundles is central to this strategy, providing a standardized framework for exchanging healthcare information electronically.

Impact on Patient Care

The shift toward a digital ecosystem is intended to reduce the administrative burden on patients and providers. By digitizing the intake process, the initiative seeks to prevent the errors and delays associated with manual data entry and the repetitive filling of paperwork.

The broader Health Tech Ecosystem initiative also explores the use of artificial intelligence and new applications to further simplify how patients interact with their medical records and access care.

CMS has challenged the health IT industry to act on these improvements immediately rather than waiting for government mandates to force the transition.