The Trump administration wants to ‘kill the clipboard'

Politico

29-07-2025

WASHINGTON WATCH
Roughly 60 entities in the health care sector will pledge to making patient data more accessible and speeding its delivery among patients, clinicians and payers, according to an HHS employee granted anonymity to discuss the sensitive plans. The White House and the Centers for Medicare and Medicaid Services are expected to announce the commitments on Wednesday, Ruth reported last week.
The agency hopes the commitments will stoke companies to make it easier for patients to import their data into an app of their choice, where they can manage their day-to-day health and easily share their history with doctors.
Pledges, not rules: The Trump administration has sought such commitments to compel the industry to make changes without having to engage in a lengthy rulemaking or guidance process.
But the federal government has tried similar tactics in the past.
In 2016, the then-secretary of the Department of Health and Human Services, Sylvia Burwell, under President Barack Obama, announced at a health IT conference that dozens of health industry organizations would commit to easing the flow of health information to patients. Nearly 10 years later, those voluntary commitments haven't materialized into better data access.
Still, the Trump administration thinks it can appeal to the private sector more effectively.
A joint effort: In a video posted Friday, Amy Gleason, strategic adviser to HHS and CMS and the acting administrator of the Department of Government Efficiency, asked viewers to envision the ability to instantly share their medical history via a QR code or manage their medications with an app.
'The future of health care technology can't come only from the government,' said Gleason. 'The apps, services and tools that make this data useful in people's lives comes from you, the private sector.'
Even though evidence that public pledges are more effective than regulation is scarce, industry might welcome the approach.
'The risk of … incremental regulatory compliance stuff is that you wind up spending all of your time trying to check boxes,' said Joe Ganley, vice president of regulatory affairs at electronic health record company Athenahealth.
What to watch for on Wednesday: The White House announcement is largely being driven by CMS, but the event could have implications for the ONC.
Health providers, data networks and payers are committing to expanding their use of Fast Healthcare Interoperability Resources, an open standard for transmitting data, according to a partial draft of a document obtained by POLITICO.
The increased use of FHIR may portend a shift in ONC's regulatory scope.
In her announcement, Gleason called on the health industry to help the government 'kill the clipboard.'
'Kill the Clipboard' is the name of a 2025 white paper by Ryan Howells, a one-time contender to lead the ONC and a principal at health management association Leavitt Partners based in Washington. It proposed ONC oversee how health care entities use FHIR.
Could ONC shift how it regulates and will this come up at the event? We'll be watching.
More to watch for: The draft also mandates data networks — entities that facilitate data exchange — create record-locating services. Requiring such services could be a boon for the ONC-supported data network, the Trusted Exchange Framework and Common Agreement, also known as TEFCA. Requiring those services could enable doctors to quickly access their patients' complete medical histories across providers, eliminating time-consuming record requests to multiple clinics.
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WORLD VIEW
Dr. Jean-Claude Mulunda is concerned that the halt of U.S. funding for contraceptives will lead to an increase in the number of unintended pregnancies and unsafe abortions in the Democratic Republic of the Congo, his home country.
Mulunda leads the country's chapter of IPAS, an international nonprofit that aims to expand access to legal abortion and contraception.
Women there 'see themselves becoming pregnant just because there's no [contraceptive] method available,' Mulunda told Future Pulse.
Why it matters: The DRC has depended almost entirely on foreign-funded family-planning commodities, such as birth control pills, intrauterine devices, long-acting injectable drugs and condoms.
But since the Trump administration cut foreign aid and dismantled the U.S. Agency for International Development, which funded contraceptives, many clinics across the vast African country have been left without any stock, Mulunda said.
He's also worried that more women will seek unlicensed contraceptives from unauthorized suppliers, which could lead to potentially dangerous consequences if the products are unsafe.
That could also lead women to lose trust in contraception, Mulunda worries.
Meanwhile: The U.S. government is set to destroy 'certain [abortion-inducing] birth control commodities from terminated Biden-era USAID contracts,' a State Department spokesperson told Future Pulse.
The spokesperson didn't specify the types of contraceptives covered but added that no HIV drugs or condoms would be destroyed.
The Mexico City Policy: The federal government can't provide the contraceptives, including those it considers to be non-abortion-inducing, to entities that don't abide by the U.S.'s Mexico City Policy, the spokesperson said.
The policy prohibits U.S. funding from going to so-called foreign non-governmental organizations, or NGOs, that provide or promote abortion with funding from non-U.S. sources. President Donald Trump reinstated the policy — which all Republican presidents since Ronald Reagan have done — upon his return to office in January.
Going to waste? The contraceptives, stored in Belgium and set to be destroyed in France, have prompted calls for interventions from those countries' governments.
A Belgian foreign ministry spokesperson told NPR on Monday that the country is exploring possible avenues to prevent the contraceptives from being destroyed.
And in France, four members of the left-wing green political coalition, the Ecologists, asked President Emmanuel Macron in a public letter to find a way to impede the contraceptives' destruction and supply the products to NGOs interested in bringing them to their intended beneficiaries in low-income countries.
'Mister President, our country cannot become an accomplice, even indirectly, to backward policies, and cannot tolerate that vital medical resources be destroyed when they could save lives, prevent unwanted pregnancies and contribute to women's autonomy,' the lawmakers wrote.