On July 30, 2025, CMS issued a press release announcing its Health Tech Ecosystem initiative, a voluntary, patient-centric initiative aimed at utilizing technology to improve the patient experience. The main goals of the initiative are to: (1) promote a CMS Interoperability Framework to easily and seamlessly share information between patients and providers; and (2) increase the availability of personalized tools so that patients have the medical information and resources they need to make decisions.
CMS is calling upon healthcare industry data networks, Electronic Health Record Systems (EHRs), health app developers, providers, payers and innovators to voluntarily align around the agency’s vision for the CMS Digital Health Ecosystem, a shared framework for data and access with a focus on consumers. Voluntary criteria aligned with the CMS Interoperability Framework are set for CMS Aligned Networks, EHRs, providers, payers and patient-facing apps.
The tools developed in connection with this initiative will allow medical records to be securely obtained and deliver key services to beneficiaries, including diabetes and obesity management, the use of AI assistants to check patient symptoms and navigate care options, and digital check-in methods. In order to achieve this, CMS has issued guidance on the functionality requirements of patient-facing apps that seek to be promoted or highlighted through CMS. These requirements for patient-facing apps include:
- Supporting data exchange with patient identity verification either via an intermediary personal health record application or using a CMS-approved service to generate digital credentials that can be used to access health records from CMS Aligned Networks.
- Enabling Medicare program connectivity, as appropriate, for users who are Medicare beneficiaries by offering a way to be notified of communications from gov (e.g., notices, EOBs, fraud alerts).
- Participating in CMS reviews, including disclosure of data sources, terms/agreements and a basic security checklist.
- Offering trial access for Medicare patients if the app charges a fee.
- Participating in the CMS discovery experience, allowing the app to be presented as a recommended option to eligible beneficiaries (such as through an “app store” interface on Medicare.gov).
- Operating in a manner consistent with the HIPAA Rules.
In addition to meeting the above standards, the app must meet one of the following initial case uses: (1) eliminating manual check-in forms and fragmented data collection (“Kill the Clipboard”); (2) using AI-powered assistants to deliver personalized guidance to patients by securely assessing and interpreting their medical history in real time; or (3) providing tailored, data-driven support to individuals at risk for or living with diabetes and obesity, powered by direct access to clinical data from trusted networks. Patient-facing apps will be required to connect to a CMS Aligned Network to retrieve patient health records.
CMS Aligned Networks must meet the following criteria focused on allowing different health data sources, such as health information networks and exchanges, to align with CMS interoperability goals:
- Implement CMS Interoperability Framework criteria, including clinical and claims data as appropriate.
- Respond to patient, provider, and when appropriate, payer requests following the CMS Interoperability Framework.
Networks that self-attest to meeting the CMS Interoperability Framework will be designated as CMS Aligned Networks but must also agree to be reviewed if it is suspected that the network does not meet the criteria.
EHRs participating in this initiative must:
- Make electronic medical information accessible to CMS Aligned Networks, including structured data (via FHIR) and unstructured clinical documents (e.g., PDFs, JPGs, TIFs) as part of the patient record as indicated in United States Core Data for Interoperability Version 3 (USCDI v3);
- Provide appointment and encounter notifications to those who are subscribed to specific patient records (including outpatient visits, telehealth, emergency department, and inpatient stays) to CMS Aligned Networks within 24 hours of occurrence; and
- Accept patient health data from patient-facing apps, and give patients the ability to retrieve a visit record via the same method used at check-in. EHRs should not require portal credentials or additional account set-up when the patient’s identity has been verified using a CMS-approved service.
Providers participating in this initiative must:
- Join CMS Aligned Networks to ensure electronic medical information is available and discoverable across care settings;
- Support patient-centered workflows that enable real-time access for treatment and for patient use to electronic medical information across systems; and
- Make electronic medical information accessible to CMS Aligned Networks, including structured data and unstructured clinical documents (e.g., notes, PDFs, JPGs, TIFs) as part of the patient record as indicated in USCDI v3.
Payers participating in this initiative must:
- Make claims data accessible to CMS Aligned Networks;
- Respond to patient, provider and where appropriate, payer requests; and
- Implement CMS Interoperability Framework criteria.
To achieve the goals of this initiative, sixty companies pledged to collaborate to effectuate the goals of the program, twenty-one networks pledged to meet the CMS Interoperability Framework criteria to be CMS Aligned Networks, and thirty companies pledged to promote real health outcomes utilizing technology.
The press release can be found here, and additional information on the initiative can be found here.
