Department of Government Efficiency (DOGE) Administrator Amy Gleason outlined a sweeping set of modernization initiatives on Wednesday for the Centers for Medicare & Medicaid Services (CMS) aimed at improving healthcare interoperability and embedding artificial intelligence (AI) into care delivery and agency operations.
The initiatives include a health technology ecosystem, a national provider directory, a Medicare.gov modernization effort, Medicaid community engagement tools, and a replacement for the decades-old Medicare claims system. The overhaul is designed to make patient data easier to access and support real-time AI applications across the health care system, Gleason said at an ACT-IAC event in Reston, Va.
Gleason – who also serves as a CMS strategic advisor – said CMS launched the health technology ecosystem initiative last July to address persistent interoperability failures.
She pointed to eight separate provider directories across CMS centers as one example of fragmentation that undermines data consistency and interoperability.
“It’s still too hard for patients to get their information, it’s still too hard for doctors to get the right information,” Gleason said.
To build trust in data exchange, she said CMS is implementing interoperable digital identity verification tools, including ID.me and Login.gov, so patients and providers can securely validate who is accessing medical records.
Gleason said the goal is to let patients access consolidated health information without logging into dozens of portals and to see who is accessing their data, similar to a credit report.
“I have a daughter that has a rare disease, and so I live this every day with her. She has 47 different patient portals, and so it’s just impossible to remember all of these different places to go, logins, passwords, etc.,” Gleason said.
Building on improved identity and data access, CMS is also advancing a “kill the clipboard” effort that would allow patients to share records via QR codes and use conversational AI tools. “You can use conversational AI … to get personalized recommendations, so you have a coach or a guide that can help you in–between visits and give you access to care,” Gleason said.
AI is already showing promise in clinical settings, Gleason added, referencing her own family’s experience when her daughter uploaded years of medical records into ChatGPT to identify clinical trial eligibility.
“And the power of AI, when you give patients their data, and you give them tools to help them, it’s kept her out of the ER, at least seven times in the last year just by using AI,” Gleason said.
On AI guardrails, Gleason said CMS needs room to test tools while putting monitoring controls in place. “We have to make sure that we’re not afraid to try things because it might have something that’s wrong,” she said.