Earlier this year, I was at a health tech conference where one of the most buzzed-about announcements was a partnership that let patients bring their medical records to their doctor’s appointment on their phone instead of by filling out paper forms. The crowd loved it. And I get it; I really do. But as I sat there, I kept coming back to the same question. Is this the best we can do?
When people talk about why healthcare is so expensive, they jump to insurance gaps, pharmaceutical costs, or hospital bills. But there’s something far more mundane that intersects with many of those costs: paperwork. Administrative overhead in U.S. hospitals reached $687 billion in 2023, nearly double what was spent on direct patient care. That overhead gets built into the cost of care and passed on to patients in the form of higher bills, higher premiums, and higher out-of-pocket costs. Every time you fill out a form you also filled out at your last visit, someone is paying for that inefficiency, and it’s almost never the institution that created it.
CMS has been pushing something they call “Kill the Clipboard,” the idea that patients should be able to show up to appointments with their records on their phone instead of completing the same paper forms they’ve been filling out for years.
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I want to be clear about something.
Replacing a paper clipboard with a QR code on your phone doesn’t kill the clipboard; it’s just a better clipboard.
Why? The burden is still on the patient. It’s the digital version of carrying a manila folder of records across town. This is a half-measure. It’s not true interoperability.
True interoperability means a provider sees a complete, current, and actionable picture of your health the moment you walk in the door — or sooner, so they can prepare for your visit — regardless of where you’ve received care before. It means the data moved not that you moved and brought the data with you.
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Think about what that could look like in a moment of need.
You’re in an emergency. You can’t speak for yourself. The ER can see your medication history, your allergies, your recent labs, your past imaging results and more, not because you were able to pull up an app, but because the infrastructure did its job.
That’s how the system should work. Instead, what we have are care teams re-running tests because they can’t access results from your regular provider across town. Patients then get frustrated answering the same questions appointment after appointment. Providers make decisions without the full picture. And in every scenario, costs keep going up.
A decade ago, the industry promised that technology would solve this. We got EHR adoption. We got FHIR. We got regulatory frameworks. The 21st Century Cures Act even created real penalties for information blocking, up to $1 million per violation, and last fall HHS began boosting active enforcement after nearly a decade without a single penalty or enforcement action. The tools exist. The rules exist. The enforcement mechanism finally exists.
And yet the pipeline is still broken. Every year we don’t fix it, costs compound. Patients pay more, providers waste time re-entering the same information across disconnected systems, and every redundant test or repeated intake form is a cost that someone pays. It is almost never the institution that caused it. Instead of fixing the infrastructure, we’re asking patients to carry their own records on their phones and calling it progress.
As someone who has spent years focused on the gap between what’s possible and what we’re actually delivering to patients, I know we can do better. The industry knows how to fix this. The standards exist. The technology exists. What’s missing is urgency and accountability.
If we actually want to kill the clipboard, we have to fix how data flows between the people providing care. Not how patients can carry it on their phone. Fixing the data is where the real savings are — and it’s what patients deserve.
Photo: ipopba, Getty Images
Jason Prestinario is the CEO of Particle Health. Under his leadership, Particle launched the Particle Platform which uses AI to add context and insights to records from 320 million patients. The tool analyzes and organizes complex health data and turns it into actionable insights. As an engineer turned operator, Jason served as Head of Data Science at Komodo and was appointed to product engineering leadership positions where he was instrumental in building and launching Prism and Sentinel, two of Komodo's most successful products. He then went on to become the General Manager of Komodo’s Healthcare Solutions Business Unit, expanding the data platform and creating a $50M revenue business in just a few years. Prior to his time at Komodo, Jason was an engineer at Palantir Technologies. He holds a Bachelor of Science and Master of Science in Mechanical Engineering from Stanford University.
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