In July 2025, the Trump administration announced what it called a “paradigm shift” in American healthcare. The plan brings together more than 60 private companies, including tech giants like Apple, Google, Amazon and OpenAI, to build a nationwide health-tracking system. The goal is to let patients share their medical records and wellness data with providers with their phone through a federal patient tracking opt-in system.
The U.S. healthcare system has struggled with fragmented records, outdated communication methods (fax machines are still everywhere) and siloed data. While this initiative could help fix a broken system, it also raises concerns about patient privacy.
Building the ‘make health tech great again’ infrastructure
In its statement, the administration positioned the initiative as a way to “kill the clipboard,” i.e., replace paper intake forms with digital ones. The hope is that patients’ health data will flow easily between providers, insurers and health tracking apps.
The Centers for Medicare and Medicaid Services (CMS) will run the government side of this medical data integration effort, while private companies build the tools that patients use. Health and Human Services Secretary Robert F. Kennedy Jr. and CMS Administrator Dr. Mehmet Oz have been the public faces of the initiative, emphasizing wearable devices and telehealth as tools to empower patients.
The new system uses USCDI Version 3 as the baseline data standard for how apps and EHRs exchange information. Here’s the basic idea:
- Patients choose to opt in and share their medical records, wearable data and app-generated health information
- That information goes into a shared system that doctors, insurers and participating health apps can all access
- AI tools like Noom can help with check-ins, personalized health tips and conversational AI that answers patient questions
- A patient traveling to the Cleveland Clinic could have their complete medical history available right away, instead of waiting for records to arrive by fax
When Sermo polled physicians on their initial reaction, responses were mixed. Only 8% were excited about potential health benefits, while 23% called themselves cautiously optimistic. 35% were concerned about privacy and security, 15% were strongly opposed and the remaining 19% wanted more information before deciding.
One neurologist sees potential benefits and risks. “I know that having to ask one physician to fax records to another, send CDs to other providers, etc., are a major source of frustration for patients, so this may help with that,” they write. “But involving the government and big tech in healthcare, especially at a time like this, feels extremely risky, and I feel there will be many ulterior motives.”
A “cautiously optimistic” family medicine doctor had a similar take: “I’d love any ways to help with patient care and informatics. But I don’t want to jeopardize patient safety and privacy.”
Health tracking system: 3 potential benefits
A system with more unified health data could have advantages. When Sermo polled physicians on which potential benefit interested them most, improved patient monitoring came out on top at 31%, followed by streamlined data sharing for research at 28% and early disease detection at 24%.
Early disease detection
When wearable data, lab results and clinical notes live in one place, patterns that might take months to catch could show up sooner. A slight but consistent uptick in resting heart rate, combined with recent blood work and lifestyle data from a fitness app could flag early signs of metabolic dysfunction before a patient ever reports symptoms.
Improved patient monitoring
With integrated data from apps tracking sleep, diet, exercise, and even medication adherence, doctors could monitor chronic conditions like diabetes and obesity continuously rather than relying on periodic snapshots.
Streamlined data sharing for research
Population health studies have always been limited by the difficulty of gathering large, standardized datasets. This kind of medical data integration could accelerate everything from drug trials to epidemiological research.
The 4 most pressing concerns
The excitement about better data comes with concerns. Most health apps don’t count as HIPAA-covered entities because they work directly with users, not with providers or insurers, as noted in an analysis of the initiative from the Brookings Institution (a nonpartisan think tank). Once medical information leaves a HIPAA-protected setting, it can be used, monetized or sold under much weaker rules, according to the analysis. The Federal Trade Commission (FTC) has previously taken action against health companies for sharing user data with advertising platforms.
Here are four of the main concerns with this initiative that Sermo members mention in community discussions:
Patient privacy and data security
Medical records hold some of the most sensitive information out there: mental health histories, substance use notes, reproductive health details and private conversations between patients and their doctors. The data flowing into apps like Noom or Apple Health sits in a kind of regulatory gray zone, creating real physician data privacy risks for those who treat patients using this information. This was the top answer in a poll asking Sermo members for their main concern, with 38% of votes.
“The way big tech and the federal government have been forced to become bedfellows leaves me extremely concerned about privacy issues,” shares a pediatrician member. “Not to mention the ability of bad players to steal private information, apparently with ongoing ease, for years, with data breaches seeming to occur with greater frequency all the time.”
Political misuse of health data
This poll response came in close second at 37%, with physicians worried about how politics impact their practice and how health information could be used against patients. Last year CMS agreed to share patient data, including addresses, with immigration enforcement, according to the Associated Press.
For physicians, the initiative raises questions about whether patients will feel safe coming in for care. “Considering the profound vindictiveness of the current administration, I would not trust them not to misuse the information for political means, and I would also be concerned about hackers accessing the information,” writes one rheumatologist. “The potential value of the idea cannot be separated from the policies of who is running it,” adds a radiologist.
Lack of physician oversight
Coming in at 13%, this concern reflects a worry that tech companies and government agencies are building a system that could sideline physicians. When AI tools from companies like OpenAI start generating health recommendations, who reviews them? Who takes responsibility when they’re wrong? The worry is that physicians could end up rubber-stamping algorithmic suggestions without properly evaluating them.
Accuracy and reliability of data
At 12% of the vote, doctors question whether consumer wearables produce data good enough for clinical decisions. There’s still a big gap between medical-grade diagnostic tools and fitness trackers, thanks to inconsistent patient use (for example, wearing a fitness watch or other wearable device while awake but not when sleeping, or extended periods of no data when the device is taken off to charge).
Integrating big tech insights into the clinical workflow
Privacy concerns aside, the practical realities of using this technology present another challenge. Physicians sometimes resist AI implementation for a variety of reasons, including data quality issues, resistance to change, lack of training or ethical concerns, according to a 2025 study.
With 60-plus companies feeding information into this health tech ecosystem, physicians could quickly face information overload. The promise of AI assistants from companies like OpenAI and Anthropic is that they’ll help filter signals from noise. Instead of reviewing weeks of raw data, you might see a summary flagging a concerning trend in blood glucose readings alongside changes in activity levels.
In a Sermo poll asking physicians whether they would integrate patient data from such a platform into their clinical decision-making,% said yes if the data was validated and secure. Another 36% said maybe, depending on patient consent. 23% were unsure, and 13% said no because the risks are too high.
Regulatory guardrails needed
Regulatory updates could help address physician data privacy risks and maintain patient trust. Right now, this initiative relies on voluntary promises from companies, not actual rules designed to protect patients. None of the 60-plus companies that signed on are legally required to meet specific cybersecurity standards, submit to audits or avoid using the data for other purposes, according to the aforementioned Brookings Institution analysis. The institution has called for:
- Updating HIPAA so that any company handling health data follows the same rules as healthcare providers
- Requiring a judge’s warrant for health data to go to law enforcement or immigration agencies
- Passing a national privacy law like the American Privacy Rights Act to define users’ data as health information
- Requiring companies to meet security standards and submit to independent audits
Without these protections, critics worry the project could lead to excessive health surveillance, i.e., the collection of health data by institutions for purposes unrelated to direct clinical care, like advertising, risk scores or law enforcement.
When Sermo asked members how likely government or tech involvement is to improve patient outcomes, 7% said “very likely,” 29% said it was somewhat likely, 28% were neutral and a combined 36% said it was unlikely or very unlikely.
What a national health tracking system would mean for physicians
If this federal patient tracking opt-in system launches as planned, it could change daily practice in concrete ways. You’ll have access to daily metrics like steps, sleep, heart rate and diet, and the “diagnostic lag” from waiting for faxed records could shrink dramatically.
With 60+ private companies feeding AI tools into this health tech ecosystem, you’ll increasingly interact with conversational AI and algorithmic recommendations you didn’t generate and may not fully understand. CMS has proposed changes to billing codes expanding reimbursement for remote patient monitoring. Documentation of “data review” may become an important part of malpractice defense.
What physicians on Sermo think
Physicians in the Sermo community have been honest about their mixed feelings, which cover the full range of this debate. Some see potential. “If there were ways to leverage data sharing, integration and privacy and incorporate AI, doors could open for both patients and the system as a whole,” writes a family medicine doctor. An emergency medicine physician thinks the new system “may be beneficial if strictly regulated for accuracy, integrity and transparency.”
Others think this will benefit the government or companies at the expense of patients. “Giving this power to tech companies will only allow them to increase their profits at the direct cost to the patients,” cautions a psychiatrist. “I don’t think the parties involved in this would be doing this unless there is something in it for them, meaning monetizing the data and/or using it for bolstering the surveillance state,” echoes a general practitioner.
Still others see both pros and cons.”Knowledge is power in terms of better patient outcomes most likely,” allows a rheumatologist. “However any time there is power the concerns are regarding abuse of those powers.”
Where health tracking will go from here
The proposed health tracking system wagers that the clinical benefits of seamless data exchange will outweigh the risks of a privacy breach or misuse. As the primary guardians of patient trust, physicians have expressed both hope and concern about how this data gets used at the point of care.
The conversation is taking shape on Sermo, where physicians are suggesting protocols for remote data monitoring and weighing in on the clinical validity of Big Tech’s new health AI tools. You can join the community for free to connect with colleagues navigating the same questions.
