The National Evaluation System for Health Technology (NEST) is a program the FDA is using to generate better real-world evidence to guide their decision-making around medical devices. NEST aims to actively surveil medical devices already on the market to quickly identify risks to patients using data from sources like clinical registries and electronic health records. This system will benefit medical device manufacturers by allowing them to identify safety issues in real-time and reduce the costs of post-market surveillance while allowing the FDA to develop more flexible regulatory models tailored to technologies. In 2019, Congress provided further funding to continue developing NEST's active surveillance capabilities.