The Department of Veterans Affairs is preparing to resume deployments of its new Electronic Health Record in mid-2026.
But watchdog offices say the VA isn’t yet halfway through a list of projects and improvements for a handful of sites already using the Oracle-Cerner EHR.
The VA is looking to launch the new EHR at four sites in Michigan by mid-2026. VA Secretary Doug Collins told lawmakers during his confirmation hearing that he’s looking to accelerate that timeline.
The project has largely been on hold since April 2023, when the department began a “reset” period to address persistent problems with the system.
Neil Evans, the acting program executive director of VA’s EHR Modernization Integration Office, told members of the House VA Committee that EHR pre-deployment activities began last month in Michigan, and are going well.
Evans added that VA officials are working on an updated deployment schedule beyond the Michigan go-lives.
“These decisions will support the iterative development of a revised integrated master schedule, in addition to updated cost estimates for this project,” Evans told the technology modernization subcommittee.
Carol Harris, the director of IT and cybersecurity issues at the Government Accountability Office, said VA completed more than 1,500 system configuration changes during the reset period — but still has another 1,800 pending changes and projects that still need to be completed.
Harris told lawmakers the VA needs a new integrated master schedule to keep the project from further delays and cost overruns.
“VA has been in reactive mode during this reset period, putting out fires with no real plan for how to move forward strategically,” she said.
Cost estimates for VA’s EHR modernization range from $16.1 billion to nearly $50 billion.
“While the latter is more realistic, neither reflects the many changes and delays to the program,” Harris said.
The latest workforce survey data from September 2024 shows that 69% of the new EHR users are dissatisfied with the system, and 75% do not believe the system maximizes efficiency.
“While there was a slight uptick in satisfaction compared to 2022, these numbers are still just too low,” Harris said.
Meanwhile, the VA office in charge of the EHR modernization project is downsizing, following several of the Trump administration policies targeting the entire federal workforce.
Evans said his office recently fired about eight probationary employees. Another 16 employees accepted the Office of Personnel Management’s deferred resignation offer.
VA’s EHR modernization office, he added, has about 250 total employees, but is authorized to have up to 330 total employees.
Seema Verma, the executive vice president of Oracle Health and Oracle Life Sciences, said the company made more than 3,000 functional changes during the reset period and overhauled training.
Verma said the productivity levels of VA sites using the new EHR are returning to — or, in some cases, exceeding — baselines from pre-deployment averages. She said Oracle is also working with VA on opportunities to accelerate future go-lives.
“We’ve been working with the VA around acceleration and how to do that. And there’s multiple things that need to be addressed in order for us to move faster and to move quicker. And I think we’re working towards that,” she said.
Verma said Oracle is in the process of migrating the VA’s new EHR to the cloud, and will eventually upgrade the system to its new cloud-based EHR “infused with AI.”
“The narrative about this program is largely negative. We understand that first impressions last, and the first impression in Spokane and the other initial sites was not good. But we are not Cerner that deployed at those sites. The totality of updates, enhancements, investments and innovations to the EHR show that this is a dramatically improved system from what was originally deployed in Spokane in 2020,” she said.
Evans said these EHR improvements are happening “in parallel” with getting more VA sites ready for the new system.
“We are seeing movement — yes, even momentum — in the right direction,” Evans said. “By sustaining these efforts, our velocity should increase over time.”
Acting VA Inspector General David Case said the Oracle-Cerner EHR continues to have “serious issues” with handling schedule changes and missed appointments.
Case said VA sites using the new system clinicians to make fewer attempts to contact “no show” patients for missed mental health care appointments, compared to legacy sites, “creating a different standard of care between sites.”
Case said VA providers at sites using its legacy EHR have to conduct manual medication safety checks for patients who have also received care at a site using the new system, because of concerns with the automated process.
“These manual safety checks are time-consuming and rely on the vigilance of pharmacists and frontline staff,” he said.
Case said the VA has improved system reliability, but said “there are still incidents occurring every month.”
“Given the stresses the system will likely experience during the next deployments in larger facilities, VA must be ready to handle any future instability and equip providers with the tools to continue working when the system is degraded or inoperative,” he said.
The IG’s office is also recommending the VA come up with an updated integrated master plan for deployments.
“The 2026 deployments are on a much larger scale, with a greater number of variables and tasks to plan and execute … A reliable master schedule will enable VA to be fully transparent with Congress and their stakeholders about what needs to happen for the successful rollout of the new EHR in Michigan,” Case said.
Subcommittee Chairman Tom Barrett (R-Mich.) said he’s not convinced the VA has “fixed all the problems” with its new EHR.
“Given these facts, VA needs to demonstrate how this system has improved and explain why this program can succeed before starting up again,” Barrett said.
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