Concerns Over Oracle Electronic Health Record Rollout at VA
Upcoming Deployments and Current Challenges
Lawmakers are expressing serious concerns regarding the problematic implementation of the Oracle electronic health record (EHR) at the Department of Veterans Affairs (VA) as the deadline for new facility deployments approaches. Thirteen medical centers are set to begin using the new system in 2026, with four locations in Michigan scheduled to go live in April, as discussed during a House Committee on Veterans’ Affairs hearing on Monday. The EHR rollout has faced numerous challenges, including patient safety issues, technological difficulties, and reliability concerns. In April 2023, the VA temporarily halted new EHR deployments to focus on necessary improvements.
With just over 100 days until the resumption of deployments, Oracle and VA officials assured lawmakers that they have made substantial progress in enhancing system performance. However, a recent Government Accountability Office (GAO) report revealed that the VA has not fully addressed most of the watchdog’s recommendations, which include updating the project’s total cost estimate, improving communication regarding system updates, and expediting issue resolution.
Urgency for a Flawless Deployment
As the timeline for the Michigan rollout approaches, Rep. Tom Barrett, R-Mich., who chairs the Subcommittee on Technology Modernization, emphasized the need for a successful launch. “The clock is ticking down in Michigan for this to go live, and the time for promises is over,” Barrett stated. “The only acceptable result is a flawless go-live because our veterans cannot accept failure.”
Accelerated Deployment Schedule
History of the EHR Implementation
Cerner, the original EHR vendor later acquired by Oracle, signed a contract in 2018 to replace the VA’s outdated medical records system. However, after over seven years, only six of the VA’s 170 medical centers have successfully deployed the EHR. The previous administration had aimed to expedite this process, with 26 facilities across 12 states expected to launch the Oracle system by 2027, according to Seema Verma, executive vice president and general manager of Oracle Health and Life Sciences.
New Deployment Strategies
The VA is now coordinating EHR deployments based on market location, allowing multiple facilities to work together and launch the system simultaneously. Dr. Neil Evans, acting program executive director of the Electronic Health Record Modernization Integration Office at the VA, noted that this approach enhances efficiency, scales deployment efforts, and facilitates the sharing of best practices. However, lawmakers voiced concerns about the challenges posed by simultaneous implementations, highlighting the risk of overlooking potential issues.
Carol Harris, director of information technology and cybersecurity at the GAO, pointed out that testing across multiple sites would demand substantial resources and managing issues simultaneously could be problematic. Despite these concerns, Oracle remains optimistic about managing the rollout effectively. “It’s not like we’re turning on the system quickly. We’ve been in these sites,” Verma stated. “We have a plan for each site, and we have adequate staff and support for each of those sites.”
Addressing GAO Recommendations
Improvements and Remaining Challenges
During the hearing, VA and Oracle leaders reported improvements in the EHR’s system performance, citing reduced downtime and fewer interruptions for users. Notably, there were no systemwide outages for ten months in fiscal year 2025, with over 200 consecutive days without outages by year-end.
However, the VA has yet to implement 16 out of 18 recommendations from the GAO, which include enhancing user satisfaction, training, change management, and timely resolution of trouble tickets. Additionally, the project’s financial aspects remain unclear; the initial cost estimate of $10 billion has ballooned to approximately $37 billion, according to Barrett. The GAO has not received this updated estimate, raising concerns about the project’s financial transparency. Rep. Nikki Budzinski, D-Ill., expressed her lack of confidence in the upcoming go-lives, stating, “There are so many recommendations from the GAO and the Inspector General as well as Congress that will continue to sit unheeded.”