The Department of Veterans Affairs is receiving bipartisan support for its renewed rollout of a new Electronic Health Record system — a multibillion-dollar initiative that has faced numerous challenges since it was launched during the first Trump administration.
VA’s implementation of the new Oracle-Cerner EHR represents one of the largest IT contracts in the federal government. The department paused the project multiple times to address ongoing outages and functionality issues.
Last month, the VA resumed EHR deployments following a three-year hiatus. In April, the VA introduced the Oracle-Cerner system across four VA health care facilities in Michigan — Ann Arbor, Battle Creek, Detroit, and Saginaw.
VA Secretary Doug Collins told the Senate VA Committee on Wednesday, “we’ve just had an outstanding rollout in Michigan so far.”
“My only issue right now in the VA is I have more centers eager to move ahead of the line than anything else, because it’s actually functioning,” Collins said.
VA’s new EHR is currently operational at 10 sites. Full deployment would extend the EHR to 170 sites. The department now anticipates completing the deployment as early as 2031. The Defense Department finished its transition to the same EHR platform in March 2024.
Collins emphasized that finishing the EHR modernization project is essential to obtain a comprehensive view of a veteran’s treatment history from both VA and non-VA community care providers.
“They’re operating at cyber speed, we’re operating at dial-up,” he said. “Until we have an EHRM system that belongs in the 21st century, we can’t communicate with community providers.”
Collins said advancing with this project is also crucial to enable VA facilities to share records seamlessly with one another.
“Our facilities can’t communicate with each other. Our current record system doesn’t allow us to communicate with each other, and we spend $700 million a year just to keep it running,” he said.
Lawmakers from both parties introduced numerous bills under the Biden administration to impose stricter controls on the EHR contract — or cancel the project altogether. But leading Democrats on several committees and their Republican counterparts say the EHR project seems to be back on track after years of difficulties.
Committee Ranking Member Richard Blumenthal (D-Conn.), a critic of many VA management decisions under Collins’ leadership, including an ongoing agency reorganization, said at Wednesday’s hearing that, “I welcome the department’s commitment to advancing the electronic health record modernization.”
Senate Homeland Security and Governmental Affairs Committee Ranking Member Gary Peters (D-Mich.) told Collins in an April 30 appropriations hearing that the VA EHR rollouts in his state have proceeded well.
“The reports have been very positive from the people in Michigan, and I appreciate that, but I will say that I’m also cautiously optimistic that future rollouts are going to be just as successful as what we have seen so far,” Peters said. “I’m concerned the accelerated deployment schedule for record modernization may impact that.”
Unlike previous deployments, which happened one site at a time, the EHR go-lives in Michigan all occurred on the same day.
The EHR modernization contract has grown significantly beyond its original $10 billion estimate. Cost estimates for VA’s EHR modernization range from $16.1 billion to nearly $50 billion.
VA aims to have the Oracle-Cerner EHR go live at 13 total sites this year and up to 24 sites in 2027.
The Trump administration is seeking to allocate the VA $4.2 billion in discretionary funding for the ongoing EHR rollout in its fiscal 2027 budget request — an increase of approximately $800 million.
Sen. John Boozman (R-Ark.) asked Collins if the VA’s FY 2027 budget request provides “sufficient funding to further accelerate the program’s rollout without compromising quality.”
“I want to help you,” Boozman said.
“We need this fully funded going forward,” Collins replied. “There’s no going back on the EHRM. We’re past that point, so it has to be done.”
‘The exact same problems’
Groups representing VA employees, however, say the latest facilities to adopt the new EHR are encountering many of the same issues as before.
Jacob Pannell, a former VA behavioral health provider in the Pacific Northwest, now a business representative for the National Federation of Federal Employees, told Democrats on the Senate VA Committee at a roundtable hearing Tuesday that he witnessed firsthand the “day one” rollout of the Oracle-Cerner EHR at VA sites in Spokane and Walla Walla, Washington — and that many of the same problems continue.
“We were the first ones to go live, and I will just say this: The reports that are coming in still from the new facilities are the exact same problems that we reported in 2020, 2021 and 2022,” Pannell said. “Every single problem. It still takes twice as long for our providers and nursing staff — even down to our [medical support assistants] and schedulers that are just getting [veterans] in the door — it takes twice as long to navigate the system.”
Full health record interoperability between VA and DoD has been the ultimate objective of this project since the VA signed its contract with Cerner in 2018.
“It integrates — I can see some things from DoD, as it was designed to do — but I will tell you this: it’s not worth the risk, it’s not worth the damage that’s been done,” Pannell said.
Under the Biden and first Trump administrations, government watchdogs identified several problems with the new EHR.
In some cases, the new EHR did not successfully transfer prescription orders to VA’s pharmacy operations as well as flags in veterans’ medical files indicating that they were at an elevated risk of suicide. Pannell told lawmakers that all these issues are still “yet to be fully resolved.” As a veteran enrolled in VA care, Pannell said VA medical facilities in Maryland that still use the department’s legacy EHR system don’t have full visibility into his medical records from when he was a patient at facilities in Washington State using the new EHR.
“I can’t even figure out where I need to go to refill my medications, so if I have that problem, someone who’s fairly good with technology, I know our Vietnam veterans and some of our older veterans, they cannot navigate that system,” he said.
Julie McLendon, legislative committee co-chairwoman of the Nurses Organization of Veterans Affairs, said the VA facilities that have transitioned to the Oracle-Cerner EHR are experiencing problems migrating inter-facility consults, referrals
She noted that the latest sites rolling out the new EHR don’t have the same level of support staff that the VA provided during earlier go-lives.
VA facilities reduce appointment availability and see a temporary drop in productivity as they switch over to the new EHR, but those metrics are expected to return to normal once clinicians become more familiar with the new system.
“We don’t have additional support with additional staff that had been provided during the initial rollout five years ago,” McLendon said. “As we learn it, we don’t have other staff available to see patients, so we are anticipating a chance of extending access and wait times,” McLendon said.
At Wednesday’s hearing, Sen. Patty Murray (D-Wash.) told Collins that the VA, as part of its budget request for next year, continues to improve the new EHR’s functionality at some of the earliest go-live sites.
“We can’t ignore the fact that those original sites are still seeing problems, and you need to be aware of that,” Murray said.
Collins said one of the key issues with previous go-lives was that the VA allowed too much customization in how local facilities implemented the new EHR. The department, he added, has now standardized the EHR deployment process.
“It was bad, and you had six facilities that were allowed to act as if they were independent, not connected, and do whatever they wanted to do, and you had some system software problems. We’ve not had that. We fixed that issue moving forward, and we’re going to go back and fix those as well,” Collins said.
Murray, who serves as the top Democrat on the Senate Appropriations Committee, expressed optimism about the future of the EHR project, even as she pressed the VA to address issues at earlier sites.
“I’m excited that you’re moving out and not hearing complaints. That’s great, but we still have problems at the original sites,” she said.
“That is what drives me every day — to make sure we get it right this time,” Collins replied.
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