VA readies to restart EHR deployments in 2026, despite lingering lawmaker unease

The Department of Veterans Affairs is only months away from restarting deployments of its new Oracle Health electronic health record system, and officials from the agency and company say they have smoothed out many of the problems that have plagued the modernization project.

With rollouts of the new EHR system set to resume after a long hiatus, 2026 will be a make-or-break year for the expansive and costly effort. But lawmakers and watchdog officials say they remain cautious as the medical facility go-live dates draw near.

Exiting the project’s deployment pause

VA first signed a $10 billion contract — later revised to over $16 billion — with Cerner in May 2018 to modernize its legacy health record system and to make it interoperable with the Defense Department’s new health record, which was also provided by Cerner. Oracle later acquired Cerner in 2022 and rebranded the new unit as Oracle Health.

A series of setbacks, however, have beset the EHR modernization project since the new software was first deployed in 2020 at the Mann-Grandstaff VA Medical Center in Spokane, Washington. VA paused most rollouts of the EHR system in April 2023 to rectify issues at the medical facilities where the software had been deployed, which included patient safety concerns and usability challenges.

The new EHR software has been implemented at just six of VA’s 170 medical centers, with one of the deployments — a joint rollout with the DOD at the Captain James A. Lovell Federal Health Care Center in North Chicago, Illinois — happening last March during the operational freeze. VA and Oracle Health said the go-live at that site, which was deemed a success, would help inform medical facility deployments moving forward.

VA announced last December that it was exiting its reset period and would be implementing the new system at four Michigan-based medical sites in mid-2026. VA Secretary Doug Collins — who highlighted the necessity for the modernized EHR during his confirmation hearing — subsequently announced in March that the department was planning to roll out the new software at nine additional medical facilities next year, bringing the total to 13 sites. 

Officials highlight progress ahead of rollout resumption

While the decision to restart some EHR deployments in 2026 was first made during the Biden administration, Collins has supercharged the effort as part of a plan to rapidly build momentum for the modernization project. This has included working to streamline coordination between VA and Oracle Health, as well as pushing to place the onus back on Oracle Health to address any system challenges.

As part of this effort, VA Deputy Secretary Paul Lawrence has also been conducting regular site visits at the facilities where the EHR system is scheduled to be deployed next year. He previously said the department is undertaking “a no-fail mission to deliver a Federal EHR at every VA medical center by 2031.” 

VA also used the reset period to renegotiate its contract with Oracle Health to to include additional accountability measures in the agreement and to enhance oversight at the medical sites using the new EHR software. 

Officials from both sides have touted the improvements that have since been made to the modernization project, from more effective change management and training initiatives to improved usability. 

During a House Veterans’ Affairs Technology Modernization Subcommittee hearing on Dec. 15, Dr. Neil Evans — acting program executive director of VA's Electronic Health Record Modernization Integration Office — said the department “has made significant strides in stabilizing its systems, with improved performance metrics demonstrating system reliability.” 

Evans added that “we're also delivering system enhancements, new features and system changes that are responsive to the feedback we're hearing from VA staff, and are driving improved standardization across the enterprise.”

Congressional and watchdog concerns

With just over 100 days until the go-lives occur at the four Michigan VA medical facilities, Congress and the Government Accountability Office are continuing to flag potential pitfalls in the modernization project’s restart. 

In a March report, GAO said VA “is making incremental improvements to the new electronic health record system but much more remains to be done,” and recommended at the time that the department develop an updated cost estimate and integrated master schedule to account for the project’s delays and reset period. 

In total, GAO has made 18 recommendations to VA to improve the EHR modernization effort, including 12 that were deemed to be priorities. During the House subcommittee hearing on Dec. 15, Carol Harris — GAO’s director of information technology and cybersecurity issues — said the department has not fully implemented 16 of its recommendations. 

At the same House hearing, lawmakers expressed particular concern about the project’s total cost, as well as VA’s push to batch together upcoming site deployments. 

A new lifecycle cost estimate provided to the panel — but that had not been shared with GAO — pegged the EHR modernization project’s new total at roughly $37 billion. A previous cost estimate conducted in 2022 on behalf of VA by the Institute for Defense Analyses predicted the ultimate cost to be around $50 billion.

Lawmakers also questioned VA’s plan to roll out the new system at multiple facilities at the same time — something that Evans said aligns with VA’s new plan to use “a market-based approach for deployments, with multiple medical centers working together and going live simultaneously in each deployment.”

While Oracle and VA have said they are prepared for the simultaneous EHR system deployments at the four Michigan-based sites, Rep. Tom Barrett, R-Mich. — who chairs the House panel — said he felt that bundling the rollouts together “elevates the risk that there's going to be problems that arise or issues that are overlooked.” 

In an interview with Nextgov/FCW, Rep. Nikki Budzinski, D-Ill. — the ranking member of the subcommittee — also said she was worried VA wasn’t effectively engaging with GAO when it came to the watchdog’s recommendations for the modernization initiative.

“What to me is the most concerning is that it makes me question how seriously are they taking outside recommendations that are, you know, all to the benefit of a successful go live,” she said. “That's what we want. But the fact that it sounds like it's falling on deaf ears at the VA is very troublesome.”

Hoping to push VA to provide more transparency around the EHR modernization project’s future, Congress included a measure in last month’s government spending package to impose potential strings on the effort’s funding. 

Although the fiscal year 2026 bill for VA allocated $3.4 billion for the EHR system’s deployment, lawmakers included a provision that would withhold 30% of the funding until July 2026, and make access to those funds contingent upon the department providing lawmakers with an updated lifecycle cost estimate, facility-by-facility deployment schedule and other certifications that the project has met or exceeded deployment goals. 

Other issues that have been raised in the past also remain largely unaddressed. Current and former VA officials previously told Nextgov/FCW that the new system has never been in compliance with federal accessibility requirements. 

A VA spokesperson and a representative from the Federal Electronic Health Record Modernization Office both said earlier this year that they could not comment on software’s accessibility issues due to “potential, pending or ongoing litigation.”