VA still on pace with EHR deployment after rollouts earlier this year, officials say

Almost a month after the Department of Veterans Affairs restarted deployments of its new electronic health record system at four Michigan-based medical facilities, ending a yearslong pause on the rollouts of updated software, the VA says the new EHR is working well. 

“The deployments in Michigan went remarkably well, and it is in part because we are learning and growing and building upon the success of our partners in the federal space,” said Dr. Neil Evans, the acting program executive officer at the VA’s EHRM Integration Office, during a Tuesday event. 

The VA rollout is part of a bigger deployment of an interoperable Oracle Health system across different agencies, including the Pentagon and U.S. Coast Guard. 

Lance Scott, the chief technology officer for that federal EHRM effort, characterized the recent VA rollouts as “absolutely phenomenal” during the event, which was hosted by the federal EHR office.

The resumption of deployments at the VA last month followed a pause of the program in 2023 due to technical, safety and usability concerns with the software, although the VA did later help with a joint rollout of the system with the Pentagon in March 2024 at a site in Chicago.

The Michigan rollouts this year are significant, as they mark the first time the VA has deployed the new EHR on its own after the rollout pause.

The VA used the time during the “program reset” to make improvements, said Evans. 

“One of the focus areas that we focused on is, ‘Let's do the work that we need to do to optimize the federal EHR to meet VA’s needs based on listening to our end users — at that time, we had five live sites — and understanding the lessons learned,’” he said. “We revisited a lot of our original design decisions for how the EHR was configured.”

“We came into closer alignment with our [Defense Department], [National Oceanic and Atmospheric Administration] and Coast Guard colleagues on those design decisions, and frankly, some of the work we did directly benefited our partners,” he said. “And we got really, really, really serious about standardizing at the national level the workflows and connected systems that work with the federal EHR.”

Now, the VA is at an “inflection point,” Evans said, staring down an accelerated schedule of deployments. The plan is for nine more sites to go live this year, 26 in 2027 and the rest by early 2031. 

“Deployment, deployment, deployment — that is clearly our top priority,” he said. 

Successful EHR deployments on an accelerated timeline are of high importance for VA Secretary Doug Collins, even as watchdogs and lawmakers flagged potential pitfalls — especially the cost of the project — leading up to the restart last month.

Before the next deployments in August, the VA will be making improvements to the system based on a recent “deep dive” on the Michigan rollouts, said Evans, although he didn’t offer specifics on those improvements. 

“The federal EHR is not a static entity. This is not a set of technologies that we deploy and forget about,” he said. “This is a set of technologies that we need to continue to optimize in perpetuity.”

Among the things the department is looking at next for the system is the addition of ambient dictation, which helps provide clinical information by capturing patient-clinician interactions and using artificial intelligence to make sense of them.

James Perkins — acting program executive officer in the Program Executive Office, Defense Healthcare Management Systems — echoed the importance of iterative improvement, saying that although the Pentagon completed the baseline deployment of the federal EHR two years ago, “that means that we finished the beginning.”

“We’re constantly optimizing it and we’re modernizing it,” he said, also pointing to the potential of ambient dictation. “We’re bringing in new capabilities.”

At NOAA, which went live with the federal EHR system in June 2023, bringing the system “out to sea” is the next frontier, said Cmdr. Scott Miller, the director of the office of health services at NOAA. 

Medical officers on the agency’s marine fleet currently use physical records and then upload them online once they’re back on land, but new connectivity on ships is set to change that, said Miller. 

“It really has taken us from essentially the Dark Ages, so to speak, of the manual paper charts to the digitized EHR that we have today,” he said.