Beginning this year, the Department of Veterans’ Affairs (VA) will restart deployment of its Electronic Health Records Modernization (EHRM) program, a move that is drawing concern from a bipartisan group of lawmakers.
Just last week, the VA electronic health records (EHR) system experienced a nation-wide outage, causing disruptions at six VA medical centers, 26 community clinics and remote VA sites.
The issue was a main topic of concern at three recent Congressional hearings, signaling the importance of getting this program right to lawmakers and the veterans they represent.
In 2018, the VA and the Department of Defense (DOD) signed a joint commitment to coordinate on the creation of interoperable electronic health record systems, and the VA awarded Cerner, which was later bought by Oracle, a $10 billion contract to modernize its systems to match those at DOD.
The implementation, which began in 2020, was a “bipartisan, multi-administration disaster,” according to Senator Thom Tillis (R-NC) at January’s nomination hearing of Doug Collins to be Secretary of Veterans Affairs.
The initial rollout of the EHR (Electronic Health Records) system was plagued with challenges, including system outages, data migration issues, and user complaints, leading to delays and increased costs. In a period of four years, Oracle-Cerner EHR experienced 826 “major performance incidents,” which led to patient harm, including 6 cases of ‘catastrophic harm’ and 4 patient deaths. In one particularly egregious example, an army veteran alleged that errors in the electronic health record system at a Department of Veterans Affairs medical center delayed his cancer diagnosis for months, and now the diagnosis is terminal.
The original $10 billion contract quickly ballooned to $16 billion, with some estimates saying the cost of the program could be more than triple that number when factoring in delays, maintenance and other expenditures. The program came under such intense scrutiny from lawmakers that it was paused in 2023 due to major technical problems and concerns for patient safety. Now, as the program is set to resume in mid-2026, major questions remain.
This month, at the Senate Hearing on the nomination of the Honorable Paul Lawrence Ph.D., Nominee to be Deputy Secretary of Veterans Affairs, Senator Patty Murray (D-WA) expressed major concern over the continued issues plaguing the system.
“Instead of helping to improve our veterans’ healthcare, that rollout ended up being a complete disaster and it endangered veteran patients. Unfortunately, the system still is not working the way the VA and doctors and nurses need and veterans are continuing to suffer,” Murray said.
She continued, “Let me make this very clear: we have heard that answer from every VA person that’s come before this committee for a number of years now. Everybody’s looked at it, everybody’s considered it, everybody’s talked about it, everybody’s convening panels. It is not working.”
At a February oversight hearing of the House Committee on Veterans’ Affairs Subcommittee on Technology Modernization, Chairman Tom Barrett (R-MI) expressed frustration over the progress of the program and highlighted that Congress has not received a schedule or an up-to-date cost estimate.
“First, VA is nearly seven years into the original 10 year contract. The Oracle EHR has been implemented in less than 4% of medical centers,” Barrett said. “Second, according to latest surveys, 69% of users are dissatisfied with the system. 75% of users believe the system does not maximize their efficiency. I told someone earlier that the approval rating is less than that of Congress, and that is a hard thing to do.”
At that same hearing, Carol Harris, Director, Information Technology and Cybersecurity Issues at GAO, stated that the cost to fully implement Oracle EHR at the VA could be in the “hundreds of billions of dollars potentially.”
According to a recent report by the U.S. Government Accountability Office (GAO), there are nearly 2,000 issues with the program that are still unaddressed.
With ongoing concern from lawmakers and bureaucrats on how this program could succeed without putting veterans in harm's way or wasting billions more in taxpayer dollars, Secretary Collins promised to make the EHR his top priority.
“This, for me, has been one of the first times when first looking at it, how only up here would this allow it to go on as long as it had? So look, I'm putting on notice today that I'm committed to everyone here. We're going to bring everyone to the table, that's the vendor, that's VA everybody in the middle, and figure out what this problem is, because it's time to fix it.”
Despite these persistent issues, the Department of Veterans Affairs just announced that it will deploy its EHR system at nine additional medical facilities next year.