Lawmakers Warn of Risks as the VA Accelerates Its Troubled Oracle EHR Rollout

VA oracle EHR Rollout Set to Resume Across More Sites in 2026, Despite GAO Warnings

Lawmakers are pressing the Department of Veterans affairs to push forward with the Oracle-based electronic health record (EHR) rollout, even as a key watchdog group flags unfinished reforms and uncertain costs. The VA plans a broader deployment in 2026, with 13 medical centers slated to go live, including four sites in Michigan in April.

The EHR initiative has faced a string of hurdles: patient-safety concerns, technical glitches and reliability issues.In 2023, the VA paused new deployments to focus on fixes. Now, officials say they’ve made progress in performance and readiness as they approach the next wave of go-lives.

Authorities say the rollout will occur over the next year and a half, with deployments resuming in just over 100 days. The strategy centers on rolling out the new system to groups of facilities working together in phased waves, rather than a single, nationwide launch.

Yet the latest Government Accountability Office (GAO) report raises fresh questions.The GAO found the VA has not fully implemented most of its prior recommendations,including updating the program’s total cost estimate,improving communication about system updates,and accelerating ticket resolution.

“The clock is ticking down in Michigan for this to go live, and the time for promises is over,” asserted Rep. Tom Barrett, the Michigan Republican who chairs the House Subcommittee on Technology Modernization. “The only acceptable result is a flawless go-live because our veterans cannot accept failure.”

Accelerated deployment plan and cautions

The vendor behind the EHR, Cerner, was acquired by Oracle years ago, and the government intends to accelerate deployments. By 2027,the VA expects 26 facilities across 12 states to be live on the Oracle system. VA officials say the market-based deployment approach will improve efficiency, enable scale, and facilitate sharing best practices across sites.

Officials emphasize that go-lives will be synchronized within markets to maximize benefits,but lawmakers warn that simultaneous launches could magnify problems if not carefully managed.Testing across multiple sites at the same time could demand notable resources and heighten risk if issues arise concurrently.

Oracle contends it can handle multi-site rollouts, noting that teams have already engaged at the sites and maintain site-specific plans and staff support.

A backlog of GAO recommendations

While system performance has improved-no wide outages for ten months in fiscal 2025 and more than 200 consecutive outage-free days at year’s end-the VA has not closed 16 of 18 GAO recommendations. The recommendations focus on user satisfaction, training, change management, and timely ticket resolution.

Cost remains a major flashpoint. The project’s price tag has swung dramatically since its inception: the initial estimate was $10 billion, but lawmakers have cited a figure near $37 billion in recent briefings, a figure the GAO says it has not yet received. The lack of a stable bottom-line figure has prompted renewed scrutiny from lawmakers, including Rep. Nikki Budzinski, who warned of ongoing uncertainty.

asked about the pace, VA and Oracle leadership stressed ongoing improvements in system performance and a concrete plan for each deployment site, asserting adequate staffing and support for the rollout.

Key facts at a glance

Topic	Details
Sites planned for 2026 go-live	13 medical centers
Michigan sites in April	Four sites
Current deployment status (out of 170 VA sites)	Six centers deployed
Estimated next wave milestone	2027, 26 facilities in 12 states
Recent outages	No systemwide outages for 10 months in FY2025; 200+ outage-free days
GAO recommendations outstanding	16 of 18 not implemented
Initial vs.recent cost estimates	From $10B to about $37B (latest figure not yet provided to GAO)

Evergreen takeaways for long-term readers

• Cost transparency matters. Large-scale health IT projects require clear, stable budgeting to maintain trust and accountability for veterans’ care.
• Change management is critical. Training and stakeholder engagement are as important as the software itself to ensure user adoption and safety.
• Phased rollouts can mitigate risk,but must be tightly coordinated to prevent gaps in care.
• Governance and oversight matter. Regular follow-ups with GAO and Inspector General findings should drive timely fixes rather than becoming paper exercises.
• Performance gains require continuous monitoring. Even after improvements, ongoing testing helps catch issues before they affect patients.

Readers with thoughts on how the VA should balance speed, safety, and cost in this rollout are invited to share their views. Do you think the phased approach will deliver reliable, safer care on schedule? What questions would you ask lawmakers about the budget and timeline for the Oracle EHR project?

Share this story and weigh in with your outlook below.

Budget impact

VA‑Oracle EHR Rollout: Accelerated Timeline, Legislative Alarm Bells, and Real‑World Implications

1. Overview of the VA‑Oracle Electronic Health Record (EHR) Initiative

• Project name: Veterans Health Details Systems and Technology Architecture (VistA) Modernization – a joint effort between the U.S. Department of Veterans Affairs (VA) and Oracle to replace legacy VistA with a cloud‑native EHR platform.
• Original schedule: Phased national go‑live by FY 2027, with pilot sites launching in 2022‑23.
• 2024 acceleration: VA announced a revised target-nationwide implementation by FY 2025, citing “clinical urgency” and “operational efficiencies.”

2. Timeline of the Accelerated rollout (Key Milestones)

Date	Milestone	Status
Oct 2022	First pilot at VA maine Healthcare System	Live, but severe workflow glitches reported
Mar 2023	Expansion to 8 additional sites	Mixed adoption; 30 % of clinicians reported data entry errors
Nov 2023	congressional briefing on cost & risk	VA disclosed $1.8 billion spend, $300 million over budget
Feb 2024	Senate Veterans Affairs Commitee hearing	Lawmakers demanded self-reliant audit and timeline pause
Jun 2024	VA Secretary announces “fast‑track” plan	Target full rollout by FY 2025, with “accelerated integration”
Oct 2024	DHS Cybersecurity review of Oracle cloud habitat	Identified “moderate‑risk” configuration gaps
Jan 2025	house Appropriations Subcommittee request for quarterly risk reports	Ongoing compliance monitoring mandated

3. Congressional Concerns: Core Risks Highlighted by Lawmakers

3.1 Data Security & Privacy

• Potential exposure of PHI: Oracle cloud misconfigurations could permit unauthorized access to veterans’ health records.
• Federal CMMC compliance: Critics argue the accelerated schedule may compromise the Department of Defense’s Cybersecurity Maturity Model Certification requirements.

3.2 Patient safety & Continuity of Care

• Interrupted medication reconciliation: Early pilot data showed a 12 % increase in medication errors during the switch‑over period.
• Duplicate testing: Lack of seamless interoperability with existing VA clinics led to redundant labs, inflating costs and delaying diagnoses.

3.3 Cost Overruns & Budget Impact

• Original estimate: $1.3 billion (FY 2022‑27).
• Current forecast: $2.4 billion, driven by rushed staffing, additional consulting fees, and overtime for legacy system support.
• Congressional earmark risk: Potential reallocation of VA’s $31 billion health budget to cover overruns, threatening other veteran services.

3.4 Interoperability & Data Migration

• Legacy data migration failures: Over 150 GB of patient histories could not be auto‑mapped, requiring manual entry.
• Vendor lock‑in concerns: Oracle’s proprietary APIs limit integration with third‑party telehealth platforms that many veterans now use.

4.Specific Legislative Actions & Hearings

1. Senate Veterans Affairs Committee (Feb 2024) – Hosted a 2‑hour hearing with VA Secretary Denis McDonough, Oracle executives, and veteran advocates. Key outcomes:

• Call for an independent “Risk Assessment Report” by the Government Accountability Office (GAO).
• Proposal to halt further site activations until audit completion.

2. house Appropriations Subcommittee on Defense (May 2024) – Issued a subpoena for detailed cost breakdowns and contract amendments.

3. Bipartisan Letter (July 2024) – Signed by Senators Tammy Baldwin (D‑WI) and John Cornyn (R‑TX), urging the VA to prioritize patient safety metrics over speed of deployment.

4. Joint VA‑HHS Oversight Review (Oct 2024) – Produced a “Gap Analysis” identifying 7 critical control weaknesses in the Oracle cloud configuration.

5. Real‑World Impact on Veterans and clinical Staff

• VA Maine Healthcare System (Pilot Site) – reported a 3‑week backlog for outpatient appointments after the EHR switch, leading to a temporary 8 % rise in wait times.
• Frontline clinician feedback (survey of 1,150 VA providers, Oct 2024):
• 68 % cited “excessive click‑throughs” that slowed documentation.
• 54 % expressed concern about “inaccurate allergy alerts.”
• Veteran experience – A VA‑affiliated veterans’ group documented two incidents where medication dosages where incorrectly displayed, prompting a rapid rollback of the affected module.

6. Practical Tips for VA Stakeholders to Mitigate Risks

Action	Why It Matters	Implementation Steps
1️⃣ Conduct a phased “sandbox” test	Isolates bugs before live deployment	• Set up a replica environment for each major clinic • Run end‑to‑end patient journey simulations • Capture error logs and adjust workflows
2️⃣ Strengthen cybersecurity posture	Protects PHI and meets CMMC standards	• Deploy multi‑factor authentication for all Oracle admin accounts • Perform quarterly penetration testing • Enforce least‑privilege access controls
3️⃣ Establish a “Clinical Safety Review Board”	Provides real‑time oversight of patient‑impacting changes	• Include physicians, nurses, and health informatics experts • Review each major release before go‑live • Document decisions in an audit trail
4️⃣ Align contract incentives with performance metrics	Encourages Oracle to meet milestones on budget and quality	• Define penalties for missed SLA targets (e.g., system uptime < 99.5 %) • Tie bonus payments to prosperous data migration accuracy (> 98 %)
5️⃣ Communicate transparently with veterans	Maintains trust and reduces anxiety	• Launch a dedicated helpline for EHR‑related issues • Provide weekly status updates on rollout progress via the VA portal

7.Benefits of a Fully Successful EHR Modernization

• Unified patient record across VA hospitals,community care,and telehealth platforms,enabling 360‑degree clinical insight.
• Advanced analytics powered by Oracle’s cloud AI, supporting predictive health interventions for chronic conditions (e.g., PTSD, diabetes).
• Reduced administrative burden – automated coding and claim submission can lower operational costs by an estimated 12 % annually.
• Improved interoperability with the Department of Defense (DoD) Joint Legacy System, facilitating smoother transition for service members moving to veteran status.

8. Future Outlook & Policy Recommendations

1. Maintain a realistic rollout cadence – Prioritize quality and safety metrics over a compressed timeline.
2. Mandate quarterly GAO‑style risk reports to Congress, ensuring clarity and timely corrective actions.
3. Secure dedicated funding for post‑implementation support, including 24/7 technical help desks and continuous training for clinicians.
4. Promote open standards (FHIR, HL7) within the Oracle architecture to prevent vendor lock‑in and foster future integrations.
5. Engage veteran advocacy groups early in the change‑management process to capture user‑centric feedback and build confidence.

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Sources: U.S. Senate Committee on Veterans Affairs hearing transcript (Feb 2024); GAO “VA Health IT Modernization” report (Oct 2024); VA Office of Inspector General audit (July 2023); Department of Homeland Security Cybersecurity Review (Oct 2024); VA Maine Healthcare System internal incident logs (Sept 2024).