Lawmakers are worried about the embattled rollout of the Oracle electronic health record at the Department of Veterans Affairs as the date to resume deployments at new facilities draws closer.
Thirteen medical centers are scheduled to go live with the new record in 2026, including four sites in Michigan in April, lawmakers and witnesses said at a House Committee on Veterans’ Affairs hearing Monday.
The EHR’s overall rollout has been troubled so far, plagued by patient safety concerns, technology challenges and system reliability issues. In April 2023, the VA largely put new deployments of the EHR on pause in a bid to focus on improvements.
Now, the VA will resume deployments in just over 100 days. Oracle and VA officials told lawmakers they have made significant progress improving system performance and preparing to continue the rollout.
However, a report by the Government Accountability Office released Friday found the VA still hasn’t fully implemented most of the watchdog’s recommendations, including updating the total cost estimate for the project, improving communication about system updates and quickly resolving tickets.
“The clock is ticking down in Michigan for this to go live, and the time for promises is over,” Rep. Tom Barrett, R-Mich., chair of the Subcommittee on Technology Modernization, said during the hearing. “The only acceptable result is a flawless go-live because our veterans cannot accept failure.”
Accelerated deployment schedule
EHR vendor Cerner — later acquired by technology giant Oracle — first signed the contract to replace the VA’s aging medical records system in 2018.
But more than seven years later, only six medical centers out of the VA’s 170 have deployed the EHR.
The Trump administration has moved to accelerate the deployment. In 2027, 26 facilities across 12 states will go live with the Oracle system, said Seema Verma, executive vice president and general manager of Oracle Health and Life Sciences, at the hearing Monday.
The VA is now deploying records to medical centers based on which market they’re located in, with facilities working together and rolling out the EHR simultaneously, said Dr. Neil Evans, acting program executive director of the Electronic Health Record Modernization Integration Office at the VA.
That method improves efficiency, allows the department to scale up the number of deployments and share best practices, he said.
Simultaneous go-lives could be challenging, lawmakers said. Rolling out the record at the same time could increase the risk the problems are overlooked, Barrett said.
Testing across four sites at the same time would also take a “tremendous amount” of resources, and dealing with potential issues across multiple sites is risky, Carol Harris, director of information technology and cybersecurity at the GAO, testified at the hearing.
Still, Oracle is confident it can handle the rollout at more than one site at a time.
“It’s not like we’re turning on the system quickly. We’ve been in these sites,” Verma said. “We have a plan for each site, and we have adequate staff and support for each of those sites.”
A backlog of GAO recommendations
The EHR’s system performance has improved, with less downtime and interruptions for users, VA and Oracle leaders said at the hearing.
For example, the EHR had no systemwide outages for 10 months in fiscal year 2025, according to Evans’ written testimony. And at the end of the year, the system had more than 200 consecutive days without any outages.
But the VA has yet to implement 16 out of 18 recommendations from the GAO, including suggestions to improve user satisfaction, training and change management, and time to resolve trouble tickets.
Additionally, the cost for the project is still unclear, the GAO noted. The project’s initial price tag was $10 billion, but the most recent estimate provided to lawmakers had grown to roughly $37 billion, Barrett said. The GAO hasn’t received that estimate, Harris testified.
Meanwhile, the cost estimate has changed multiple times, raising concerns that no one knows what the bottom line will be, said Rep. Nikki Budzinski, D-Ill.
“There are so many recommendations from the GAO and the Inspector General as well as Congress that will continue to sit unheeded,” she said. “I have no confidence that the next round of go-lives is going to be any better than the last.”
