As the Department of Veterans Affairs (VA) prepares to resume the rollout of its Electronic Health Record Modernization (EHRM) program, the Government Accountability Office (GAO) is urging the VA to update the program’s modernization life cycle cost estimate and schedule.
The VA’s EHRM program aims to provide a seamless experience for veterans as they transition from receiving care under the Department of Defense (DoD) to receiving care under the VA, with a single, fully integrated EHR system.
The VA began modernizing the system in 2020 but paused deployments in 2023 as part of a “program reset” due to user concerns.
“The VA made numerous system improvements during the pause, but more can be done,” a new GAO report issued today says.
“For example, it hasn’t updated cost estimates to consider the pause and the changes it made in that time,” the watchdog said. “VA also hasn’t updated the rollout schedule. Without these, VA may not be able to properly budget or know if the rollout is progressing as it should.”
The VA’s initial cost estimate for the program was $16 billion. However, after facing ongoing delays, the VA requested an independent life cycle cost estimate on the program from the Institute for Defense Analysis in 2022, which said it totals $49.8 billion.
These previous estimates do not reflect the impact of the pause, system changes, and updated processes. GAO said updating the EHR modernization life cycle cost “is imperative to understanding the full magnitude of VA’s investment.”
“Similarly, it is critically important that VA update its schedule to informing decision-making,” GAO adds.
While the VA has made improvements to the EHR system, GAO says “much more remains to be done.” For example, as of February 2025, GAO noted that 1,800 configuration change requests have still not been addressed.
Additionally, the government watchdog said surveys of user feedback “continue to reflect general dissatisfaction with the new system.” As of September 2024, 75 percent of users disagreed or strongly disagreed that the new system made them as efficient as possible.
GAO is making three new recommendations to the VA, including updating the EHR’s modernization life cycle cost estimate and schedule. It also recommends the VA “identify baselines and performance targets for all nine identified metrics intended to measure program and system performance.”
The VA concurred with all three recommendations but agreed “in principle” to obtain an updated and independent total life cycle cost estimate.
“VA noted that it intends to employ best practices to develop a cost estimate for site deployments through May 2028, which is when the current contract with Oracle Health concludes, assuming all options are exercised,” the report says.
“However, the department acknowledged that not all VA medical centers would have the modernized EHR system by the end of the contract; therefore, VA stated that the life cycle cost estimate would be dependent on a future acquisition,” it adds.
Thus far, the VA has only deployed the new EHR system to six out of the 164 VA medical centers.
Given the slow deployment pace, officials from the VA, GAO, and the VA Office of Inspector General all agreed at a hearing last month that it will be “impossible” to complete the VA’s EHRM program on its current timeline.
The VA announced in late December that by mid-2026 it would deploy the Federal EHR system to four Michigan facilities: Ann Arbor, Battle Creek, Detroit, and Saginaw.
Last week, the VA announced it is also planning to deploy the program to nine additional medical facilities in 2026, bringing the total number of deployment sites in 2026 to 13. The VA has not yet identified where the nine additional sites will be.
The VA has yet to provide a deployment schedule for the other approximately 145 VA medical centers and associated clinics.
“It is important that VA update the EHRM integrated master schedule to include all deployments,” the GAO report says. “When delivered, the updated schedule can be used to help determine if the program’s parameters are realistic and achievable and can serve as a measure by which the program can be held accountable.”
