The Department of Veterans Affairs’ (VA) electronic health record modernization (EHRM) program is working and back on track, VA Deputy Secretary Paul Lawrence said, pointing to a faster pace of deployments and improvements in system safety and reliability.
“We are on time, and we are delivering benefits,” Lawrence said Nov. 9 at the National Academy of Public Administration’s 2026 National Conference in Washington, D.C.
The department aims to deploy the new electronic health record (EHR) system at 170 sites by 2031, including 26 additional deployments in 2027. The department brought the system online at 13 hospitals in 2026, bringing the total to 19 deployment locations. The latest “go-lives” occurred Oct. 24 at medical centers in Cleveland and Anchorage.
A troubled modernization effort
The VA’s EHRM program was initially launched in 2018 to replace its decades-old Veterans Health Information Systems and Technology Architecture with a modern, commercially unified platform powered by Cerner, which Oracle acquired in 2022 and now operates as Oracle Health.
However, the program has faced years of technical delays, system outages, workflow problems, budget increases, and criticism from veterans and healthcare providers. The COVID-19 pandemic and changes in administration also disrupted the implementation, Lawrence said.
In 2023, the VA initiated a nearly two-year program reset, pausing new deployments while working to address technical and operational problems at existing sites. The department resumed federal EHR deployments in April 2026.
Contract costs and patient safety remain concerns
Despite the faster deployment pace, the VA’s EHRM program continues to face scrutiny over rising costs and operational challenges.
The department’s decision to increase its Oracle Health contract ceiling from $10 billion to nearly $27 billion drew bipartisan criticism, particularly because lawmakers said they were not notified in advance. The House Veterans’ Affairs Committee later voted unanimously to subpoena Oracle executives Larry Ellison and Mike Sicilia after they declined to testify about the increase. The subpoenas direct Sicilia to appear before the committee on Nov. 19, and Ellison on Dec. 10.
Lawrence said the expanded ceiling would be sufficient to complete deployments through 2031 and that VA would not seek another increase.
Patient safety remains a concern, though Lawrence said VA has addressed earlier problems with prescription transfers and laboratory order queues. He also said the department now transfers both active and older prescriptions during “go-lives” with accuracy rates above 99.9% and more closely monitors order queues to prevent requests from going unnoticed.
“Since we went live in 2026, there have been no critical patient safety issues,” Lawrence said.
VA emphasizes training and employee feedback
Lawrence said VA has learned from earlier implementation problems and is taking a different approach to remaining deployments that helps employees adapt to the new EHR system rather than customizing it to replicate the department’s legacy technology.
He described employee feedback, site visits, and enhanced training as central to the modernization strategy.
The VA has expanded training opportunities, established trained “super users” at facilities to help colleagues navigate the system, introduced an EHR chatbot, and developed an “Adoption University” program led by VA clinicians.
Lawrence also emphasized the importance of involving healthcare workers in the implementation process rather than imposing changes without their input.
VA sees potential for efficiency and future innovation
Beyond replacing legacy technology, Lawrence described the EHRM program as a broader transformation of how the department delivers healthcare to veterans.
He estimated the new system could save providers 10 to 15 minutes during some patient interactions, potentially giving clinicians more time to focus on care.
“This is not an IT project. This is really an enormous transformation initiative that we’re undertaking,” Lawrence said.
He added that the modernization could ultimately support new approaches to healthcare delivery, particularly as the veteran population ages and its healthcare needs evolve.
“The electronic health record is a project that really opens the window to amazing possibilities in the future,” Lawrence said.