Why It Matters
Congress is preparing to scrutinize the Department of Veterans Affairs' troubled effort to overhaul its electronic health record system, which has consumed far more money and time than initially planned. The VA increased the ceiling on its Oracle EHR contract from approximately $10 billion to approximately $27 billion in August, as the department moves to accelerate deployments of the system.
A Government Accountability Office report found significant dissatisfaction among selected VA staff using the Oracle-Cerner EHR. Of 71 users interviewed in 2023 and 2024, 58 said the system had increased or greatly increased patient safety risks. Separately, a September 2024 VA survey found only 13% of respondents agreed or strongly agreed that the system made them as efficient as possible.
The Big Picture
GAO has repeatedly raised concerns about VA's management of the EHR modernization program. A 2025 report found that VA needed an updated cost estimate and schedule as it prepared to resume deployments. The department had implemented more than 1,500 system configuration changes by June 2024 but still had about 1,800 outstanding configuration change requests as of February 2025.
The same report found persistent dissatisfaction among users. Of 71 selected users interviewed by GAO in 2023 and 2024, 58 said the new EHR had increased or greatly increased patient safety risks. In a separate September 2024 VA survey, only 13% of respondents agreed or strongly agreed that the EHR made them as efficient as possible, while 75% disagreed or strongly disagreed.
VA paused most EHR rollouts in April 2023 due to feedback from veterans and clinicians that the system was not meeting expectations, including concerns about patient safety and system reliability. According to Nextgov/FCW, there was lingering lawmaker unease about restarting EHR deployments even as VA and Oracle Health argued the pause had allowed them to enhance the software.
GAO subsequently warned that VA had not fully implemented 16 of 18 recommendations addressing cost estimates, scheduling, program management, user adoption and satisfaction, and operational testing as the department prepared to accelerate deployments.
The Bottom Line
House Veterans' Affairs Committee Chair Mike Bost (R-IL) and the committee will hold a hearing titled "Beyond Go-Live: VA Electronic Health Record Modernization Status Update" on Sept. 2.
Oracle America Inc. filed lobbying disclosures for the third and fourth quarters of 2025 and the first and second quarters of this year, each reporting $20,000 in lobbying expenditures through Capitol Consulting Group LLC on issues related to VA electronic health record modernization and general technology matters.
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