Why It Matters
The Department of Veterans Affairs (VA) has spent years struggling to modernize its electronic health records system, a critical infrastructure project meant to improve care for millions of veterans. In a September 2 testimony before the House Committee on Veterans' Affairs, the U.S. Government Accountability Office (GAO) reported that the VA has fully implemented only 4 of 18 recommendations made across five prior reports spanning June 2020 through March 2025, leaving 14 recommendations unaddressed, including 12 priority recommendations deemed critical to successful future deployments.
The VA undertook its fourth attempt at electronic health records modernization beginning in 2017, deploying the new system to its first site in 2020. By May 2023, users were already reporting dissatisfaction with the system, and the VA had not adequately identified and addressed the underlying issues. In 2023, VA halted future system deployments due to feedback from veterans and clinicians that the new system was not meeting expectations. In December 2024, VA announced plans to restart deployments beginning with four facilities in Michigan. The agency now plans nine additional site deployments in 2026 and aims to complete approximately 170 sites by 2031.
The Big Picture
GAO has designated VA health care as a high-risk area for the federal government, in part due to its challenges implementing Electronic Health Record Modernization (EHRM) initiatives.
The configuration backlog underscores the scale of unfinished work. As of June 2024, the VA had implemented over 1,500 configuration changes to the system. Yet by February 2025, approximately 1,800 pending configuration change requests remained unaddressed.
The VA's restart plan in December 2024 offered hope but came without the documentation Congress needed to assess feasibility. The agency has not provided clear cost projections or timelines tied to specific milestones. Senate and House Authorizing and Appropriations Committees requested a detailed cost estimate and schedule by September 30, 2025, but the VA delivered only a "notional schedule" without the cost estimate or detailed documentation necessary to determine consistency with leading practices.
In March 2025, GAO reported that the VA had made improvements at five initial sites but noted that the department's actions to address challenges had impacted the program's total cost estimate and schedule.
The Bottom Line
As the VA moves to accelerate deployments across nearly 170 facilities by 2031, the question remains whether the department has actually solved the underlying problems. Until VA fully implements the remaining recommendations, future deployments risk prolonging management challenges like those experienced in the initial deployments, and users will likely not be positioned to achieve optimal usage of the new electronic health record system.
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