Federal EHR Leaders Prioritize Ambient Dictation, Offline Functionality, and Interagency Interoperability

As the Department of Defense and the Department of Veterans Affairs prepare the next wave of their joint EHR deployments, program executives are placing new strategic weight on functionality once considered peripheral. Ambient voice technology, offline documentation, and site-level interoperability have emerged as defining requirements for a federal electronic health record system built for operational environments, not just clinical ones.

At last week’s State of the Federal EHR event, senior officials detailed how rollout experiences across military and VA sites are driving a more practical, user-centered roadmap. Yvette Weber, Program Executive Officer for the Defense Healthcare Management Systems, said ambient dictation is now a front-line capability request from clinicians across both departments. Weber acknowledged that adoption depends on budget availability but emphasized that such features are critical to modern EHR performance. The program’s field experience at the Lovell Federal Health Care Center in North Chicago, a joint DOD-VA facility, has already provided a functional template for interoperability that other shared facilities can emulate.

Ambient documentation tools, increasingly prevalent in commercial systems like Epic and Oracle Health, are seen by federal leaders as essential for reducing clinician burnout and improving record completeness in high-tempo settings. Their deployment across DOD and VA systems would mark a meaningful step toward parity with top-tier private sector EHRs, particularly as vendor partners build voice-enabled documentation directly into user interfaces.

The momentum behind ambient tools is just one thread in a broader shift toward making the federal EHR functional in low-connectivity environments. According to Weber, the agency is rolling out EHR extensions to deployed military units and locations where network reliability is constrained. That includes efforts to enable clinical documentation and medical decision-making in field conditions, with subsequent upload once connectivity is restored. She cited the deployment of a DOD-wide virtual visit platform called Converge, with new integrations planned for the Coast Guard and the Military Entrance Processing Command.

Cmdr. Sayeedha Uddin, the Coast Guard’s Chief Medical Information Officer, highlighted one such extension: the planned fleetwide deployment of the Battlefield Assisted Trauma Distributed Observation Kit (BATDOK), a mobile care documentation tool originally developed by the Air Force. Uddin noted that BATDOK’s ability to operate in disconnected mode and later sync with MHS Genesis will improve point-of-care charting and continuity of care across service branches.

That continuity is also central to the VA’s reset of its EHR Modernization program. Dr. Neil Evans, Acting Program Executive Director of the VA’s EHRM Integration Office, confirmed that 13 new VA sites will go live in 2026. This will bring the full Veteran Integrated Service Network (VISN) 10 onto the federal EHR platform, marking a major milestone following the program’s pause and reevaluation in 2023. According to Evans, the new deployment schedule prioritizes natural referral and clinical relationships across VA sites to strengthen continuity of operations.

Site interoperability, both within VA networks and between VA and DOD installations, has become a strategic imperative following earlier setbacks in record exchange and user experience. The renewed focus on aligning deployments with pre-existing care relationships reflects a deeper shift from abstract system rollout to clinically informed infrastructure sequencing. As the VA and DOD navigate the next phase of implementation, the ability to synchronize technical milestones with provider workflows may determine whether the federal EHR finally delivers on its long-promised modernization goals.

The combined agency focus on ambient dictation, offline documentation, and inter-network data exchange suggests a shift away from monolithic EHR implementations and toward modular functionality that meets clinicians where they practice, whether in a stateside medical center, a field tent, or aboard a Coast Guard cutter. That operational specificity, not just system scale, may be what ultimately defines success in this next phase of federal EHR modernization.