The U.S. Department of Veterans Affairs (VA) has announced plans to expand the deployment of its Federal Electronic Health Record (EHR) system to nine additional medical facilities by 2026, bringing the total number of sites online that year to 13. The broader rollout aims for complete implementation across all VA medical facilities by 2031. However, questions remain about the system’s efficiency, cost, and user satisfaction, raising both optimism and concerns about the program’s future.
Expansion Plans and Early Efforts
The new deployment wave will be guided by collaborative planning sessions involving the VA’s Electronic Health Record Modernization Office, regional VA leadership, clinicians, and Oracle Health, the EHR vendor. While the specific locations of the nine facilities will be announced later this year, the VA has begun early-stage planning for four Michigan sites—Ann Arbor, Battle Creek, Detroit, and Saginaw—with implementation targeted for mid-2026.
The EHR project, paused in April 2023 for over 18 months, allowed the VA to address reported inefficiencies and listen to feedback from veterans and healthcare providers. According to Deputy Secretary Tanya Bradsher, “As a result of those efforts, veteran trust and system performance have improved across the board.” These improvements reportedly include reduced downtime and increased clinician satisfaction, with surveys showing higher agreement with statements like “the EHR is available when I need it.”
Critical Feedback from GAO
Despite reported progress, a new Government Accountability Office (GAO) report underscores lingering issues. The report criticizes the VA for failing to update cost estimates and rollout schedules in light of the pause and subsequent adjustments. Without these updates, the GAO argues, the VA risks mismanaging its budget and rollout timeline. Additionally, user feedback indicates persistent dissatisfaction; as of late 2024, 75% of surveyed users disagreed that the new system makes them as efficient as possible.
These findings raise concerns about whether the deployment is being executed effectively and whether the VA is adequately addressing clinician needs. The GAO’s analysis serves as a reminder that achieving functional interoperability and widespread adoption will require more than just technical improvements—it will also demand ongoing engagement with end users.
System Improvements: Optimism and Challenges
During the deployment pause, the VA implemented changes designed to improve the EHR’s performance and usability. The department reported increased clinician satisfaction each year since 2022, though the overall numbers still highlight areas for growth. Some of these improvements include a market-based approach to selecting deployment sites and adopting a standardized baseline of workflows, products, and integrations.
The VA’s market-based site selection process aims to scale deployments efficiently while maintaining service quality. Additionally, a standardized national baseline is expected to accelerate future rollouts and support continuous optimizations, potentially addressing some of the challenges flagged in early implementations.
However, clinicians and staff remain skeptical. Many cite usability issues and inefficiencies in the system’s workflow, which they argue hinder the delivery of high-quality care. The VA has committed to further refinements but acknowledges that full adoption will take time.
Long-Term Goals and National Impact
Once fully deployed, the Federal EHR system aims to create a unified healthcare record for veterans, bridging gaps between the VA and the Department of Defense’s healthcare services. This interoperability is expected to streamline care coordination, reduce redundancies, and improve patient outcomes for veterans navigating complex medical needs.
For U.S. healthcare systems broadly, the VA’s experience offers valuable insights into the challenges of large-scale EHR implementations. Interoperability remains a nationwide goal, with many private systems also struggling to integrate disparate records into a single, cohesive platform.
A Cautious Path Forward
The VA’s renewed push for EHR deployment reflects both the promise and the pitfalls of healthcare technology modernization. On one hand, the system’s potential to improve care coordination and efficiency for veterans is undeniable. On the other hand, the continued dissatisfaction among clinicians and the GAO’s warnings about cost management and rollout planning indicate that significant hurdles remain.
For the VA, transparency will be critical. Regular updates on costs, timelines, and user feedback should be prioritized to rebuild trust and demonstrate accountability. Additionally, engaging frontline users—clinicians and staff—in the refinement process will be essential to ensuring the system meets its intended goals.
The VA’s approach to market-based site selection and standardized workflows is a step in the right direction, but execution will be key. Policymakers and healthcare leaders must closely monitor the implementation to ensure it delivers on its promises without further exacerbating frustrations for users and veterans alike.
As the VA gears up for the next phase of EHR deployments, the stakes are high. The department’s ability to address lingering concerns while scaling its system efficiently will determine not only the success of its own modernization efforts but also its role as a model for healthcare technology reform nationwide. With complete deployment not expected until 2031, the journey to a unified Federal EHR system is far from over.
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