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Why the VA’s $16B EHR Modernization Is Still Falling Short
Jared Dashevsky, MD
March 23, 2025 • Estimated Reading Time: 11 minutes
GRAND ROUNDS
Why the VA’s $16B EHR Modernization Is Still Falling Short
The VA says it plans to wrap up its EHR modernization by 2031—replacing its outdated CPRS system with Oracle’s electronic health record. But just last week, the VA cut contracts with six companies helping support the rollout.
If you’ve been following this saga, you know: the whole thing has been one big mess.
In today’s article, I’ll walk you through the latest updates, recap how this $16B+ project got so off track, and break down what it all means for patients, providers, and the system as a whole.
The Deets: VA Cuts Contracts
The VA recently canceled hundreds of contracts labeled as “non-mission critical,” claiming it’ll save $900 million to reinvest elsewhere in the VA health system. The broader plan? Slash 90,000 contracts and save $67 billion. On paper, that sounds like fiscal responsibility.
Some of the contracts on the chopping block were supporting the very EHR modernization they’re trying to accelerate. And while the VA insists these cuts won’t affect care, many of the companies involved had already laid off staff, and some provided essential interoperability and integration work for the Oracle rollout.
To make things even more surreal: despite this being a multi-billion-dollar, years-long initiative (I explain more below), about 94% of VA medical centers are still using CPRS—eight years after the contract was signed.
So while the VA is trying to speed things up, they’re also cutting ties with many of the folks actually helping them get there. Maybe they’re tossing out luggage mid-flight to save fuel and go faster… or maybe they just chucked the bolts and rivets holding the engine together. Time will tell.
Quick Recap: The VA’s EHR Fumble
The VA’s effort to modernize its electronic health record system officially began in 2018, when it signed a $10 billion contract with Cerner (now Oracle Health) to replace its aging CPRS platform. The goal? Create a seamless, interoperable record system between the VA and the Department of Defense.
Since then, the rollout has been rocky.
The first site went live in Spokane, Washington in 2020. Four more followed in 2022. But progress quickly stalled. The system was plagued by technical glitches, frequent outages, and serious usability issues. Clinicians reported poor workflow design, and the VA Office of Inspector General linked EHR-related issues to patient harm—including missed orders, scheduling failures, and pharmacy delays.
Meanwhile, costs ballooned. The original $10 billion price tag has grown by over $6 billion, and lawmakers have raised concerns about oversight and accountability.
In 2023, the VA hit pause on all new deployments and entered what it called a “Reset” period—essentially a time-out to fix what was broken. The VA and Oracle signed a new 11-month, $375 million contract extension, and the VA committed to improving the system at existing sites before expanding further.
Now, the VA says it’s ready to resume. As I stated above, the new plan includes deploying the Oracle EHR at 13 additional sites by the end of 2026, with a full rollout targeted for 2031. That’s seven years into the contract and billions of dollars later.
To their credit, the VA has reported some gains: improved veteran trust scores at EHR-enabled sites, decreased system outages, and better clinician satisfaction. But whether those improvements will scale across a complex, nationwide rollout remains to be seen.
So that’s where we are—tens of billions in, seven years deep, and still far from the finish line.
Dashevsky’s Dissection
From a 30,000-foot view, this rollout had all the makings of a transformative upgrade. A unified record system between the VA and DoD. Streamlined transitions of care. Consistent, centralized health data for millions of veterans.
But here we are—seven years and billions of dollars later—and over 90% of VA facilities are still using CPRS. Meanwhile, the VA is cutting contractors while claiming they’re accelerating deployment. It’s like trying to remodel your house while firing the construction crew.
I’m all for efficiency—you know that. But efficiency without a clear outcome isn’t progress. And so far, the VA’s rollout has been neither efficient nor effective. It’s burned taxpayer money, frustrated clinicians, and left administrators scrambling.
As someone who switches between Epic and the VA’s CPRS, the gap is obvious. Using CPRS is like going from an iPhone to a flip phone. Modern EHRs like Epic have built-in safety checks and workflows that reduce the chance of errors. CPRS doesn’t. Orders get missed. Notes slip through the cracks. Care coordination becomes a guessing game.
Modernizing CPRS is about safety. Veteran care will unquestionably be safer with a modern, well-integrated EHR. But the VA’s execution has been one long fumble.
And what I still can’t wrap my head around is this: how do sprawling health systems with dozens of hospitals manage to pull off EHR transitions in under two years… while the VA—one fully integrated system, with unified patient records—can’t do the same?
In summary, the VA’s EHR modernization effort was meant to streamline care and improve safety for millions of veterans. But seven years in, with billions spent and minimal progress made, the project has become a case study in inefficiency. CPRS remains in widespread use, patient safety is still at risk, and the rollout continues to be bogged down by poor execution and conflicting priorities. Until the VA aligns its strategy, support, and infrastructure, a modern EHR will remain more promise than reality.
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