The Department of Veterans Affairs is facing challenges in determining the updated cost estimate for the rollout of an Oracle electronic health record system across its facilities. Witnesses and lawmakers discussed this issue at a House subcommittee hearing, highlighting the potential for a much higher cost than initially projected.
Cost projections for the EHR deployment vary widely, with the VA’s 2019 estimate at around $16 billion and an independent evaluation suggesting a figure closer to $50 billion. Carol Harris of the Government Accountability Office testified that the higher estimate is likely more realistic, considering the changes made to the program over the past two years. However, the exact cost remains uncertain.
The EHR project, led by Cerner and later acquired by Oracle, has encountered numerous challenges since its inception in 2018. Issues such as patient safety concerns, technology glitches, and system reliability issues have plagued the implementation. Currently, only six out of 170 VA medical centers are using the Oracle record, with the program already costing approximately $12.7 billion.
The VA’s outdated cost projection of $16 billion does not reflect the program’s evolution over the years. An independent assessment in 2022 estimated a total cost of $32.7 billion for implementation and $17.1 billion for ongoing operations. However, these figures do not fully account for delays, system changes, and process updates.
Neil Evans, from the VA’s Electronic Health Record Modernization Integration Office, stated that the agency is committed to developing a master schedule for new deployments and a more accurate cost estimate. The plan includes resuming deployments at four Michigan facilities by mid-2026, which will inform a broader deployment strategy and cost estimate.
Both the VA and Oracle emphasized the program’s progress and commitment to accelerating the rollout. Seema Verma of Oracle highlighted the system improvements and innovations made since the initial deployment in Spokane in 2020. The VA is also ending a pause on new EHR deployments, focusing on enhancing existing sites, with plans to continue deployments in Michigan as scheduled.
Despite these efforts, challenges remain, including the tight timeline to deploy the record to all VA facilities before the contract with Oracle ends in 2028. Additionally, concerns about job cuts at the VA affecting the EHR rollout were raised, with some staff members being let go or opting for deferred resignations.
In conclusion, the VA’s EHR modernization project faces complex challenges, including cost uncertainties, deployment delays, and workforce changes. However, with a renewed focus on scheduling, cost estimation, and system improvements, the VA and Oracle are working towards a successful rollout of the Oracle electronic health record system across VA facilities.
