Sources: VA’s new EHR is not accessibility compliant
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A VA official told Nextgov/FCW that, at the facilities where VA’s new electronic health record has been deployed, “veterans with disabilities cannot access their own records because the patient portal is inaccessible to them.”
The Department of Veterans Affairs’ new Oracle Cerner electronic health record system has never been in compliance with federal accessibility requirements, current and former VA officials, veteran service organizations and congressional staffers told Nextgov/FCW.
VA contracted with Cerner — which was later acquired by Oracle — in 2018 to modernize its legacy health record system and make it interoperable with the Pentagon’s new electronic health record, which was also provided by Cerner. The modernization effort, however, has been beset by a myriad of problems, including cost overruns, patient safety concerns and technical glitches since the software rollout began in 2020.
VA subsequently paused deployments of the EHR system in April 2023 as part of a “reset” to address problems at the facilities where the software had been deployed, although the department announced in December that it was “beginning early-stage planning” to restart deployments in mid-2026. The new Oracle Cerner EHR system has been deployed at six of the VA’s 172 medical centers.
But even as VA moves to end its reset phase, it has still not made its new EHR system compliant with a key mandate: Section 508 of the Rehabilitation Act, which requires that federal agencies make their digital and IT systems accessible to those with disabilities.
An accessibility problem from the start
Although the performance work statement for VA’s initial contract with Cerner required that the EHR system be compliant with Section 508 upon its delivery, current and former VA personnel told Nextgov/FCW the department never tested the system for accessibility.
In an October 2019 memo from the VA Office of Electronic Health Record Modernization that was provided to Nextgov/FCW, officials requested an exemption to department policy for training on the new EHR system’s functionality, since “the Cerner system in not 508-compliant and training to use the system must mirror system functions to be effective.”
The officials further wrote that “including 508-compliant features in the training would be a negative training since these features are not available in the Cerner EHRM.”
Blind and visually impaired veterans and clinicians, in particular, are affected by the system’s accessibility challenges.
Donald Overton, national executive director of the Blinded Veterans Association, has been in contact with VA officials and the team at Cerner — and then Oracle — who have been behind the system since it first started being rolled out. In an interview, he said the issues with the EHR software were embedded into the system.
“What I was able to glean early on and throughout the whole process is, when they hard coded the system, they didn't take accessibility — or the integration of accessibility remediation software — [into account] to be able to plug and play, to be able to render it,” Overton said. “So literally, they're having to rewrite the code for the entire system so that they'll be able to do that.”
Multiple sources told Nextgov/FCW that VA informed the Office of Management and Budget that it would take five to seven years for the EHR system to be 508 compliant. They added that, to continue using the new software while attempting to remediate accessibility issues, the department has been attempting to shut off “non-compliant functions” or shift duties around in the facilities using the Oracle Cerner EHR.
Reworking the EHR patient portal
A VA official with knowledge of the agency’s work, who spoke on the condition of anonymity because they were not authorized to publicly discuss the matter, told Nextgov/FCW that “in the facilities where EHRM rolled out, veterans with disabilities cannot access their own records because the patient portal is inaccessible to them.”
The patient portal accessibility issues, coupled with VA’s plan to restart deployments of the EHR system in mid-2026, come as the number of veterans with disabilities connected to their military service has increased. According to a November report from the U.S. Census Bureau, “about 30 percent of veterans had a service-connected disability in 2022, up from 15 percent in 2008.”
Overton said VA officials conveyed to him that they are building their own patient portal that can be integrated into the new EHR system to address those accessibility concerns.
In a November 2022 press release providing an update on the EHR system’s rollout, VA said the EHR modernization effort included the implementation of a new Oracle Cerner patient portal called My VA Health. The portal for the department's legacy health record system — known as the Veterans Health Information Systems and Technology Architecture, or VistA — is called My HealtheVet.
In a subsequent blog post, however, VA said “the new My HealtheVet on VA.gov will combine tools and health data from My HealtheVet and My VA Health (Oracle Cerner) into one unified patient portal.”
A VA spokesperson confirmed to Nextgov/FCW that the two portals are being combined and that the department “is building the digital experience Veterans will interact with.”
“That's never worked in the past. Anytime VA has gone through their DevOps team, now you're dealing with even greater challenges on integrations, deployments, updates,” said Overton. “So, you know, VA is basically now saying they're never going to use the patient portal that Oracle Cerner has been working on."
VA did not respond to questions about the accessibility concerns associated with the Oracle Cerner software being a motivating factor for the combined patient portal, but said that the effort aligns with the department’s 2017 digital modernization strategy.
“This includes bringing the tools and health data from VistA’s My HealtheVet and Oracle Health’s My VA Health portals together in one unified digital patient experience on VA.gov and VA Health & Benefits,” the spokesperson added. “The combined portal will make it easier for Veterans to access health and benefits features that are important to them, such as medical supply reordering, beneficiary travel claim submission, disability claims and profile and notification management.”
Pat Sheehan, the former chief of VA's Section 508 Program Office who retired in January 2024, told Nextgov/FCW that “veterans have been able to get into that and do a pretty good job” with using the current VistA patient portal.
He said, however, that his office identified a number of defects and issues in the process as VA transitioned to the new Oracle Cerner portal while he was with the department.
“In the four years that I was there, it went from one thing, to the next, to the next, to the next,” he said. “It's an HTML portal interface. How hard can that be?”
Oracle Cerner did not respond to a request for comment about accessibility issues related to their VA-provided patient portal.
Overton said his organization’s understanding is that the Veterans Health Administration will use the new combined portal as a solution to mitigate the accessibility challenges with the Oracle Cerner software’s patient portal.
Restructured work for disabled clinicians
Sheehan said that, from January 2020 through December 2021, the Section 508 Program Office looked at 43 EHR applications in the new Oracle Cerner system and none of them were compliant with the accessibility requirements.
“EHRM is just trying to cover up the fact that they know they have these defects,” he said, adding that “the last number that I had is that there were 12,108 defects — individual defects — in these applications.”
To mitigate the impact of the non-508 compliant software on medical facilities with the new Oracle Cerner EHR system, VA is also reportedly trying to identify personnel with disabilities and shift around their work duties.
The VA official with knowledge about the agency’s work said the department “intends to reach out to employees at facilities prior to implementation and ask what disabilities they have in order to find workarounds for them or find them other jobs not requiring access to medical records.”
Issues with the accessibility of the new EHR system, however, have already resulted in legal action.
Laurette Santos, a blind social worker at the VA medical center in White City, Oregon, filed a lawsuit with the U.S. District Court for the District of Columbia last June claiming that the Oracle Cerner EHR system is inaccessible to disabled clinicians and veterans. The new software was rolled out at the White City VA facility in June 2022.
In her lawsuit, Santos said the Oracle Cerner EHR system is not compatible with screen readers and other assistive devices that allow blind users to view information on their computers, despite VA’s contract with Oracle Cerner requiring that the new software be compatible with Section 508 requirements.
Santos subsequently filed a preliminary injunction against VA last September seeking to block new deployments of the Oracle Cerner EHR system until it is Section 508 compliant.
A VA spokesperson and a representative from the Federal Electronic Health Record Modernization Office both said they could not comment on 508 issues related to the EHR software due to “potential, pending or ongoing litigation.”
When asked if it was looking into the matter, VA’s Office of Inspector General also said it “does not confirm or deny any investigation, inspection, review or audit.”
OMB also did not respond to multiple requests for comment.
Congressional involvement
A spokesperson for the House Veterans’ Affairs Committee said the Section 508 Program Office depends on VA and Oracle Cerner to give them access to each user role within the new system to determine their compliance with Section 508, and that the audits conducted thus far have only focused on a handful of “user roles” within the system.
“As far as we’ve been told, there are no plans to do a full audit of all user roles and there has never been a complete audit despite compliance with Section 508 accessibility standards being a condition in the original contract,” they said. “In summary, this system was supposed to be Section 508 compliant when VA bought it. It never has been, and nobody has bothered to confirm whether it is or not.”
Rep. Mike Bost, R-Ill. — who chairs that House panel — is also looking into the EHR software’s accessibility and has been pressing VA to disclose how it is working to identify and address the usability gaps in the system.
In a Dec. 20 letter to former VA Secretary Denis McDonough that was shared with Nextgov/FCW, Bost asked the department to provide documents to his committee regarding the Oracle Cerner EHR system’s compliance with accessibility requirements. This included a request for a copy of the Section 508 roadmap for the new system and copies of the Section 508 Office's audits of “employee user roles and/or the veteran facing patient portal in the Oracle Cerner EHR.”
Although the letter asked that VA respond by Inauguration Day, the department did not provide the committee with any of the requested documents.
“Veterans and VA employees with visual or sensory impairments need to be considered at the very beginning when VA purchases an IT system, not treated like an inconvenience after the fact,” Bost told Nextgov/FCW in a statement. “No system is exempt from the law, and I’ll keep pushing VA to comply.”
With President Donald Trump transitioning back into the White House, it appears as though his administration will continue to move forward with the Oracle Cerner EHR system’s broader deployment.
Former Rep. Doug Collins, R-Ga., who was confirmed as VA’s new secretary on Tuesday, told lawmakers last month that he would look at the software’s rollout with fresh eyes but said “there's no reason in the world we cannot get this done.”