VA plans to restart EHR deployments before the end of FY25, secretary says

The Department of Veterans Affairs expects to resume deployments of its new electronic health record system before the end of fiscal year 2025, VA Secretary Denis McDonough told lawmakers on Thursday.

During a House Veterans’ Affairs Committee committee hearing on the department’s budget requests for FY25 and FY26, McDonough said VA is “committed” to ensuring that deployments of its modernized EHR system resume once it has addressed issues at the medical facilities currently using the new software.

VA’s Oracle Cerner EHR system — which is designed to be interoperable with a similar system recently rolled out by the Department of Defense — has been plagued with technical issues, patient safety incidents and cost overruns since it was first deployed in 2020 at the Mann-Grandstaff VA Medical Center in Spokane, Washington.

After rolling out the system at just five medical facilities, VA announced in April 2023 that it was implementing a “program reset” to address issues at facilities using the new software. The reset included a pause on future rollouts of that software, with the exception of a joint VA-DOD deployment at the Captain James A. Lovell Federal Health Care Center in North Chicago, Illinois, that occurred in March. 

Sen. Patty Murray, D-Wash., the chair of the Senate Appropriations Committee and a home state senator for two of the Cerner sites  — sent a letter to McDonough on April 9 calling for the department “to incorporate provider and veteran feedback as it continues to assess the system” during its program reset. She noted feedback she has received from providers continues to highlight workflow issues and gaps in clinician training and support.

McDonough defended the continued push to implement a modernized EHR system across VA medical facilities during his testimony, saying “we need a single health record across the VA system and we need one that talks more effectively to DOD.” And he signaled that the department was making progress on addressing issues identified in the ongoing reset phase. 

“As we approach the end of the year, I anticipate us being in discussions to get out of reset,” McDonough said. When asked if VA plans to maintain the program reset for all of FY25, McDonough said “we do not.”

The White House’s FY25 budget request for VA, however, does not include any funding for the agency to resume new deployments of the software and represents a significant decrease in money slated to support the EHR modernization efforts. 

The Biden administration’s proposed FY25 budget for VA, which was released last month, would allocate over $369 billion to the department but only $894 million toward the EHR modernization project. The belated FY24 budget for VA, which President Joe Biden signed into law on March 9, included more than $1.3 billion for the department to continue deploying the new EHR system, but made 25% of that total contingent on McDonough submitting requested information on the software’s rollout to the House and Senate Veterans’ Affairs committees. 

In written testimony submitted to the House committee ahead of Thursday’s hearing, McDonough said the department’s proposed FY25 budget for the EHR program “supports the reset and sustainment/maintenance of the six sites” where the system has been deployed. It notably does not include any additional funding for assessing or deploying the new system at additional VA medical facilities. 

“The dramatic budget cut in this program leaves me concerned that there are no real plans to move from reset to implementation,” said Rep. Sheila Cherfilus-McCormick, D-Fla.

McDonough said, however, that the department has carryover funding that is available for it to resume deployments of the EHR system once the reset period concludes. 

“We have existing money that would not be accounted for — prior year appropriated money — not accounted for in this year's request that is slated and available for us when we exit reset,” he said.