Government Accountability Office in Washington (Photo: Public Domain)
According to a new report from the U.S. Government Accountability Office, the VA is preparing to relaunch its troubled electronic health record system, despite many of the management and technical issues that stalled earlier deployments remaining unresolved.
The VA launched its Electronic Health Record Modernization program in 2017 after three failed efforts over two decades to replace its aging VistA system. The program is designed to transition the department to a modern commercial platform shared with the Department of Defense, allowing medical records to follow service members as they transition into Veteran care. While the strategy promises better coordination and data sharing, its execution has faced delays, cost concerns, and widespread user frustration.
The first live deployment occurred in October 2020 at the Mann Grandstaff VA Medical Center in Spokane, Washington. Four additional sites followed in 2022 in Washington, Ohio, and Oregon. Clinicians and Veterans at those locations reported problems ranging from system outages to workflow disruptions that affected patient care. Those concerns led the VA to pause further deployments in 2023 while it worked to stabilize the system. One facility, the Captain James A. Lovell Federal Health Care Center in North Chicago, went live in March 2024 as part of continued testing.
In December 2024, the VA announced it would resume preparations for new installations, starting with four facilities in Michigan by mid 2026, followed by nine more sites later this year. The department plans to complete about 170 deployments across the country by 2031.
GAO has reviewed the program across five major reports and issued 18 total recommendations designed to improve cost estimating, scheduling, governance, user adoption, and testing. Of the recommendations, 12 were identified as priority actions because of their importance to future success. As of late 2025, only two recommendations had been fully implemented, leaving most critical issues still unaddressed.
Related Article: GAO forces VA to reevaluate Electronic Health Record Modernization program launch
One of the most serious gaps is the lack of an updated and independently validated cost estimate and schedule. A 2022 analysis put the total life cycle cost of the program at nearly $50 billion, but that figure does not account for the pause in deployments, the system reset, and other changes over the last two years. Congress directed the VA to submit updated cost and schedule information by September 2025, but auditors report that only a high-level timeline has been delivered.
GAO also found continuing problems with user satisfaction and change management. Many staff at early deployment sites reported difficulty using the system, and the VA has yet to complete an independent operational assessment to confirm that the technology performs as intended in clinical settings. Without that step, auditors warned that expanding the system could expose Veterans to unnecessary risks.
GAO concluded that the VA must complete its priority reforms before accelerating new deployments. With more than nine million Veterans relying on the department for care, the outcome of the modernization effort will have lasting effects on the VA health system.
Author: Rikki Almanza
Rikki is a Web Content Coordinator for the American Legion, Department of California. With a deep-rooted family connection to the military, Rikki is committed to using her skills and knowledge to provide valuable assistance and resources to servicemembers and veterans.
