The $10 Billion Record System That Reached Six Sites
In May 2018 the VA signed a 10-year, $10 billion sole-source contract with Cerner (now Oracle Health) to replace its ancient, beloved in-house record system. It was the VA's fourth attempt at the job — three efforts had already failed between 2001 and 2018. Seven years on: the VA's own program estimate had been $16 billion, an independent estimate put the lifecycle cost at $49.8 billion, and as of December 2024 the new record was live at six locations, with over 160 to go.
The cost curve
The arithmetic tells the story by itself. Contract: $10 billion. The VA's own initial program estimate: $16 billion. The Institute for Defense Analyses' 2022 independent estimate: $49.8 billion — $32.7 billion for 13 years of implementation plus $17.1 billion for 15 years of sustainment. The current contract concludes in May 2028 — and the VA concedes not all medical centers will have the new system by then.
The pause
Deployments were paused in 2023 for a "program reset" over user concerns and patient-safety issues. By February 2025, 1,800 configuration change requests remained unaddressed, and in a September 2024 survey, 75% of users disagreed that the system made them as efficient as possible. The people who document veterans' care for a living were telling the VA, in numbers, that the tool fights them.
The safety record
At the first go-live site — Mann-Grandstaff VA Medical Center in Spokane — the OIG found data-migration errors that produced inaccurate medication lists, a system that erroneously discontinued medications, and workflows that let registered nurses enter orders without provider authorization. The OIG identified no associated patient deaths, and this page says so plainly. Its warning stands on its own: "deployment of the new EHR without resolution of deficiencies may present risks to patient safety."
A medical record is not office software. It is the document a dying veteran's next doctor reads at 3 a.m. The VA is spending toward fifty billion dollars on one that, seven years in, covers six sites and carries an inspector general's patient-safety warning.
Sources: Congressional timeline of VA/DOD health record systems (House Appropriations) · GAO High-Risk Series GAO-25-107743 · GAO EHRM report (March 2025, via MeriTalk reporting) · VA OIG report 21-00656-110 (Mann-Grandstaff medication management). Part of the VA Fraud record.