With a little over 100 days to go until the Department of Veterans Affairs (VA) resumes deployments of the Federal Electronic Health Record (EHR), lawmakers are questioning whether the VA has a firm grasp on the Electronic Health Record Modernization (EHRM) program’s future expenses.
During a hearing on Monday afternoon held by the House VA Subcommittee on Technology Modernization, lawmakers and witnesses scrutinized the department’s new life cycle cost estimate for the program: $37.2 billion.
“I’m concerned that nobody actually knows what the bottom-line cost is,” said Rep. Nikki Budzinski, D-Ill., the ranking member of the subcommittee. “The American taxpayers and veterans deserve transparency.”
In 2019, the VA initially estimated that its life cycle cost for the EHRM program would total about $16.1 billion. This consisted of a contract award for $10 billion over 10 years, as well as $6.1 billion for expected costs for technology infrastructure readiness and program management support.
After ongoing delays, the VA requested an independent life cycle cost estimate on the program from the Institute for Defense Analysis in 2022, which totaled $49.8 billion. This included $32.7 billion for 13 years of implementation and $17.1 billion for 15 years of sustainment.
On Monday, Rep. Budzinski and Rep. Tom Barrett, R-Mich., chairman of the subcommittee, said that in September, VA Deputy Secretary Paul Lawrence informed the committee that VA now estimates the life cycle cost of the program at $37.2 billion.
“We cannot keep writing blank checks that risk taxpayer money and slows down, or worse, endangers delivery of veteran care,” Barrett said. “The clock is ticking down.”
Earlier this year, the Government Accountability Office (GAO) published a report calling on the VA to provide an updated life cycle cost estimate and schedule for the EHRM program.
Despite the VA providing an updated cost estimate to Congress, Carol Harris, a director of information technology and cybersecurity at GAO, told lawmakers on Monday that the VA has yet to provide that estimate to GAO.
“We have not received that estimate, so I would ask the department to provide that to us so we can review it,” Harris said. “The updated estimate is imperative to understanding the full magnitude of the VA’s investment.”
Dr. Neil Evans, the acting program executive director of the VA’s Electronic Health Record Modernization Integration Office, pledged to provide that estimate to the GAO.
“As soon as our office receives that, we will certainly do a deep scrub of that,” Harris told members of the subcommittee. “But I will say, the independent cost estimate that is out there is the total life cycle cost is roughly $49.8 billion, so roughly $50 billion. So, we’re going to go through the differences.”
Harris did note that the independent cost estimate is outdated, as it does not reflect the pause in the VA’s deployments.
The agency has spent over two and a half years in “reset” mode for its EHRM program. As part of that reset, the VA and contractor Oracle Health – formerly Oracle Cerner – paused all deployments in April 2023 to address user concerns.
Thus far, the VA has deployed the new EHR system to six out of the 164 VA medical centers.
The agency now plans to resume its deployments of the Federal EHR to 13 sites in fiscal year 2026, beginning in April with four Michigan facilities: Ann Arbor, Battle Creek, Detroit, and Saginaw. Later in 2026, it plans to deploy the system to nine additional medical facilities with sites located in Ohio, Kentucky, Indiana, and Alaska.
Beyond these 13 planned deployments, the VA has not released a schedule for the remaining 145 sites.
Notably, the funding package that reopened the federal government last month allocates $3.4 billion to the VA’s EHRM program. However, Congress is withholding 30% of the funding until July 1, 2026, pending the VA’s completion of a series of requirements.
Those requirements include delivering an updated life cycle cost estimate and providing a site-by-site deployment schedule, among other tasks.