1978 – 2016
The system clinicians built
In 2016, CPRS-VistA — VA's homegrown health IT system — was among the top-rated electronic health records in the world. It had been designed in-house and refined over decades by VA clinicians, for the purposes of patient care, education, research, and benefits — not billing or data monetization, as with most commercial EHRs. For over two decades, it was the digital backbone for improvements in safety and clinical outcomes known widely as the "VA quality revolution."
2017 – 2018
The no-bid contract
VA leaders decided to replace VistA with Cerner, a commercial vendor whose Millennium product was marketed primarily to improve medical billing.
At $10 billion, it was one of the largest no-bid contracts in civilian government history.
The decision was driven partly by Jared Kushner, amid a larger, well-documented push to privatize VA healthcare.
"[Former VA Secretary] Shulkin and I talked about this issue… he sent over his top five people on the EMRs… We said guys, we want a solution to some of the systems… in two weeks, come back to us, that's what we want to see. They came back in two weeks with something that made a lot of sense."
— Jared Kushner, leaked audioWhen VA clinicians and bioinformatics experts asked why, they were given three justifications:
Outsourcing VA's health IT would save money.why it's false ＋
In 2018, VA leaders testified before Congress that VistA modernization would cost "approximately $19 billion over 10 years" and that Cerner replacement would be "billions less." The report they cited — unpublished, but available by FOIA — says the opposite.
VistA couldn't be modernized.why it's false ＋
VistA runs on the same M technology that powers Epic, and has been hosted on modern cloud architecture since 2024. Clinician-built ambient dictation and AI chart summarization already run on CPRS today. Completing the job — including updates to the CPRS user interface — could be achieved for an order of magnitude less than the cost of the Oracle contract.
Cerner's product was necessary to link veterans' VA and military health records.why it's false ＋
Interoperability, as defined by the Office of the National Coordinator for Health IT, rests on standardized data exchange between different systems — not on every hospital buying the same vendor. VistA has achieved this for decades, via connections to more than 450 health information exchanges; national and DoD remote data patches for national VA and DoD records; and the Joint Legacy Viewer for Community Care.
Each of these claims is false. click a claim above to learn why
2020 – 2022
First rollouts, first harms
The Cerner system went live at five sites — Spokane, Walla Walla, White City, Roseburg, and Columbus. Within days, clinical staff in Spokane identified dozens of problems — including a safety risk they would spend years fighting: the "unknown queue." Orders that clinicians had correctly entered — referrals, medications, appointment requests — vanished into a destination no one was watching.
"the new EHR did not alert the provider but accepted the entry as successful and then routed the order to the unknown queue."
"A healthcare provider entered a follow-up psychiatric care order for a homeless patient identified as at risk for suicide. The new EHR sent the order to the unknown queue. The patient was not scheduled for follow-up care and later contacted the Veterans Crisis Line reporting a razor in hand and a plan to kill himself."
— VA Office of Inspector General, July 2022
The Inspector General also learned that Cerner had known about the unknown queue before VA's go-live: customers had flagged the problem on the company's user forum since 2014.
"This is dangerous, and they're going to inflict it on my fellow veterans."
— Monica McLaughlin, Navy veteran and nurse at Mann-Grandstaff VA, December 2021"My fear was that somebody was going to die."
— Heather Hill, psychotherapist, December 2021Over eight months at Spokane VA alone, over 11,000 orders disappeared into the unknown queue, causing harm to 149 veterans.
One of them was Charlie Bourg — a Vietnam-era patient and VA employee whose prostate cancer spread undetected for over a year while his urology referral sat in the "unknown queue."
Page 2 · The human cost"I've got two little 7-year-old granddaughters. I know I'm not living forever, but I would have liked to see them graduate from high school."
— Charlie Bourg, Army veteran · Chewelah, Washington
Read Charlie's story, and others like it, on the next page →2022
Rollouts are halted, numbers get counted, and Oracle takes the helm
VA clinicians rendered their verdict on Cerner in the KLAS national EHR survey:
Independent analysts projected the actual cost of EHR "modernization":
And Cerner was acquired by Oracle Corporation — a Silicon Valley database company with no previous healthcare business — for $28 billion.
Oracle promised to review and improve the product. Before long, it was washing its hands.
"Our findings show that nothing related to the EHR's functionality or performance had anything to do with the care this veteran received."
— Michael Egbert, Vice President of Corporate Communications, Oracle · September 2022
2023
"Flip the switch."
With rollouts on hold, the original five rollout sites continued grappling with hundreds of "major system failures": outages, degradations, over 1,909 hours of downtime — about 80 days in total.
"Our clinicians are exhausted, sometimes tearful, and frankly, distressed."
— Dr. Meredith Arensman, Chief of Staff, Columbus VA · House testimony, September 2023The majority were attributed to the vendor.
Meanwhile, the remainder of VA facilities — over 165 medical centers and 1,200 clinics — continued to run CPRS-VistA without issues. Oracle users also relied on CPRS every day, for read-only review of charts Oracle had failed to migrate to the new system. That year, over 600 of them petitioned VA to "flip the switch" from read-only to live, read-write VistA — and to finally pull the plug on the Cerner-Oracle contract.
They were ignored. But the switch still exists.
2024
One "success," on crutches
VA finally "successfully deployed" the Oracle system at the North Chicago Lovell Federal Health Care Center in March. Lovell was given every advantage. A fully integrated VA-DoD facility, more than half the staff were dually appointed in the military health system — which had just completed its Oracle migration. In addition to this head start, VA devoted "a tremendous amount of national support" to the Lovell rollout: shadowing visits to previous Oracle sites and additional staff redeployed from those sites to Lovell. VA researchers concluded that replicating this level of support at future sites was "unsustainable."
Three months later, the same researchers found Lovell's rollout limping along, taxpayer-funded crutches notwithstanding. EHR satisfaction was down by 12 points; twice as many clinicians reported high EHR-related stress; and confidence in the system's ability to keep patients safe had declined.
This "success" was later cited as evidence to proceed with new rollouts.
Meanwhile, a separate VA analysis — presented in September 2024 but never published — found persistent 30–40% drops in primary care volume across all six rollout sites.
Early 2025
The Oval Office, day one
On the first day of his administration, President Trump hosted Oracle founder Larry Ellison in the Oval Office and announced Oracle's lead role in the $500 billion Stargate AI data-center buildout.
Shortly thereafter, Sahil Lavingia — a software developer charged by DOGE with rooting out fraud, waste, and abuse at the VA — wrote a blog post.
"The world's first electronic health record system, VistA, was built by VA employees over 40 years ago. Maybe the government could in-source and open-source its software stack after all."
— Sahil Lavingia, "DOGE Days"He was fired the next day.
In January, the inspector general who had helped expose the failures in Spokane had been fired as well.
Shortly thereafter, new VA Secretary Doug Collins wrote — in the Detroit Free Press — that Oracle EHR rollouts were among the top priorities for the Veterans Health Administration.
Late 2025
Same warnings, new experts, new privacy concerns
GAO and the Washington Post reported that few improvements had been made to the product being deployed at VA — including to known safety risks. Their concerns were ignored.
Meanwhile, new concerns had emerged about patient data privacy: outside VA, Oracle Health was being sued over security breaches and monetization of identifiable patient data.
2026
Acceleration
Messaging about the virtues of the Oracle product — now rebranded the "Federal EHR" — has begun appearing in VA staff emails and on waiting-room video screens.
The White House has requested $4.25 billion for further Oracle deployments in Fiscal Year 2027 — enough to double VA's psychology staff for five years. The House ultimately appropriated $3.4 billion. The Senate has not passed the budget. Click here to take action to stop the handouts … or keep reading.
Meanwhile, Oracle rollouts have accelerated at VA medical centers — in Michigan, Indiana, Ohio.
Clinicians at those sites report the same issues documented at every Oracle site for six years:
No historic patient notes migrated from CPRS-VistA.
Work that used to take seconds — order entry, notewriting, scheduling — now takes minutes or more.
Dozens of staff have been pulled from clinical duties — including at other VAs — to babysit the Oracle EHR.
Morale is plummeting, moral injury is rampant, and clinicians are weighing early retirement.
Productivity has been ramped down, appointments cancelled, and patients pushed to Community Care.
Referrals appear to be disappearing into an unknown queue after successful entry by providers.
Rumors abound regarding serious patient harms.
"I now write out prescriptions to private pharmacies old-school, on paper, because I don't trust it."
— a VA physician, December 2025"The system should make us safer. We shouldn't have to figure out how to make the system safer."
— Gordon Winters, Army veteran and retired VA nurseWhen clinicians and healthcare leaders speak up, they are ignored or silenced. Some have been asked to sign non-disclosure agreements.
On August 19, 2026, VA raised Oracle's contract ceiling by another $17 billion, to nearly $27 billion, and extended it through 2031.
The contracting documents record: "no changes to the nature of the work."
— Contract modification, August 19, 2026
On October 24, 2026, VA plans to deploy the Oracle EHR at 3 new medical centers, including the Louis Stokes Medical Center in Cleveland.