VA reported about $13.84 billion in total EHR modernization obligations through the second quarter of fiscal year 2025. In August 2026, the ceiling on the Oracle Health contract reportedly increased from nearly $10 billion to nearly $27 billion while a separate 2022 independent estimate placed the full lifecycle cost at $49.8 billion and VA still has not produced the updated estimate GAO requested. A contract ceiling is not money already spent, and the lifecycle estimate includes far more than payments to Oracle.
For more than 30 years, most Department of Veterans Affairs facilities have relied on the Veterans Health Information Systems and Technology Architecture—better known as VistA—to document and deliver care.
VistA became deeply embedded in VA medicine, but it is costly to maintain, varies across facilities, and does not optimally exchange information with the Department of Defense or the community providers who increasingly treat Veterans outside VA walls.
VA's answer is the Federal Electronic Health Record, a commercial system originally purchased from Cerner in 2018 and now operated by Oracle Health after Oracle acquired Cerner in 2022. The central promise is powerful: a service member's record should follow that person from military service into Veteran status, while clinicians across VA and the Department of Defense work from the same core platform.
The destination makes sense. The cost, safety record, usability problems, and length of the journey demand equal attention.
The agreement grew because the rollout proved harder than expected
The original 2018 Cerner agreement carried a ceiling of just under $10 billion. In August 2026, VA raised that ceiling to nearly $27 billion—an increase of almost $17 billion—according to a federal award notice reported by FedScoop and other federal technology publications.
Contract documents attributed the increase to unanticipated deployment complexity, extensive site-specific customization, and the work required to deploy and sustain the system under VA's accelerated schedule. The modification also added three optional one-year ordering periods, potentially extending the agreement through May 16, 2031.
That does not mean VA wrote Oracle a $27 billion check. A ceiling establishes the maximum value of orders that may be placed under the contract. Actual obligations occur through funded orders, and optional periods still must be exercised.
It does mean the original contract capacity was no longer enough. The modification documents said VA expected to use the remaining old ceiling by the first quarter of fiscal year 2027.
How much has VA spent so far?
The most current comprehensive figure published by the Government Accountability Office is not a September 2026 spending total. It reaches only through the second quarter of fiscal year 2025.
In its September 2026 testimony, GAO reported approximately $13.84 billion obligated across the EHR modernization program from fiscal year 2018 through that period. GAO broke the amount into:
- $5.85 billion for the EHR contract
- $3.35 billion for information-technology infrastructure
- $1.48 billion for program management
- $2.85 billion for Veterans Health Administration expenses
- $324 million for VA's Office of Information and Technology
Those figures show why the Oracle contract and the full modernization program must not be treated as interchangeable. VA must upgrade networks, hardware, facilities, interfaces, staffing, training, workflow support, and program operations in addition to buying and configuring the EHR itself.
How many more billions may be spent?
No responsible answer can give one exact number, because VA still has not published a current, independent lifecycle cost estimate.
The Institute for Defense Analyses estimated in 2022 that the complete lifecycle would cost $49.8 billion: $32.7 billion for 13 years of implementation and $17.1 billion for 15 years of sustainment after full deployment. GAO says that estimate is now outdated because it predates the lengthy deployment pause, changed schedule, additional improvements, and accelerated rollout.
If someone simply subtracts the $13.84 billion obligated through March 2025 from the old $49.8 billion estimate, the mathematical remainder is about $36 billion. But that is only a rough comparison between figures measured at different times—not an official forecast of remaining spending.
For the Oracle contract alone, the new ceiling adds room for nearly $17 billion beyond the old ceiling. Again, that is purchasing authority, not proof that every dollar will be ordered or paid.
As of August 2026, GAO said VA had not supplied the updated independent lifecycle cost estimate requested by congressional committees. VA had provided a notional schedule, but not the detailed documentation GAO needed to judge whether that schedule follows leading practices.
A rollout now scheduled to last until late 2031
The first VA facility went live in Spokane, Washington, in October 2020. Four more followed in 2022. After Veterans and clinicians reported safety, reliability, and usability problems, VA halted most new deployments in April 2023 and entered what it called a reset. A joint VA–Department of Defense facility in North Chicago went live in March 2024 during the pause.
Deployments resumed in 2026. VA's official schedule lists 17 VA medical centers as having gone live through August 22, 2026, with Anchorage and Cleveland scheduled for October 24. Twenty-six more medical centers are scheduled during 2027.
The department's target is to reach all 170 VA medical centers and their associated clinics by November 2031. That means the transition still has more than five years to run from the publication of this article—and a long sustainment period follows deployment.
Until the rollout is complete, the country effectively has a mixed VA environment. Some facilities use the Federal EHR; most are still on VistA; the Defense Department uses its version of the Oracle platform; and community-care and private providers maintain their own systems.
What has gone wrong?
The problems have not been limited to inconvenience. Federal watchdogs have documented issues involving patient safety, clinical workflow, prescriptions, scheduling, data quality, outages, incident response, training, and staff confidence.
Medication and allergy information
A 2024 VA Office of Inspector General report found that a software coding error caused inaccurate medication and allergy information to be transmitted from new-EHR sites to legacy-EHR sites. The inspector general also found known pharmacy usability problems, operational inefficiencies, workarounds, increased staffing needs, burnout, and decreased morale. VA subsequently closed the report's nine recommendations as implemented, but the episode demonstrates the danger of inaccurate information crossing the boundary between systems.
Scheduling and follow-up
The inspector general separately found that a scheduling error and inadequate mental-health follow-up at the VA Central Ohio Healthcare System contributed to a patient's disengagement from treatment, substance-use relapse, and death. A health record is not merely an archive. When appointment status, follow-up responsibility, or clinical alerts fail, a digital workflow problem can become a patient-care problem.
Outages and major performance incidents
In a September 2024 audit, the VA inspector general called for better real-time data sharing, clearer incident-response standards, enforceable performance metrics, more useful post-incident reports, stronger staff awareness of downtime procedures, and adequate backup systems.
User adoption, training, and unresolved change requests
GAO reported that VA users had expressed dissatisfaction and that the department had not adequately identified and resolved system issues. As of August 2026, VA had not fully implemented 14 of GAO's 18 recommendations across cost, schedule, change management, user satisfaction, trouble tickets, data quality, operational testing, and stakeholder involvement.
GAO also said VA had not yet conducted the independent operational assessment needed to validate that the system satisfies users in a real operating environment. Without that assessment, GAO warned of unnecessary risk from premature deployment.
VA and Oracle say the system is improving
The record is not one-sided. During the reset, VA reported improved uptime, fewer interruptions, higher Veteran trust scores at live sites, increasing staff satisfaction, and better performance during the joint North Chicago deployment.
After the 2026 rollout resumed, VA said it had made more than 13,000 improvements, that more than 29,000 clinicians and front-line employees were using the Federal EHR to serve more than 515,000 Veterans, and that the initial sites were meeting or exceeding pre-launch productivity measures. VA also reported no outages during the preceding 12 months in its August 2026 statement, as included in reporting on the contract increase.
Those are meaningful claims of progress. They do not erase the inspector general's findings or GAO's open recommendations. Both can be true: the system may be substantially better than it was during the troubled early launches, while major management, evidence, and oversight gaps remain.
What must improve before the nationwide rollout is complete?
The watchdog reports point to a practical checklist:
- Publish a current independent lifecycle cost estimate and a credible, detailed master schedule.
- Complete an independent operational assessment before acceleration outruns evidence.
- Measure the accuracy, accessibility, and clinical usefulness of migrated data.
- Resolve high-impact trouble tickets on time and show that recurring problems stay fixed.
- Improve role-specific training, local readiness, and clinician involvement in configuration decisions.
- Track user adoption and satisfaction against meaningful targets—not deployment dates alone.
- Strengthen outage response, real-time incident visibility, backup operations, and contractor accountability.
- Protect medication, allergy, referral, appointment, and follow-up information as it moves between systems.
The test of the Federal EHR is not whether software can be installed at 170 medical centers. The test is whether the right information appears for the right person, in the right context, at the moment care is delivered.
Where PBRx may help during the transition
PBRx.Vet is not a replacement for VistA, the Federal EHR, VA.gov, Oracle Health, or a clinician's official medical record. It cannot repair VA's software, complete the national rollout, or guarantee that every source contains accurate information.
Its intended role is different: provide a Veteran-controlled longitudinal layer across authorized information the Veteran can obtain—from VA, community care, private hospitals and specialists, laboratories, pharmacies, home-health devices, and supported wearables.
During a five-year transition, that distinction matters. A Veteran may receive primary care at a VistA facility, travel to a Federal EHR facility, see a community specialist whose note has not arrived, use a private emergency department, and track symptoms or measurements at home. No single institutional system automatically guarantees that every part of that history will be visible together.
PBRx.Vet is being designed to organize authorized records into a source-linked chronology, preserve where each fact came from, surface missing periods and conflicting entries, and prepare concise questions and reports for the Veteran to review with qualified professionals. It should identify uncertainty—not invent what is missing.
That is not competition with VA's modernization. It is a patient-side continuity function that may remain useful even after the Federal EHR reaches every VA facility, because Veterans will continue to receive care from providers and devices outside any one health system.
The Veteran cannot wait until 2031 for a complete story
A nationwide EHR transition of this scale was never going to be simple. VA must move beyond aging, locally varied technology. Veterans and clinicians deserve a safer, more interoperable system connecting military and VA care.
They also deserve an honest accounting of cost, schedule, safety, and performance. Nearly $13.84 billion had already been obligated by March 2025. The Oracle contract now has a ceiling approaching $27 billion. The best available lifecycle estimate approaches $50 billion and is already outdated. The rollout is scheduled to continue until November 2031.
While government modernizes the institutional record, Veterans still need a way to see their own history across every place care happened. The system may take years to finish. A Veteran's health story is already happening now.