The VA Must Fix Its Woefully Outdated Health Records System
Editor’s Note: This also appeared in The Hill.
When I was a primary care provider in the Department of Veterans Affairs health care system, it wasn’t my job to think about all 9.1 million veterans enrolled in VA care. My role was to sit one-on-one with individual veterans, listen to their health concerns and find the best and most comprehensive way to address their medical needs.
Too often, the bureaucracy involved with servicing such a broad population got in the way of providing the individualized care that each of our veterans deserves.
The VA health care system relies on a dated electronic health record system that has been patched with periodic updates over the years but never modernized. Though every veteran in the VA is enrolled under a common system, their records are siloed under the particular VA hospital to which they are assigned. This means that when a veteran moves into a different VA health care system, like a different hospital system, or seeks care from a hospital outside their network, their records do not travel along with them without substantial time consuming effort by staff.
In 2018, electronic health records company Cerner acquired a much-needed contract to modernize the health records, which was the first step toward bringing all VA patients onto a combined records sharing system. Oracle Health purchased Cerner in 2022. Though leaders say system upgrades have improved Oracle Health’s record system, today, only six of 170 VA medical centers and 1,193 outpatient sites have migrated to the new system, with 13 new sites set to come online in 2026.
In this time, Oracle Health also fulfilled a contract to provide a new electronic health record to the entire Department of Defense system. The Pentagon and VA system will be fully interoperable by 2031, when the system is expected to be deployed across VA. It will take half a decade before new and existing service members have a single medical record that travels with them from the beginning of their military service, through their transition and beyond.
Until the VA’s records modernization takes place, the additional layers of administrative tasks associated with navigating a clunky, overburdened system diminish the quality of patient interactions with the VA, and they create unwelcome burdens for overtaxed practitioners.
Whenever I saw a veteran patient who was new to our clinic but had a history inside the VA, it became an exercise in sincere frustration. While I worked to establish rapport and understand a patient’s current complications, I also had to log in to a separate computer system to sift through old scans of medical and prescription records in hopes that some bit of historical information might help me understand a new concern.
In some cases, details that could make the difference between vastly different diagnoses were difficult to find in the overwhelming amount of data across multiple platforms. At other times, I could not find the results of recent labs or procedures, which forced me to re-order labs or procedures patients had already completed. This not only adds an extra cost burden on the VA, but increases frustration among veterans looking for answers to their medical concerns.
Most importantly, any time I had to populate important details from old records into a new record system or fill out new prescription requests, it took time away from being present with my patient as they sought my help.
Because the current electronic health records system is not streamlined with the Defense Department’s medical recordkeeping system, it can also be difficult to understand whether a veteran patient might be at risk for some of the complex diagnoses that are commonly associated with our nearly two-decade Global War on Terror, including toxic exposures, traumatic brain injury, operator syndrome and post-traumatic stress disorder.
Standardized medical records would save veterans and physicians from replicating unnecessary recordkeeping and smooth the pathway to the important work of healing.
The importance of updating the VA’s dated record system with precision cannot be overstated. Through their selfless service, VA patients earned their right to expect a standardized and excellent level of care across every VA hospital and clinic. For practitioners, having a reliable system that is easy to access and navigate preserves time best spent helping a patient, ensuring that every veteran feels seen, understood and cared for inside the VA’s expansive network.
This also appeared in The Hill.