Electronic health record

The Department of Veterans Affairs has added nearly $17 billion and three option years to its contract with Oracle Health, extending the deal for a troubled electronic health record system through May 2031 with a maximum payout of almost $27 billion. The original contract, a 10-year, $10 billion sole-source award, went to Cerner (acquired by Oracle in 2022) under the first Trump administration in 2018.

The system was first tested at Spokane's Mann-Grandstaff VA Medical Center in 2020, where implementation problems contributed to thousands of patient-harm incidents, including ten cases the VA classified as catastrophic. After further rollouts and reporting on the harm, the Biden administration paused expansion, with limited exceptions. VA Secretary Doug Collins has since accelerated deployment under the second Trump administration, launching the system at hospitals in Michigan, Ohio, and Kentucky in 2025. The VA has not released an official estimate of the project's total taxpayer cost, which includes added infrastructure and outside care for veterans affected by reduced clinic efficiency.