VA Electronic Health Record Modernization: Critical Actions Needed to Support Accelerated System Deployments
Kimball Bighorse
Alvin Marcelo
Here’s the best available breakdown (absolute and percentage) of how many VA facilities remain on VistA (legacy EHR) versus how many are live on the Oracle (Federal EHRM) system, based on the latest publicly available reports:
📊 Current VA EHR Deployment Status
📌 Total VA Health Facilities
- Veterans Health Administration (VHA) operates ~146 medical centers plus hundreds of associated clinics.
🟦 Legacy VistA (Business as Usual)
- After early Oracle EHRM rollout and pause, ~160 medical centers (94%) still have not yet transitioned from VistA to the new system as of early 2025.
- Absolute estimate: ~137–146 facilities still on VistA (if we approximate VA’s ~146 medical centers).
94% of 146 ≈ 137 facilities.
🟧 Oracle (Federal EHR / EHRM) Live Sites
- Oracle EHRM was deployed at 5 initial VA sites by April 2023.
- The Captain James A. Lovell Federal Health Care Center (North Chicago) was added in March 2024.
- That makes approximately 6 facilities live on Oracle EHR as of early 2025.
- Planned deployments for 2026: 13 additional sites (bringing total scheduled live sites to at least 19 by end of 2026, if those proceed).
📈 Percentages (Approximate)
| Category | Count (Estimated) | Percentage of VA Facilities |
|---|---|---|
| VistA still in use | ~137 | ~94% |
| Oracle EHRM live | ~6 | ~4% |
| Planned Oracle deployments (by end of 2026) | +13 | ~13% total by end of 2026 |
(Percentages relative to ~146 VA medical centers.)
🧾 Notes / Clarifications
- Oracle EHRM deployment was paused in 2023 after the first five sites due to user feedback, then restarted planning in late 2024.
- GAO and VA have not published a complete, up-to-date list showing exactly which facilities have gone live beyond those initial sites, so the exact live count may vary slightly.
- The schedule anticipates full deployment across VA by ~2031, meaning most facilities remain on VistA today.
🧠 Summary (as of 2025)
- ~94% of VA medical centers are still running VistA as their primary EHR.
- ~4% have transitioned to the Oracle Federal EHR so far.
- Additional EHRM rollouts are planned but not yet complete.
If you’d like, I can map this deployment status to costs — e.g., comparing average annual spend per facility for VistA vs. projected spend for fully modernized Oracle sites.
https://www.gao.gov/products/gao-26-108812 --
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Rob Kellock
Nancy Anthracite
Have you noticed that this subcommittee is usually made up of the newly elected? To me this is a sign that it is just giving lip service to oversight and seriously considering keeping VistA, which for the most part, is not even mentioned. I will say that from the VA side, In my opinion, Neal Evansis the real deal trying to make this work and improve things for users.
--
Nancy Anthracite
On Monday, December 15, 2025 7:19:19 PM EST 'Alvin Marcelo' via Hardhats wrote:
> According to ChatGPT:
>
> Here’s the *best available breakdown (absolute and percentage)* of how many
> VA facilities remain on *VistA (legacy EHR)* versus how many are *live on
> the Oracle (Federal EHRM) system*, based on the latest publicly available
> reports:
> ------------------------------
> 📊 Current VA EHR Deployment Status 📌 *Total VA Health Facilities*
>
> - Veterans Health Administration (VHA) operates *~146 medical centers*
> plus *hundreds of associated clinics*.
>
> ------------------------------
> 🟦 *Legacy VistA (Business as Usual)*
>
> - After early Oracle EHRM rollout and pause, *~160 medical centers*
> (94%) still *have not yet transitioned* from VistA to the new system *as
> of early 2025*.
> - *Absolute estimate:* ~*137–146* facilities still on VistA (if we
> approximate VA’s ~146 medical centers).
> *94% of 146 ≈ 137 facilities*.
>
> ------------------------------
> 🟧 *Oracle (Federal EHR / EHRM) Live Sites*
>
> - Oracle EHRM was deployed at *5 initial VA sites* by April 2023.
> - The *Captain James A. Lovell Federal Health Care Center* (North
> Chicago) was added in March 2024.
> - That makes approximately *6 facilities live on Oracle EHR* as of early
> 2025.
> - *Planned deployments for 2026:* *13 additional sites* (bringing total
> scheduled live sites to at least 19 by end of 2026, if those proceed).
>
> ------------------------------
> 📈 *Percentages (Approximate)*
> Category Count (Estimated) Percentage of VA Facilities
> *VistA still in use* ~137 ~94%
> *Oracle EHRM live* ~6 ~4%
> *Planned Oracle deployments (by end of 2026)* +13 ~13% total by end of 2026
>
> *(Percentages relative to ~146 VA medical centers.)*
> ------------------------------
> 🧾 Notes / Clarifications
>
> - *Oracle EHRM deployment was paused in 2023* after the first five sites
> due to user feedback, then restarted planning in late 2024.
> - GAO and VA have not published a complete, up-to-date list showing
> exactly which facilities have gone live beyond those initial sites,
> so the *exact
> live count may vary slightly*.
> - The schedule anticipates *full deployment across VA by ~2031*, meaning
> most facilities remain on VistA today.
>
> ------------------------------
> 🧠 Summary (as of 2025)
>
> - *~94% of VA medical centers are still running VistA* as their primary
> EHR.
> - *~4% have transitioned* to the Oracle Federal EHR so far.
> - Additional EHRM rollouts are planned but not yet complete.
>
> ------------------------------
>
> If you’d like, I can map this deployment status to costs — e.g., comparing
> average annual spend per facility for VistA vs. projected spend for fully
> modernized Oracle sites.
>
> Alvin B. Marcelo, MD https://orcid.org/0000-0001-6250-9169,
>
>
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>
> On Tue, Dec 16, 2025, 2:23 AM Kimball Bighorse <kim...@bighorse.net> wrote:
>
> > https://www.gao.gov/products/gao-26-108812
> >
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