The Challenge
In 2017, the VA launched the Electronic Health Record Modernization (EHRM) initiative to replace its decades-old VistA system — a program affecting 170 medical centers, 1,200 healthcare facilities, and 17.8 million veterans. The goal was to standardize workflows, improve interoperability with the Department of Defense, and enhance care coordination across the enterprise.
The rollout has been one of the most complex IT modernization efforts in federal history. By 2023, deployments were temporarily paused due to safety and performance concerns — with over 75% of users reporting increased documentation time, confusing interfaces, and misaligned workflows. Only 6% of medical centers had gone live at that point. Issues included latency, scheduling errors, and significant user experience failures.
The Solution
RHO has served as a key partner in supporting multiple workstreams across the EHRM program:
Infrastructure & Deployment Readiness
- Set up 10+ Oracle Health instances at local VA sites, including physical device setup, interface configuration, and connectivity management
- Tested and managed IP connectivity in collaboration with VA on-site technicians and Oracle Health
- Supported the planning and execution of go-live deployments across VA medical centers
Content & Compliance
- Set up 10+ Oracle Health instances at local VA sites, including physical device setup, interface configuration, and connectivity management
Content & Compliance
- Provided PMO support including governance, risk management, stakeholder engagement, and resource optimization across the enterprise-wide initiative
The Results
- 10+ Oracle Health instances deployed at VA sites
- Latency and performance issues significantly reduced compared to earlier deployments
- Improved user feedback and usability scores vs. prior site deployments
- Implementation timelines accelerated — increasing the pace of rollout toward the 2031 target of 170 medical centers