The VA’s tech mess began in Kansas City. Here’s how to fix it for veterans | Opinion

Some failures are dramatic and people die. Others smolder — just as consequential, just as deadly.

This is the story of a smoldering failure: the ill-conceived effort to replace the U.S. Department of Veterans Affairs’ world-class, publicly-owned electronic health record system with an inferior, private system from Kansas City’s Cerner Corporation. It is a failure that has harmed patients, demoralized staff and weakened the care of American veterans. It is also one of the most costly missteps in the history of federal contracting.

As background, an electronic health record system or EHR is the humming brain of the modern health care system — the essential link for all clinical activity. If it malfunctions, processes degrade or grind to a halt: patient histories, scheduling, order entry, lab and X-ray results, alerts, prescriptions, clinical notes, decision support, patient portals and much more. The VA’s custom-built EHR, VistA, is one of the finest in the country, refined over decades by clinician-coder teams to support clinical care, not maximize revenue. Serving 10 million veterans across nearly 1,400 hospitals and clinics, it has been adopted worldwide at a fraction of the cost of proprietary alternatives.

It was not in need of replacement.

Jared Kushner, no-bid contract

The story of failure began in 2017, when Donald Trump’s son-in-law, Jared Kushner, facilitated a no-bid contract negotiation — a mechanism that invites corruption — to replace VistA with Cerner’s private “off-the-shelf” EHR. The VA waived competitive bidding as a “public interest exception” because of “the urgency and critical nature” of having the VA and the U.S. Department of Defense’s Military Health System on the same Cerner EHR. The resulting $10 billion contract remains the largest non-defense no-bid contract in government history.

Eight years on, despite the “urgency” invoked to justify the no-bid contract, the company now known as Oracle-Cerner has deployed the system at just 10 VA hospitals — 6% of the total. The other 94% continue to run VistA uneventfully. A three-year moratorium was triggered by bipartisan alarm over catastrophic patient harm and deaths, systemwide outages and collapsing clinician morale and productivity in the VA’s using the Oracle-Cerner EHR. In December 2025, the nonpartisan Government Accountability Office concluded that “future deployments risk prolonging management challenges … and users will likely not be positioned to achieve optimal usage.” (That’s bureaucratic-speak for flashing red lights.)

Cerner and its VA contract were acquired in 2022 by Oracle — a company whose focus has shifted from the Cerner platform and from health care altogether. Some analysts suggested it might sell Oracle-Cerner outright. Three of four Kansas City-area campuses have since been abandoned, and more than 500 local workers were laid off — despite Oracle’s professed commitment to growing its community presence in the Kansas City area.

Staff quit, retired early over new EHR

Since the first deployment in 2022, VA frontline staff has shown unprecedented, near-unanimous dislike of the Oracle-Cerner EHR. At rollout sites, huge numbers have quit or retired early, including many who initially welcomed the transition until they experienced it firsthand. Their concerns fill congressional hearings, Office of Inspector General and GAO reports, news investigations, professional journals and user forums. In Michigan, where deployments restarted in April amid sweeping Oracle layoffs, end-user feedback is blunt: “The training is awful.” “Everyone gets error messages scheduling appointments.” “Cerner will just blame you for being untrainable while they fudge the data.”

Oracle has responded with aggressive, well-funded lobbying and artful misdirection. Vice President Ken Glueck frames the problems as simply growing pains — “a complex technology modernization effort in search of a scandal” — while dismissing VistA as a relic incapable of artificial intelligence, cloud infrastructure or interoperability. He minimizes hundreds of documented patient harms as ginned-up fodder for the real problem: Oracle’s “congressional opponents.”

These claims are all false. VistA runs on the same database architecture as Epic, Oracle-Cerner’s far larger rival. In 2024, VistA migrated to the VA Enterprise Cloud, where VA developers are developing homegrown AI applications. VistA is a pioneer in adopting global interoperability standards and health information sharing. The harm to patients has been irrefutable.

Following Oracle’s lead, current VA Secretary Brooke Rollins and Deputy Secretary Paul Lawrence blame politics — specifically Joe Biden — for “putting a successful rollout on the back burner,” omitting that the initial rollouts and failures began under the first Trump administration.

The failure is fiscal, too — and staggering. Upgrading VistA would cost a fraction of the Oracle-Cerner contract — and as a public asset, reclaiming it would eliminate the murky layers of private-sector accountability and align the system with the public interest, not a vendor’s bottom line. Cost estimates for the Oracle-Cerner installation have ballooned to $32 billion or more.

Great health care for veterans

There is a clear road forward. American veterans deserve — have earned — great health care, guided by the VA’s mission: “to care for those who have borne the battle.”

Wind down Oracle-Cerner. Stop throwing good money after bad. Returning to VistA systemwide would increase functionality, safety and performance — and provide enormous relief to clinicians and taxpayers.

Reinvest in VistA. Restore funding for VA bioinformatics. Engage end users and VistA colleagues worldwide. Leverage AI — as VA teams are already doing — to accelerate development.

Make it ground-up. VA leadership must stop defending flawed technology and become true advocates for frontline workers and patients. Frontline feedback, with ironclad whistleblower protections, must drive the mission.

Pay attention. The most reliable intelligence doesn’t come from executive conference rooms — it comes from VA clinicians and information technology specialists who know the situation firsthand. Be wary of corporate spin and blame deflected onto “incompetent workers.”

This is fixable.

VistA is equipped for transformative innovation and is already covering for the failing Oracle-Cerner EHR. Countless skilled VA engineers, developers and clinicians are ready to support that transformation — motivated not by quarterly earnings, but by the mission. They know what it means to care for those who have borne the battle. They know VistA is the right tool: safe, battle-tested, designed for veterans and ready to be reclaimed.

Ace Allen is a retired medical oncologist. He lives in Overland Park.