Trump’s VA pick voices support for continued EHR deployment

Former Rep. Doug Collins, R-Ga., told members of the Senate Veterans’ Affairs Committee on Tuesday that he was committed to looking at the Oracle Cerner software’s beleaguered deployment with fresh eyes and that “there's no reason in the world we cannot get this done.”

During Trump’s first term, VA contracted with Cerner — which was subsequently acquired by Oracle in 2022 — to modernize its legacy EHR system and make it interoperable with the Department of Defense’s new EHR system that is also from Oracle Cerner. 

VA first rolled out the new software in 2020 at the Mann-Grandstaff VA Medical Center in Spokane, Washington, but since then the EHR system’s implementation has been bogged down by technical issues, cost overruns and patient safety concerns. 

The department paused deployments of the EHR system in April 2023 to address the range of problems affecting the five facilities where the new software had been deployed, although the department and DOD subsequently worked to implement the system at the Captain James A. Lovell Federal Health Care Center in North Chicago, Illinois, last March.

The Biden administration announced in December that VA was “beginning early-stage planning” to deploy the new EHR system at four of its Michigan-based medical facilities in mid-2026, a move that would officially take the department out of its “reset” period.

Lawmakers from across the aisle have expressed numerous concerns about the new system’s troubled deployment, and both Democrats and Republicans used Tuesday’s confirmation hearing to press Collins about the software’s future. 

Collins echoed their concerns about the program, slamming its slow rollout and the ballooning cost of its deployment. But he said VA needs to adopt a new EHR system to better serve veterans and that he would work to quickly identify roadblocks to its broader deployment.

“We've got to get our health records straight so that we can have an easy hand off,” Collins said about servicemembers transitioning from active service to civilian life. “What should be a simple click of the button has many times taken … up to almost a year to get those records transferred. That leaves uncertainty for the veteran, that leaves uncertainty for the family, and makes a very unhealthy experience for those that are serving.”

He noted several times that “the VA is special, but it's not unique” when it comes to providing healthcare services and ensuring the success of its modernization efforts, and that deploying the system at a total of six facilities thus far “is not acceptable.”

Collins said that, under his leadership, the department would work with Oracle Cerner, clinicians and VA medical facilities to better identify the barriers to the system’s deployment. And he said he would task members of his staff “as soon as possible” with examining the issues affecting the system. 

Collins also questioned the Biden administration’s stated goal of resuming deployments in mid-2026, saying “I believe we can actually get it done quicker,” although he added that his goal is ultimately to “do it properly, not rushed.”

Lawmakers also raised concerns about funding needed to modernize many outdated VA facilities, with Sen. Jim Banks, R-Ind., noting that — beyond infrastructure upgrades — these medical sites are also “going to have to have major work just to hold the computer systems” to make the EHR rollout ultimately successful.

Collins said the department will have to take a more focused approach when it comes to acquisitions and construction projects so that modernization efforts do not have to go “through multiple layers” to successfully occur. 

Collins is a former four-term congressman who was first elected to the House in 2012. He challenged incumbent Sen. Kelly Loeffler, R-Ga., and Democrat Raphael Warnock in Georgia’s special election in 2020 to fill the remaining two-year term of former Republican Sen. John Isakson. Collins finished third in the state’s nonpartisan blanket primary and subsequently endorsed Loeffler in her unsuccessful runoff against Warnock.

Collins previously served as a chaplain in the armed forces, first as a Navy chaplain and then as a member of the Air Force Reserve following the September 11th terrorist attacks. A stalwart Trump supporter, Collins faces a favorable road to confirmation as secretary given GOP control of the Senate and the bipartisan nature of the VA. 

Beyond voicing support for the EHR system’s continued rollout once deployment issues have been addressed, Collins also expressed his openness to exploring artificial intelligence capabilities to support veterans’ benefits and care. 

Sen. Bill Cassidy, R-La., said he was concerned about the backlog of veterans applying for disability benefits and said that artificial intelligence could potentially process vast amounts of information to speed up the process — particularly after the PACT Act expanded access to benefits and health services for veterans exposed to burn pits and other chemicals.

He asked Collins his thoughts on comparing AI tools to decisions made by VA personnel and working to “figure out why it's different, and if the AI is not as good, we're going to continue to refine it until we can scale it and a veteran does not need to wait for his or her benefits.”

Collins said enhancing veteran care and services means “looking at AI, looking at other technology — not just from the benefit perspective, but also from the medical perspective as well.” He added that these modernization considerations could also extend to VA’s health record system.

“Why would I be satisfied for [sic] a system that is old and outdated or non-existent when my goal and my purpose in my mission is to take care of a veteran?” he said.

VA has been increasingly exploring the use of AI capabilities in recent years, with the department reporting 227 AI use cases to the Office of Management and Budget in 2024. VA said the majority of these use cases were safety- and rights-impacting.