<\/p>\n
Donald Trump\u2019s son-in-law Jared Kushner facilitated a no-bid contract to use inferior Cerner health records software.<\/p>\n
Getty Images<\/p>\n
Some failures are dramatic and people die. Others smolder \u2014 just as consequential, just as deadly.<\/p>\n
This is the story of a smoldering failure: the ill-conceived effort to replace the U.S. Department of Veterans Affairs\u2019 world-class, publicly-owned electronic health record system with an inferior, private system from Kansas City\u2019s 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.<\/p>\n
As background, an electronic health record system or EHR is the humming brain of the modern health care system \u2014 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\u2019s custom-built EHR, VistA<\/a>, is one of the finest in the country<\/a>, 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.<\/p>\n It was not in need of replacement.<\/p>\n Jared Kushner, no-bid contract<\/p>\n The story of failure began in 2017, when Donald Trump\u2019s son-in-law, Jared Kushner, facilitated a no-bid contract negotiation<\/a> \u2014 a mechanism that invites corruption \u2014 to replace VistA with Cerner\u2019s private \u201coff-the-shelf\u201d EHR. The VA waived competitive bidding as a \u201cpublic interest exception\u201d because of \u201cthe urgency and critical nature\u201d of having the VA and the U.S. Department of Defense\u2019s Military Health System on the same Cerner EHR. The resulting $10 billion contract remains the largest non-defense no-bid contract in government history.<\/p>\n Eight years on, despite the \u201curgency\u201d invoked to justify the no-bid contract, the company now known as Oracle-Cerner has deployed the system at just 10 VA hospitals \u2014 6% of the total<\/a>. The other 94% continue to run VistA uneventfully. A three-year moratorium was triggered by bipartisan alarm over catastrophic patient harm and deaths<\/a>, systemwide outages and collapsing clinician morale and productivity in the VA\u2019s using the Oracle-Cerner EHR. In December 2025, the nonpartisan Government Accountability Office concluded that \u201cfuture deployments risk prolonging management challenges<\/a> \u2026 and users will likely not be positioned to achieve optimal usage.\u201d (That\u2019s bureaucratic-speak for flashing red lights.)<\/p>\n Cerner and its VA contract were acquired in 2022 by Oracle<\/a> \u2014 a company whose focus has shifted from the Cerner platform and from health care altogether. Some analysts suggested it might sell Oracle-Cerner outright<\/a>. Three of four Kansas City-area campuses have since been abandoned<\/a>, and more than 500 local workers were laid off<\/a> \u2014 despite Oracle\u2019s professed commitment to growing its community presence in the Kansas City area.<\/p>\n Staff quit, retired early over new EHR<\/p>\n Since the first deployment in 2022, VA frontline staff has shown unprecedented, near-unanimous dislike of the Oracle-Cerner EHR<\/a>. 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<\/a>: \u201cThe training is awful.\u201d \u201cEveryone gets error messages scheduling appointments.\u201d \u201cCerner will just blame you for being untrainable while they fudge the data.\u201d<\/p>\n Oracle has responded with aggressive, well-funded lobbying and artful misdirection. Vice President Ken Glueck frames the problems as simply growing pains \u2014 \u201ca complex technology modernization effort in search of a scandal\u201d<\/a> \u2014 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\u2019s \u201ccongressional opponents.\u201d<\/p>\n These claims are all false. VistA runs on the same database architecture as Epic, Oracle-Cerner\u2019s 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.<\/p>\n Following Oracle\u2019s lead, current VA Secretary Doug Collins and Deputy Secretary Paul Lawrence blame politics \u2014 specifically Joe Biden \u2014 for \u201cputting a successful rollout on the back burner,\u201d omitting that the initial rollouts and failures began under the first Trump administration.<\/p>\n