Supporting VHA’s Transition to a New Electronic Health Record
Supporting VHA’s Transition to a New Electronic Health Record
Implementing decision-ready governance, operational alignment and adoption support to modernize care delivery
The Department of Veterans Affairs (VA) is modernizing its electronic health record (EHR) ecosystem by deploying the Federal EHR across VA medical facilities, replacing legacy platforms and strengthening interoperability with the Department of Defense (DoD) and external care partners. For Veterans, the goal is straightforward: better coordinated care, safer transitions and more reliable access to complete health information.
To help make that goal real at scale, the Veterans Health Administration (VHA), alongside the Electronic Health Record Modernization Integration Office (EHRM-IO), is building the awareness, skills and operational readiness required for facility leaders and frontline staff to successfully adopt new workflows and technology without disrupting patient care.
Within VHA, the Office of Clinical Informatics (OCI) and Client Portfolio Management Office (CPMO) connect modernization priorities to day-to-day operations. Together, they focus on standardizing workflows and tools, improving readiness across sites and ensuring issues are surfaced, assessed, routed and resolved in a way that protects patients and supports deployment momentum. Aptive supports CPMO and OCI’s Electronic Health Record Modernization (EHRM) efforts by strengthening the operating model, so the program delivers measurable value, not just a system change.
Challenge
Modernizing a national EHR across America’s largest integrated health care system
VA’s EHR modernization effort is among the most complex health IT transformations in government: moving from more than 130 instances of Veterans Health Information Systems and Technology Architecture (VistA)/Computerized Patient Record System (CPRS) to a shared, interoperable Federal EHR environment used across federal partners and connected to community care. The scale – across 1,380 sites of care across America’s largest integrated health care system – and the imperative to accelerate deployment timelines create a high-stakes environment where inconsistency can quickly translate into delays, rework and uneven user experiences.
Leadership identified several barriers to success: limited enterprise visibility into field issues, inconsistent decision pathways, variable readiness and workflow standardization across sites, and the need to resolve risks rapidly – especially those affecting patient safety and deployment readiness. Meeting these challenges required an approach that could coordinate across organizations, move quickly in two-week delivery cycles (called sprints in Scaled Agile Framework [SAFe]) and stay aligned as priorities and dependencies shifted.
Solutions
Operational models and decision frameworks supporting VHA-wide modernization
VHA engaged Aptive to support OCI and CPMO as they strengthened the foundations for Federal EHR readiness and deployment, focusing on scalable operations, transparent decision-making and adoption support that holds up in real clinical environments.
Operational Design and Program Enablement
Aptive helped mature repeatable operational processes that align resources, plans and staffing to modernization priorities. Using Organization for Standardization (ISO) and Capability Maturity Model Integration (CMMI)-informed practices, the team supported structured planning and rapid adjustment as constraints emerged, helping maintain consistency across a complex, multi-stakeholder program.
Tiered Governance and Decision Management
Aptive supported a tiered governance model that standardizes issue intake, triage, escalation and resolution. By clarifying thresholds and routing issues to the lowest appropriate level, the model improves enterprise visibility, reduces bottlenecks and helps leaders focus attention on risks that affect readiness and deployment outcomes.
Enterprise Issue and Risk Management
Aptive helped strengthen centralized tracking of risks and unresolved EHR issues using a structured, four-step framework. Standardized criteria and disciplined monitoring enable earlier identification of roadblocks, faster mitigation planning and coordinated response for systemic issues – especially those with patient safety implications.
Program and Tier 1 Operations Support
Aptive supported CPMO’s program management backbone by coordinating cross-cutting initiatives and Tier 1 SME engagement. This operational support helps sustain consistent solutioning, escalation management and project execution, improving baseline standardization and helping teams move complex work forward without losing alignment.
Analytics, Reporting and Decision Support
Aptive enabled decision-ready visibility through metrics, dashboards and reporting that illuminate workload, risk and progress. After-action reviews and enterprise assessments help identify root causes, track performance and inform continuous improvement – supporting leadership oversight with timely, usable insights.
Award-Winning Communications Practices
Aptive developed an award-winning strategic communications plan informed by the Federal EHR User Experience Survey, directly addressing communications fatigue and audience saturation. Applying Prosci change management practices and adapting SAFe principles, the team tailored messaging and resources to readiness needs, improving clarity and reinforcing adoption across diverse audiences.
Training and Adoption Strategies
Aptive supported targeted training and adoption strategies aligned to evolving governance and EHR workflows. Prosci-based change practices and agile-informed delivery helped shape role-based resources, strengthen readiness and promote sustained adoption, supporting site leaders and staff through practical, “use it tomorrow” guidance.
Agile Execution and Continuous Improvement
Modernization priorities shift as dependencies evolve. Aptive applied SAFe-informed practices to support incremental delivery, transparency and adaptability, helping teams sustain momentum, manage constraints and deliver workable solutions without waiting for perfect stability.
Governance, Policy and Stakeholder Integration
Aptive supported governance and executive coordination by helping connect issue tracking, action ownership and communication across OCI pillars, external partners and the field. This integration reinforces policy alignment and accountability – key to sustaining safe, standardized operations during modernization.
Results
Building a durable foundation for Federal EHR readiness and deployment
Aptive’s support helped VHA strengthen the operational “throughline” from field signal to enterprise decision to measurable action. The work contributed to more consistent readiness efforts across sites by improving workflow and process standardization, clarifying decision paths and strengthening the structures used to identify, prioritize and resolve issues.
With improved visibility into performance and risk – and a governance approach designed to resolve issues at the lowest appropriate level – leaders are better positioned to manage enterprise-wide readiness while protecting patient safety and reducing rework. In parallel, adoption-focused communications and training helped reduce fatigue, improve message clarity and reinforce practical readiness behaviors across stakeholder groups.
Together, these capabilities support what large-scale transformation demands: operational alignment, disciplined decision-making and continuous improvement that keeps delivery moving while maintaining the standards required in a clinical environment.