On Go-Live Morning, a Veteran is Waiting: What We’ve Learned Supporting One of the Most Complex EHR Transitions in U.S. Health Care

On Go-Live Morning, a Veteran is Waiting

 

What We’ve Learned Supporting One of the Most Complex EHR Transitions in U.S. Health Care

 

By Tami Corson
EHR Veteran Waiting Web

Picture a clinician at a VA facility on go-live morning. The new electronic health record system is live. The workflows are different. The dropdown that used to take two clicks now takes five or doesn’t exist at all. Patients are waiting. The clinician adapts, because that’s what clinicians do. But adaptation has a cost, and in healthcare, that cost is measured in time, attention and safety.

This is what large-scale health IT modernization is actually about. Not the deployment schedule. Not the configuration spreadsheet. The moment a real clinician, in a real clinic, has to make the system work for their patient.

At the Department of Veterans Affairs (VA), the stakes don’t get much higher. The transition from legacy VistA/CPRS systems to the Federal Electronic Health Record is a massive, enterprise-wide transformation that touches clinical practice, policy, operations, training and, most importantly, patient safety. The goal is clear: enable safer, more coordinated and more seamless care for Veterans across VA, the Department of Defense and community partners. Getting there takes more than deployment schedules and technical configuration. It takes structured decision-making, disciplined problem-solving and a genuine respect for and knowledge of how care is actually delivered at VA.

That nexus is where Aptive has had the privilege and honor of supporting VA for the past few years, working alongside leaders, clinicians, technologists and program teams to help turn complexity into clarity. Aptive does this work through Arrow ARC, its joint venture with Artemis ARC.

From Technological Change to Operational Reality

The Federal EHR delivers powerful new capabilities, seamless shared data environments and modern workflows. But modernization moves fast, often outpacing policy, standards or established practice. When that happens, organizations need a proven way to close the gap: aligning what the system can do with what safe, VA-compliant care requires.

Through our work supporting VA’s Tier 1 Solution and Decisions Project Management Team, Aptive helps executives, program offices and subject matter experts navigate these exact moments. Our role is usually not to prescribe answers, but to help VA teams frame options, assess impacts and execute resolution paths for complex, multidisciplinary issues that emerge during EHR transition, and these issues rarely sit neatly in one lane.

A single challenge might involve clinical workflow, informatics, policy interpretation, training needs and technical constraints, often cutting across multiple organizations and partners at once.

A single challenge might involve clinical workflow, informatics, policy interpretation, training needs and technical constraints, often cutting across multiple organizations and partners at once.

Where Solutions and Decisions Matter Most

Across VA’s modernization effort, several recurring focus areas shape how issues are addressed and resolved:

Policy alignment. When technology moves ahead of formal policy, teams need guidance that reflects what leaders and clinicians actually see in the EHR. This includes refining or developing policy to support new workflows, shared records across DoD and VA and tools such as PowerForms that can trigger downstream clinical or administrative actions.

Standardization with purpose. VA’s strength lies in its diversity of care settings. However, successful modernization requires a shared baseline. By standardizing essentials, like patient care and location names, and aligning key workflows for insulin pump management, telehealth and specimen collection, VA ensures Veterans receive consistent, high-quality care no matter where they are seen. The goal is not uniformity for its own sake, but reliable, high-quality care for every Veteran, everywhere.

Language and data clarity. Digital systems depend on precise language. New products often introduce unfamiliar terminology, while existing terms may vary by region or specialty. Whether addressing women’s health data elements or prosthetics product lists, getting consistent language supports safer ordering, clearer documentation and more reliable data.

Technology shaped by business rules. VA’s operational realities often require systems to be adapted. This includes mapping medication data flows into the EHR, enabling mass vaccination workflows and supporting point-of-care tools. When technology cannot flex far enough, targeted mitigation strategies become essential.

Safety by design. Every modernization decision eventually touches patient safety. Consider something as simple as a cluttered dropdown or a poorly sequenced alert. In a high-volume clinical environment, those friction points compound. In high-risk areas, Aptive partners with teams to apply human factors engineering, optimizing queue management, decluttering dropdowns, intelligently prioritizing alerts, and delivering clear supplemental guidance. These improvements create intuitive workflows aimed at empowering clinicians instead of overwhelming them, reducing cognitive burden, minimizing errors, and helping prevent adverse events so Veterans receive safer, high-quality care.

Training that mirrors reality. Proficiency does not happen in a classroom alone. As sites prepare for go-live, hands-on, scenario-based training, often including simulated learning for high-risk clinical situations, is essential. Aptive supports “train-the-trainer” approaches that help staff build confidence while delivering care.

Baseline development and refinement. Like any modern digital product, an EHR requires a maintained baseline broad enough to support diverse workflows, but not so expansive that it slows performance. Supporting national standards and solution profiles helps keep the system usable, relevant and scalable.

Go-live support and productivity mitigation. Go-live events are managed chaos no matter how well we prepare. Aptive partners with VA, delivering structured readiness guidance, on-site liaisons, productivity mitigation planning and surge strategies, especially critical for rural or highly specialized facilities navigating patient load alongside system transition.

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A Partnership Model that Respects the Mission

One of the most important lessons in large-scale federal EHR modernization is simple: the journey and the end result belong to VA and Veterans. No one understands VA’s mission, its patients and its unique operational realities better than VA clinicians, leaders and staff who work there every day.

Aptive’s role is to be a true strategic partner in that journey. We meet teams where they are, surface clear options, support informed decision-making and strengthen execution, always respecting VA’s leadership of its own EHR. Our combination of small-team agility and enterprise-scale capability enables us to build trust and deliver meaningful support during periods of uncertainty and rapid change.

As more sites go live and new clinical domains come online (such as transplant services), the demand for this adaptive, solution-oriented partnership continues to grow. Whether addressing urgent patient safety risks that require immediate action or managing a broader backlog of enhancements that demand disciplined prioritization and long-term planning, Aptive stands shoulder-to-shoulder with VA to drive successful outcomes.

Looking Ahead

VA’s Federal EHR modernization is not a single milestone. It is a continuous journey of learning, refinement and improvement, and at every step, the measure of success is the same one that matters on go-live morning: does this make it easier for a clinician to do right by a Veteran?

Strong governance matters. Clear decision pathways matter. Sustained collaboration across clinical, operational and technical communities matters. But they’re the means, not the end.

Aptive and our partners are proud to support VA in this work, helping translate enterprise priorities into practical solutions that function in hospitals, clinics and care settings across the country. By focusing on solutions and decisions grounded in policy, safety and real-world practice, we contribute to a modernization effort built around the person at the center of every project: the Veteran.

 

 

About the Author: Navy Veteran Tami Corson is a senior health program leader supporting the VA EHR Modernization initiative. With more than 20 years of experience across VA and DoD health systems, she leads multidisciplinary teams advancing Oracle Health EHR implementation and sustainment for the Veterans Health Administration. A trained nurse and an experienced program manager, Tami brings a strong clinical perspective to large-scale health IT transformation, patient safety and enterprise change.