VA Deputy Secretary recaps EHRM update during Michigan Milestone Week
Paul Lawrence speaks with Rick Ivnik, host of the Federal EHR Update
Deputy Secretary Paul Lawrence, Ph.D., joined Rick Ivnik, EHRM strategic planner, on the April 14 edition of the Federal Electronic Health Record (EHR) Update to discuss the April 11 deployment of the Federal EHR at Ann Arbor, Battle Creek, Detroit, and Saginaw, Mich.
Lawrence, who visited all 13 facilities scheduled to deploy the Federal EHR in 2026 to meet with Veterans, staff and site leadership, shared his experiences during these engagements and what he learned about what’s working and where adjustments were needed. He also gave an update on the Michigan deployments and outlined his vision for continuous improvements to benefit future sites.
The following has been edited and condensed from the full interview.
Q: As we prepared for the go-lives, what were some of the main areas of focus around people and processes, and why is it different this time?
First, I have to give a shout-out to everybody in Michigan and those who helped support them. We talked to the Ohio Change Leadership Team this week leading up to go-live, and it is great to see them pay it forward. Everybody was there to support, and it was great to feel the energy. High fives to all for great teamwork!
As for what was different, we listened to what Secretary Doug Collins said about the need for standardization and communicated the value that we get when we make that happen. The other thing was [that] I really listened to our folks, including our Veterans in town halls. Their questions guided our training and communications to both them and staff.
Q: What are the major improvements we’ve made to prepare for the success that we’re seeing in Michigan and that will support us beyond Michigan?
I would say two major areas played a part: the collaboration between EHRM-IO, the local teams and Oracle Health, and the better understanding of the software and workflows. Many of the changes were driven by the local folks who were telling us what support they needed from us. They might need shorter meetings, more advance notice or fewer meetings. That was the feedback, and it was pretty clear.
Q: You’ve been on the road a lot visiting the sites, preparing for deployment. What kind of interactions are you having with Veterans and staff? What feedback are you hearing?
With the staff, it was a lot about how we work together, especially how we use their time wisely. For example, if I am a provider and giving up time that I could be serving my patients, be mindful of that tradeoff and use it wisely. They also want to see specifics on how their job changes. As we do more rollouts, we will have a better understanding of the specifics of how jobs change and will be better at communicating that.
Q. You and Secretary Collins spent time in Michigan right before go-live, and you were there on go-live day, April 11. What did you see on the ground, and what were your key takeaways? I’ve got to imagine that was a nervous time for those sites.
It wasn’t as nervous as you’d imagine. There was a lot of high energy, and everybody was like, “We’re all ready. We’re ready to go. Let’s do this!” Oracle Health and VHA were there. It had that celebratory launch atmosphere.
There was a lot of confidence at Detroit—not based on arrogance, but instead confidence based on doing the work. It was very reassuring, and I saw that later when I went to Ann Arbor, then Saginaw, and again in Battle Creek. And then when we talked to people who were sitting there with it live on their screen, it was like, “Wow, this is pretty neat!” It was a really good feeling!
Q: We have only been live for four days—effectively two business days. Have we seen any major issues?
It’s going really good! We’re hearing and seeing the kind of things we expected. “I can’t get my printer to work,” or “I can’t access the system.” Well, we have a process to deal with that, and some people missed the training and sign-on fairs. We took care of it.
There is nothing unusual. We are seeing more patients as the week goes on, and it will continue to grow. There is a lot of support between EHRM-IO, Oracle Health, super users, bridge calls, events and so on. We are dealing with any issues right away. And while they are important, they are not big or show-stopping.
Q: How are we taking what we’ve learned in Michigan into the next deployments in Ohio and beyond?
In the immediate time frame, I think it’s more training aids, more reminders and enhancements in the training. But as we get more of these facilities online, we need to focus on fixing the items that we know are going to happen and focus on making them not happen. For example, we saw they were having a problem with the printers. How can we get the printers ready for next time? We should really challenge ourselves to make sure that we are creating fixes for the problems that arise, so the next in line does not have to deal with the same issue that a previous site did when they went live. The bar is going to be raised continuously. We don’t want the same issues to be experienced again and again.
Q: One thing I’ve heard is that there is a real appreciation for current live sites that have allowed their end users to pay it forward and participate in support activities. They have been invaluable to help train the new sites.
I think you make a good point about those that are paying it forward. I saw the super users and their identifying badges, but then I saw all these white lanyards. I found out they were all from Columbus (Pay-It-Forward teams also include staff from the existing live sites, the program offices, Tier 1 support, the Federal Electronic Health Record Modernization office, and the Department of War.). That’s exciting to see! It’s exciting to see how Ohio will play out with folks coming from Michigan.
This is the result of a lot of hard work. Sure, there are some hiccups, but so far everyone is feeling good. We haven’t let our foot off the gas. We’re still watching. We are still 24/7. We are going to learn from this. We’re going to apply that to Ohio. We’re going to learn from Ohio and apply it to Indiana. We are going to apply it to Anchorage and Cleveland, and we’re just going to keep going.
It is happening like we imagined. And at the end of the day, think about what Secretary Collins says: It’s all about the Veterans. Veterans are the center of everything.
This is going to enable many new and exciting things in health care.
For more information and resources, visit the EHRM website.