Original Broadcast Date: 04/19/2026

Presented by Abnormal AI

The Department of Veterans Affairs is moving forward with a major step in its electronic health record (EHR) modernization effort, as Deputy Secretary Paul Lawrence outlines during his interview. Four VA sites in Michigan—Detroit, Battle Creek, Ann Arbor, and Saginaw—are now live on the new system, marking an important moment in a long and complex rollout.

Lawrence explains that preparation for this launch begins well before the system goes live. Over the course of several months, staff participate in a structured training process that starts with computer-based instruction and progresses to hands-on experience. Employees work in test environments, referred to as “sandboxes,” and then move into learning labs where they interact with the system in more realistic scenarios. By the time the system officially launches, staff are already familiar with how it works and how it will affect their day-to-day responsibilities.

Support does not end at launch. Lawrence notes that teams provide “at the elbow” assistance, meaning experienced users are physically present to help clinicians and staff navigate the system in real time. This support continues intensively for about a month, with additional follow-up over the next several weeks. Early issues tend to be routine, such as login problems or equipment questions, rather than unexpected system failures.

A key difference in this rollout, according to Lawrence, is the emphasis on standardization. Rather than customizing the system for each location, the VA is implementing a consistent approach across sites. He explains that this helps ensure safety and reliability while reducing complications that can arise from excessive customization. Alongside this, leadership plays a central role. Lawrence highlights the importance of clear decision-making and coordination, supported by senior leaders who communicate the value of the effort.

Another major focus is engagement with staff. Lawrence describes visiting multiple sites to hear directly from employees, understand their concerns, and ensure the system reflects their workflows. This approach emphasizes doing the work “with” staff rather than “to” them, helping build confidence and understanding ahead of deployment.

The VA also works closely with its vendor to address past challenges. Lawrence notes that reliability improvements are a priority, including addressing concerns about system downtime. He says the system now meets performance expectations, which is critical for building trust among users. Ensuring the platform can handle complex medical procedures and workflows is another essential requirement.

The Michigan rollout is part of a broader strategy known as the “market approach.” By deploying the system across geographically connected facilities that often refer patients to one another, the VA ensures continuity of care within regional networks. Lawrence explains that this approach supports better coordination and consistency across sites that already function as a group.

Looking ahead, the VA plans to continue expanding the system. Lawrence outlines a schedule that includes additional sites in Ohio and Indiana, followed by further deployments in the coming years. The current plan calls for 13 sites to go live in 2026, 26 more in 2027, and between 28 and 30 sites annually after that until completion in 2031. He notes that there is growing interest from locations scheduled for later phases that may want to move up in the timeline.

Alongside the EHR rollout, Lawrence discusses progress in another key area: reducing the disability claims backlog. He explains that the backlog has decreased significantly, from 265,000 claims to approximately 83,000, while average processing times have also improved. He attributes this progress to focused management, clear metrics, and consistent attention to performance.

Lawrence emphasizes that the goal is to reach what he calls a “functional zero” backlog, where claims are processed as efficiently as possible given the need to gather records and complete necessary steps. He also highlights the importance of maintaining momentum, noting that the VA processed a record number of claims while improving efficiency.

Planning and preparation are recurring themes throughout the conversation. Lawrence points to lessons learned from past initiatives, stressing the importance of allowing time to set up systems, write rules, and ensure readiness before launching new programs. He explains that rushing implementation can lead to backlogs and undermine trust.

Beyond specific programs, Lawrence underscores the importance of keeping veterans at the center of all efforts. Whether it is deploying new technology, reducing backlogs, or improving access to benefits, the focus remains on delivering timely and effective services.

He also highlights the value of direct feedback from veterans and staff. Through town halls and site visits, leadership gathers insights that help identify areas for improvement, from access to services to overall user experience.

Lawrence presents a picture of steady progress built on preparation, consistency, and engagement. The VA continues to move forward with its modernization efforts while applying lessons learned to improve outcomes for both employees and the veterans they serve.