More questions for Oracle as VA doctors and dentists question EHR rollout safety, demand a pause; Oracle’s $20B AI building raise

November 5, 2026 | by | No Comments

A surprise development not making the VA nor Oracle happy–and another monkey wrench for the committees. The National Association of Veteran Affairs Physicians and Dentists (NAVAPD), a national VA association that represents VA’s 20,000 doctors and dentists, sent a letter in mid-October to chairs and ranking members of the House and the Senate Veterans’ Affairs, Appropriations, Oversight and Government Reform and Homeland Security and Governmental Affairs panels. It recommends that the Oracle Health EHR rollout be paused until “critical concerns about patient safety, system performance, cost, and long-term feasibility are independently evaluated”.  In addition, they cite concerns involving clinical workflow disruptions, delayed referrals, patient safety incidents, and rising program costs.

The letter, disclosed on 29 October, specifies that actions be taken by the committees before deployments continue:

  • Pause further deployments: Suspend additional Oracle EHR implementations while continuing to fund patient care, system maintenance, and the correction of safety problems at existing sites.
  • Require an independent safety assessment: Evaluate patient safety and operational readiness at facilities already using the system, with meaningful input from frontline physicians, dentists, and nurses.
  • Strengthen transparency and accountability: Require regular reporting of patient safety incidents associated with the system.
  • Evaluate alternatives: Conduct an independent comparison of the costs, risks, and feasibility of continuing the Oracle program versus modernizing the VA’s existing Veterans Health Information Systems and Technology Architecture (VistA), including the potential use of AI-assisted software development tools.
  • Increase financial oversight: Require additional documentation and justification of proposed contract cost increases.

Surprisingly, the full text letter states that that the venerable VistA EHR still runs at all of VA’s 170 medical centers—including the sites transitioned over to the Oracle EHR. VistA is still used for longitudinal chart review. The letter also states that VistA is “currently best suited to meet our institutional mission.” which is not exactly a ringing endorsement of change. The dislike of a new EHR runs deep in this group but the workflow flaws are still many in the Oracle system. Another small surprise in the letter is this statement: “One recent analysis, which incorporates AI coding capabilities, estimates that modernization and maintenance of VistA would cost $1–2 billion over the next decade.” This is a group very much advocating continuing to use VistA with bolt-on, AI build/assisted software.

Even without this, it is already leading to a situation where VA clinicians use two EHRs for different purposes that don’t speak to each other.  Which wasn’t the intent.

A response was requested by 23 October. That was not disclosed.

The NAVAPD summary and full text letter to the committees. NextGov  Hat tip to our anonymous ‘eye on VA’.

So where is VA and Oracle now? The Oracle system has been rolled out to only 19 of 170 medical centers and associated clinics. The 2026 portion has ended with go-lives 24 October in the Alaska VA Healthcare System and the Louis Stokes Cleveland VA Medical Center. The Cerner, then Oracle rollout started disastrously in 2022. VA has also requested a $17 billion increase in budget for Oracle’s EHR development, from the original $10 billion, to cover both current costs and the three-year extension to May 2031 in the 2027 Military Construction, Veterans Affairs, and Related Agencies Appropriations Act. Both Mike Sicilia and the mighty Larry Ellison have been subpoenaed and have agreed to appear before both House and Senate committees on 19 November and 10 December, respectively. TTA 17 Sept

Oracle raised $20 billion for its AI data center plans in the past two weeks. In its new role as Data Center Builder and Landlord, Oracle’s raise consisted of “concurrent offerings of US$10b in common stock and US$10b in senior notes to fund heavy AI and cloud infrastructure spending. This included multiple tranches of fixed rate, senior, unsecured bonds with coupons between 7% and 8.65% and a US$10b equity sale at US$116 per share.” The further analysis in Yahoo Finance from Simply Wall St isn’t simple but comes down hard on the risk that Oracle is taking on the buildouts, “You have to believe its huge AI and cloud buildout converts a US$638b backlog and multicloud database momentum into durable, cash generative usage.”  Most of Oracle’s contracts are with OpenAI. Meaning that if AI demand trails off, or (as Ed Zitron has opined) if OpenAI goes bust, Oracle is in trouble plenty [TTA 19 Aug].

Rounding up the funding and M&A action of early Q4–plus CVS’ split, Anthropic’s IPO

November 5, 2026 | by | No Comments

Your Editor has returned after a fair amount of travel away from the desk. She was also sidelined to attend to some health issues, including a nasty cold that hasn’t quite taken its claws out of her head and lungs yet, and some technical difficulties on our publishing site.

The big news today is CVS’ split that undoes their ‘big bang’ of 2018. Unusually, there’s a lot of early Q4 investment at the Series A level and a bit of M&A action. In AI World, Anthropic finally filed for their IPO while OpenAI is asking for more bridge money. Here’s our selective roundup:

  • Today’s bombshell was that CVS is splitting its lines of business into two publicly traded companies by H1 2028. Aetna and Caremark, the CVS pharmacy benefit manager (PBM), Oak Street Health, home health firm Signify Health and CVS’ specialty drug business will be in one company as CVS Health, and their roughly 9,000 retail stores and pharmacies, plus the mail order pharmacy, walk-in clinics and Health100 technology services. will constitute CVS Pharmacy. According to CNBC, CVS Health will be run by current CEO David Joyner, while CVS Pharmacy will be led by Prem Shah, group president of CVS Health. The company’s market value is about $117 billion. Current shareholders will receive shares in both companies. Healthcare Dive
    • Both companies have done well in recent quarters. The Merlo/Bertolini vision of an integrated healthcare giant lasted exactly ten years. 
  • In late October, Vera Health raised $28.5 million in Series A funding to expand its evidence-based AI clinical search platform. It’s a word-of-mouth story, as it’s accumulated a claimed 800,000 clinicians using it worldwide from a few thousand a year ago. It’s now used across 190 countries, including approximately 1 in 4 physicians in Spain and Italy and 1 in 7 in France. Vera managed to do this with just 12 employees. The Series A was led by Threshold Ventures, with participation from Mantis VC and SV Angel. Existing investors Y Combinator and Gradient tripled down, bringing the company’s total funding to $32 million. Website/release, HIStalk, PYMNTS.com
  • Tegria acquired CloudWave for an undisclosed amount. Tegria is a global healthcare consulting and IT services company that partners with provider and payer organizations. CloudWave is a full-service cybersecurity and cloud services provider for community hospitals and health systems. Release
  • Administrative automation platform ClarityCare raised $16.5 million in a Series A funding, led by global venture capital firm Headline. New investors were Arthur Ventures and FJ Labs and existing investors were Maverick, firstminute, Top Harvest Capital, and Transpose Platform for a total funding of $20 million. According to their very flashy website, they run AI agents inside health plans, payers and TPAs to automate the administrative and clinical work needed to run cost containment operations. Spurring the funding is the CMS Rule CMS-0057-F which mandates a prior authorization decision timeframe of 72 hours for expedited requests, and seven days for standard requests.  Website/release, MedCityNews
  • Midstream Health garnered $20 million in a Series A for its autonomous financial operations platform. This round was led by Valtruis, and included participation from Andreessen Horowitz (a16z), Foundry and CommonSpirit Ventures. Its network covers over 250 hospitals nationwide and emphasizes recovery via monitoring of contracts, claims, rebates, other supply chain areas,  and payments. Release, MedCityNews
  • And closing today’s roundup, Anthropic PBC, which markets its AI tools as Claude, finally filed its SEC Form S-1 to go public on the Nasdaq, trading under ANT. No target date is given, nor pricing and number of shares. The company is presently closely held by founders Dario and Daniela Amodei. Anthropic’s revenue was $16.3 billion for the first six months of 2026, up 1,300% from $1.2 billion during the same period last year. It all looks lovely except that on-balance sheet liabilites total around $117.5 billion (balanced against roughly $112 billion in cash prior to its IPO). Bloomberg Tax and off balance sheet and long-term compute commitments of $895.4 billion. CNBC, Mobihealthnews
    • Given all this, the Anthropic IPO may not happen until 2027.
    • For instance, OpenAI filed initial SEC forms in June, but is delaying their IPO to sometime in 2027. They are currently seeking a bridge raise of $10 to $20 billion this year in advance of the IPO. FT.