TTA’s Autumn Leaves: Oura puts off IPO, Anthropic’s IPO November (?); Sycamore Partners nearing Boots sale; telehealth support for pediatricians in youth mental health, Oracle’s Congressional spanking, more!

October 3, 2026 | by | No Comments

 

2-5 October 2026

Here we are past the first week of Fall (or Autumn). The leaves may be turning, but the healthcare/AI  IPOs aren’t, with the Oura health monitoring ring postponing its IPO indefinitely and the Anthropic AI rumored only for early-to-mid-November. Another turning is for Boots, with Sycamore Partners breaking up the Walgreens Boots Alliance combine for $9 billion. And this week’s Perspectives discusses the burden pediatricians are taking on in youth mental health and how telehealth can support this need.

For Readers: Your Editor will be on publishing leave due to travel to 21 October. ‘Best Of’ Alerts will be out weekly on Fridays and Saturdays after this week till then. Some past highlights:

  • Humanity’s Rumored Doom in 10 years at the hands of AI are Zebras, not Horses.
  • Oracle’s simultaneous strong Q1, 3,000 layoffs, and its two top execs subpoenaed by the House VA Committee for a whacking over the 170% increase in budget to cover the next three years (Congress is Fed Up).
  • How infrastructure tech needed by healthcare organizations can’t get arrested on funding, while whiz-bang consumer apps can.

Please feel free to comment on the articles and pass along this Alert. Let me know if this is worth it to you! Also check out my personal page on Substack.

IPOs, IPOs–Oura’s stalls out, Anthropic’s restarts, possibly mid-November. To everyone’s amazement!

Developing: Walgreens’ Sycamore Partners owner on final approach to sell Boots operation to Canada’s Weston family for ~$9B

Perspectives: What Meta’s settlement reveals about youth mental health, access shortages, and where telehealth can support pediatricians

More of Interest 

Oracle’s continued restructuring cuts 3K more jobs, adds $700 million while revenue grows 30%; House VA Committee subpoenas Ellison, Sicilia 19-0–and why Congress is mad at a 170% budget increase (Updated for how Congress really feels)

(Related) Revealed: Oracle’s extended VA EHRM contract increased by $17B as original ceiling reached this year; VA Indy EHR goes online

AI’s hoofbeats as Horses, not Zebras: a Gimlety view of AI’s destructive capacity (updated) (P(doom) may be conquered by F(doom), or Why Worry?

Perspectives: Digital Health Capital Keeps Rewarding What Patients See, Not What Keeps Companies Alive (Infrastructure tech can’t get funding)

Silicon Valley Bank’s take on H1 investment: among the “have and have nots”, it was “the best half in years” for health tech

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Donna Cusano, Editor In Chief
donna.cusano@telecareaware.com

Telehealth & Telecare Aware – covering news on latest developments in telecare, telehealth and eHealth, worldwide.

TTA’s Summertime Wrap: Taking apart Humanity’s AI Doom; Oracle’s layoffs, financials, and House subpoenas; and how infrastructure health tech can’t get funding

September 17, 2026 | by

17-30 September 2026

It’s hard to believe that the last Alert was before Labor Day, and here we are staring at the chronological End of Summer, bracing for a cold winter again. The 25th anniversary of 9/11 (real doom) was followed by Humanity’s Rumored Doom in 10 years at the hands of AI. My essay takes it apart and puts it back together. (Pro Tip–trust no one). We also caught up with Oracle trumpeting its Q1, laying off another 3,000, and its two top execs subpoenaed by the House VA Committee. This week’s Perspectives is about how infrastructure tech needed by healthcare organizations can’t get arrested on funding, while whiz-bang consumer apps can.

Please feel free to comment on the articles and pass along this Alert. Let me know if this is worth it to you! Also check out my personal page on Substack.

For Readers: Your Editor will be on a second publishing leave to 1-2 October. ‘Best Of’ Alerts will be out 1x weekly only on Fridays after this week till then. I’ll be resting up for what may prove to be an epic Q4!

Oracle’s continued restructuring cuts 3K more jobs, adds $700 million while revenue grows 30%; House VA Committee subpoenas Ellison, Sicilia 19-0 (The Oracle soap opera grinds on)

Perspectives: Digital Health Capital Keeps Rewarding What Patients See, Not What Keeps Companies Alive (Infrastructure tech can’t get funding)

AI’s hoofbeats as Horses, not Zebras: a Gimlety view of AI’s destructive capacity (updated) (P(doom) may be conquered by F(doom), or Why Worry?

Most recent headlines 

Silicon Valley Bank’s take on H1 investment: among the “have and have nots”, it was “the best half in years” for health tech

News roundup: Verma’s rumors, DEA’s new (?) telemedicine rule goes to OMB for review, Cityblock Health goes rural with Homeward buy, Scottish housing sensor tech could save millions–study

Revealed: Oracle’s extended VA EHRM contract increased by $17B as original ceiling reached this year; VA Indy EHR goes online

Must Reads

This Week’s Must Reads: how lack of focus dooms startup financing, Commure’s Sea of Red Flags Flapping, and what happens if OpenAI expires? (Doom…DOOM!)

Why Readers can be assured that TTA is 100% Written by Humans (A handy guide to detecting AI Copy Slop and why it’s not here)

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Advertise on Telehealth and Telecare Aware
Support not only a publication but also a well-informed international community.

Contact Editor Donna for more information.

Help Spread the News

Please tell your colleagues about this free news service and, if you have relevant information to share with the rest of the world, please let me know!

Donna Cusano, Editor In Chief
donna.cusano@telecareaware.com

Telehealth & Telecare Aware – covering news on latest developments in telecare, telehealth and eHealth, worldwide.

Oracle’s continued restructuring cuts 3K more jobs, adds $700 million while revenue grows 30%; House VA Committee subpoenas Ellison, Sicilia 19-0–and why Congress is mad at a 170% budget increase

September 17, 2026 | by

Oracle trumpets successes to Wall Street while continuing layoffs, tightening spending. Oracle’s downsizing continues while revenue is parked on the sunny side of the street. Its fiscal 2027 Q1 revenue (ending August 2026) grew 30% to $19.3 billion while non-GAAP operating income rose 31% to $8.2 billion and non-GAAP earnings per share came in at $1.92, also up 30%. Some was driven by cloud growth. For those following their data center builds, their remaining performance obligations, a measure of contracted future revenue, grew by $26 billion but much of it was prepaid or with customer supplying their own hardware, meaning no cash outlay for Oracle. Another way of looking at this is conversion to revenue over the next 36 months which is now estimated at 50%.

This perked interest by investors. Barclays has upped its Oracle price target to $252 from $250 and kept an “Overweight” rating on the tech stock. The stock price is currently around $154, down 54% from its high. The Street

This is despite that debt is high and building. Total debt climbed to $155.9 billion on a trailing twelve-month basis, up from $90.5 billion just two years ago. Net debt now sits at $118.9 billion.

More Oracle employees got their severance notes and cutoffs at the beginning of September. Restructuring has a price and it’s in people. Business Insider quoted ‘insiders’ that they started on 14 September with a chilly 6am note signed “Oracle Management” similar to the previous round: “After careful consideration of Oracle’s current business needs, we have made the decision to eliminate your role as part of a broader organizational change. As a result, today is your last working day.” Severance was 4 weeks’ base salary plus 1 week per year of employment. The count of the layoffs, LOBs, and states is unconfirmed by Oracle but estimated at 3,000, several hundred in Washington state. Not quite the ‘double digit percentages’ rumored in August but possibly so on some teams. This is on top of the earlier 21,000 global cuts, 13% of their workforce, originally posted as near 30,000 [TTA 31 March]. Oracle’s original restructuring cost estimate of $2.1 billion on severance payments and other costs linked to restructuring through 31 August was increased this quarter by over $700 million, bringing that total to $2.8 billion. NDTV, Quartz

Updated 22 Sept: It appears that the employee severance package for most people, in the tech context, is skimpy. It’s four weeks of base pay plus one additional week for each completed year of service, subject to a 26-week maximum. Microsoft’s maximum was up to 39 weeks. Moreover, Reddit employee threads state that the WARN period is deducted from the base pay (e.g. two weeks of WARN, two weeks of severance) and accrued vacation is lost if state law allows it. The article in TechTimes confirms that laid off employees forfeit unvested stock, but does not have how severance affects corporate bonus and the employee stock purchase plan.

Oracle’s new CFO Hilary Maxon denied in the next day’s all-hands that the layoffs did not mean that remaining employees would be doing more with less. CEO Mike Sicilia cheered the survivors on with “How does the work that I’m doing help deliver a better outcome for a customer?” Not an off-target ask, but if the work load does not change especially in healthcare or implementing an EHR, how does this situation not mean doing more with less? 2+2≠5

Rounding out a roller coaster two weeks for Oracle was a 19-0 House Veterans Affairs Committee subpoena for Larry Ellison and Mike Sicilia. It was voted on by the House Veterans Affairs Committee and issued before Labor Day, when Oracle did not attend the 2 September hearing citing scheduling conflicts. The hearing covered the $17 billion increase in budget for Oracle’s EHR development for current costs and the three-year extension to May 2031. It turned out to be rather raucous with accusations of “unreasonable” and “corruption.” The original $10 billion estimate was by Cerner and is running out [TTA 27 August]. The new budget request brings the total to $26.94 billion. Apparently the House members found out about it through news reports, While the House is not in session until 9 November, House committees can meet anytime, but both hearings are after the midterms. Sicilia is due on 19 November and Ellison on 10 December. FedScoop, Becker’s, Stars and Stripes, MedCity News, Healthcare IT News (updated for appearance dates)

Updated. Why Congress is Madder than Wet Hens is revealed in this FedScoop article and timeline. Simply and quickly, back in July 2022, when things started to go sideways in the EHRM implementation [TTA 28 July 2022], then-EVP for Industries Mike Sicilia told the Senate Veterans Affairs Committee that Oracle would absorb any “performance or workflow” issue costs above the original $10 billion ceiling. For Oracle, after the Transformational Big Vision kvelling faded, Cerner’s painful stumbles became Oracle’s VA Migraine. There are also other add-on costs for infrastructure related to the EHRM but not part of Oracle’s costs. 170% is a big surprise in the VA budget and it blindsided Congress.

TTA’s August-Sept Wrap: how health tech fared in H1 investment, Oracle’s VA EHRM contract $ bump, Verma’s rumors, Cityblock buys Homeward, sensors could save Scots millions, more!

August 28, 2026 | by

28 August-early September 2026

It’s the last of the August Doldrums, so it’s a good time to look back, courtesy of SVB, on What Happened in Healthcare Investing this first half. (For once, health tech didn’t take a beating with its best H1 in years.) Oracle just can’t help being in the headlines, this time with a nice (and expected) budget bump in its extended VA EHRM contract, and with its Oracle Health EVP, the well-known Seema Verma, possibly under consideration by PhRMA. The only notable transaction was another acquisition in the General Catalyst family, Cityblock Health and Homeward Health. DEA may get a controlled substances telehealth rule yet. And the Scots have discovered and tested sensor-based facility monitoring that could save millions. Aye! (Will Harry and Meghan’s Cotswolds lair have it? Save on security!)

Please feel free to comment on the articles and pass along this Alert. Let me know if this is worth it to you! Also check out my personal page on Substack.

For Readers: Your Editor will be on publishing leave to mid-September. ‘Best Of’ Alerts will be out 1x weekly on Fridays after this week till then. I’ll be resting up for what may prove to be an epic September-October!

Silicon Valley Bank’s take on H1 investment: among the “have and have nots”, it was “the best half in years” for health tech

News roundup: Verma’s rumors, DEA’s new (?) telemedicine rule goes to OMB for review, Cityblock Health goes rural with Homeward buy, Scottish housing sensor tech could save millions–study

Revealed: Oracle’s extended VA EHRM contract increased by $17B as original ceiling reached this year; VA Indy EHR goes online

Last week’s headlines 

This Week’s Must Reads: how lack of focus dooms startup financing, Commure’s Sea of Red Flags Flapping, and what happens if OpenAI expires? (Doom…DOOM!)

News roundup: UHS-Talkspace $850M buy final, DocGo to buy Hicuity Health for $52M in stock/debt, R1 to buy Humata Health, PointClickCare EHR to integrate Anthropic’s AI

UK’s Alertacall sold to Constellation Software’s Volaris Group (Happily, remaining independent)

Recent Headlines and Must Reads

Why Readers can be assured that TTA is 100% Written by Humans (A handy guide to detecting AI Copy Slop and why it’s not here)

News potpourri: OpenAI sued for practicing unlicensed medicine”, Cleveland Clinic med drone delivery, Solventum separates out health info systems, Unlimited Technology RCM in 3.8M data breach, Samsung Galaxy Buds FDA cleared for hearing assist

VA moves to secure Oracle for its EHR Modernization through mid-2031 (More reasons beyond Captain Obvious)

Breaking report: Oracle drawing up plans to lay off employees in “double digit percentages” by 1 September (We’re waiting for this shoe to drop next month)

Chutes & Ladders, Oracle Edition: Surprise! Project Jupiter data center build overages, “social costs” multiply. Pentagon inks $7B, 10 year deal for software.

This week’s Must Read: the dangerous financing of AI data center buildouts–and how they resemble the 2020 health tech boom (Remember the SPAC boom that cracked and left nearly all companies and billions in the dust?)

A gloomy view on Oracle going forward: debt, cash flow, and dependence on OpenAI

 

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Support not only a publication but also a well-informed international community.

Contact Editor Donna for more information.

Help Spread the News

Please tell your colleagues about this free news service and, if you have relevant information to share with the rest of the world, please let me know!

Donna Cusano, Editor In Chief
donna.cusano@telecareaware.com

Telehealth & Telecare Aware – covering news on latest developments in telecare, telehealth and eHealth, worldwide.

Revealed: Oracle’s extended VA EHRM contract increased by $17B as original ceiling reached this year; VA Indy EHR goes online

August 27, 2026 | by

The cost of Oracle’s extended EHRM contract with the Department of Veterans Affairs disclosed. The ten-year contract for the EHR Modernization (EHRM), originally due to expire in May 2028, was extended earlier this month by three years to May 2031 and, we now know, an additional $17 billion was added to the ceiling. The full contract for Oracle will total by May 2031 $26.94 billion. The original contract was just under $10 billion–a cost ceiling expected to be reached by end of 2026.

Background: Oracle’s current VA contract 36C10B18D5000, the Electronic Health Record Modernization Indefinite-Delivery/Indefinite-Quantity (IDIQ) contract with Oracle Health Government Services, the successor to Cerner Government Services, originally was structured with a 10 year base period without annual renewals. This started in May 2018. In early 2023, the contract was renegotiated. The base period was halved to five years with the remainder of the contract subject to annual renewals from May 2023 and expiring 10 years after the contract start, in May 2028. The Modification P00008 to the IDIQ contract adds another three one-year firm fixed-priced optional ordering periods, taking the duration of the contract to May 2031.

According to the released contract modification documents, VA projects that the original ceiling would be reached by Q1 in Federal FY 2027, which is between October and December 2026. The rationale is that “Due to unanticipated complexities in deploying this system, extensive site-specific customizations, as well as the other factors … VA has reached the current contract ceiling sooner than originally planned. VA anticipates using the remaining ceiling by the first quarter of fiscal year 2027 and thus requires an increase.” 

“Building upon the Trump Administration’s successful deployment of VA’s new electronic health record system at several VA facilities, VA and Oracle Health agreed earlier this month to renew their collaboration,” VA spokesperson Quinn Slaven previously said in an emailed statement to FedScoop.

As previously noted in our original article [TTA 12 Aug], in this Editor’s view, the three-year extension is a smart move on the VA EHRM team’s part.

  • The obvious one is that the VA EHRM rollout requires another three years from 2028 to 2031 to fully cover all locations. Releasing the main single-source contractor three years prior to its finalization is not an intelligent move unless another EHR company could take it up–and that has not happened. Things apparently are going smoothly in the newly formatted rollout. It was also obvious that the cost ceiling had to be increased.
  • The other is protection. Now you won’t read this elsewhere. Since the late winter, Oracle was rumored to be interested in selling, wholly or in part, Oracle Health AI (OHAI). Oracle Health sale rumors were confirmed this summer. In the event of a sale, the buyer would be obligated to honor the VA contracts and its terms.
  • The other possibility is if disaster strikes Oracle as a result of their AI landlord strategy, such as bankruptcy, the VA has some contractual protection in a Federal court. 

Orange Slices, NextGov/FCW

VA Indiana’s three-hospital system (Fort Wayne, Marion, and Indianapolis, VISN 3) cut over to the Oracle EHR on 22 August. X announcement (@VAIndyHealth)  The last two scheduled for 2026 will be Anchorage, Alaska (VISN 5) and Cleveland, Ohio (VISN 3) on 24 October.

TTA’s August Ice Cream Run 2: Oracle talks layoffs (again) and VA extends EHRM contract; OpenAI sued for ‘doctoring’; big vendor data breach; med drone delivery; and a tart take on AI Copy Slop

August 14, 2026 | by

14-17 August 2026

Still in the ‘dog days’ of August weather, despite the back to school and Halloween (!) stuff in the stores. We should enjoy our last days of ‘traditional’ summer (versus ‘local’ or ‘smart’ summer) but the merchers won’t let us. In other news, there was a lot of news around Oracle Health this week, from pending layoffs to the VA extending its contract to 2031. We also have our (likely first, but not last) lawsuit claiming OpenAI doctoring harmed a ‘patient’, meds and supplies delivered by drone, a big vendor data breach, affordable hearing assistance, and yet another likely spinoff. And on the hot subject of AI writing and AI Copy Slop, your Editor has more than a few thoughts after reading an excellent article by Alys Denby. Grab the cuppa for this one. Or you’ll faint like Pepper!

Please feel free to comment on the articles and pass along this Alert. Let me know if this is worth it to you! Also check out my personal page on Substack.

Why Readers can be assured that TTA is 100% Written by Humans

News potpourri: OpenAI sued for practicing unlicensed medicine”, Cleveland Clinic med drone delivery, Solventum separates out health info systems, Unlimited Technology RCM in 3.8M data breach, Samsung Galaxy Buds FDA cleared for hearing assist

VA moves to secure Oracle for its EHR Modernization through mid-2031 (More reasons beyond the obvious)

Breaking report: Oracle drawing up plans to lay off employees in “double digit percentages” by 1 September

Last week’s headlines

News roundup #2: Function Health’s jumbo $450M raise from General Catalyst, Hinge Health’s $105M Cylinder buy, and Throne Science’s $10M Series A

News roundup #1: AI governance ‘in’ with Feds, ATA; Centene’s shrinking but more profitable future; repositions and partnerships for DispatchHealth, WHOOP; Te Whatu Ora Health New Zealand modernization

Recent Headlines and Must Reads

Chutes & Ladders, Oracle Edition: Surprise! Project Jupiter data center build overages, “social costs” multiply. Pentagon inks $7B, 10 year deal for software.

Catching up to Masimo’s ‘unfinished’ business: Danaher completes $9.9B acquisition of Masimo. $634 million damages from Apple upheld, but Kiani lawsuits continue

This week’s Must Read: the dangerous financing of AI data center buildouts–and how they resemble the 2020 health tech boom (Remember the SPAC boom that cracked and left nearly all companies and billions in the dust?)

A gloomy view on Oracle going forward: debt, cash flow, and dependence on OpenAI

Vinegary Must Reads This Week: Silicon Valley’s ‘Cargo Culture’; the clinical query tool explosion between OpenEvidence and general AI

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Support not only a publication but also a well-informed international community.

Contact Editor Donna for more information.

Help Spread the News

Please tell your colleagues about this free news service and, if you have relevant information to share with the rest of the world, please let me know!

Donna Cusano, Editor In Chief
donna.cusano@telecareaware.com

VA moves to secure Oracle for its EHR Modernization through mid-2031

August 12, 2026 | by

It’s an extension that likely has a very good and smart reason behind it. This short article in a specialized Federal services publication, OrangeSlices PBC (public benefit corporation), that broke the story early AM today (12 Aug), has a few tidbits that anyone who is following the VA’s EHRM will find of interest. 

The first is the three-year extension of the current VA contract 36C10B18D5000, the Electronic Health Record Modernization Indefinite-Delivery/Indefinite-Quantity (IDIQ) contract with Oracle Health Government Services, the successor to Cerner Government Services. The proposed Modification P00008 to the IDIQ contract adds another three one-year optional periods, taking the duration out to May 2031.

Some history is in order here.

  • The contract originally had a base period of 10 years starting in May 2018 with a value of $10 billion, later revised upwards to $16 billion.
  • It was rewritten and renegotiated in early 2023 after the failure of the initial five-location rollout. The ten-year base period was halved to five years, ending in 2023, with a renewal instead of five successive one-year optional ordering periods ending in May 2028.
  • This renewal took place only after much debate, a hail of flak from both the House and Senate Veterans Affairs’ full committees and tech subcommittees, and calls to dump Oracle and start all over again. The contract redo was designed to bring Oracle to heel.  It subjected both Oracle and the VA to lengthy accountability metrics that culminated in multiple modifications and testing. [TTA 18 May 2023]
  • The EHRM rollout was radically modified by geography to VA Health Centers mostly within the same VA region, or VISN, then with additional implementations every two months. The rollout resumed in April 2026, with five more locations added in August and October to complete 13 for 2026 and another 27 in 2027. [TTA 8 Feb and the updated VA rollout schedule]

The three-year extension brings the contract to the projected final VA rollout and conclusion in 2031. According to the article, 36 sites are scheduled to go live between August 2026 and January 2028. Subtracting 2026 (5) and 2027 (27), that leaves four in 2028 before the contract’s original expiration. There are at least another 120 to be covered within VA’s existing VISNs.

The contract modification has an anticipated award date of on or about 17 August 2026. SAM.gov (published Tuesday 11 Aug)

The second is why this three-year extension is a very smart move on the VA EHRM team’s part.

  • The obvious one is that the VA EHRM rollout requires another three years from 2028 to 2031 to fully cover all locations. Apparently all is going smoothly but releasing the main single-source contractor three years prior to its finalization is not an intelligent move.
  • The other is protection. Now you won’t read this elsewhere. Since the late winter, Oracle was rumored to be interested in selling, wholly or in part, Oracle Health AI (OHAI). Oracle Health sale rumors were confirmed this summer. In the event of a sale, the buyer would be obligated to honor the VA contracts and its terms.
  • The other possibility is if something truly awful happens to Oracle as a result of their AI landlord strategy, such as bankruptcy, the VA has some contractual protection in a Federal court. 

Whether Oracle can even sell OHAI is an open question. But for VA to tighten the contract to confirm an obligation to continue the VA EHRM to the end (or near end) is commendably businesslike–to not leave the VA and our veterans who served in the lurch with their medical records, scheduling, research, and much more. That would be unacceptable.

Update: Just posted in NextGov/FCW and FedScoop. The last notes that the House-passed fiscal 2027 Military Construction and Veterans Affairs appropriations bill would give $3.4 million for EHRM.

Breaking report: Oracle drawing up plans to lay off employees in “double digit percentages” by 1 September

August 12, 2026 | by

30,000 global layoffs (18%) in March were evidently not enough. Oracle’s transformation into an AI infrastructure landlord with the corresponding debt (closing FY26 at $100 billion, projected by an analyst to exceed $120 billion in their FY27) is coming at a huge cost. This afternoon (US Eastern Time), Business Insider broke the news that Oracle is planning another significant round of layoffs to reduce payrolls by 1 September. 

FTA: “The cuts could reach double-digit percentages on some teams, according to the document. The company has requested managers provide lists of affected employees, with the intention of reducing payroll by the time the second quarter begins on Sept. 1, according to one of the people with direct knowledge.” Note: the Oracle FY27 began on 1 June 2026, thus Q2 27 starts on 1 September.

The Business Insider writer claims to have seen an internal document confirming this. Considering that today is 12 August, there is not much time between now and 1 September. Oracle currently has around 141,000 employees. If there were, for instance, a 10% (double digit) overall layoff, that would be 14,000 people. No hard numbers are included in the BI article.

The BI article does not have information on whether this will affect only the US, North America, or global Oracle sites. The last round of layoffs were global in scope.  Oracle ran into expensive buzzsaws in countries such as Germany; many European countries have layoff notice and benefit requirements. In the last layoff, India was hard hit.

The scuttlebutt on The Layoff rumor board has other tidbits that may be true or sheer speculation:

  • The actual date may be 15 September. But historically Oracle layoffs happen around Labor Day (US 7 September). (Ed.–It could be both!)
  • Managers are preparing lists for upcoming layoffs. One poster scores his or her part time remote manager who remained after the last layoff round.
  • Nothing is showing up in Federal/state WARN notices yet. However, WARN does not cover remote, dispersed employees nor offshore employees.
  • There are about $300 million in restructuring costs included in the FY 27 SEC 10-K filing. This is a comparatively low amount that has to cover earlier layoff costs, which may indicate that this upcoming layoff will be lower than March’s.

The money continues to flow out, not in. Oracle’s high-profile data center buildouts, notably Project Jupiter, are being hit with increasing “social costs”. Despite initial permitting, local groups have been successful in mobilizing for changes. Redesigns in cooling and power draw are expensive. Data center locations and builds are one of the few US issues that cross political lines [TTA 29 July]. Unlike Microsoft, Oracle no longer has the cushion of free cash flow to pay the bills. Oracle also has crushing performance obligations to meet with OpenAI and Meta [TTA 16 July].

What’s the healthcare impact, other than AI?  For the business segments in the former Cerner, now is Oracle Health AI, the news has been dismal–and concerning to entities such as the Federal Government.

  • The Oracle EHR, bought in the palmy days of June 2022 for $28 billion, is now down to a ‘sloppy second’ versus Epic in the acute care (20%) and the health system (27%) segments. The EHR is not prospering as an alternative, as much as many in healthcare don’t care for Epic.
  • There is no one reportedly lining up to buy OHAI. In June, London-based investors Nelson Advisors confirmed the rumors that the division was up for sale. The ‘usual suspects’ all have regulatory and competitive road blocks. The alternative may be private equity purchase or investment, including the Federal Government. PE is not jumping up and down to lay the money down. In other words, OHAI is a hard-to-sell asset.
  • Even if an OHAI sale freed up anywhere near the purchase price, an unlikely outcome, it would make only a dent in the stunning amount of debt. Whether it would improve Oracle’s low credit rating is doubtful.

There are also ongoing and new Federal commitments to meet:

  • There are the EHRs managed by the Veterans Health Administration EHR Modernization (EHRM) and the Military Health System (MHS), two separate but mandatorily interoperable systems. MHS is rolled out but modifications continue, while VA’s EHRM is only getting started, with extensive Federal oversight and guardrails in place. That rollout is expected to continue into 2031. These are both hot potatoes that show no signs of cooling off.
  • In Oracle’s traditional software business, Oracle’s latest commitment is to the Department of War (a/k/a Department of Defense). In late July DoW announced a software contract with Oracle which could be worth up to $7 billion over ten years as part of the cross-agency Enterprise Software Initiative. 

The layoffs can only increase the perception of Oracle as losing the staff to meet their commitments, as unstable and in trouble. This is a developing story. A TTA ‘hat tip’ to an observer who wishes to remain anonymous.

VA’s EHR goes live with four more centers; GAO criticizes VA, MHS on EHR cybersecurity collaboration

June 12, 2026 | by

VA stays on schedule with four more EHR go-lives. On 6 June, right on schedule, the Oracle EHR went live at four more VA Medical Centers in Ohio and Kentucky: Cincinnati VA Medical Center, Chillicothe VA Medical Center, Dayton VA Medical Center, and the Cincinnati VA Medical Center-Fort Thomas. All are in VISN 10 (VISN=region). This second wave of 2026 transitions, according to the VA release, more than 107,000 veteran patients and 7,200 VA clinicians and staff. The next wave of three more VAMCs will roll out in August with a final two in October.

Interestingly, the VA release also scores the previous Biden Administration on holding up the EHR implementation for two years, starting after the well-publicized disastrous implementations of 2020-2023. Our Readers and this Editor remember that Congress, led by a Republican House and the Veterans committees (the House approves budgets), basically forced VA to end the deployments [TTA 26 April 2023] and renegotiate the next five years of the Oracle contract to contain performance metrics and requirements [TTA 18 May 2023]. At least some of the reforms noted in the release started under that previous administration, but the second Trump Administration starting in 2025 should be credited with accelerating what many of us observers considered a ‘dead in the water’ repair and rollout. The biggest change is the standardization of the system across the VAMCs; the previous deployments allowed for too much customization by facility, something Oracle wasn’t exactly equipped to handle with the legacy Cerner system.  Federal News Network

There’s also an enjoyable, locally made YouTube video of the go-live at the Dayton VAMC. It focuses on the IT team and how they are helping the clinical staff, including the first new patient entered into the EHR. Complete with an opening group prayer service and dancing–how can they lose? YouTube video, 3 minutes. 

What’s not going so well is VA-Department of War (DoW formerly DoD) cooperation on EHR cybersecurity issues. A new Government Accountability Office (GAO) report discusses how the Federal Electronic Health Record Modernization office (FEHRM) that is responsible for oversight and direction on joint functions is not adhering to “leading practices” in several areas. The Oracle EHR is not only used at the VA but also in a different version covers the Military Health System (MHS),  the US Coast Guard, and the National Oceanic and Atmospheric Administration (NOAA). The DoW has the primary responsibility for ensuring cybersecurity of the EHR systems. Where the agency fell short was in defining common goals, outcomes, and performance metrics, as well as communicating progress on EHR cybersecurity and privacy.

FTR:

GAO is making one recommendation to DOD and one to VA to direct the FEHRM to define common goals, outcomes, and associated performance measures, and monitor, assess, and communicate progress on collaboration efforts toward ensuring the cybersecurity and privacy of the federal enclave. DOD disagreed with our report and VA neither agreed nor disagreed with the recommendations. GAO maintains its recommendations are valid, as discussed in this report.

The GAO is required by the Further Consolidated Appropriations Act of 2024 to conduct performance audits; this one covers June 2024 to June 2026. GAO summary with links to full report, Healthcare IT News

Selling Oracle Health’s EHR–what are the potential buyers, their odds, and price?

June 2, 2026 | by | 5 Comments

The speculation is now “official”, since it is by a London investment banking firm, but it confirms this Editor’s earlier view: Oracle, to become an “AI Infrastructure Landlord” (in their apt term), has to sell off what was Cerner and the EHR operation. 

That train is now approaching, though realistically, no one knows when it is due and at what station.

The need: Oracle must reduce the extent of its “liquidity and capital expenditure crisis” in order to stay in the AI Game. Layoffs of 30,000 staff, or 18% of their global employees, is not enough. A fresh financing of $16 billion from the PIMCO bond fund and others cannot relieve the financial stress created by a previous estimated $72 to $100 billion in previous debt load and payments, so significant that banks refused to lend to still-profitable Oracle. And the AI transformation itself is high risk. Oracle owes OpenAI alone $553 billion in remaining performance obligations, and it has obligations to Meta as well. Add to this the long “taffy pull”–the years-long process of building, chip expenditure, then making a data center operational and generating cash. [TTA 14 May, 7 May, and prior; also Ed Zitron’s article for a much longer take.] Take all of them together, and they are polite words for “rock and a hard place” or a Very Dark Corner.

The London investment banking firm Nelson Advisors has taken a deep yet remarkably easy-to-digest analysis on a potential sale. Highlights are below. The paper is one long web page, not a deck of 50 pages. It is well worth your reading time.

Background: Cerner was bought four years ago in the go-go days of June 2022 for $28 billion. Cerner had an aging EHR and a deteriorating market share. Recently it’s plummeted to a 27% market share versus Epic’s 48% in large health systems. Oracle’s interest was not only in health, but also the health data Cerner contained. The plans were to update the software based EHR to a cloud-native data platform as the linchpin of Healthcare Transformation (Ed. note), except that integration proved to be slow and far more expensive than estimated.

Oracle also inherited from Cerner two huge and impossible to escape Federal obligations: the Military Health System EHR and the Veterans Health Administration EHR Modernization, two separate but mandatorily interoperable systems. MHS was the first implemented and is now  completed, but remains an obligation. The VA EHRM, as TTA has chronicled, started rolling out in 2020 and by 2023 was halted after five implementations Due to Disaster. It resumed in April 2026. The VA and Congressional process for funding now has tight guardrails in place on continuance.  

Who will buy the Oracle/Cerner EHR operation is the question. For how much isn’t as clear. Selling Oracle Cerner “represents the most significant “lump sum” of liquidity available. In the Nelson analogy, Oracle took the Cerner cow, milked it of data to feed its data into its LLMs, and no longer wants knackered ol’ Bessie even rejuvenated by the cloud. (In this Editor’s view, Oracle knows it is fighting a losing battle against Epic, which does privately pretty much what it wants and plans to stay that way.)

The obvious group of potential buyers are ‘hyperscalers’ who view health data as the Next Frontier. They already have feet in this healthcare pond. They also meet approved FedRAMP High security requirements for the VA and MHS contracts. Equally, they all have drawbacks.

Microsoft seems the most logical. It already has a huge footprint and expertise within health systems, courtesy of ambient scribe Nuance/DAX Copilot and cloud computing platform Azure.

  • Conflict #1: Epic is a major Azure customer. Would Microsoft be willing to lose this business in a high-stakes move?
  • Conflict #2: FTC would likely challenge the acquisition based on this huge existing footprint.

Amazon is also engaged in healthcare, but not with health systems. It has Amazon Health Services comprising Pharmacy, One Medical, and DTC telehealth services. (Editor’s note: not mentioned by Nelson is that Amazon Health has a new leader, Dr. Roy Schoenberg, with experience in Federal contracts via Amwell for the Defense Health Agency and MHS. This broke late last week.)

  • Conflict: Amazon Web Services is an established vendor in other areas of health systems, and acquiring an EHR could be seen as too much under one roof.
  • Problem: no experience with EHRs (same as Oracle) nor highly regulated health systems. The scale of the MHS/VA implementation and academic hospitals would be a steep learning curve with little existing precedent or credibility in Amazon-World.

Google certainly has the size and resources, and could position the EHR to rival both Microsoft and Epic. 

  • Conflict #1: Cultural. Google moves fast and healthcare slowly.
  • Conflict #2: Lacks the enterprise sales and support needed to service health systems. It doesn’t have a service culture.
  • Editor’s note: Google has tried and failed to be a healthcare giant at least twice. It doesn’t seem to fit.

Nelson also looked at two outliers, UnitedHealth Group/Optum and the hospital groups HCA or CommonSpirit Health. Both would be vertical integrators. Hospital groups do not have the margin nor borrowing power to make the move. UHG and their Optum operation face cash crunches and ongoing Federal scrutiny. (Had this been a few years ago under a different management, this would have been on strategy for UHG.)

Another outlier from the international space is SAP. Their aim would be global expansion into the Middle East and Europe with another asset their enterprise resource planning (ERP) expertise. Their problem? Lack of experience in the highly regulated US environment. In the Nelson view, the US Government could be the make/break for any deal.

The final destination for this ‘hard to sell’ asset? Private equity. And more than one involved. Nelson looked at five PE players in the healthcare space: Thoma Bravo, Francisco Partners, Bain Capital, Blackstone, and New Mountain Capital. (All are familiar PEs to Readers.) Even with their considerable individual assets, it would likely take a consortium to buy Oracle Health in a $20 to $25 billion deal. Nelson rates this as the most likely scenario as long as a consortium could be formed and it can be seen as a turnaround. The drawbacks are a governance structure and the real lack of an exit strategy. (PEs always need exit strategies to keep the funders happy. They are not in it to buy and keep.) The lower price could be made palatable to Oracle if they retained the Oracle Cloud Infrastructure (OCI) network and the Oracle Autonomous Database revenue streams.

The other partner in this consortium scenario? The Federal Government. It’s a high priority to secure the EHR for both the MHS and VA. Congress is already concerned.

Place your bets!  Hat tip to a Reader who wishes to remain anonymous.

Holiday weekend roundup: VA asks for ‘cyberspeed’ 25% EHR budget bump, update on EHRM fraud indictment; Commure raises $70M; Innovaccer buys Caduceus, lays off staff; Doximity, OpenEvidence slugfest gets hot

May 22, 2026 | by | 2 Comments

A slower news week preceding the Memorial Day holiday in the US and the UK late May bank holiday.

Federal budgets for 2027 are in the Congressional washing machine, and the cycle is on ‘agitate’. VA Secretary Doug Collins has tagged a 25% increase in the EHR Modernization budget for FY 2027 over what is currently in the 2027 Military Construction and Veterans Affairs Appropriations bill –$4.2 billion versus $3.4 billion, an increase of $840 million. He testified on Wednesday 20 May to the Senate Veterans’ Affairs Committee and Thursday 21 May to the House Appropriations Subcommittee on Military Construction, Veterans Affairs and Related. Apparently, the biggest problem VA has with the much-repaired and now standardized Oracle EHR is that every VA executive director wants it now, not later. An additionally funded EHRM would speed up the cutover for VA facilities to go from ‘dial-up’ to ‘cyberspeed’ internally, in communicating with other VA hospitals, community care, and in record sharing with the military system and civilian health facilities.

Difficulties reported to date (April for four sites in Michigan, VISN 10) are around transferring health records between VA and Department of War facilities. DoW healthcare also uses Oracle, but a different version suited for their needs that has been fully implemented. 

While the House has already passed the bill at the lower budget number and sent it to the Senate, the subcommittee chair John Carter (R-Texas) during the hearing said they’re “not through with the possibility of getting you some more money”. 

VA’s implementation timeline is 19 before the end of this year (13 new and the 2020-24 six), 26 new sites in 2027 and 28 VA Medical Centers in 2028. Even sped up, there are still 90 more to go and the deployment is not expected to be complete till 2031. FedScoop 21 May, 30 April

Update on the fraud indictment of the former EHRM director, John Windom. Surprisingly, there has been little to no mainstream media coverage of the Federal charges against John Windom, who was indicted on 25 March in the Federal District Court for the District of Columbia. The three counts related to accepting cash and gifts from vendors plus failure to report them could bring a maximum of 35 years. This article on conservative news website PJ Media is the most recent (re)telling of the tale and links to nearly all the same sources this Editor included in our 3 April article. It is more colorful than our reporting but brings up an important point I overlooked: where, oh where, are the indictments of some of the vendors who doled out cash, gifts, and maybe more, and in return got prime and sub-contracts. He knew, they knew to keep quiet–‘loose lips sink ships’. Because any Federal contractor–I worked for two, Viterion Digital Health and Collaborative Health Systems, then part of WellCare Health Plans–receives compliance training on working with their Federal agency counterparts. 

Perhaps there are investigations and indictments to come, as I’ve seen in Federal Medicare fraud cases that peel like an endless onion over years. According to the VA inspector general, Mike Missal, who served from 2016 until January 2025, evidence was being gathered internally back during the Biden administration. This fits the timeline of the US Attorney requesting a grand jury be summoned then sworn in on 30 October 2025. Mr. Missal was fired along with 16 other inspectors general by the incoming Trump administration.

Since Mr. Windom was deeply engaged in the choice of Cerner for the VA EHR in 2017-2018, and in the disastrous implementation of VA Mann-Grandstaff (VISN 20) in October 2020 and four more in 2022, resulting in the rollout’s termination in 2023, Oracle would be unwise to not prepare for a few questions about Cerner’s relationship with Mr. Windom, as I wrote at the time. 

The PJ Media article also references the comprehensive article in the 27 March Spokane Spokesman-Review, which has been on the Cerner/Oracle implementation story since the implementation failure in the region’s Mann-Grandstaff VA facility. Their check of the OEHRM website as of that date confirmed that Mr. Windom was still listed as the deputy director of the Federal Electronic Health Management Office, the joint VA-DOD initiative in the role he assumed in January 2022 after the Mann-Grandstaff problems detonated and the then-Secretary reorganized the department. (Heads did not roll, but they rarely do with SES members). FTA: “The Federal Electronic Health Record Modernization Office did not respond on Thursday (26 March) when asked if Windom remains employed there.” The article by Orion Donovan Smith is a recommended read.

In the funding/M&A department

Healthcare software integrator Commure received a $70 million funding from current investors. Commure’s lead investor is General Catalyst. Commure now has $750 million raised and a $7 billion post-money valuation for its AI infrastructure development. Its subsidiary, Athelas, provides AI-based revenue cycle management and clinical workflow tools. The General Catalyst funding of $200 million plus is an interesting scheme, in that GC fronts the cost of sales and marketing and, in return, receives a share of the revenue from new customers generated by that investment, up to a fixed cap. The new funding will be used for scaling its RCM and practice management platforms, advancing the ‘shared intelligence layer’ beneath Commure’s workflows, and expanding their AI infrastructure into global healthcare markets. Release, Mobihealthnews

Innovaccer acquires CaduceusHealth, a revenue cycle management (RCM) and management services (MSO) provider. Neither transaction cost nor management transitions were disclosed. Well-funded Innovaccer ($675 million through a Series F) has been growing in AI-centric healthcare IT services mainly through acquisition. CaduceusHealth is the fifth in their creating a “comprehensive agentic stack” for health systems and provider groups in their Flow suite. Innovaccer claims to serve over 200 health systems and payers, 95% of community pharmacies, and 80 million patient lives across the US. Release Unfortunately, their growth has been matched by a reduction in staff, with 340 layoffs in the US and India. It is their third layoff in four years as it applies its own AI to automate its own processes. (We are seeing a lot of this across the board, allegedly.) FierceHealthcare

We close with a major Must Read with the OpenEvidence-Doximity battle.

OpenEvidence and Doximity are slugging it out for the same market funding–and a third competitor has just sneaked into the ring. OpenEvidence is the upstart, founded four years ago, and the best valued ($12 billion) yet private healthcare AI company on the planet Earth and is generally thought of as the up-and-coming platform for physician information. Doximity is the mature company, public with a $3.6 billion market cap, proven revenue of $645 million, and (be still my heart) profitable with an EBIDTA margin of 55% and a stunning 49% free cash flow margin. It’s been dubbed ‘LinkedIn for doctors’ but is actually much more with tools for secure telehealth, news, reputation management, and free CME.

They are mutually litigious. Both OpenEvidence (OE) and Doximity tag-team each other in product offerings, use defamation tactics and key staff poaching, and in product development, copycat each other, with Doximity generally leading development and OE following shortly thereafter. Coming up is Doximity’s new product, an in-workflow e-prescribing, prosaically called Doximity Prescribe. Based on the pattern, how long will it be before OE develops a similar product?

Where they make their money is only indirectly from users. Both are supported by a fixed source–pharmaceutical advertising. They both slug it out for physician attention. While doctors love (or hate) both, if they become too similar, the balance will tip. Into this bout steps OpenAI with a new professional product, ChatGPT for Clinicians [TTA 30 April]. Lurking near the ropes is the AI-powered iteration of Wolters Kluwer’s UpToDate peer-reviewed medical content, integrated with Microsoft and Abridge, already in 70% of the largest enterprise health systems because it’s been around forever. OE’s vulnerability may be overpromising in claiming ‘no hallucinations’ of their AI-generated medical content–a claim that is structurally impossible, and results in deficits in completeness, communication quality, and systems-based safety reasoning.

Digging through all of this is the intrepid Sergei Polevikov on his Substack AI Health Uncut. Grab a cuppa and sandwich for this one. For most of the article (Part 1 of 2!), a subscription is required. Consider it money well spent for access to some of the best investigative reporting around with plenty of backup. OpenEvidence Prescribe Coming to Your Doctor’s Office This Month?

Chutes & Ladders: Vendor protest filed against VA-OIT, Teladoc stock touted as ‘best buy’, Treehub ‘founder residency’ launches, AcuityMD raises $80M to near-$1B valuation

April 23, 2026 | by

This one’s a puzzlement. This Editor was ‘tipped off’ to a bid protest filed against the Department of Veterans Affairs (VA), specifically against the Office of Information Technology (OIT) Industry Day that took place on 27 March. It was found on the Government Accountability Office (GAO) website, filed on 17 April by The Gilchrist Law Firm, PA on behalf of an undisclosed vendor, under the solicitation number for the OIT Industry Day. The update from the source, Orange Slices, a government contract (GovCon) news site, stated that “the vendor” (whoever enters the info into GAO) “made a mistake in their entry to GAO and it has nothing to do with the industry day…” It has still not been fixed on the GAO website on the bid protest page.

Run out and buy TDOC stock! That’s the advice from “Insider Monkey” publishing on Yahoo Finance. In fact the Monkey rates Teladoc “among the best medical AI stocks to buy now”. The article is an overview of the Pineal Capital Management call for $200 million in share buybacks, breaking up the Integrated Care and BetterHelp businesses, and other shareholder friendly cash-generating ‘reforms’ [TTA 3 April]. Teladoc’s 2026 revenue forecast under CEO Chuck DaVita is essentially flat–$2.47 to $2.59 billion versus 2025’s $2.53 billion. This Editor noted a small rise in the stock price in the past month of about 70 cents. There may be some drama around the Q1 earnings report which will be issued next Wednesday (29 April). 

The interestingly named Treehub launches out of Stanford University. It’s designed to bridge the gap between the extreme early stage of a developing healthcare idea or technology, usually out of an academic lab, to where the formed company is fundable. It seems to be a combination of a healthcare tech scout, a venture studio with hands-on support, and an incubator community, with the capital of a venture fund. The Los Altos-based residency program is funded via the AI Health Fund and has some heavyweight names attached to it: Mary Minno, herself a former venture-backed founder now at Google, a brace of Stanford professors, Derek Minno of Point Capital, and two Wojcickis: Anne Wojcicki, founder of 23andMe, as Operating Partner and her mother, Esther Wojcicki, as a Founding Advisor. One wonders how Anne Wojcicki is faring in rebuilding 23andMe’s business and the 23andMe Research Institute; certainly they haven’t been shy about new products such as add-ins of African genetic groups, reconstructing ancestors’ DNA, and genetic predictors for GLP-1 effectiveness (press release list). Treehub release, Mobihealthnews interview with Ms. Minno and Esther Wojcicki, ‘the godmother of Silicon Valley’.

Raises this week so far have been slim. Medical commercial intelligence platform AcuityMD announced a raise of $80 million in a Series C led by existing investor StepStone Group, with additional participation from Benchmark, Redpoint Ventures, ICONIQ, and Atreides Management. Previous investment was $76 million. The company’s valuation is nearing the $1 billion mark at $955 million. AcuityMD’s platform helps medtech companies towards commercial insights that are typically scattered across claims databases, FDA filings, government records, and market signals. The fresh funding will be used to accelerate platform capabilities via AI. The company claims as customers 16 of the top 20 medtech companies and helping to identify $34 billion in pipeline. Release, Mobihealthnews

VA’s Oracle EHR resumes go-lives at four Michigan systems–finally

April 15, 2026 | by

On schedule, the VA’s EHR Modernization resumes after a three-year-plus hiatus. The four VA Medical Centers (VAMCs) announcing their go-lives over this past weekend are all in Michigan’s VISN 10: Ann Arbor, Battle Creek, Detroit and Saginaw. Four more are planned for June, also in VISN 10 (a VISN is a VA region): Dayton Ohio, Chillicothe Ohio, Cincinnati, and Cincinnati-Fort Thomas Kentucky, then three more in August and two more in October. Based on the schedule, calendar 2026 will have a total of 13 system rollouts, all in VISN 10 except for the last in October, which will include VISN 20’s Anchorage, Alaska VA Health System. [TTA 8 Feb]

The only exception to the hiatus was a joint Military Health System/VA implementation at Lovell in Chicago, which has had its own bumps after its start in March 2024. VA previously had five disastrous implementations, VA Mann-Grandstaff (VISN 20) in October 2020 and four more in 2022. After many actions to fix them, the VA halted implementations in April 2023. Even in 2025, in its agency report, the VA’s Office of Inspector General in their March 2025 report, and their January 2026 report on VA’s Management and Performance Challenges for FY 2025 found a distinct lack of VA staff confidence in the EHRM and its performance to date [TTA 8 Feb].

Strategically, confining the rollouts to one VISN and a small group at a time is smart because of the geographical adjacency and not scattering efforts all over the US. After these 13 however, there are 157 more. VA has pegged a full completion by 2031.

In its press release announcing the April go-lives, the VA identified four factors that got the EHRM off the dime. FTR: 

  • Fixing hundreds of problems related to the initial rollout of the EHR system at the six original VA sites. Some of these related to efforts by local VA facilities to customize the system, which only complicated the process.
  • Eliminating the bureaucracy that was holding the project back. VA replaced that unwieldy system with a single council that answers to top VA leaders, increasing accountability and making it easier to find and implement common sense decisions.
  • Getting local facilities more involved. As VA’s lead official on the EHR rollout, VA Deputy Secretary Paul Lawrence has visited all 13 deployment sites this year and has engaged directly with facility leaders at each location to answer questions and make sure these sites are ready to go.
  • Hiring more people to ensure the rollout goes smoothly. VA has already hired dozens of staff to help with the rollout in Michigan and other locations and is in the process of hiring a total of 400 people.

Last year, VA terminated contracts for at least six independent contractors supporting the EHRM as part of a mass cleanup of department contracts. FNN

Federal News Network, Healthcare Dive

There is nothing in the release, of course, about Oracle Health’s manpower cuts, rumored to be 30%, nor the persistent talk that the EHR unit will be sold or spun off. Or the effects that the recent indictment of a former EHRM head will have in Congress. In this Editor’s view, Oracle’s corporate redirection to and big bet on AI datacenters strongly suggests that Oracle will not be engaged with this deployment by the time 2031 rolls around.

Former VA EHRM executive director Federally charged with accepting vendor cash and gifts, making false statements

April 3, 2026 | by

Not knighted, but indicted. The former executive director of the VA’s Office of EHR Modernization (OEHRM) from 2017 to 2021, John H. Windom, was charged with failing to disclose cash and gifts from vendors, then making false statements to investigators in failing to report those gifts. The three counts were brought by a grand jury in the Federal District Court for the District of Columbia on 25 March. They were originally sworn in on 30 October 2025.

According to the Department of Justice (DOJ), the charges carry a statutory maximum sentence of 20 years in prison, with false statements adding another five years maximum per charge and possible financial penalties. The three counts involve violations of United States Code (USC) Title 18, Sections 1001 and 1519.

As executive director for the OEHRM, Mr. Windom was responsible for leading the long-term vision, strategic management, technical direction, acquisition, and deployment of the Cerner EHR in the VA that was announced in June 2017 and awarded in May 2028. He is being charged with accepting and soliciting gifts and cash from a group of VA contractors and subcontractors he termed the “Power Group”, then failing to disclose them according to law. This group included eight persons in seven independent minority-owned contractor companies in IT and health IT services and technology, management consulting, diversity and inclusion work, project management, business development, and general support services. Two companies were prime contractors directly on the VA EHRM project and overseen by Mr. Windom. 

He is accused of flagrantly accepting and demanding cash and gifts from the contractors, including meals, drinks, entertainment, casino chips from the MGM National Harbor and Aria Las Vegas, and gift cards for Louis Vuitton luggage totalling over $15,600. His demands from individuals and interactions with them are extensively detailed in the indictment. Mr. Windom also failed to report gifts on standard VA forms, and denied the gifts to Federal law enforcement officials interviewing him twice in 2021. In 2024, when interviewed again, Mr. Windom admitted accepting chips. The gift acceptances from vendors with clear conflicts of interest and failures to report, including on his required annual public financial disclosure form, were violations of established Federal ethics laws and regulations restricting gifts. 

According to the indictment, he also pressured the vendors to make business decisions unrelated to the EHRM that advanced certain personal diversity objectives and then demanded to be rewarded. He also threatened this Power Group with economic and reputational harm, particularly but not only related to his diversity networking expectations (General Allegations, point 14).

John Windom, aged 64, has an interesting background. He joined the VA in September 2017 after retiring from service as a Navy Captain. While in the Navy, he had direct experience of the Cerner EHR implementation at the Department of Defense (DoD) as a program manager for their Defense Healthcare Management System Modernization Program. His 2017 appointment as executive director of the OEHRM replaced Genevieve Morris, interim chief health information officer, who had moved from ONC in July but resigned almost immediately in August citing a change in direction (MedCityNews). He became a three-year Limited Term Senior Executive Service (SES) member, a prestigious status in the Federal Government. As OEHRM ED, he reported to the Deputy Secretary of the VA and shifted after the May 2018 selection to onboarding the Cerner EHR. He became a career SES in July 2020. His Federal biography for Congress from this time is here. Mr. Windom was reassigned from OEHRM in April 2022, moving to deputy director of the Federal Electronic Health Management Office, a joint DoD-VA initiative to support the delivery of a single, integrated EHR.  It is not clear where or if he is currently employed. 

US Attorney for the District of Columbia Jeanine Pirro said in the DOJ release “As alleged, the defendant exploited his senior position for personal gain and concealed gifts and financial relationships that created serious conflicts of interest in the health care of our nation’s veterans. Such conduct is not only a betrayal of the public trust—it undermines confidence in the institutions dedicated to serving those who have sacrificed for this country.” The case is being investigated by the US Attorney’s Office for the District of Columbia, the FBI Washington Field Office, and the Veterans Affairs Office of the Inspector General (OIG). It is being prosecuted by Assistant US Attorney Emily Miller. No timeline for the start of the trial was announced.

None of this seems to have directly involved Cerner, now Oracle Health, per the indictment. But in this Editor’s opinion, because of Mr. Windom’s role in the selection of the Cerner EHR and the disastrous implementation of VA Mann-Grandstaff (VISN 20) in October 2020 and four more in 2022, all terminated in 2023, Oracle would be unwise to not prepare for a few questions about Cerner’s relationship with Mr. Windom. 

Both Senate and House VA committee chairs are highly concerned about this indictment. Apparently, it will not delay (and reasonably should not) the scheduled rollout of the 13 VA locations starting this month [TTA 8 Feb].

News sources include Federal News Network, Healthcare IT News, and Military Times.

The Oracle shoe dropped: Oracle lays off 18%–20-30K–of global employees, in their largest ever layoff (Updated 2 Apr)

March 31, 2026 | by

A bad wake up this morning for too many people. To absolutely no one’s surprise to close out this month, including Mr. Market (right), Oracle Corporation laid off an estimated 20-30,000 staff globally, or a reported 18% of its 162,000 employees. Emails signed by “Oracle Leadership” went to affected employees as early as 6 AM US Eastern Time.

It is the largest layoff in the company’s history, by a company not shy about rolling layoffs. It was rumored to be this extensive at the top of this month with the departure of five key executives and a TD Cowen analysis [TTA 6 Mar]. As is typical, Oracle stock on the NYSE rose close to 4% as of 1pm ET today.

What we know:

There were no HR calls, no videos, no manager calls, no advance warning, which is the current cold and human-free style one now expects. Many surviving managers up to senior levels weren’t told in advance of team layoffs, based on Reddit postings.

As anticipated, Oracle Health, as part of the RHS area, was hard hit with 30% layoffs, based on press reports and Reddit/The Layoff.

Early reports (to be updated) out of primarily India, where Oracle employs many thousands in IT and development, indicated the layoffs hit hardest in these areas–FTA RollingOut via Times of India:

  • RHS (Revenue and Health Sciences) — employees described a reduction in force of at least 30%, with 16 or more engineers from individual business units cut in a single action. (Editor’s Note: this includes the Oracle Health EHR team which was the former Cerner) 
  • SVOS (SaaS and Virtual Operations Services) — similarly reported a 30% or greater reduction, with manager-level roles included in the sweep.
  • NetSuite’s India Development Centre (IDC) — cuts spanned project management, individual contributor, and manager roles across multiple seniority levels.

The terse email informs employees that “we have made the decision to eliminate your role as part of a broader organizational change. As a result, today is your last working day.” Employees are also instructed to provide their personal email in order to receive FAQs and separation documents to sign off via DocuSign, as their Oracle emails will be deactivated “soon”. They are also warned against downloading any Oracle “confidential information”. Reports indicated that Mac laptops have new tracking software to determine violators, and that access to systems was already disconnected for those released. Full email text is available on Business Insider.

Some employees noted April 3 as their formal last working day, with a one-month “garden leave” period to follow. Based on TheLayoff postings, some in the US have later dates such as June 1. 

Details for India employees indicate that the normal “N+2” severance package of salary paid in months=years of service was offered. Unvested stock (e.g. RSUs) was lost. Those with vested stock still had access via Fidelity.

Many of those laid off in the US are in Kansas City Missouri (the former Cerner HQ), and have 10-20 years with the company. Most dates are before vesting of unvested RSUs. Slack counts indicate at least 10,000 gone, and likely more. Layoffs also took place in Canada and Europe, according to reports.

US labor laws about layoffs are at two levels, Federal and state; the latter varies. To this Editor’s knowledge, no Federally required WARN (Worker Adjustment and Retraining Notification) notices nor information under OWBPA (Older Workers Benefit Protection Act, which applies when employees over 40 years old are laid off) have been filed. Federal WARN starts with 50 or more employees 60 days before a plant closing or mass layoff. Many states have their own WARN laws and triggers.

What does this mean?

Oracle has taken on a massive debt load that has halved the stock from last year’s highs. For starters, Oracle took on $58 billion in new debt in just two months. Without exception in these reports, the need for layoffs and restructuring are being laid at the feet of the debt required for an extraordinary and costly change in company direction–from a provider of rapidly eroding SaaS to cloud computing services and AI datacenter contracts. This is  despite a strong Q3 and year projections [TTA 11 Mar] which had some but not enough positive effect. It is not just the debt load dragging down Oracle though–it is the time that these datacenters take to build out, get online, and generate cash flow.

TD Cowen’s report, covered in our 5 February article, nailed this quandary to the max. Oracle has entered into multiple contracts with OpenAI, Meta, and Nvidia. Lenders have doubled their interest rates on these Oracle projects to near non-investment grade levels, Oracle’s credit default swap (CDS) spreads have tripled, and private datacenters for lease are scarce because of limited market financing. Oracle can transfer some of these buildout costs to clients, but takes on risk for the bulk of it. In this Editor’s view, Oracle trapped itself into a classic squeeze. FTA: If the company doesn’t build the datacenters, it risks falling behind its massive strategy to dominate the AI datacenter business. Yet the price of this is to abandon its massive investment in healthcare, a linchpin strategy, and the customers there.

Oracle is in a tight spot without a lot of options other than more unattractive debt that further depresses the stock price. Their buildouts of datacenters, such as Stargate in Abilene, Texas, have been fraught with conflicts–the long ‘taffy pull’ of buildouts versus the annual development of ever more powerful chips that AI clients want before cash flow gets going. The difference in timelines is the killer [TTA 10 Mar]. And I suspect that Nvidia doesn’t take exchanges on their chips, once purchased.

Their largest shareholder with 40% of voting stock, executive chairman/CTO/founder Larry Ellison, still took his dividend. Unlike other founders in the past, he hasn’t mortgaged a yacht, an island, or sold a share to help stake the company in this transformation [TTA 6 Mar]. Instead, he seems to be focused on supporting his son’s Skyhorse media endeavors, the latest being the besting of Netflix in buying Warner Bros. He is also 81. These are factors to investors. Our Readers will recall that in 2022, Michael Neidorff, 25-year CEO of Centene, was forced out at age 79 by an activist shareholder group (Politan Capital, later famous for upending Masimo) that referred to both his age and tenure.

One does wonder how many of the laid off employees had specific skills that would have been useful in changing over to cloud/AI. It’s doubtful that Oracle had any process to evaluate individual competencies or capabilities for future fit. Having gone through a mass layoff when Centene absorbed WellCare Health Plans, this Editor knows first hand that companies do not evaluate individuals–they cut based on category, place, title, compensation, and other factors. Survivors either are in the right place, category, or sprint through internal contacts to another berth. This post on LinkedIn by a company that has created a ‘verification infrastructure’ to do this evaluation, instead of layoffs “based on broad assumptions about job categories rather than verified assessments of individual capability” makes you wonder whether an IT giant like Oracle even considered this approach before spending easily half a billion dollars on ‘restructuring’. 

What are the consequences of fewer people at Oracle Health? This month (April), the massive 13 facility EHRM rollout with the VA begins. And Congress, by this late spring and summer, which is budget time, will be turning the full force of scrutiny on Oracle if it doesn’t go as smooth as 30 momme silk satin. And what will it mean to health system clients and prospects? Where is their reassurance that when an IT person emails or picks up the phone with a problem, that there will be someone at Oracle Health who even knows them? Based on Reddit posts, some employees were doing their onsite support jobs when they got their termination notices and had to leave. “Is anybody there? Does anybody care?” may be the cry of hospital IT managers. That’s not good for sales or account teams…if anyone at Oracle cares about new sales and retentions.

Is Health, once the focus of Oracle’s Big Transformation, now just a used and broken toy? What’s the future of Oracle Health if the strategy is AI 24/7 and EHRs and healthcare system SaaS just do not fit the picture anymore?

Updated 31 March PM: Oracle is not admitting the cuts or the volume of them publicly. CNBC’s sources are stating only that the cuts are ‘in the thousands’. This corresponds to the early reports in Business Insider (link above). This Editor wonders if they ever will beyond a filing with the SEC. Also Wall Street Journal.  One wonders how long they can keep mum to customers and shareholders.

In addition, if WARN notices aren’t filed at locations with 50+ employees and layoffs aren’t delayed for 60 days, expect blowback at the US and state department of labor levels plus class action lawsuits. Oracle may actually sneak under this particular wire with dispersed locations and remote workers. Updated 2 April: A WARN notice was filed in Missouri, home to most of Oracle Health’s employees at the Kansas City campus. 539 employees have been laid off effective 26 May-1 June, which fulfills the 60 day notice requirement. Reportedly they are on payroll but not working. As of now, Oracle will keep the campus open. We previously noted that KC gave Cerner and later Oracle considerable incentives to build that campus. Fox 4 Kansas City

Drafted House bill may threaten VA/Oracle EHRM rollout

March 25, 2026 | by | 1 Comment

The VA’s EHR modernization (EHRM) plans may be hearing screeching brakes or a swerve if this bill sees daylight. Last week’s House Committee on Veterans’ Affairs reviewed 27 bills plus five discussion drafts as part of its sweeping reauthorization initiative to review, improve, and reauthorize specific programs and sectors at the Department of Veterans Affairs (VA). Many of these programs haven’t been reauthorized by Congress in three decades. House VA Committee release 18 March

A two-year leash. Of most interest re the EHRM plans is the 33-page discussion draft (PDF) of a bill proposed by Rep. Nikki Budzinski (D-IL), “To provide for the modernization of the electronic health record system and other health information technology activities and systems of the Department of Veterans Affairs, and for other purposes.” It specifies a series of reports from the VA Secretary that constitute ‘guardrails’ on the EHR  implementation–a noun used extensively by both Chairman Bost and member Budzinski. At the 18 March meeting, according to FedScoop, Rep. Budzinski’s proposed bill would require the VA to “create a baseline of clinical and business workflows, as well as technical requirements, to ensure the standardization of VA practices and systems.” It would also set new “health care quality metrics” based on the VA’s own Strategic Analytics for Improvement and Learning Value Model, and new reporting and independent verification and validation requirements.” If the bill becomes law, the VA secretary has two years to certify that the system’s requisite baselines and metrics “show consistent improvement” and that at least two VA facilities implement the Oracle EHR with the certifications in place. What this bill does introduce is to prevent any renewal or options for the Oracle contract if the requirements aren’t met. 

The question that this Editor would pose to Rep. Budzinski is: isn’t this bill and its requirements coming a little late in the day? 13 health system EHR rollouts are already planned, starting in April for the year, announced in February by the EHR Modernization Integration Office (EHRM-IO) [TTA 8 Feb]. The VA stopped Oracle EHR rollouts in 2023 save for Lovell in Chicago. Since then, the original six disastrous installs have been overhauled and tested. There have been multiple hearings, floggings of Oracle executives, and extensive reports from the VA’s Inspector General. What does this bill add to the mix, and do these ‘guardrails’ add meaningfully to performance?

The Committee chair, Rep. Mike Bost (R-IL), reportedly wants to use an NDAA-style process (named after the National Defense Authorization Act) to unify the bills into one ‘must-pass’ legislative bill. One can expect that some of the bill’s language will be written into the final bill, but it will be, in true House fashion, picked over and simplified from the elaborate language in the draft.

It makes Oracle’s clean performance on the upcoming VA EHRM implementations even more critical, yet…

Yet another factor. By end of month, the rumored 20-30% Oracle layoffs, outlined with some specificity on boards such as Reddit, will  undoubtedly hit Oracle Health hard. Oracle has a contract, governmental, and regulatory obligation with the VA. Despite that, the rumors also say that even those areas will be hit, perhaps less hard, but still reduced in size–sacrificed for the financial obligations tied into the New Shiny Object, datacenters. [TTA 6 March, 10 March] This is also despite Oracle’s strong Q3 showing which didn’t break out Oracle Health. Something has to give, and it’s politely called ‘restructuring’.