VA Pharmacy Upgrades Bring New AI Capabilities to EHRs

The Department of Veterans Affairs is deploying artificial intelligence-based enhancements to its pharmacy module in conjunction with the nationwide rollout of its modernized electronic health record.

The new pharmacy module includes an AI transcription agent to help clinical pharmacists generate notes after speaking with a patient. This allows clinicians to focus on patient care. The system is already being deployed and should be fully operational at all current EHR sites by the end of October, VA National Pharmacist Executive Nellie Jafari told GovCIO Media & Research.

Work began on the module a little more than a year ago and incorporated feedback from VA’s pharmacy community, said VA Deputy Secretary Paul Lawrence.

“The pharmacists really thought through this … It’s hard to do because you’ve got to think through, then develop requirements, and then test. So to actually see something all the way through is hard work,” Lawrence told GovCIO Media & Research.

The pharmacy team provided a list of 20 improvements to the module. Of those, the first seven were selected to enhance the module before the Michigan EHR rollout. These were then tested after Oracle developed them, and pharmacists were given a go-no-go choice on whether to use them.

“It is exactly what they asked for, and that’s something we’re proud of because I think some of the feedback from when this all started in 2018 to 2019, was, gee, nobody talked to the providers. You weren’t listening to what they’re saying. This is exactly the opposite. This was all driven by their feedback,” Lawrence said.

The enhancements touched every part of the pharmacy process, Jafari said. Most of this work focused on outpatient pharmacy services. This is important because VA is an integrated health care system, which is very different from commercial services, she said.

Integration with VA’s EHR

The pharmacy enhancements are scheduled to go live with the agency’s EHR rollouts. Lawrence noted Oct. 24 as the next EHR go-live date for Anchorage and Cleveland. The pharmacy enhancements are being put in place several weeks beforehand “so that we have time to train everybody,” he said.

The system changes require pharmacists to have time for training. The process is intended to be seamless, with staff in Anchorage and Cleveland getting up to speed before the broader system launches.

Jafari noted that the pharmacy module enhancements are not available to sites that have not deployed the new EHR.

The final enhancements to the pharmacy module for 2026 are rolling out in October. Additional enhancements will come online in February and March 2027, Jafari said.

Pharmacy Forward

Looking ahead, VA and Oracle are working on a new module called Pharmacy Forward. This will be an entirely new module featuring additional AI tools.

An exact launch date has not been decided, but the goal is to roll it out in 2027, Lawrence said. When it does deploy, it will supersede the current pharmacy module upgrades. Because a new platform will be available, the intention is to provide something entirely new.

A key part of Pharmacy Forward is a better user interface, Jafari said. She noted that pharmacists have complained about too many steps and other inefficiencies in the current workflow. Pharmacy Forward aims to reduce those steps to allow for more efficient prescription processing. It will also have enhanced AI capabilities.

While the current module upgrades have some AI capabilities, Pharmacy Forward will potentially incorporate more AI, Jafari said. VA also plans to hold workshops with pharmacists to develop more efficient workflows.

Although the effort is still in its early stages, Jafari noted that there is strong collaboration between the VA pharmacy community and Oracle on developing the new module.