VA’s $4.8B facilities budget makes the EHR rollout a network upgrade

VA’s biggest facilities budget line this year is not a chiller plant or a roof. It’s the electronic health record rollout, and the wiring that has to be in place before the first clinician logs in.

Health Facilities Management reported that the U.S. Department of Veterans Affairs set aside a record $4.8 billion for fiscal year 2026 under the Veterans Health Administration’s nonrecurring maintenance program, funding upgrades, repairs and broader improvements to its health care facilities. The publication also said the package includes $1 billion to get sites ready to connect to the federal electronic health record system, which is planned to be implemented nationwide by 2031.

For operators, that $1 billion matters because it formalizes a reality many health systems learn the hard way: major clinical IT migrations break on campus infrastructure. Not servers. Pathways, closets, switching capacity, and the sheer logistics of getting cable through occupied buildings without taking down clinical operations.

EHR readiness is showing up as fiber, closets, and switch refreshes

Health Facilities Management’s reporting gets unusually specific about what “getting ready for the federal EHR” looks like on the ground. The Dayton (Ohio) VA Medical Center, one of nine VA facilities moving to the federal EHR in 2026, has been upgrading infrastructure across a 283-acre campus with more than 60 buildings, including adding roughly 38 miles of fiber-optic cable and Category 6 cabling.

The story notes the cable runs were shortened to mitigate potential latency issues. That’s a tell for how the program is being engineered: not simply “more bandwidth,” but tighter performance targets that drive new pathways and redesigned intermediate distribution. Dayton also upgraded data closet cores and switches, according to Health Facilities Management.

Dayton’s IT backbone work has also improved internal networks used by building management systems and physical security systems, alongside external networks like internet access, Health Facilities Management reported. That detail is operational gold for facilities and security leaders: the same capital project that supports clinical workflows can also remove friction from BAS segmentation, camera upgrades, and badge system refreshes if those programs are coordinated instead of sequenced in conflict.

The $4.8B plan puts hard numbers on what gets bundled, and what doesn’t

The VA’s FY 2026 nonrecurring maintenance total breaks into several buckets, according to Health Facilities Management: $2.8 billion for repairing and upgrading outdated infrastructure systems, $500 million for major building upgrades, and another $500 million aimed at modernizing medical centers for current and future care. The additional $1 billion for EHR preparation sits alongside those facility-centric categories, not inside them.

That accounting structure is a procurement and governance clue. It suggests EHR readiness work will increasingly be scoped, competed, and scheduled like a facility infrastructure program, with the EHR timeline acting as the forcing function. It also implies that projects that touch both sides, say, network segmentation that affects BAS, cameras, and clinical devices, will need clearer ownership than “IT will handle it.”

Health Facilities Management also described patient-facing modernization, such as renovating fourth-floor patient rooms at the Olin E. Teague Veterans’ Center in Temple, Texas, including conversion to single-occupancy rooms and additions like lifts and private bathrooms. Operators shouldn’t read that as a separate storyline. It’s part of the same operating thesis: VA is funding clinical experience upgrades while simultaneously funding the technical backbone that enables new care models and documentation requirements.

Why VA’s operating model changes the playbook for vendors and peer systems

This matters for more than federal procurement because VA’s care system is both enormous and closely interconnected. A Veterans Health Administration brief in Health Affairs described VA as an integrated provider network, made up of 168 medical centers plus more than 1,000 outpatient clinics, along with 250 brick-and-mortar pharmacies and seven mail-order pharmacies. Health Affairs said that structure, paired with centralized tools such as a national formulary, has long helped VA standardize operations and negotiate aggressively on pharmacy.

The same integrated footprint changes how infrastructure standards propagate during EHR programs. Once the system decides what “good” looks like for closets, fiber counts, switching, segmentation, and endpoint policies, those standards can quickly become de facto requirements for multiple sites and successive waves. For suppliers, it raises the value of being aligned to VA’s reference architectures. For other health systems, it creates a public-sector benchmark for how much physical plant work is getting pulled into what is often treated as a software program.

There’s also a sequencing implication. If a campus is already planning BAS controller replacements, camera expansions, or a physical access control refresh, Dayton’s example suggests those programs may be cheaper and less disruptive when bundled with the EHR-driven backbone rebuild, because pathways, labeling, and closet power and cooling can be handled once.

Where this lands in 2026 work plans and specs

• For facilities and IT program leaders: when an EHR “readiness” scope arrives, ask for the site’s latency and segmentation requirements in writing, because Health Facilities Management’s reporting shows VA is designing cable runs to performance targets, not just capacity.
• For network and cabling contractors: use Dayton’s reported scale, about 38 miles of fiber across a 283-acre, 60+ building campus, as a sanity check when estimating pathway work, labeling, testing, and the coordination time required to stay out of clinical downtime windows.
• For security and BAS owners: confirm whether backbone upgrades explicitly include improvements for building management and physical security traffic, as Dayton’s project did, and align your refresh cycles to avoid ripping out newly installed switching or re-patching closets twice.
• For procurement teams: separate “facility infrastructure” buys from “EHR application” buys on purpose, but force a shared acceptance test. If the network backbone is a prerequisite, it should have measurable handoff criteria before EHR go-live dates are committed.