Interactive architecture map of the Department of Veterans Affairs IT landscape — systems, integrations, and data flows compiled from publicly available sources.
The VA Enterprise Architecture organizes IT across six domains. OIT manages one of the largest IT operations in the federal government, supporting 170+ medical centers, 1,300+ outpatient sites, 56 regional offices, and 155 national cemeteries.
block-beta
columns 1
A["Strategic Domain — Mission, vision, goals, measures"]
B["Business Domain — Capabilities, processes, orgs, regulations"]
C["Data & Information Domain — Standards, subject areas, governance"]
D["Systems & Applications Domain — Applications, interfaces, services"]
E["Networks & Infrastructure Domain — Hardware, platforms, delivery"]
F["Security Domain — Cybersecurity, compliance, monitoring"]
style A fill:#1a4480,stroke:#2491ff,color:#e8ecf1
style B fill:#1a4480,stroke:#2491ff,color:#e8ecf1
style C fill:#1a4480,stroke:#2491ff,color:#e8ecf1
style D fill:#1a4480,stroke:#2491ff,color:#e8ecf1
style E fill:#1a4480,stroke:#2491ff,color:#e8ecf1
style F fill:#1a4480,stroke:#2491ff,color:#e8ecf1
The CIO directs operations across staff offices and five operational divisions, each identified by an OIT organizational code.
graph TD
CIO["CIO / Asst Secretary for IT"]
CIO --> DCIO["Principal Deputy CIO"]
CIO --> CTO["Chief Technology Officer"]
CIO --> OIS["Office of Information Security"]
CIO --> BF["IT Budget & Finance"]
CIO --> SS["Office of Strategic Sourcing"]
CIO --> PS["Office of People Science"]
CIO --> CRR["Compliance, Risk & Remediations"]
CIO --> AMO["Account Management Office"]
CIO --> PE["Product Engineering · OIT-005P"]
CIO --> SPM["Software Product Management · OIT-005S"]
CIO --> SD["Solution Delivery · OIT-005T"]
CIO --> IO["Infrastructure Operations · OIT-005I"]
CIO --> EUS["End User Services · OIT-005U"]
style CIO fill:#005ea2,stroke:#2491ff,color:#fff
style PE fill:#1a2e47,stroke:#5a7fd4,color:#e8ecf1
style SPM fill:#1a2e47,stroke:#5a7fd4,color:#e8ecf1
style SD fill:#1a2e47,stroke:#5a7fd4,color:#e8ecf1
style IO fill:#1a2e47,stroke:#5a7fd4,color:#e8ecf1
style EUS fill:#1a2e47,stroke:#5a7fd4,color:#e8ecf1
style DCIO fill:#132338,stroke:#a0aec0,color:#e8ecf1
style CTO fill:#132338,stroke:#a0aec0,color:#e8ecf1
style OIS fill:#132338,stroke:#d16ba5,color:#e8ecf1
style BF fill:#132338,stroke:#a0aec0,color:#e8ecf1
style SS fill:#132338,stroke:#a0aec0,color:#e8ecf1
style PS fill:#132338,stroke:#a0aec0,color:#e8ecf1
style CRR fill:#132338,stroke:#a0aec0,color:#e8ecf1
style AMO fill:#132338,stroke:#a0aec0,color:#e8ecf1
OIT's unified software delivery methodology organized around five platforms:
Tools and methods for fast, innovative, secure software delivery
Technical documentation and self-service activation for shared services
VA-specific design guidelines and accessible digital services
Hub for product managers on VA Way product management practices
Engineering strategies, tools, and technology guidelines
The Veterans Health Administration operates one of the nation's largest healthcare systems. VistA has been the backbone for 30+ years, with Oracle Health (Millennium) gradually replacing it under the EHRM program.
VistA consists of 180+ applications organized into 99 software packages, running across ~130 instances at VA medical centers. Built on M (MUMPS) with the FileMan database engine running on InterSystems Caché (or the open-source GT.M/YottaDB). The Kernel provides core services: security, task scheduling, device management, and menu control.
| Layer | Technology | Details |
|---|---|---|
| Language | MUMPS / M | Hierarchical key-value language with built-in persistence; all VistA routines are M code |
| Database | FileMan | Data dictionary layer atop M globals; defines all VistA data structures, validation, and cross-references |
| Runtime | Caché / GT.M | InterSystems Caché at most sites; some use open-source GT.M (YottaDB). Each VAMC runs its own instance |
| Kernel | VistA Kernel | Sign-on/security, TaskMan (job scheduler), MailMan, device I/O, menu manager — the OS-like services layer |
| Clinician GUI | CPRS | Windows desktop client (Delphi) since 1997. Order entry, results reporting, clinical notes, medication reconciliation |
| Imaging | VistA Imaging | DICOM/PACS integration, 250+ medical device interfaces, scanned documents, clinical images |
| Packages | 99 software packages | Pharmacy, Lab, Radiology, Surgery, Registration, Scheduling, Billing, and more — each a distinct M namespace |
graph TD
subgraph CPRS_GUI["CPRS — Clinician Interface"]
CPRS["Computerized Patient Record System"]
end
subgraph Clinical["Clinical Applications"]
PHARM["Pharmacy
(inpatient, outpatient, IV)"]
BCMA["Bar Code Medication
Administration"]
RAD["Radiology /
Nuclear Medicine"]
LAB["Laboratory
(pathology, blood bank)"]
SURG["Surgery"]
MH["Mental Health"]
NURS["Nursing
(vitals, assessments)"]
TIU["Text Integration
Utilities (notes)"]
OERR["Order Entry /
Results Reporting"]
CREM["Clinical Reminders"]
CONS["Consult / Request
Tracking"]
end
subgraph Admin["Administrative"]
SCHED["Scheduling"]
REG["Registration / ADT"]
ENROLL["Enrollment /
Eligibility"]
PMOV["Patient Movement"]
end
subgraph Finance["Financial"]
AR["Accounts Receivable"]
IBILL["Integrated Billing"]
IFCAP["IFCAP
(procurement)"]
end
subgraph Infra["Infrastructure / Integration"]
VIA["VIA
(VistA Integration Adapter)"]
VIMG["VistA Imaging"]
HL7["HL7 Messaging"]
HDR["Health Data
Repository"]
VDEF["VistA Data
Extraction Framework"]
end
subgraph Core["VistA Core Platform"]
MUMPS["M (MUMPS) Environment"]
FM["FileMan Database Engine"]
KERN["Kernel (security, tasks)"]
end
CPRS --> Clinical
CPRS --> Admin
CPRS --> Finance
Clinical --> Core
Admin --> Core
Finance --> Core
Core --> Infra
style CPRS fill:#005ea2,stroke:#58b4ff,color:#fff
style MUMPS fill:#0d1b2a,stroke:#5a7fd4,color:#e8ecf1
style FM fill:#0d1b2a,stroke:#5a7fd4,color:#e8ecf1
style KERN fill:#0d1b2a,stroke:#5a7fd4,color:#e8ecf1
style VIA fill:#1a2e47,stroke:#54a8a5,color:#e8ecf1
style HDR fill:#1a2e47,stroke:#a86fa3,color:#e8ecf1
The $10B contract (independent cost estimate: $49.8B over lifecycle) to replace VistA with a commercial EHR shared with the Department of Defense. Currently live at 6 sites. April 2026: Michigan wave (4 sites). 13 total facilities targeted for 2026, with 164 total target by 2031.
graph LR
subgraph Oracle["Oracle Health Millennium"]
PC["PowerChart
(clinician GUI)"]
PN["PharmNet"]
PTN["PathNet"]
RN["RadNet"]
SN["SurgiNet"]
end
subgraph Analytics["Data Platform"]
HI["HealtheIntent
(population health)"]
end
subgraph Viewer["Cross-Agency"]
JLV["Joint Longitudinal
Viewer"]
end
subgraph Legacy["Legacy"]
VISTA["VistA
(130 instances)"]
end
subgraph DoD["DoD"]
MHS["MHS Genesis
(same platform)"]
end
Oracle --> HI
Oracle --> JLV
VISTA --> JLV
MHS --> JLV
VISTA --> HI
Oracle --> CDW["Corporate Data
Warehouse"]
VISTA --> CDW
style PC fill:#1a2e47,stroke:#e5a000,color:#e8ecf1
style JLV fill:#1a2e47,stroke:#54a8a5,color:#e8ecf1
style VISTA fill:#1a2e47,stroke:#d45a5a,color:#e8ecf1
style MHS fill:#132338,stroke:#a0aec0,color:#e8ecf1
style HI fill:#1a2e47,stroke:#a86fa3,color:#e8ecf1
style CDW fill:#1a2e47,stroke:#a86fa3,color:#e8ecf1
After a pause in 2023 due to user satisfaction concerns (79% of users disagreed the system enabled quality care), VA resumed planning in late 2024. FY2026 budget: $3.5B (+164% from FY2025). GAO has issued 18 recommendations; only 1 of 15 directed at VA has been fully implemented. The program remains on the GAO High Risk list.
graph LR
subgraph VistA_Sites["VistA Sites (~124 remaining)"]
V_CPRS["CPRS"]
V_VIA["VIA
(VistA Integration Adapter)"]
V_IMG["VistA Imaging"]
end
subgraph EHRM_Sites["Oracle Health Sites (6 live)"]
OH_PC["PowerChart"]
OH_FHIR["Oracle Health
FHIR APIs"]
end
subgraph HIE["Joint Health Information Exchange"]
JLV["Joint Longitudinal Viewer
(274 hospital systems, 40K clinics)"]
JHIE["FHIR-based
Data Exchange"]
end
subgraph DoD_MHS["Department of Defense"]
MHS["MHS Genesis
(same Millennium platform)"]
end
subgraph DataStores["Data Platform"]
CDW["Corporate Data
Warehouse"]
HI["HealtheIntent
(population health)"]
end
V_CPRS --> V_VIA
V_VIA --> JLV
V_VIA --> CDW
V_IMG --> JLV
OH_PC --> OH_FHIR
OH_FHIR --> JLV
OH_FHIR --> HI
OH_FHIR --> CDW
MHS --> JHIE
JHIE --> JLV
JLV --> JHIE
style JLV fill:#005ea2,stroke:#54a8a5,color:#fff
style OH_PC fill:#1a2e47,stroke:#e5a000,color:#e8ecf1
style V_CPRS fill:#1a2e47,stroke:#5a7fd4,color:#e8ecf1
style MHS fill:#132338,stroke:#a0aec0,color:#e8ecf1
style CDW fill:#1a2e47,stroke:#a86fa3,color:#e8ecf1
style JHIE fill:#1a2e47,stroke:#54a8a5,color:#e8ecf1
The FHIR-based Joint HIE connects VA with 274 hospital systems and over 40,000 clinics nationwide, enabling bidirectional data exchange between VA, DoD, and community care providers.
The veteran-facing patient portal providing secure messaging, prescription refills, health records, and appointment scheduling. Migration to va.gov (MHV-on-va.gov) completes June 4, 2025, after which the standalone MHV portal will redirect to va.gov.
The Veterans Benefits Administration processes nearly 100% of disability compensation claims electronically through VBMS, with over 387 million documents in the system. The benefits ecosystem spans 57 regional offices with 195 on-premise and 51 cloud components (BEP).
graph LR
VET["Veteran"] --> SUBMIT["va.gov / 526EZ
or Paper Scan"]
SUBMIT --> INTAKE["Benefits Intake API
(Central Mail)"]
INTAKE --> VBMS["VBMS
(electronic claims folder)"]
VBMS --> AICES["AICES
(AI evidence indexing)"]
AICES --> NWQ["National Work Queue
(auto-assignment)"]
NWQ --> RATE["Rating / Decision
(VBMS-R)"]
RATE --> BGS["Benefits Gateway
Services"]
BGS --> CORPDB["Corporate Database
(award data)"]
CORPDB --> PAY["Payment
(FMS / Treasury)"]
style VET fill:#005ea2,stroke:#2491ff,color:#fff
style VBMS fill:#1a2e47,stroke:#d45a5a,color:#e8ecf1
style AICES fill:#1a2e47,stroke:#e5a000,color:#e8ecf1
style NWQ fill:#1a2e47,stroke:#d45a5a,color:#e8ecf1
style BGS fill:#1a2e47,stroke:#c49460,color:#e8ecf1
style CORPDB fill:#1a2e47,stroke:#c49460,color:#e8ecf1
graph TD
subgraph Upstream["Upstream Data Sources"]
BGS["Benefits Gateway
Services (BGS)"]
BIRLS["BIRLS
(beneficiary records)"]
CORP["Corporate
Database"]
MVI["MVI / MPI
(identity)"]
FTI["FTI Capture
(federal tax)"]
D2D["Digits to Digits
(data exchange)"]
end
subgraph Core["VBMS Core"]
VBMS["Veterans Benefits
Management System"]
VBMSR["VBMS-R
(ratings)"]
AUTO["VBA Automation
Platform (AI/NLP)"]
end
subgraph UI["User Interfaces"]
SEP["Stakeholder
Enterprise Portal"]
EB["eBenefits
(→ migrating to va.gov)"]
EVSS["EVSS
(→ migrating to Lighthouse)"]
VAGOV["va.gov"]
end
subgraph Auth["Security"]
CSS["Common Security
Services (auth)"]
end
Upstream --> Core
Core --> UI
CSS --> Core
AUTO --> VBMS
style VBMS fill:#005ea2,stroke:#d45a5a,color:#fff
style AUTO fill:#1a2e47,stroke:#e5a000,color:#e8ecf1
style MVI fill:#1a2e47,stroke:#54a8a5,color:#e8ecf1
style BGS fill:#1a2e47,stroke:#c49460,color:#e8ecf1
style VAGOV fill:#1a2e47,stroke:#4a8fe8,color:#e8ecf1
| System | Purpose & Technical Detail | Status |
|---|---|---|
| VBMS | Electronic claims folder. Includes EDR (Electronic Document Repository) for scanned evidence, VBMS-R for rating decisions, and the National Work Queue (NWQ) for auto-assigning claims to available raters across all 57 ROs | Active |
| BGS | Benefits Gateway Services — SOA middleware layer since 2011. Exposes SOAP/REST web services connecting VBMS, CorpDB, BIRLS, and downstream consumers. The bgs-ext Ruby gem wraps BGS calls for vets-api |
Active |
| CorpDB | Corporate Database — the VBA system of record for veteran/dependent demographics, award data, and payment info. ~1,100 data tables + ~600 reference tables (Oracle RDBMS) | Active |
| BIRLS | Beneficiary Identification & Records Locator Subsystem — veteran identity index linking SSN, file number, and service records | Active |
| RBPS | Rules-Based Processing System — auto-processes dependency claims (686c/674) using business rules engine, no human rater needed for qualifying claims | Active |
| AICES | Agentic AI Claims Evidence Support — indexes 1B+ documents including handwritten notes, using ML to classify and route evidence to the correct claim contentions | New |
| Caseflow | Appeals management for AMA (Appeals Modernization Act): Supplemental Claims, Higher-Level Reviews (HLR), Board Appeals. Includes Automatic Case Distribution (ACD) for judge assignment. Open source (Ruby on Rails) | Active |
| BIP | Benefits Integration Platform — cloud-enabled SOA modernization layer replacing legacy point-to-point integrations with standardized APIs | Deploying |
| BEP | Benefits Enterprise Platform — 195 on-premise + 51 cloud components spanning 57 regional offices; the operational backbone for VBA IT | Active |
| Loan Guaranty (LGY) | VA home loan management — COE issuance, appraisal tracking, servicing | Active |
| Education Service | GI Bill benefits processing (Ch 33, 30, 31, 35) | Active |
| VR&E | Vocational rehabilitation & employment tracking | Active |
Systems that span all VA administrations, providing identity correlation, notifications, and integration middleware.
graph TD
subgraph Identity["Identity & Correlation"]
MPI["MPI / MVI
Master Person Index"]
ICN["Integration Control
Number (ICN)"]
end
subgraph Shared["Shared Services"]
NOTIFY["VA Notify
(email, SMS)"]
PROFILE["VA Profile
(contact/preferences)"]
EDM["Enterprise Document
Management"]
ESB["VA Enterprise
Service Bus"]
end
subgraph Consumers["Consumer Systems"]
V["VistA"]
VB["VBMS"]
VG["va.gov"]
MHV["My HealtheVet"]
LH["Lighthouse APIs"]
end
MPI --> ICN
MPI --> V
MPI --> VB
MPI --> VG
MPI --> MHV
MPI --> LH
ESB --> V
ESB --> VB
PROFILE --> VG
NOTIFY --> VG
style MPI fill:#005ea2,stroke:#54a8a5,color:#fff
style ICN fill:#1a2e47,stroke:#54a8a5,color:#e8ecf1
style ESB fill:#1a2e47,stroke:#c49460,color:#e8ecf1
MPI/MVI is the single authoritative identity source across all VA. It cross-references identities across VistA, VBMS, DoD, and community records using the Integration Control Number (ICN) as the unique veteran identifier.
VA is consolidating to two veteran credential providers (Login.gov and ID.me) while using Okta as the identity broker for both veteran-facing and staff-facing SSO.
March 5, 2025: My HealtheVet (MHV) credentials removed — veterans must use Login.gov or ID.me. November 18, 2025: DS Logon (DoD) credentials removed for VA services. After both dates, only Login.gov and ID.me remain as veteran credential providers.
sequenceDiagram
participant V as Veteran
participant VA as VA.gov
participant CSP as Login.gov / ID.me
participant OKTA as Okta (SSOe Broker)
participant MPI as Master Person Index
participant APP as va.gov / Mobile App
V->>VA: Click "Sign In"
VA->>CSP: Redirect to Login.gov or ID.me
CSP->>CSP: Identity proofing (IAL2)
CSP->>OKTA: SAML assertion
OKTA->>OKTA: OAuth 2.0 + OIDC token
OKTA->>MPI: Resolve ICN from identity traits
MPI->>OKTA: ICN + correlation IDs
OKTA->>APP: OAuth access token + ICN
APP->>V: Authenticated session
| Credential Provider | Assurance Level | Status |
|---|---|---|
| Login.gov (GSA) | IAL2 / AAL2 | Active |
| ID.me | IAL2 / AAL2 | Active |
| DS Logon (DoD) | IAL2 / AAL1-2 | Removed Nov 2025 |
| MHV Credentials | IAL1 / AAL1 | Removed Mar 2025 |
VA employees authenticate via PIV/CAC smart cards. Okta IDaaS provides SSO for both internal (SSOi) and external (SSOe) applications. Remote workers without PIV readers use MobilePASS soft tokens as a secondary factor.
graph TD
S["VA Employee"] --> PIV["PIV / CAC Card"]
S --> MP["MobilePASS
(remote soft token)"]
PIV --> OKTA_I["Okta IDaaS
(SSOi)"]
MP --> OKTA_I
OKTA_I --> CPRS["CPRS / VistA"]
OKTA_I --> VBMS["VBMS"]
OKTA_I --> INT["Internal Tools"]
OKTA_I --> TEAMS["MS Teams / O365"]
style S fill:#005ea2,stroke:#2491ff,color:#fff
style OKTA_I fill:#1a2e47,stroke:#e5a000,color:#e8ecf1
style PIV fill:#1a2e47,stroke:#d16ba5,color:#e8ecf1
graph LR
subgraph Sources["Data Sources"]
V130["VistA
(130 instances)"]
OHM["Oracle Health
Millennium"]
VBMS["VBMS"]
end
subgraph Warehouse["Enterprise Data"]
CDW["Corporate Data
Warehouse (CDW)"]
HDR["Health Data
Repository"]
HI["HealtheIntent
(Oracle)"]
end
subgraph Analytics["Analytics & Research"]
VSSC["VSSC
(operational reporting)"]
VINCI["VINCI
(research computing)"]
BISL["BISL
(BI dashboards)"]
end
subgraph Open["Open Data"]
DG["data.va.gov"]
end
V130 --> CDW
V130 --> HDR
V130 --> HI
OHM --> HI
OHM --> CDW
VBMS --> CDW
CDW --> VSSC
CDW --> VINCI
CDW --> BISL
CDW --> DG
style CDW fill:#005ea2,stroke:#a86fa3,color:#fff
style VINCI fill:#1a2e47,stroke:#a86fa3,color:#e8ecf1
style HI fill:#1a2e47,stroke:#a86fa3,color:#e8ecf1
VA Enterprise Cloud (VAEC) provides FedRAMP High authorized environments on AWS GovCloud and Azure Government. Approximately 50% of workloads have migrated to cloud, with data center consolidation ongoing. VA is also evaluating Google Cloud and Oracle Cloud for additional capacity.
graph TD
subgraph Veterans["Veteran / Public Access"]
WEB["va.gov / Mobile App"]
API["developer.va.gov
(Lighthouse)"]
end
subgraph CDN["Edge Layer"]
CF["CloudFront / CDN"]
WAF["AWS WAF /
Shield Advanced"]
end
subgraph VAEC["VA Enterprise Cloud (VAEC) — FedRAMP High"]
subgraph AWS_GOV["AWS GovCloud (Primary)"]
EKS["EKS / ECS
(containers)"]
EC2["EC2 / Lambda"]
RDS["RDS / Aurora
(PostgreSQL)"]
S3["S3
(static assets)"]
end
subgraph AZURE["Azure Government"]
AKS["AKS
(containers)"]
AVM["Azure VMs"]
ASQL["Azure SQL /
CosmosDB"]
end
end
subgraph EVAL["Under Evaluation"]
GCP["Google Cloud
Platform"]
OCI["Oracle Cloud
Infrastructure"]
end
subgraph DC["On-Premise Data Centers"]
AITC["Austin IT Center (AITC)
FMS mainframe, CDW"]
HITC["Hines IT Center (HITC)
Disaster recovery"]
PHIT["Philadelphia IT Center"]
end
subgraph Edge["Facility Edge (~1,300+ sites)"]
VAMC["~130 VAMC
Server Rooms (VistA)"]
RO["57 Regional Offices"]
end
subgraph Network["Network"]
WAN["VA Wide Area Network"]
TIC["TIC 3.0"]
end
WEB --> CF
API --> CF
CF --> WAF
WAF --> VAEC
DC --> WAN
Edge --> WAN
WAN --> TIC
TIC --> VAEC
style VAEC fill:#0d1b2a,stroke:#c49460,color:#e8ecf1
style AWS_GOV fill:#0a1420,stroke:#c49460,color:#e8ecf1
style AZURE fill:#0a1420,stroke:#c49460,color:#e8ecf1
style TIC fill:#1a2e47,stroke:#d16ba5,color:#e8ecf1
style AITC fill:#132338,stroke:#a0aec0,color:#e8ecf1
style WAF fill:#1a2e47,stroke:#d16ba5,color:#e8ecf1
style GCP fill:#132338,stroke:#6b7a8d,color:#a0aec0
style OCI fill:#132338,stroke:#6b7a8d,color:#a0aec0
FY2026 allocates $277M (+94% over FY2025) for the Infrastructure Readiness Program. VBMS has completed cloud migration to AWS for PACT Act scalability. Approximately 50% of VA workloads now run in VAEC, with ongoing data center consolidation targeting the remaining on-premise systems.
VA's public API gateway providing secure, RESTful access to VA data. Built on Kong (migrating to Apigee/GCP), PostgreSQL, and Okta, hosted in VAEC AWS GovCloud at FISMA Moderate. Default rate limit: 60 requests/minute per consumer.
graph LR
subgraph Consumers["API Consumers"]
DEV["Third-Party
Developers"]
VSO["Veteran Service
Organizations"]
VG["va.gov /
vets-api (Rails)"]
MOB["VA Mobile App"]
end
subgraph Auth["Identity Layer"]
IDme["ID.me"]
LGov["Login.gov"]
OKTA["Okta
(OAuth 2.0 + OIDC)"]
end
subgraph Gateway["API Gateway Layer"]
KONG["Kong Gateway
(current — nginx-based)"]
APIGEE["Apigee / GCP
(migration target)"]
HAP["HAProxy
(load balancer)"]
end
subgraph App["Application Layer"]
VAPI["vets-api
(Ruby on Rails)"]
LH_SVC["Lighthouse
Microservices"]
end
subgraph APIs["API Catalog"]
HC["Health (FHIR R4)
Argonaut / USCDI"]
BC["Benefits Claims"]
BI["Benefits Intake"]
DR["Decision Reviews"]
FAC["Facilities"]
VV["Veteran Verification"]
LGY["Loan Guaranty"]
FORMS["VA Forms"]
end
subgraph Backend["Backend Systems of Record"]
VISTA2["VistA (via VIA)"]
VBMS2["VBMS / BGS"]
MPI2["MPI / MVI"]
CDW2["CDW"]
CORPDB["Corporate DB"]
CASEFLOW["Caseflow"]
end
Consumers --> IDme
Consumers --> LGov
IDme --> OKTA
LGov --> OKTA
OKTA --> KONG
KONG --> HAP
APIGEE -.->|migration| HAP
HAP --> VAPI
HAP --> LH_SVC
VAPI --> APIs
LH_SVC --> APIs
APIs --> Backend
style KONG fill:#005ea2,stroke:#4a8fe8,color:#fff
style APIGEE fill:#132338,stroke:#e5a000,color:#e8ecf1
style OKTA fill:#1a2e47,stroke:#e5a000,color:#e8ecf1
style VAPI fill:#1a2e47,stroke:#4a8fe8,color:#e8ecf1
style HAP fill:#1a2e47,stroke:#4a8fe8,color:#e8ecf1
| Method | Use Case | Data Access |
|---|---|---|
| OAuth 2.0 + OIDC | Veteran-authorized apps accessing PII/PHI | Health records, claims, personal info |
| OAuth 2.0 + PKCE | Public/mobile consumer apps (no client secret) | Same as OAuth, for SPA/mobile clients |
| API Key | Open/public data endpoints | Facilities, forms, public benefit info |
| Client Credentials | System-to-system (VSO bulk access) | Claims status, benefits intake |
| Environment | Base URL | Purpose |
|---|---|---|
| Sandbox | sandbox-api.va.gov |
Test data, no PII/PHI, instant API key |
| Production | api.va.gov |
Live VA data, requires production access approval |
Lighthouse is migrating from the self-hosted Kong (nginx) gateway to Google Apigee on GCP. This is an in-progress platform shift that will provide improved analytics, developer portal features, and managed scaling. Default rate limit remains 60 requests/minute per consumer key.
Patient health data via Argonaut/USCDI — conditions, medications, allergies, immunizations, observations
Auto-establishment of disability claims (526EZ), claim status, intent to file
PDF document upload to Central Mail / VBMS evidence repository
Supplemental Claims, Higher-Level Reviews, Board Appeals (AMA)
Locations, services, hours, wait times for 1,700+ VA facilities
Veteran status confirmation, service history, disability rating
COE (Certificate of Eligibility), appraisal data, loan status
Searchable catalog of all VA forms with PDF links and metadata
VA's financial modernization has been one of its most challenging programs, with two prior failed attempts before the current iFAMS initiative. The program is on the GAO High Risk list. Estimated lifecycle cost: ~$8.6B through 2050.
timeline
title VA Financial System Modernization
~2004 : CoreFLS (abandoned)
~2005-2014 : FLITE (abandoned)
2016 : FMBT / iFAMS program established
2020 : iFAMS Phase 1 deployed at NCA
2022 : Phase 2-3 (VHA accounting)
2024 : Phase 4-5 complete
2027 : Enterprise deployment target
~2050 : End of lifecycle (~$8.6B total)
| System | Purpose & Technical Detail | Budget | Status |
|---|---|---|---|
| FMS | Financial Management System — 35-year-old COBOL mainframe running at AITC (Austin). Single-site deployment, no failover. Processes all VA accounting, payments, and Treasury reporting | — | Being replaced |
| iFAMS | Integrated Financial & Acquisition Management System — CGI Federal's Momentum ERP product, hosted on Azure Government cloud. 5 deployment phases complete. Replaces FMS, IFCAP, and other legacy financial systems | ~$8.6B lifecycle | Deploying |
| FMBT | Financial Management Business Transformation — the program office managing iFAMS rollout. Enterprise deployment target: 2027 | $135M (FY26) | Active |
| IFCAP | Integrated Funds Distribution, Control Point Activity, Accounting & Procurement — legacy VistA-based procurement module being replaced by iFAMS | — | Legacy |
VA financial management has been on the GAO High Risk list since 2019. The iFAMS program has faced schedule delays, with enterprise deployment slipping from 2027 to potentially 2030. CGI Federal is the prime system integrator. Independent cost estimate through 2050: approximately $8.6 billion.
The veteran-facing digital platform. Fully open source on GitHub, built by the Digital Service team. Follows the Platform Collaboration Cycle: Midpoint Review, then Staging Review before production launch.
graph TD
subgraph Frontend["Frontend Layer"]
VW["vets-website
React + Redux SPA"]
VADS["VA Design System (VADS)
design.va.gov
Web Components"]
METAL["Metalsmith
(static site generator)"]
MOB["VA Mobile App
(React Native)"]
end
subgraph Backend["Backend Layer"]
VAPI["vets-api
Ruby on Rails"]
PG["PostgreSQL + PostGIS"]
REDIS["Redis
(sessions, cache)"]
SIDEKIQ["Sidekiq
(async jobs)"]
end
subgraph CMS["Content Management"]
DRUPAL["va.gov-cms
(Drupal 10.1)"]
end
subgraph CICD["CI/CD Pipeline"]
JENKINS["Jenkins
(primary)"]
GHA["GitHub Actions
(emerging)"]
end
subgraph Deploy["Deployment"]
S3["S3
(static assets)"]
NGINX["nginx
(reverse proxy)"]
end
subgraph Integrations["Backend Integrations (~30+ systems)"]
LH["Lighthouse APIs"]
MPI3["MPI / MVI"]
ESR["Enrollment System
Redesign"]
PPMS["Provider Profile
Mgmt System"]
VIA2["VistA (via VIA)"]
VBMS3["VBMS / BGS"]
EVSS2["EVSS
(→ Lighthouse)"]
end
VW --> VAPI
MOB --> VAPI
DRUPAL --> METAL
METAL --> S3
VAPI --> PG
VAPI --> REDIS
VAPI --> SIDEKIQ
VAPI --> Integrations
VADS --> VW
VW --> JENKINS
JENKINS --> S3
GHA -.-> S3
S3 --> NGINX
style VW fill:#1a2e47,stroke:#4a8fe8,color:#e8ecf1
style VAPI fill:#005ea2,stroke:#4a8fe8,color:#fff
style DRUPAL fill:#1a2e47,stroke:#4a8fe8,color:#e8ecf1
style MOB fill:#1a2e47,stroke:#4a8fe8,color:#e8ecf1
style VADS fill:#1a2e47,stroke:#4a8fe8,color:#e8ecf1
style PG fill:#1a2e47,stroke:#a86fa3,color:#e8ecf1
style REDIS fill:#1a2e47,stroke:#d45a5a,color:#e8ecf1
style JENKINS fill:#132338,stroke:#a0aec0,color:#e8ecf1
| Component | Technology | Details |
|---|---|---|
| vets-website | React + Redux | Single-page application with Metalsmith static site generation for content pages. Monorepo with ~100+ applications |
| vets-api | Ruby on Rails | API gateway connecting frontend to 30+ backend systems. PostgreSQL + PostGIS for geospatial queries. Redis for sessions and caching. Sidekiq for async jobs |
| VA Design System | Web Components | design.va.gov — reusable component library based on USWDS. Used across va.gov, mobile app, and internal tools |
| CMS | Drupal 10.1 | va.gov-cms manages facility pages, VAMC sites, Vet Center pages, and editorial content |
| CI/CD | Jenkins / GitHub Actions | Jenkins handles primary build/deploy pipeline. GitHub Actions emerging for automated testing and linting |
| Deployment | S3 + nginx | Static assets served from S3 via CloudFront CDN. vets-api runs on AWS ECS/EKS behind nginx reverse proxy |
All va.gov source code is publicly available on GitHub at github.com/department-of-veterans-affairs. Key repos: vets-website (React), vets-api (Rails), va.gov-cms (Drupal), va-mobile-app (React Native). Teams follow the Platform Collaboration Cycle: Design Intent → Midpoint Review → Staging Review → Production launch.
VA operates under a Zero Trust First strategy with a "Cyber Dominance" posture announced in 2025. OIT's Office of Information Security (OIS) manages TIC 3.0 compliance, continuous monitoring, and the Enterprise Cybersecurity Rationalization Initiative (ECRI).
graph TD
subgraph Identity["Identity Pillar"]
PIV["PIV / CAC"]
MFA["MFA
(Login.gov, ID.me)"]
OKTA["Okta IDaaS
(SSO broker)"]
end
subgraph Device["Device Pillar"]
EDR["Endpoint Detection
& Response (EDR)"]
MDM["Mobile Device
Management"]
PATCH["Automated
Patch Management"]
end
subgraph Network["Network Pillar"]
TIC3["TIC 3.0
(cloud-aware)"]
ZTNA["Zero Trust
Network Access"]
MICRO["Microsegmentation"]
end
subgraph App["Application Pillar"]
SAST["Static Analysis
(SAST/DAST)"]
ATO["Continuous ATO
(cATO)"]
WAF["Web Application
Firewall"]
end
subgraph Data["Data Pillar"]
DLP["Data Loss
Prevention"]
ENCRYPT["Encryption
(at rest + transit)"]
CLASSIFY["Data
Classification"]
end
subgraph Ops["Visibility & Monitoring"]
SOC["VA SOC
(24/7 monitoring)"]
SIEM["SIEM / Log
Aggregation"]
THREAT["Threat Intel
& Hunting"]
end
Identity --> OKTA
Device --> SOC
Network --> SOC
App --> SOC
Data --> SOC
OKTA --> ZTNA
style OKTA fill:#1a2e47,stroke:#e5a000,color:#e8ecf1
style TIC3 fill:#1a2e47,stroke:#d16ba5,color:#e8ecf1
style SOC fill:#005ea2,stroke:#d16ba5,color:#fff
style ZTNA fill:#1a2e47,stroke:#d16ba5,color:#e8ecf1
VA's strategic approach: never trust, always verify. All access requires identity verification, device health checks, and least-privilege authorization regardless of network location.
OIT's updated posture emphasizing proactive threat hunting, red team exercises, and offensive security capabilities alongside traditional defensive monitoring.
Updated Trusted Internet Connection policy supporting cloud-native architectures. Allows direct cloud access with appropriate security controls rather than backhauling through TIC access points.
Enterprise Cybersecurity Rationalization Initiative — consolidating and deduplicating VA's security tooling portfolio to reduce complexity and improve coverage.
VA has become one of the largest federal adopters of AI and robotic process automation, driven by the PACT Act claims surge and the need to reduce processing times across health and benefits.
graph TD
subgraph Claims_AI["Claims Processing AI"]
AICES["AICES
Agentic AI evidence indexing
(1B+ documents, handwriting)"]
TERA["TERA Memo Automation
(ML prepopulation of
toxic exposure memos)"]
PACT["PACT Act Automation
(1M+ claims processed,
~20 day advantage)"]
end
subgraph Health_AI["Health AI"]
SCRIBE["Ambient AI Scribe
(launched Oct 2025,
nationwide 2026)"]
CDSS["Clinical Decision
Support"]
end
subgraph Community["Community Care"]
CCRS["CCRS
99.9% auto-adjudication
reimbursement <7 days"]
end
subgraph RPA["Robotic Process Automation"]
COE["RPA Center of Excellence"]
NINTEX["Nintex / Blue Prism
(bot fleet)"]
end
subgraph Platform["AI Platform"]
VAEC_AI["VAEC AI/ML
Infrastructure"]
end
Claims_AI --> VAEC_AI
Health_AI --> VAEC_AI
Community --> VAEC_AI
RPA --> COE
style AICES fill:#1a2e47,stroke:#e5a000,color:#e8ecf1
style PACT fill:#1a2e47,stroke:#e5a000,color:#e8ecf1
style SCRIBE fill:#1a2e47,stroke:#e5a000,color:#e8ecf1
style CCRS fill:#1a2e47,stroke:#e5a000,color:#e8ecf1
style VAEC_AI fill:#005ea2,stroke:#e5a000,color:#fff
| Initiative | Domain | Details | Status |
|---|---|---|---|
| AICES | VBA | Agentic AI system that indexes 1B+ claim documents, including handwritten notes. Classifies evidence, extracts medical conditions, and routes to correct contentions automatically | Deploying |
| PACT Act Automation | VBA | ML models auto-process toxic exposure claims. Over 1 million claims processed with automation assistance, yielding approximately a 20-day processing advantage over manual review | Active |
| TERA Memo Automation | VBA | ML prepopulation of Toxic Exposure Risk Activity (TERA) memoranda, reducing manual data entry for raters processing burn pit and Agent Orange claims | Active |
| CCRS | VHA | Community Care Reimbursement System — auto-adjudicates 99.9% of community care claims with reimbursement in under 7 days, down from 30+ days manually | Active |
| Ambient AI Scribe | VHA | AI-powered clinical documentation — listens to patient encounters and drafts clinical notes for provider review. Launched October 2025, nationwide rollout planned for 2026 | Expanding |
| RPA Center of Excellence | Enterprise | Nintex and Blue Prism bot fleet automating repetitive tasks across benefits, health, and finance — data entry, eligibility checks, report generation | Active |
When VA cannot provide timely or geographically accessible care, veterans are referred to community providers through the Community Care Network. Two Third-Party Administrators (TPAs) manage five regions covering all US states and territories.
graph TD
VET["Veteran"] --> VAMC["VA Medical Center
(determines eligibility)"]
VAMC --> CCREQ["Community Care
Referral Request"]
CCREQ --> R1["Region 1 — Northeast
CT DE DC ME MD MA NH
NJ NY PA RI VT VA WV"]
CCREQ --> R2["Region 2 — Southeast
AL FL GA KY MS
NC SC TN PR VI"]
CCREQ --> R3["Region 3 — Central
AR LA OK TX IL IN MI
MN OH WI IA KS MO NE ND SD"]
CCREQ --> R4["Region 4 — Mountain
AZ CO ID MT
NV NM UT WY"]
CCREQ --> R5["Region 5 — Pacific
AK CA HI OR
WA GU AS"]
R1 --> OPTUM["Optum
(Regions 1-3)"]
R2 --> OPTUM
R3 --> OPTUM
R4 --> TRIWEST["TriWest Healthcare
Alliance (Regions 4-5)"]
R5 --> TRIWEST
OPTUM --> PROV1["Community
Providers"]
TRIWEST --> PROV2["Community
Providers"]
PROV1 --> CCRS["CCRS
(Reimbursement)"]
PROV2 --> CCRS
style VET fill:#005ea2,stroke:#2491ff,color:#fff
style VAMC fill:#1a2e47,stroke:#5a7fd4,color:#e8ecf1
style OPTUM fill:#1a2e47,stroke:#54a8a5,color:#e8ecf1
style TRIWEST fill:#1a2e47,stroke:#54a8a5,color:#e8ecf1
style CCRS fill:#1a2e47,stroke:#5fa86a,color:#e8ecf1
style CCREQ fill:#1a2e47,stroke:#e5a000,color:#e8ecf1
| TPA | Regions | Portal | Phone |
|---|---|---|---|
| Optum | 1 (Northeast), 2 (Southeast), 3 (Central) | vacommunitycare.com | (888) 901-7407 |
| TriWest | 4 (Mountain), 5 (Pacific) | vaccn.triwest.com | (877) 226-8749 |
National Contact Center: 877-881-7618 (Option 1 for Veterans). CCRS auto-adjudicates 99.9% of reimbursements in <7 days.
How VA systems connect to the programs that actually reach veterans. These programs are organized by VISN and linked to VA Medical Centers through station codes. Data sourced from VA Lighthouse API and official program award records.
graph TD
VISN["18 VISNs
(Integrated Service Networks)"]
VISN --> VAMC["130+ VA Medical Centers
(by station code)"]
VAMC --> HEALTH["Healthcare Delivery"]
VAMC --> HOUSING["Housing Programs"]
VAMC --> EDUCATION["Education & Training"]
VAMC --> COUNSELING["Counseling & Readjustment"]
HEALTH --> LH_FAC["Lighthouse Facilities API
api.va.gov/services/va_facilities/v1"]
HEALTH --> TELEHEALTH["VA Telehealth
50+ specialties"]
HEALTH --> MOBILE_UNITS["25 Mobile
Medical Units"]
HOUSING --> HUDVASH["HUD-VASH
421 PHAs / 46 states
Housing Choice Vouchers"]
HOUSING --> SSVF["SSVF
235 grantees
Rapid rehousing"]
HOUSING --> GPD["GPD
295 grantees
Transitional housing"]
EDUCATION --> GIBILL["GI Bill Schools
~10,000 institutions
WEAMS / GIDS API"]
EDUCATION --> OJT["On-the-Job Training
& Apprenticeships"]
COUNSELING --> VETCTR["300+ Vet Centers
+ Mobile Vet Centers"]
HUDVASH --> PHA["Public Housing
Authorities"]
HUDVASH --> CASE_MGMT["VA Case
Management"]
SSVF --> NONPROFITS["Nonprofit
Grantees"]
GPD --> TRANS_HOUSING["Transitional Housing
+ Service Centers"]
VETCTR --> READJ["Readjustment Counseling
PTSD · MST · Grief
Family · Employment"]
style VISN fill:#005ea2,stroke:#2491ff,color:#fff
style VAMC fill:#1a2e47,stroke:#5a7fd4,color:#e8ecf1
style HEALTH fill:#1a2e47,stroke:#5a7fd4,color:#e8ecf1
style HOUSING fill:#1a2e47,stroke:#d45a5a,color:#e8ecf1
style EDUCATION fill:#1a2e47,stroke:#c49460,color:#e8ecf1
style COUNSELING fill:#1a2e47,stroke:#a86fa3,color:#e8ecf1
style HUDVASH fill:#1a2e47,stroke:#d45a5a,color:#e8ecf1
style SSVF fill:#1a2e47,stroke:#d45a5a,color:#e8ecf1
style GPD fill:#1a2e47,stroke:#d45a5a,color:#e8ecf1
style VETCTR fill:#1a2e47,stroke:#a86fa3,color:#e8ecf1
style GIBILL fill:#1a2e47,stroke:#c49460,color:#e8ecf1
style LH_FAC fill:#1a2e47,stroke:#4a8fe8,color:#e8ecf1
| Program | Scale | Model | Eligibility |
|---|---|---|---|
| HUD-VASH | 421 PHAs across 46 states | Housing Choice Vouchers + VA case management + mental health & substance use counseling | Homeless or at-risk, VA healthcare eligible, income ≤ 80% AMI |
| SSVF | 235 grantee organizations | Rapid rehousing, homelessness prevention, temporary financial assistance, case management | Very low-income veteran families, income ≤ 50% AMI |
| GPD | 295 grantees | Transitional housing (24-month max) & service centers. Bed types: bridge, low-demand, clinical, intensive, dependents | Homeless veterans, VA healthcare eligible |
National Hotline: 1-877-4AID-VET (1-877-424-3838). All programs organized by VISN and linked to VA Medical Centers via station codes.
300+ community-based counseling centers (plus mobile units for underserved areas) providing readjustment services outside the traditional VA medical setting. No co-pay required.
| API / Source | Endpoint | Data Available | Auth |
|---|---|---|---|
| VA Facilities | api.va.gov/services/va_facilities/v1 | Health facilities, benefits offices, vet centers, cemeteries — services, hours, wait times, patient satisfaction | API Key |
| GI Bill Schools (GIDS) | va.gov/gids/v1/institutions/search | ~10,000 approved institutions — degree types, Yellow Ribbon, caution flags, accreditation, certifying officials | None |
| VHA GIS | ArcGIS FeatureServer | Geospatial facility locations for mapping and proximity search | None |
| CMS Provider Data | data.cms.gov | VHA provider-level data, quality metrics | None |
| HRSA Health Centers | data.hrsa.gov + findahealthcenter.hrsa.gov | 50,000+ FQHCs — serves veterans in community care referral pathway | None |
The full picture: how the major systems connect, from veteran-facing interfaces through API gateways down to core systems of record.
graph TD
VET["Veteran"]
VET --> VAGOV["va.gov"]
VET --> MHV["My HealtheVet"]
VET --> MOBILE["VA Mobile App"]
VAGOV --> VAPI["vets-api
(Rails)"]
MHV --> VAPI
MOBILE --> VAPI
VAPI --> LH["Lighthouse
API Gateway"]
VAPI --> MPI["MPI / MVI"]
VAPI --> IAM["IAM / SSOe"]
LH --> VISTA["VistA
(via VIA)"]
LH --> VBMS["VBMS"]
LH --> BGS["BGS"]
VISTA --> HDR["Health Data
Repository"]
VISTA --> CDW["Corporate Data
Warehouse"]
VBMS --> CDW
HDR --> CDW
CDW --> ANALYTICS["VSSC / VINCI
Analytics"]
VISTA --> JLV["JLV"]
OHMIL["Oracle Health
Millennium"] --> JLV
DOD["DoD MHS
Genesis"] --> JLV
OHMIL --> HI["HealtheIntent"]
STAFF["VA Staff"] --> PIV["PIV/CAC"]
PIV --> SSOI["SSOi"]
SSOI --> CPRS["CPRS"]
CPRS --> VISTA
style VET fill:#005ea2,stroke:#2491ff,color:#fff
style STAFF fill:#005ea2,stroke:#2491ff,color:#fff
style VAPI fill:#1a2e47,stroke:#4a8fe8,color:#e8ecf1
style LH fill:#1a2e47,stroke:#4a8fe8,color:#e8ecf1
style MPI fill:#1a2e47,stroke:#54a8a5,color:#e8ecf1
style VISTA fill:#1a2e47,stroke:#5a7fd4,color:#e8ecf1
style VBMS fill:#1a2e47,stroke:#d45a5a,color:#e8ecf1
style CDW fill:#1a2e47,stroke:#a86fa3,color:#e8ecf1
style JLV fill:#1a2e47,stroke:#54a8a5,color:#e8ecf1
style OHMIL fill:#1a2e47,stroke:#e5a000,color:#e8ecf1
style CPRS fill:#1a2e47,stroke:#5a7fd4,color:#e8ecf1
style IAM fill:#1a2e47,stroke:#e5a000,color:#e8ecf1
VistA (Veterans Health Information Systems and Technology Architecture) is one of the most significant government-built software systems in history. Born from a programmer-led counter-culture within the VA, it grew from unauthorized code on hospital minicomputers into the backbone of America's largest integrated healthcare system.
In late 1977, Ted O'Neill and Marty Johnson — key figures in MUMPS standardization at the National Bureau of Standards — moved into a small VA office called CASS (Computer Assisted System Staff). They began recruiting programmers already working at individual VA hospitals in St. Petersburg, Lexington, and San Francisco.
Tom Munnecke and George Timson sketched the foundational "Onion Diagram" on a paper placemat in 1978 — MUMPS at the center, a kernel of shared programs around it, with applications floating like electrons. An informal network dubbed the "Underground Railroad" formed in 1979, with participants self-describing as "conspirators against the enemy," building software that directly defied VA central management's preference for centralized, top-down IT procurement.
Developed in 1966–67 by Neil Pappalardo, Robert Greenes, and Curt Marble at Massachusetts General Hospital. ANSI-standardized; officially renamed "M" in 1995. Chosen for the VA because it was vendor-neutral, supported multi-user concurrency natively, and offered extreme performance on minimal hardware.
Variables prefixed with ^ are automatically persisted to disk. No separate database engine or query language needed — predating NoSQL by decades.
No impedance mismatch between language and storage. The database is implicitly "open" for every application. Local and global variable syntax is identical.
Rapid development cycles and runtime flexibility. Code can be stored in and executed from globals, enabling meta-programming patterns used throughout VistA.
Created by George Timson ("Father of FileMan") in 1978. A self-describing, active data dictionary that can invoke the full power of MUMPS from within a data reference — setting a value may trigger cross-references, send mail, or encrypt data.
timeline
title VistA Evolution
1978 : DHCP conceived
: Onion Diagram sketched
1979 : Underground Railroad forms
: Ted O'Neill fired
1981 : DHCP formally recognized
1982 : Executive Order legitimizes DHCP
1996 : Rebranded to VistA
1997 : CPRS GUI released (Delphi)
: BCMA pioneered
2003 : WorldVistA nonprofit founded
2006 : Harvard Innovation Award
2011 : OSEHRA established
2014 : VistA #1 rated EHR (Medscape)
2016 : VistA #1 rated again
2017 : VA decides to replace VistA
2018 : $10B Oracle/Cerner contract
2020 : OSEHRA ceases operations
2024 : VistA migrated to cloud
: VistA still at 166+ sites
| Innovation | Description |
|---|---|
| Kernel | OS-like services layer: user auth, device management, TaskMan (job scheduler), MailMan (email system operational before commercial email existed), menu driver |
| RPC Broker | Middleware bridging Delphi GUI clients to M servers, enabling the CPRS client-server architecture with security context controls |
| KIDS | Kernel Installation and Distribution System — a package manager for distributing patches across 130+ sites, decades before npm or apt |
| BCMA | Bar Code Medication Administration — VA pioneered barcode scanning to reduce medication errors, later adopted industry-wide |
| HL7 Engine | Inter-system messaging both within VistA packages and with external systems, including the optimized HLO variant |
| CPRS | Computerized Patient Record System (1997) — unified order entry, clinical notes, results, medications, and clinical decision support in a single GUI |
Dumb terminal "green screen" interfaces. Users entered commands line by line.
Structured terminal interface for reviewing lists and choosing actions. Used by TIU and other packages.
Windows desktop client in Borland Delphi. First major VA GUI. Still the primary clinical interface at 166+ sites after 25+ years.
EWD.js prototypes and community-driven web frontends. No fully successful web replacement has been deployed. Delphi technology is "effectively obsolete."
| Program | Period | Cost | Outcome |
|---|---|---|---|
| HealtheVet VistA | 2001–2010 | ~$600M+ (est. $11B to complete) | Canceled. Only deliverable: My HealtheVet patient portal |
| iEHR | 2011–2013 | Part of $1.1B (138 contractors) | Joint VA-DoD effort collapsed when DoD chose Cerner |
| VistA Evolution | 2013–2017 | Part of $1.1B | Abandoned when VA decided to buy commercial solution |
| EHRM (Oracle Health) | 2017–present | $10B contract; lifecycle est. $33–39B | In Progress Deployed at 5 of 171 sites. ~$5B spent. Plagued by safety issues and congressional criticism |
VistA and its derivatives have been deployed worldwide: Jordan (entire national healthcare system), Finland (first non-US adopter, early 1980s), India (IHS RPMS derivatives), Mexico (IMSS), Egypt (NCI Cairo), plus American Samoa, Kurdistan, Iraq, Germany, Kenya, Nigeria, Malaysia, Brazil, Pakistan, and Denmark.
The Office of Connected Care oversees VA's telehealth portfolio, which exploded during COVID-19 and has sustained as a core care delivery channel. VA Video Connect (VVC), built on Pexip Infinity, handles millions of video-to-home visits annually.
| Component | Details |
|---|---|
| Platform | Pexip Infinity — software-defined video conferencing. FedRAMP ATO at Moderate Impact (April 2023) |
| Deployment | Originally on-premises in VA data centers; migrated to cloud during COVID. Cloud deployment is now primary |
| Encryption | FIPS 140-2 validated. IPsecv3 between nodes, TLS v1.2 / DTLS at transport layer |
| Client | Browser-based (Chrome, Edge, Safari, Firefox) or native iOS/Android app |
| Minimum | 3G/4G cellular with 2+ signal bars |
| Scheduling | Virtual Care Manager (VCM) integrates with both VistA and Oracle Health credentials |
Real-time video between patient (at CBOC or home) and provider at VA medical center. Includes VVC as the video-to-home subset.
Asynchronous capture and transmission. TeleRetinal Imaging, TeleDermatology, TelePathology. 360K encounters in FY2023.
In-home devices (BP monitors, glucometers, pulse oximeters) transmit data to Care Coordinators. 132K veterans enrolled (2022). 41% reduction in hospital admissions.
Community access points at American Legion, VFW, and Walmart locations with private rooms and telehealth equipment. GAO found 14 of 24 sites had zero visits (FY2022–23).
graph LR
REQ["Veteran/Provider
Requests Video Visit"] --> SCHED["Clinic Scheduler
Creates Appointment
(VistA VSE GUI or
Oracle Health)"]
SCHED --> VCM["Virtual Care Manager
Generates VVC Link"]
VCM --> EMAIL["Automated Emails
(at scheduling, 14d,
7d, 1d, day-of)"]
EMAIL --> VET["Veteran Clicks Link
Enters Virtual
Waiting Room"]
VET --> VISIT["Provider Launches
from VCM Dashboard"]
VISIT --> DOC["Visit Documented
in VistA/Oracle Health"]
style REQ fill:#005ea2,stroke:#2491ff,color:#fff
style SCHED fill:#1a2e47,stroke:#5a7fd4,color:#e8ecf1
style VCM fill:#1a2e47,stroke:#54a8a5,color:#e8ecf1
style EMAIL fill:#1a2e47,stroke:#c49460,color:#e8ecf1
style VET fill:#005ea2,stroke:#2491ff,color:#fff
style VISIT fill:#1a2e47,stroke:#5a7fd4,color:#e8ecf1
style DOC fill:#1a2e47,stroke:#5a7fd4,color:#e8ecf1
| Period | Video-to-Home Visits | Total Telehealth | Unique Veterans |
|---|---|---|---|
| FY2019 (pre-COVID) | 294,847 | 2.6M episodes | ~900K |
| FY2021 (peak surge) | 9,575,958 | 11.2M episodes | 2.3M |
| FY2023 | — | 11.6M episodes | 2.4M (~40% of all veterans served) |
| FY2025 | 11.7M+ video-to-home | 14.6M episodes | 2.9M |
Since 2016, VHA has provided tablets to over 180,000 veterans. From April 2020 to February 2023, 119,926 veterans received loaned video-capable tablets with internet service through the Digital Divide Consult. Recipients had nearly 3x the likelihood of having a video visit within a month compared to the general VHA population. Legislative authority for cross-state telehealth delivery comes from the VA MISSION Act of 2018, which enabled ~10,000 VA providers to deliver out-of-state telehealth.
The VA's flagship mobile app, launched July 2021 in React Native. Shares the same vets-api Rails backend as va.gov. Open source at github.com/department-of-veterans-affairs/va-mobile-app.
graph TD
APP["VA: Health and Benefits
(React Native / TypeScript)"]
APP --> AUTH["OAuth 2.0 + PKCE"]
AUTH --> IDP["Login.gov / ID.me"]
IDP --> OKTA["Okta
(Identity Broker)"]
OKTA --> SIS["Sign-in Service
(vets-api)"]
APP --> PAPI["platform-api.va.gov
(vets-api endpoints)"]
PAPI --> VAPI["vets-api
(Ruby on Rails)"]
VAPI --> VISTA2["VistA"]
VAPI --> VBMS2["VBMS"]
VAPI --> BGS2["BGS"]
APP --> LHAPI["api.va.gov
(Apigee Gateway)"]
LHAPI --> LH2["Lighthouse APIs"]
APP --> NOTIFY["VANotify
(Push Notifications)"]
NOTIFY --> FCM["FCM / APNs"]
style APP fill:#005ea2,stroke:#2491ff,color:#fff
style VAPI fill:#1a2e47,stroke:#4a8fe8,color:#e8ecf1
style LH2 fill:#1a2e47,stroke:#4a8fe8,color:#e8ecf1
style OKTA fill:#1a2e47,stroke:#e5a000,color:#e8ecf1
style VISTA2 fill:#1a2e47,stroke:#5a7fd4,color:#e8ecf1
style VBMS2 fill:#1a2e47,stroke:#d45a5a,color:#e8ecf1
style NOTIFY fill:#1a2e47,stroke:#54a8a5,color:#e8ecf1
| Layer | Technology | Details |
|---|---|---|
| Frontend | React Native (TypeScript) | Single codebase for iOS and Android. Chosen because VA had existing React expertise from va.gov |
| Backend | vets-api (Ruby on Rails) | Shared backend with va.gov. Mobile-specific endpoints exist within vets-api |
| Auth | OAuth 2.0 + PKCE | Login.gov or ID.me → Okta (broker) → Sign-in Service. MFA required. My HealtheVet credentials deprecated March 2025 |
| Biometrics | Face ID / Touch ID / Fingerprint | Local device gate. OAuth tokens stored in Keychain (iOS) / Keystore (Android), protected by biometric access controls |
| Notifications | VANotify → FCM / APNs | Centralized VA notification platform (forked from UK/Canadian Gov "Notify"). Triggers: appointments, Rx shipments, claim updates |
| CI/CD | GitHub Actions, Jenkins | Docker/Kubernetes build platform. Updates ship every 2–4 weeks via App Store / Google Play |
| Accessibility | WCAG 2.2 AA / Section 508 | VoiceOver and TalkBack testing. Feedback sessions with blind and low-vision veterans |
Secure messaging (525K+ messages), appointments (995K+ views), prescription refills (194K+), vaccine records
Claims & appeals tracking, disability rating, VA letters (2M+ downloaded), direct deposit, payment history
Submit mileage-only BTSSS claims for past in-person appointments. View claim status and history
Digital proof of veteran status, facility locator, Veterans Crisis Line quick-access button
The Appeals Modernization Act (AMA), implemented February 2019, replaced the legacy linear appeals process with three concurrent review lanes. The open-source Caseflow Rails application (built with USDS and Nava PBC) manages Board appeals, replacing the 40-year-old VACOLS Oracle system.
Submit new and relevant evidence. Processed by Regional Office (AOJ). Goal: 125 days. Veterans can file unlimited supplemental claims.
De novo review by a senior technical expert. No new evidence allowed. Optional informal conference. Goal: 125 days.
Appeal to Board of Veterans' Appeals. Three dockets: Direct Review (365d goal), Evidence Submission, Hearing Request (730d goal). Virtual hearings via Pexip.
Key AMA feature: veterans can switch lanes after receiving a decision in any lane, enabling flexible pursuit of benefits.
graph TD
CLAIM["Veteran Files Claim"] --> RO["Regional Office
Initial Rating Decision"]
RO --> VBMS3["VBMS / BGS / CorpDB"]
RO --> DISAGREE{"Veteran
Disagrees"}
DISAGREE --> SC["Supplemental Claim
(New Evidence)"]
DISAGREE --> HLR2["Higher-Level Review
(No New Evidence)"]
DISAGREE --> NOD["Board Appeal
(Notice of Disagreement)"]
SC --> AOJ["AOJ Re-adjudicates"]
HLR2 --> SENIOR["Senior Reviewer
at AOJ"]
NOD --> INTAKE["Caseflow Intake
(Matches to VBMS records)"]
INTAKE --> DOCKET["Docket Assignment
(Direct / Evidence / Hearing)"]
DOCKET --> ACD2["Automatic Case
Distribution (ACD)"]
ACD2 --> VLJ["Veterans Law Judge"]
VLJ --> ATTY["Attorney Drafts
Decision (Reader)"]
ATTY --> REVIEW["Judge Reviews
& Signs"]
REVIEW --> QR["Quality Review"]
QR --> DISPATCH["Dispatch
(EndProduct in VBMS)"]
DISPATCH --> GRANT["Grant"]
DISPATCH --> DENY["Deny"]
DISPATCH --> REMAND["Remand
(Back to AOJ)"]
DENY --> CAVC["U.S. Court of Appeals
for Veterans Claims"]
style CLAIM fill:#005ea2,stroke:#2491ff,color:#fff
style DISAGREE fill:#1a2e47,stroke:#e5a000,color:#e8ecf1
style SC fill:#1a2e47,stroke:#5fa86a,color:#e8ecf1
style HLR2 fill:#1a2e47,stroke:#5fa86a,color:#e8ecf1
style NOD fill:#1a2e47,stroke:#d45a5a,color:#e8ecf1
style INTAKE fill:#1a2e47,stroke:#4a8fe8,color:#e8ecf1
style VLJ fill:#1a2e47,stroke:#a86fa3,color:#e8ecf1
style DISPATCH fill:#1a2e47,stroke:#c49460,color:#e8ecf1
style GRANT fill:#1a4480,stroke:#00a91c,color:#e8ecf1
style DENY fill:#1a4480,stroke:#d83933,color:#e8ecf1
style REMAND fill:#1a4480,stroke:#e5a000,color:#e8ecf1
| Component | Technology | Notes |
|---|---|---|
| Backend | Ruby on Rails | Primary application server. Open source on GitHub |
| Frontend | React (via react_on_rails) | USWDS design system. Webpack for asset bundling |
| Primary DB | PostgreSQL | AMA appeals, tasks, hearings |
| Legacy DB | Oracle | VACOLS connection for remaining ~35K legacy appeals |
| Cache | Redis | POA names cached 30 days, addresses cached 24 hours |
| Video | Pexip API | Virtual tele-hearings. Launched March 2020. 1,000+ hearings/week capacity |
Virtual front door. Matches appeal forms to existing decision records in VBMS/BGS. Creates appeal records in PostgreSQL.
Task management for BVA judges and attorneys. Algorithmic case distribution (ACD) with docket-type levers and preferential routing.
Document review interface. Retrieves from VBMS eFolders. Supports annotations, notes, and tags across thousands of documents per case.
Four modalities: Central (in-person), Video (RO to BVA), Virtual (Pexip), Travel Board. 90-day evidence window post-hearing.
Creates EndProducts in VBMS from completed cases. Uploads final BVA decisions. Routes grants, denials, and remands.
Downloads all files in a claimant's VBMS eFolder in chronological order for offline review.
Led by a Presidential appointee (Chairman, 6-year term). Staffed by 125+ Veterans Law Judges (FY2022) with the largest judge expansion in BVA's 90-year history occurring in FY2023. ~195 decision-writing attorneys hired in FY2023; ~155 in FY2024. FY2025 production goal: 118,000 decisions.
VA operates one of the federal government's largest acquisition functions, with over $34B obligated in FY2021. The Office of Procurement, Acquisition and Logistics (OPAL) manages pharmaceutical distribution through 7 automated CMOP pharmacies, medical supply distribution via prime vendors, and prosthetics logistics from the Denver Logistics Center. VA acquisition management has been on the GAO High-Risk List for years.
VA's Pharmacy Benefits Management (PBM) oversees the national drug plan for 9.1M+ enrolled veterans. The VA National Formulary (established 1997) consolidated 170+ individual facility formularies. Under the Veterans Health Care Act of 1992, manufacturers must offer VA prices no higher than 76% of non-federal average manufacturer price — VA pays approximately half what Medicare Part D pays for common brand-name drugs.
| CMOP Location | Region |
|---|---|
| Chelmsford, MA | Northeast |
| Hines, IL | Midwest |
| Leavenworth, KS | Central |
| Murfreesboro, TN | Southeast |
| North Charleston, SC | Mid-Atlantic |
| Lancaster, TX | South Central |
| Tucson, AZ | Southwest (~23.8M Rx/year) |
CMOPs fill ~80–84% of all VA outpatient prescriptions using automated robotic dispensing with pharmacist verification. McKesson Corporation is the pharmaceutical prime vendor servicing 750+ VA locations.
Integrated Funds Distribution, Control Point Activity, Accounting & Procurement. Core procurement module automating fund allocation, purchase orders, RFQs, and payment processing.
Generic Inventory Package. Tiered inventory control with standardized national, VISN, and VAMC business rules. Real-time supply station transactions.
Automated Engineering Management / Medical Equipment Reporting. Manages non-expendable equipment "cradle to grave."
VistA package (v2.0) that interfaces with local pharmacy systems. Prescriptions electronically transmitted from VAMCs to assigned CMOP for fulfillment.
graph TD
VAMC["VA Medical Center"] --> IFCAP2["IFCAP
(Procurement)"]
VAMC --> GIP2["GIP
(Inventory)"]
VAMC --> PHARM["VistA Pharmacy"]
PHARM --> CMOP2["CMOP
(7 Automated
Mail Pharmacies)"]
CMOP2 --> USPS["USPS/UPS/FedEx
→ Veteran's Home"]
IFCAP2 --> MSPV2["MSPV Prime Vendor
(Medline, Cardinal,
McKesson)"]
MSPV2 --> VAMC
IFCAP2 --> DLA2["DLA Troop Support
(Philadelphia)"]
DLA2 --> VAMC
IFCAP2 --> FMS2["FMS/iFAMS
(Obligation Recording)"]
NAC2["NAC (Hines, IL)
FSS Contracts"] --> MSPV2
NAC2 --> PPV2["McKesson PPV
(Pharma Prime Vendor)"]
PPV2 --> CMOP2
PPV2 --> VAMC
DLC2["Denver Logistics Center
(Hearing Aids, Prosthetics,
Telehealth Equipment)"] --> VAMC
DLC2 --> VET2["Direct to Veteran"]
style VAMC fill:#005ea2,stroke:#2491ff,color:#fff
style CMOP2 fill:#1a2e47,stroke:#5fa86a,color:#e8ecf1
style NAC2 fill:#1a2e47,stroke:#c49460,color:#e8ecf1
style DLA2 fill:#1a2e47,stroke:#54a8a5,color:#e8ecf1
style DLC2 fill:#1a2e47,stroke:#a86fa3,color:#e8ecf1
style VET2 fill:#005ea2,stroke:#2491ff,color:#fff
VA launched a new Enterprise Supply Chain Modernization effort in 2023 to replace 58 separate logistics and ordering systems across VHA, VBA, and NCA. The MSPV Gen-Z V1 contract (2024) awarded 6 companies positions on a potential $15B, 10-year IDIQ. Congressional scrutiny remains high — cost estimates have been called "stratospheric" with insufficient transparency on timelines.
VA operates one of the largest WANs in the federal government, connecting 1,200+ facilities. The network backbone is managed under a $725M AT&T EIS contract. Disaster recovery spans cloud-based VistA DR instances in VAEC, satellite communications, and COOP plans with 12-hour activation timelines. Health information exchange connects VA to 46,000+ community partners.
| Component | Details |
|---|---|
| WAN Backbone | AT&T EIS task order ($725M/12yr, awarded June 2021). Modernizing from MPLS to IP-based SD-WAN. 1 GbE to desktops, ≤90ms latency to data centers |
| SD-WAN/Mobile | Verizon EMDS 2 contract ($448.3M/9yr, May 2023). Mobile Edge Compute and SD-WAN for VA facilities |
| TIC 3.0 | VA Directive 6513. All external connections route through VA TIC Gateways. Aligned with zero trust and CISA TIC 3.0 core guidance |
| Remote Access | Cisco AnyConnect VPN (GFE), Citrix Access Gateway (non-GFE), Azure Virtual Desktop. PIV card authentication required |
| Wi-Fi | Separate networks: Veterans Guest Internet Access (VGIA) for patients/visitors; secured clinical/enterprise network for staff. 802.11ac Wave 2 with Bluetooth LE/IoT |
| CSOC | VA Cybersecurity Operations Center. 24/7/365 monitoring. $333.1M task order (Maveris, Oct 2023) |
Primary data center hub. Hosts CDW, critical IT applications, veteran claims processing systems.
757+ apps across AWS GovCloud and Azure Government (5 regions in TX, AZ, VA). Multi-region deployment provides inherent redundancy.
VistA instances hosted in VAEC-AWS with both production and DR instances. Migrated to cloud July 2024.
VA Handbook 0320. Sustain essential functions within 12 hours for up to 30 days. Quarterly comms testing, annual DR testing. DR-COOP team deploys satellite, hotspots, and emergency kits.
COVID-19 stress test: VA went from 30–40K daily remote workers to ~140K/day. Remote access capacity expanded from 120K to 240K users in two months. 16K+ laptops and 7.5K iPhones deployed. Video telehealth surged from ~2K/day to 20K/day.
| Exchange | Description | Scale |
|---|---|---|
| Joint HIE | Launched April 2020 by FEHRM. Connects DoD, VA, USCG, NOAA. Shares prescriptions, allergies, labs, immunizations, procedures, clinical notes | 46K+ community partners |
| JLV | Joint Longitudinal Viewer. Primary tool for DoD/VA providers to view shared health data | Cross-agency provider access |
| VHIE | Veterans Health Information Exchange. Two channels: VA Exchange (org-level) and VA Direct Messaging (provider-to-provider) | 314+ eHealth Exchange members, 483 Direct Messaging partners |
| CommonWell | Added October 2024 via joint HIE | 15K+ hospitals and clinics |
| FHIR R4 | Lighthouse API (developer.va.gov). Patient Health API conforms to Argonaut FHIR. Aggregates CDW, VistA, HDR, MPI, Oracle Health data | Public and restricted APIs |
| SSA/IRS | Health Eligibility Center (Atlanta) matches veteran income against IRS/SSA records for means testing and copayment determination | All enrolled veterans |
graph TD
VISTA3["VistA
(130 instances)"] --> HDR2["Health Data
Repository"]
VISTA3 --> CDW2["Corporate Data
Warehouse"]
ORACLE["Oracle Health
(5 sites)"] --> HI2["HealtheIntent"]
HDR2 --> JLV2["Joint Longitudinal
Viewer (JLV)"]
ORACLE --> JLV2
DOD2["DoD MHS Genesis"] --> JLV2
CDW2 --> LH3["Lighthouse
FHIR R4 API"]
HDR2 --> LH3
VISTA3 --> LH3
LH3 --> DEVVA["developer.va.gov"]
VISTA3 --> VHIE2["VHIE"]
VHIE2 --> EHEX["eHealth Exchange
(314+ members)"]
VHIE2 --> CW["CommonWell
(15K+ facilities)"]
VHIE2 --> DIRECT["Direct Secure
Messaging
(483 partners)"]
FEHRM["FEHRM
Joint HIE"] --> EHEX
FEHRM --> CW
FEHRM --> JLV2
HEC["Health Eligibility
Center (Atlanta)"] --> IRS["IRS/SSA
Income Verification"]
style VISTA3 fill:#1a2e47,stroke:#5a7fd4,color:#e8ecf1
style ORACLE fill:#1a2e47,stroke:#e5a000,color:#e8ecf1
style DOD2 fill:#1a2e47,stroke:#54a8a5,color:#e8ecf1
style JLV2 fill:#1a2e47,stroke:#54a8a5,color:#e8ecf1
style LH3 fill:#1a2e47,stroke:#4a8fe8,color:#e8ecf1
style FEHRM fill:#1a2e47,stroke:#a86fa3,color:#e8ecf1
style VHIE2 fill:#1a2e47,stroke:#5fa86a,color:#e8ecf1
| Program | Description | Budget (FY26) | Status |
|---|---|---|---|
| EHRM | VistA → Oracle Health (Millennium) | $3.5B | Resumed |
| FMBT / iFAMS | Financial system modernization | $135M | Deploying |
| Infrastructure Readiness | Aging infrastructure modernization | $277M | Active |
| VBMS Cloud Migration | VBMS moved to AWS | — | Complete |
| MHV → va.gov | Patient portal migration | — | In Progress |
| eBenefits → va.gov | Benefits portal migration | — | In Progress |
| EVSS → Lighthouse | API consolidation | — | In Progress |
| Supply Chain | Cloud-based supply chain platform | — | Canceled |
| Zero Trust Architecture | Network security transformation | — | In Progress |
| Credential Consolidation | MHV creds removed Mar 2025; DS Logon removed Nov 2025 | — | In Progress |
| Kong → Apigee | API gateway migration to GCP | — | In Progress |
| AICES (AI Evidence) | Agentic AI claims evidence indexing | — | Deploying |
| Ambient AI Scribe | AI clinical documentation, nationwide 2026 | — | Expanding |
Context for current modernization efforts — previous attempts that were abandoned:
| System | Era | Outcome |
|---|---|---|
| Scheduling Replacement | 2000–2009 | Terminated after $127M spent over 9 years |
| HealtheVet (EHR attempt 1) | 2001 | Folded into later efforts |
| CoreFLS (financial) | ~2004 | Abandoned |
| FLITE (financial) | ~2005–2014 | Abandoned |
| iEHR (joint DoD/VA) | 2011–2013 | VA & DoD went separate paths |
| VistA Evolution | 2013–2017 | Strategy shifted to commercial EHR |