Architecture Maps

VA Office of Information & Technology

Interactive architecture map of the Department of Veterans Affairs IT landscape — systems, integrations, and data flows compiled from publicly available sources.

Public Sources Only Budget: $7.5B (FY2026) ~16,000 IT Staff Updated: Mar 2026
01

Enterprise Overview

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.

$7.5B
FY2026 IT Budget
~16K
IT Workforce
305+
TRM Technologies
180+
VistA Applications
130
VistA Instances
Enterprise Architecture Domains
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
                
02

OIT Organizational Structure

The CIO directs operations across staff offices and five operational divisions, each identified by an OIT organizational code.

OIT Reporting Structure
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
                

VA Way Framework

OIT's unified software delivery methodology organized around five platforms:

Software Factory

Tools and methods for fast, innovative, secure software delivery

CODE VA

Technical documentation and self-service activation for shared services

Design VA

VA-specific design guidelines and accessible digital services

Product VA

Hub for product managers on VA Way product management practices

Architecture VA

Engineering strategies, tools, and technology guidelines

03

Health Systems (VHA)

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 Ecosystem

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
VistA Application Architecture
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

EHRM — Oracle Health (Millennium)

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.

6
Live Sites
13
Target 2026
164
Target 2031
$49.8B
Independent Est.
EHRM Deployment & Integration
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
EHRM Status & GAO Findings

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.

VistA ↔ Oracle Health ↔ JLV Data Flow
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
Joint Health Information Exchange

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.

My HealtheVet (MHV)

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.

04

Benefits Systems (VBA)

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).

Claims Processing Pipeline
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
VBMS Ecosystem & Data Flow
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

Key VBA Systems — Deep Dive

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
05

Enterprise Shared Services

Systems that span all VA administrations, providing identity correlation, notifications, and integration middleware.

Enterprise Service Layer
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
Master Person Index

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.

06

Identity & Access Management

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.

Credential Deprecation Timeline

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.

Veteran Authentication

Veteran Auth Sequence
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

Staff Authentication

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.

Internal Staff Auth Flow
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
07

Data & Analytics

Data Platform Architecture
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
08

Infrastructure & Cloud

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.

Cloud Architecture Layers
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
Infrastructure Modernization

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.

500K+
Managed Endpoints
~50%
Cloud Migrated
$277M
Infra Modernization
3
Data Centers
09

API Platform (Lighthouse)

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.

Lighthouse API Architecture (Detailed)
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

Authentication Methods

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

Environments & Limits

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
Kong → Apigee Migration

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.

API Catalog

Health (FHIR R4)

Patient health data via Argonaut/USCDI — conditions, medications, allergies, immunizations, observations

VHA → VistA / Oracle Health

Benefits Claims

Auto-establishment of disability claims (526EZ), claim status, intent to file

VBA → VBMS

Benefits Intake

PDF document upload to Central Mail / VBMS evidence repository

VBA → VBMS EDR

Decision Reviews

Supplemental Claims, Higher-Level Reviews, Board Appeals (AMA)

VBA → Caseflow

Facilities

Locations, services, hours, wait times for 1,700+ VA facilities

Enterprise

Veteran Verification

Veteran status confirmation, service history, disability rating

Enterprise → MPI / CorpDB

Loan Guaranty

COE (Certificate of Eligibility), appraisal data, loan status

VBA → LGY

VA Forms

Searchable catalog of all VA forms with PDF links and metadata

Enterprise
10

Financial Systems

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.

Financial System Evolution
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
GAO High Risk

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.

11

Web Platform (va.gov)

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.

va.gov Platform Architecture (Detailed)
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

Platform Technical Stack

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
Open Source & Collaboration Cycle

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.

12

Cybersecurity

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).

Zero Trust Architecture Layers
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

Zero Trust First

VA's strategic approach: never trust, always verify. All access requires identity verification, device health checks, and least-privilege authorization regardless of network location.

Security

Cyber Dominance (2025)

OIT's updated posture emphasizing proactive threat hunting, red team exercises, and offensive security capabilities alongside traditional defensive monitoring.

Security

TIC 3.0 Compliance

Updated Trusted Internet Connection policy supporting cloud-native architectures. Allows direct cloud access with appropriate security controls rather than backhauling through TIC access points.

Security

ECRI

Enterprise Cybersecurity Rationalization Initiative — consolidating and deduplicating VA's security tooling portfolio to reduce complexity and improve coverage.

Security
13

AI & Automation

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.

1M+
PACT Act Claims (AI-assisted)
~20 days
Processing Advantage
99.9%
CCRS Auto-Rate
<7 days
CCRS Reimbursement
AI & Automation Landscape
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
14

Community Care Network (CCN)

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.

Community Care Network Regions & Data Flow
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

Specialty Coverage

Primary & Specialty
Primary Care, Mental Health, Cardiology, Orthopedics, Dermatology, Neurology
Ancillary Services
Dental, Eye/Vision, Audiology, Physical Therapy, Chiropractic, Podiatry
Diagnostics
Radiology/Imaging, Laboratory Services
Access
Urgent Care (no referral needed), Telehealth available

TPA Contact & Portals

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.

15

Service Delivery Programs

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.

Veteran Service Delivery Ecosystem
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

Housing Programs

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.

Vet Centers

300+ community-based counseling centers (plus mobile units for underserved areas) providing readjustment services outside the traditional VA medical setting. No co-pay required.

Core Services
PTSD treatment, MST support, grief/bereavement, depression & anxiety counseling
Family & Community
Family counseling, substance abuse assessment, employment & benefits referrals, community outreach
Eligibility
Combat veterans, MST survivors (no discharge status requirement), drone crews, mortuary personnel, bereaved family members
Contact
24/7 Vet Center Call Center: 1-877-927-8387

Public APIs & Data Sources

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
16

System Interconnections

The full picture: how the major systems connect, from veteran-facing interfaces through API gateways down to core systems of record.

End-to-End System Map
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
17

VistA History & Evolution

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.

1978
DHCP Origins
180+
Applications
130
Active Instances
#1
EHR User Satisfaction (2014, 2016)
~$2B+
Spent on Failed Replacements

The Underground Railroad (1978–1982)

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.

Reprisals: Ted O'Neill was fired in 1979 and drove a cab. Marty Johnson found refuge at the Washington D.C. VA, where the computer he worked on was later destroyed by a fire of suspicious origin. Despite these setbacks, the movement continued until VA Chief Medical Director Donald Custis visited the Washington VA in 1981, found the "unauthorized" software in active use, and formally recognized the project as the Decentralized Hospital Computer Program (DHCP) in June 1981.

The MUMPS/M Language

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.

Hierarchical Globals

Variables prefixed with ^ are automatically persisted to disk. No separate database engine or query language needed — predating NoSQL by decades.

Built-in Persistence

No impedance mismatch between language and storage. The database is implicitly "open" for every application. Local and global variable syntax is identical.

Interpretive Execution

Rapid development cycles and runtime flexibility. Code can be stored in and executed from globals, enabling meta-programming patterns used throughout VistA.

FileMan Data Dictionary

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.

VistA Evolution Timeline
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
                

Key Technical Innovations

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

GUI Evolution

Roll-and-Scroll (1970s–80s)

Dumb terminal "green screen" interfaces. Users entered commands line by line.

List Manager (1980s–90s)

Structured terminal interface for reviewing lists and choosing actions. Used by TIU and other packages.

CPRS GUI (1997–present)

Windows desktop client in Borland Delphi. First major VA GUI. Still the primary clinical interface at 166+ sites after 25+ years.

Web Attempts (2010s–present)

EWD.js prototypes and community-driven web frontends. No fully successful web replacement has been deployed. Delphi technology is "effectively obsolete."

Failed Modernization Attempts

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

International Adoption

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.

Cultural Significance: VistA received the 2006 Innovations in American Government Award from Harvard's Ash Institute. The system that VA management tried to kill in the late 1970s became the foundation of what multiple studies identified as the best healthcare system in America by the early 2000s. The original developers called themselves the "Hardhats" — a community that continues today at hardhats.org. And now, after spending an estimated $37B to replace it, VistA continues to run at 166+ facilities with no end date in sight.
18

Telehealth & Connected Care

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.

14.6M
Telehealth Episodes (FY2025)
2.9M
Veterans Using Telehealth
3,147%
Video Visit Growth (FY19→21)
91.7%
Veteran Satisfaction Rate
180K+
Tablets Distributed

VA Video Connect (VVC)

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

Telehealth Modalities

Clinical Video Telehealth (CVT)

Real-time video between patient (at CBOC or home) and provider at VA medical center. Includes VVC as the video-to-home subset.

Store-and-Forward (SFT)

Asynchronous capture and transmission. TeleRetinal Imaging, TeleDermatology, TelePathology. 360K encounters in FY2023.

Remote Patient Monitoring

In-home devices (BP monitors, glucometers, pulse oximeters) transmit data to Care Coordinators. 132K veterans enrolled (2022). 41% reduction in hospital admissions.

ATLAS Sites

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).

VVC Appointment Flow
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

Growth Trajectory

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

Digital Divide Program

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.

19

VA Health & Benefits Mobile App

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.

3M+
Downloads (June 2025)
1.4M
Monthly Active Users
4.8
iOS App Store Rating
4.6
Google Play Rating
2M+
Letters Downloaded
Mobile App Architecture
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

Technical Stack

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

Features

Health Care

Secure messaging (525K+ messages), appointments (995K+ views), prescription refills (194K+), vaccine records

Benefits

Claims & appeals tracking, disability rating, VA letters (2M+ downloaded), direct deposit, payment history

Travel Reimbursement

Submit mileage-only BTSSS claims for past in-person appointments. View claim status and history

Veteran Status & Safety

Digital proof of veteran status, facility locator, Veterans Crisis Line quick-access button

20

Decision Reviews & Appeals

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.

111K
BVA Decisions (FY2024)
118%
AMA Decision Growth (YoY)
35,494
Legacy Appeals Remaining
5yr
Faster Than Legacy
4.4M
Claims (FY23–24, PACT Act)

AMA Review Lanes

Supplemental Claim

Submit new and relevant evidence. Processed by Regional Office (AOJ). Goal: 125 days. Veterans can file unlimited supplemental claims.

Higher-Level Review (HLR)

De novo review by a senior technical expert. No new evidence allowed. Optional informal conference. Goal: 125 days.

Board Appeal (NOD)

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.

Appeals Data Flow (End-to-End)
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

Caseflow Technical Architecture

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

Caseflow Modules

Intake

Virtual front door. Matches appeal forms to existing decision records in VBMS/BGS. Creates appeal records in PostgreSQL.

Queue

Task management for BVA judges and attorneys. Algorithmic case distribution (ACD) with docket-type levers and preferential routing.

Reader

Document review interface. Retrieves from VBMS eFolders. Supports annotations, notes, and tags across thousands of documents per case.

Hearing Scheduling

Four modalities: Central (in-person), Video (RO to BVA), Virtual (Pexip), Travel Board. 90-day evidence window post-hearing.

Dispatch

Creates EndProducts in VBMS from completed cases. Uploads final BVA decisions. Routes grants, denials, and remands.

eFolder Express

Downloads all files in a claimant's VBMS eFolder in chronological order for offline review.

Board of Veterans' Appeals (BVA)

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.

21

Supply Chain & Logistics

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.

$34B+
Annual Procurement (FY2021)
117M
Prescriptions/Year (CMOP)
$21B
FSS Pharma Sales (FY2024)
$8.1B
DLA Cost Avoidance (Cumulative)
58
Separate Logistics Systems

Pharmaceutical Operations

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, MANortheast
Hines, ILMidwest
Leavenworth, KSCentral
Murfreesboro, TNSoutheast
North Charleston, SCMid-Atlantic
Lancaster, TXSouth Central
Tucson, AZSouthwest (~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.

VistA Supply Chain Modules

IFCAP

Integrated Funds Distribution, Control Point Activity, Accounting & Procurement. Core procurement module automating fund allocation, purchase orders, RFQs, and payment processing.

GIP

Generic Inventory Package. Tiered inventory control with standardized national, VISN, and VAMC business rules. Real-time supply station transactions.

AEMS/MERS

Automated Engineering Management / Medical Equipment Reporting. Manages non-expendable equipment "cradle to grave."

CMOP Software

VistA package (v2.0) that interfaces with local pharmacy systems. Prescriptions electronically transmitted from VAMCs to assigned CMOP for fulfillment.

Supply Chain Architecture
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

Modernization Failures

DMLSS (2019–2022): VA deployed DoD's Defense Medical Logistics Standard Support system at Jesse Brown VAMC (Chicago) in August 2020. It failed to meet 44% of high-priority operational requirements. VA canceled all future DMLSS deployments in December 2022 after spending part of a $2.6B interagency agreement with DoD.

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.

22

Network, DR & Interoperability

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.

$725M
AT&T EIS Contract (12yr)
1,200+
Connected Facilities
757+
Apps in VAEC Cloud
46K+
HIE Community Partners
12hr
COOP Activation Target

Network Infrastructure

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)

Data Centers & Disaster Recovery

AITC (Austin, TX)

Primary data center hub. Hosts CDW, critical IT applications, veteran claims processing systems.

VAEC Cloud

757+ apps across AWS GovCloud and Azure Government (5 regions in TX, AZ, VA). Multi-region deployment provides inherent redundancy.

VistA Cloud DR

VistA instances hosted in VAEC-AWS with both production and DR instances. Migrated to cloud July 2024.

COOP

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.

Health Information Exchange

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
Interoperability Ecosystem
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
23

Modernization Tracker

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

Historical Failures

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
24

Acronym Reference

ACDAutomatic Case Distribution
ADTAdmit-Discharge-Transfer
AICESAI Claims Evidence Support
AITCAustin Information Technology Center
AMAAppeals Modernization Act
AOJAgency of Original Jurisdiction
APNsApple Push Notification service
ATLASAccessing Telehealth through Local Area Stations
ATOAuthorization to Operate
BCMABar Code Medication Administration
BTSSSBeneficiary Travel Self-Service System
BVABoard of Veterans' Appeals
BEPBenefits Enterprise Platform
BGSBenefits Gateway Services
BIPBenefits Integration Platform
BIRLSBeneficiary ID & Records Locator
CCNCommunity Care Network
CCRSCommunity Care Reimbursement System
CDWCorporate Data Warehouse
CMOPConsolidated Mail Outpatient Pharmacy
COOPContinuity of Operations Plan
CorpDBCorporate Database
CPRSComputerized Patient Record System
CSOCCybersecurity Operations Center
CSSCommon Security Services
CVTClinical Video Telehealth
D2DDigits to Digits
DHCPDecentralized Hospital Computer Program
DLADefense Logistics Agency
DLCDenver Logistics Center
DMLSSDefense Medical Logistics Standard Support
ECRIEnterprise Cybersecurity Rationalization Initiative
EDRElectronic Document Repository
EHRMEHR Modernization
ESBEnterprise Service Bus
EISEnterprise Infrastructure Solutions
ESREnrollment System Redesign
EUSEnd User Services
EVSSEnterprise Veteran Self Service
FCMFirebase Cloud Messaging
FEHRFederal Electronic Health Record
FEHRMFederal EHR Modernization Office
FHIEFederal Health Information Exchange
FHIRFast Healthcare Interoperability Resources
FISMAFederal Info Security Mgmt Act
FMBTFinancial Mgmt Business Transformation
FQHCFederally Qualified Health Center
FMSFinancial Management System
FTIFederal Tax Information
GIDSGI Bill Data Service
GIPGeneric Inventory Package
GPDGrant and Per Diem
HECHealth Eligibility Center
HIEHealth Information Exchange
HDRHealth Data Repository
HLRHigher-Level Review
HITCHines Information Technology Center
HUD-VASHHUD-VA Supportive Housing
ICNIntegration Control Number
iFAMSIntegrated Financial & Acquisition Mgmt
IFCAPIntegrated Funds Distribution / Procurement
JHIEJoint Health Information Exchange
JLVJoint Longitudinal Viewer
KIDSKernel Installation and Distribution System
LGYLoan Guaranty
MHVMy HealtheVet
MPIMaster Person Index
MSPVMedical/Surgical Prime Vendor
MUMPSMassachusetts General Hospital Utility Multi-Programming System
MVIMaster Veteran Index
NACNational Acquisition Center
NCANational Cemetery Administration
NODNotice of Disagreement
NWQNational Work Queue
OPALOffice of Procurement, Acquisition & Logistics
OSEHRAOpen Source Electronic Health Record Alliance
OISOffice of Information Security
OITOffice of Information & Technology
PBMPharmacy Benefits Management
PKCEProof Key for Code Exchange
PHAPublic Housing Authority
PPVPharmaceutical Prime Vendor
PPMSProvider Profile Management System
RBPSRules-Based Processing System
RPARobotic Process Automation
RPMRemote Patient Monitoring
SFTStore-and-Forward Telehealth
SISSign-in Service
SSVFSupportive Services for Veteran Families
SEPStakeholder Enterprise Portal
SSOeSingle Sign-On external
SSOiSingle Sign-On internal
TERAToxic Exposure Risk Activity
TICTrusted Internet Connection
TIUText Integration Utilities
TRMTechnical Reference Model
TPAThird-Party Administrator
VADSVA Design System
VACOLSVeterans Appeals Control and Locator System
VAECVA Enterprise Cloud
VBAVeterans Benefits Administration
VCMVirtual Care Manager
VHIEVeterans Health Information Exchange
VLJVeterans Law Judge
VBMSVeterans Benefits Management System
VHAVeterans Health Administration
VIAVistA Integration Adapter
VINCIVA Informatics & Computing Infrastructure
VistAVeterans Health Info Systems & Tech Architecture
VISNVeterans Integrated Service Network
WEAMSWeb Enabled Approval Management System
VSSCVA Support Service Center
VVCVA Video Connect
ZTNAZero Trust Network Access
Diagram
100%
Scroll to zoom · Drag to pan · Esc to close