This is just a bureaucratic checkbox though. IT approvals are "an employee asked if they could use this" not some kind of broader endorsement.
Emacs is not approved unfortunately. Not sure why. I wonder if it has to do with that exploitable bug from decades ago from Cliff Stoll's The Cuckoo's Egg. Rationale for other technology choices they make go back even farther in history.
The VA maintains something like 30 hospitals nationwide, in addition to various amphatheaters and storage depots, it's a huge org. Someone somewhere will be designing stuff with FreeCAD and 3D printing stuff within a week to solve some problem, even if it's something as simple as a shim to keep some HVAC flashing from vibrating.