InformationWeek: Startup iCare aims to take “cloud VistA” beyond academic trials.

To the extent cloud-based electronic health records (EHR) systems have won success, they have so far done it in the physician-practice market rather than with inpatient systems for hospitals. At this week’s HIMSS Conference, Fort Lauderdale-based cloud EHR startup iCare will for the first time be actively courting enterprise customers for cloud apps that put an HTML5 front end on the established government open source VistA system. Athenahealth is also showing its ambitions to capture the hospital market, although so far with a care-coordination module it says will work with any EHR rather than its own AthenaClinicals EHR.

I met with iCare prior to the conference for a demo of its web and mobile apps. With refreshing modesty, chief marketing officer Don Cook acknowledged the product is probably not ready to run the operations of a big hospital yet — “probably an under-100 bed facility would be our sweet spot” — and will need to win the imagination of a daring hospital CEO, willing to try something new.

“We know we’re not ready to take over the world yet, but we’re ready for the world to see it,” he said. iCare showed its product at HIMSS last year but initially sought adoption in academic settings, where medical informatics schools were seeking a product for their students to experiment with. The company was founded by the creators of, a cloud-based learning management platform that was acquired by Taleo in 2010 and subsequently absorbed into Oracle, and is hiring to build its health IT expertise.

Most of the credibility for the iCare platform comes from incorporating the decades of work invested in VistA, which was originally developed by the Veterans Administration and has spawned many government and commercial variants. Cook compares iCare’s approach to the way Apple, after the return of Steve Jobs, adopted Unix as the solid “kernel” of a revamped Mac operating system but innovated at the user interface layer.


“We know we’re ahead of the market,” Cook acknowledged. Although established enterprise software vendors sometimes host applications for their customers, healthcare executives remain skeptical of using newer cloud models for precious patient data. However, the economic pressures on hospitals will force them to reconsider that position if iCare can offer an inexpensive alternative to on-premises enterprise software implementation and maintenance, he said.

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David F. Carr oversees InformationWeek’s coverage of government and healthcare IT. He previously led coverage of social business and education technologie