Changing the world, one line of code at a time...

Welcome to the ICU, the Intensive Code Unit, Iora Health’s Tech Blog.

Iora Health is building an entirely new model of primary care. To power our medical practices and manage interactions with our patients, we’re building our own IT platform. We like our software open, interoperable, and scalable. We’re designing it to be robust yet nimble, to allow for the continuous changes in process and roles that are hallmarks of rapid-cycle redesign in an innovative medical practice. We’ve named our software ICIS - Iora Clinical Intelligence System.


Most existing EHR systems are well-designed to support documenting and coding visits so physicians can get paid but do not provide a longitudinal view of the patient or their practice as a whole. Because our business model removes the operational burden of a fee-for-service model, we are free to focus our software primarily on patient care and can tailor ICIS to fit our care team’s evolving needs. This focus includes tools and support to better manage health conditions before they lead to complications: a robust, group-enabled task management system, patient registration, scheduler, and a dynamic “facesheet” which provides a dashboard view into the patient’s issues and clinical indicators via markers and vitals.

Here’s a screen shot of the facesheet:

ICIS Facesheet

Here’s a screen shot of the task list:

ICIS Tasks List

In addition, we’re developing interfaces for: electronic prescriptions, laboratories, document management, insurance elligibility, hospital census, claims data, personal health care records, and other EHRs and specialists. Core to our philosophy is our belief in participatory medicine: that is, we recognize and expect patients to be responsible drivers of their own health. To enable this, we’re providing patients access to ICIS with a direct means of collaboration with their care team, along with data analytic tools to make sure all users of ICIS have the information they need to make the best decisions.

Culinary Extra Clinic

We’ve been running a virtual clinic for months, making sure the initial version of ICIS (our MVP-minimal viable product) works in a simulated clinical setting. We’re excited to finally launch ICIS later this month when we open the first Iora Health practice in Las Vegas. The practice is called Culinary Extra and will be located in St. Louis Square right near the Stratosphere.

Our current stack includes Ruby on Rails, Postgres, Redis, Resque, Faye, Backbone.js, jQuery, Passenger, Ubuntu. We’re building Ruby services using Sinatra. We’ll be open sourcing some of our gems and some are already available at our GitHub repository. Of course we believe in testing and behavior driven development and are using Cucumber, RSpec, Jasmine, and TeamCity. We’ll be documenting our lessons learned here at the ICU.

We’ve assembled an amazing internal team to get ICIS built: John Norman (the Professor), Will Mernagh, Brian Fitch, Patrick Robertson, and Matt Sisto (aka Conksy). Jess Kadar is our Product Manager (the Spearcatcher) and keeps our backlog of user stories primed. Key to our software design are three Iora Health physicians helping us define system requirements: Rushika Fernandopulle, Neil Patel, and Andrew Schutzbank. We started development in June 2011 and kicked it off with the help of thoughtbot for the first four months, thanks to Dan Croak, Jason Morrison, Harold Giménez, Phil LaPier, Gabe Berke-Williams and Alex Godin. Since then, we’ve continued to build a leading edge medical app that will power the Iora Health medical practices.


Also thanks to Spotify,, Radio Paradise, Spirit Kid, Steve, and especially Loretta for inspiring us, especially when we’re in heads down coding mode.

Stay tuned to this blog for our team’s adventures building a revolutionary health care platform.