Many medical plays require large capital investment. Regulations, bizdev, and long sales cycles are all huge barriers to entry. Advertising to Doctors is incredibly expensive, and it is hard to monetize consumer applications that will scale (some people are trying their hand at medical compliance, but I haven't heard of a great business model yet.)

23andme is a great medical startup, but it is a capital-intensive business that has to spend time and money on Washington.

We (Epocrates) are working on an Electronic Health Record system as an additional product. Our core team is small, but we have the resources and brand of a midsize company. We have 40% of US physicians using our existing reference software and we are going to leverage our brand to provide a usable and moden system that increases the level of patient care and effectiveness of Doctors. We're a mixed RoR/Java/Mobile shop. We're currently hiring RoR developers, so please feel free to contact me if you are interested in this space and want to make a real impact on US healthcare.