Intelligent Business Solutions (IBS) was incorporated in August 1989. The company began by deploying state ­of ­the ­art information technology. IBS clientele base included NASA, RJR Tobacco, B/E Aerospace, Sara Lee and Wake Forest University . In 1991 IBS began development of a Cardiothoracic Surgery information system. This system not only met stringent database requirements but also revolutionized automated document and workflow within the Cardiothoracic Surgery environment. In 2002, IBS began doing business as Clinical Automated Office Solutions (CAOS). In the latter half of 2005, CAOS expanded the Practice EMR product line to include an outsourced service that provides a coding and billing solution as well as the CAOS EMR.