CareSpark was established in 2005, following two years of research and planning to explore ways to share health information securely, efficiently, and cost-effectively. CareSpark was initiated by volunteers with the Community Health Improvement Partnership (CHIP), who had been working together for more than a decade through the local non-profit citizen organization Kingsport Tomorrow to develop collaborative processes to improve the health in the community.

In December 2002, leaders from local and regional organizations met to consider the potential use of electronic systems and health information technology as a means of sharing information and coordinating care. Individuals with relevant expertise from local and national organizations researched and recommended ways to address the clinical, technical, legal, financial, and communications challenges that inhibit collaboration and outcomes improvement. The group sought to learn from other communities and organizations that shared similar goals, and were one of nine communities to be awarded a grant for seed funding by the Foundation for eHealth Initiatives (funds provided by HRSA/OAT). These funds of $100,000 awarded in July 2004 were matched by nearly $500,000 from local organizations and their partners, allowing the group to conduct a thorough feasibility and planning process from August 2004 - April 2005. Consulting partners HealthAlliant, Inc. (fundraising and strategic business planning), Manatt, Phelps, and Phillips (legal and regulatory guidance), CareScience / QuoVadx (technical inventory and technology planning) and n*tara (branding and marketing) assisted the 80 volunteers actively engaged throughout the planning process.

The CareSpark planning process is recognized nationally as a model for its broad-based coalition, multi-state region, long-range and comprehensive scope, and development of a sustainable financial model. National leaders, including Drs. David Brailer and Rob Kolodner, former National Coordinators for Health Information Technology, have recognized and encouraged this effort as one of the true grassroots community-based coalitions to develop a Regional Health Information Organization which advances the National Health Information Infrastructure framework.

In May 2005, CareSpark adopted its initial Strategic Business Plan and Call to Action, and began working to develop the organizational structure, secure the human and financial resources required, and implement technical infrastructure, clinical process improvement, and financial incentives as proposed in its initial three-year strategic plan.

In 2006, CareSpark began the development of its infrastructure and its participation in the Nationwide Health Information Network (NHIN). The prototype demonstration phase lasted from 2006 until 2007, the trial implementation from 2007-2008. In September 2008, the first demonstration of core services was held, with the demonstration of medication management, consumer empowerment, and wounded warrior use cases being held in December of 2008. The extension of the trial implementation occurred from 2009-2010 preceding the emergence implementation of medication management in 2010.

CareSpark signed a contract with the Social Security Administration in 2010. The same year marked the beginning of CareSpark's collaboration both with both Tennessee and Virginia health information exchange (HIE) organizations and regional extension centers in Tennessee and Virginia.