We recognize that many users have iCould accounts (so do we) and would like to use iCloud to store their notes. iCloud is a great service, but using it for our backup service at this time would probably make HIPAA compliance impossible.
In order to maintain the security of the notes and in order to be HIPAA compliant, Insight Notes was designed as a closed system. We also wanted to protect against the loss of your notes, and to do that while maintaining HIPAA compliance we also had to design a custom backup solution.
The backup solution had to be independent of iCloud because, to our knowledge, business associate agreements are not available with iCloud.* Put somewhat differently: we don't use iCloud or enable the storage of notes on iCloud because of the strong likelihood that it would violate US law on the storage of healthcare information (and since so many of our users are in the USA....).
Instead, we have servers in an independent and highly secure hosting environment that specializes in the storage of healthcare and financial data; we use one of the largest hosting providers in the world. We are insured, and the servers are repeatedly backed up for redundancy, both on-site and off-site. Unfortunately, it's impossible for us to offer this without a fee because it costs a great deal to provide and maintain the HIPAA-compliant storage.