Of my five startups, two have been virtual. I am gearing up to start a virtual team with my new startup. What I like about my virtual teams is that it makes the best use of each employee's time, it forces employees to communicate in ways they may not if they are in an office together everyday, and each employee feels like they have some control, which leads to a less bureaucratic environment.
All that said, you have to have an absolute level of trust in each employee, because not having the team within arms reach can leave you feeling a bit uneasy at times.
At TechStars, they tell you on day one that not all the teams will make it through the program intact. I've actually seen a team member leave one team for another.
As someone who has built APIs on node+express, I love it for small lightweight API's that require very little processing beyond getting data from a database and returning it.
I have gone through much frustration though when I needed to use it for an API that required processing that only made sense to handle synchronously. At that point, it becomes less practical.
It's like starting a band. If you're not friends first, when friction begins, things usually get ugly. Having the mutual respect that friendship brings will give all parties better perspective on where everyone's interests lie.
About as creative use of the web as you'd expect from a "webmaster". I bet this guy (http://www.phildub.com/) could have come up with something better.
As an entrepreneur (and engineer) who has built two healthcare companies, I believe we'll get to a point where the speed at which innovation moves in other sectors will start to take foot in healthcare. But like everything in the space, it takes time. Sometimes too much time.
Classic case of an industry that has controlled the broadcast of content for over a century and now they've lost control and can't seem to adapt. Music and TV industries are in this boat too. We all know the music side isn't going to end well for them and it looks like the TV thing won't either, although they have been able to fend off change better than other industries.
All that said, you have to have an absolute level of trust in each employee, because not having the team within arms reach can leave you feeling a bit uneasy at times.