Talking with Peter O’Toole about gathering clinical data and sharing medical knowledge

My guest for this week’s Innovators show is Peter O’Toole from mTuitive, a company whose authoring toolkit for clinical data collection I featured in a 2006 screencast. mTuitive is working at the intersection of a number of disciplines that all need to come together to deliver cheaper and better health care.

First, usability. Designing clinical data gathering systems that capture what’s right for the patient, along with what’s mandated by the insurance company, requires a careful balancing of constraints and freedom in software user interfaces.

Second, knowledge engineering. Clinical systems don’t merely record data, they embody medical protocols that reflect an ever-changing consensus about methods and best practices. mTuitive’s authoring system aims to enable leading practioners to encode that knowledge in ways that can then guide others. But knowledge grows at the edge as well as at the center. So mTuitive also enables practitioners to extend and modify the software, injecting local knowledge and custom. Who owns this knowledge? Who’s liable for the consequences of its use? These are some of the implications we discussed.

Third, semantics. Electronic medical records are still mainly narrative in form, says Peter O’Toole. But we’re moving toward more computable ways of describing observations about, say, the nature and size of tumors.

Fourth, social software. My hunch, and Peter O’Toole’s too, is that progress toward the nirvana of medical records that are both semantically rich and interoperable will be powered by a two-stroke engine. One stroke of the piston will be driven by centrally-defined standards and centrally-imposed legislation. But the other will be driven by networked collaboration, at the edge, among doctors who pool and codify their experiential knowledge using ad-hoc, Web 2.0-like methods.