A retired pathologist enters the high-tech world
by Glenn RittAt 71, he helps launch mTuitive software company. Dr. William O’Toole slouches into a soft leather chair, his grizzled face enveloping bright, intelligent eyes. He may have retired from Cape Cod Healthcare as a pathologist, where he worked since 1968, but his extraordinary resume as a physician – Johns Hopkins University, Georgetown University, Harvard University – and his fascination with computers has hatched an entirely different identity at 71 years of age. He is a founder and vice president of strategy for mTuitive, a high-tech startup hidden away within a maze of offices on the second floor of a Centerville strip mall.
He is surrounded by a diverse group of practitioners and dreamers. John Murphy – MBA, entrepreneur and early stage investor – is CEO, leveraging his accounting and finance background. Mark Law, PhD and "knowledge engineer," has focused his career on experimental psychology. John Everson, vice president of client services, is a software developer, and Jeffrey Broberg, vice president of engineering, was founder of eObject, which sold for $23 million in 2000.
mTuitive could be located in California’s Silicon Valley or on Boston’s Route 128 corridor, but a common value shared by its principals is a love for the Cape and its quality of life – the same passion for place that motivated O’Toole to leave Boston to raise his children 30 years ago. One of them now works alongside his father.
The company’s mission is elegant in its simplicity, even if its execution demands complex and intricate expertise that crosses many technical, medical and intellectual boundaries. mTuitive’s main business is developing electronic decision-making tools for physicians to improve patient care and long-term medical research.
"By training and experience, physicians gather facts, then draw conclusions," said O’Toole. "It’s an inspection process that leads to valid conclusions only if that deductive pathway is well illuminated by current knowledge and the process itself is ruled by logic."
Until recently, that process has been hindered by paper and ink; and even as computerization and software has enabled better fact-gathering, there are problems connecting all the data, standardizing it and making it readily accessible to any and all players.
mTuitive’s software can be used by the medical profession much as TurboTax serves income-tax processors. For one, you do not need to be a programmer to use it. But, more importantly, mTuitive has integrated a virtual encyclopedia of knowledge – in part by recruiting ‘domain experts’ from academic centers, government and think tanks – along with ‘knowledge engineers’ who are usually business or scientific consultants who can import structure and logic rules into the applications.
With its software, doctors, nurses and even aides who input the information are prompted through tree-structures of questions. "Most current electronic health record solutions scan in pages of paper, forms, notes and other records to make them visible electronically," said Murphy. "But they add little to the ultimate goal of capturing structured data."
The bottom line is that mTuitive’s applications can save time, money and manpower while they help pathologists and surgeons obtain the most detailed analysis of a patient’s condition. That can save lives. The applications also enhance the accuracy and speed of clinical drug trials, said Murphy, who is a board member of the Cape Cod Technology Council.
These two areas alone represent a $750 million market, with 5,000 hospitals across the country and 15,000 pathologists, as well as 1,500 accredited cancer treatment facilities. Those are heady numbers for a modest company in the center of Cape Cod, vying in a highly competitive world that requires more than brainpower and passion. Its board of directors and advisers is peppered by venture capitalists.
While much of its research and early sales have focused on the medical marketplace, the basic mTuitive software, which is designed to work especially well with Microsoft’s Tablet PC, has wide application, said Murphy. The company also is targeting the spheres of bioterrorism and emergency preparedness, government compliance, and commercial inspections.
It is evident from the company’s business plan and O’Toole’s strategic influence that mTuitive’s passion veers toward the world of medicine and the opportunity to save lives.
"Using their observations, physicians use logic to arrive at the right diagnosis and treatment," wrote O’Toole in a presentation to investors. "Practical artificial intelligence techniques can assist in this process when used judiciously. Simple checks for contradictory errors or unlikely conclusions are very useful in preventing the human error that will inevitably seep into even the most meticulous practitioner’s work."
"Imagine a pathologist examining samples of tumors in a medical lab," reported the Journal of New England Technology in an article on the company last year. "Complete checklists are pushed through the mTuitive software. At the same time, the pathologist receives online access to reference material and can call up textbook tumor images for side-by-side comparison with the samples. From there, treatment is developed and compliance achieved."
O’Toole hopes his software will help remove clutter and noise. "As a simple example, if the gender of the patient is male, do not present data sections for females. Similarly, a flood of information, as opposed to knowledge, delays the arrival at a conclusion," he said.
mTuitive’s first customer was the Medical College of Georgia, one of five hospitals to pilot the firm’s Pathology Workstation. Other prospective clients are Brigham and Women’s Hospital, New England Baptist Hospital, Cape Cod Hospital and Westerly (R.I.) Hospital, said Murphy, who is a partner with Clarence Ventures and has helped finance and manage 10 companies in the past nine years.
One of its newest clients Price Waterhouse Coopers’ medical consulting practice, which will license the software to track clinical trial data.
Market timing may be fortuitous for the Centerville startup. President Bush, in his 2004 State of the Union address, pointed to the need for greater computerization of medical records to slow down health-care inflation and improve patient outcomes. "Use of promising health information technology … would encourage the replacement of handwritten charts and scattered medical files with a unified system of computerized records. By computerizing health records, we can avoid dangerous medical mistakes, reduce costs and improve care," he said.
Meanwhile, the American College of Surgeons and Medicare have instituted new mandates requiring specific data elements for hospitals to retain certification. This plays directly into mTuitive’s software and business model.
"We believe we can help curtail health-care costs and reduce error," says Murphy. "So we see a great potential."
As with many startups that require significant financial support, mTuitive is looking to partnerships. A significant one evolved late last year with Mentat Systems Inc., a leader in clinical data entry and emergency medicine. The Los Angeles-based company will license mTuitive’s software to develop emergency service protocols for triage and assessments of patients by both paramedics and EMTs in the field and hospital staff in emergency rooms. The tablet PC works especially well in this environment, since it is portable and wireless.
Under the deal, both companies will share in future revenues and jointly market the product.
Software extends to managing terror incidents
Using much the same logic that serves pathologists, mTuitive has put its toes into the arena of homeland security. Last year, it announced a venture with Hudson-based Spill Center to speed up the analysis of information to respond to terrorist incidents.
"Terror response experts can apply sophisticated logic rules to existing guidelines, protocols, checklists and instructions to guide remote emergency personnel and public health professionals more efficiently," said Murphy.
Spill Center has developed a Hazmat Tracking Center and an Internet-based Electronic Response Management system, said its president, Tom Moses, a former toxicologist with the U.S. Environmental Protection Agency. The system integrates satellite-tracking technology and wireless communications to provide fast and secure access to real-time information needed to expedite responses.
"The process of building a solution to terror attacks begins with the knowledge of response experts," said Murphy. "Fast access to real-time information is what our combined companies offer," said Moses.
While mTuitive’s developers push the technology envelope, Murphy dedicates his energies to finding new clients, obtaining venture capital and designing a return-on-investment strategy. Coming to the board since last year are Don Emery and John Sloane, partners in Clarence Ventures, and Michael Benoit of Bay Angels, a Cape Cod-based investment group; they are among 20 shareholders.
The company, with 12 employees, has identified 28 prospects across five industries that could develop $1.5 billion in revenues. In the meantime, Murphy works on an "exit strategy," which by no means refers to a retreat; it is a critical element to any business plan for venture capitalists who want to see a return on capital or a "a liquidity event" within one to three years.
Murphy sees three possibilities: mTuitive could sell rights to a particular market without compromising its ability to apply its software to new arenas; it could be acquired by a partner or competitor; or it can organize an initial public offering.
Nothing is certain. After two years of development, mTuitive is only now going aggressively to market. "Starting companies is very much like raising children," said Murphy. "And I love being a parent."
Glenn Ritt Glenn Ritt is editor and co-publisher of Cape Business Publishing LLC. He is the former publisher of Cape Cod Community Newspapers and editor of The Bergen Record in New Jersey. 
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