The processing of a patient in a medical facility encompasses data acquisition, data analysis, diagnosis and medical reporting. The result is a program of treatment for the patient. It is postulated that the latter two stages can be facilitated by allowing acquisition locations to avail of data interpretation by multiple off-site analysts who interactively annotate patient data in a collaborative fashion. The concept of "meta annotations" is also introduced, whereby users can comment on an annotation or supply a confidence rating that indicates their assessment of the accuracy of an annotation. This concept enhances the utility of annotations by transforming them from simple textual labels to focal points for discussion and consensus building. © 2011 IEEE.