The first regular instructional use of television in medicine came in 1949, when television equipment was installed at the University of Kansas Medical Center to teach surgery. Using a mirror and a camera mounted above the patient, the incision area could be viewed in detail by many more students than could otherwise be accommodated and without affecting the sterile environment. With the introduction of videotape recording, procedures could be recorded and reviewed later. This innovation allowed for notable or exceptional cases to be archived and no longer restricted observation to physical presence at the time of surgery. Television is especially important for training in situations where the field of operation is small, such as in dentistry or microsurgery. In these instances, television provides a view otherwise visible only to the doctor.

Beyond formal training in schools, television is also important in the continuing education of health care providers. By the early 1960s, broadcast stations (sometimes with the signal scrambled) were being used along with closed-circuit networks to distribute programs to physicians in broad geographic areas. This application has continued to take advantage of available technologies, and medical programs are provided to health care providers through videocassettes or a variety of wired and wireless networks. The opportunities presented by the introduction of cable television and satellite receivers led to many attempts to offer programming aimed at physicians, often sponsored by pharmaceutical advertisers. However, such ventures as the Hospital Satellite Network, Lifetime Medical Television, American Medical Television, and Medical News Network all failed to attract a large enough target audience (although those services available over cable television often attracted a number of lay viewers), and all had ceased operations by the mid-1990s.

“Telemedicine” (or “telehealth”) refers to the use of telecommunication systems to practice medicine and provide health care when geographic distance separates doctor and patient. The first documented use of this method came in 1959 as part of a demonstration project where closed-circuit, two-way interactive television was used to provide mental health consultations between the Nebraska state mental hospital and the Nebraska Psychiatric Institute more than 100 miles away in Omaha. In telemedicine, a nurse, nurse practitioner, or physician assistant is typically present with the patient to assist, while the physician is in another location. For example, examination rooms specially equipped with television cameras and monitors allow for remote diagnostics and consultations between physicians.

During the 1970s, several U.S. programs made use of the National Aeronautics and Space Administration’s Applied Technology Satellites to improve health care availability in Alaska, the Appalachian region, and the Rocky Mountain states, where access to physicians and health care facilities was extremely limited. These and similar strategies have been developed further with the use of satellites, fiber-optic and coaxial cables, and microwave technologies, which can connect medical facilities across towns or even around the world. Such networks have important implications for developing nations, offering the possibility of access to higher-quality health care, often at a reduced cost. As technology improves, new uses for television continue to be developed. In 2001, using a high-speed video cable connection and robotics, surgeons in New York City successfully removed the gallbladder of a 68-year-old woman in Strasbourg, France. Although the video signal traveled a round-trip distance of more than 14,000 kilometers, the speed of the connection was such that the surgeon’s movements appeared on his video screen within 155 milliseconds. With the development and growth of the Internet, telemedicine is increasingly adjusting to take advantage of the opportunities, although television continues to play an important role in “telehealthcare.” An added benefit of telemedicine is that once the video networks are established, they can also be used for administrative aspects of medicine, such as for teleconferences or other meetings.

Although hardly as dramatic as long-distance surgery, patient care and education can also be greatly improved through the use of television. For example, educational videos can explain such matters as surgical procedures before they are performed and proper posthospital home care. Television is also used in patient surveillance—for example, in intensive care units—so that several areas can be monitored from a central nurses’ station. Video can also contribute to psychiatric examinations by allowing behavior to be observed without intruding or introducing outside stimuli.

Public in formation applications of television have enabled hospitals and other health care providers to aim programs at broader communities. The same equipment used for education and training can also be used in preparing materials for public outreach. Not only do hospitals produce video news releases that are provided to local television outlets, but some also syndicate their own “health segments” to national or regional broadcast stations. There are even examples of hospitals that produce their own telethons to raise research funds, often for diseases that afflict children.

As it has in so many other arenas, the convergence of video and computers is having an impact in medicine in areas such as picture archival and communication systems (PACS). Many medical technologies, such as magnetic resonance and ultrasound imagers, filmless radiology, and CT scanners, generate digital images, and PACS then integrate the images with other clinical information so that all relevant patient data are available through the computer network. The Veterans Administration Medical Centers in the United States have 22 Veterans Integrated Service Network Telemedicine Networks that enable images and other data to be shared in such areas as radiology, pathology, cardiology, dermatology, dentistry, and nuclear medicine, among others. The use of video, then, in conjunction with computers and as a technology in its own right will continue to be an important part of the health care field.