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Surgery on demand: Doctors and patients get real on camera

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On location at a hospital webcast, the technical director and producer for OR-live.com view camera images. (Courtesy of OR-Live)

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Dr. Robert Sheu and Suzanne Lamoureux discuss her surgery with moderator Dr. Lara Dhingra of Beth Israel Medical Center. (Courtesy of OR-Live)

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A projection of Suzanne Lamoureux's spine at Beth Israel Medical Center as Dr. Robert Sheu places the neurostimulation lead. (Courtesy of OR-Live)

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Dr. Grace Keenan of Nova Medical Group in Ashburn, Va. shooting an iHealth video. (Courtesy of Medem Inc.)

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Dr. Thomas Sculco, chief of surgery at the Hospital for Special Surgery in New York, filming a video on hip replacement surgery for Dramatic Health. (Courtesy of Dramatic Health)

When Suzanne Lamoureux was told she had multiple sclerosis four days before she graduated from college in 1998, she was sure her life was over.

Determined to fight back, she got a tattoo across her lower back of serpents woven together--a mystical talisman from “The Neverending Story,” which guides the protagonist to find a cure for an ailing queen. But Lamoureux’s condition only worsened. By the age of 31, she could not walk without the help of a cane.

Her tattoo now appears in a health care video on the Web site OR-live.com, an Internet broadcasting company based in West Hartford, Conn.

In September, she allowed cameras to tape the implantation of two wires in her spine connected to a small, pain-suppressing neurostimulation device.

Dr. Robert Sheu of Beth Israel Medical Center in New York performed the surgery. Eight weeks later, Lamoureux and Sheu participated in a webcast on chronic pain management.

“I have my life back now” said Lamoureux, a third grade teacher who now lives in Florida. “If this video might give another person that chance, then that’s my goal.”

Now that the Internet supports faster video streaming, thousands of health care segments are proliferating online, from professionally produced programs to video bloggers telling stories about their latest office visit. Physicians and hospitals are also using video to webcast live surgeries, to communicate with and to educate patients, and largely, to market their services.

“Ten years ago a physician having a Web site was a novelty,” said Dr. Ed Fotsch, CEO of Medem Inc., a San Francisco company that provides 70,000 doctors across the country with a suite of online services called iHealth. “Three or four years ago physicians having a Web site with a picture and e-mail was a novelty. Video is the next step.”

Statistics show Americans increasingly turning to the Internet for health care advice. Seventy-nine percent of all adult Internet users and 86 percent of those with chronic conditions seek health information online, according to a 2007 Pew Internet and American Life Project Survey.

OR-Live’s 400 videos on YouTube have been viewed close to 4 million times, and the site has documented surgeries ranging from heart transplants to gastric bypass. Forty percent of viewers are surgical candidates.

“I have to have my knee replaced, and this makes it not seem so scary!” wrote an enthusiastic (and not squeamish) viewer of a knee operation that has been viewed 35,861 times on OR-Live’s YouTube channel. “I now know a lot of questions to ask and how I can be more informed before getting it done!”

In private practice, more and more physicians are taking advantage of this technology by offering video welcomes and virtual tours.

While these online videos may be very sophisticated, they’re not the most innovative use of technology, said Dr. Jay Parkinson, who is known as the “virtual doctor” in Williamsburg, Brooklyn.

Parkinson combines old medical practices with new technology, making house calls to see his patients and then texting, e-mailing or IMing to follow up.

“The concept of motion pictures has existed since--I don’t know, 1900? I use the Internet to communicate efficiently and effectively with someone about their health,” said Parkinson, who noted that most doctors do not take advantage of technology as basic as e-mail.

One doctor in Las Vegas, Nev., has moved beyond e-mail to video e-mail. Dr. Loring Jacobs says it takes him less time to communicate with patients in a video e-mail than to write one.

“I got this technology about a year ago and immediately saw all kinds of potential,” said Jacobs, who says video e-mails are a huge time saver. “I can now send my patients their results by the next day. They can see my expression and they’re not getting results from a nurse. It makes a huge difference.”

Of course, not all health care videos are backed by credible sources. Video bloggers who want to offer testimonials and tell their stories are posting on YouTube and sites like icyou.com, a company in Charleston, S.C., that aims to be an aggregator of health care videos on the web.

One man has posted a video on icyou.com titled “My Excellent Colonoscopy.”

Before the Internet, patients relied on pamphlets or videos produced by companies to get in depth medical information. The webcast from Beth Israel was not sponsored by any company, and it was real patients—-not actors—-who discussed chronic pain.

“All of the patients who helped put this video together did so voluntarily,” emphasized Sheu, who was able to maintain the integrity of Lamoureux’s tattoo when he implanted the neurostimulation device. “We wanted patients who had undergone spinal cord stimulation to tell their story.”

Still, these patient stories are intrinsically commercial in that they help hospitals to promote themselves, their best doctors and their latest procedures.

“Just marketing the fact that you have a particular service is not enough now,” said Rick Wade, senior vice president of the American Hospital Association. The Internet has caused a shift “from traditional kinds of marketing to providing education and substantive information.”

Increasingly, this information is packaged in such a sophisticated video format that the line between education and entertainment becomes blurred.

“Health care is intrinsically dramatic,” said Sean Maloney, marketing director for Dramatic Health, a New York City company that produces slick health care videos, resembling short films, for hospitals. “We don’t just turn the camera on and film the surgery. We add documentary features to keep the viewers’ attention.”

In the beginning of the Beth Israel webcast, the video shows Lamoureux walking with difficulty through the hospital hallways with the help of a cane.

“My cane is in the closet now,” she said. “I can walk again.”

E-mail: mfh2107@columbia.edu