Background and History of VIA
The practice of medicine has changed dramatically over the last century. Where clinicians once made housecalls to patients, visiting them in their living environments, they are now confined to a clinical office, under increasing pressure to see more patients at a faster rate. Brief, problem-focused visits in a sterile setting do not permit the clinician to see or understand the context in which patients live with and manage illness. When clinicians lack knowledge of their patients’ life circumstances, they are unable to develop realistic, sensitive, or effective medical management plans. When patients are framed as biomedical problems and are not asked to contribute their experiences and strengths to their own healing, they are not engaged as partners in their own health care.

During the clinical immersion of his residency, Dr. Michael Rich realized that medical issues were often difficult to solve because the lives of the participants and environments in which they lived them powerfully affected both their conditions and their medical management. Further, he observed a gap in communication between clinicians and their patients caused by their power differential, particularly when the patient was a child or adolescent. Drawing on his previous experience as a filmmaker and knowing that young people are quite comfortable with technology, his solution was to apply the unique power of visual media to reveal and to communicate what traditional clinician-patient interactions and brief, focused visits could not.

Dr. Rich hypothesized that if patients had the tools to originate information on their own health, they could teach their clinicians about their needs and would acquire more ownership of their disease and its management. He set out to devise a way to give patients voice, to make them the authors of their own health outcomes. He engaged in an eclectic range of reading, from psychology to phenomenology, from anthropology to grounded theory, from qualitative analysis software to documentary filmmaking, from children's studies to technical video manuals. What resulted was VIA, simple, straightforward, even obvious on its face, but built on a complex foundation of well-developed and widely respected research traditions.

Since 1994, VIA has loaned camcorders to children and adolescents with a variety of chronic medical conditions, enabling them to share the stories of their lives. In 1998, Dr. Rich was honored with the Society for Adolescent Medicine New Investigator Award for developing VIA. The VIA team is currently exploring the rich possibilities of developing the VIA visual illness narratives into interactive audiovisual curricular material for medical training and patient-centered documentaries with which to advocate for improved health policies and educate patients, families, and the general public to the real life issues faced by patients.

View Rich, M., & Ginsburg, K. R. (1999). The reason and rhyme of qualitative research: Why, when, and how to use qualitative methods in the study of adolescent health. Journal of Adolescent Health, 25(6), 371-378.
  Rich, M., Taylor, S. A., & Chalfen, R. (2000). Illness as a social construct: Understanding what asthma means to the patient to better treat the disease. Joint Commission Journal of Quality Improvement, 26(5), 244-253.
View Patashnick, J. L., & Rich, M. (2005). Researching human experience: Video intervention/prevention assessment (via). Australasian Journal of Information Systems, 12(2), 103-111.

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