In the 1950s, Vladimir K. Zworykin, an engineer recently retired from research at RCA, looked at the rising cost of health care and the shortage of medical personnel in America, and decided to do something about it. His solution was to apply computer engineering techniques to the problems of health care and medical diagnosis. To do so, Zworykin established an interdisciplinary research group of engineers, statisticians, and physicians, and tasked them with developing computer programs capable of aiding medical diagnosis. 

In this episode of Stories from the Stacks, Andrew Lea, PhD candidate in the history of science and medicine at the University of Oxford, discusses the work of Zworykin and company, tracing the origins of the push for bio-medical computing, its uneven reception in the medical world, and the unfolding legacy the movement has left. The Zworykin project focused on hematology, and worked on diagnostic software to assist the identification of blood diseases. Translating a vast and incomplete body of organic conceptions of disease into objective, numerical, and standardized concepts legible to machines proved to be an almost insuperable challenge. Paper technologies, such as the Cornell Medical Index, that standardized medical data gathering, aided computerization.

Using Hagley Library collections, including the Vladimir K. Zworykin papers, and the David Sarnoff Research Center records, Lea discovered that the advent of computer-aided diagnosis elicited mixed reactions from the medical profession. The first demonstration of the technology, which took place in 1957 at the RCA labs in Camden, NJ, sparked decades of debate over the art versus the science of medicine. Does computerization dehumanize health care, or does it rationalize and thereby improve health care? Is there a need for diagnostic programming when the majority of health care involves not diagnosis but ongoing disease management? Is human cognition reducible to computerized functions, or do computers undermine the clinical authority of the physician? Initially debated in the twentieth century, these questions continue to shape the twenty-first-century conversation about health care. 

To support his use of Hagley Library collections, Lea received a Henry Belin du Pont research grant from the Center for the History of Business, Technology, & Society. More information on funding opportunities for research at Hagley can be found at www.hagley.org/research/grants-fellowships.

For more Stories from the Stacks, go to www.hagley.org, or subscribe on your favorite podcatcher.

Interview by Amrys Williams. Produced by Gregory Hargreaves.

Image: “Two of RCA Victor's famous staff of television research engineers, Dr. V.K. Zworykin (left) and E.W. Engstrom, examine a new piece of equipment at the Camden Laboratories.” Television, 1945-1950, PC20110303_456, Box 46, Chamber of Commerce of the United States photographs & audiovisual materials, Series II. Nation’s Biusiness photographs (Accession 1993.230.II), Audiovisual Collections & Digital Initiatives Department, Hagley Museum & Library, Wilmington, DE 19807.

Programming Health: Early Bio-Medical Engineering & Computer Diagnosis with Andrew Lea

Hagley Museum and Library