After entering the cell tower and moving cables to play the vcr, i can see the video and it plays fine, but at the end of it, the game crashes.

Ive tried the steps outlined in the post "things to try when sanitarium crashes all the time", but its still the same regardless.

Anyone had any success getting past this? Im using windows 7 x64.

I had this bug, too and that's why I wrote the list of things to do.
You need to fiddle around with compatibility settings.

Some further tips:

1. reinstall the game, right-clicking the installer and selecting "run as administrator"
2. play the game in windowed mode (adding " -w" through a shortcut or command line)
3. When running windows: open dxdiag, go to Appearances and deactivate DirectDraw Speeder

If you press Windows + R and run dxdiag.exe in 32-bit mode, what does it say in the "Display" tab?

If the three types of acceleration are disabled (partially or fully) under "DirectX Features", give this link I got from the GOG Support team a shot:

https://answers.microsoft.com/en-us/windows/forum/windows_7-gaming/direct3d-acceleration-is-not-available-in-windows/4c345e6e-dc68-e011-8dfc-68b599b31bf5

It involves some registry editing, but after adding the registry key I was able to solve the puzzle and keep playing afterwards on Windows 7 HP x64.