Burned individuals living far from University Health Care's burn trauma intensive care unit can still see one of the physicians there in a matter of minutes. But if it's late at night, he may be wearing a robe and slippers.

Increasingly, the burn center relies on its telemedicine equipment to connect it to doctors and patients in distant and rural communities. And burn center director Dr. Jeffrey R. Saffle hopes more rural hospitals and doctors will see the value of the technology, which costs about $15,000 — not much more than the amount that's wasted on air transport when a patient with minor burns is flown to Salt Lake City when care could easily be managed at home.

Saffle demonstrated the technology and how it's changing burn assessment in the region Thursday as part of a two-day conference on burn care. The U. burn unit serves patients in Utah, Idaho, Montana, Wyoming and Nevada, an area that covers about one-fifth of the entire country. Attendees included physicians, nurses, physical therapists paramedics and others, who came to learn more about basic burn care, ethical issues, disaster management and advanced burn life support.

"E-burn," as Saffle calls telemedicine in burn care, spares patients needless worry, time and expense if their wounds are not severe enough to require transport. It also allows him or a colleague to look at wounds carefully, see how extensive they are and recommend what needs to be done. They can "e-burn" from the hospital or from their homes if it's after-hours, so delays are minimal.

"There is great potential for telecommunication to streamline and improve care," he said. "If you could prevent one unnecessary transport, you can pay for the unit. And it does not steal your thunder; it complements your care."

It's also a tool of the times. Over the years, safety efforts like fireproofing have decreased the number of burns that must be treated. But the number of burn doctors and centers have also decreased by more than one-fourth. And even a moderate-size calamity involving chemical or fire burns could swamp available care options. In the Sept. 11 attack on the World Trade Center, only 19 survivors had burns. Even so, those 19 overwhelmed the New York Hospital burn center, the largest in the country. "They brought it to its knees for three months," Saffle said, because burn care is so labor, resource and time intensive. At one point, the U. sent three nurses to help. That's one reason triage tools to separate out severe from manageable on the spot is important.

Doctors who aren't burn experts are not even sure always what it is they're seeing. Their estimates of what percentage of a body a burn covers has varied from that of experts like Saffle, who see and treat it every day, by as much as 500-plus percent. In a head-to-head comparison, one U. burn doctor assessed the extent of injuries on the TV screen, while another looked at actual patients. Their assessments, including sketching which burns were second or third degree and what portion of the body was burned, were nearly identical — and wildly different from those of doctors who don't have burn expertise.

Saffle said telemedicine also helps patients once they return home. Instead of driving for hours to return for a five-minute follow-up appointment, they can teleconference with the burn center and make sure everything's going OK.

His vision of e-burn includes real-time video links with every health care facility in the region, around-the-clock consultation on burns and other wounds when it's needed and weekly e-burn clinics with remote locations.

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E-mail: lois@desnews.com