TAMPA, Fla. — The use of telemedicine, in which doctors practice from afar using everything from telephone consultations to remote-controlled surgical tools, is rapidly expanding as the military upgrades medical care.

"We see it as a force multiplier — that's the buzz word," said Army Col. Ron Poropatich, a critical-care doctor who is also the telemedicine consultant for the U.S. Army surgeon general.

Although military doctors aren't performing remote surgeries just yet, telemedicine has been vital to helping diagnose soldiers in the Middle East who suffer from leishmania, a parasitic disease carried by sand flies. Left untreated, some forms of the disease can cause organ damage.

The disease is easily diagnosed by dermatologists, but there is only one such doctor in the military's medical crew in Iraq, so dermatologists in the United States are helping by reviewing digital pictures of infected skin.

It takes just a couple hours to diagnose the problem and recommend a treatment via e-mail. The doctors have handled about 600 cases in six months out of the Iraq, Kuwait and Afghanistan, officials said.

The Department of Defense has invested roughly $100 million in telemedicine over the past decade to improve wartime health care. Still, the technology's widespread use in Iraq has been slowed by a lack of satellite bandwidth to accommodate the high-tech tools.

In Afghanistan, where bandwidth is more readily available, a video camera suspended over an operating table transmits images back to Walter Reed Army Medical Center, where neurosurgeons help guide operations.

Poropatich is going to Iraq in June in hopes of implementing a system that will allow doctors to store digital medical records, such as X-rays and echocardiograms. When bandwidth is available, those images will be transmitted to military doctors in Europe for review.

He also hopes to begin using video conference phones for psychiatric services and pathology services.

For now, however, medical personnel are making use of what they have. In Iraq, 30 new Stryker evacuation vehicles allow medics to send and receive text messages about injured soldiers to other medical personnel.

"It instills a lot of confidence knowing in a battle, you have someone to fall back on," said Army Sgt. Stephen Dunne of Fort Lewis, Wash., a medic who is set to go to Iraq in September. "It's good to have someone else who can sit and think with you."

On the Net:

American Telemedicine Association: www.americantelemed.org/