Margaret Greenwood-Erickson, MPH of the Department of Emergency Medicine at the University of Michigan in Ann Arbor, call for partnership between emergency medicine and primary care to reverse the trend of failing health in underserved parts of the country. The study published in Annals of Emergency Medicine suggests a novel healthcare delivery model to meet unique rural healthcare needs.

Dr. Greenwood-Erickson said that the traditional urban healthcare delivery is an ineffective model for the improvement of rural health. Rural hospitals would serve as a center for healthcare services like emergency care, primary and preventive care, and social services for improving rural population health.

"Our emergency medicine-primary care model embraces the role that emergency departments play in providing primary care in rural areas while also connecting patients to other physicians and resources in the community.” She added.

The exemplary proposed by Greenwood-Erickson would supplement, but not replace the prevailing outpatient rural safety net, comprised of federally qualified health centers and rural health clinics.

The Carolinas Healthcare system in Wadesboro, N.C., is cited as an example of the new rural hospital. The final hospital design has no physical walls separating emergency and primary care, rather, the two are combined. The authors say it is a test of their new model of rural healthcare delivery.

Similar partnerships in other communities could provide high-quality emergency care, meet unscheduled acute care needs, address rural social determinants of health across the care continuum, achieve financial stability and support public health.

Dr. Greenwood-Erickson says a critical approach is needed to improve the rural healthcare system, as the health of rural Americans declines very sharply. "The partnership we propose is novel yet practical and acknowledges that an emergency department might be the closest source of health care for rural patients. Emergency medicine-primary care partnerships can address rural populations' most pressing social and medical needs," she added.