Background: In 2020, COVID-19 emerged as the third leading cause of mortality in the United States with high death rates in urban areas at the beginning of the pandemic. By December 2020, the COVID-19 mortality pattern changed with higher mortality in rural areas.1,2 Epidemiological studies showed that rural populations were at a higher risk of [...]

Background: Rural healthcare in both the US and Brazil faces critical challenges in diagnostic services accessibility and efficiency. The Decentralized Integrated Laboratory System (DILS), an evolved form of Point of Care Testing (POCT) technology, aims to overcome these obstacles by enhancing diagnostic processes and patient care in rural settings of both countries. Building on successful [...]

Background: Around one in five Americans live in rural areas, but only 5 percent of physicians practice in these same areas. As such, hospital located in rural area such as Roosevelt Rehabilitation and Specialty Hospitals (RRHS) struggle with physician staffing. Tele-hospital medicine has expanded rapidly since the Coronavirus Preparedness and Response Supplemental Appropriations Act in [...]

Background: Background: Essentia Health St Mary’s Medical Center, a tertiary referral center serving the rural areas of Northeastern Minnesota and Northwestern Wisconsin, identified disparities in hospice utilization of Medical Shared Savings Programs (MSSP) decedents in 2021 – 2022 (40% vs 53% Medicare national, 2nd quarter 2022). Health system metrics on hospital readmission and length of [...]

Case Presentation: A 33-year-old Kenyan male school teacher presented to the hospital with a 3-day history of a gradually worsening diffuse headache, nausea and vomiting, and fevers. His past medical history was notable for liver cirrhosis of unknown etiology (Child-Pugh class B), complicated by portal hypertension. He had no known history of tuberculosis. His vital [...]

Case Presentation: A 74-year-old man presented to our rural hospital for evaluation of three days of right flank and abdominal pain with constipation. Initial examination and workup were unremarkable, and the patient was discharged on laxative therapy. Two days later, the patient returned with worsening abdominal discomfort, constipation, and a painful rash to the right [...]