While emergency care is important in all hospitals, the emergency department is particularly important in rural hospitals where the distance to urban medical centers makes the effective triage, stabilization, and transfer of patients essential. Communication problems are a major contributing factor to adverse healthcare events in hospitals, accounting for 65% of sentinel events tracked by The Joint Commission. In addition, research indicates that deficits exist in the transfer of patient information between hospitals and community primary care physicians, and between hospitals and long-term care facilities. For example, when a patient arrives at an emergency department needing time-sensitive care that includes transfer to a tertiary care center, the rural hospital’s ability to quickly assess, arrange, and get the patient out the door with the necessary and appropriate information can be of life or death importance.