Evidence map›Paper›PMID 42205359›Full record

ArticleHealth affairs scholar2026

The decentralized academic health center: a 21st-century model for rural health innovation.

Patrick C Hardigan, Johannes Vieweg

Abstract read
In one paragraph

Article in Health affairs scholar, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

2 authors.

Patrick C HardiganCollege of Health Sciences, University of Wyoming, Laramie, WY 82071, USA.
Johannes ViewegMass General Brigham, Harvard University, Cambridge, MA, USA.ORCID https://orcid.org/0009-0003-6228-1741

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Rural communities in the United States face persistent gaps in health care access, workforce capacity, and outcomes despite substantial federal investment. Academic health centers (AHCs) are central to clinical care, research, and education, but remain largely urban-based and structurally misaligned with rural needs. We propose the Decentralized Academic Health Center (D-AHC), a distributed model that integrates academic institutions, rural providers, public health systems, and communities through shared governance, interoperable data infrastructure, and digital health tools. Unlike traditional hub-and-spoke systems, the D-AHC treats rural partners as co-equal participants in education, research, and care delivery. Using Wyoming as a case example, we outline 5 implementation domains: workforce development, research and data systems, clinical partnerships and digital health, community engagement and policy, and financial sustainability. We further describe provider and community readiness considerations and present a practical implementation roadmap. The D-AHC aligns with major federal initiatives, including HRSA rural investments and the 2025 Rural Health Transformation Program, offering a scalable framework for improving access, strengthening workforce pipelines, and enhancing system sustainability in rural and frontier regions.

Indexed as

academic health centerscommunity engagementD-AHCDecentralized Academic Health Centerdigital healthinteroperable data systemsrural health carerural health transformationrural workforce developmentshared governance

Identifiers

PMID42205359
PMCPMC13207580

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.