Rural_EMS is a discussion group for people interested in the delivery of emergency medical services in rural areas throughout the United States. The idea for this group came about in a focus group held as part of the 2000 NOSORH (National Organization of State Offices of Rural Health) annual meeting. The focus group was convened to discussed rural EMS within the context of the Critical Access Hospital/Medicare Rural Hospital Flexibility program. The Rural_EMS listserv is open to all who are interested in the future of EMS, and enhancements to rural EMS systems that will lead us into the future.