Generative AI Summaries to Facilitate ED Handoff.

Background Emergency Department (ED) handoff to inpatient teams is a potential source of error. Generative Artificial Intelligence (AI) has shown promise in succinctly summarizing large quantities of clinical data and may help improve Emergency Department (ED) handoff. Objectives Our objectives were to: 1) evaluate the accuracy, clinical utility, and safety of AI-generated ED-to-inpatient handoff summaries; 2) identify patient and visit characteristics influencing summary effectiveness; and 3) characterize potential error patterns to inform implementation strategies. Methods This exploratory study evaluated AI-generated handoff summaries at an urban academic ED (February-April 2024). A HIPAA-compliant GPT-4 model generated summaries aligned with the IPASS framework; ED providers assessed summary accuracy, usefulness, and safety through on-shift surveys. Results Among 50 cases, median quality and usefulness scores were 4/5 (SE = 0.13). Safety concerns arose in 6% of cases, with issues including data omissions and mischaracterizations. Consultation status significantly affected usefulness scores (p < 0.05). Omissions of relevant medications, laboratory results, and other essential detailss were noted (n=6), and EM clinicians disagreed with some AI characterizations of patient stability, vitals and workup (n=8). The most common response was positive impressions of the technology incorporated into the handoff process (n=11). Conclusions This exploratory provider-in-the-loop model demonstrated clinical acceptability and highlighted areas for refinement. Future studies should incorporate recipient perspectives and examine clinical outcomes to scale and optimize AI implementation.