text: **Introduction**
  
  Handoffs, where patient information is exchanged between health professionals during a transfer of 
  clinical responsibility, have been identified as a critical source of medical errors.1,2 The Joint 
  Commission, the Accreditation Council for Graduate Medical Education, and the Association of 
  
  American Medical Colleges have all recommended the development of high-quality and standardized 
  handoff processes to address the substantial patient risk of this ubiquitous event.3,4 Implementing 
  handoff tools has previously demonstrated significant reductions in medical errors.5,6 High-quality 
  handoffs from emergency medicine (EM) to inpatient (IP) services (EM-to-IP) are challenged by 
  medical complexity, diagnostic uncertainty, rapidly evolving care plans, and time constraints.7-10 The 
  EM-to-IP handoff structure is not well standardized, frequently communicated verbally, and poorly 
  
  adhered to in emergency departments (EDs), including in medical centers with formalized handoff 
  systems.11-14 Prior research has demonstrated that suboptimal EM-to-IP handoff is associated with 
  adverse events, EM leaders and front-line clinicians themselves view the EM-to-IP handoff as high 
  
  risk, and an electronic health record (EHR)-based technology is commonly mentioned as the most 
  desired assistive tool in improving ED transitions of care.15-18 Limited work to date has demonstrated 
  EM electronic handoff tools as feasible, efficient, and effective.19-21 In April 2023, EM and internal 
  medicine leadership of the study site collaboratively developed and launched a mandatory, 