text: **Discussion**
  
  The study demonstrated success in generating EM-to-IP handoff notes using both a fine tuned, 
  
  pretrained LLM and rule-based approaches within an end user–developed note template. It is 
  
  important to note that (largely due to time constraints within the EM care delivery model) the 
  
  performance of EM-to-IP handoff notes was not the current standard of care in EM. The study site’s 
  
  unique electronic handoff process enabled a comparison between physician-written and 
  
  LLM-generated handoff notes. Traditional automated evaluations of the model output suggested 