47 articles found

Original Research

Emergency Medicine Data Analytics

15 September 2026

The emergency department (ED) is often referred to as the heart of the hospital, but it faces significant challenges such as overcrowding, understaffing, and budget constraints. According to Hu, Chan, and Dong (2024), data analytics plays a vital role in addressing these challenges by enabling hospitals to predict patient trends and manage staffing and resources more effectively. By examining historical data, healthcare providers can anticipate surges in specific medical conditions, such as flu seasons or pandemics, leading to more efficient staffing and equipment management. This, in turn, contributes to improved patient satisfaction and outcomes.

Connor Mitchell

Original Research

Remote Speakers for Emergency Medicine Residency Education

15 September 2026

The COVID-19 pandemic has created an unanticipated and sudden change to the traditional delivery of Emergency Medicine (EM) residency conference. The use of digital platforms, like Academic Life in Emergency Medicine (ALiEM) Remote, has eased the transition to a virtual platform for medical education. ALiEM Remote supports educators by providing a curated list of speakers and their topics for virtual lectures and educational resources for launching a virtual curriculum, and by providing a calendar of residency conference dates and time so that programs can identify opportunities to combine or co-host conference sessions. In this descriptive observational study, we used the Airtable platform to create a form that collected speaker and residency conference information, and Google Analytics to collect and store data on website traffic between March 10, 2020 and April 28, 2020 which coincided with the transition from in-person to virtual educational engagement. During this period, the website received a total of 1,852 unique users, with the majority being located in the United States (79%). Ultimately, ALiEM compiled a list of 162 speakers from 54 institutions across the globe with a wide range of expertise in the areas of public policy, critical care, and pediatrics, among others. Engagement data suggest early utilization of the speaker list for conference planning. However, no learner-level or educational outcome data were collected. Our repository of virtual speakers and educational material on virtual instruction offer a descriptive, early-stage model for recruiting speakers for future virtual conferences.

Deborah Lai

Adaira Landry

Sarah Mott

+6

Perspective

innovatED! Fostering Low-Cost Innovation, Creativity, Entrepreneurship, and Research in Global Emergency Medicine

29 July 2026

The complex and evolving healthcare demands in Low- and Middle-Income Countries (LMICs) are often beyond the scope of traditional Emergency Medicine (EM) practices, creating vital gaps in the delivery of medical care. The objective of this study is to present and evaluate the InnovatED model, a low-cost, entrepreneurial approach, and demonstrate its effectiveness in addressing critical challenges within EM in LMIC settings. This model incorporates the principles of Innovation, Creativity, and Entrepreneurship (I|C|E) by fostering non-hierarchical, inclusive spaces that prioritize equity, diversity, and well-being. Through the agile problem-solving approach of 'jugaar,' InnovatED cultivates a proactive culture of innovation that adapts to the dynamic demands of modern EM and broader healthcare contexts. Key initiatives such as Hackathons and the National Health Incubator have sparked interdisciplinary collaborations, enhancing EM education and practice. Wellness-focused startup like ZalsaED has reported high satisfaction rates, improving healthcare provider well-being, while consultancy programs like EmTEx and Innov’dBoard have streamlined policies and strategies, improving efficiency within emergency departments and past those across whole hospitals. These programs highlight InnovatED’s scalability and its potential for monetization, demonstrating its ability to adapt to diverse healthcare environments and generate sustainable solutions. As an innovative, cost-effective bridge between traditional EM and modern healthcare needs, InnovatED is poised to optimize outcomes on a global scale. However, the integration of more robust metrics and data will be essential in quantifying its success. Addressing future challenges, fostering global adaptation, and expanding collaborative efforts will be key to enhancing the model’s credibility and impact.

Zunaira Namal

Syed Waqas

Mahreen Sulaiman

+1

Application of the ARIMA Model to Forecast Future Overdose Deaths

Original Research

Application of the ARIMA Model to Forecast Future Overdose Deaths

12 February 2026

Current data for opioid policy in affected states is outdated by 1-2 years, highlighting the necessity for a predictive model to forecast fatal drug overdoses and aid in the implementation of evidence-based preventative policies. We utilized Auto-ARIMA, an automated version of the ARIMA linear regression model, to forecast overdose deaths in the U.S., each state, and Washington D.C. Our forecasts for 2021 and 2022 were based on data from 2015 to 2021, sourced from the CDC's Vital Statistics Rapid Release program. Our ARIMA model forecasts an increase in overdose deaths across the U.S. and in many states, with some states potentially seeing a doubling of deaths from 2020 to 2022. This research represents an initial step in using real-time forecasts to evaluate the effectiveness of state-level public health policies in combating the opioid crisis.

Parash Bhakta

Neha Balapal

Saadh Ahmed

+7

Abstract

Understanding PrEP: Perceptions and Misconceptions Amongst Men Who Have Sex With Men in Upstate South Carolina

12 February 2026

Despite the effectiveness of pre-exposure prophylaxis (PrEP) in preventing HIV, uptake among men who have sex with men (MSM) in Upstate South Carolina remains limited. This study investigates barriers to PrEP access and utilization in this population to guide targeted public health strategies. A cross-sectional survey of MSM aged 18 and older was conducted to collect demographic information, perceptions and misconceptions about PrEP, and reported obstacles to accessing it. Pearson correlation tests were used to examine associations between participant characteristics and identified barriers. Social stigma, financial constraints, and limited provider engagement emerged as the most frequently reported barriers. Notably, lower socioeconomic status was significantly associated with perceptions of discrimination in healthcare settings, while racial and ethnic minority participants were more likely to express a desire for proactive discussions about PrEP with their providers. Participants also emphasized the need for clearer pathways to locate PrEP access programs and indicated that reducing wait times for initiation would improve their likelihood of starting PrEP. These results highlight the need for interventions that address both social and structural barriers to PrEP uptake. Expanding financial support, increasing provider involvement, and implementing statewide public awareness efforts are critical to improving access and reducing disparities among MSM in this region.

Jack Golder

Christian Zanetti-Weeks

Evan Lagerberg

+1

Abstract

Eating Disorders & Sports Participation

12 February 2026

Eating disorder research is scarce due to the stigma surrounding the condition. Much of the research has focused on the influence of societal norms and social media, while many patients attribute their relationship with physical activity as problematic. This study focused on self-reported symptoms potentially indicative of an eating or body image disorder, even if a diagnosis is not present, and how those symptoms differed across athletes and non-athletes. The 11 eating disorder questions, which were coded on a scale from 1 to 5, included how much people are worried about their physical appearance and how much exercise is perceived to be a tool for controlling and altering one’s physique. Differences in self-reported symptoms were also considered between genders. Predicting the severity of eating and body image issues from sports participation alone proved to be inconclusive, but a strong association between gender and eating disorders existed. Additionally, predicting eating disorders from sports participation when accounting for gender was more statistically-significant, demonstrating unique psychological pressures on women, whether involved in athletics or not, that predispose them to an eating or body image disorder that are not as apparent in men.

Ajay Krishnan

An Entropy-Based Approach to Decision Tree Analysis in Emergency Medicine: Optimization of Diagnostic Tool Selection to Thoracic Aortic Dissection

Original Research

An Entropy-Based Approach to Decision Tree Analysis in Emergency Medicine: Optimization of Diagnostic Tool Selection to Thoracic Aortic Dissection

22 January 2026

Introduction Shannon entropy is a key concept in both machine learning and information theory, significantly influencing decision tree modeling. In emergency medicine, the utilization of testing and imaging tools to reduce uncertainty is vital for enhancing medical decision-making, especially in time-sensitive scenarios. While sensitivity and specificity assess test accuracy, entropy provides insight into how much a test clarifies the overall clinical picture, which is crucial in time-sensitive situations like thoracic aortic dissection. The aim of this study is to evaluate and compare the effectiveness of entropy and entropy reduction against conventional metrics of sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV), in the diagnostic evaluation of thoracic aortic dissection. Methodology We gathered diagnostic metrics, including true positives and negatives, as well as false positives and negatives, from a well-established online diagnostic accuracy database known as "Get the Diagnosis" for thoracic aortic dissection. Data collection took place from November 17, 2022, to January 22, 2023. This dataset allowed us to compute sensitivities, specificities, negative predictive values (NPVs), and positive predictive values (PPVs). A decision tree representing the diagnostic tool was created and examined for Shannon entropy and entropy reduction across the various child nodes. The decision tree was based on 2x2 diagnostic tables, covering total cases (N), true positives (TP), false positives (FP), false negatives (FN), and true negatives (TN). Results Using a helical CT scan for thoracic aortic dissection, we observed a sensitivity of 97.64% and a specificity of 98.90%, whereas MRI exhibited a lower sensitivity (93.33%) but a higher specificity (99.30%). However, entropy removal calculations revealed that the helical CT scan removed 87.23% of entropy associated with thoracic aortic dissection, while MRI removed 81.36%. Within these populations studied, this suggests helical CT scan may provide greater reduction in diagnostic uncertainty than MRI in thoracic aortic dissection assessment and underscores the unique insights offered by entropy removal, which sensitivity and specificity fail to provide. Conclusion Unlike sensitivity and specificity, entropy captures the inherent variability and uncertainty in diagnostic data, especially in complex medical scenarios where it accommodates individual variability in patient responses and disease manifestations.

Daerin Hwang

Abdel Badih El Ariss

Norawit Kijpaisalratana

+4

A Qualitative Assessment of the Feasibility, Usability, and Clinical Impact of the Keva365 Remote Patient Monitoring Platform for Asthma Management

Original Research

A Qualitative Assessment of the Feasibility, Usability, and Clinical Impact of the Keva365 Remote Patient Monitoring Platform for Asthma Management

30 October 2025

Background Remote Patient Monitoring (RPM) has emerged as a promising approach to managing chronic conditions like asthma, particularly during the COVID-19 pandemic. However, limited research exists on the use of qualitative analysis to capture patient feedback and experiences in RPM programs. This study extends a quantitative observational study that explored the impact of RPM on patients with moderate-to-severe asthma. Objective The aim of this study was to evaluate the feasibility and usability of Keva365, a digital therapeutic platform designed for remote asthma management, and to explore its impact on patient-provider relationships, asthma management, patient compliance, and engagement. Methods A purposeful sample of six patients with moderate-to-severe persistent asthma participated in the study. Over a nine-month period, participants were interviewed once using an open-ended question guide to collect qualitative data. The interviews were recorded, transcribed, and analyzed thematically using NVivo software. Data were used to assess the feasibility of the RPM intervention, its usability, and its impact on patient experiences. Written consent to publish these details has been obtained from all participants that were included in this research. Results Thematic analysis identified key themes related to patients' experiences with the app, their compliance and engagement with the program, their relationships with providers, and asthma management. All participants reported positive experiences with the program, noting the app’s usability, efficiency, and impact on their relationships with healthcare providers. Participants expressed high levels of satisfaction and a willingness to recommend the program to others. Feedback from the interviews contributed to near real-time modifications of the RPM application, enhancing its usability and navigation. Conclusions The study found that integrating patient feedback is essential for improving the usability of RPM platforms. Continuous iterative refinement based on patient experiences can lead to more patient-centered digital health solutions, enhancing both patient compliance and the overall care experience. The findings suggest that RPM programs can effectively support asthma management while fostering positive patient-provider relationships. make a scope statement for Conduct Science journal that focuses on current and latest research that focuses on shaping the future of medicine.

Naomi Rajput

Jyotsna Mehta

Denzil Reid

+1

A Message from the Editor-in-Chief

Letter from the Editorial team

A Message from the Editor-in-Chief

27 September 2025

This is the official Letter from the Editor for Volume 1, Issue 1 of The Journal of the American Medical Student Association. In this inaugural note, the Editor-in-Chief introduces the journal’s mission.

Andres Felipe Diaz

Humanizing Critical Care: Transforming ICUs Through Empathy and Innovation

Original Research

Humanizing Critical Care: Transforming ICUs Through Empathy and Innovation

2 September 2025

Background: Intensive Care Units (ICUs) in resource-limited settings face persistent challenges, including high infection rates, staffing shortages, and inconsistent patient-family engagement. Standardized ICU audits provide a structured approach to assessing and improving infection control, staff preparedness, and patient-centered care. This study evaluates CritiCore, a structured ICU audit framework innovation piloted and applied longitudinally over three sequential cycles at a single center, designed to drive iterative, evidence-based quality improvements through targeted intervention cycles. Methods: CritiCore was implemented at Evercare Hospital Lahore, Pakistan, across three cycles: baseline audit (November 2024), first re-audit (January 2025), and second re-audit (April 2025). Each cycle included structured observational assessments, infection-surveillance review, and multidisciplinary stakeholder interviews with ~20 ICU professionals (physicians, nurses, infection control specialists, and administrative staff). Findings from each audit informed targeted interventions focusing on real-time infection surveillance, simulation-based staff training, and standardized patient-family engagement strategies (Empatheon). Results: The initial audit revealed elevated hospital-acquired infection rates (≈40–50%), linked to inconsistent hand hygiene and ventilation gaps. Staffing continuity was affected by reliance on locum personnel and limited simulation-based training. Patient-family engagement was inconsistent, with unclear visitation policies and fragmented communication. By the first re-audit, adherence to infection-control protocols improved, simulation training participation increased, and structured family communication and visitation protocols were adopted. By the second re-audit, most improvements were sustained, with additional gains in simulation training coverage, consistency of family engagement, and environmental control measures. Infection control adherence remained markedly higher than baseline, and staffing continuity improvements were maintained. Conclusion: This three-cycle ICU audit from Lahore demonstrates the feasibility and sustained impact of a structured, iterative quality-improvement framework in an LMIC private hospital. The same CritiCore approach was subsequently rolled out at Evercare hospitals in Nigeria (twice) and Kenya (once), supporting adaptability across diverse settings; a formal multi-site analysis is planned. Keywords: critical care transformation; Evercare hospitals; ICU audit; infection surveillance; LMICs; patient-family engagement; quality improvement; staff training; Empatheon.

Asad I Mian

Muhammad Taha Anver

Mahreen Sulaiman

+4

Money as Medicine: Beyond the Monetary Value of Cash Assistance Programs

Discussion

Money as Medicine: Beyond the Monetary Value of Cash Assistance Programs

29 August 2025

Social determinants of health (SDOH)—the root causes of health disparities—often fall outside the scope of traditional clinical care. In this discussion, we argue that financial interventions, particularly cash assistance programs, play a transformative role in improving health outcomes by addressing SDOH. Drawing on lessons from established public health approaches, we explore the concept of "Money as Medicine," which reframes cash assistance not just as economic relief but as a vital component of healthcare, directly impacting physical and mental well-being.1 To build healthier communities, we recommend integrating cash assistance programs into the healthcare system to reduce emergency department (ED) utilization, enhance mental health, and promote overall health stability. We explore key evidence, highlight successful models, such as the nonprofit Link Health, and propose pathways for integration.

Julissa Barrios

Timothy Scheinert

Jessica Johnson

+3

Empathy-Driven Innovation: Human-Centered Design Thinking for Transforming Healthcare Delivery

Original Research

Empathy-Driven Innovation: Human-Centered Design Thinking for Transforming Healthcare Delivery

23 August 2025

Background: Healthcare systems in low- and middle-income countries [LMICs] face systemic challenges in high-stakes environments such as emergency medicine and intensive care. Limited resources, fragmented workflows, and communication gaps often compromise patient care. Human-Centered Design Thinking [HCDT] provides an empathy-driven, iterative framework for problem-solving tailored to these settings. Methods: Two HCDT workshops were conducted in 2024 at Evercare hospitals in Lekki [Nigeria] and Lahore [Pakistan]. Using the Stanford d.school’s five-step framework—Empathy, Problem Definition, Ideation, Prototyping, and Testing—participants applied tools including empathy mapping, PICO problem dissection, brainstorming, and rapid prototyping. Teams included physicians, nurses, paramedics, and administrators. Results: Eighty-six participants engaged, with 23 structured evaluations per site. In Lekki, solutions addressed referral delays and communication gaps through referral coordinators, checklists, and digital tools. In Lahore, ICU-focused teams developed interventions for staff turnover, communication inefficiencies, and humanization of care—culminating in the Empatheon program, which applied PDSA cycles to strengthen staff well-being and patient-family engagement. Both sites reported high satisfaction, with >65% rating inspiration, knowledge, and practicality as very high. Conclusion: HCDT shows strong potential to address healthcare challenges in LMICs through low-cost, scalable, and context-sensitive innovations. Embedding empathy, co-creation, and iteration into care processes enhances outcomes and fosters sustainable, patient-centered innovation. Further validation through real-world implementation is warranted.

Mahreen Sulaiman

Hira Amran Chowdhry

Kazim Ali Tarar

+5

From Boarding to Breakthrough: Tailored Interventions for Vulnerable Patients

Original Research

From Boarding to Breakthrough: Tailored Interventions for Vulnerable Patients

22 August 2025

Emergency Department (ED) boarding–prolonged stays in the ED while awaiting inpatient placement–is a crisis exacerbating crowding, increasing costs, and negatively impacting health outcomes. Vulnerable populations, including individuals with low socioeconomic status (SES), medically-complex older adults, and psychiatric patients are disproportionately affected. Yet, solutions tailored to their needs remain underexplored. This discussion examines root causes of boarding and proposes innovative, scalable interventions to mitigate its harms, specifically for marginalized groups. We highlight three strategies: (1) Patient Navigators, who assist low-SES patients navigating healthcare systems, (2) Community Paramedicine, which delivers in-home care to complex patients, and (3) Emergency Psychiatric Assessment, Treatment and Healing (EmPATH) Units, which provide targeted care for psychiatric patients. All three are associated with reduced ED visits. Traditional approaches to boarding have fallen short, particularly for vulnerable populations. Patient navigation, Community Paramedicine, and EmPATH units represent feasible, evidence-based solutions that health systems can implement. Broader adoption of these models can alleviate crowding, enhance care quality, and promote health equity. Future efforts must align these innovations with policy and funding mechanisms to ensure sustainable, system-wide improvements.

Alister Martin

Timothy Scheinert

Amelia Papadimitriou

+1

Innovation Skills Assessment in Healthcare: Benchmarking Capacities in Low-Resource Settings

Original Research

Innovation Skills Assessment in Healthcare: Benchmarking Capacities in Low-Resource Settings

17 August 2025

ABSTRACT Background: Innovation is a key driver of healthcare transformation, particularly in low-resource settings where systemic constraints often hinder service delivery. Assessing innovation capacities among healthcare employees can inform workforce development strategies. This study applies the previously validated Innovation Skills Assessment (ISA) tool to examine workforce innovation potential at a tertiary care hospital in Pakistan, offering insights for targeted capacity-building interventions. Methods: A cross-sectional survey was conducted at Mukhtar A. Sheikh Hospital in Multan, Pakistan, using the ISA tool adapted from the General Innovation Skills Aptitude Test. The survey captured demographic data and assessed innovation skills across four pillars: idea generation, risk-taking, interpersonal relationships, and idea implementation. A total of 250 electronic surveys were distributed via hospital communication channels, with 161 responses (64% response rate). Responses were rated on a 5-point Likert scale, and mean scores with standard deviations were calculated for each pillar. Descriptive statistics were used to explore observable trends across age, gender, education level, and job designation, without formal hypothesis testing. Results: Participants aged 36–45 years had the highest overall mean scores (4.48 ± 0.31), with notable strengths in idea generation (4.48 ± 0.31) and implementation (4.53 ± 0.33). Males showed higher average scores across all pillars, with interpersonal relationships as the strongest domain (4.49 ± 0.42). Participants with intermediate education reported higher mean scores in creativity and risk-taking (4.36 ± 0.45 and 4.20 ± 0.57, respectively). These patterns suggest potential demographic influences on innovation capacities. Conclusion: The ISA tool can be feasibly applied to map innovation skills within healthcare workforces in low-resource contexts. The identified trends may help guide workforce development through tailored training and institutional policies that promote a culture of innovation. Keywords: Innovation Skills Assessment, Healthcare Workforce, Low-Resource Settings, Human-Centered Design, Capacity-Building, Pakistan, Benchmarking, Workforce Innovation

Ahmed Raheem

Hasan N Tahir

Zeeshan Ahsan Allana

+5

Human Drugs & Veterinary Drugs - A Cost Comparison

Original Research

Human Drugs & Veterinary Drugs - A Cost Comparison

16 August 2025

Objective: The aim of this study was to provide an updated comparison of veterinary drug costs with human pharmacy equivalents. Design: A cross-sectional study was conducted by identifying the 50 most common drugs from Medicare Part D spending data, and obtaining the costs of these drugs, in addition to select antidepressants and ophthalmic medications, from human retail (GoodRx, DiRx, and Cost Plus Drugs) and veterinary pharmacy websites (Chewy and Pet Meds). Main outcome measures: Drug costs per tablet were calculated using 30-, 60-, and 90-count quantities. Drug cost data was normalized, and costs were compared via Student’s T-test. Results: 41 drugs were analyzed between human and veterinary pharmacy alternatives. For 90-day supply costs, Cost Plus Drugs provided the cheapest price for 30/41 cases. The lowest normalized drug cost per unit 90-day supply was 0.4406 for Cost Plus Drugs, with DiRx second at 0.5789 (p < .05). For 30-day supply costs, Chewy provided the cheapest price for 30/41 cases. The lowest normalized drug cost per unit for a 30-day supply was 0.4665 for Chewy, with no significant difference to Cost Plus Drugs at 0.5270 (p > .05). Conclusion: These results demonstrate that home-delivery pharmaceutical services offer more affordable options and address the high cost of human medications compared to equivalent veterinary medications. This represents a step forward in identifying solutions to reduce healthcare expenditures and pharmaceutical costs.

Paul Chong

Kevin Shannon

Julian Fine

+2

Leveraging Text-Based Outreach to Improve Enrollment in Federal Benefit Programs and Address Broadband Internet Access

Original Research

Leveraging Text-Based Outreach to Improve Enrollment in Federal Benefit Programs and Address Broadband Internet Access

13 August 2025

Background: Federal benefit programs form the backbone of a social safety-net that provides access to essential services for millions of Americans. However, access to these programs is hampered by complex application processes and administrative barriers. Link Health is a Boston-based nonprofit organization that, through strategic community partnerships, has developed a framework to streamline benefit program enrollment, resulting in the disbursal of over $4 million in benefits. We evaluate the effectiveness of embedding benefits access within existing private messaging frameworks as a strategy for reducing systemic barriers to federal program utilization and improve broadband internet access. Methods: In this prospective observational study of data from June 2024 through December 2024, Link Health conducted a targeted Massachusetts-based text-messaging campaign aimed at enrolling patients from partner community health centers in the Lifeline program, a broadband phone and internet access discount. DaisyChain, a web-based communication platform, enabled Link Health’s multilingual digital navigator team to collect patient responses and conduct follow-ups. Results: The campaign reached 68,529 patients, with 2.15% (n=1,470) engaging with the initial message. Among those who engaged, 41.84% identified as Hispanic, 35.58% as White, 10.61% as Black or African American, and 2.79% as Asian. 62.59% of participants preferred English, 32.31% preferred Spanish, and 5.10% preferred another language. 68.91% of sign-ups were female. Applicants were predominantly working and middle-age adults, with 24.15% of applicants between the ages of 35-44 years and 24.15% between 45-54 years. Patients primarily qualified for Lifeline through SNAP (64.97%), Medicare (37.21%), or Medicaid (41.16%). Conclusion: This study describes the effectiveness and feasibility of text-based initiatives in connecting patients from racially and linguistically diverse communities with the Lifeline benefit program. The campaign successfully and predominantly engaged Hispanic, publicly-insured groups, with an especially high enrollment rate among working and middle-age adults. By integrating digital technology with public health, Link Health’s text-messaging campaign provides a scalable and replicable framework to improve access to federal benefits.

Abhi Jain

Timothy Scheinert

Sammer Marzouk

+3

A Three-Pillar Approach to Benefit Enrollment Reaches Underserved Communities

Original Research

A Three-Pillar Approach to Benefit Enrollment Reaches Underserved Communities

31 July 2025

Background. The Affordable Connectivity Program (ACP), established in 2021, provided eligible low-income households a monthly $30 internet subsidy. Despite its role in reducing digital disparities, only 40% of eligible households enrolled nationally. Link Health (LH), a Boston-based grassroots initiative, implemented a three-pillar (active, passive, and digital) outreach model to increase ACP uptake in Massachusetts and Texas. Methods. From November 2022 to May 2024, LH partnered with community health centers in Boston and Houston to deliver on-site sign-up clinics (active approach), distribute multilingual printed materials (passive approach), and provide personalized text-message support (digital approach). Multilingual volunteers led screening and application filing, with follow-up via a dedicated helpline. Enrollment data were collected across 17 clinics and analyzed descriptively. Results. Of approximately 9,774 individuals screened, 1,086 (11.1%) enrolled in the ACP. Enrollees were predominantly racial/ethnic minorities (78.9%), with 55.4% Hispanic/Latinx and 23.5% Black/African American. 68.4% of enrollees qualified for the ACP through current Medicaid enrollment, and 29.2% qualified through current SNAP enrollment. Digital sign-ups constituted 33.8% of enrollments. LH’s efforts distributed an estimated $390,960 in annual subsidies. Conclusion. LH’s community-driven, three-pillar strategy bridged barriers to ACP enrollment. This model may inform future initiatives aimed at closing the digital divide and advancing health equity through targeted benefit enrollment.

Nicholos P Joseph

Timothy Scheinert

Ashley K Roth

+4

Leveraging Network Analysis for Global Connectivity in Emergency Medicine

Original Research

Leveraging Network Analysis for Global Connectivity in Emergency Medicine

29 July 2025

Introduction: In the field of international emergency medicine (IEM), navigating the vast and often fragmented online resources can be a challenge. This abstract explores how network analysis, a method examining connections within a system, can be applied to improve online accessibility and navigability of these resources. By focusing on the International Federation for Emergency Medicine (IFEM), the study aims to utilize network analysis to understand the current digital landscape of IEM stakeholders and their connections. This will ultimately lead to recommendations for improved information sharing within the IEM community. Methods: We focused our data collection on the IFEM website (www.ifem.cc), a central node connected to global emergency medicine organizations. Using an automated network analysis pipeline, we crawled the IFEM website to three levels deep with the Screaming Frog SEO Spider tool, mapping its structure and extracting pertinent data. The BeautifulSoup library was then used to parse the HTML content, while the Gemini 1.0 Pro language model helped filter and identify relevant information about global emergency medicine organizations. This results were then compared with the official IFEM member list for validation. Finally, Geographical details were pinpointed using the Geopy library and Nominatim tool to convert names and countries into exact coordinates. An interactive global map of these organizations was created with the Folium library, enhancing our understanding of the global emergency medicine network and its interconnections. Results: We identified 4,775 external links, narrowing down to 156 unique base URLs for further content analysis. On the IFEM website, of 55 countries listed, only 41 had accessible links; 10 were non-functional, and 3 were missing. Our automated pipeline pinpointed 41 pertinent multilingual URLs from the available ones, achieving 100% accuracy rate. Our analysis also revealed 28 additional URLs, potentially linked to EM organizations not listed on their member page. Conclusion: By leveraging an automated network analysis pipeline, we gained valuable insights into the digital connections between emergency medicine organizations. This approach not only identified key organizations and their connections but also potentially improved the accessibility and navigation of online information in emergency medicine

Norawit Kijpaisalratana

Abdel badih El Ariss

Jeffrey Yuan

+6

LipidLlama: A Multilingual AI Chatbot for Personalized Cardiovascular Risk Assessment

Original Research

LipidLlama: A Multilingual AI Chatbot for Personalized Cardiovascular Risk Assessment

23 July 2025

Background Cardiovascular disease is the leading cause of death worldwide. Many patients with cardiovascular disease struggle to understand their risk factors and medical test results due to health literacy limitations and/or inadequate resources for personalized education. Existing digital solutions often provide generic, one-size-fits-all information with varying degrees of medical accuracy. Methods LipidLlama addresses this gap by integrating a rule-based AI system—adapted from a validated cardiovascular risk assessment tool—and a chatbot powered by a Large Language Model (LLM) enhanced with retrieval augmented generation (RAG). To improve document retrieval, a custom query-only adapter was trained on synthetic query corpus document pairs. Response quality was independently evaluated by three board-certified physicians (two cardiologists and one internist) who rated 30 responses to synthetically generated, realistic patient queries using a 5-point Likert scale across four dimensions: correctness, conciseness, comprehensiveness, and comprehensibility. Rater reliability was assessed using generalizability theory. Results The trained adapter improved top-k document retrieval accuracy from 67% to 80%. Responses received consistently high clinical ratings across all dimensions (mean composite score = 18.21, 95% CI: 17.80-18.62) and demonstrated strong reliability metrics across raters (generalizability coefficient E⍴² = 0.88; dependability coefficient Φ = 0.84). Conclusion LipidLlama provides clinically grounded, personalized explanations in response to cardiovascular health questions. With further clinical validation, this mobile health application has the potential to enhance health literacy and minimize provider burden, significantly improving access to preventive cardiovascular care, particularly in underserved communities.

Tyler J Smith

Amogh Karnik

Jonathan Hourmozdi

+2

Transforming Emergency Care: Scalable Clinical Audit Innovations for Emerging Markets

Original Research

Transforming Emergency Care: Scalable Clinical Audit Innovations for Emerging Markets

22 July 2025

Resource constraints, staff brain drain, operational inefficiencies, and incidents of workplace violence undermine emergency care outcomes in emerging markets. The Emergency and Trauma Excellence (EmTEx) framework, a structured and human-centered approach, was implemented at Evercare Hospital Lahore to address these systemic challenges. A two-day clinical audit, led by a senior emergency physician, pediatrician, and innovation consultant, evaluated resuscitation readiness, triage efficiency, infection control, staffing adequacy, and staff safety using JCIA-inspired checklists, staff interviews, and facility walkthroughs. Findings revealed insufficient resuscitation spaces, poor separation of pediatric and adult patients, inconsistent triage protocols during peak hours, staffing shortages, and reports of aggression toward healthcare staff during high patient volumes of up to 190 daily. Additional gaps in infection control practices and variability in triage accuracy highlighted operational inefficiencies. Recommendations included tablet-based triage systems for real-time data capture, enhanced isolation zones for infection control, structured staff training programs, and robust safety measures such as de-escalation training and security protocols. Projected outcomes include a 20–30% reduction in patient wait times, improved workflows, and enhanced staff safety and engagement. These findings underscore the scalability of the EmTEx framework, demonstrating its ability to deliver empathy-driven solutions for transforming emergency care in resource-limited settings.

Asad I Mian

Muhammad Taha Anver

Mahreen Sulaiman

+5

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