AGEM Author Spotlight

 

Published Work by AGEM Members

July 2026 AGEM Author Spotlight: Adrian D. Haimovich, MD, PhD

Marginal Dispositions and Shared Decision-Making Among Older Adults in the ED: A Prospective Cohort Study

Summary

Hospital admission decisions are among the most consequential choices made in geriatric emergency care, yet we know surprisingly little about how emergency physicians think about patients whose need for hospitalization is uncertain. In this prospective study, we found that nearly one in six older adults in the emergency department had a “marginal” disposition, where clinicians felt admission and discharge were both reasonable options. These patients experienced longer evaluations and frequently could participate in decision making, highlighting an important opportunity for shared decision making and patient-centered care. For geriatric emergency medicine, these findings suggest that rather than focusing solely on who is at highest risk, we should also focus on identifying patients for whom multiple care pathways may be appropriate and ensuring that what matters most to older adults is incorporated into disposition decisions.

Bio

Adrian D. Haimovich, MD, PhD, is an emergency physician and Director of the Division of Artificial Intelligence in the Department of Emergency Medicine at Beth Israel Deaconess Medical Center and Harvard Medical School. His research focuses on improving care for older adults, serious illness communication, and the application of artificial intelligence to clinical decision making and healthcare quality.