Delayed discharge summaries have long been blamed for poor care transitions: the primary care physician sees the patient before the summary arrives, and the handoff fails. Automating summary generation addresses that delay directly, and several systems have now done it at scale.

Median time to summary completion at one large system fell from four days to under six hours. Follow-up appointment attendance within fourteen days was unchanged. Readmission rates were unchanged. Primary care physicians reported that the summaries arrived promptly and that this had not affected their practice.

Follow-up interviews suggest why. The receiving physicians were not previously waiting on the summary; they were working from the discharge medication list and a phone call when one was needed. The summary was a documentation artifact whose absence was recorded as a quality gap and whose presence changed nothing.

The system considers the project successful anyway, on documentation-burden grounds, and has been unusually clear internally that the transition-of-care justification did not hold up. That candor is rarer than the result.