Lin J, et al. – In this present study, the authors examine how specific patient and health system factors in the Emergency Department (ED) influence who is and is not screened in a combined targeted and non–targeted, EMR–driven, opt–out, HIV screening program. Many patients are missed in ED HIV screening programs, particularly adolescents and young adults, that require a blood draw and depend on providers to obtain consent for testing. Future ED screening programs should strive to develop innovative workflows that allow for blood draws for HIV screening only and streamline the processes of obtaining informed consent and ordering tests for all eligible patients to ensure these patients are reached.