Multi-Center Project: Building Electronic Tools To Enhance and Reinforce CArdiovascular REcommendations - Heart Failure

This study will test an automated, electronic health record (EHR-)embedded alert to improve prescribing of guideline-directed medical therapy for patients with heart failure and reduced ejection fraction (HFrEF). The investigators have previously tested and implemented this alert at NYU Langone Health (NYULH), and will now test and implement this alert across three other health systems.

Inclusion Criteria: * Patient with an encounter visit at participating cardiology practice during the study period * Patient with EF of less than or equal to 40% on most recent echocardiogram at the time of visit * Patient ages 18-90 Exclusion Criteria: * Pregnancy * Ventricular assist device * Hospice * Cardiac amyloid * Medication-specific exclusion for MRA: most recent systolic blood pressure less than 105 mm Hg, most recent potassium \< 5.1, any potassium \> 5.5, most recent glomerular filtration rate \< 30 (using MDRD equation), or a documented MRA allergy.