Clinical prioritization | Elevated problem that would otherwise not been prioritized PCP autonomy preserved for initiation of GDMT PCPs appreciated reminder and specialists enjoyed helping
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Implementation barriers external to the implementation strategies | Inconsistent patient visits limit initiation of GDMT Cost and prior authorization barriers remain a barrier Patient hesitancy to change medication remains a barrier Additional patient monitoring needed after initiation of new medications remains a barrier
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Content of recommendation | Appreciation of evidence-based and detailed note content PCPs used note as a reference while writing their own notes Appreciation of specialists’ chart review and ability to adapt notes for needs of complex patients
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PCP characteristics | PCPs felt they were not always up to date on recommendations PCP specialization affected confidence PCP willingness to learn novel treatments
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Multidisciplinary collaboration | Improved PCP access to specialists E-consults need to balance being prescriptive and collaborative Added to PCP burden with no specialist follow-up
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Workflow | Timing allowed for real-time application Need for follow-up mechanism to ensure implementation of GDMT Messages may get lost in EHR inbox
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