This article examines the use of comprehensive heart failure (HF) medical therapy in a large, diverse health system. The study utilized an electronic health record (EHR)-based patient registry to evaluate factors that impact the use of guideline-directed medical therapy (GDMT) for HF. The findings showed that cardiology engagement within the last 12 months was strongly associated with higher GDMT scores. HF hospitalization and all-cause hospitalizations were associated with worse GDMT use, although HF hospitalization was linked to an increased likelihood of prescription for certain medications. The study also found no difference in GDMT scores based on patient race or sex when certain medications were excluded from the analysis. The authors suggest that this EHR-based approach can be used to evaluate GDMT opportunities in other health systems, but acknowledge the limitations of the study and the need for further research. [Extracted from the article]