Secondary and exploratory aims:

• Aim 2 will examine the effect of the alerts targeting newly prescribed inappropriate DOACs. In Aim 2a, we will examine the overall proportion of alerts that result in a prescription change within 7 days, without accounting for the type of alert received. In Aim 2b, we will examine whether the type of alert (i.e., alert only or alert + pharmacist referral) resulted in a higher proportion of inappropriate DOAC prescriptions changed within 7 days.• Aim 3 will examine changes in the magnitude of effects over time for both alerts and notifications. In aim 3a, we will examine the change in the proportion of existing inappropriate DOAC prescriptions that trigger notifications that are changed within 7 days over the 18-month course of the study, both overall and by condition. In aim 3b, we will do the same for new DOAC prescriptions that trigger alerts.• Exploratory analyses will examine potential moderators for alerts and notification conditions, to understand whether there are certain prescribers or patients that benefit most from alerts or notifications that encourage pharmacist collaboration. We will also examine implementation outcomes including patient reach for all types of alerts and notifications, variation in prescriber engagement with alerts/notifications that encourage pharmacist collaboration, and fidelity of prescription changes. Finally, we will assess the effect of the entire system of notifications and alerts on the prevalence of patients with the health system that are receiving inappropriate DOACs.