What is needed in speci c patient cohorts: African Americans, older adults, and the frail. 7. How to manage your patients costs and access to HF medications. 8. How to manage the increasing complexity of HF. 9. How to manage common comorbidities. 10. How to integrate palliative care and the transition into hospice care. The original 2017 ACC ECDP was drafted using a struc- tured format that was created subsequent to the release of the 2016 and 2017 ACC/AHA/HFSA focused updates of the 2013 ACCF/AHA HF guideline (2,4,6). The evolution of that ECDP involved developing questions to identify ev- idence gaps and convening a multidisciplinary panel of stakeholders who carried out a literature review to aggregate relevant evidence addressing contemporary HF care. At that time, the references were separately reviewed by the Chair and Vice Chair of the ECDP, and an agreed-upon compendium was developed. Print copies of the references were provided to each member of the panel before a live roundtable meeting held on July 19, 2016, at the ACC Heart House. Participants attending the HF roundtable included cardiologists, internists, emergency physicians, hospitalists, nurses, representatives from pa- tient advocacy groups, pharmacists, fellows-in-training, quality improvement experts, epidemiologists, and biostatisticians. Since the publication of the 2017 ECDP, numerous clinical trials have been reported, providing updated knowledge to inform the clinical management of patients with HFrEF. In addition, more knowledge is now available regarding biomarkers and imaging, management of comorbidities, and the mitigation of dif culties encoun- tered in care coordination. Lastly, the considerable impact of the coronavirus disease 2019 (COVID-19) pandemic on outpatient management of chronic disease states such as HFrEF justi es its consideration in this document. 