Despite well‑established clinical guidelines, significant practice gaps persist in the management of heart failure with reduced ejection fraction (HFrEF). Frontline clinicians often lack consistency in initiating and titrating GDMT, resulting in prolonged periods of suboptimal therapy. In addition, referral pathways to cardiology, pharmacy‑led titration, and the Virtual GDMT Clinic are often unclear or delayed, limiting timely access to coordinated heart failure care.

Transitions of care remain a critical vulnerability. Patients are frequently discharged without a clear Heart Failure Action Plan or effective use of digital tools such as the Home Journey app, limiting symptom recognition, adherence, and self‑management, and contributing to avoidable emergency department visits and hospitalizations.

Clinicians need to utilize evidence‑based GDMT optimization strategies, appropriate referral timing, standardized use of Heart Failure Action Plans, and effective integration of digital tools into routine practice. Addressing these gaps has the potential to improve GDMT optimization, enhance patient self‑management, and reduce preventable utilization across the heart failure population.