Anticoagulation With Enhanced Gastrointestinal Safety

Inclusion Criteria for Patients: * Enrollment with the Michigan Medicine anticoagulation monitoring service * Currently prescribed warfarin with anticipated use for ≥90 days on day 1 of trial enrollment, according to the electronic health record documentation. * Currently prescribed an antiplatelet medication (aspirin, clopidogrel, ticagrelor, or prasugrel) according to the electronic health record medication list Inclusion Criteria for Clinicians: * Cardiologists at Michigan Medicine who in the prior year had a face-to-face or virtual visit with a patient who meets eligibility criteria * Michigan Medicine primary care providers for patients who meet eligibility criteria * Clinicians in any specialty who are designated as the clinician of record with the anticoagulation clinic for a patient who meets eligibility criteria Exclusion Criteria for Patients: * Age less than 18 * Currently prescribed a PPI * Documented intolerance or allergy to PPI use * Left ventricular assist device * Heart transplant * Participation in a previous pilot study of these implementation strategies Exclusion Criteria for Clinicians: * Cardiologists specializing in electrophysiology or who saw the patient for a clinic visit related to a TAVI procedure unless they are the clinician of record for a patient followed by the anticoagulation service who does not have a Michigan Medicine PCP. * Participation in a previous pilot study of these QI strategies