In Reply We are grateful to Garneau and colleagues for their interest in our study.1 We agree that a best practice alert, by itself, appears to have a smaller effect size than multimodal interventions in the reduction of unnecessary cardiac monitoring. We highlighted this in the Discussion section of the article: “It therefore appears that the effect size from only making changes to the [electronic health record] is smaller than what can be expected from including other elements typical of quality improvement interventions….”1(p14) We also agree that the success of our intervention was likely because of, in large part, its careful targeting in accordance with the 5 “rights” of clinical decision support.2