This was a pragmatic, randomized, stepped-wedge comparative effectiveness trial. Patients with HFrEF receiving care at 2 IHS facilities in Navajo Nation were randomized to the telehealth care model or usual care in a stepped-wedge fashion, with 5 time points (30-day intervals) until all patients had crossed over into the intervention. The primary outcome was an increase in the number of GDMT classes filled from pharmacy at 30-days post randomization. Secondary outcomes include increase in rates of each GDMT class and safety outcomes.