Through the use of this novel alert system, we will identify patients at high risk for VTE, maximize the implementation of VTE prophylaxis, learn the rationale for physicians' withholding anticoagulant or mechanical prophylaxis in some high-risk patients, and test whether this novel electronic intervention reduces clinically important episodes of PE and DVT. The success of this program will provide a useful model for dissemination of VTE preventive strategies nationwide and worldwide.