CV Wizard provides clinical decision support to reduce cardiovascular (CV) risk. We seek to determine realistic expectations for frequency of CV Wizard use and to identify patient attributes associated with use. Methods: EPIC data was used to calculate use frequency. Random chart audits were conducted of 40 HealthPartners encounters with high CV risk patients. Patient attributes (age, gender, smoking status) and appropriateness of CV risk discussion were assessed. Results: Out of 12,274 eligible visits (age 18-75 with a BP entered) in June 2013, CV Wizard was recommended at 2156 (17%) due to high reversible CV risk or suboptimal diabetes or cardiovascular goal measures. CV Wizard was printed in 44% of these high risk situations. Of patients with CV wizard used, 15/20 (75%) were men and 13/20 (65%) were smokers. Of high risk patients without CV Wizard use, 8/20 (40%) were men and 6/20 (30%) were smokers. Documentation of smoking counseling was found in 32% of smokers and did not increase with CV Wizard use. A discussion about CV risk reduction was considered potentially appropriate at 34/40 encounters (85%), and inappropriate at 6/40 encounters (15%) due to more serious acute medical problems. Conclusion: The study goal of 80% CV Wizard use is a reasonable. Data suggests a gender disparity (p=.03), and additional analysis is warranted to evaluate the possibility of gender bias with regard to using CV Wizard. CV Wizard is used more often in smokers (p=.03) and future analysis will determine if rates of smoking cessation improve.