Management of tests pending at discharge (TPAD) is a continued focus of safety efforts. Although improved discharge summaries address certain gaps in communication, additional strategies are still required. This study describes the development and implementation of an automated TPAD email notification system. The goal was to push results to the discharging inpatient provider and facilitate communication with primary care providers. Discharging providers received approximately 1.6 email notifications per discharged patient and were satisfied overall with the new system. The authors reflect on key elements of improving the system, which include further refinement of the computer logic to minimize alert fatigue and careful attention to assigning accountability for acting on the notifications. A past AHRQ WebM&M commentary discussed an adverse outcome that resulted from poor test follow-up after hospital discharge.