Polypharmacy is common among veterans. This articles describes the Veteran Health Administration’s implementation of an electronic, portable medication management tool to reduce polypharmacy by using the principles of high reliability organizations and combining best practice evidence, interprofessional teams, patient engagement, and integration of existing medical records systems. After three-years of implementation, an average of 2.15 medications were deprescribed per patient, with the most common being antihypertensives, over-the-counter medicines and antidiabetic medications.