Background Prior studies have shown that colorectal cancer (CRC) screening/surveillance colonoscopies are performed earlier than guideline-recommended intervals. We implemented an Electronic Health Record (EHR) based intervention to improve the proportion of appropriate 5-year colonoscopies that are scheduled at a tertiary academic medical center. Methods This was a single-center pre-post study of patients with a primary care provider at our institution with an active EHR flag for 5-year screening/surveillance colonoscopy due in 2023. We first conducted a chart review of cases scheduled between 4/2023-7/2023 to evaluate indication and appropriateness for 5-year screening based on US Multi-Society Task Force Feb 2020 guidelines. Starting 7/2023, if the case was guideline inappropriate, the EHR flag was revised to reflect updated guideline-based recommendations. Post implementation was measured between 10/2023-1/2024. Results Of 17,313 cases scheduled in the 10-month period, 9,831 were screening/surveillance colonoscopies. 1,746 of 17,313 (10.1%) had a 5-year return flag, with 555 patients in the pre-implementation, 538 in the transition phase, and 653 in the post-implementation phase. In the pre-implementation phase, 69.2% (384/555) were guideline inappropriate, whereas post implementation, 56.5% (369/653) were non-guideline. There was a 10.9% increase in appropriately scheduled cases per week post implementation. Conclusion This study highlights the effectiveness of an EHR intervention in improving adherence to colorectal cancer screening protocols. The concomitant decrease in polyp-based guidelines inappropriate cases shows that the intervention reflected updates in polyp guidelines. However, continued efforts are needed to reduce the high proportion of non-guideline cases, to increase capacity for other indicated procedures.