Significance: To our knowledge, there are no studies examining strategies to improve care for this vulnerable and high-risk population, and we believe our results will be important regardless of findings. If "negative" it will provide evidence that more costly and laborious interventions will be needed to overcome clinical inertia; if positive, however, our intervention should be widely applicable. In addition, positive results can be easily extended to other related populations (e.g., routine chest radiographs done for admission to nursing homes) and can be adapted for implementation via other modalities (e.g., computerized decision support, telemedicine).