Objective: The East Tennessee State University Quillen College of Medicine Library (ETSUQCOML) wanted to determine if the introduction of phone calls to an existing outreach visit increased the usage of the ETSUQCOML’s services. Methods: Eight hospitals and sixteen clinics were chosen to participate. Two site visits were made a month to each participating institution. A total of two phone calls and two emails a month were given to multiple contacts in the hospital or clinic. The hospitals and clinics were randomized to determine which received the phone call intervention. Interlibrary loan statistics and reference search statistics were then analyzed to determine if there was a statistically significant difference. The data were also analyzed to determine if the intervention was more successful in hospitals or clinics. Results: Librarians learned to what degree email and phone calls could be substituted for personal visits in an outreach service as a means of maintaining it and not experiencing a decline in service requests. Conclusions: In today’s economic times, it is important to maintain services to underserved health care providers but to do it in the most cost effective manner. This study has provided helpful data as to the possibility of substituting less expensive contacts such as emails or phone calls for more expensive ones such as face-to-face visits in order to sustain an outreach service. The authors are looking to extend this project to multiple end-points such as six months, nine months, and one year to determine sustainability.