No clinic left behind: providing cost-effective in-services via distance learning.

Based on the successful pilot implementation of a Veterans Affairs Quality Enhancement Research Initiative (QUERI) aimed at increasing HIV testing throughout four local facilities and their associated satellite clinics, we expanded our efforts to deploy our methods to substantially more sites spanning six states. Our goal was to implement and examine the cost effectiveness of a distance-learning model to offer provider education to geographically remote (sub)facilities. We developed and implemented an equivalent interactive online version of our in-person presentation. Handouts were shipped to each site before the day of the in-service. Remote participants were receptive to this cost-effective form of provider activation. The technology functioned dependably; no presentation anomalies were encountered. Participants rated in-person presentations higher than online, however, mean scores for both methods were >80%. Online presentations were found to be considerably more affordable than in-person. These findings suggest that this alternate approach may offer a feasible alternative for a variety of subjects.