Behind the Scenes
Cut telephony costs
with appliances, SaaS
Appliances, free software and software-as-a-service
offerings all provide feature benefi ts, as well.
By Sidney VanNess
elephone consultations constitute 10 percent specifi cally designed for medical practices, but rather
a set of programming tools that can be manipulated to
to 20 percent of all primary-care interac-
tions, up to 80 percent of after-hours care, meet specifi cations.
and account for more than one quarter of all Using Asterisk, a competent engineer can develop cus-
medical decisions in some sub-specialties. Though phone tomized applications that perform automated functions,
interactions are characterized by a greater probability including message capture and transmission to the on-call
of malpractice lawsuits than face-to-face interactions, provider, message escalation of notifi cations to backup
providers document fewer than 30 percent of phone devices and call recording. There are a variety of integra-
interactions and most commonly rely on medically un- tion opportunities, including integration with EHRs (drop
trained phone operators to screen and relay messages to recordings into a patient’s chart) and scheduling systems
on-call providers. (automate appointment reminders).
For smaller practices, or practices that rely on telephone The primary benefi ts of Asterisk are its fl exibility and
triage services to manage most after-hours patient care re- the potential to control long-term recurring costs. Asterisk
quests, a one-time investment of less than $5,000 in a con- has no licensing cost and runs well on barebones computer
fi gurable unifi ed-messaging appliance might be considered. hardware. Furthermore, an Asterisk application can work
These appliances are feature rich and allow practices to with both voice-over-IP and PRI lines, and should produce
confi gure a work fl ow that meets their specifi c needs. little or no incremental change in recurring phone charges.
Modern messaging appliances include features allowing The major investment associated with implementing an
users to receive instant notifi cation of messages via e-mail Asterisk-based solution is labor (a competent programmer
or SMS, return calls from the voice-mail interface, and with Linux experience is required).
record live conversations. Since the appliances eliminate Simple Asterisk systems can be implemented in a
SHOWLINE the need for a third-party intermediary, patient privacy matter of days or weeks, while larger projects would
and HIPAA risk is better consume proportionally larger resources. Customized
Sidney VanNess is president managed. Asterisk implementations make sense for larger practices
and CEO of On Call Central.
Chad Jensen, IT manager looking to make a moderate one-time investment in order
For more information on
at LaTouche Pediatrics in to automate several telephony processes and eliminate
On Call Central solutions:
Anchorage, Alaska, replaced large monthly answering service bills.
his practice’s answering ser- Another alternative for practices are software-as-a-
vice with a unifi ed messaging appliance that integrates service (SaaS) products that can be confi gured to answer
with an existing PBX and has resulted in almost no in- calls, collect messages and transmit notifi cations to an on-
cremental recurring cost. The investment paid for itself call provider’s device of choice according to a predefi ned
in less than one year. Jensen notes that practices with call schedule.
complex call schedules, specifi c call-escalation protocols, Once confi gured, practices forward their phones to a
2500 Tamiami Tr N
or other advanced needs should consider options with an number provided by the vendor, and the vendor’s serv-
Nokomis, FL 34275
enhanced feature set. ers handle calls according to the agreed-upon protocol.
Asterisk is one of several freely available open-source The SaaS option is typically offered at a fl at monthly
telephony-development platforms that turn standard rate; minutes are not counted and superfluous fees
computer hardware into customized voice-application are not assessed. Call recordings can be maintained,
servers. Asterisk is used to power small offi ce PBX sys- downloaded over an encrypted connection and placed
tems and large call centers. Asterisk is not an application in an EHR. HMT
44 February 2010 HEALTH MANAGEMENT TECHNOLOGY www.healthmgttech.com
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