Thanks for all the info- I will have a look into it Regards Stephen -----Original Message----- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] Behalf Of Neil McAliece Sent: Wednesday, April 05, 2006 8:49 PM To: General Practice Computing Group Talk Subject: Re: [GPCG_TALK] Online appointmenting - with voip
There is a couple of ways you can go. I think traditional proprietary phone systems with voicemail, queues, etc are probably less expensive than they were a few years ago. I think you can get systems from Alcatel that support VoIP using SIP (supported by pretty much all VoIP providers) that also have a lot of other features for reasonable dollars that can be installed by traditional phone system businesses. Others in the gpcg list are familiar with the Asterisk project. It's stirred up a lot of excitement because you can take PC hardware, load it with linux and the Asterisk software and build PABX solutions anything from a home office through to hundreds of extensions with a feature list that seems almost endless. I guess the trick to using it in a business situation is finding someone who knows Asterisk very well and also having support options for it. I've spoken to a few traditional phone contractors who's jaws have droped at the flexibility of it all, but weren't sure that they could learn to do it. (It's sort of telephony crossed over into server configuration and administration). Alternate support options for these guys are a couple of regional IT companies who are learning Asterisk so they can offer it as a solution (so they aren't there yet) or remote support from people who know Asterisk very well. Off the top of my head equipment for the install mentioned: Basic high quality PC..... Asus P4 MB with 5 PCI slots and lots of control over IRQ settins (multiple phone line cards need care taken that no IRQs are shared + some MBs are troublesome). 1GB High quality RAM (Massive overkill, but RAM is cheap and you don't want a PABX thrashing about with a swap file). Good quality IDE hard drive. Good quality low noise power supply connected to a decent UPS......... About $1000 for the PC bits + about $400 for the UPS. A couple of TDM400P POTS line cards. Price depends on the number of line modules. A card to support 4 phone lines is about $500. If you have ISDN, good Australian certified cards are going to be about $800+ depending on the number of channels. Snom 320 IP deskphones About $270 each (might get a bit cheaper in quantity). You might want Snom 360s at reception if you have a lot of extensions (extra button/light panels are available for them). About $50 for professionally recorded Aussie accent system sounds (default is an american woman) $10 per g729 license if you wanted a low bandwidth high quality option (this system is using alaw which is free but higher bandwidth use and probably slightly better quality). Roughly a license per simultaneous call plus a couple. (The system uses a license whenever audio is transcoded from another format, including vocemail prompts). This system is 14 extensions and roughly $2000 in my time including setting up call queue statistics (database of stats with web page reporting on call volume, numbers of callers who gave up before their call was answered etc) setting up phones with quick dial and web based phone book entries (snoms have a nice web interface with click to dial phone book). Asterisk has a distinct advantage over proprietary systems..... IAX trunking. IAX is a VoIP protocol developed for Asterisk that is an alternative to things like SIP and H323. It's big advantage is bandwidth efficency. You can get up to 45 simultaneous calls on 512/512 ADSL with g729 codec compared to about 16 with SIP or H323 (very few VoIP call providers support H323. It's commonly used as a trunking protocol between proprietary PABXs. Asterisk does have support for it). IAX also has an adaptive jitter buffer. Re sharing calls with other data on a 1mbit link..... The bigger the link the more chance you have of getting away with it, but it still depends on what users are doing with the link. VoIP, even on the higher bandwidth codecs doesn't use much data. About 80kbit for alaw/g711a. VoIP is very sensitive to fluctuations and packet loss though. If you get latency varying by much more than 15-20ms in short spaces of time you will often notice a bit of a warble in the call or even choppy dropped out calls. Jitter buffers can help, but they can also worsen echo problems. If you had someone download something big on a 1mbit link while a couple of calls were in progress, the calls would suffer. QoS routers can help but just having QoS routing in your own router only properly manages your upload data. For QoS routing to work really well you also need your ISP to be prioritising you voip packets on your download. You can throttle downloads, but you have to be really savage about it to make sure voip is fine (you can't directly control packet queues in ISP routers). It's hard to find end to end QoS solutions that aren't really expensive. Internode's Nodephone product is an example of where you can get QoS routing from your ISP that needs to be coupled with QoS in your own router to be really effective. You have to be using Internode ADSL + their VoIP. Nodephone isn't a great match for business just yet I think (multiple calls per account). If you are making good call savings, it's just better to have a DSL account dedicated to call data if you can. A good fixed IP account will cost about $60/mth for 512/128 which should handle about 8 simultaneous g729 calls over IAX. I also wouldn't go slashing PSTN lines. VoIP systems add extra complexity and sometimes thing go wrong... ISP outage, voice provider problems. I recommend keeping PSTN for incoming for business and give staff the ability to override VoIP themselves if there are problems (eg with a prefix like *55 before the number). Also configuring TDM400P POTS line cards for good quality can be a bit of a black art. By default everything is set up for North American phone lines (bad quality if it is left that way). Also they don't have a hardware echo canceller on board and rely on echo cancel software in Asterisk. It can be pretty good, but the best echo canceller I've used is commented out by default (because it is a bit new). You need to change the compile options for the driver to enable it. There is a new TDM2400 that has a hardware echo canceller supporting up to 24 ports but it isn't Austel certified or distributed here yet. The Snom320 and 360 phones are great quality and work well with Asterisk. Particularly the extension activity lights and the ability to plug in extra button panels (as you can with more traditional reception phones). Some of the less expensive IP phones are a bit yuck but useable. The $100 Grandstream budgetones are surprisingly acceptable if you accept the fact that the speaker phone on them is completely useless :) Neil ----- Original Message ----- From: S+C Barnett <[EMAIL PROTECTED]> To: General Practice Computing Group Talk <[email protected]> Sent: Wednesday, April 5, 2006 8:13:23 PM GMT+1000 Subject: RE: [GPCG_TALK] Online appointmenting - with voip Hi Neil, Can you give me some more details on how to access more info on this setup, including costs etc? We are currently about to replace our PABX and get a new phone system. We are interested in the 'messages on hold' function, but all the other flexibility sounds good too. We currently have a 1mb bband connection.....would we need a dedicated connection, or can it all run over our current bband? Regards Stephen Dr Stephen Barnett Bowral Street Medical Practice Bowral NSW 2576 -----Original Message----- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] Behalf Of Neil McAliece Sent: Wednesday, April 05, 2006 10:33 AM To: General Practice Computing Group Talk Subject: Re: [GPCG_TALK] Online appointmenting - with voip I have recently put in a system for a group medical centre that will almost give that. No direct patient access to appointments though. (I think Medtech have that on their development horizon somewhere) At the moment we just have VoIP integrated into their creaking old pabx. Once the rest of the SNOM deskphones arrive (probably today) the system will be set up as per below. Quick description: 512/512 ADSL dedicated to VoIP. (No QoS complications with bandwidth contention) Legacy phone system removed and replaced with an Asterisk telephony server with TDM line cards (allows the system to function as a conventional PABX with incoming calls on standard lines through a call queue with music and position announcements). Reception can log phones on to accept calls from the queue, but so can anyone else from the other rooms. It's inexpensive to set up IPSEC VPN for a remote site. I currently have one setup to home for remote support. I can connect an extension at home and have it behave just like any of their other extensions. I can log my phone onto their queue and take calls. The button panel shows me which extensions are in use (in practice or remote extensions). I can transfer calls including to in use extensions if the caller wants to leave voicemail. Similar to my remote support VPN I can set up an extension anywhere that has decent broadband. If the practice has the ability to provide terminal logins from their server (this practice does) the remote worker can access appointments from a home office while taking reception calls. It doesn't need to be limited to appointments. If a specialist calls to speak to a GP they can transfer just the same as someone physically at reception. The terminal login would be locked down so that they only get access to the appointment application. The user security in the billing/appointment app can further restrict things if needed (options editing, financial reports etc) Also if you were a practice with satellite practices, you could build a phone system accross multiple locations and have someone from another practice location log in to take reception calls for your main practice if a couple of people had called in sick. I think one of the long lasting benefits of VoIP will be flexibility. Ultimately I think traditional telcos will start to compete with VoIP rates (then sometime down the track we will see enough maturity in systems to have a very high percentage of calls being able to be routed for free..... maybe in 5-10 years) Neil ----- Original Message ----- From: Dr Michael Daly <[EMAIL PROTECTED]> To: gpcg talk <[email protected]> Sent: Wednesday, April 5, 2006 8:15:45 AM GMT+1000 Subject: [GPCG_TALK] Online appointmenting - with voip Dear Group Is anyone here aware of a service that offers online appointmenting? Ideally, this would coupled with voip. I.e. a patient calls a voip #, the 'secretary' (where-ever they may be and whomever they are employed by ) checks the online appointment system and books the patient in. Alternatively, the patient themself can book online. The practitioner has similar access. Please let me know - what would be the terminology for such a thing? Sincerely Michael Daly MBBS Melbourne _______________________________________________ Gpcg_talk mailing list [email protected] http://ozdocit.org/cgi-bin/mailman/listinfo/gpcg_talk _______________________________________________ Gpcg_talk mailing list [email protected] http://ozdocit.org/cgi-bin/mailman/listinfo/gpcg_talk _______________________________________________ Gpcg_talk mailing list [email protected] http://ozdocit.org/cgi-bin/mailman/listinfo/gpcg_talk _______________________________________________ Gpcg_talk mailing list [email protected] http://ozdocit.org/cgi-bin/mailman/listinfo/gpcg_talk _______________________________________________ Gpcg_talk mailing list [email protected] http://ozdocit.org/cgi-bin/mailman/listinfo/gpcg_talk
