Choosing a Phone Systems for your Medical Office Introduction The phone system a medical office chooses will give the first impression of the office to its patients and anyone who contacts the office. Investing in a phone system is more than answering the calls. The telephone system represents the level of medical office’s operational sophistication and the value of its services. The consideration narrows down to: cost versus perception. Also, a medical office phone system should be a strategic investment. Telephone systems are not cheap. Depending on the phone system, features and user extensions prices can range from a few hundred dollars to several thousand dollars. The prices and cost of implementing a telephone system should not be a deterrent in choosing a much needed telephone system. An expensive telephone system that increases efficiency in the office may help the office gain savings in the long run. However, it is very important to determine a budget for the purchase and implementation. There are many factors to be evaluated in purchasing a phone system for medical offices. For example, what is the system capacity to handle patient calls while leaving room for possible increase in calls? For instance, if there was pandemic – could your system handle the increased volumes? Also, evaluate the system’s compatibility with the office’s existing equipment and features like voicemail and conferencing. This guide can help in determining medical offices specific needs, considerations prior to contracting vendors, weighing phone system options and negotiating prices. A medical office in the market to purchase a telephone system should compile the following information to make an informed decision: (1) medical office’s specific need for telephone system, (2) telephone systems in the market, (3) systems prices, (4) type of implementation support various system sellers provide.
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By: Samuel Kohan
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(1) Medical Office Telephone System Requirements Initial questions to ask and answer prior to starting the search for purchasing a telephone system: •
How many telephone lines does the office need?
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How many extensions does the office need?
Generally, the type of telephone system a medical office needs is determined based on the number of telephone lines and user extensions. The future growth of the office and the future need for additional phone lines and user extensions should be considered. For example, the questions to answer are: •
How many new physicians and employees the office is likely to add in the next two to ten years?
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How many outside phone lines going to be needed for additional fax machines, modems, and any other equipment that will require a phone connection?
The phone system should make it easy for a medical office to added additional phone lines and user extension. Additional questions to consider are as follows: •
How many employees are there in the medical office?
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How many offices?
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How many calls each office receives and answers daily?
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How many outbound calls are made daily?
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Is there a need for long distance calls? A toll free number?
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How much internal technical expertise does your staff has? (2) Telephone Systems and Features
Once a medical office determines the number of telephone lines and user extensions it requires, the next step will be determining the system type and features. As the health care system moves towards a patient centred care model, medical practitioners should also use this opportunity to select a telephone system that can be a resource to them. Patient centred care at a system level means making your services accessible to your
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By: Samuel Kohan
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patients. Will your system’s capacity match the demand with minimal delay? When demand exceeds capacity, what happens to your callers? When designing your telephone system you should put yourself in the shoes of your patient. Are you accessible? How many rings before the call is answered? What happens after hours? If you elect to use automated attendants and voicemail menus, are there opt out options? The standard options most phone systems offer are: •
Auto attendant. A voice response system that replaces the human operator and directs callers to the appropriate extensions or voice mailboxes.
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Conference call. A telephone call between three or more people in different locations.
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Caller ID. A telephone system that provides the name and telephone number of a caller, which appears on a display.
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Intercom. An intercommunication system linking different rooms within an office.
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Dialing option: by name, by extension, and directory.
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Voice Mail. Recording, saving and relaying messages.
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Call transfer, call back, call hold, and call recording.
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Cost features. Provides detailed reports on call recipient and duration of call.
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Office Directory. Provides an office directory and automatic dial up.
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Reports. Provides reports on phone usage: calls received and made. Reporting can be a valuable tool in monitoring the activity in your practice. Knowing your average call length and peak call periods during the day can help you staff accordingly so that your patients are serviced in a timely fashion.
More sophisticated systems may include some of these features and more: •
Call routing. Transfers calls to mobile phones or a desired destination.
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Operator console. Allows receptionist to process tasks such as call transfers, paging, conferencing, and speed dialing, without having to remove their hands from the keyboard.
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By: Samuel Kohan
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Conference bridge. A conference bridge connects large numbers of people participating in conference calls. The bridge is a server that acts like a telephone and can answer many calls at the same time.
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Multisite management. Medical offices with several branches can have single extension list for all servers.
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Call Hunt. Several lines ring until the call is answered.
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Call convergence. Handles phone calls, voice mail, e-mail, instant messages, video conferences, faxes and other types of communication.
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Call queuing. This system would allow a medical office to accept more calls than available extensions or employees capable of answering them.
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Interactive voice response. Automates interaction with callers. It provides options to callers.
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Call Block. It prevents unwanted calls. Caller may have to enter a code. (3) Hosted, On-Premise, or Managed
After selecting the features that best meet the office requirements, the next step is to select a model: (1) Hosted1, (2) On-Premise, (3) Managed solution2. This selection would be based on the medical office’s telephone system needs and factors including the budget, office size, structure, and availability of technical staff in the office. If the medical office is small and does not have technical support and the purchasing budget is limited then consideration should be given to hosted telephone system 3. On the other hand, the traditional on-premise system provides total control over the medical 1
With hosted system, a medical office can have web-based access to configure the phone system, access call data, retrieve deleted voice mail, and many more features. This system allows small but expanding offices to easily modify their phone systems to meet new requirements such as additional extensions. A major benefit to a hosted system is that expensive equipment such as a phone server is not required to be purchased since it is located at the provider’s premises. The features this system can offer are too extensive and vary depending on the provider. A vendor should be able to provide a full list of features. 2 A medical practice can obtain full featured phone system with little investment by utilizing a managed telephone system. With a managed solution, a small office outsources the ownership of equipment, software, and technical expertise to phone system provider. 3 What distinguishes a hosted solution from a managed solution is technical support. With a hosted solution a medical office would still need internal technical expertise to make updates and changes to the system; however, full technical support should be provided with a managed solution for all updates, and changes to the system, including customizing. Basically, under a managed solution, a provider manages provides all equipment and technical expert support.
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By: Samuel Kohan
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office communication. The benefit of on-premise system is low maintenance and operating costs. A medical office can customize the features.
Types of Phone Systems Selecting a phone system based on number of employees or user extensions can make the process much simpler. For example: 1. One to ten employees
KSU-less system4.
2. Ten to forty employees
Key system5.
3. Forty and more employees
PBX System6.
VoIP. In addition to traditional telephone systems, there are systems that use voice over the internet protocol (VoIP) technology that can allow a medical office to receive phone calls using its broadband internet connection and special internet protocol (IP) enabled telephone. VoIP system can save medical office significant costs such as reduced maintenance, calling charges. VoIPs are gaining popularity over traditional phone systems. Similar to traditional phone systems, VoIP systems come in two types. (1) On-Premise: hardware is installed in the medical office very similar to a PBX or key system, (2) Hosted: calls are processed at a data center outside of the medical office before forwarding them to an extension at the medical office. The pros and cons of these two types are similar to the traditional phone systems discussed under the “hosted or onpremise” section above. What are the cons of VoIP? Presently, there are concerns over security, reliability, and quality of voice calls. However, these concerns are being addressed and improved 4
KSU-less system usually manages about five phone lines and are not wired into the office. The phones can be unplugged and moved to another office, if need be. Prior to purchasing a KSU-less system, its compatibility with the existing wiring in the office should be checked. In this system, the features are contained in the phones. KSU stands for Key system units. 5 Key system. A central devise either on-premise or hosted externally controls the calls. They may be less customizable. The Key system requires professional wiring and installation which can be as costly as the phone system. 6 PBX system. Private Branch Exchange (PBX) systems are for large medical offices. They are programmable and can support very complex implementations.
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By: Samuel Kohan
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systems are being introduced. VoIP has a significant role in the future of phone systems with major benefits to all types of medical offices. Unified Communications (UC) For medical offices to gain best return on their technology investment should consider unified communication (UC). What is UC? It integrates fax, e-mail, voice and other systems into one infrastructure and streamlines communications. For example, voice messages and faxes can be sent to an email. There is long list of systems that can be unified. Having a VoIP system makes UC implementation easier. Hidden Costs Prior to signing a purchase agreement medical office should be on look out for hidden fees that can burden their budget. Some of these hidden fees are found in equipment replacement, unexpected license costs of supplementary software such as SQL and Windows, unexpected labor costs in upgrading the system, technical support cost, unaccounted components such as insurance, taxes and other expenses. Selecting the Phone Dealer Some of the questions a medical office should ask the dealer are as follows: •
Does the dealer provide a detailed, unambiguous Service Level Agreement that addresses factors such as Quality of Service, application and network performance?
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Does the dealer provide a choice between a network overhaul and leveraging the existing infrastructure?
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Does the dealer have products/services/strategy to address new office communication requirements as the office evolves?
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Is there a backing company that will honor warranties if the dealer goes out of business?
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Does the dealer provide clearly defined support policies for preinstallation, during and post installation?
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By: Samuel Kohan
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Telephone System Implementation Once a phone system is selected and an agreement is signed, a medical office should work with the dealer and create a checklist of things to do regarding the process of implementation. The new system should be tested before implementation. This prototyping will help the office to be familiar with the new system. The dealer should assure that medical office’s operations are not interrupted or adversely affected during the implementation. Maintenance Agreement A written maintenance commitment should be secured by the medical office prior to the purchase. This commitment should clearly state that the post-implementation support the dealer or the company will provide, and that there will be a single point of contact to work with the medical office.
Practice Tips: 1. Dealers often try selling products that are needed in medical office. Don’t blindly follow a dealer’s recommendations or sales pitch. 2. Visit a few medical offices that purchased phone systems from the dealer. 3. Prior to signing a purchase agreement, ask the dealer to provide you with a clear, specific and timetabled implementation plan. 4. Seek assistance of an independent phone systems consultant when you make a substantial investment in communication products and system. 5. Create a list of dealers that compares their products, features, and prices. 6. Ask for a single point of contact. Otherwise there is a good chance that after the purchase your inquiries will be transferred to different people who may not know you and would require familiarization process with your office and you. 7. Request for proposal from three to five phone companies or dealers.
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By: Samuel Kohan
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