According to Webopedia, T-1 or Trunk Line One is a dedicated phone connection supporting data rates of 1.544Mbits per second. A T-1 line consists of 24 individual channels, each of which supports 64Kbits per second. Each 64Kbit/second channel can be configured to carry voice or data traffic.

Within the communications world, trunking is analogous to the structure of a tree with one trunk and many branches. According to Wikipedia, this is exactly how trunking got its name. Trunking is a concept by which a communications system can provide network access to many clients by sharing a set of lines or frequencies instead of providing them individually.

T-1 lines are a popular leased line option for businesses connecting to the Internet and for Internet Service Providers (ISPs) connecting to the Internet backbone. Here are some more facts for your review:

• T-1 transmits digital signals instead of analog.
• T-1 connections are available in US, Japan and South Korea, while E-1 connections are available in Europe.
• T-1 PRI offers 23 channels and 1 additional channel to pass data such as Caller ID and improve performance. T-1 PRI is often used for call centers.
• A Bonded T1 is two T1 lines offering 3.0 Mbps of bandwidth.
• A T-1 line is either made of fiber or copper and T1 is being replaced by Fiber to the x (FTTx) technologies, which is a generic term for any broadband network architecture that uses optical fiber to replace all or part of the usual metal local loop used for last mile telecommunications.

Inphonite, LLC develops and markets professional, automated phone messaging systems and interactive computer telephony products that improve the profitability and productivity of a wide range of organizations. InphoniteVoice supports Digital, Analog and VoIP connections.

• Converging your local, long distance and broadband Internet services onto a single pipe with dynamic bandwidth allocation
• Reduce toll charges on long distance calls and eliminate them on local and on-network calls
• Reduce hardware costs and leverage your existing legacy system investment with seamless integration
• Leverage dynamic bandwidth allocation to maximize your network
• Instantly, incrementally and infinitely scale your business communications as demand dictates
• Bring all of your communication needs into one location with one bill and one point of contact.
• Choose DIDs from anywhere in the country and serve them to the central PBX simply and efficiently

As an office clerk of a local school you have a lot of kids to keep track of. Once the teachers turn in their attendance notes, you need to call all the parents that haven’t already called in and let them know their child is absent. If you reach them, you need to ask if their child is home sick or has a valid excuse for being out. If you don’t reach them, you may need to call another number, or series of numbers and leave several messages.

Imagine this, set up InphoniteVoice to say, “Your child is absent today. If they are ill, we need to know their symptoms, so we can keep the rest of the students safe. To leave a message and confirm they are home ill or explain another reason for an excused absence, please press “1.” If you prefer to speak directly to the attendance clerk, please press “0” now.”

Your attendance duties are done and you can move on to other things.

This concludes my series of posts and ideas of when to use InphoniteVoice for Emergency or Blast Notifications. I hope to have shed some light on the amazing capacity and flexibility of a program such as InphoniteVoice.

As stated in an earlier post, I'm sure you can come up with your own scenarios. Unfortunately for this writer's friends, while I took a break from blogging, a local Tucson neighborhood experienced flooding. How useful might InphoniteVoice have been, if the Neighborhood Association, or City were able to warn our friends to evacuate. With InphoniteVoice as an in-house solution, the power to do so, could have been directly in their hands. And therein, is another scenario. Do you have one?

• According to AT&T, commercial touch tone telephones were previewed at the 1962 Seattle World’s Fair.
• The Bell System was the sponsor of Disneyland’s Circle-Vision theater in the late 1960’s. After viewing a 360° movie entitled America the Beautiful, guests were welcomed to a hands-on demonstration on the speed of touch tone dialing versus rotary dialing.
• SugarLoaf’s 1975 hit Don't Call Us, We'll Call You included the sound of a touch tone phone dialing two phone numbers – one an unlisted CBS number and the second a public number to the White House. According to Wikipedia, this was a practical joke on CBS Records for turning down the band for a recording contract.

A young woman rushes into the campus police having just been attacked. InphoniteVoice can send out a quick message to everyone on campus to be on the lookout for the assailant. The police can blast a message, “This is a Campus Police Warning. Please be on the lookout for a stocky white male, approximately 5’7” wearing baseball cap and navy sweatpants. Contact campus police at *5555 with any information.”

The entire faculty and student body will know someone amiss is in their midst and can help to apprehend the criminal before they hurt someone else.

What is PBX? :
PBX (Private Branch eXchange) is a privately owned telephone switching system for handling multiple telephone lines without having to pay the phone company to lease each line separately. A PBX essentially takes the place of the phone company's Central Office within the company by acting as the exchange point, routing calls. With a PBX in place, each phone only needs an extension, not a phone number, and the PBX handles all calls made from desk-to-desk within the company.

Currently, there are four distinct scenarios in use:

1. PBX (Private and Circuit Switched)
   See definition above.
2. Hosted/Virtual PBX (Hosted and Circuit Switched)
   PBX is located at and managed by the telephone service provider, and features and calls are delivered via the Internet. You just sign up for a service, rather than buying and maintaining expensive hardware. This essentially removes the branch from the private premises, moving it to a central location.
3. VoIP PBX (Private and Packet Switched)
   Uses the Internet Protocol to carry calls. Companies need packet switched networks for data, so using them for telephone calls was tempting, and the availability of the Internet as a global delivery system made packet switched communications even more attractive.
4. IP Centrex or Hosted/Virtual IP (Hosted and Packet Switched)
   Combination of 2 and 3 above.

History of PBX and How it Can Help You :
Historically, the expense of full-fledged PBX systems has put them out of reach of small businesses and individuals. However, since the 1990s there has been a large set of small, consumer-grade and consumer-size PBXs available. And because of the scenarios above, you have many more choices on what can help your business specifically. Inphonite, LLC develops and markets professional, automated phone messaging systems and interactive computer telephony products that improve the profitability and productivity of a wide range of organizations.

ftp://ftp.inphonite.com/Downloads/InphoniteVoice/ReminderPro-Migration-Tool.zip

1. Automate and Integrate.Outbound IVR makes it easy (and cheap!) to keep in contact with your customers and opt-in prospects through timely and focused messages.
2. User Friendly. An outbound IVR solution can be easy to use, allowing you to focus your creativity on targeting segments of your audience with the right message.
3. Better Insight. All your employees will be better informed and therefore be able to consider what messages should be targeted to what customers.
4. Two heads are better than one! With everyone in the company playing a marketing role and adding their individual experiences and talents to the mix, the end result is superior to that of the lone marketer.
   

• You can select what type of message to send, whether it is via phone, email, text, or even Twitter!
• You can determine the calling windows when messages will be delivered. 
• If you can’t reach the contact at the primary number, the system will recognize this and try the secondary number next time.
• You can create messages utilizing the text-to-speech engine, or the library of professionally recorded phrases, or you can record in your own voice, giving your message that personal touch.
• InphoniteVoice gives you multiple options when sending messages to your contacts, but you can also insert choices for the call recipients, for example, “Press 1 to confirm your appointment; Press 2 to give us two better times to reschedule; Press 3 to leave a message at the tone”. InphoniteVoice also records replies in an inbox so you can hear and review all messages at a convenient time.
  

You are a doctor’s office and you just received the awaited new vaccine in stock. All of your patients need to know.

You ask your office staff to “call” every patient. They set up InphoniteVoice to say, “This is Dr. Smith’s office calling to let you know that we have the new flu vaccine available. You may come in anytime during office hours. However, there may be a wait. If you prefer to schedule an appointment, press 2 now to speak to the operator, or call 555-555-9876 between 8am and 5pm.”

Your patients start coming in, scheduling and getting vaccinated. You charge a nominal fee. It adds up, and you have healthy patients. As an added bonus, you just contacted those patients that haven’t been in for a long time and some of them call in for check-ups and refer family or friends for vaccines or appointments as well.

There have been some big storms rolling through and the one that came through last night was bigger than anyone was expecting. You weren’t prepared for four feet of snow. Most of your employees can’t make it in and you’ve heard of multiple power outages. You know most of your appointments are going to be “no shows” anyway, and at this point it’s probably better to just close the office for the day.

Maybe there are a select few appointments that can be done over the phone instead of in person.

Maybe, if you’re a doctor, you will need to refer patients to a different doctor, or different office.

It’s 6:00 a.m. and your appointments were to start at 7:00. What do you do? You’re at home. You don’t have access to your files with everyone’s contact information. All of your employees are probably snuggled back in bed after they called in unable to make it out through the snow.

Remembering InphoniteVoice, you sit down at your desk, pull up your account, open last night’s calls, make a few edits and set up a blast call saying, “My office is closed due to the weather. Please call 555-555-1212 to reschedule your appointment for later in the week.”

Thinking of that business meeting with the vendor, you select that contact, edit the message and send a direct message tweet saying, “Due to weather I won’t be in the office. Please call 555-555-1213 at our meeting time. I look forward to speaking with you.”

Knowing your first appointment for the day has probably already left for your office, you edit that person and send an SMS message saying, “I’m sorry, our offices are closed due to weather. Let’s reschedule.”

You look at the clock, and it’s only 6:15. Job well done, InphoniteVoice.

• Launched as the steam ship Peralta in 1926.
• Burned to the main deck in an arson fire in 1933.
• Launched in 1935 as the Kalakala, the world’s first streamlined vessel.
• Welcomed to the Washington State Ferry fleet in 1951.
• Retired from service in 1967.
• Converted to a crab-processing vessel for Dutch Harbor, Alaska.
• Converted to process shrimp and floated onto a pre-made bed of sand at Gibson Cove, Kodiak Alaska.
• Repaired, refloated and returned to Elliot Bay in 1998 after a 32 year absence.

• Reduced Upfront Investment. A SaaS application does not require the upfront investment in IT infrastructure that is required for an on-premise solution.

• On-Demand Elasticity. With an on-premise deployment, “You buy it – You keep it.” A SaaS application is easy to scale up or down and your costs scale up or down accordingly.

• Anytime/Anywhere Access. To access a SaaS solution, you simply need a browser and an Internet connection.

• Frequent Product Updates. One of the key benefits of SaaS is frequent product updates and enhancements.

• Economies of Scale. A SaaS solution can become costly versus an on-premise solution if you are sending large numbers of messages daily. This is much like buying pizza by the slice rather than simply buying the whole pizza.

• Security and Control. Many clients prefer to have their data and applications maintained and securely accessible onsite.

• Rapid ROI. Some on-premise solutions have an almost immediate Return on Investment (ROI). For example, an InphoniteVoice on-premise edition often has an ROI of 30 days or less. Once the system has paid for itself, additional messages such as follow-up calls, past-due reminders, or a second reminder call per appointment can be made at virtually no additional cost.

• Emergency Notification. Consider a hospital IT Department that is already making appointment reminder calls via an on-premise edition of InphoniteVoic. Let’s say they want the ability to send Emergency or Mass Notifications to their 2,500 employees. Assuming the system can place 45 calls per channel per hour, it would require 56 channels (phone lines) to call all employees within sixty minutes. Such bandwidth is very expensive and it would remain unused most of the time.

Once configured, the incremental cost to deliver 2,500 messages using InphoniteVoice SaaS is only $350.

• Redundancy. As a backup to your InphoniteVoice on-premise solution, InphoniteVoice SaaS, at a cost of pennies per message, can ensure that your messages are delivered every day.

• Purchase Assurance Plan. A customer may prefer to thoroughly test InphoniteVoice and implement the SaaS version before purchasing an on-premise edition. To facilitate this, Inphonite will apply 100% of the InphoniteVoice SaaS implementation fee toward the purchase price of an On-Premise edition for up to 12 months after purchase. We will also implement the migration at no additional charge.

• Register to vote
• Update your address
• Order and pay for a duplicate drivers license and even express delivery
• Renew your car registration
• Request a Restricted Use 3-Day Permit online and print it on your home computer. (A Restricted Use 3-Day Permit allows the operation of an unregistered vehicle for purposes such as vehicle inspection or emissions testing.)

Stammtisch is a German term referring to a table at a restaurant or tavern where people meet at a set time, usually weekly, to discuss topics of common interest such as hobbies, local politics, or philosophy. I have never attended a real Stammtisch, but I have always been a big fan of eating food and talking with friends.

It occurs to me that social networking sites such as Facebook or LinkedIn allow you to establish a 24 X 7, virtual Stammtisch with friends, family, customers, and business associates. You can share ideas, photos, and web links – a Stammtisch without the calories! For example, Facebook helps me keep in touch with friends in places as diverse as the UK, the Czech Republic, Chile and the Philippines.

Closer to home, we recently created a Facebook Fan Page for Inphonite. I welcome you to become a Fan (and join our Stammtisch)!

If you have thoughts on social media, please share them with us.

Back when I was running an office of ten psychologists and therapists, there was no HIPAA. There were no online medical records. We did our filing the old fashioned way, in a filing cabinet. We had one DOS program we used for billing that was made in Canada somewhere. Tech support took days to reach, and even longer to resolve an issue, and it was all there was.

I made reminder calls daily for some of the doctors. The therapists would make their own reminder calls. Since they were merely renting office space, I wasn’t on their payroll and couldn’t do extra tasks for them. How awful that was for them, they would make a simple call to remind a person of their appointment the next day, and the person would engage them with their issues. It was all the therapists could do to end their calls quickly. I could overhear it all from my front desk. Sometimes I would chuckle. Too bad they didn’t have someone else making their calls.

Once a day I would make my calls. I hated making those calls probably as much as the therapists hated making their own calls. The people on the other end would range from angry and annoyed to positively gleeful—they were seeing psychologists after all, perhaps for their telephone mood swings, I sometimes thought. It took about an hour for me to confirm ten appointments.

When HIPAA passed we were left scratching our heads and rushing around, checking the locks on filing cabinets and moving the locked cabinets to a locked closet. I still had to make my reminder calls though, and HIPAA made it more difficult for me. What I wouldn’t have done for an automated and HIPAA compliant service back then. We already had to be discreet with our calling because of the nature of the business, and now because of HIPAA, my life was chaos.

The issues of reminder calls were not the only thing I struggled with when HIPAA came on the scene. We removed our “sign in” sheet from the front desk, I only did filing when I was certain no one was in, or going to be in the office, lest they glance a name on a sheet of paper from afar. I never left papers on my desk, and I always locked my computer, even if I just was running to the restroom. Additionally, I couldn’t make calls to insurance companies to follow up on invoices, unless I was certain someone wasn’t listening in. I didn’t want to let anyone around hear a patient’s name or private information.

Eventually, we just moved the computer desk, phone and computer into that locked closet and I would spend hours hidden away doing all my work in there. I suppose I was lucky that the closet was actually converted from a bathroom and had a small window, as the offices were in an historic house that had been renovated. Incidentally, I think this prepared me for my next job, which happened to be in a basement and offered about the same amount of sunlight as my little closet.

I imagine that the creators of HIPAA didn’t mean for people like me to begin working in tiny spaces, or closets devoid of outside light, but maybe they did. I don’t know. What I do know is that I would have spent fewer hours in that closet if I could have used InphoniteVoice to make my reminder calls.

All of my experiences in that office and closet gave me the strong foundation and background for working at Inphonite. It’s interesting to me the path HIPAA has taken me on personally, and I am eager to see where we’re going next.

Tichy’s is located next to the Reumannplatz metro station on Vienna’s U1 line. It is also very close to Favoritenstrasse, a popular pedestrian shopping zone. These connections provide Tichy’s its customers.

An on-premise IVR solution should provide multiple connectivity options including analog, digital and VoIP.  Of course a SaaS IVR solution simply requires a browser and Internet access.

Tichy’s ice cream parlor has both indoor and outdoor eating areas, as well as a takeout counter. This is where they serve their ice cream specialties, including the Eismarillenknoedel (apricot ice cream dumpling). Usually, I fight my way (it’s more of a crowd than a queue) to the takeout counter to order their fantastic ice cream.  Tichy’s appeals to customers with different wants and budgets.

An IVR system should meet the varied needs of customers, whether the customer is a single doctor practice that appreciates the minimal upfront investment of a SaaS, or a hospital using an on-premise IVR solution to cost-effectively send 100’s or even 1000’s of appointment reminders and other notifications each day.

Tichy’s is open about six months of the year, from April to early October.  On the day Tichy’s closes for the season, people wait in long lines to receive free ice cream.  Everyone is served until supplies run out.  Talk about customer appreciation!

Don’t just give people a little taste of your IVR solution, provide them with a generous free sample. (Better yet, don’t make them wait in line to get it!)

•    Need an outstanding primary care doctor.

•    Don't want to waste time in a waiting room.

•    Need acute care, but want to avoid the ER or urgent care "clinic."

•    Can't get a timely appointment with their doctor.

•    Can't get out of the house, or feel too sick to drive.

•    Want more privacy and personalized attention.

•    Want to avoid exposure to other sick people.

• Social networking
• Social media
• Social bookmarking
• Cloud computing
• Twitter
• Twitter Search
• RSS
• Wikis

•    Let the patient suggest the appointment time
•    Call to confirm upcoming appointments
•    Establish a priority list of patients who will come in if a last-minute opening occurs
•    Track offenders
•    Overbook
•    Charge patients who don’t call to cancel
•    Look within for the cause (Is your practice doing something to cause more no-shows?)

• Each bonsai tree is a living object lesson that overcoming adverse conditions can result in stunning beauty.
• Dan is not afraid to challenge traditions in the pursuit of artistic creation.  He even introduced the use of power tools to the art of Bonsai.
• Although he clearly has a vision and plenty to do, Dan is always willing to take a moment to speak with you personally and answer your questions.

• Got us involved by allowing us to hold almost all of the bugs that were on display.
• Was very knowledgeable on the subject of bugs (insects, spiders, and other arthropods).
• Took time to answer every question
• Clearly loved his job.

"The Advantages of Automated Appointment Reminders," written by Bob Young, appeared in the August/September 2009 edition of the call center magazine ANSWERStat.  Bob’s premise is that automating appointment reminders can provide health care providers with a competitive edge by:

• Saving time and expense over manual phone calls or reminder postcards

• Reducing no-shows (thereby increasing the associated revenue)

• Easing staff workload

• Improving patient care and patient relations

Bob also points out that automating the creation and sending of appointment reminder messages removes potential errors associated with manual execution.

Let me provide some additional ideas for your consideration:

• Under the HIPAA Privacy Rule, appointment reminders are considered part of an individual’s treatment and, therefore, can be made without an authorization. However, HIPAA requires that reasonable requests for alternative means of receiving health communications be accommodated (such as a placing a reminder call to a work number instead of a home phone).

• In addition to reminder phone calls, appointment reminders can also be sent via email or SMS text messages

• Offering automated appointment reminders in multiple languages can result in an improved level of patient care.

The article states that the payback period for an automated appointment reminder system is a few months. Your mileage may vary, but our experience shows that such a system can usually pay for itself in a matter of weeks.

If you would like to add your comments, please do so by clicking here.

According to the Agency for Healthcare Research and Quality (AHRQ), non-adherence to prescription medications is a documented public health problem. Medication non-adherence costs an estimate $100 billion annually and accounts for 10 percent of hospital admissions.

The good news is that telephone reminders to refill or pick up prescriptions improve medication adherence.

AHRQ, an agency of the US Department of Health & Human Services, posted an automated telephone reminder call script for pharmacies. The script was designed to be literacy-friendly to assist patients with limited health literacy. Not only does the script remind patients when prescriptions are due to be refilled, it also allows patients to order prescription refills by entering the correct digital prescription numbers over the phone.

The script can be implemented in either ReminderPro or InphoniteVoice.

1. Social networking is a free way to gain exposure
2. Your patients are looking for your medical practice online
3. Your patients are reviewing your doctors online
4. Communication online is easy and fast
5. Social networking can help advance your career

Forbes.com reports that new US study shows that breast cancer screenings increased 17% through use of a reminder program at Kaiser Permanente. A similar article by Kathleen Hoheny can also be found in the Health News section of the WebMD site. The study itself appears in the August issue of the American Journal of Preventive Medicine.

The reminder program included postcard reminders, automated reminder calls and follow-up calls placed by the local health care team.

According to the study's lead author Adrianne Feldstein, MD, “This study is the first to show that these reminder programs can be effective in such a large group of women. If we could improve the country's mammography rate by the same amount, we could detect as many as 25,000 additional cases of breast cancer a year.”

Several vendors mentioned in links below offer solutions that schedule and track appointment and medication reminders.  Our SaaS solution,  InphoniteVoice, offers the ability to send SMS text messages for as little as $.10 per message.

Part I - Why

Part II - How    

Part III - Costs

Part IV - Privacy

We are pleased to announce that online training videos for ReminderPro are now available! If you are new to ReminderPro, or could simply use a refresher on some program basics, visit this page and select the video you would like to see.

In order to view the videos, you will need to have Adobe Flash Player installed.

We hope you find these videos useful.

According to a study in the June 22 issue of the Archives of Internal Medicine, "Primary care clinicians and their staffs sometimes fail to inform all patients of the results of lab or screening tests -- or fail to keep records that patients were informed and thus have no proof."

For more information on this issue, here is link to the related WebMD article by Bill Hendrick. 

The study included a review of 1,889 abnormal test results (selected at random) and found that for approximately 7.1% of the tests, either the result was not communicated to the patient, or there was no record that the patient had been informed.

The article does not address specific solutions that offer patients secure, phone-based access to lab test results.  For example, at least one LabRetriever customer uploads between 450 and 500 lab results each day.  LabRetriever also provides an accurate record of those patients have not yet accessed their lab results.  This informs healthcare providers as to which patients require follow-up.

Some of our customers, including Del Mar Family Practice of San Diego, have implemented LabRetriever and ReminderPro as an integrated solution.  ReminderPro can automatically call patients to inform them that their lab results are available. A patient can then transfer to LabRetriever and access those lab results immediately with a secure access code.

According to the article above, Atlanta internist Sandra Fryhofer, MD, past president of the 120,000-member American College of Physicians said, "(I'm) glad they did a study like this that uncovers this problem. It's a wake-up call to doctors and patients".

Well, ReminderPro does wake-up calls too.

Here is a link to a March 2009 article in Physicians Practice regarding appointment reminder systems by Jonathan McCallister.

Healthcare IT: Obtaining Stimulus Grants & Incentive Money

You do not need to be a LinkedIn user to access this page.

In the Microsoft Windows world, malware like viruses and spyware are a part of our daily lives. I particularly enjoy the ones that install a program on your computer that continually nags you to buy their software to remove it. I'm sure you know what I'm talking about. And the software that is installed can bog down your computer and interfere with the programs you run. Quite a pain.

Last weekend, a conversation with a friend gave me an idea to blog. I've always dealt with the situation I described quickly, and never really gave thought that some folks may not know what to do (outside of paying Geek Squad to fix it), just as my friend didn't.

So here's what I do: The easiest way that I have found to rid your computer of the effects of this stuff is to perform a System Restore. Of course, this assumes that you have that option enabled. (You can turn it off.) Performing a System Restore returns the state of your computer to a previous time. Its like this: Windows takes a snapshot of the computer periodically, and then lets you return to that time in history. Its as though the infection you just got never happened. And none of your documents or other data is affected. What a great feature of Windows! Go Bill Gates!

Now, let me tell you how to make sure the System Restore option is available. First, go to Start and then right click My Computer and open Properties. From there, go to the Sysytem Restore tab, and make sure the Turn off System Restore box is unchecked. That means its on. And that's it. It's now available.

So should you ever need it, you can restore your computer to an earlier date by simply going to Start > All Programs > Accessories > System Tools > System Restore. You can select a date to restore to and then the tool guides you through the remainder of the process. Pretty slick. In fact -- and this is recommended -- you can even create a "restore point" on that window that will then be available. Of course, you will want to do this while your computer is healthy, but it is a good idea if the System Restore option had been disabled.

Have you ever used System Restore before? Do you have other ways to recover from a malware infection? Let me know your thoughts.

Perhaps I should have titled this post, “Everything I Needed to Know about Customer Service I Learned from My Endodontist.” 

Yes, I had a root canal (endodontic therapy) last Friday, just in time for the holiday weekend.

I hope I never have to have another root canal.  But if I do, I know who I will ask to perform the procedure, Dr. Daniel Funk.

Dr. Funk is a professional.  He is great at what he does.  Perhaps what impressed me most was that he took the time to make sure his somewhat anxious patient was calm and understood exactly what was happening (at my request) throughout the procedure.

What does this have to do with appointment reminder software?

Sometimes customers can feel anxious about implementing software solutions.  They are professionals and often specialists, but not necessarily IT specialists.  We try to make the installation and implementation process as smooth as possible by providing online training as well as remote implementation assistance.  We also provide phone and email Technical Support, forums, a Wiki and this blog.  If you have suggestions on how we can improve our customer service or Technical Support offerings, please let us know.