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.

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

Occasionally, we speak with customers who find themselves faced with a dilemma: They need to record (or re-record) a ReminderPro message, but the room where the computer is located is noisy and not suitable for recording professional messages. Certainly, we want the messages we deliver to our clientele to be of a high quality, and background noise doesn't meet the standard.

In this situation, we often suggest using alternative software and a microphone for the recording of the ReminderPro messages. You see, ReminderPro stores each message in two WAV files located in the ReminderPro program directory. For example, the greeting for the Daily message says "Hello, this is...", and is stored in a file named daily.wav. The closing is the portion of the message that says "Press 1 to confirm your appointment...", and is stored in a file named ^daily.wav. You can use other software to record the greeting or the closing for your message, and then drop the file into the ReminderPro directory, replacing the existing file. ReminderPro will then use the recording you made elsewhere for the message.

There are a couple of gotchas here. First, the recording needs to meet certain specifications. The specs necessary for ReminderPro to use the file(s) are as follows:

• Channels: Mono
• Bit Rate: 128 kbps
• Sample Rate: 8 khz
• File Format: Wave Sound (.WAV)

Secondly, the files must be named correctly. So, if you have a message named Daily, there must be a daily.wav and a ^daily.wav file located in the ReminderPro directory. If they're not there, the program won't find them and, thus, can't play them when calls are made. The name of the message determines the names of the files.

Now, you may already have voice recording software you can use. If not, there is a plethora of them. Personally, I have used Audacity, which is free. It allows you to make recordings that meet the requirements. If recording directly through ReminderPro won't work for you, Audacity could be an option you'll want to consider.

If there are other freeware packages you like, please share your suggestions here.

•    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?)

Will you be making appointment reminder calls over the Labor Day holiday weekend? To help you configure ReminderPro to run over weekends and holidays, we have prepared a Knowledgebase article to offer instructions for automating ReminderPro for a few days. See our Running a Multi-Day Call Session article for more information.

And have a great (and safe) holiday weekend!

"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.

Have you considered using ReminderPro to send appointment reminder text messages (SMS) to your patients' cell phones? With a bit of work upfront, ReminderPro can do this for you. But there are some considerations.

Most cell phones can receive emails as text messages. The key is knowing where to send the email. Let me give you an example. I use Verizon as my cell phone service provider. If I email 5205551212@vtext.com, the message will be received on my cell phone as a text message. Do you have patients that would like to receive reminders on their cell phones? If so, simply obtain their cell numbers and the providers they use, then enter the proper email addresses in your practice management system. When you generate the call session and send emails, those patients will receive a text message reminder.

The email address to be used varies by provider. It will always be phonenumber@something.com. For a list of the domain names for the various cell phone providers, you can check out this page (external link), or contact the service providers directly.

Now, a word of caution. Not everyone receives text messages on their cell phones for free. The mobile plan they purchased determines this. So if a patient wishes to receive text reminder messages, they must either have a plan that doesn't charge them, or they need to be willing to absorb the cost. There is an interesting article on the AIDS.gov website that discusses this.

In addition, cell service providers impose a limitation on the number of characters in the text messages (usually 120 or 160). Our recommendation is to keep text message appointment reminders under 100 characters.

And there are other considerations directly related to getting email addresses into ReminderPro. First, your PMS/EMR must have the ability to include the email address in the data ReminderPro imports. Second, ReminderPro's import must have the ability to import these email addresses along with the other appointment data. If you are not sure if ReminderPro is set to import email addresses, our Support Department can help you find out.

In summary, this is what you need to consider if you want to offer this service to your patients:

• You must have the patient's cell number on file, as well as the cell phone provider.
• You must know what the email address is for that provider, and have it correctly entered in the email address field in your practice management system.
• Your practice management system must be able include the email address in the export to ReminderPro, which must then be able to import it.
• You must make sure to let patients interested in receiving reminder texts know that they could be charged by their provider for receiving these texts.
• The message sent to their phone should be kept under 100 characters.

With just a few steps you can have a very useful service to offer your patients.

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.

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.”

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.

I am pleased to announce that service pack 1 for ReminderPro 2008 DX is officially released. This service release fixes numerous problems reported to our technical support department. If you are a ReminderPro 2008 DX customer you can download the new service pack here:

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

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.

Do you use a Remote Desktop Connection to access the ReminderPro computer? A number of our users do. The process is normally to launch the Remote Desktop Connection from the Start menu, but did you know that you can create a shortcut on your desktop to automatically launch a direct connection to that computer? No need to dig through the Start menu to find the icon, or type in the name or IP address of the computer. Creating a shortcut like this is a quick and convenient way to access the ReminderPro computer.

What you do is right click on your desktop, and go to New > Shortcut. In the Type the location of the item field, type something like:

%SystemRoot%\system32\mstsc.exe /v: computer_name_or_ip

Or, for example:

%SystemRoot%\system32\mstsc.exe /v: rpws-1

When you complete the wizard and save the shortcut, you can double click it and launch the remote connection. The next window that appears should be the login prompt for that computer. Handy, huh?

Was this helpful?

Our Support Department has had some inquiries from users recently about decreasing the delay between a live person answering the phone and the start of the message playing to them. There are setting changes you can make, so I thought I would share.

Before I go through this, I want to point out that the setting is changed differently depending upon the version of ReminderPro being used. If you're not sure what version you are running, launch ReminderPro and go to Help > About and the version will be shown at the top.

That said, if you are using ReminderPro version 2 or 2008, you would adjust the Live Answer Handling option, located in the Setup screen, under the Other/Advanced tab. Due to the sensitivity of some of the options on that tab, you must press CTRL+F10 to view the options on that page. Also, please be aware that the setting is in milliseconds; our recommendation is to set it to 700.

Now, if you're using ReminderPro DX with a Pika telephony card, you would go to the same tab and press CTRL+F10, but you would then click the Voice Board Settings (Advanced) button. Look for the Speech End Time field, and set that to a value between 500 and 3000. Again, this is in milliseconds. So if you want the message to begin immediately after answer, set it to 500.

Finally, a note of caution. It is important to make sure you know what you're doing when you start changing settings like this. So if you have questions about these settings or something else you stumble upon, please be sure to contact our Support Department for clarification before making any adjustments.

Was this helpful? Is this something you've been wondering about? Let me know what you think.

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Ever have a situation when, after you've imported your patient information for a calling session, you need to change the message a patient receives? Maybe you need to change the provider a patient will be seeing, and want to send a message that reflects the new provider's name. Or perhaps the appointment is untimed, and you don't want the message to specify a time (which typical messages do). Or maybe its a surgical appointment and you want to send out a special message to them. Whatever the reason, there is an easy and quick way to change the messages your appointments will be receiving. We call it QuickEdit.

To use QuickEdit, go to Schedule > Quick Edit on the Reminder Pro menu. The first thing you do is choose a date or date range of appointments to look at. Clicking OK brings up a list of all appointments on the calendar for the date(s) in question. You can then use the Message to Assign dropdown to choose the message, and the Change Message button to assign it to the selected patient. This changes the message assigned to that patient, but leaves all appointment information intact. Handy, don’t you think?

Have you ever used QuickEdit? What are some situations a tool like this might be useful for? Please comment on this post with your thoughts.