Howdy,

My wife's medical practice is moving to a new building that is under construction. With the move, they're planning on scraping their existing digital phone system with a new one. At the new site, there will be a need to have around 25 handsets sharing 6 or so lines (right now they have 4 lines but are getting complaints from patients experiencing busy signals).

Our first decision to make: Hosted PBX or Premise PBX? Personally, I like the hosted pbx as it's one less piece of hardware for the practice to maintain/update (they're not tech folks and I don't want to be their support person..especially on phone matters). The drawback with hosted is that our ISPs (cable, DSL) are not especially reliable (DSL is better than cable but folks get mighty nervous imagining the phone system down).

If we go premise pbx, should we use TDM/Digital or IP based? One of the techs is suggesting that we go with an ESI digital system but I'm a little hesitant to go that route considering that it will require separate phone lines (unless we can run them over the planned Cat6 lines) and doesn't offer all the flexibility in moving/programming phones that office staff could be expected to handle. As far as needed features the digital system should meet the needs now but I wonder about flexibility/upgradability for the years to come). Also, a large majority of stuff selling today is IP based so I wonder if tdm is being weeded out (don't want to be the last person buying a betamax player :)

What kind of lines to use. At a former job, I had to support an Avaya IPO 500 that we had POTS lines connected to it. It worked but I always felt we were getting nickeled and dimed when trying to add additional POTS lines. Currently the office has 4lines but I think going to 8 would provide enough breathing room. We've had a vendor come out and pitch SIP trunks but that still relies on a reliable internet connection no? We should have fiber up in the area when we move to the area and I'm chomping at the bit to use that for networking and telecom needs. Any suggestions are greatly appreciated here as we want reliability without forking over a ton of moola to Ma Bell.

Well, that's all the questions that we have now. I can appreciate that different folks will have different answers that work perfectly for their environment but would like to see what logic folks use for their decision to go with x as opposed to y.

Thanks for the read and any advice you can dole out.

Have a great day!

chris

Most practices we have are now using Shortel IP based premise systems. The Shortel's have been pretty solid with just the typical MAC request's (name changes etc)
http://www.shoretel.com/solutions/ip_phone_system

STAY AWAY FROM HOSTED!!!!!!!!!!!!!! THEY WELL CHARGE YOU FOR EVERY LITTLE THING YOU EVER WANT DONE OR TOO ADD. YOU ARE VERY LIMITED!!!!!!!! shortel is a awsome system but also a very pretty penny for it. if you are looking for a budget system i would go for the NEC SL1100 it is a good system and very up to date it can go IP or Digital depending on what you want. the Voicemail is awsome with voicemail to email intergration. i have installed many SL1100 in doc. offices because it is perfect for there neeeds. you could even save a little more by going with the sister unit NEC DSX 80.....

Shore tel is a nice product but definately not nearly as popular as the Avaya or toshiba systems

The great thing about toshiba is it is available as a hosted product as well.

Avaya is heading towards this route also.

We also sell a product called lime box that is hybrid hosted/premise based.. Pretty cool stuff

My only suggestion is go with a name brand, don't let one of these no name companies come in and sell you.

One too many horror stories that make us look like heroes :)

Is ESI a known name brand? A tech in our group has good experience with it (at least the TDM/Digital flavors of ESI). Granted, I'd like to get the best tech for the money but one can't discount your support person's comfort and familiarity with a product (too bad this isn't one of those simple decisions but more so a tradeoff :)

Great suggestions so far. Keep 'em coming!

One thing that may be helpful is having a system that offers backend flexibility. Initially, we may go with the local teleco for local lines and the like but as internet reliability improves, we may want to expand out with SIP trunks (holler at me if SIP Trunks are the devil or the like..they seem appealing from a cost standpoint :)

The NEC DSX80 and the SL1100 supports pots ,sip, and T-1 and offers lots of flexiblity. there voice mail will even let you do a custom message on hold greeting

SIP is great depending on your internet connection if you get just basic speeds dont wast your time i would go with the bussness class such as time warners 10x i have customers that use that and they are fine very little packet loss and very good sound quality......... i would not recomend it on a DSL line. an i always tell customers to keep one pots line for a back up and use it as a fax

We have charter cable in our neck of the woods (rural NC) and it's as flaky as a box of Kellogg's :) Thanks for the idea to keep a POTS as a backup/fax. I was hoping to do faxing in the cloud in the long run but it never hurts to have a life line.

If this is a medical practice, I would not skimp on a phone system. Patients need to reach you and you need to reach patients, suppliers and other medical services. Go digital/hybrid. Run a dedicated phone cable to each jack location. No SIP trunk, no voip, no hosted. You want reliability, go with an established brand name with many vendors in your area. Why pinch pennies?

Jsadd,

You're right on the importance of having a reliable system for the medical practice. I was just hoping that the technology has come further along that going VOIP/SIP/Hosted was as reliable as the old tried and true phone system. Eventually, stuff will get to that point and I wanted to factor in some form of flexibility in the our system to be able to go to the better option.

Just go with the IP Office again. You already know it. Stick with it.

ACSS - SME
General Geek

I wouldn't say I *know* mainly we didn't quabble with each other (I tried not to meddle with it as long as it promised to work without fail ;)

I don't think I'll have free time to support the system and as such would want something that staff can easily manage but not break (and if they breakt than a "professional" would be available to fix it on the spot).

I agree with hairlessupportmonkey. Go back to the IP Office. They are a great phone system and generally pretty easy to configure/use. Also go with hard lines if you are saying the cable round there is bad. Nothing worse than not being able to get through to your doc in an emergency because the internet died :S

Where are you based? Perhaps you might be better off getting in your local business partner for some consultation time? They will fit and support it for the practice.

ACSS - SME
General Geek

The clinic is located in Roxboro, NC (aka "slim pickings") when it comes to tech stuff. With fiber coming to town, I think we'll at last have fast and reliable on one side of the chart (still don't know about cheap though). Since this a construction project, hopefully the fiber will be in place (just need to find who the last mile carrier will be to connect us to that bad boy).

STAY AWAY FROM HOSTED!!!!!!!!!!!!!! THEY WELL CHARGE YOU FOR EVERY LITTLE THING YOU EVER WANT DONE OR TOO ADD. YOU ARE VERY LIMITED!!!!!!!! shortel is a awsome system but also a very pretty penny for it. if you are looking for a budget system i would go for the NEC SL1100 it is a good system and very up to date it can go IP or Digital depending on what you want. the Voicemail is awsome with voicemail to email intergration. i have installed many SL1100 in doc. offices because it is perfect for there neeeds. you could even save a little more by going with the sister unit NEC DSX 80..... email me at schoebo35@gmail.com and i can give you some more advice. but if you decide to go hosted you are going too pay for somthing that well never be yours ever. and you minuse well just throw your money away...........

What a load of rubbish you do talk
we charge a set fee and you can have as much support and programing as you like. Its more reliable than on site with just as many features if not more and you are not restricted by the amount of lines you can have and you will get full disaster recovery. vm to email is standerd now on most systems and is included foc on our hosted as well as a long long long list of outher features that you pay through the nose for on most outher systems

Have you considered the E-MetroTel UCx50? It's a phone system designed by engineers and developers that were at Nortel for over 30 years....

Joseph Sus-Nortel Installer/Programmer
http://www.linkedin.com/pub/joe-sus/12/1a7/856

The best part is the "hosted" guy telling us that all other systems are junk. Perhaps he would suggest hosted in a critical mission like a hospital, or county office building?

Six phone lines and 24 phones is NOT A HOSTED application. It's a tried and true TDM system that should have simply been a new KSU and reuse your old phones for economy. Why retrain your users on phone systems when you can retain the old sets?

LkEErie

whats rong with hosted in a doctors?? they prob host there servers in a data center so why not phones allot more relable and secure than tin on the wall

My head hurts from all the spelling and grammar errors.
I agree with LKEErie and jsaad. Telephones are their lifeline (literally). Get a tried and true system and skip the BS. When your phones go down because of a problem in a datacenter, or your internet takes a crap, I don't think the patients will be too understanding.

jeff moss

Regarding reliability, is the scale from least to most like the following:
hosted pbx -> sip trunks with premise pbx -> POTS with premise pbx

I don't mind going with a TDM system but want to make sure that we have something that offers the flexibility for when we're piggy backing on a fiber connection and want to route phone traffic via sips instead of the local CO phone lines.

Again, thanks to everyone with the myriad of ideas. Like one of my teachers said, "there's always more than one way to skin a catfish"

Have a great day!

chris

Let's see. My eye doctor customer, Panasonic TDA-50 instaleed about 6 years ago, no down time, ever. CICS installed in my old doctor's office, I think it's about 15-18 years with down time measured in minutes. The most problems we have is when the APC unit starts flashing lights because the batteries need to be replaced. It doesn't require a "reboot" or "software upgrade" every so often and it doesn't have "licenses" to keep it working.

Hosted, agree to disagree, and quit talking about the "tin on the wall" before I start talking about "cloud promiseware". Half the SMB's don't need much more than 2 tin cans and a string. You might like to sell someone bells and whistles, but the truth is it's just sizzle to someone who could care less. Geeze, even CID is only "our" tool, the average retailer doesn't need it.


LkEErie

A hosted PBX is still a tin, just a tin in a rack in a far off place, its just the means of connecting to it thats different.

Avaya's IP1000 has been released, its a server based IP Office capable of running up to 1000 users, and will utilise your IP500 hardware as a gate way for trunks and TDM phones.

The IP1000 is also ripe for hosting in a data centre, and soon will be VM compatible, with voice mail and call reporting all running in the same box, all in the cloud. Heck, even an IP500 now will be OK to do it with their new remote worker features. IP Office with SIP trunks in one end, h323 or SIP endpoints out the other.

ACSS - SME
General Geek

right, i dont think most of these hosted guys know exactly how everything works yet... just sales guys looking to sell

every customer i have has there internet go down at least a few times a year..

now tell me how many have their copper trunks go down in that same span

that is tried and true and hosted is not there yet, and by the time it is there people will be buying the avaya and toshiba systems that are hosted in data centers, not all of these no name hosted brands with half the features and twice the bugs :)

Quote (OP (my emphasis))

The drawback with hosted is that our ISPs (cable, DSL) are not especially reliable (DSL is better than cable but folks get mighty nervous imagining the phone system down).

OP has clearly stated that reliability is a key requirement and decided that they cannot achieve that reliability using their IP connectivity

@Hostedtelephone (but little hope of an answer)

How do suggest that your hosted solution can meet this requirement, in a cost effective manner?

The OP has clearly researched SIP trunks and discounted them (correctly IMO) on based on the connection stability issue - hosted simply does not stack up!

My personal preference would be IP office, but I've always had misgivings about the IPO and analogue lines. Maybe a decent panansonice would be a good choice, but hosted never!

Take Care

Matt
I have always wished that my computer would be as easy to use as my telephone.
My wish has come true. I no longer know how to use my telephone.

and i also love the "hosted" guy saying that his system is more reliable and less expensive and more features

we sell hosted and premise base at my company and let me argue all 3

More Reliable?

see my above post... you lose internet you lose everything

Less expensive?

yes maybe per month by a few pennies... Everytime we set up someone with a lease for a phone system with avaya toshiba and a hosted product (we propose all 3)

every time the hosted comes in just slightly cheaper per month (maybe 100 $), but here is the kicker, they pay off the avaya or the toshiba in 3-4 years, you NEVER stop paying for the hosted. If you only plan on having the system 3-4 years ok, but tell me anyone on the planet that only keeps a system for 3-4 years. You should get 10 years easy.

PLUS they usually dont include the phones or the setup fee so add that in and hosted ends up costing MUCH MUCH MORE

and the last more features? I have been throug at least 5 hosted solutions and countless of these other variations of freepbx, and not one of them has even 65% of the features of avaya or toshiba.


so please tell me again "hosted" guy how your product is better

So tell me this Phoneguy610, am I the only one in the world that likes Nortel IP phones? Are the 11xx and 12xx sets dinosaurs? I keep recommending them on here and no response. Maybe I need a reality check?

Joseph Sus-Nortel Installer/Programmer
http://www.linkedin.com/pub/joe-sus/12/1a7/856

i am a HUGE nortel guy

in fact we still install bcms to this day, mostly t series phones (which we also install with IPOS)

i love the 11xx series and when the customer is willing to pay for them we install them

they are very nice looking phones, something avaya does not really have much of a selection from

Hi Phoneguy610, does your name come from the Feature 610 Paging?

GordonKapes is the name of a complicated paging module I once learned how to install....it was a nightmare but I got it working :)

Do you have a website for your company? I'd sure love to share my Nortel story with you.

Joe

Joseph Sus-Nortel Installer/Programmer
http://www.linkedin.com/pub/joe-sus/12/1a7/856

Aweee - Nortel love right here.

*puke*

ACSS - SME
General Geek

Oh and back to the main point,

Glad to hear I am not the only one who is a Nortel fan!

Yes the Nortel IP Phones are probably the best on the Market.....Cisco is popular, but the phones do not seem to have the same quality as the 11xx sets.

There are quite some awesome deals on the Nortel phones that are "like new" with warranties from reputable sources.

So for this person who started the original topic above, with a new building, I'd highly suggest an Avaya CS1000 with 11xx phones, BCM with IP phones, Pure SIP with the Nortel SIP phones, or a Emetrotel UCx with the 11xx phones.

Joseph Sus-Nortel Installer/Programmer
http://www.linkedin.com/pub/joe-sus/12/1a7/856

Haha, Hairless, you have to admit the Nortel phones are great solid phones....Avaya still makes them and slaps their labels on them!

Joseph Sus-Nortel Installer/Programmer
http://www.linkedin.com/pub/joe-sus/12/1a7/856

Hey All,

*Laugh* This thread has gone on an epic journey. I'm still looking into the suggestion of buying a new KSU and re-using existing handsets (may not work considering the age on the system but it'd be good to know). If the support guy is more comfortable with TDM systems and it's not too much of a cost difference in pulling the Cat 3 (vs planned Cat6a for data) then I may follow his lead (especially if it'll be a free install and he'll be supporting it).

There's not a way to close the thread (at least that I can see) and I still check it once someone posts to it. Again, thank you everyone for sharing your wisdom in this matter.

Have a great day!

chris

Chris what type of digital sets do you have now?

Joseph Sus-Nortel Installer/Programmer
http://www.linkedin.com/pub/joe-sus/12/1a7/856

I actually don't know (should have took a look while I was at the meeting). I'll see if I can find out and post that info here.

So, I asked and was told it has an NEC on it. Well, that narrows it down some (and the fact that I know the phone system is 5+ years old).

Oh man. I apologize for everyone here. Who knew that you didn't have your original problem solved before the flames and rants started? Is your NEC monster an SV8100? There should be a part number on a tag on the bottom of the phone. Please post it and we'll really go to work. Also, what country are you in?

LkEErie

I guess my bad use of the grammar and the like does imply that I'm not from the US but I'm actually in NC. Unfortunately, I'm not on site but asked a staff member to take a photo of the sticker on the back.