Seven Great Applications for IP-PBXs in the Medical Practice

At Software Advice, we just finished implementing a new phone system. It’s great! It got us thinking of how medical practices can take advantage of Internet Protocol – Private Branch Exchange (IP-PBX) phone systems to be more efficient and provide better patient care.

First, let’s get some definitions out of the way. A PBX is the system that routes phone calls to appropriate extensions within an organization. Actually, it can do a whole lot more (e.g. voicemail, auto attendants, etc.). To keep it simple, we’ll just say that it’s the system that manages the phone system within your four walls, rather than the big network of switches and routers that the phone companies use to move voice and data traffic around the country, or across the World.

PBXs have been around for decades. However, IP-PBXs are the newest breed of PBX based on Internet Protocol (IP) – the technology that makes the Internet work. So, they make it really easy to combine voice (i.e. phone calls) with data (e.g. patient information). IP-PBXs can exist as hardware or software; both have advantages and drawbacks. For example, software-based IP-PBX systems (e.g. 3CX Phone System) don’t require hardware, so it’s less expensive to implement and easier to manage using web-based interfaces.

Many other IP-PBXs are Asterisk-based. Asterisk is a collaborative project to build and maintain an open-source IP-PBX. It was started in 1999 and by now, it is pretty rock solid technology. And it’s free.

For the medical practice, we think there is a great opportunity to combine voice and data by integrating IP-PBXs with electronic health records (EHRs) and practice management systems. To our surprise, little has been developed in the way of medical-specific applications. We think that the leading EHR and practice management software vendors should integrate this open source technology into their systems. The combination could be intriguing.

So we decided to put together a list of ways IP PBX and EHR technology can be combined. A preliminary word of caution: Asterisk developers, make sure you understand HIPAA guidelines before developing any of these applications.

• Patient screen-pops – When a patient calls, caller ID recognizes their number and opens their patient demographic data in the practice management system. A dashboard view shows general demographics, appointments and recent encounter summaries. Of course, the system would require user-level permissions that limit available patient information by the user’s role in the practice.

• IP faxing – Faxing is still HUGE in most practices, but most leading IP-PBXs make faxing simple. Digital information such as the data in an EHR can be faxed through the IP-PBX and over the telephone network. For example, a primary care physician can easily fax a patient record to a specialist. No need to print paper, feed through a fax machine, etc. Just click a button in the EHR to fax a patient record to the specialist.

• Appointment reminders – The system will automatically call the patient to remind them of an upcoming appointment or the need to schedule an appointment. It may be a call to remind the patient of their appointment tomorrow, or it may be a reminder to schedule an annual mammogram. Regardless, the patient will have the option to “Press 1 to talk to a member of the doctor’s staff.”

• Find me, follow me – The system would prioritize an after-hours call based on the urgency of the situation. Emergencies could be immediately forwarded to 911. Calls from patients that recently had an ambulatory procedure might be forwarded to the physician’s mobile phone. All others might receive voicemail or the answering service. Urgency could be assessed not only by patient responses (e.g. pressing 1 for an emergency), but also by the content of recent encounters (e.g. yesterday’s botox injection).

• Dunning Voicemails – If a patient hasn’t paid their balance after a given time period, this module automatically calls and leaves a voice message: “Dear %%INSERT FIRST NAME%%, we recently noticed your balance of %%INSERT OVERDUE BALANCE%% has yet to be paid. If you’d like to pay now over the phone, press one. If you think you have received this message in error, press two.”

• vPrescribing – Need to get a prescription refilled? Call your doctor’s dedicated prescription-refill phone number. Following instructions from the IVR, you can request a prescription be refilled. The system then automatically initiates a workflow for the physician to approve or deny the refill. This may be in the EHR, on a mobile device or even via the phone after hours by voice or SMS communication with the physician.

• Patient-centric recordings – When a patient calls, they get a custom recording based on their billing or appointment status. If they have an overdue bill, the IVR prompts them to make a payment. If they have an upcoming appointment, the IVR reminds them of the time and date. Of course callers will be required to share a piece of personally identifiable information (PII) in order to proceed with any task.

Now it’s your turn. Leave us a comment with your ideas for integrating voice and data in the physician practice.