Doctors On Call

St. Joseph Mercy Health System (SJMHS) in Ann Arbor, Mich., has just begun an ambitious two-year deployment of Voice over Internet Protocol (VoIP) telephony across its 27 affiliated hospitals, clinics, long- and short-term care facilities, and offices in southeastern Michigan. In doing so, SJMHS is replacing a 15-year-old phone system that is no longer supported by its manufacturer, Fujitsu, and that it deemed unable to handle the current capacity or anticipated growth.

Though still in the early stages of the roll-out, SJMHS and its parent organization, Trinity Health of Novi, Mich., have already seen tremendous advantages from switching to VoIP. Using wireless IP softphones, doctors, nurses, administrators, and staff can make and receive phone calls, text and voice messages, emails, and more. Other functionality contained within the system includes Web access, call center applications, call logging and recording through an integrated call management system, voicemail, unified messaging, caller ID, an auto attendant, automatic call transfer and forwarding, and teleconferencing for up to six parties. 

"That one phone becomes a unique system for them because they can do so much with it," says Chris Brown, the account manager at Altura Communication Solutions, who is responsible for designing and implementing the system at SJMHS.

"We are looking at VoIP as an enabling technology, as an opportunity to make better use of our infrastructure and our people," says Rosanne Carey, director of corporate telecommunications at Trinity Health, a Catholic healthcare provider operating 44 hospitals in seven states. 

More important, though, are the improvements in patient care that both SJMHS and Trinity Health envision from the implementation. The VoIP system, using equipment and software from Avaya, is quickly proving its ability to solve a pressing issue at any hospital—locating key employees quickly when time is a critical factor.

Because the technology allows doctors, nurses, and administrators to carry wireless IP phones with them wherever they go, it reduces the amount of time and effort needed to track them down for diagnoses, to authorize a procedure, gather patient information, or perform a consultation. "The ability for a physician to be reached anywhere and at any time will be a huge benefit for both patients and the hospital staff," says Kevin DiCola, a Trinity Health spokesman.

"When you can get to the right people at the right time and compress the amount of time it takes to communicate with people, it improves patient care," Carey adds. 

And because it's an Internet-based service, VoIP extends those capabilities beyond the four walls of the hospital to anywhere in the world where a connection to the Web can be established, says Scott Washburn, Avaya's director of marketing to the healthcare industry. An add-on called Extension to Cellular allows incoming calls and messages to also be routed to a cell phone or other wireless device. 

The mobility that the system provides is also a key factor in improving patient care. Because doctors and nurses are not chained to phones at their desks or workstations, they can spend more time on the floor with patients. With the enhanced productivity that VoIP provides, doctors can see two to three more patients each per day, Washburn says. "It's a productivity- enhancing tool that can translate into more money for the hospital."

VoIP also offers SJMHS opportunities to create operational efficiencies, while at the same time accommodating growth in size and the number of patients served. Last year alone, emergency room visits at its three hospitals totaled more than 140,000, an increase of 4 percent over the previous year. Its 1.33 million outpatient visits were 7 percent higher than the previous year. Its 37,000 patient stays showed a 1.8 percent increase.  

For SJMHS, VoIP so far has been at least as reliable as what it had before. It "provides the same level of stability as our existing TDM network," Carey says.

But SJMHS is still in the early phases of its migration to VoIP and is currently using a combination of IP, digital, and analog equipment as it makes the transition. Once VoIP is fully implemented, it should prove to be more reliable, leaving only a few seconds of down-time a year versus a few minutes a month in some cases with more traditional phone services, Washburn maintains. 

The system is also helping SJMHS to cut costs . The most obvious saving is in the lower cost of IP communications in general. Because the hospital chain is installing one network to converge all of its voice and data communications across all of its facilities, it will mean less equipment to buy, manage, and maintain. "All around, it's more effective for us from a cost perspective," Carey explains.

Greater employee satisfaction and an ability to retain staff are other side benefits that can be expected. "In healthcare, we focus on workflow, and this will improve that," Carey says. 

The results at SJMHS are typical of what hospitals that switch to VoIP can expect, Washburn says. "If they already have some kind of network in place and it can be beefed up slightly, there are tremendous advantages that hospitals can enjoy with VoIP. They can really see a lot of savings in the end."

Altura's Brown and representatives from SJMHS and Trinity Health spent the last three years beefing up the existing network for just that purpose. So far, the VoIP conversion has been completed at SJMHS's Woodland Health Center and Woodland Cancer Center, both in Livingston, Mich., along with selected clinical areas on the main campus in Ann Arbor. The total installation will cover more than 8,000 ports at 27 locations. 

The implementation will be phased in slowly over the next two years. The main reason for that approach is that the hospital and its many offices and departments cannot afford to be without telephone service. "For us, access to information and personnel is vitally important, Carey says.

"It's a real challenge to move off the Fujitsu system while putting in the new system, all while keeping everything up and running. It's a huge upgrade, involving a tremendous amount of work," she continues. "We have to do it without disrupting hospital activities. It's not like we can send people home and put it in over a weekend because we are a twenty-four/seven operation." 

Though many other hospital systems around the world have started to explore VoIP, Brown says the project at SJMHS is among the most ambitious that he's seen so far. "I'm very surprised that they're going after VoIP so aggressively," he admits. "They're putting in a very robust system with a lot of security and backups in place."

Dual servers and local survivable processors maintain continuous access to communications in the event of a network or system failure, he explains. 

"We decided to migrate to IP telephony for many reasons, including the ability to improve patient care, add more locations as we grow, and implement new voice- and IP-based applications to streamline operations," Carey says.

One of the other applications it's looking at is interactive voice response (IVR), an automated, voice-driven call center application, for its pharmacy. 

Once the VoIP implementation is completed at SJMHS, Trinity Health will look to expand the technology across its network, which includes facilities in Ohio, Indiana, Michigan, Maryland, Iowa, Idaho, and California.

"With all of our initiatives we are looking to improve patient and family care. We see VoIP as critical to that mission," Carey says. 

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