Alexander Graham Bell most likely had no idea that he had discovered what would eventually change the world in more ways than can be imagined. The technology that started out for telephones has led to more discoveries in the telecommunication field that keep people in touch and connected around the world.

The Early Days

On March 10, 1876 Alexander Graham Bell transmitted the first speech using electricity. From that day forward, the telephone system changed every aspect of life. Although it did not immediately change the world, it set communication on a path that would alter the future of communication.

The initial lack of acceptance of Mr. Bell’s discovery was due the telegraph being the dominating form of communication and it had been around for over 50 years. This voice across electrical lines that Mr. Bell was proposing was a new and daunting discovery.

In the late 1870’s Bell took his public telephone demonstrations on the road in an attempt to raise awareness and public finance for the project. Mr. Bell presented the telephone as a broadcasting system.

Initially, phones connected only two lines. In June30, 188 there were 287 phones installed, by July there were 750. Ten years later there would be 167,000 phones and a maze of wires overhead. (Pool, Ithiel de Sola; _The Social Impact of the Telephone_; Cambridge, MIT Press, 1977.)

Technology

Mr. Bell wasn’t the only person working on ideas that would impact telephone technology. Thomas Edison invented the first transmitter and receiver that would be practical for commercial use. He had already invented a type of multiplexing that allowed messages to be sent in opposing directions simultaneously.

Many more changes came about in the ensuing years and AT&T incorporated in 1885 to lease phones to homes and offices but maintained ownership of the technology.

Then, in the 1880’s the switchboard came on board. During this time, there was no dialing, no signaling system, and no electronic switches. Callers would crank the handle; get an operator who then connects them to their party and then have their conversation. This type of system had no ringer to alert of incoming calls and no privacy due to the operator being the middle man holding the call together.

By 1946 the number of telephone callers made switchboard operators’ jobs too much for people alone to handle. Nearly a quarter of a million operators were working for AT&T in 1946 but that number would decrease significantly with the invention of automatic call switching.

Although this switching system was invented in 1889, it was not until 1914 that it was installed on a large scale basis in New Jersey. Then, it wasn’t until 1976 that the first computerized switch was put into action and by 1982 almost half of all telephone calls were switched electronically.

Turning the Century

Bell’s patent ran out at the turn of the century and approximately 6000 independent phone companies opened up shop. These independent companies could only connect locally, AT&T refused to allow them to link to the national system. Instead, they waited for the little guy to go bankrupt and then bought them out.

In 1984, AT&T got out of the local telephone service at the end of a ten-year lawsuit pushing to break up the telecommunication giant. This resulted in the forming of the so called ‘baby Bells’.  This breakup also allowed users to own their phones and hook up their own devices to them.

Prior to the 20th century phone systems used twisted copper wires which were expensive to install and absorbed a great deal of electrical energy. The coming years would see copper wire give way to coaxial cables, then microwave stations and then telecommunication satellites.

Digital transmission, though not new, did not come into telephone play in a large way until the 1980’s. Using fiber optic cables, digital transmission was up to 125,000 times faster than that of copper cable. Copper wire is still in use in many areas due to the high cost involved with running fiber optic cable to every home, though many areas have replaced the lines with fiber optic cable.

Beyond the Telephone

Having mastered the basic telephone and communication across great distances, there were still technological advances waiting to be discovered. The fax machine uses telephone lines to transmit digital signals to a modem on the receiving in which decodes the signals into messages. Then along came the mobile or cell phone.

Cell phones appeared in the early 1980’s and today there are millions in use. Cell phone networks use the regular phone system connected to a computer controlled center and transmission towers to transmit messages. Originally, there were few transmission towers and the mobile phones were bulky and had to be used near towers in order to have clear transmission.

Within a few years, the phones became small enough to fit in the palm of a hand and towers were located nearly everywhere. While there are zones with poor reception, most cell phones are always in a usable zone.

Today, cell phones do much more than just allow for voice conversation, cell phones allow access to the Internet, email, business applications, pictures and much more.

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For midsize businesses, a time will come when they will be asked about moving to a Voice PRI with their next service provider change or phone system change. How does a business decide if a Voice PRI is right for them? Let’s take a look at some of the unique benefits of PRI, and what they can mean to your business.

Let’s get technical for just a moment to define PRI:

The primary rate interface (PRI) is a telecommunications standard for carrying multiple DS0 voice and data transmissions between two physical locations. All data and voice channels are ISDN and operate at 64 kbit/s. North America and Japan use a T1 of 23 B channels and one D channel which corresponds to a T1 line. Europe, Australia and most of the rest of the world use the slightly higher capacity E1, which is composed of 30 B channels and one D channel. Fewer active B channels (also called user channels) can be used for a fractional T1. More channels can be used with more T1s, or with a fractional or full T3 or E3.

Each B-channel carries data, voice, and other services. The D-channel carries control and signaling information. The Primary Rate Interface consists of 23 B-channels and one 64 kbit/s D-channel using a T1 line or 30 B-channels and 1 D-channel using an E1 line. Thus, a Primary Rate Interface user on a T1 line can have up to 1.544 Mbit/s service or up to 2.048 Mbit/s service on an E1 line. PRI uses the Q.931 protocol over the D-channel. The B and D channel sizes are dependent on the Framing format of the T1 circuit. ie. Super Frame (SF) is a 56kb channel and the Extended Super Frame (ESF) is a 64kb channel. Nearly all US carriers provide PRI via ESF format and B8ZS line coding.

In English?

The Voice PRI is a high capacity communications line designed to give the business user more features at a more competitive price with greater flexibility. The service is carried via T-1 line, and gives the user calling capacity of 23 simultaneous calls for each T-1 PRI line. This service is practically a must now for any company with 20 users or more depending on call volume.

Are there costs associated with a PRI?

Yes. In order for your phone system to interface or “talk” to the PRI circuit from your T-1 carrier, your phone system must have a digital PRI card. Not all systems have the ability to handle a PRI card, but most do. PRI card prices can range anywhere from $500 to upwards of $3,000 depending on the age of the system and who the manufacturer is. Add installation costs, and it’s a decision that is carefully weighed against the benefits.

What are the benefits of a PRI?

In comparison to an analog environment, the benefits of a PRI are many. Hunting groups, DID’s, call tracking and call reporting, CTI, out of rate center DID’s, pulsed digits, call routing, less taxes and reduced costs are all chief reasons to consider Voice PRI.

1. Hunt Groups: In an analog environment, it is typical to have a linear or circular hunt group for all incoming calls, and possibly for outgoing calls. All incoming calls start from the top of the “hunt group” and work their way down to the bottom. A ten (10) phone line hunt group would allow an organization to have 10 simultaneous incoming calls with a single main number. Outgoing calls would then pick up the last of the ten (10) lines in the “hunt group” and work their way up towards the main or first line in the hunt group. The goal obviously is to have a large enough hunt group so that the incoming calls and outgoing calls never cause you to use all of your capacity. This is called “line pooling” in an analog environment.

If you have multiple businesses or departments, you will often have separate “line pooling” hunt groups. Changes in configuration and capacity have to be made through your carrier. Private lines are typically left off the “hunt groups” at additional costs. With a PRI, you can have multiple hunt groups all programmed from your phone system. Your basic rule is that you can make or receive a total of 23 simultaneous calls in whatever configuration you want per PRI, and they can be bonded. Do you want 10 different hunt groups for 10 different departments? No problem. Need a dozen private numbers? No problem. You don’t even have to call the carrier, as the programming is done at the PBX level.

2. DID’s: Direct Inward Dial numbers are key for any growing organization. Direct Inward Dial numbers are typically assigned in blocks of 20, and are designed exclusively to work with digital voice circuits like PRI. Most carriers limit the number of DID’s per PRI circuit to 200, but we’ve seen some rare cases where 400-600 have been allowed. Did you catch that?

“I have 23 channels on a PRI for simultaneous phone calls, but you can give me 200 phone numbers?”

Yes, that’s right. You literally can assign everyone in your organization their own phone number AND their own fax number if you want. Phone numbers run around $5 a month per block of 20.

“Why would I want all those numbers?”

Do you consider service a priority? Then perhaps you insist on your clients not having to deal with automated attendants. With DID numbers, your incoming caller can bypass the automated attendant and have their call routed directly to your representative of choice. In a world of automation, large companies wouldn’t do without it. Is your receptionist inundated with calls and a professional call transferer? Bypass the need by routing the call directly to their party.

With the ever increasing capabilities of desktop fax server applications, it is also possible for every employee to have their own fax number that delivers .pdf or other common format attachments to their desktop via email application. Send and receive faxes from the desktop without getting up, and without paying for additional dedicated fax phone lines.

3. Call Tracking and Call Reporting: Along with DID’s, the enhanced capabilities of your phone system to track your data with a PRI can be vital to your operation. (Software often required) Ever wonder just how many outgoing calls your sales reps are making? Need to know how many incoming calls came in to customer service to assist with staffing decisions? How many calls did you get on that last advertising campaign? With DID level call tracking and reporting, you can create a myriad of tools for your business to streamline operations like never before.

4. Out of Rate Center DID’s: Some areas call them exchange numbers, foreign exchange numbers, Remote Call Forward numbers, etc. Essentially they are numbers in neighboring markets outside of your local phone company office that are forwarded to your location. The local phone company will often charge a monthly line charge in addition to any call volume charges and mileage charges associated with the number. Those costs can be astronomical for businesses that need a local “presence” in other markets. Locals in a market prefer to deal with someone who is also local, so having that local number is essential. With a PRI, you can turn your out of area number into a DID and avoid mileage and forwarding charges. For the right company, this can mean a difference of hundreds or thousands per year. It also opens up the ability to go after additional markets and have that “local” presence.

For companies that relocate, their local phone company will often tell them they cannot take their number with them. By using a CLEC, it is often possible to take your number with you to another market and not incur the high costs formally associated with doing so by forwarding or telebranching. .

5. CTI (Computer Telephony Integration): Many sophisticated business operations integrate their voice and data infrastructures, and they require the ability to route calls based on database lookups. Using DID’s and the Caller ID of the incoming caller, your system via PRI can actually look up in your database which one of your representatives has been dealing with this customer, and route the call directly to their extension in a moment’s notice. The user than can see a screen popup on their computer informing them of the status of this customer or account before they even answer the phone! This feature has limitless applications, but you must first determine if the protocol between your database and phone system is compatible. Common protocols are TAPI, TAPI 2.x, TAPI 3.x, H.323, and others.

6. Outgoing Caller ID: In large corporations or organizations with several companies under one roof, it is imperative to have separate outgoing Caller ID appearances. With PRI, you can assign an individual company name and number pulsed out by phone or phone group level, all while leveraging the same telecommunications PRI circuit.

Do you want all calls to go through the switchboard? Then assign the same Caller ID to all phones as the main outgoing Caller ID for your company. All callers returning calls will have the calls routed as you program. With PRI, you maintain total control, and can make programming changes as often as needed or desired. (Programming typically must be performed by a trained technician)

7. Reduced Cost: Growing businesses choose Voice PRI for all of the above reasons, but perhaps most importantly for cost reasons. If you have been operating in a similar capacity analog environment, but without the benefit of all of the above features, your scenario would look something like this:

23 analog lines monthly charge each: $30 (23 x $30 = $690)

Service Line charges per line: $6 (23 x $6 = $138)

Features charges: ??? Caller ID is often extra, but comes with PRI

Additional taxes: ??? Depends on carrier and Bell region

Calling charges: ??? Depends on carrier, region, and negotiated rates

$690 for 23 analog lines

$138 for service line charges

$828 before features, taxes, and calling charges.

Most T-1 carriers we deal with now offer PRI for around $500 a month plus a line charge equal to 5 channels of the PRI. (Around $30) PRI has Caller ID included automatically, although some carriers charge an additional fee for Caller ID Name and Number. So for $530 per month, you get all of the above mentioned features, typically more competitive calling rates, reduced taxes and line charges, and a bottom line difference of around $300 per month. So…..

When should I move my business to a Voice PRI?

When it costs less to be digital over analog, or whenever the benefits of the additional features outweigh any additional costs associated with the service. Additional options are now available with fractional PRI circuits, integrated voice and data PRI circuits, and voice compression high capacity options that have made the service affordable for most businesses. Your telecommunications professional can help you decide which option is right for you.

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Video conferencing solutions allow participants in a meeting to see and hear each other, making for an interactive conference. Video conferencing is also used for educational training, surveillance, emergency response and security. When video conferencing is used correctly, it has a significant effect on the way people do business and the success of the business. Decisions can be made faster and deals sealed quicker. This enables you to stay in front of your competitors.

Another obvious benefit of using video conferencing is that it allows people, especially business owners, to meet with their clients from any location, This obviously saves a great deal of time and money that can be better spent for educational training, etc. Video conferencing is also used to provide customer service and for sales.

Unfortunately, with the pluses that come with video conferencing, there are some limitations. This sophisticated technology requires months to design a network and install conferencing equipment. The initial cost is very high. A conference room has to be available for the video system to be installed, and the system might be underutilized. Also, the system itself will need at least one staff person to run the technical part of any conference. This could also be an under utilization of staff time.

There are still problems with this video technology, thus there can be a lot of wasted time that can cause disruptions, etc. It can also sometimes be difficult to really see how a particular client or group may be reacting via video conferencing.

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T3 bandwidth provides data transfer speeds of 45 megabits per second (mbps) and contains 672 individual channels that are each equal to voice grade telephone lines, capable of transmitting online video shoots, real time video, and large databases over a busy network. T3 bandwidth is by and large, used in large universities and companies that have large number of users in the same network.

T3 bandwidth is provided through fiber optic cables that contain two cables for receiving data and two cables for transmitting data. Individual users with limited needs can subscribe to three to four sub channels for sharing music, video, and other multimedia applications, which usually take a long time to download. Each of these individual channels is equivalent to regular voice grade telephone lines that transmit data at 64 kilobits per second.

T3 bandwidth is expensive and can cost anywhere between four to fifteen thousand dollars depending on the service provider and usage. It is most commonly used in call centers and contact centers for providing uninterrupted access to its customers via multiple channels such as voice calls, e-mail, live chat, internet telephony, voice over internet protocol (VoIP), and internet fax. It is used in multinational companies to share information with sister concerns located in different countries of the world.

Some service provider’s offer T3 broadband services with additional options such as multiple self-managed e-mail boxes with Spam and virus filtering. These services allow users to check the availability, usage, and latency of connection along with monitoring of mail and web services. Notifications regarding these are sent directly to the user’s cell phone or pager number.

T3 broadband services provide an ideal solution for connectivity requirements of large organizations that require high-bandwidth access at reasonable prices. It also provides an economical way of hosting high traffic websites, supporting web hosting, and providing high capacity bandwidth as and when needed.

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T3 lines refer to a type of broadband connection that transmits data at 45 megabits per second and consists of 672 individual channels, each capable of transmitting data at 64 kilobits per second, which is equivalent to a single voice grade telephone line. These lines form the backbone of Internet service providers who provide dedicated lines to large organizations with multiple users and set of two to four sub channels to individual users.

T3 lines consist of two receiving and two transmitting fiber optic cables that are capable of transmitting data at forty-five megabits per second. A single T3 connection consisting of all individual channels can cost anywhere between 4 and 15 thousand dollars depending on addition services provided with the broadband service.

The most common use of T3 lines can be found in call centers and contact centers where it is used for providing uninterrupted access to its customers via multiple channels such as voice calls, e-mail, live chat, internet telephony, voice over internet protocol (VoIP), and internet fax. These lines have helped government agencies in effectively dealing with emergency situations such as floods, hurricanes, and tornadoes by distributing the required information to those in need.

T3 lines can be used for a wide variety of applications such as T3 point-to-point, T3 Internet, T3 frame relay, T3 voice, and T3 virtual private networks (VPN). The cost of using T3 lines varies depending on the carrier, location of service, and the application for which it is being used.

Increase in Internet traffic has forced Internet service providers to develop new broadband technologies that provide even higher speeds of data transfer and uninterrupted Internet connectivity. New broadband technologies such as SONET (51.8 mbps) and Asynchronous Transfer Mode (ATM- 155 to 622 mbps) are already in the market but are very expensive and have a limited market as compared to T3 lines.

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Why does communication so often go wrong? Here are the top four reasons for breakdowns in communication:

1. Poor Listening Skills. Poor listening skills top the list when it comes to barriers to communication. Poor listening skills can result from:

* Lack of involvement with the other person or the topic at hand: you just don’t care enough to listen.

* Distractions in the environment such as excessive noise or activity.

* Disagreement with the speaker, resulting in mentally “shutting off” the other person.

* Passive listening rather than active involvement with the speaker.

2. Assumptions. There are many assumptions we make while communicating with others. For instance, you might think that you know what the other person is going to say, so you simply “leave” the conversation.

3. Non-Verbal Signals. One recent study showed that only 7% of our communicating is tied to what we actually say! A full 55% of communication happens through non-verbal signals, and another 38% is based on tonality. So if your non-verbal signals are contradicting what your mouth is saying, people are going to remember what you didn’t say.

4. Improper Use of Questions. Many people believe that if they ask a multitude of questions, they are communicating well and connecting with the other person. This may or may not be the case! We must ask the right questions at the right time to get the information we need to communicate effectively. That means asking open-ended questions – questions that begin with who, what, when, why, where, and how. Open-ended questions help true discussion and understanding to take place.

© 2008 Timothy I. Thomas

You have my permission to reprint and distribute this article as long as it is distributed in its entirety, including all links and copyright information. This article is not to be sold or included with anything that is sold.

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Although all communication is subject to misunderstandings, business communication is particularly difficult. The material is often complex and controversial. Moreover, both the sender and the receiver may face distractions that divert their attention. Further, the opportunities for feedback are often limited, making it difficult to correct misunderstandings. The following communication barriers in organizations and ways to overcome them will be the main topic of this article.

1. Information Overload. Too much information is as bad as too little because it reduces the audiences ability to concentrate effectively on the most important messages. People facing information overload sometimes try to cope by ignoring some of the messages, by delaying responses to messages they deem unimportant, by answering only parts of some messages, by responding inaccurately to certain messages, by taking less time with each message, or by reacting only superficially to all messages.

To overcome information overload, realize that some information is not necessary, and make necessary information easily available. Give information meaning rather than just passing it on, and set priorities for dealing with the information flow. Some information isn’t necessary.

2. Message Complexity. When formulating business messages, you communicate both as an individual and as representative of an organization. Thus you must adjust your own ideas and style so that they are acceptable to your employer. In fact, you may be asked occasionally to write or say something that you disagree with personally. Suppose you work as a recruiter for your firm. You’ve interviewed a job candidate you believe would make an excellent employee, but others in the firm have rejected this applicant. Now you have to write a letter turning down the candidate: You must communicate your firms message, regardless of your personal feelings, a task some communicators find difficult.

To overcome the barriers of complex messages, keep them clear and easy to understand. Use strong organization, guide readers by telling them what to expect, use concrete and specific language, and stick to the point. Be sure to ask for feedback so that you can clarify and improve your message.

3. Message Competition. Communicators are often faced with messages that compete for attention. If you’re talking on the phone while scanning a report, both messages are apt to get short shrift. Even your own messages may have to compete with a variety of interruptions: The phone rings every five minutes, people intrude, meetings are called, and crises arise. In short, your messages rarely have the benefit on the receivers undivided attention.

To overcome competition barriers, avoid making demands on a receiver who doesn’t have the time to pay careful attention to your message. Make written messages visually appealing and easy to understand, and try to deliver them when your receiver has time to read them. Oral messages are most effective when you can speak directly to your receiver (rather than to intermediaries or answering machines). Also, be sure to set aside enough time for important messages that you receive. Business messages rarely have the benefit of the audiences full and undivided attention.

4. Differing Status. Employees of low status may be overly cautious when sending messages to managers and may talk only about subjects they think the manager is interested in. Similarly, higher-status people may distort messages by refusing to discuss anything that would tend to undermine their authority in the organization. Moreover, belonging to a particular department or being responsible for a particular task can narrow your point of view so that it differs from the attitudes, values, and expectations of people who belong to other departments or who are responsible for other tasks.

To overcome status barriers, keep managers and colleagues well informed. Encourage lower-status employees to keep you informed by being fair-minded and respectful of their opinions. When you have information that you’re afraid you boss might not like, be brave and convey it anyway. Status barriers can be overcome by a willingness to give and receive bad news.

5. Lack of Trust, Building trust is a difficult problem. Other organization members don’t know whether you’ll respond in a supportive or responsible way, so trusting can be risky. Without trust, however, free and open communication is effectively blocked, threatening the organization’s stability. Just being clear in your communication is not enough.

To overcome trust barriers, be visible and accessible. Don’t insulate yourself behind assistants or secretaries. Share key information with colleagues and employees, communicate honestly, and include employees in decision making. For communication to be successful, organizations must create an atmosphere of fairness and trust.

6. Inadequate Communication Structures. Organizational communication is effected by formal restrictions on who may communicate with whom and who is authorized to make decisions. Designing too few formal channels blocks effective communication. Strongly centralized organizations, especially those with a high degree of formalization, reduce communication capacity, and they decrease the tendency to communicate horizontally thus limiting the ability to coordinate activities and decisions. Tall organizations tend to provide too many vertical communication links, so messages become distorted as they move through the organization’s levels.

To overcome structural barriers, offer opportunities for communicating upward, downward, and horizontally (using such techniques as employee surveys, open-door policies, newsletters, memo, and task groups). Try to reduce hierarchical levels, increase coordination between departments, and encourage two-way communication.

7. Incorrect Choice of Medium. If you choose an inappropriate communication medium, your message can be distorted so that the intended meaning is blocked. You can select the most appropriate medium by matching your choice with the nature of the message and of the group or the individual who will receive it. Face-to-face communication is the richest medium because it is personal, it provides immediate feedback, it transmits information from both verbal and nonverbal cues, and it conveys the emotion behind the message. Telephones and other interactive electronic media aren’t as rich; although they allow immediate feedback, they don’t provide visual nonverbal cues such as facial expressions, eye contact and body movements. Written media can be personalized through addressed memos, letters, and reports, but they lack the immediate feedback and the visual and vocal nonverbal cues that contribute to the meaning of the message. The leanest media are generally impersonal written messages such as bulletins, fliers, and standard reports. Not only do they lack the ability to transmit nonverbal cues and to give feedback, they also eliminate any personal focus.

To overcome media barriers, choose the richest media for no routine, complex message. Use rich media to extend and to humanize your presence throughout the organization, to communicate caring and personal interest to employees, and to gain employee commitment to organizational goals. Use leaner media to communicate simple, routine messages. You can send information such as statistics, facts, figures and conclusions through a note, memo or written report

8. Closed communication climate. Communication climate is influenced by management style, and a directive, authoritarian style blocks the free and open exchange of information that characterizes good communication.

To overcome climate barriers, spend more time listening than issuing orders.

9. Unethical Communication. An organization cannot create illegal or unethical messages and still be credible or successful in the long run. Relationships within and outside the organization depend or trust and fairness.

To overcome ethics barriers, make sure your messages include all the information that ought to be there. Make sure that information is adequate and relevant to the situation. And make sure your message is completely truthful, not deceptive in any way.

10. Inefficient Communication. Producing worthless messages wastes time and resources, and it contributes to the information overload already mentioned.

Reduce the number of messages by thinking twice before sending one. Then speed up the process, first, by preparing messages correctly the first time around and, second, by standardizing format and material when appropriate. Be clear about the writing assignments you accept as well as the ones you assign.

11. Physical distractions. Communication barriers are often physical: bad connections, poor acoustics, illegible copy. Although noise or this sort seems trivial, it can completely block an otherwise effective message. Your receiver might also be distracted by an uncomfortable chair, poor lighting, or some other irritating condition. In some cases, the barrier may be related to the receiver’s health. Hearing or visual impairment or even a headache can interfere with reception of a message. These annoyances don’t generally block communication entirely, but they may reduce the receiver’s concentration.

To overcome physical distractions, try to prepare well written documents which are clear, concise, and comprehensive. When preparing oral presentations try to find a setting which permits audience to see and hear the speaker clearly.

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Electronic health record system is definitely a better way to do store patient’s medical health records. It allows for accurate record keeping, increased level of healthcare and a reduction in malpractice insurance premiums. It involves doing away with the pen and paper system of keeping medical records and embracing the digitalizing of all information. Like every new thing, change is not always welcome. A few physicians are stuck in their ways and are not embracing this new system without a fight.

The good news is that you can work around disadvantages to turn them into positive territory or find a replacement. Some of the disadvantages include:-

Privacy Protection

There will always been privacy issues in the healthcare system on who has access to your medical records. With a pen and paper system, with the physical file located at a particular institution there is a limit to who can see your records. Even if there was a security breach and your information is not secured, it is only available to people in that proximity.

But in a situation where your information is sent to a centralized information repository in digital format, all bets are off. This privacy concern is a big issue with many people and will continue to be an issue until it is addressed for good.

Medical records synchronization

Until recently with centralized information repositories, individuals being treated at different facilities could not have their information updated at the same time which could lead to healthcare providers not having updated information when they become available. However, with centralized repositories this problem has been solved, but it has given rise to the above mentioned issue of data security and protection.

High start up cost

There is a high start up cost when transforming a pen and paper system to EHR. Some physicians do not see any immediate benefit to their practice in the short run and drag their feet in implementing EHR.

Legal issues

Taking the healthcare industry to court has in the past few decades been a lucrative venture for attorneys trying to right the wrong done to a patient, whether by omission or commission.

Doctors are already practicing defensive medicine and electronic health record system brings a new potential avenue for litigation and revenue stream for lawyers. With a new system, anything can go wrong, the system could fail or the stored data stolen. Improper uses of collected information are all potential avenues for a law suit.

Gradually, electronic health record system is gaining traction. More and more doctors are embracing it, and depending on the part of the country you are looking at, conversion could be as high as 40%. With government involvement and the amount of resources it is investing, the time will come when digital medical record keeping will be the norm.

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1. Introduction to Cloud Computing

Cloud computing refers to both the applications delivered as services over the Internet and the hardware and systems software in the data centers that provide those services. The data center hardware and software is what we will call a Cloud. Cloud computing is relatively new concept and it has become popular recently. Cloud leverages virtualization technology and in the essence of Cloud computing there is a logical separation between different nodes, each node appears as a different physical machine to the user. Unlike grid computing, it makes several distributed computers connected together to form a big logical computer which can handle large amount of data and computation. In case of Cloud computing the virtualization technology makes it possible to have each node appear as separate physical machine allowing user to load custom software and operating system on each node and configure custom rules for each node.

The idea of Cloud computing is evolved from parallel processing, distributed computing and grid computing. There is a bit similarity between them but they work differently. Although Cloud computing is an emerging field of computer science, the idea has been around for a few years. It’s called Cloud computing because the data and applications exist on a “cloud” of Web servers. To simplify the concept, Cloud computing can be defined as simply the sharing and use of applications and resources of a network environment to get work done without concern about ownership and management of the network’s resources and applications. According to Scale, with Cloud computing, computer resources for getting work done and their data are no longer stored on one’s personal computer, but are hosted elsewhere to be made accessible in any location and at any time.

2. Related Technology Comparison

2.1. Grid computing A form of distributed computing and parallel computing, whereby a ’super and virtual computer’ is composed of a cluster of networked, loosely coupled computers acting in concert to perform very large tasks

2.2. Utility computing The packaging of computing resources, such as computation and storage, as a metered service similar to a traditional public utility, such as electricity.

2.3. Autonomic computing

Computer systems capable of self management.

3. General mechanism

Cloud computing using information technology as a services over the network. The concept generally encompasses of Infrastructure as a service (IaaS), Platform as a service (PaaS) Hardware as a Service (HaaS) and Software as a service (SaaS). It can be the ability to rent a server or servers and run a geophysical modeling application available anywhere. It can be the ability to (S Rupley, 2009) rent a virtual server, load software on it, turn it on and off at will, or clone it to meet a sudden workload demand. It can be storing and securing large amounts of data that is accessible only by authorized applications and users. It can be supported by a cloud provider that sets up a platform with the ability to scale automatically in response to changing workloads. It can be using a storage cloud to hold application, business, and personal data. And it can be the ability to use a handful of Web services to integrate photos, maps, and GPS information to create a front page in customer Web browsers.

In a cloud computing system, there is a significant workload shift. Local computers no longer have to run applications. The network of computers that make up the cloud handles them instead. In this situation the demand of hardware and software on the user’s side is decreased. Let the cloud take care of it. The only thing that local computers should aware is the interface software that will run the application. Today’s, a Web Browser such as Mozilla Firefox and Internet Explorer 8 is widely use as an interface software in cloud computing system.

The truth is, internet users already used some form of cloud computing. If they have an email account with a Webbased email service like Hotmail, Yahoo! Mail or Gmail, then they had some experience with cloud computing. Instead of running an email program on a local computer, user will log in to a Web email account remotely. The software and storage for the account does not exist in the local computer it is on the service’s computer cloud.

4. Key characteristic of Cloud Computing

Currently, there is no standard definition or specification for Cloud Computing. It may take some time to define the key characteristics of Cloud Computing based on practices in the field.Based on practices in the areas of service provisioning and solution design, the following two key enabling technologies could play a vital role in this revolutionary phase of cloud computing:

4.1. Virtualization technology

Virtualization technology works to handle on how the image of the operating system, middleware, and application procreated and allocated to a physical machine or part of the server stack away. The virtualization technology can also help reuse licenses of operating systems, middleware, or software applications, once a subscriber releases their service from the Cloud Computing platform.

4.2. Service Oriented Architecture (SOA).

A service oriented architecture is essentially a collection of services. These services communicate with each other. The communication can involve either simple data passing or it could involve two or more services coordinating some activity. Some means of connecting services to each other is needed. The evolution of a system or software architecture is now moving towards services oriented, unlike several decades ago most of the application is stand alone and purposely for single use. Recently, the gigantic growth of the internet user and internet technology availability the use of software now can be rented. Giant company such as Google, Microsoft, Sun or even Amazon have this capability provide software services instead of selling the software directly to user. The SOA is software or system architecture that addressing componentization, reusability, extensibility, and flexibility. These entire characteristic is a fundamentals need for company that are looking for reducing cost and opt to rent instead of purchase.

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In this highly competitive world, medium and small business groups struggle for survival. As they established with small capital investments, these organizations usually will not have enough money to overcome the massive promotional campaigns by their large counterparts. Thus the most effective solution they got to keep their customers and to attract new clients is to enhance customer satisfaction through better customer service methods. The mouth publicity by the satisfied customers is the most useful advertising tool for these companies. Offering some great benefits to good customers and creating new plans for infrequent customers can boost the company turnover.

Today, Customer Relationship Management (CRM) programs have become the most effective tools for all marketing and service providing companies to enhance their customer satisfaction. Now, there are so many CRM vendors who offer different customized customer relationship management solutions according to business needs. You can purchase a standard pre-customized CRM solution or an open source CRM solution, or can hire a hosted/on demand CRM solution. The choice mainly depends on your business structure and volume.

Customer relationship management programs enhance the customer-friendly services by automating all proceedings and procedures in a company. All CRM systems are primarily large customer databases capable of storing all customer information such as customer’s name, address, customer contacting method, ability to spend money on products, money spending per visit etc. The specific programs built in these systems integrate the stored data on demand to identify good customers and help to create better service plans for them.

CRM software systems are capable of automating every thing involved in a small business. The main features of a CRM solution include sales force automation, data tracking, data migration, data integration, contact management, account management, opportunity management, customer service training, custom reporting, product management, lead routing, lead assignment, task management, calendaring, quota management, territory management, partner tracing, sales forecasting, customization analytics, sales analytics, trouble shooting, etc.

For small sized companies, there are two popular CRM options as open source CRM and hosted or on-demand CRM. Open source CRM software programs are customizable CRM programs. These programs are available in standard formats, which can be customized according to the company needs. But the requirement with these CRM solutions is your company must have enough technical knowledge to customize the program. Also there are some pre-customized CRM versions available today.

Hosted CRM or on demand CRM is a web-based application provided by an ASP (Application Service Provider), is an example of SaaS (Software-as-a-Service). In this type of CRM solution, all your CRM needs are satisfied by a distant CRM provider. The CRM provider or host will automate all proceedings including data tracking, data integration and data migration. The provider will offer the CRM solutions on your demand and will charge a monthly fee for that. Benefits of on demand CRM include reduction in the initial cost essential for installing a CRM system and accessibility from any part of the world at any time. But before signing a contract with any on demand CRM provider, make sure that he uses special data encryption techniques for securing your data. Also check the data integration capacity of the provider.

Today an another alternative, namely open source hosted CRM, which combines the merits of both open source and hosted CRM is becoming rapidly popular. This CRM solution is proven effective in tackling specific situations. For all CRM types, most providers now offer 30 days free trail, making use of these offers can help you to find a good CRM solution for your company.

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