RECOMMENDATIONS Medical Phone System Configuration + Plivo

[HartW]

I have built a pretty powerful VOIP system on top of Plivo.com but alas it has it's shortcomings (doesn't support a lot of standard SIP features such as Call Transfer). Perhaps the PIAF community can give me some advice on how they would setup a system with the following constraints:

1. This is intended for multiple small to medium medical private practices (5 - 20 phones per location generally). As such, security and stability are priorities, and there is a relatively high call volume. Our system handles the storage side (encrypted voicemail stored on Amazon S3), but ideally the data in transit would also be as secure as possible.

2. Because Plivo doesn't fully support all the traditional PBX features, I need an intermediary solution to trunk the SIP routes. In other words the traffic would flow: Phone < - > ? PBX < - > Plivo

3. It would be great if said solution had the ability to tightly integrate with Plivo (for example, I could send a custom SIP header for a particular extension I wanted to DID into).

4. Along those same lines, it would be great if our web app had the ability to talk with the solution and setup extensions.

The questions I have:

1) For the intermediary solution, would you recommend a hosted PBX (say something like PIAF resting in the cloud somewhere) or an on-premise PBX with dedicated hardware?

2) What hardware/software combo would you recommend for the above answer.

3) How can I integrate a web app with something like PIAF (for example have my web app call out to the PBX and create an extension)?

 

[atsak]

In companies where they live and die by the phone (like a docs office):
1. server on prem - something light like an atom based supermicro has always worked well for me. A few extra bucks for hardware raid would not be misplaced. Big UPS, dual power supplies (for street and UPS)
2. Regular old phone lines - get them. There's nothing like them as reliable. For sure use VOIP for outbound, and maybe toll free.

Not sure about the web app but you can do anything you want with Asterisk - you might not need the PIAF in full though - you could write your web app to do the things Freepbx does (write out the configuration files).

Not easy but if you are putting it together for 50 customers . . . ROI may be there.

 

[HartW]

atsak thank you for the advice!

1) good info--out of curiousity, what would be your main argument for on-premise over hosted (I've read many comparison articles, but none seem to give a definitive edge on one vs the other)?
2) Ultimately, it would be great if I didn't have to replace much of the existing systems (though some of them are in bad shape and need some modernizing). Is there a practical way to route inbound traffic to our external hosted PBX, then back to the existing PBX if necessary? I imagine you could forward all calls for a certain DID to Plivo, then dial back into a separate DID. Not sure if this would cause too much latency?
3) That's what I was thinking as well regarding just an Asterix configurator. Wasn't sure if that would be more difficult than utilizing the tools FreePBX provides like bootstrap.

Our goal is to get to about 50-100 businesses in the next year, so I think long term any solution that makes our lives easier is worth the effort.

 

[atsak]

1. The need for POTS lines, and the ability to operate when internet is out. I find customers intolerant to things like power failures in datacenters or BGP table overruns when their office is working just fine.
2. Sure, use DUNDI and or trunks between the systems. Latency under 200ms shouldn't be noticable and since most round trips in geographic areas are under 40ms in North America, you should be able to do what you like. This sounds complicated though, and complicated is always unreliable . . .
3. You can do both in theory though if you use the override and custom files.

 

[HartW]

Thanks for the quick replies... this info has definitely got me thinking of some new possible solutions for us!