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Avaya Aura architecture, SIP trunking help healthcare system scale UC

With the Avaya Aura architecture and SIP trunking, a healthcare system centralizes and distributes UC services that were too expensive for some clinics to deploy on their own.

SIP trunking's ability to obviate the need for public switched telephone network (PSTN) lines can do more than reduce a company's long-distance bill. Unified communications (UC) pros at one healthcare provider paired Session Initiation Protocol (SIP) trunking with Avaya's Aura Architecture -- a SIP- and software-based UC platform -- to allow its member hospitals to share UC and voice applications across a wide area network (WAN) and support advanced communications services at some of its smaller clinics for the first time.

"Nobody can argue the effect of UC. It's just too expensive for a small entity to [deploy]," said Jay Long, senior vice president of Health Group Telecommunications, a division within Vantage Healthcare Network, a private system of healthcare providers based in Meadville, Pa. "We can try to use our buying volumes and get the best discount we can, but that's still unaffordable for a lot of [members]."

Nobody can argue the effect of UC. It's just too expensive for a small entity to [deploy].

Jay Long
Senior Vice President of Health Group Telecommunications, Vantage Healthcare Network

With a SIP trunking service, Vantage eliminated its PSTN trunks and moved its voice traffic onto the WAN. Voice traffic is no longer isolated on a separate public network; it becomes just another form of data traffic on the private WAN. This integration and control enables Long to unify voice with other SIP-based applications and distribute those services from a central location to any other site on the WAN.

SIP trunking's ability to give remote sites access to centralized UC infrastructure was especially helpful for Vantage Healthcare, a for-profit network of nonprofit hospitals and private clinics, pharmacies and small medical offices throughout western Pennsylvania. Eleven hospitals and the Lake Erie College of Osteopathic Medicine share ownership of Vantage Healthcare and function as its shareholders. Eight other community hospitals and the hundreds of private clinics and medical offices pay membership dues, which grant them access to some shared services while still operating as independent providers. 

The smaller members of Vantage Healthcare buy their own IT equipment, whereas the hospital co-owners pool their IT budgets. However, all members receive basic IT support and administration from the Health Group Telecommunications division.

Until recently, every member of Vantage was a communications island. None of the communications infrastructure was connected via a WAN, so each location made its own local investments in UC infrastructure. Smaller members struggled to afford the enterprise-class UC technologies that larger members had installed, Long said.

This approach left many smaller clinics underserved and many larger hospitals overinvested in UC technology. Vantage's largest hospital, Saint Vincent Health System in Erie, Pa., invested in a voicemail system with 1,800 mailboxes even though it needed just 800. It was unable to find a product that scaled exactly to its needs, so it had 1,000 unused mailboxes, Long said. Meanwhile, a smaller Vantage hospital that may have needed a couple hundred voicemail mailboxes or a small clinic that may have needed only a dozen couldn't have used St. Vincent's excess capacity and had to purchase their own systems, he said.

"There was a lot of waste," Long said.

SIP trunking, Avaya Aura architecture provide on-ramp for UC strategy

Through an MPLS network with SIP trunking services, Vantage members now tie directly into Long's UC infrastructure. That network serves as the vehicle for the SIP-based Avaya Aura architecture, which distributes software-based UC services to all of Vantage's hospitals and clinics from a central location.

By centralizing UC services and distributing them as software to smaller doctors' offices or clinics, Long has delivered new communications and collaboration opportunities to members that had previously only been able to afford basic telephony.

"Call centers are becoming increasingly important to healthcare," Long said. "That's one thing we're able to provide now for our smaller folks that aren't able to [afford their own deployments]. When we own it and can extend it out on a per-click basis, that's a different animal." 

Smaller members must still purchase some equipment on their own, but it's a relatively inexpensive piece of hardware, such as a media gateway, Long said. He expects that some clinics and doctors’ offices will shave 30% to 40% from their communications expenses once the deployment is completed in mid-April with the help of systems integrator Carousel Industries Inc.

"I can give [a small office] two IP phones. [It] doesn't have to buy a phone system, but [it's] immediately tied into a $5 million communications infrastructure," he said. "There is no doubt this will change patient care."

Avaya's Aura architecture, which uses virtualization to share multiple UC applications or services on a single server, has also enabled Long to extend IM and presence capabilities to all of Vantage's hospitals, pharmacies, clinics and doctors' offices.

But that still only scratches the surface of Vantage's overall goals with SIP trunking and the Avaya Aura architecture. Long plans to integrate communications, tie in mobility and make patient care more efficient across Vantage. He wants  to implement a find me/follow me application that would enable mobile devices to use a user's GPS coordinates to determine presence and route communications as a call, email, IM or text message, based on location and routing policies.

The Avaya Aura architecture can also use SIP to "learn" a user's call patterns and link that intelligence to presence information and policies, he said. A nurse may frequently call or email the same three physicians, and the system could start suggesting those as primary contacts to eliminate the need for users to fish around for the right person and appropriate contact method, Long said.

"If [we're treating] a patient in an auto accident somewhere, we're trying to get information rapidly to that physician. In today's world, you've got nine ways to even call the [physician]," he said. "But when you start looking at the way SIP-based networking flows, you take a lot of the guesswork out of it and you're making the communications system become a functional part of patient care."

Let us know what you think about the story; email: Jessica Scarpati, News Writer.

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