Despite this being 2012, communication in most Canadian doctor's offices still revolves around phone and fax.
Having said that, it doesn't mean you have to go to the phone company, get them to activate a few phone lines, plug a fax machine into one, and some phones into the others. And especially when you start looking at various telephony features useful for businesses, this can start getting both painful and expensive.
In the olden days, that would mean plugging your own office phone system into those phone company provided lines. Nowadays, you can run things over the internet using "voice over internet protocol" (VOIP) technology, and run a "virtual" phone system (where you don't have any equipment beyond the phones themselves), outsourcing the whole management of the phone system and its features.
Look ma, no phone system!
There are lots of companies that provide these services. We picked RingCentral, and in particular their "RingCentral Office" cloud-based phone system as they call it. We bought three Polycom IP phones up front (plus a ATA, which I'll come back to), plus some network gear, and then for $132 (CAD, incl taxes) per month, we've got effectively six different phone numbers (two of which are publicized, the rest are internal and let us ring particular extensions directly), multiple incoming lines per phone number, plus all the minutes we need, a wonderfully configurable phone system with all the business telephony features we'd ever need, etc.
With this kind of system, rather than plugging a telephone cable from the phone into the wall, we connect each phone to a network router via an Ethernet cable.
This does of course need an internet connection to run, so tack on another $60 for business internet service from the cable company, which we of course can use for other things too.
One of the nice things about a cloud phone service is you can get at everything remotely. There are web interfaces, desktop interfaces and smart phone interfaces to get at the system, configure it, and pick up voice mails. We also have things set up so that all voice mails are sent to the office email address as attachments. So the email inbox is also the voice mail inbox. Again, all completely configurable. So we've set things up too so that even though there are different phone numbers, all of the voice mails get dumped into the same voice mail box.
Send this telegram... err, fax...
The evil faxes are also handled the same way, automatically coming in as emails with the fax contents being a PDF attachment. So they can be printed if necessary, but not necessarily printed. It's also easy of course just to forward them around to another email address.
Outgoing faxes can be sent through a email to fax service provided by RingCentral. Essentially we just need to create a regular email, attach the pages of our document to send as PDF's, and send the email to a special email address that contains the fax number of the recipient. Way easier than printing things out and sending them through the fax machine.
But speaking of which, we can still send faxes from paper without scanning them into the computer and emailing them. The main office printer is a multifunction printer (MFP) which includes fax capabilities. Of course, these are analog using a regular phone line, which wouldn't jive well with the digital phone system. A special box called an Analog Telephone Adapter (ATA) lets you connect your analog device to the system. So then we can use the MFP to send faxes the old fashioned way.
As an aside, we use RingCentral's 'Mobile' product for our home number, and have done so for a long time. We'd set it up when we were first starting to plan our move from Ontario to Alberta. We got an Edmonton number and just had it ring whereever we happened to be at the time, which changed quite a bit as we jumped between a couple of short-term locales before we bought our current house here.
Other Internet setup
The phone system requires a wired network, though at least the phones have a little hub in them so that you can run the long Ethernet cable from each phone to the main hub, and then just plug each computer into the phone. We've also got a (protected) wireless network running, which is used for the doctor's laptop, as well as for our mobile devices (e.g. iPhone).
Email was set up using an existing service (via IMAP) that we were already using on our own domain name, with one "public" email address that everyone gets, and some private email addresses which are used mostly to route things internally.
Any downsides of settings things up this way?
Admittedly, the quality of VOIP phones can be a bit less than regular phone lines on occasion, but with a decent internet connection and decent network configuration, this can be greatly minimized. If you've never set up a network before you'll need to worry about things like purchasing hubs and/or switches, along with lots of network cables. RingCentral has good recommendations on their websites and instructions how to set things up, but its still not for the faint of heart.
Actually configuring the system (setting up phone lines, etc.) which is all done through the web interface can also be a bit complex, but the staff at RingCentral set up an appointment with you to figure out your needs and help you get all this working. We didn't use this because we were already familiar with the basic RingCentral service from using it at home.
And of course, the learning curve to use any business phone system is higher than it probably needs to be, but the Polycom phones we bought from RingCentral have nice large displays and lots of dedicated feature buttons that make this easier. I think it will be a while (if ever) before I install the desktop based "Call Controller" application for them to use.
Oh, and the one thing that still pisses me off about RingCentral's service is that they don't support Busy Lamp Field (BLF) which would show on the receptionist's phone that the doctor is currently on the phone with someone else.
Anyway, enough about that, but I'd be happy to provide more details on any specific piece.