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Modern Phone System, Cabling and Internet Connection Needs of Small Medical Office

Modern Phone System, Cabling and Internet Connection Needs of Small Medical Office

Here at Teltek, we offer free onsite technology assessments and consultations for all prospective customers. The information below are the findings and recommendations from a Maryland-based medical office that Teltek recently consulting with.


Following the needs assessment, I have identified several issues that I think are likely contributing to the phone system/service problems you have described. As we discussed when we met, I am certain that you have at least two issues, if not more.  I believe there are likely minor programing configuration issues in phone system which are occasionally directing the calls to the incorrect entity at various times or under unknown circumstances. I also think you have a two-part phone service issue with Comcast; trouble on the line and likely not having enough phone lines to meet your demand.  I don’t think your problems are resulting from the age/condition of the interior cabling, but it is old, dated and limits your options when evaluating new solutions. That said, if you choose not to replace the cabling as suggested below, I would recommend that you clean up the unused cabling in both the phone and server rooms at a minimum. Below is a summary of our findings and recommendations for your practice.

Internet and Phone Service:

Problems: You currently have Comcast coax internet which is an asymmetrical non-dedicated service with a “best effort” service level agreement (SLA). This asymmetrical service is providing download speeds that are 75-90% faster than the upload speeds causing delays in uploading information from your office to the web. This is especially problematic when using cloud-based technologies like EHR software, Microsoft 365, offsite data backup and VOIP. The shared service means there is one pipe of internet that is shared with a large number of other businesses and homes in the same area and you not guaranteed the speeds that you are subscribed to. Sometimes you will get the full speed and sometimes not, Internet speeds tend to slow when kids get home from school and are on social media sites; now more than ever with all the remote work and distant learning. The best effort SLA means that Comcast will not guarantee you uptime and does not prioritize service request as they do for their fiber-based internet customers. This often leads to more outages and sometimes a very long and difficult time to get recurring issues resolved. Finally, the coax service is an older copper-based infrastructure that is more prone to problems like to water (rain) and lightning; fiber is a glass infrastructure, does not conduct electricity and is not affected by water.

Solution: I am recommending that you move to fiber-based internet service to alleviate all the items detailed above and provide you with better and faster internet to open more technology options. Typically, fiber interest starts around $1K a month and is not available in all areas; fortunately, we have identified a low-cost alternative so I would suggest that we start with them to assess availability. Additionally, I would recommend a second internet provider (possibly keeping a reduced Comcast connection) and implementing a new technology called Software Defined WAN (SD-WAN). This enables you to use multiple lower cost internet providers to achieve the same results of more costly enterprise fiber connections. Essentially, it load-balances the internet traffic in real-time based on what data you are transmitting and how well the internet connection is performing. It also provides real-time failover between connections; so, if one internet connection goes out or has problems it will automatically failover to another connection without even dropping a phone call. We work as a broker with nearly every internet carrier available and typically assist our clients in sourcing and deploying new internet and SD-WAN services as part of our engagement.


Phone System:

Problem: You have a Vertical-brand phone system and due to being older and not a widely used brand, there are limited dealers in the area that service them. This is problematic because we are not experienced on this brand and do not have the knowledge to review the phone programming to see if we can identify any configuration issues. As stated above, I suspect you have some and they are contributing to the problems you described. Additionally, this is a premise-based phone system and the industry has widely moved to cloud-based technology. This rapid migration has put a massive strain on premise-based PBX manufactures, both financially and continued development of their premise-based technologies. Finally, many older premise-based systems do not meet new compliance standards such as HIPAA, Keri’s Law and the Ray Baum’s Act and STIR/SHAKEN (check out these links to the FCC.gov site to learn more).

Solution: I am recommending a Microsoft/MetaSwitch Cloud-Based phone system – this will bring you up to the current technology standard and address the new compliance requirements. It is also an open standard technology and fully integrated HIPAA compliant telework solution. Calls can be made from desktop phones, computers, smart phones or tablets from anywhere they can connect to an internet connection. The new telephone system will enable your users to simply take their desktop phones home with them and be fully integrated to answer, make and transfer calls. This also means that the new phone system is super portable, should you ever decide to relocate or expand your office. Additionally, cloud technology offers many collaboration features like instant messaging, integrated screen sharing, video calling, SMS text messaging from the business phone number. Teltek’s cloud phone system offers a 1:1 phone to trunk (line) ratio, this means that you will expand the number of concurrent calls from the current 12 lines to 35 (requested number of phones), enabling more patients to get through to your staff. Finally, because cloud phone system include phone service in addition to the phone system features, the new system will offset the current costs you are paying Comcast for local and long distance phone service; in many cases the VoIP system will actually save you money in addition to all of the added features and benefits detailed above.



Problem: The current cabling infrastructure is old, terminates to multiple splice points throughout the building, is not labeled and is extremely messy. Additionally, it is Category 3 standard which only supports analog technology. The current standard is CAT-6 which is an Ethernet standard and enables digital and TCP/IP technology (same as what interconnects your computer network):

Solution: I am recommending that you install new CAT-6 cabling throughout your building with a dedicated home-run cable to each desired telephone location. The new cabling will be properly installed to BISCI standards, properly tested and labeled. At the time of new cabling, I would also, strongly recommend installing a proper network rack and installing the existing computer network hardware and cabling as well as the new phone system/cabling. This will keep it secure, promote proper ventilation and make it much easier to troubleshoot and service both your voice and data networks.


We have prepared a preliminary quote for budgetary purposes only to begin; this will likely change a lot as we move through this process. I recognize this is a ton of information and would strongly suggest another call/meeting to review all this information and continue the discussion.


If you or someone you know would benefit from a similar technology assessment and review give us a call, we are here to help!

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