The Cloud (still)Doesn't Support VoIP

Shawn Wiora, CIO & CISO, Creative Solutions In Healthcare
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Shawn Wiora, CIO & CISO, Creative Solutions In Healthcare

As the CIO of the first medium-to-large healthcare company in the U.S., to be 100 percent in the cloud, many have asked how we manage VoIP. Answer is easy – we are not. I wish we were in the cloud with VoIP. I wish we were using VoIP. Love the ideas of additional features, economies of scale, and cohesive networking.

Creative Solutions In Healthcare is the largest independent owner and operator of skilled nursing facilities in the state of Texas. With almost 6,000 employees, 80 locations and 1,000s of residents, we look to bring the best technology to the company.

Verizon VoIP

As a young technology-based manager at Verizon in the 1990s, I launched the company’s VoIP line of business. Since then, Verizon has become one of the world’s most capable and innovative VoIP providers – especially on a wholesale basis. In addition to having tremendous support from Verizon’s management team, the company had a 50-person R&D facility in Waltham, MA, where a stream of VoIP innovation took place. Patents, products and profits were all launched from Verizon Labs based on the early work done in my VoIP department. At that time we quickly focused on innovative QoS solutions to support this new technology. We suggested CD-QoS, HD-QoS, etc.

Cloud Fundamentals

Scale, flexibility, economies and improved security are a few of the cloud’s advantages. Our goal at Creative Solutions In Healthcare, in the IT department, is to be the best. We pride ourselves on being the first at many technologies. But delivering the best IT services is what we are passionate about. With that fundamental goal in mind, we believe the most important of all cloud benefits relates to human resources. How could a top rated, medium-sized healthcare company in Texas hope to attract, hire and retain the best of networking engineers, security experts and virtualization architects? We’re talking about the best people in the industry. Not so easy – especially because we don’t offer any options for our employees. Good compensation packages – yes, options – no. The answer here is that we don’t hire them, we rent. We rent them through our cloud providers.

  ​The answer for Cloud VoIP rests upon a futuristic notion that the cloud VoIP providers will have a cloud-based VoIP service that is guaranteed to be 100 percent reliable 

Criteria for Success and Why POTS is clearly BEST

It’s clear, simple, the criteria for our IT department are based on the level of happiness and love between the IT department and our IT users. And speaking of clarity, VoIP has been riddled for two decades with complaints of audio quality problems from network delay, jitter, packet loss, bursts, gaps, codecs, or some combinations of these problems. Users have issues within their own company’s VoIP dialing plan. There are more frequent issues with VoIP domestic calls. And international VoIP calls almost always have issues. Even if these items were properly addressed with fantastic equipment, full-blown private networks and the best resources, there’s the remaining ongoing issue of “tracking network performance”. Having to hire an internal administrator responsible for ensuring VoIP quality would be another hire, that isn’t easy to find. Of course, the admin tools available help IT staff dig deeper into the statistics and you can determine why things are failing, what is causing jitter, delay or packet loss. If the criteria of success is giving IT something to give your staff some toys to play with, then I’d say go ahead, VoIP it up.

The answer for Cloud VoIP rests upon a futuristic notion that the cloud VoIP providers will have a cloud-based VoIP service that is guaranteed to be 100 percent reliable with HD quality voice. (Think iPhone FaceTime audio – but available 100 percent of the time, no exceptions.) If your criteria of success is to have a system that is 100 percent reliable, consistent and clear, then stay with Plain Old Telephone Service (POTS) like we did and plan to do going forward. And here’s the kicker - costs for POTS lines have dropped so much that it’s super inexpensive to buy and support. But wait – there’s more, training costs for users is about 10percent of VoIP. And in healthcare, we have not found any VoIP features that we can’t support via other enterprise apps (many already in use). I’ve asked every CIO and VoIP vendor I can about this question: are there any documented cases whereby a VoIP implementation resulted in fewer trouble tickets to a company’s internal IT helpdesk?

So, go ahead and put away the toys. Pull out your POTS, dust them off, and be the best you can be for your IT users.

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