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CMC System Redundancy
Tom_Sheridan24During the summer of 2004 MedCom invested in a revolutionary new call processing and database system called the Call Management Center (CMC). This new system was developed by the Startel Corporation in Irvine, California. During the 1980s Startel was a pioneer in developing "paperless" messaging systems and MedCom has upgraded to several new Startel platforms since we were founded in 1987.

With the release of the CMC in 2004, we are now able to manage complex information in ways that were not possible before. The CMC has enabled us to expand our role from being a messenger to that of managing information. For example, we can now access different message forms depending on time of day, day of week and type of call. This way we consistently get the exact information required by our clients. The CMC platform uses Microsoft SQL 2005 database software which has allowed for many longstanding wish list items in our call center to become a reality.

Redundant Hardware - In the summer of 2005 we purchased a second CMC system and installed it in our building so we would have a fully redundant running "spare" in the event of a main system hardware failure or system problem. While this did cover us for the majority of potential hardware problems, it still did not go far enough to recover and transfer our database to the backup system to minimize downtime and disruption in the event of a system problem. Updating and maintaining data on two separate systems for a 24/7 business is not a simple task.cmc3

MedCom reached another significant milestone in late 2006. Working in conjunction with our prime system vendor, the Startel Corporation, MedCom was able to implement SQL transactional replication between our live database server and our backup CMC system. Our customer database is now being replicated and updated every twenty minutes to our backup system located in the opposite end of MedCom's building. This added capability enables us to quickly transfer our operations from the running system to the backup system and minimize any disruptions to our clients. Full operations can now be transferred to the backup system in about twenty minutes.

For additional system protection and redundancy, we also employ an off-site data vault storage company where we store a back-up copy of our entire customer database each night. This off-site data storage would allow MedCom to quickly restore our database in the unlikely event of a facility disaster that impacted both of our redundant system servers, such as a natural disaster or a computer virus.
Continuous Reliabilty
Systemwide Battery Backup - A systemwide battery backup provides several levels of protection. High capacity batteries when used in conjunction with power conditioning equipment serve as the “shock absorbers” in electrical surge protection. Clean power helps ensure a reliable operation while extending the life of electronic equipment. In addition, when there are the occasional momentary lapses in electrical power, the battery backup system kicks in and delivers continuous power. In the event of a complete power outage, between the time the lights go out and the backup generator comes on, the battery backup must provide full electrical power. If ever necessary, we can keep all of our equipment, including the computer system, and all related telephony equipment operating for up to two hours on battery power alone.

Generator1235 KVA Back-up Generator - A 35 KVA Back-up Generator was installed at MedCom during the summer of 1999 and this investment was made for several reasons. First, because of the critical nature of many of the calls we handle, we wanted to provide the highest reliability possible. Of course, without electrical power it is not possible to process calls at all. Even though the battery backup and portable generators had served us well, we were concerned about Y2K (remember), electrical shortages in other parts of the country, and the possibility of severe weather disrupting utility power for a sustained period of time.

Our backup generator is clean, quiet, completely enclosed and fully automatic. In the event of a power outage it switches on right away, and can run everything in our call center including the heating, air conditioning and outside security lighting. Our management and our clients have the added peace of mind that no matter how long the utility power is off we can continue normal operations. There is no disruption or inconvenience to our clients nor to any of our employees. This demonstrates the MedCom level of commitment to excellence that sets us apart from other call centers and answering services. At MedCom, we want to do everything possible to ensure reliability for our clients.
Digital Clarity
Startel_CMC2Responding to the needs of our clients and to the changes in the tele-communications industry, MedCom Professional Services began the conversion from analog to digital technology back in 1997 with the investment in a StarTel 5700 digital switch. This intelligent, highly responsive system provides us with capabilities that far exceed ordinary telephone answering service centers. Fast call set-up time, crystal clear digital sound, and “Caller ID” captured directly to each message slip, are examples of what sets us apart. In addition, our StarTel 5700 system is fully networked and Internet enabled.
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In 1999, we had a fiber-optic link installed from our switch room directly to our local telephone company central office. This digital fiber technology brought our customers clearer, faster telephone connections and enhanced reliability. Then in late 2001, we further upgraded our telephone service to level one “On-Net,” meaning we now have a fiber link for all local, regional and long-distance communications, direct to our carrier, without having to be switched through our local central office. A direct connection adds reliability, especially during peak calling periods, and in essence, we are our own local phone company.
Documentation
Our system has many other features all designed to make our job of taking and relaying messages more efficient and more reliable. You should know that our system can automatically track calls with “actions” that give on-call personnel ten or fifteen minutes to reply to a page. If they don’t respond, the message automatically reverts back to the dispatcher’s screen for follow-up. This feature is like a built-in “alarm clock” that ensures all important messages are delivered promptly.
ReportsEvery step of taking and relaying messages is documented by our system. If there ever is a question regarding the handling of a message, the documentation will show the staff involved, and what was done with that call. This includes the on-call(s) contacted, how they were contacted and how much time elapsed between the time of the call and when the message was given to the on-call person.

Our call documentation is stamped in each message slip and is included in your daily fax message reports and/or daily e-mail message reports. With these reports, our clients can confirm the quality of our work as well as the response time of their on-call staff. For a modest additional charge, we can also provide message archiving service whereby we save a copy of each message for up to three years, just in case there would ever be an issue pertaining to one of your calls.
Messaging Protocols
  • SMS (Short Message Service / Text Messaging)

Short Message Service (SMS) is a communication service standardized in the GSM (Global System for Mobile communications, using standardized communications protocols allowing the interchange of short text messages between mobile telephone devices. Text messaging, or texting is the common term for the sending of "short" (originally 160 characters or fewer, including spaces) text messages from mobile phones using SMS.

SMS text messaging is the most widely used data application on the planet, with 2.4 billion active users, or 74% of all mobile phone subscribers sending and receiving text messages on their phones. The SMS technology has facilitated the development and growth of text messaging. The connection between the phenomenon of text messaging and the underlying technology is so great that in parts of the world the term "SMS" is used as a synonym for a text message or the act of sending a text message, even when a different protocol is being used.

SMS gateway providers facilitate the SMS traffic between businesses and mobile subscribers, being mainly responsible for carrying mission-critical messages, SMS for enterprises, content delivery and entertainment services involving SMS, e.g. TV voting. Considering SMS messaging performance and cost, as well as the level of messaging services, SMS gateway providers can be classified as aggregators or SS7 providers.

The aggregator model is based on multiple agreements with mobile carriers to exchange 2-way SMS traffic into and out of the operator's SMS platform (Short Message Service Center - SMS-C), also known as local termination model. Aggregators lack direct access into the SS7 protocol, which is the protocol where the SMS messages are exchanged. SMS messages are delivered in the operator's SMS-C, but not the subscriber's handset, the SMS-C takes care of further handling of the message through the SS7 network.

  • SMPP (Short Message Peer-to-Peer)

The Short Message Peer-to-Peer (SMPP) protocol is a telecommunications industry protocol for exchanging SMS messages between SMS peer entities such as short message service centers. It is often used to allow third parties (e.g. value-added service providers like news organizations) to submit messages, often in bulk. SMTP is a relatively simple, text-based protocol, in which a mail sender communicates with a mail receiver by issuing simple command strings and supplying necessary data over a reliable ordered data stream channel, typically a Transmission Control Protocol (TCP) connection.

An SMTP session consists of a series of commands, initiated by the STMP client, and responses from the SMTP server through which the session is opened, operating parameters are exchanged, the recipients are specified, and possibly verified, and the message is transmitted, before the session is closed. The originating host is either an end-user's email client also known as mail user agent (MUA), or a relay server's mail transfer agent (MTA).

  • SMTP (Simple Mail Transfer Protocol)

Switch_Room3Simple Mail Transfer Protocol (SMTP) is an Internet standard for electronic mail (e-mail) transmission across Internet Protocol (IP) networks. SMTP was first defined in RFC 821 (STD 10), and last updated by RFC 5321 (2008) which includes the extended SMTP (ESMTP) additions, and is the protocol in widespread use today. While electronic mail servers and other mail transfer agents use SMTP to send and receive mail messages, user-level client mail applications typically only use SMTP for sending messages to a mail server for relaying. For receiving messages, client applications usually use either the Post Office Protocol (POP) or the Internet Message Access Protocol (IMAP) to access their mail box accounts on a mail server.

Please Note: While this protocol is popular, it was not designed for paging and as such it is not time sensitive, there can be delays in the receipt of the email depending on the routing (this does not have anything to do with the software but the design of the protocol).

  • SNPP (Simple Network Paging Protocol)

Simple Network Paging Protocol (SNPP) is a protocol that defines a method by which a pager can receive a message over the Internet. SNPP is a standard for sending one and two-way wireless messages to paging devices. SNPP provides a simple way to make a link between the Internet and a TAP compliant paging terminal.

It is supported by most major paging providers, and serves as an alternative to the paging modems used by many telecommunications services. The protocol was most recently described in RFC 1861. It is a fairly simple protocol that may run over TCP/IP (using TCP port 444) and send out a page using only a handful of well-documented commands.

  • TAP (Telocator Alphanumeric Protocol)

The Telocator Alphanumeric Protocol (TAP) is by far the most common way to send full-text messages to pagers is through the TAP protocol. The Telocator Alphanumeric Protocol (TAP) is the paging industry's method of a computer talking to a paging terminal.

The Telocator Alphanumeric input Protocol (TAP) has become the paging industry standard protocol for sending page requests from automated equipment, computers and other data-entry devices to radio paging systems. The TAP protocol primarily is used to forward one or more alphanumeric pages over a single telephone connection. TAP is a digital communications protocol, which operates through dial up modems or dedicated RS-232 serial I/O connections. Nearly 100% of paging systems in the U.S.A. and a large percentage of paging equipment outside of the U.S., provide public access TAP connectivity.

  • WCTP (Wireless Communications Transfer Protocol)

Wireless Communications Transfer Protocol (WCTP) is a standard for sending one and two-way wireless messages to paging devices over the Internet. WCTP provides a simple way to make a link between the Internet and a TAP compliant paging terminal.

Paperless Messaging
Training_Room5Paperless Messaging has many advantages over handwritten messages. Two or more CSRs can view messages simultaneously, and all associated call documentation is very precise. For example, when a message slip is created, the CSR’s initials as well as the date and time are stamped into the message. This is unalterable, so there is never a question as to who took the message or what time the call was received. Another advantage of our system is that the originating number (Caller ID number) is automatically captured and inserted into every message slip whenever it is available. This way, unless the caller’s number is blocked, we have the originating phone number as a back-up, just in case the number given by the caller is incorrect.
Service Levels
At MedCom, busy signals are a rare event. "Busies" rank up there with long hold times in the bad customer service department.  Busy signals are annoying to the caller. It also means a delay and having to call back again. When a caller receives a busy signal because of an answering service, it usually means there are staffing issues or inadequate inbound phone lines, or both. With insufficient staffing to handle a given call volume, the lines fill up until all overflow callers receive busy signals. A busy signal means there is no path for the call to reach the service.
 
Busy signals can also be generated by the phone company when caused by network problems or equipment problems, which are outside of our control. The telephone company will usually provide a generic recording or a "fast busy" when this happens.
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MedCom addresses the busy signal issue by first ensuring that we have plenty of inbound talk paths as part of our overall digital network design. We maintain excess inbound call capacity even during peak calling periods. This way, all calls forwarded to us can actually get to us. The second part is staffing. Since call volume constantly varies, there must be enough staffing in place to handle spikes and fluctuations in call volume. To ensure the highest service levels, at MedCom we tend to overstaff on most shifts and schedule one or two extra CSRs. This greatly reduces stress in the call center and generally allows us to spend the extra time for genuine courtesy and allows us to double check our work.
 
Our service levels are such that three out of four calls are answered live, and when a call is placed on hold, usually through a personalized auto attendant (PAA) greeting, or a call screen, it is only on hold for less than 30 seconds. Our hold times average about 20 seconds. Because our staffing levels are so strong, we can stay on each call until it is completed, without interruption, and all calls can reach us without delay.
 
Note: During severe weather, and weather-related emergencies call volume can increase dramatically. Please use discretion when calling medical facilities during such times as longer hold times and busy signals are likely. True emergency calls can be delayed because of high call volume generated by non-essential weather-related calls.
Timed Actions
startel_actionsOur system has many other features designed to make taking and relaying messages more efficient and more reliable. You should know that our system can automatically track calls with timed actions that give on-call personnel ten or fifteen minutes to reply to a page. If they don’t respond, the message automatically reverts  to the dispatcher’s screen for follow-up. This feature is like a built-in “alarm clock” that ensures all important messages are delivered promptly.