When Summit County, Ohio, consolidated three public health agencies, voice over IP was the only choice for replacing legacy telecom systems.
In 2010, Summit County, Ohio, and the cities of Akron and Barberton decided to merge their separate public health agencies into a single department. The consolidation took effect on Jan. 1, 2011, with the creation of Summit County Public Health.
“And then the fun starts,” said Cory Kendrick, the department’s information systems manager. “You have three separate entities with separate IT systems and separate telephone systems, so how do you bring that together?”
Change is never easy and after its first year the consolidation remained a work in progress, but in that time the combined agencies realized a savings of about $1.5 million, a significant chunk of which is coming from the new IP telephony system from Digium Inc. that replaced legacy analog PBX systems. With savings in maintenance and line fees expected to be $100,000 or more a year, the Digium Switchvox VOIP system is expected to pay for itself within four years.
A report from Kent State University on the first year of the consolidation identified IT and telecom as one of five major operational challenges to the consolidation.
“These conversions required re-tooling more than one hundred computers and setting up new back-up systems, as well as establishing new phone numbers for employees and establishing interoperability across phone systems in multiple facilities,” the report said. “While these unavoidable changes have now been largely accomplished, they were disruptive to agency personnel, operations, and services.”
But not nearly as disruptive as they could have been, Kendrick said. “On the plus side, Summit County had a pretty robust infrastructure already,” that was able to easily accommodate the smaller IT systems of the Akron and Barberton public health operations. Databases were consolidated and 11 offices for the new department around the county were linked with existing fiber optic cable where possible, and with fiber and cable leased from telecoms where necessary.
“An aging telephone system was the challenging piece,” Kendrick said. The new department got authority from the Board of Health to buy the Switchvox system in September 2011 and the equipment arrived in November, in what proved to be a case of good timing. “Our old system just died,” he said. “It forced an upgrade instantly.”
The new phones already were on desks and “we had telephones ringing again almost instantly,” Kendrick said. Still, “it was a huge learning curve for our main office of about 100 employees. It was a rough first week, but we had everybody up and running in a day or two,” undoubtedly much more quickly than if the old system had died without a transition system already in place.
The VOIP upgrade for 10 of the 11 Health Department offices was completed in May 2012 (the 11th office is too small to warrant extending the system to), but the system still was being tweaked in November. “The technology was the easy part,” Kendrick said. Configuring infrastructure and porting phone numbers for various agencies was the real challenge, and routing policies for the automated call attendant are being fine tuned to get the most efficient performance not only from the equipment, but from staff.
As departments go, the consolidated Summit County Public Health is not large. It has about 260 employees with about 350 phone lines in 11 locations throughout the Northeast Ohio county. It handles a wide range of tasks, however, from immunizations and clinics for overseas travelers to testing for and tracking HIV and sexually transmitted diseases and reporting communicable diseases to the federal Centers for Disease Control and Prevention. It performs environmental health and air quality monitoring as well as performing inspections of hotels, restaurants and public swimming pools.
Bringing together three different staffs to work under a single department was difficult, but the job is eased a little by a unified IT system that now has a standard software configuration and a planned replacement cycle.
The decision to replace the old Nortel PBX system with a voice over IP system was not difficult. “It was given,” Kendrick said. “If we were going with something new, it had to be VOIP to give us the flexibility we needed.”
Kendrick already had experience with Switchvox from an implementation he did while working in the county engineer’s office that saved $30,000 on system costs alone.
For the new health department, the Switchvox solution, offered through the Cleveland-based integrator N2Net Inc., came in about $200,000 under the offering from Cisco, said Mark Amick, Digium’s director of product management.
Switchvox is the commercial version of the Asterisk open-source VOIP platform, which is managed and maintained by Digium. The company’s commercial offerings began with network cards for connecting the open-source Asterisk PBX servers to telephone systems. But about five years ago, as Session Initiation Protocol was becoming ubiquitous and SIP Trunking could deliver unified communications to IP PBXs, it began looking for other sources of revenue. Switchvox is an appliance-based PBX based on Asterisk, but with a graphical user interface and technical support. It is shipped on a purpose-built Intel-based server that can scale to meet the customer’s needs. Digium also offers its own SIP handsets.
The system typically is used in small-to-medium business environments with 400 or fewer users and provides the full range of unified communications functionality, from basic call handling to integrated voice mail and e-mail, call forwarding and call routing through Interactive Voice Response. Call routing supports call centers by routing and queuing calls for multiple answering stations.
The browser-based Switchboard interface can provide receptionists or operators with a view of the system and enable drag-and-drop transfers without looking up phone numbers.
“The system is very easy to configure,” Kendrick said. “I didn’t have any formal training. I bought the system and figured it out. The technology was the easy part.”
The challenge was in managing the phone numbers for the three agencies that had each been operating independently until 2011. It turned out to be surprisingly complicated to track down all of the numbers and find out who was using them, especially with personnel being reassigned to new offices and positions, and this had an impact on operations, the Kent State study found.
“While these changes in telephone systems and operations are now largely in place, employees reported that the process of making these telephone system changes caused significant disruptions in some cases,” the report said. “Some telephone numbers were effectively abandoned (at least for periods of time) and resulted in messages left by callers that were not returned in timely fashion. In other cases, calls were routed to numbers with misleading messages.”
This left some workers less than happy with the transition. In an employee survey for the Kent State study, 62 percent called the consolidation an ongoing process with expected ups and downs, 22 percent called it very problematic and 11percent called it “a major problem with very negative consequences.”
But discovery of the numbering systems has continued and routing policies have been tuned to help ensure that calls end up with the right person, and there is no denying that the consolidation saved money almost immediately. Total funding for the separate agencies in 2010 totaled about $10 million, and for the consolidated department in 2011 it was about $8.5 million, a savings of $1.5 million or 15 percent. Most of that was realized in the city of Akron, which saw its health department costs drop from about $6.6 million in 2010 to $5.26 million in 2011, a savings of a little more than $1.3 million.
The consolidated department has maintained its services while cutting costs and has the capacity to improve them, the study concluded. “The new consolidated department has greater expertise and programmatic capacity than any of the individual health departments that preceded it,” it said. “The capacities of any one of the original departments can now be made available to citizens throughout the county without referrals across organizations.”