Ring, Ring, Why don't you give me a call?"

My 4th Class textbook was confident that the telephone was invented by Alexander Graham Bell in 1876. His rather uninspiring first words were said to be “Mr Watson, Come here, I want you”. What Mr Bell wanted Watson for was not documented in ‘Social Studies for 4th Class’, 1972 edition.

Travel broadens the mind. I have recently journeyed to Italy, (well, New Italy, Woodburn, if we are going to be accurate), where I visited a museum devoted to that great Italian inventor, Antonio Meucci, and to the telephone he demonstrated in 1849!

Indeed, Wikipedia informs me that the British government has recently decreed that schools are to acknowledge Meucci as the first inventor of the telephone. (In Australia our post modern curriculum doesn’t bother itself with that sort of stuff). It appears that the major beneficiaries of the new technology for the first 50 years were patent lawyers.


So that’s the POTS (Plain Old Telephone Service). You speak into a diaphragm at one end, the vibration of which causes a diaphragm at the other end of a wire to vibrate the same amount, producing sound. Not much change in the last one hundred years (if you disregard the development of the electret microphone, the manual switchboard, the rotary dial, the automatic telephone exchange, the computerised telephone switch, touch tone dialing, roads, law and sewerage).


Now for the PANS (Pretty Amazing New Stuff). Telephony is going digital - in the same way that digital CDs have replaced analog LPs, and digital DVDs have replaced video tape. The advantage of this is that you can make calls via the Internet - bypassing the telephone network, and therefore Telstra and its phone bills. As the Internet network is used, this technology is often known as VOIP (Voice Over Internet Protocol), or Internet telephony.


The main advantage of VOIP is that it is cheaper than normal telephone calls - in fact, it can be free. There are other advantages with regard to mobility - instead of being tied to a particular physical telephone, your VOIP number can follow you wherever you happen to be. To use VOIP, you do require broadband Internet access, and it is better with unlimited or high data transfer limits.

The clarity of a VOIP call can be quite variable, depending on the Internet access speeds of each participant, the congestion on the network, and the quality of the microphone and speaker used. Sometimes the conversation can be crystal clear, sometimes there will be considerable delay, and ‘jitters’.

So, how do you use VOIP? There are two main ways - one using your computer, with or without accessories, and one using your normal phone.

VOIP Using Your Computer

Using Internet telephony via your computer requires special software. There are a number of options, but the most widely used is Skype (which has recently been purchased by eBay). The Skype software is available free of charge for MacOS X, Windows and Linux. It is easy to set up - you download and install the software, and then register a username and password with Skype. To phone someone who also uses Skype, you search for their username from the Skype database, and press dial. Hey presto - if they are also online, their computer will ring, they answer and you can speak to them through your computer microphone and speaker. There is no charge at all for a Skype to Skype call, from anywhere in the world, to anywhere in the world.

Video conferencing, multi-user audio conferences, text messaging and file transfers are also possible with Skype.

Skype Out

What if the person you are calling is not set up for Skype, but just has a plain old telephone? No problem. You can get an account with Skype that allows you to call from your computer to nearly any phone number in the world, for about 2c a minute. This is a boon when traveling.

Skype In

You can also obtain a phone number through Skype, through which anyone with a phone can contact you. So if you live outside of Sydney, you can still obtain a Sydney SkypeIn number that will enable your family and friends to ring you for a local call. If you do a lot of work in New York, lease a New York SkypeIn number.

VOIP Without A Computer

A number of companies now make it possible to use VOIP services without a computer, although you do need to have a broadband account. For example, the company Engin sells a Voice Box, which you connect to both your broadband line and your existing phone line. After a $10 monthly charge, untimed local calls can be made to anywhere in Australia for 10c, and overseas for 3.5c / minute. Engin to Engin calls are free.

VOIP At Work

VOIP technology is now often used by companies for their internal telephone systems. North Coast Radiology uses the Asterisk open-source VOIP system to manage calls between their scatterred radiology suites, creating a private exchange that extends over 800km from Sydney to Mullumbimby. Dr Nick Repin is responsible for implementing the system, which has some cool functions that would be impossible to implement without digital telephony. As he says ‘The Linux PBX allows integration with the other IT systems in the organisation to a level we’d never have dreamed of a few years ago.’

For example, to call Nick internally, just dial his initials - ‘nr’. Cleverly, the software looks up the staff rosters to determine where the call should be forwarded - it knows whether he is working that day in Byron Bay or Casino. The prefix 7 enables role based dialling - ‘7012’ will get you the on call radiologist, wherever he or she is.

Nick says ‘Asterisk based conferencing has also been a major benefit, as calls from all internal phones and indials can be joined together simply into (free!) conferences. We are finding this exceptionally useful.’ All the VOIP phones can dial out into the ‘normal’ phone system - so to ring me as the doctor who referred a particular patient for an X-ray, Nick simply has to click the ‘Referrer’ button in the patient’s window of his reporting software, and I’ll be rung.

The division has applied for a government grant to manage a broadband ‘Health Network’ that, among other things, would facilitate the widespread adoption of VOIP by health providers in this region. All calls between health providers and institutions would therefore be free, and we would have the capacity to utilise some of the technology used by North Coast Radiology. Need the on call surgeon - dial ‘8surgeon’!


Luckily, you can spend all the money you save on calls by buying VOIP-related gadgets! You can decrease feedback and improve the clarity of your calls by plugging a headset into your computer. There are also a number of USB phones available, that look like normal phones but attach to a USB port. At home we have a cordless ‘dualphone’, the base station of which plugs into both the computer and the normal telephone socket. It communicates directly with the Skype software, so that you can access your Skype address book from the phone, and make and receive VOIP calls without needing to be seated at the computer. You can, of course, also make and receive normal phone calls from the same phone. And ‘hot off the press’ is the introduction of mobile VOIP phones, which connect to Skype and make free calls without a computer from any wireless hotspot. Sweet, as the gadget kids would say.

Posted in Australian eHealth

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