New additions to

So it's been a while since I've added to  Here are a few standounts from the 20-or-so recent submissions that I added today.  If your blog was submitted but it doesn't yet appear in Medlogs – chances are that you don't have a valid RSS feed (, msspnexus blog, etc) or that our editorial board (me) decided that the weblog has commerce as a primary goal rather than the sharing of information.  Some blogs are on-the-edge of this (such as and have been added to the "more"section. 

  • Christina's Considerations focuses on "workplace effectiveness, regional health information exchanges and health information technology, and healthy children and families."  She recently posted a sample RHIO executive director job description. 

    RHIOs are all-the-rage these days – and our area is no different.  Trouble is – no one can agree on what a RHIO should be.   My concern is that the primary goal of a RHIO – to improve the care of the patient – is often secondary to more selfish goals of an orginazation.  Unless the providers ina  community cal really agree on the basic principles – a RHIO is not likely to succeed. 

  • Dr GNU is a podiatrist and has interests in open-source software.  Not many posts yet …
  • The Fat Doctor.  'nuf said?  Excellent.
  • Cosmic Watercooler is a nurseblog:
        "I am an RN and I don't know why.
         I like it, but the pay sucks.
         I have a wonderful family and that's all that matters."
  • The Healthcare IT guy and Neil Versel's Health IT Blog are about .. um .. healthcare IT.
  • And of course .. there is a new bird flu blog.

There are many more .. and as always – the resident/student blogs offer some of the best ..

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Web Host Trouble

The Web host that provides services for and has had some difficulties recently.

About 10 days ago (as you may have noticed) the server was down for about two days.  This is because one of their servers (srv2) needed to be replaced. they moved all of the clients off of that machine and onto new machine (srv3). 

Today's difficulties are described in their response to the trouble ticket pasted below.

Unfortunately, they made no mention of this on their web site – and the whole thing bothers me enough that I think it might be time to move to new Web host that offers some redundancy or just move it to one of the servers that we host ourselves.  Originally, we were on a very inexpensive plan with this host, and "you get what you pay for" was understood and accepted.  At this point, we are paying $30 per month in light of the band with required to support

I think for that much, a little redundancy would be in order. 

VOIP in Healthcare – Version 1.0

Since my post about 5 weeks ago on the SwitchVox PBX .. lots has happened .. including at least one patient who decided to leave the practice because our phone system was broken .. and many more who were frustrated .. and a sleepless night or two for me.

The story will be told – but I don't have the time (or the typing skills to tell it now). 

Short version:

  • VOIP has a rolein healthcare are and will improve patient care and service.
  • SwitchVox is good software. Not great (yet) but quite good.
  • Four Loop Technologies (developers of SwitchVox) is an excellent company and their tech support is extraordinary.  Even with good software – there needs to be good support.
  • Time Warner Telecom has very good 24 x 7 tech support.
  • After several weeks of post-live troubleshooting  (after weeks of beta testing) … The SwitchVox team determined that the Time Warner Telecom hardware  was sending out-of-spec ISDN messages to the PBX.  Since SV is based on Asterisk – this problem would occur in any environment running Asterisk.  Our problem was that the system would disconnect calls.  At first it seemed random – but eventually we figured out that it was happening only on outgoing calls that went through the IDSN PRI circuit.  So I routed all outgoing calls through VOIP providers for a few weeks while we sorted things out.  Brian, from SV's tech support team, was able to log in to our server, log the errors and then patch Asterisk so that it ignored the out-of-spec messages coming in from the Time Warner hardware.  (and that's the short version!)