As a technology focused clinic, we're oftentimes asked by other small businesses and start-ups for technology related recommendations. Sometimes it's health care related; sometimes it's not.

This is the start of #TuesdayTechTips - a series of weekly (*hopefully) posts where we'll share our research and experiences. We'll cover issues as mundane as our printer and where we buy refurb toner cartridges, to core issues related to how our clinic organizes itself and communicates (*spoiler alert - we depend heavily on Trello).

To be clear, we're not experts in any of these topics - so please do take everything you read with a grain of salt. We'll do our best, but we may have overlooked options, or misstate things. Moreover, our conclusions are definitely skewed toward our own particular business needs.

To kick things off, we're chatting today about phone lines and phone systems.

Sounds simple, right? Buy a phone, have your local phone company install a line, and presto!

Unfortunately, for small businesses, there's a bit more complexity for reasons such as needing multiple phones that can communicate internally & externally, and a desire for phone trees and call queues.

Our take on things is that there are really four options:

Dedicated POTS lines
Onsite PBX
Cloud-Hosted PBX
Feature-Rich VOIP

Dedicated POTS Lines

What we mean by this are dedicated "plain old telephone service" (POTS) lines. This is what people are usually referring to when they say "landline" - the highly reliable system that has been in use for a 100+ years.

Upsides? It's super reliable & simple. Downsides? It's costly, especially if your business has many phones, and, as a system, doesn't have any of the advanced features that small business might want (e.g. extensions, call queues, phone trees, etc...). Expect to pay $20+/mo per phone line. Our take? Unless you're a super small business with just a couple phones or less, you need something more robust.

PBX

PBX stands for private branch exchange. Frankly, we still don't completely understand the concept - our grasp on this is that our internal phones connect to a PBX, and the PBX connects to the outside world, and as a result, the PBX is able to provide additional functionality such as call queues, phone trees, internal extensions, etc... as well as cost savings.

To use a more concrete example, we might, for example, have 10 phones connected to a PBX, and the PBX is in turn connected externally via three traditional POTS lines. In practice, any of the ten phones can call externally, but only up to three at a time; and up to three people can call in at any given time. The PBX also enables internal phones to call one another without needing to tie up external lines (by directly connecting the two phones).

An onsite PBX is where you buy a PBX and host it onsite. One big upside is that it's usually a one time cost (plus the monthly cost of phone lines to connect the PBX to the outside world), but there's the need to install, maintain, and configure the PBX.

A cloud-hosted PBX is where you use internet-enabled phones, and connect the phone to a PBX that is hosted and maintained externally. You've outsourced all the technical work, and there's usually no upfront-fee, but you'll be paying a monthly fee per phone that's comparable to dedicated POTS lines. It's still potentially advantageous though since having a PBX gives you those advanced features mentioned above.

Feature-Rich VOIP

From our point of view, this last option of a feature-rich VOIP provider is very similar to a cloud-hosted PBX. Indeed, we've never quite gotten a straight answer as to why exactly they're different. This is the option that we use and, in practice, our internet enabled phones simply connect to an online server and we configure everything via a web dashboard hosted by the VOIP provider, similar to how we envision a cloud-hosted PBX would work.

Frankly, it might just come down to pricing. Most feature-rich VOIP providers offer per-minute pricing whereas most cloud-hosted PBX providers offer monthly flat fees per phone.

Why does this matter? As businesses move online, while phones remain a critical tool, their use is decreasing. Especially for a clinic such as ours with nearly 15 phones sprinkled about, paying $20+/mo for each phone to sit idle for probably 99% of the time is wasteful. With feature-rich VOIP providers, we can have 15 phones sprinkled about, but only pay for the time that they are used. The net result? We pay, in total, only about $15/mo for phone service, a nearly 95% monthly cost-savings.

On top of that, here's some of what we're able to do:

callers are presented with a phone tree that lets us direct them to the right information or the right staff member;
different information can be presented by the phone tree depending on the time of day / day of week;
staff can take and make calls from different locations (e.g. their personal home) very easily;
callers can be placed into a call queue;
we have no practical limit on the number of simultaneous incoming or outgoing calls;

So who exactly do we use? Choosing a specific provider is a whole other discussion that we may get into another day - suffice it to say for now, we use Voip.ms and we're delighted with this company and their service. They're priced right, reliable, and feature-rich. If you're thinking of trying out this option of a feature-rich VOIP provider, in our view, Voip.ms is definitely worth a serious look.