April 2004

Peribit Boosts VoIP Performance For Health Care Call Centers

BY DAN LEARY

Many companies are turning to VoIP as an easy way to slash communications costs while improving user feature sets, but adding VoIP to an existing wide-area network (WAN) can spell trouble if the network can�t handle the additional traffic. Hines and Associates, Inc., is a case in point. Hines is a nationwide healthcare management firm that hoped to reduce communications costs by deploying VoIP among its offices in Illinois, Iowa, and Virginia. But when call quality suffered due to WAN performance issues, Hines faced the prospect of spending an extra $40,000 per year for larger WAN pipes. Instead, Hines found another way to ensure quality VoIP performance without WAN upgrades

Founded in 1987, Hines & Associates is a healthcare utilization review and case management firm that helps its customers � enterprises, insurance companies, municipal governments, and other large organizations � conserve healthcare dollars. Much of Hines� work is done directly with insured patients and their families, so Hines must ensure quality telephone communications with its customers and their employees. Hines is headquartered in Elgin, Illinois, but serves more than two million patients, from 25 offices nationwide. To handle most of the initial patient contacts, Hines maintains call centers in Elgin and Rockford, Illinois.

TECHNOLOGY CHALLENGE

As Hines� business has grown, so have its communications demands. While its call centers typically handle initial calls from patients for authorization or other services, many patients are often redirected to other Hines employees for specialized evaluations or information. Hines began investigating a migration to VoIP in 2002 as a way to reduce its infrastructure costs and to facilitate intra-office call transfers. In November of 2002, Hines deployed Nortel IP PBXs in its two call centers as well as in offices in St. Charles, Illinois; Panora, Iowa; and Virginia Beach, Virginia. The Nortel system was deployed in a central hub configuration.

While initial testing and network engineering by Nortel had shown that there was enough bandwidth over all of the intra-office links to enable high-quality voice connections, this proved not to be the case. �We estimated that we would be overflowing only two to three calls at a time from one call center to other locations, but by early 2003, we were dealing with 10 overflow calls at a time, and we started getting call quality degradation.� said Hines IT director Carl Valiulis. �We were also having some other network performance issues related to printing Citrix documents across the WAN.�

Valiulis and consultants from other network equipment providers felt the problem was a combination of application contention and bandwidth capacity. Hines� call volume was on a rapid growth curve (up 250 percent in 2003), and the WAN links to four of the VoIP sites were 256 Kbps and 512Kbps. The team reasoned that between Citrix, HTTP, SQL, Net BIOS, and the rising VoIP traffic, some of the links were either overcrowded or simply not dealing efficiently with the traffic mix.

ALTERNATIVES CONSIDERED

One obvious solution to the problem would be to increase bandwidth across the WAN. However, Valiulis found that upgrading the five WAN connections and adding a second router at headquarters to support a second T1 line would cost the company an additional $48,000 per year. As an alternative, Hines� router vendor suggested using router-based compression and QoS features to manage the traffic flow. Upon testing, however, the vendor�s compression solution reduced traffic only about five percent, while its compression and QoS mechanisms were expensive to set up and administer.

�We started looking at stand-alone bandwidth optimization solutions because we wanted something that would deliver a lot of additional bandwidth, give us real-world traffic prioritization tools, and allow us to monitor and troubleshoot the network easily,� said Valiulis. His team evaluated products from four different vendors, including Peribit. Bandwidth optimization solutions sit at each endpoint of a WAN link, compressing and decompressing traffic.

�Once we did port mirroring with Peribit�s SR-20 product, we didn�t move forward with the others,� said Valiulis. �We saw the highest overall average data reduction (72 percent), and all of Peribit�s QoS and monitoring tools had a simpler interface than the other vendors� products.� Because of their strategic location in the WAN, Peribit systems provide a comprehensive, real-time view of traffic at the packet level, along with the ability to set QoS priorities.

SOLUTION

Hines installed Peribit SR-20 Sequence Reducers at its five VoIP-enabled offices in March 2003, and saw its voice quality problems immediately disappear. The Peribit gear�s plug-and-play installation made it possible to eliminate performance problems within half an hour at each location. �I like the easy setup with these systems,� said Valiulis. �We can ship an SR-20 to a remote location with some simple instructions, and the office manager can have it up and running with very little support from us.�

The SR-20 units have nearly quadrupled available bandwidth and gave Valiulis and his team the ability to easily prioritize network traffic. �One of the things we found by using the traffic monitoring and QoS tools was that the Citrix printing application would use up all available bandwidth if it wasn�t regulated,� said Valiulis, �so our ability to overflow voice calls from one call center to another would immediately drop whenever someone printed a Citrix document across the network. With Peribit�s QoS, we quickly assigned a low priority to Citrix printing jobs and the highest priority to VoIP traffic.�

Another issue that Peribit�s monitoring tools revealed was that the Blaster virus had invaded Hines� IP network, causing massive traffic increases that also affected VoIP performance. �Using the Top Talkers report available in Peribit�s software, we were quickly able to identify the sources of the virus traffic and to stop them,� said Valiulis. Now, monitoring the Top Talkers report after hours for suspicious activity is a regular routine for the IT staff, and it is able to quickly spot and deal with abnormal traffic before it affects call quality the following day.

RESULTS

Despite a near tripling of its call volume during 2003, Hines & Associates� VoIP system has handled all calls with high quality and rapid connections. �Now,� said Valiulis, �our VoIP system can support twice as much traffic as we thought it could, and much more than the original engineering studies showed us our network would handle.� Along with fatter WAN pipes, his staff�s ability to rein in Citrix printing and other traffic ensures that voice calls have all the room they need to connect smoothly and reliably.

When compared against the cost of WAN link upgrades and associated equipment, the five Peribit SR-20 systems returned their investment in roughly four months. Now that it has a solid technical infrastructure for further VoIP rollouts, Hines & Associates will be expanding its deployment as it migrates branches from DSL to Frame Relay connections.

For other companies struggling with VoIP deployments, Valiulis� advice is not to give up without exploring all the options. �I�ve talked with other companies that abandoned VoIP deployments because they couldn�t get them to work, and even our own router vendor was skeptical about it,� he said. �Peribit showed us that there was a simple, practical, and cost-effective solution to our problems, and we�ve ended up with a VoIP system that saves money and delivers new features without a drop in call quality.�

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