Call Answering Rules for the End User: Exchange 2010 Help #answer #to


#call answering

#

Call Answering Rules for the End User

Each call answering rule that you create contains two key parts:

Conditions – The criteria that must be met before the rule can be applied to an incoming call.

Actions – The options that should be presented to the caller when all the conditions are met. These actions will be read to the caller over the phone, and the caller can then choose what they want to do using the keypad on their phone.

The following figure shows the form for creating a call answering rule. The form is divided into two columns. The right column displays the list of available conditions and actions you can use to build the rule. The left column displays the list of conditions and actions that have been added to the rule.

Conditions are rules that you can apply to call answering rules. By using a combination of conditions, you can create multiple call answering rules that will trigger when the conditions are met. To create a default rule that will be applied to every call, you create a rule that doesn’t contain any conditions.

There are four conditions that can be used when you set up call answering rules, including:

Automatic e-mail reply is enabled/disabled

Use one of the following options to add a condition for a call answering rule:

Actions are used to define what you want to happen when a condition is met. The three kinds of actions are:

Leave a Voice Mail

Use one of the following options to add an action for a call answering rule:

Adding a Find-Me Action

When a caller selects Find-Me, the voice mail system will attempt to locate you at up to 2 different phone numbers, and then connect the caller to you if you’re available at one of the phone numbers. To add Find-Me to your list of actions, click .

In the Find-Me dialog box, specify the phone numbers and other settings. The settings that are available are listed below:

You can specify text that will be read to the caller. For example, if you enter “Urgent Matters” to inform your callers that they should only select this action if they have important things to discuss with you, the voice mail system will say “For Urgent Matters, press the 1 key.”

You have to associate the Find-Me action with the number on the telephone keypad that the caller will have to press to select this action. In the example above, the 1 telephone key is the number callers will press to reach you at one of the phone number or numbers you specify.

Next you have to specify the one or two phone numbers that the voice mail system will dial. If you specify two telephone numbers, the second number will be dialed if you’re not available at the first. Each phone number that you specify has an associated duration. The duration is the time period during which the voice mail system will try to dial the phone number before it moves on to the next number. Or, if you can’t be contacted, the voice mail system will go back to the options menu.

After you’ve entered this information, click Apply to save the Find-Me settings.

Adding Call Transfer Options

By setting a Call Transfer action, you provide callers with the option to be transferred to another person’s phone number. To add Call Transfer to your list of actions, click .

There are several options that are available when you want to transfer an incoming call to another phone or Contact. The Transfer the Caller dialog box is shown below.

You can specify text that will be read to the caller. For example, you can enter “Important Matters” to inform your callers that they should choose this option if they have an important matter to discuss and need to speak to someone.

You have to associate the Call Transfer action with the number on the telephone keypad that the caller will have to press to select this action.

When you choose the Call Transfer action, you have to specify a person or phone number for the caller to be transferred to. You can choose a phone number or select a Contact to be called when the caller presses the correct key on the telephone keypad. If you specify a contact who’s within your company directory, the voice mail system will try to transfer the call to the extension number of that contact.

In addition to specifying a person or number for the caller to be transferred to, you also need to specify the number on the telephone keypad that the caller will have to press to select the Call Transfer action.

After you’ve entered this information, click Apply to save the Call Transfer settings.

Adding and Removing the Leave a Voice Mail Action

By default, the voice mail option is automatically added to each call answering rule. If you don’t want to offer this option, you can remove it by clicking . Press the # key to record a voice message. If you’ve removed the option for receiving a voice message, you can add it back by clicking the option.


Tour – Mathematics Stack Exchange #24 #hour #answering #service


#question and answer sites

#

Welcome to Mathematics Stack Exchange

Mathematics Stack Exchange is a question and answer site for people studying math at any level and professionals in related fields. It s built and run by you as part of the Stack Exchange network of Q A sites. With your help, we re working together to build a library of detailed answers to every question about math.

We re a little bit different from other sites. Here s how:

Ask questions, get answers, no distractions

This site is all about getting answers. It s not a discussion forum. There s no chit-chat.

Good answers are voted up and rise to the top .

The best answers show up first so that they are always easy to find.

The person who asked can mark one answer as accepted .

Accepting doesn t mean it s the best answer, it just means that it worked for the person who asked.

Is the measure of the sum equal to the sum of the measures?

up vote 14 down vote favorite

Let $A,B$ be subsets in $\mathbb$. Is it true that $$m(A+B)=m(A)+m(B)?$$ Provided that the sum is measurable.

I think it should not be true, but could not find a counterexample.

Is the measure of the sum equal to the sum of the measures?


Should I write – any question – or – any questions? English


#ask any question

#

Are they both correct? Should there be singular or plural that right after “any”? If they are both correct, what’s the difference?

Here, I quote some sentences from the Internet and I wonder if the word “problem” can be changed into “problems” or vise versa.

  • I don’t think there was any question she wore the pants.
  • I can ask you any question. and you will answer?
  • We were never asked any questions .
  • Any questions about what is happening in mine are put aside until dessert is served.

asked May 3 ’11 at 12:42

“Call me with any questions you may have”.

Yeah, it still sounds better in plural. Though thinking about it, even though it is not a question, it works in the ambiguous or uncertain tense that “any” works with. which is generally plural.

“Do you have any cats, hats, tires, fires, mice, etc”

They all run in plural.

However at the beginning of a sentence, in a more certain, assertive, authoritative tense, singularity is fine.

“Any question can be answered. “

“Any child can learn to swim”

“Any wall can be torn down” etc

Honestly, I think I might need more context to give a thorough answer, But I’ll take a stab at it anyway.

If you are referring to a test, and saying:

“I didn’t miss any question(s) on that test”

Then both are correct, because both are true. You didn’t miss a single question, nor did you miss any 2 (or more) questions.

-EDIT- In general, I think it’s safe to say that both are grammatically correct. But depending on whether you are referring to one, or more than one question, would determine which to use.

answered May 3 ’11 at 12:45

as far as I know, “Any” is singular. )

therefore it should be Any question?

“any question?” is just the shortcut of “is there any question?” if you would like to make it plural then just omit the “any” like

are there questions?

answered Dec 1 ’13 at 15:20

First, any dictionary will tell you that any can be singular or plural as a pronoun. Second, Is there any question? means something different from Are there any questions? choster Dec 1 ’13 at 19:56

2016 Stack Exchange, Inc


What is the best answer to the question – How are you


#are you the answer

#

Fine, thanks. What about you?

There’s nothing wrong with your answer, although it might get tiresome if you word it exactly the same way, every time you’re asked. But the solution for that is to merely use a few simple variations:

I’m doing great today – and you?

Doing well, thanks. How about you?

Not bad, yourself?

Thanks for asking, I’m doing fine.

I think it’s usually best to avoid clever responses to such a standard question, particularly when you’re with new acquaintences. Sure, you could reply with something like, “I’m happy as a clam ,” but that’s not very professional, and it would probably undermine your credibility rather than enhance it. Such jocular ways of answering are best left said among close acquaintences when everyone is kidding around.

I used to work with someone, who when asked how are you? would pause, consider for a few seconds, and then reply Good! with a tone that suggested he was quite touched that you had cared enough about his well-being as to ask. For most of us though, it s a formality more than anything more, and this answer, as with Barrie s, fit the bill fine. Jon Hanna Jan 28 ’13 at 20:45


Call Answering Rules for the End User: Exchange 2010 Help #book #answers


#call answering

#

Call Answering Rules for the End User

Each call answering rule that you create contains two key parts:

Conditions – The criteria that must be met before the rule can be applied to an incoming call.

Actions – The options that should be presented to the caller when all the conditions are met. These actions will be read to the caller over the phone, and the caller can then choose what they want to do using the keypad on their phone.

The following figure shows the form for creating a call answering rule. The form is divided into two columns. The right column displays the list of available conditions and actions you can use to build the rule. The left column displays the list of conditions and actions that have been added to the rule.

Conditions are rules that you can apply to call answering rules. By using a combination of conditions, you can create multiple call answering rules that will trigger when the conditions are met. To create a default rule that will be applied to every call, you create a rule that doesn’t contain any conditions.

There are four conditions that can be used when you set up call answering rules, including:

Automatic e-mail reply is enabled/disabled

Use one of the following options to add a condition for a call answering rule:

Actions are used to define what you want to happen when a condition is met. The three kinds of actions are:

Leave a Voice Mail

Use one of the following options to add an action for a call answering rule:

Adding a Find-Me Action

When a caller selects Find-Me, the voice mail system will attempt to locate you at up to 2 different phone numbers, and then connect the caller to you if you’re available at one of the phone numbers. To add Find-Me to your list of actions, click .

In the Find-Me dialog box, specify the phone numbers and other settings. The settings that are available are listed below:

You can specify text that will be read to the caller. For example, if you enter “Urgent Matters” to inform your callers that they should only select this action if they have important things to discuss with you, the voice mail system will say “For Urgent Matters, press the 1 key.”

You have to associate the Find-Me action with the number on the telephone keypad that the caller will have to press to select this action. In the example above, the 1 telephone key is the number callers will press to reach you at one of the phone number or numbers you specify.

Next you have to specify the one or two phone numbers that the voice mail system will dial. If you specify two telephone numbers, the second number will be dialed if you’re not available at the first. Each phone number that you specify has an associated duration. The duration is the time period during which the voice mail system will try to dial the phone number before it moves on to the next number. Or, if you can’t be contacted, the voice mail system will go back to the options menu.

After you’ve entered this information, click Apply to save the Find-Me settings.

Adding Call Transfer Options

By setting a Call Transfer action, you provide callers with the option to be transferred to another person’s phone number. To add Call Transfer to your list of actions, click .

There are several options that are available when you want to transfer an incoming call to another phone or Contact. The Transfer the Caller dialog box is shown below.

You can specify text that will be read to the caller. For example, you can enter “Important Matters” to inform your callers that they should choose this option if they have an important matter to discuss and need to speak to someone.

You have to associate the Call Transfer action with the number on the telephone keypad that the caller will have to press to select this action.

When you choose the Call Transfer action, you have to specify a person or phone number for the caller to be transferred to. You can choose a phone number or select a Contact to be called when the caller presses the correct key on the telephone keypad. If you specify a contact who’s within your company directory, the voice mail system will try to transfer the call to the extension number of that contact.

In addition to specifying a person or number for the caller to be transferred to, you also need to specify the number on the telephone keypad that the caller will have to press to select the Call Transfer action.

After you’ve entered this information, click Apply to save the Call Transfer settings.

Adding and Removing the Leave a Voice Mail Action

By default, the voice mail option is automatically added to each call answering rule. If you don’t want to offer this option, you can remove it by clicking . Press the # key to record a voice message. If you’ve removed the option for receiving a voice message, you can add it back by clicking the option.


SNMP Monitoring Software #network #monitor, #network #monitoring, #server #monitor, #exchange #server, #sql,


#

SysUpTime Network Monitor

Current Version: 6.1 (build 6204)

SysUpTime network/server monitor is a powerful agentless network management software. It provides users out-of-box capabilities to efficiently and proactively manage any network of any size.

SysUpTime network monitor is easy to set up and use. It can monitor the availability and performance of your Windows and Linux/UNIX servers, workstations, software applications (SQL, Exchange, Web Servers, etc), and network devices (routers, switches, etc). When a failure is detected, SysUpTime network monitor can alert the administrators by email, sound, running a script or other methods, as well as taking corrective actions such as executing remote Windows/Linux command, rebooting the machine, restarting the Windows/Linux service or running a script.

SysUpTime network monitor’s server runs on both Windows and Linux.

Key Features:

Automatic Network Discovery and Accurate Topology Map

Automatically discovers layer 1, 2 and 3 networks, gathering topology data to deliver complete and accurate maps of devices and connectivity across networks. Powerful map editing function allows user to add or change discovered map easily.

The combination of unique extensible mediation layer technology and CIM (Common Information Model) based object model enables SysUpTime network monitor to support new devices and applications on an ongoing basis with minimum efforts.

Major features of network discovery and topology maps:

  • Support for a wide range of network devices and new devices can be easily added.
  • Configurable filters to narrow down the scope of discovery.
  • SNMP v1/v2c/v3 discovery.
  • Scheduled discovery.
  • Support for VLAN, HSRP, VRRP.
  • Custom views, which are user-defined maps based on IP address, location or other selection criteria.
  • Automatically discovered topology maps contain properties of network devices such as servers, routers, etc. Device list can be exported to a CSV file.
  • Devices can be manually added to topology map.
  • New properties or notes, such as license info, installed software, purchase price, can be manually added to devices. You can do search to find device with certain property.

Trended Performance, Status, and Service Monitoring

Detailed monitoring of network availability and performance.

  • Fully Automated Performance Monitoring

Core monitoring capabilities include:

  • Ping monitor
  • SNMP monitor(supports SNMP v1/v2c/v3 monitors)
  • MS Exchange server monitor
  • WMI monitor (Windows Services, Processes, CPU/Disk Utilization, etc.)
  • TCP/UDP port monitor
  • URL (HTTP/HTTPS) monitor
  • Telnet/SSH-2 monitor
  • FTP/File/Directory monitor
  • DNS/LDAP/RADIUS server monitor
  • Windows Event Log monitor
  • SMTP/POP3/IMAP4 server monitor
  • Database SQL monitor for all major database servers

More network/server monitoring capabilities are scheduled to be added soon.

  • Self-learning Dynamic Statistical Baseline (based on historical data)
  • Multi-level Fixed Thresholds

Real-time, End-to-End Event Management

SysUpTime network monitor collects and consolidates events and alarms. Event de-duplication, event auto-clearing, robust alerting, automated actions, and alarm escalation help organizations identify potential problems faster, shorten mean-time-to-repair and reduce IT and operations costs.

Core capabilities of event management include:

  • Supports SNMP v1/v2c/v3 traps and informs
  • Event reduction
  • Event clearing
  • Alarm escalation
  • Event forwarding
  • Event categorization

SysUpTime network monitor offers a wide range of alerting actions. Major actions include:

  • Send to different email accounts at different time.
  • Forward to another trap receiver.
  • Post to a web site using GET or POST methods.
  • Run remote command via SSH, Telnet or Windows RPC.
  • Run command.
  • Play sound.
  • Built-in Reporting and Graphing

    SysUpTime network monitor offers real-time and historical reporting and graphing capabilities for performance monitors, and top-N reports for users to identify problem elements. Scheduled reports in PDF format can be generated by month, week or day.

    Application monitoring helps you diagnose application problems, and prevent downtime or network performance degradation. SysUpTime network monitor provides out-of-box support for MS Exchange Server and SQL server. It can be configured to monitor critical parameters of both servers and their services.

    High Availability and Scalability

    SysUpTime’s server clustering technology allows two or more servers that are interconnected to form a unified virtual computing resource.

    Clustering servers increases the availability of a system by ensuring that if a server becomes unavailable because of failure or planned downtime, another server in the cluster can assume the workload, ensuring that the monitoring service is uninterrupted. Clustering also enhances scalability by automatically distributing workloads across all the available servers.

  • Key Benefits

    • Intuitive graphical user interface minimizes training requirements and increases productivity
    • Advanced fault management minimizes equipment downtime
    • Measure and report real time performance against designated SLA
    • Preempt performance problems by identifying potential trouble spots before they affect service quality
    • Increased operational efficiency
    • Use trending data to make the most of network resources and forecast CapEx needs
    • Protect existing investments — can be integrated with existing management systems
    • Implement high-quality management capabilities priced to suit enterprise IT budgets

    Professional and free personal editions

    The free personal edition is intended exclusively for private use on a single workstation. You may copy the complete program package and pass it on to others for private use only. The free personal edition may not be used for commercial or professional purposes.

    The professional edition has many more features and can be used for commercial or professional purposes.

    Features Table


    Creating a Custom Receive Connector in Exchange 2013 #2013, #connector, #creating, #custom,


    #

    Creating a Custom Receive Connector in Exchange 2013

    In this tip we will look into creating a Custom Receive Connector in the new Exchange 2013.

    Receive Connectors are used to control the flow of inbound messages into Exchange. With Exchange 2013 they are configured on servers with the Transport service (all mailbox servers) or with the Front End Transport service (all Client Access servers).

    This means we can configure a Receive Connector in two different places. However, the big difference is that the Front End Transport service does not queue any messages locally while the Transport service does! Therefore, if you want Exchange to queue e-mails received by a custom Receive Connector (for example, in case of a problem with the recipient s mailbox) you have to create it on your Mailbox servers.

    Obviously, all the Receive Connectors required for internal mail flow are automatically created when a Client Access server or Mailbox server is installed. While Exchange 2007/2010 Hub Transport servers were not configured out of the box to accept e-mails from the internet, the new Client Access server comes with a Receive Connector named Default Frontend server_name already configured to allow Anonymous Users to connect to it to allow inbound flow from the Internet.

    But sometimes custom Receive Connectors are required for various reasons: to control which servers receive messages from a particular IP address; to configure special connector properties for messages received from a particular IP address such as allowing larger messages or more recipients per messages; or to allow servers, applications or devices such as printers to establish unauthenticated SMTP connections to Exchange in order to send e-mails.

    To create Receive Connectors in Exchange 2013 we can use the Exchange Administration Center [EAC] or the Exchange Management Shell [EMS]. In this tip, we will be using the Shell to create a Receive Connector that:

    • Is associated with the Mailbox server called MBX1;
    • Listens for incoming SMTP connections on the IP address 10.10.1.1 and port 25;
    • Accepts incoming SMTP connections only from the IP range of 192.168.1.1 to 192.168.1.10;
    • Accepts e-mails of a size up to 50MB;

    New-ReceiveConnector -Name Application 1 Server MBX1 -Usage Custom -Bindings 10.10.1.1:25 -RemoteIPRanges 192.168.1.1-192.168.1.10 -MaxMessageSize 50MB

    But what if a server is multi-role and has the Client Access and Mailbox server roles? How does Exchange know which role to associate the Receive Connector with? For these situations we have the TransportRole parameter exactly to designate the server role associated with this connector. The valid types are FrontendTransport and HubTransport.

    So our example would become:

    New-ReceiveConnector -Name Application 1 Server MBX1 -Usage Custom -Bindings 10.10.1.1:25 -RemoteIPRanges 192.168.1.1-192.168.1.10 -MaxMessageSize 50MB TransportRole HubTransport

    See Also

    The Author Nuno Mota

    Nuno is an Exchange MVP working as a Senior Microsoft Messaging Consultant for a UK IT Services Provider in London. He specializes in Exchange, Lync, Active Directory and PowerShell.

    Latest Contributions

    Never miss an article by subscribing to our newsletter!


    Managed Funds and ETP product list #asx, #australian #stock #exchange, #lmis, #listed


    #

    Products

    Managed Funds and ETP product list

    Research Managed Funds (A-REITs, Absolute Return Funds, LICs / LITs and Pooled Development Funds)and Exchange Traded Products (ETPs) by clicking on the ASX code for delayed prices, recent announcements, price history charts, past dividends and contact details. You can also go to individual websites by clicking on the name.

    Note: MER (management expense ratio) figures have been extracted from the relevant PDS or as updated by the issuer of the product. Under the Corporations Regulations, management costs do not include transactional or operational costs or certain other fees and costs which may apply. Such costs may be significant. When considering a product or comparing between products you should refer to the relevant PDS(s) for more information on any additional costs associated with each product. You should obtain independent professional investment advice tailored to your specific circumstances prior to making any investment decision.

    Latest product announcements

    ETF – Exchange Traded Funds
    MF – Managed Fund
    SP – Structured Product
    *Share – Redeemable preference share

    #See the relevant Product Disclosure Statement for a full explanation of the Fees and Other Costs

    Specific risks for fixed income, inverse, leveraged, single-asset and synthetic ETPs as well as Structured Products can be found here .

    Undelrying Bond Issuer (Parent Entity)

    ASX Code of Underlying Issuer or Parent Entity

    Australian Corporate Bonds

    ANZ Banking Group Ltd

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    AGL Energy Limited

    5.00% 5 November 2021

    APA Pipelines (APA Group)

    7.75% 22 July 2020

    5.50% 19 November 2019

    Ausnet Services Holdings Pty Limited (Ausnet Services Limited)

    5.75% 28 June 2022

    Aurizon Network Pty Ltd (Aurizon Holdings Ltd)

    5.75% 28 October 2020

    BHP Billiton Finance Ltd (BHP Billiton Ltd)

    3.75% 18 October 2017

    BHP Billiton Finance Ltd (BHP Billiton Ltd)

    3.00% 30 March 2020

    Bank of Queensland Limited

    4.00% 12 June 2018

    Caltex Australia Limited

    7.25% 23 Nov 2018

    Coca Cola Amatil Limited

    4.25% 13 November 2019

    Crown Group Finance Ltd (Crown Resorts Ltd)

    5.75% 18 July 2017

    Downer Group Finance Pty Limited (Downer EDI Limited)

    5.75% 29 November 2018

    Downer Group Finance Pty Limited (Downer EDI Limited)

    4.50% 11 March 2022

    Dexus Finance Pty Ltd (Dexus Property Group)

    5.75% 10 September 2018

    Dexus Finance Pty Ltd (Dexus Property Group)

    4.75% 5 November 2025

    GPT RE Ltd as RE for the General Property Trust (General Property Trust)

    6.75% 24 January 2019

    Incitec Pivot Ltd

    5.75% 21 February 2019

    Lend Lease Finance Limited (Lend Lease Corporation Limited)

    5.50% 13 November 2018

    Lend Lease Finance Limited (Lend Lease Corporation Limited)

    6.00% 13 May 2020

    Mirvac Group Finance Limited (Mirvac Group)

    5.75% 18 September 2020

    Mirvac Group Finance Limited (Mirvac Group)

    5.50% 18 December 2017

    Macquarie Group Limited

    3.25% 3 March 2020

    National Australia Bank Limited

    4.00% 16 December 2021

    National Australia Bank Limited

    4.25% 20 May 2019

    Novion RE Ltd (as RE for the Novion Trust formerly Commonwealth Managed Investments Ltd as RE for the CFS Retail Property Trust 1)

    5.00% 19 December 2019

    Qantas Airlines Limited

    6.50% 27 April 2020

    Qantas Airlines Limited

    7.50% 11 June 2021

    Qantas Airlines Limited

    7.75% 19 May 2022

    RE1 Ltd as Trustee and RE of Westfield Retail Trust 1 (Scentre Group)

    5.00% 23 October 2019

    Stockland Trust Management Ltd as RE for the Stockland Trust (Stockland)

    5.50% 6 September 2019

    Stockland Trust Management Ltd as RE for the Stockland Trust (Stockland)

    8.25% 25 November 2020

    Sydney Airport Finance Company Pty Ltd (Sydney Airport)

    7.75% 6 July 2018

    Transurban Queensland Finance Pty Limited (Transurban Group)

    4.75% 8 December 2021

    Telstra Corporation Limited

    7.75% 15 July 2020

    Telstra Corporation Limited

    4% 16 September 2022

    Westpac Banking Corporation

    3.50% 28 July 2020

    Westpac Banking Corporation

    3.25% 22 January 2020

    6.25% 28 March 2019

    4.75% 12 March 2020

    6.00% 21 March 2019

    AMP Bank Limited (AMP Limited)

    6 June 2018 FRN (3 Month BBSW +0.87%)

    Bank of Queensland Limited

    7 November 2016 FRN (3 Month BBSW +1.15%)

    Bank of Queensland Limited

    12 June 2018 FRN (3 Month BBSW +1.00%)

    National Australia Bank Limited

    8 November 2018 FRN (3 Month BBSW +0.88%)

    National Australia Bank Limited

    20 May 2019 FRN (3 Month BBSW +0.85%)

    Suncorp Metway Limited (Suncorp Group Limited)

    23 April 2019 FRN (3 Month BBSW +1.10%)

    ANZ Banking Group Ltd

    17 April 2020 FRN (3 Month BBSW + 0.82%)

    Bank of Queensland Limited

    6 November 2019 FRN (3 Month BBSW + 1.07%)

    Macquarie Group Limited

    3 March 2020 FRN (3 Month BBSW + 1.10%)

    National Australia Bank Limited

    3 June 2020 FRN (3 Month BBSW + 0.80%)

    Westpac Banking Corporation

    28 July 2020 FRN (3 Month BBSW + 0.90%)

    Independent Power Producers Energy Trader

    Highways Railtracks

    Highways Railtracks

    RBA cash rate + 2% pa.

    All Ordinaries Accumulation Index

    MSCI All Country World World Net Index (AUD)

    UBS Aus Bank Bill

    Duxton Water Limited

    S P/ASX All Ordinaries Accumulation Index

    UBS Aus Bank Bill

    ASX All Ordinaries

    S P/ASX 200 Franking Credit Adjusted Daily Total Return Index (Tax Exempt)

    RBA cash rate+4.25% pa.

    S P/ASX All Ordinaries Accumulation Index

    S P/ASX 200 Accumulation Index

    S P/ASX All Ordinaries Accumulation Index

    S P/ASX All Ordinaries Accumulation Index

    S P/ASX 300 accumulation index

    S P/ASX 200 Accumulation Index

    UBS Aus Bank Bill

    MSCI All Country World Index ex-Australia with gross dividends reinvested reported in Australian dollars and unhedged)

    MSCI AC Asia Ex Japan

    MSCI All Countries Total Return Daily INdex

    MSCI All country Asia ex Japan Net (AUD)

    Sunvest Corporation Limited

    S P.ASX 300 Metals Mining Index

    FTSE Global Core Infrastructure 50/50 Index (net total return AUD) BofA Merrill Lynch Fixed Rate Preferred Securities Index (AUD)


    Direct Exchange of Health Care Information Fuels Meaningful Use Stage Two #direct


    #

    Direct Exchange of Health Care Information Fuels Meaningful Use Stage Two

    December 11, 2013 12:41 pm Sheri Porter

    Family physicians have been front-line adopters of electronic health record (EHR) technology for the past decade, so it’s no surprise that many FPs are ready, able and willing to push forward with the meaningful use (MU) of those EHRs as directed by CMS and the Office of the National Coordinator for Health IT (ONC).

    David C. Kibbe, M.D. M.B.A.

    With stage one of MU well underway and stage two poised to begin early in 2014, AAFP News Now recently sat down with family physician David C. Kibbe, M.D. M.B.A. of Oriental, N.C. to discuss a key component of stage two — Direct exchange of health information.

    Kibbe is nationally recognized for his health information technology (IT) expertise. He is the president and CEO of the nonprofit organization DirectTrust and serves as a senior adviser to the AAFP on health IT issues.

    Q. How would you define the term Direct exchange for family physicians?

    A. Direct exchange is just like regular e-mail, but with an added layer of security and trust-in-identity operating behind the scenes. This makes Direct exchange of messages and attachments suitable for electronic sharing of personal health information. Put simply, this is a way for users of two separate EHR systems to send and receive information securely.

    The Health Insurance Portability and Accountability Act requires that the transfer of such information remain confidential at all times and across geographic and health IT vendor boundaries.

    Story highlights
    • Direct exchange of health information is a key component of meaningful use stage two, which begins in January.
    • Direct exchange ensures that the transfer of information is secure and confidential at all times, as called for by the Health Insurance Portability and Accountability Act.
    • Direct exchange will be integrated into upgraded electronic health record technology for 2014, and systems must be certified as to this capability.

    Q. How is Direct exchange different from e-mail?

    The difference is that Direct e-mails are encrypted and signed before they go out onto the Internet.

    Q. Explain how the Direct exchange of health information relates to MU stage two, which is coming in 2014.

    A. When used by providers and hospitals to transport and share qualifying clinical content, the combination of that content and Direct exchange is now an integral component of MU stage two objectives and measures. For example, if a family physician refers a patient to a (sub)specialist and uses Direct exchange to provide a clinical summary to the (sub)specialist, he or she will be able to attest to having met one of the stage two objectives for transitions of care.

    Physicians attesting for MU stage one or two in 2014 must use an EHR that is capable of Direct exchange and that meets the other certification requirements as directed by the ONC. This will mean a significant software upgrade for most physicians by mid-2014.

    Q. What’s the difference between health information exchange (HIE) requirements and Direct HIE requirements as they relate to MU stage two?

    A. MU stage one focused on data collection in EHR technology; stage two is all about exchange of that data. In other words, HIE becomes a verb. Many of the stage two objectives involve moving data and information from the EHR to some destination, such as a public health immunization repository or a cancer registry.

    Q. What are the three most important points for physicians to understand when it comes to Direct exchange of health information?

    A. First, understand that Direct exchange will be integrated into upgraded EHR technology for 2014, and EHRs must be certified as to this capability.

    Second, physicians will be able to use secure Direct exchange for a wide range of data and information communication needs with other physicians, health care professionals, patients and some payers. This can mean a significant reduction in a practice’s paper, mail and fax correspondence with commensurate decreases in cost and mishandled care transitions.

    Finally, physicians have some say in how their EHR vendors configure the Direct exchange services. Costs of services will vary vendor to vendor, so physicians need to communicate with their vendors about these issues.

    Q. How important is the patient engagement piece of MU stage two, and how difficult will it be for physicians to comply?

    A. Patient engagement is a very important aspect of stage two MU, and it will pose challenges to some physicians in terms of compliance. For one thing, practices must have a Web-based patient portal to comply with view, download and transmit requirements. And the portal must be able to send — via Direct exchange — certain health information documents, such as clinical summaries and visit notes, to patients who request this.

    To meet the MU stage two patient engagement objective, patients must be able to view, download and transmit a summary-of-care record provided by the EHR technology to a third party of their choosing, and, importantly, 5 percent of patients must actually do this.

    Q. Why should family physicians care about the electronic transfer of health information and secure messaging?

    A. Aside from the requirements of stage two MU, family physicians care about continuity and coordination of care for their patients. Electronic messaging makes it easier for critically important health information to follow patients wherever they go in the patient-centered medical home neighborhood.

    Q. What steps do physicians need to take now to prepare for MU stage two next year?

    A. A couple of aspirin would be useful! Seriously, physicians should have already been preparing their practices for the new objectives and measures of stage two MU and working closely with their EHR vendors to manage the needed new features in their software to meet them. Remember, physicians who are not engaged in MU will face a 1 percent penalty in their Medicare payments starting in January 2015.

    Q. What questions should physicians ask their EHR vendors related to Direct exchange?

    A. Here are several:

    • Has the new software version of the EHR for use in 2014 been fully certified for stage two MU, including for compliance with Direct exchange?
    • When will the new software upgrade be available for installation? (Remember, attestation for three months of stage two MU requires installation of the upgraded software no later than July 2014.)
    • Is the EHR’s health information service provider accredited by DirectTrust, as required by the ONC, to meet the needed security and trust-in-identity features?
    • What will Direct integration for both transitions of care and for patient view, download and transmit measures cost the practice?
    • How can physicians find the Direct addresses of parties with whom they need to transfer information via Direct exchange?

    Q. Are there any red flags physicians should be aware of when assessing their own EHR systems and in working with vendors?

    A. Indeed there are. One would be a delay in software upgrade installation availability beyond the first quarter of 2014. Another would be the inability of a software vendor to identify dates for both certification and accreditation of the Direct exchange components of the upgraded version the practice will be using.

    Q. How can the AAFP and other organizations help physicians work through this process?

    A. Stage two MU is more complex than was stage one, and by a long shot. We need to help our members prepare for a smooth transition to their upgraded software and help them avoid attestation problems during the first year of stage two MU — that is, during 2014.

    Q. What’s the most important takeaway point for family physicians?

    A. Expect Direct exchange to be part of your EHR’s feature set in 2014, and be prepared to use Direct exchange to the benefit of your practice and your patients.

    Related ANN Coverage
    CMS Announces New Meaningful Use Timeline
    Caution: MU Two Requirements Remain Unchanged
    (12/11/2013)

    What Does Meaningful Use Stage Two Rule Mean for FPs?
    AAFP Looks at Positives and Negatives of Recently Released Rule
    (9/5/2012)