Integreted EHR

Integrated Services Digital Network (ISDN) is a set of communication standards for simultaneous digital transmission of voice, video, data, and other network services over the traditional circuits of the public switched telephone network. It was first defined in 1988 in the CCITT red book.[1] Prior to ISDN, the telephone system was viewed as a way to transport voice, with some special services available for data. The key feature of ISDN is that it integrates speech and data on the same lines, adding features that were not available in the classic telephone system. The ISDN standards define several kinds of access interfaces, such as Basic Rate Interface (BRI), Primary Rate Interface (PRI), Narrowband ISDN (N-ISDN), and Broadband ISDN (B-ISDN).
ISDN is a circuit-switched telephone network system, which also provides access to packet switched networks, designed to allow digital transmission of voice and data over ordinary telephone copper wires, resulting in potentially better voice quality than an analog phone can provide. It offers circuit-switched connections (for either voice or data), and packet-switched connections (for data), in increments of 64 kilobit/s. In some countries, ISDN found major market application for Internet access, in which ISDN typically provides a maximum of 128 kbit/s bandwidth in both upstream and downstream directions. Channel bonding can achieve a greater data rate; typically the ISDN B-channels of three or four BRIs (six to eight 64 kbit/s channels) are bonded.
ISDN is employed as the network, data-link and physical layers in the context of the OSI model. In common use, ISDN is often limited to usage to Q.931 and related protocols, which are a set of signaling protocols establishing and breaking circuit-switched connections, and for advanced calling features for the user. They were introduced in 1986.[2]
In a videoconference, ISDN provides simultaneous voice, video, and text transmission between individual desktop videoconferencing systems and group (room) videoconferencing systems.
Global usage
United States and Canada
ISDN-BRI never gained popularity as a general use telephone access technology in Canada and the US, and remains a niche product. The service was seen as a solution in search of a problem,[10] and the extensive array of options and features were difficult for customers to understand and use. ISDN has long been known by derogatory backronyms highlighting these issues, such as It Still Does Nothing, Innovations Subscribers Don't Need, and I Still Don't kNow.[11][12]
Once the concept of "broadband Internet access" came to be associated with data rates incoming to the customer at 256 kbit/s or more,[a] and alternatives like ADSL grew in popularity, the consumer market for BRI did not develop. Its only remaining advantage is that, while ADSL has a functional distance limitation and can use ADSL loop extenders, BRI has a greater limit and can use repeaters. As such, BRI may be acceptable for customers who are too remote for ADSL. Widespread use of BRI is further stymied by some small North American CLECs such as CenturyTel having given up on it and not providing Internet access using it.[16] However, AT&T in most states (especially the former SBC/SWB territory) will still install an ISDN BRI line anywhere a normal analog line can be placed and the monthly charge is roughly $55.
Australia
Telstra provides the business customer with the ISDN services. There are five types of ISDN services which are ISDN2, ISDN2 Enhanced, ISDN10, ISDN20 and ISDN30. Telstra changed the minimum monthly charge for voice and data calls. In general, there are two group of ISDN service types.