OnCall Platform

The RingRx OnCall platform sends urgent calls to the right provider at the right time. It keeps a full record of every OnCall call: when the message was left, who was called, who listened to it, and when it was removed.

How OnCall works 

Everything starts from an OnCall group. A group is usually a department or a team that shares after-hours duty, such as “Pediatrics after hours”. Callers reach the group at its extension. Point a phone number at that extension to take outside calls.

A group has shifts. A shift says who is on call, in which order, and when. A group can have many shifts, and they can overlap. RingRx always uses one shift at a time: the most specific one (see Shift selection).

Each group works in one of two modes: OnCall mode or Router mode. The mode decides what happens to a call (see OnCall Call Flow).

OnCall Call Flow 

An OnCall group operates in one of two modes.

`OnCall Mode`

RingRx answers the call and takes a message, then calls the people on call until one of them listens to it. Every step is recorded. Use this mode when patients call the group, or when calls must be triaged.

The caller hears the group greeting (if one is set).
The caller enters a callback number, then records their name and a short description of the problem (up to 60 seconds).
RingRx saves the message in the group mailbox at once, with the callback number. If the call drops after this point, the message is not lost.
RingRx finds the shift that is active at this moment, and the first person in its call order.
- If that person turned on new message notifications, they get an email or text now. Only the first person gets this notification. It does not contain the message or any PHI.
- The OnCall rule of that person (see Provider contact) decides between Patch and Relay.

If Patch:

RingRx keeps the caller on hold (with the group hold music) and calls the first person right away, the way their rule says (ring my phone, simultaneous, sequential or forward).

When they answer, they are greeted by the OnCall platform and must enter their OnCall PIN before any PHI is played.
The message plays. The message is now marked as read.
They choose:
1. Connect the caller.
2. Do not connect. The caller is disconnected.
If the person does not answer or does not enter the PIN, the caller is told that the provider is on another call, and the call ends. The message stays unread, so the relay calls start.

If Relay:

The caller is told that a provider will call them back, and the call ends. The relay calls start.

If nobody is on call:

The caller is told that no provider is available and that the call will be returned. The message stays in the group mailbox, but there is nobody to call.

`Relay calls`

RingRx calls the people on the shift that was active when the message was left, in call order.

Each person is called the number of times set in Calls to each person, Minutes between calls apart, before RingRx moves to the next person.
When a person answers, they enter their OnCall PIN. Then they can:
1. Hear the message. This marks the message as read.
2. Call the caller back at the callback number.
3. Hear the callback number.
Relay calls stop when anybody reads the message: by phone, in the portal, or in the mobile app.
Relay calls also stop after the last person on the shift has been called, or 24 hours after the message was left.

Note

The relay always uses the shift that was active when the message was left. A shift change after that does not change who is called for that message.

`Router Mode`

RingRx sends the call to the people on call but does not answer it or take a message. Use this mode when staff call the group and want to reach a person directly.

The caller hears the group greeting (if one is set).
RingRx finds the shift that is active at this moment.
Each person on that shift rings in call order. How they ring (which phones, for how long) comes from their own OnCall rule.
If nobody answers and Forward to is set, the call goes to that extension or phone number for Ring for (seconds).
If nobody answers, the caller can leave a voicemail in the group mailbox.

Note

Router mode calls are normal calls. They do not get the oncall tag or the OnCall summary in the call log, and they are not in the OnCall report.

OnCall Group Settings 

To see your groups, go to Settings › OnCall Groups. Each group shows its extension, its mode, who is on call now, and a short description of what happens to a call. Search by name or extension. From each group you can open its settings or its calendar.

Warning

When you delete a group, calls to its extension (and phone numbers that point at it) stop being answered at once, and its shifts are deleted. Point your numbers somewhere else first. This cannot be undone.

Click a group, or New OnCall group, to open its settings. The page shows the steps of a call in the order the caller goes through them, so you only see the settings that apply to the selected mode. Save sends all changes at once. If you leave the page with unsaved changes, you are asked first.

`Basics`

Name:: The name of the group. It must be unique in your account.
Extension:: What callers dial to reach the group. Point a phone number at it to take outside calls.
Time zone:: The time zone of the group. Shift times on the calendar are in this time zone.
Tags:: Added to the call record of every call to the group, so you can filter the call log and analytics. Separate tags with spaces. Letters, numbers and underscores only.

`How calls are handled`

Select OnCall mode or Router mode. See OnCall Call Flow.

`When a call comes in`

Greeting:: Optional. A recording from the media library that the caller hears first.
Hold music:: Plays while the caller waits to be connected.
Mailbox:: Where messages are kept. All users on all shifts of the group get access to this mailbox.

In OnCall mode only:

Calls to each person:: How many times RingRx calls each person before it moves to the next person. 1 to 100.
Minutes between calls:: The time between relay calls. 3 to 600.

In Router mode only:

Forward to:: Optional. An extension or phone number that rings after the people on call. Leave it blank to skip this step.
Ring for (seconds):: How long Forward to rings before the caller goes to the mailbox. The default is 24 seconds.

`What the people on call see`

Caller ID number:: The number shown on calls from the group, such as relay calls.
Caller name prefix:: Up to 15 characters added before the caller’s name, so the person on call knows where the call comes from. For example, Peds: shows Peds:JOHN SMITH.

`Recording`

Record calls:: Records the calls of the group, including the patch call and the relay calls. Recording must also be on for your account.
Tell callers the call is recorded:: Plays a warning to the caller before the call is recorded.

`Schedule`

Shifts come from:

Where the shifts of the group come from.

This page: you add shifts on the OnCall calendar.
Amion: shifts come from Amion on every sync. Shifts added or changed in RingRx, including repeated shifts, are removed at the next sync. Change the schedule in Amion.
ShiftAdmin: one-time shifts come from ShiftAdmin on every sync. One-time shifts added in RingRx are removed at the next sync. Repeated shifts are kept.
QGenda: one-time shifts come from QGenda on every sync. One-time shifts added in RingRx are removed at the next sync. Repeated shifts are kept. When several people are on call at the same time, they are in one shift, in the call order from QGenda.

Amion password, Services, Sites:

The view password of the Amion schedule, and optional filters. Separate filter values with commas. Leave a filter blank to get all.

ShiftAdmin API key, Shifts, Facilities:

The ShiftAdmin key, and optional filters. Separate filter values with commas. Leave a filter blank to get all.

QGenda company key, API user email, API user password:

The login of a QGenda user that has API access to the schedule. API access is an option on your QGenda contract.

Tasks, Locations:

Optional QGenda filters. Separate filter values with commas. Leave a filter blank to get all. The order of the Tasks is also the call order, for tasks that have no External Call Priority in QGenda.

Sync now:

Gets the shifts from Amion, ShiftAdmin or QGenda at once. Save your changes first. Shifts also sync on a schedule. If a sync would make more than 1,000 shifts for the group, it changes nothing. Narrow the filters.

Email when nobody will be on call:

One or more email addresses, separated by commas. Leave it blank to send no email. These addresses also get an email when a sync finds people that do not match a RingRx user.

Minutes ahead:

How far ahead RingRx looks for a time with nobody on call. 15 to 600. If it finds one, it sends the alarm email.

The OnCall Calendar 

The On Call page in the main menu is the OnCall calendar. It shows who is called, and when, for one group.

Group switcher:: Select the group at the top left. Search by name or extension. Each group shows its mode and who is on call now. Your own groups are listed first. My on-call — all my groups shows every group you are in, in one calendar, in your own time zone. It also shows when you are called first, when you are a backup, and when you are called first in two groups at the same time.
Times in:: All times on the page are in the time zone of the group.
On call now:: Who is called at this moment, until when, and the full call order.
Uncovered windows:: Times this month when nobody is on call.
Overridden shift-days:: Shifts that are scheduled but never called, because a more specific shift covers the same time. A day with overridden shifts shows how many. Turn on Show overridden shifts to list them in each day. The switch shows only when a shown day has an overridden shift.
Shifts with no users:: Shifts that have nobody in them. They are skipped and never called.
Called first:: A bar that shows how much of the month each person is called first.
Views:: Month, list or week. The week view shows one lane for who gets called and thin lanes for every shift on the day. Print prints the period you see.

Click a day to open it. The bar at the top shows who gets called through the day. Below it are the shifts of the day, most specific first. Each shift shows its call order, and whether it is called, partly called or overridden. Use Add one-time shift or Add repeating shift to add a shift, and Edit, Copy or Delete to change one. If the day is in the past, you are asked to confirm first. Click outside the window to close it.

If the group syncs from Amion, ShiftAdmin or QGenda, a banner says so, with a Sync now button. Shifts that the next sync will replace cannot be changed here.

Edit Repeated Shifts opens the repeated shifts of the group. OnCall Groups opens the group settings. My OnCall Profile opens your own OnCall rules.

Before you save a shift, What changes if you save shows who is called before and after the change.

Repeated Shifts 

Repeated shifts occur on the same days, from the same time to the same time, every week.

Description:: Optional. A shift is named by its days and times, for example Mon–Fri · 5:00 PM – 11:59 PM. A description is shown with that name.
Start Time:: The time of day (in the group time zone) that the shift begins.
End Time:: The time of day (in the group time zone) that the shift ends.
Days:: The weekdays the shift applies to.
Users:: One or more users that are on call when this shift is active. Use Call order to set who is called first.

Important

Repeated shifts may not cross midnight. If you want one to go overnight, you must make two, one from midnight to its AM end, and one from its PM start until 11:59 PM.

One-Time Shifts 

One-time shifts have a start date and time and an end date and time. Once the end time has passed, they are never active again.

Description:: Optional. A shift is named by its days and times, for example Mon–Fri · 5:00 PM – 11:59 PM. A description is shown with that name.
Start Date, Start Time:: When the shift begins (in the group time zone).
End Date, End Time:: When the shift ends (in the group time zone).
Users:: One or more users that are on call when this shift is active. Use Call order to set who is called first.

Important

One-time shifts MAY cross midnight. Set the end date to the next day.

To repeat a one-time shift on other days, use copy mode in the shift window, then click the days to copy to. Copies keep the same local start and end times and the description, and are named by their own date. A day that already has the same shift does not get a second copy.

Schedule Integrations 

Instead of entering shifts by hand, an OnCall group can take its shifts from an Amion, ShiftAdmin or QGenda schedule. Every 2 hours RingRx reads the schedule and creates, updates or removes the group’s One-Time Shifts to match, placing each provider on a shift by the email address on their RingRx user. Filters let several OnCall groups share one schedule, each taking only the sites, services or shifts that belong to it.

Important

When a schedule integration is enabled, the schedule is the source of truth for that OnCall group. Shifts that are not in the schedule are removed at the next sync, so make changes in Amion, ShiftAdmin or QGenda rather than in RingRx.

Schedule integrations are enabled and configured by RingRx support. For how they work, what they need, and how filters are used, see Scheduling Integrations.

Shift selection 

Shifts can overlap. RingRx uses one shift at a time, and only that shift’s users are called. To select the shift, RingRx uses these rules, in this order:

A shift with no users is skipped. The shift under it is used.
The most specific shift wins: the shift that covers the smallest amount of time.
- A one-time shift: its length.
- A repeated shift: its length times the number of days per week.
Every one-time shift wins over every repeated shift.
If two shifts cover the same amount of time, the shift ranked first (the lower priority number) wins.

For example, a repeated shift Mon–Fri 5 PM to 11:59 PM covers 35 hours a week. A repeated shift on Wednesday 5 PM to 11:59 PM covers 7 hours a week. On Wednesday evening the Wednesday shift wins. A one-time shift on that Wednesday from 6 PM to 8 PM wins over both from 6 PM to 8 PM.

Provider contact 

When RingRx knows the shift, it must know how to reach each person on it. Each user sets this in their own OnCall rules: OnCall Settings

User rules are like repeated shifts:

Name:: A name for the rule
list of days:: The days the rule applies to.
start time:: The time of day (in your local time zone) that the rule begins
end time:: The time of day (in your local time zone) that the rule ends
Method:: How the user is called (Ring my phone, Simultaneous, Sequential, Forward). These are the same behaviors as for your calls under “My Phone”.
Call Handling:: Patch keeps the caller on the line while you are called, so you can connect to them. Relay ends the call and relays the message to you. This applies only when you are the first person on the shift.

Important

OnCall user rules may not cross midnight. If you want one to go overnight, you must make two, one from midnight to its AM end, and one from its PM start until 11:59 PM.

OnCall Call Records 

Every OnCall mode call is recorded in the call log with the oncall tag and any tags of the group. RingRx adds the OnCall events to the call record as they happen. The record stays when the message is deleted, so you always have proof of how the call was handled.

Note

This tracking applies to calls made after the OnCall call tracking release. Older OnCall calls do not have it.

`What is recorded`

Message left:: When the caller finished the message, measured from the start of the call. If the caller hung up before this, the call has no message.
Patch:: For a patch call: how long it took the person to answer, how long they took to choose, who it was, and the result.
First read:: The first time anybody listened to the message: when, who, how (phone, or the portal or app), and how many relay calls had been made.
Reads:: How many times the message was read, and the last time. Reads less than 60 seconds apart count as one.
Deleted:: The first time the message was removed: when, who, how, and what kind of removal (moved to trash, deleted permanently, or removed by the system).

Patch results:

Patched:: caller connected: The person entered their PIN and connected the caller.
User declined:: The person heard the message and chose not to connect.
PIN correct, no choice:: The person heard the message and hung up.
User answered, no PIN:: The person answered but did not enter a PIN.
PIN failed:: The person entered a wrong PIN too many times.

A message removed by the system was removed because the mailbox was over its quota, because of the retention period, or because the mailbox was deleted.

`Outcomes`

Each OnCall call gets one outcome, in this order:

Hung up before message:: The caller hung up before leaving a message.
Patched live:: The caller was connected to a person on call.
Acknowledged:: Somebody listened to the message, by phone, in the portal or in the app.
Deleted unread:: The message was removed before anybody listened to it. Look into these calls.
Unread:: Nobody has listened to the message yet.

`In the call log`

In Calls, an OnCall call shows an OnCall chip with its outcome, for example OnCall · Acked 15m 51s or OnCall · Unread 2h 10m. Expand the call to see the OnCall summary: every step in time order, with the clock time and who did it. The OnCall group of the call details has the same data.

If the OnCall group was deleted, the call shows Removed OnCall group with the extension.

`Download OnCall Report`

The Download OnCall Report button in the OnCall summary downloads a text file about that one call. Keep it as a record of how the message was handled, for a service review or a compliance file. It has:

A summary in plain words.
A timeline with the date and time of each step.
The details of the call.
How to read the report.
About this record.

Important

The report can contain PHI, such as the caller’s name and number. Store and share it the same way as other patient records. The report is a copy of the RingRx call record. It is not a certification.

`Raw notes`

The OnCall data is kept in the notes field of the call record. It is in the Download CSV export and in CDR callbacks (see the API). The format is key=value pairs separated by commas. Fields in a value are separated by |. All times are in seconds.

vm_id:: The message id.
oc:: The OnCall group id | seconds from the start of the call to the message.
oc_pt:: Patch: seconds from the message to the answer | seconds from the answer to the choice | user | result (1 patched, 2 declined, v PIN correct with no choice, a answered with no PIN, 0 PIN failed).
oc_rd:: First read: seconds after the message | user | via (i phone, u portal or app) | relay calls made.
oc_lr:: Reads: count | seconds from the message to the last read.
oc_del:: First removal: seconds after the message | user | via (i phone, u portal or app, s system) | kind (t trash, d deleted permanently, p removed by the system).

OnCall Report 

Calls › OnCall shows how your OnCall groups handle messages over a date range. As in Analytics, admin users see the calls of the whole account, and other users see only their own calls. Select a group to see only that group. Download CSV exports the figures.

OnCall calls:: All OnCall calls in the range, and how many callers hung up before leaving a message.
Patched live:: The percent of messages where the caller was connected live.
Median time to patch:: From the message to the connection.
Relay median time to ack:: From the message to the first read, for messages that were not patched. Half of the messages were read faster than this.
Relay 90th percentile:: 9 in 10 messages were read faster than this. Also shows the average number of relay calls before the read.
Median time to clear:: From the message to its removal.
Still unread:: Messages nobody has listened to, and the age of the oldest one.
Deleted unread:: Messages removed before anybody listened to them.

Below the tiles:

Relay time to acknowledge: how many messages were read in each time range. Patched calls are not included, because the patch marks the message read within seconds.
Message outcome by group: the share of each outcome for each group.
OnCall performance by group and by user: the same figures for each group or each person. The user table also shows how each person read messages (phone or app) and how many messages they removed.

Note

Times are medians, so one very slow message does not change them much.