If you are a small practice and want to incorporate email and voice communications, Response Point can be purchased at Costco. You need an active LAN and a phone RJ-11 connection and can handle up to 50 users. This is Voice over IP and contains speech recognition options...
If you have not heard about this product, check it out... I have used it for a few months now and it helps me keep right up to date on everything I need....I have an old saying "if it's not in Outlook, then I don't get to it". ..and that is the key here. Bill Gates even recommended...