We have finally come to a decision. Only took the better part of a year. smile

We looked at Cisco, Avaya, and Shoretel.
Shoretel is not too bad a system for smaller companies. But it is not very flexible. It is one of those systems that if you like what it is then great, but if you want to change something well good luck.

Avaya is actually a very nice system, rather pricey, even by Cisco standards, And lots of training, even more training then the Cisco.

We went with Cisco, It is actually a nice system, not much of what you read in these forums is true. It scales to an almost unlimited size, it is very complex, but that allows it to do almost anything at all. Training is intense, especially if you want the certifications. But all in all I think it was the best solution for the Health System.