Need info finding/implementing VOIP solution

I need info/help on finding and implementing a VOIP solution.
We have a call center using a dialogic board and need to cut expenses, so we're looking to VOIP.
Is the technology there yet?  I have a VOIP phone (packet8) and the quality is pretty bad, but may need more bandwidth.

I need info on an application that will use an sql database to make patient calls, ask questions (wav files) based on assigned survey, collect and update database with keypad entered answers.

I have EDI (segment) experience, basic/Fortran/C#/VB experience and don't really care what language - I'll learn if I need to, but I need a low cost solution where I can use sql and program the flow and branching.

Thanks for any help -
dcassAsked:
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grbladesConnect With a Mentor Commented:
VoIP can be very good quality but you tend to find that calling other countries over VoIP sends the calls over the internet to the local country and then jumps onto the local telephone system. This means for countries with good internet connections the quality is good but some others can have problems.

For your situation I would recomend Asterisk (http://www.asterisk.org and http://www.voip-info.org/wiki-Asterisk). The dialplan is very customisable and you can call external programs from it. You could write a shell script, C#, Perl, PHP etc... application which receives the data and automatically updates the database.
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