We've just completed development and testing of SkypeOut support within Synapse EMR Express. Formal release is pending completion of an updated installer, although any existing users can request this release in the forums.
SkypeOut is a service from Skype supporting Voice Over Internet Protocol (VOIP) communication between a Skype enabled computer and most telephone or cellphone numbers anywhere in the world. Using our Synapse EMR Express client you can bring up a patient on-screen and click the SkypeOut icon next to whichever contact number you want to call. (The first time this is executed, SkypeOut asks for permission.)
USA & Canada based customers can enter a number using a regular US number format 555-555-5555 or optionally international format +1-555-555-5555 if planning to call patients while on vacation outside US territories. International customers must enter the full international country code, e.g. +441926485043 for the UK dropping zero before area code. See the Skype web site for more help and assistance.

The first time you click a SkypeOut link the Skype application will ask you if you want to permit Synaspe EMR Express to integrate with Skype calls. Normally you want to select "Allow this program to use Skype". Once selected, everytime that a SkypeOut call is made, Skype automatically starts the telephone call.

Our installation package needs to ship the Skype4com.DLL library and register this DLL within the Registry. This can be done manually by Start > Run > regsvr32.exe C:\Skype\Skype4com.dll* and Enter. This will report registration of the DLL.
(*drag and drop Skype4com.dll from where it is installed onto the Start Run dialogue box and this will automatically complete the long path to the DLL library)