A VOX interface is provided that interfaces with at least two communication paths to two separate devices. One communication path may be to a first electronic device, such as a central monitoring station remote from the VOX interface, and another communication path may be to one or more remote devices, such as to one or more patient devices remote from the VOX interface. The VOX interface may determine which of the communication paths is sending a signal (such as an audio signal), and configure the VOX interface (via one or more switches) to pass the signal through. Specifically, the VOX interface may sense signals indicating the presence of audio from a central station audio bus and the patient station bus, may do some background noise filtering on the signals, and may pass these filtered values through a differentiator circuit to determine which bus presented the audio. Depending on which bus presented the audio, one or more switches (such as a relay) may be configured so that the audio may be passed through.