Taking a page from the doctors at Moses Taylor Hospital, IT staff at the US facility last year diagnosed their messaging system and came up with an effective treatment that's turned out to be a life saver.

The patient in this case was an aging Microsoft Exchange 5.5 environment that couldn't support increased message loads and was going to cost a bundle to upgrade.

After conducting an evaluation of alternatives, the hospital decided not to upgrade to a newer version of Exchange. Instead, it went with a Linux-based Exchange clone that it felt could meet the needs of its 700 users without forcing them and IT to learn a whole new system.

As it turns out, it wasn't feature sets that swayed the decision. It was the price, according to Frank Fallo, manager of network systems and workflow development at Moses Taylor.

"[With Exchange,] I saw extremely high cost, especially the [client access licenses]," Fallo says. "The Microsoft billing structure was considerably more expensive and that is just talking about the software side. If you want to include hardware, we also needed a more robust server."

Fallo got the more powerful hardware anyway, but it is running PostPath Server, a Linux-based clone of Exchange, on top of the Linux Centos operating system.

"We have estimated that PostPath saved us 50 per cent over the cost of Exchange," Fallo says, and that doesn't count what Microsoft would have charged for maintenance and support (Fallo declined to get into the project's specific dollar figures).

The hospital also went from three staffers managing e-mail to one.

Another benefit is that PostPath is a "very good representation of the Exchange server," Fallo says.

So good, in fact, everything on the network that talks to the server thinks it is Exchange, including Active Directory, making integration of Microsoft and third-party tools, and other add-ons much less of a headache, Fallo says.

The integration also includes the Outlook clients that run on desktops at Moses Taylor, a 173-bed hospital that was opened in 1892 by New York City merchant/banker/industrialist Moses Taylor to care for the railroad workers and coal miners of the region.

Fallo says the integration with Outlook has eased any training issues for the hospital and numbed the inevitable end-user complaints.

The one client difference, however, that has worked in Fallo's favor is the AJAX-powered Zimbra Web mail client that PostPath uses. The hospital likes it better than the Outlook Web Access client of Exchange 5.5 (Microsoft has since improved its Outlook Web Access client).

"You can basically do anything with the Web mail client that you can do in the [Outlook] desktop client," Fallo says.