For three health care centers, the challenge was clear: Find a way to improve internal communications by expanding e-mail accounts to all employees, including doctors, nurses, security staffers, dietary workers and others, without breaking their IT budgets.

To do it, the hospitals needed to look at alternatives to traditional ways of creating and administering e-mail accounts.

In the end, all three health centers chose an application that could do the work of Microsoft's Exchange e-mail administration package while maintaining calendaring and other group features.

Wade Grimes, the IT operations manager for the three-hospital Appalachian Regional Healthcare System in the US, had to update an e-mail system that served only about 400 of 2,000 staff members, with a mandate to find an economical way to get service for the rest of staff. The infrastructure was a hodgepodge, with Microsoft Exchange 2000 running in one facility while two different brands of e-mail appliances were used in other areas. The three hospitals in the systems are Watauga Medical Center, Charles A. Cannon Jr. Memorial Hospital and Blowing Rock Hospital.

When Grimes checked into replacing it all with new Exchange infrastructure about a year ago, the estimated US$250,000 to $300,000 cost quickly put an end to the search. That's when the IT staff brought in a server using the free, open source Postfix e-mail application running on Ubuntu Linux to operate along side the Exchange server so that more users could be added at little cost.

"It was nuts," Grimes recalled. "It worked, but there were several challenges. User management was an impossibility" because it lacked central management for the entire system.

A bigger problem was that as the IT staff provided the additional workers with e-mail accounts in the Postfix environment, they quickly heard requests for such features as shared calendaring and other collaboration tools that the Exchange users had. Users on the Exchange system couldn't share these features with users on the Postfix system, which sent Grimes again searching for an answer.

Grimes looked at other big e-mail/collaboration applications, including Novell's GroupWise and IBM's Lotus Notes, but those were also too expensive for the hospitals, he said. "E-mail is incredibly important, but budgets are important, too."

That's when one of his IT staff members found PostPath's PostPath Server application, which runs on Linux and allowed the hospitals to save money while still connecting new users with the Exchange users, all while allowing collaboration features to work for everyone. It was sufficiently inexpensive that Grimes "didn't need to go to the capital budget committee to get it passed."

He also looked at the open source alternative Open-Xchange, but tests didn't show the needed results, he said. "Some calendars didn't sync up quite right," he said. "We've got some decent Linux talent in-house and looked at these things on virtual machines to see if they could get them to work. We could get it 80 per cent of the way there, but the [missing] 20 per cent were the features I wanted."

"We really tried not to use PostPath, we really did," Grimes said. But in the end, "it was the obvious choice for all the things we tried to do." Another benefit of PostPath Server, he said, is being able to add more Web servers at no charge, unlike Exchange. With PostPath, customers pay for mailboxes and can add servers at no charge.