I came across this interesting case study about a University Clinic in Aachen, Germany.  I visited Aachen once, several year's ago, and I've just been reading Bill Bryson's early 90's tavel book, Nether here nor there, where he visits Aachen too.  So between this case study and Bill there is pelnty already written about Aachen and Bill puts it all far far better than I could hope to achieve.

The interesting thing to note from this case study is how People were very much at the centre of the decision and the recognition that to enable an organisation to funtion at its best, you have to focus on the people because its people and not process that make the difference.  Of course, in this particular University, they were looking at both the clarity of the interface which is particularly important in helping users to get the best out of a procedural system and also the integration aspect.  It was also encouraging to see the notes on costs, which have been reduced with the introduction of Exchange.  It seems that they could not integrate Lotus Notes effectively with core applications, which made information sharing and collaboration difficult

http://www.microsoft.com/casestudies/casestudy.aspx?casestudyid=200240

What this also highlights is that the Microsoft messaging system can form a fundamental part of a business application and because of its familiarity can deliver improvements in a very short time.  I believe that the improvements come from the people because the Microsoft tools allow them to produce at their best.