When Debbie Cancilla took charge of the IT operation at Grady Health System, which operates one of the largest public hospitals in the U.S., she inherited an email system that had become a nightmare for doctors, nurses and administrators.

Most companies or organizations experience occasional email downtime. Grady's aging Novell GroupWise email system was averaging an outage per week.

At the time, in 2008, Grady was facing severe budget problems, and the organization's beleaguered IT team didn't have the time or materials needed to fully fix an email system that cost some $200,000 annually to operate, said Cancilla, CIO and senior vice president.

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