The kalmstrom.com team uses HelpDesk OSP for support cases. We also use this incident management tool in other situations where e-mails need to be organized and discussed among us, for example to sort and comment on job applications.
Since the team members live and work far apart in different countries, we use OWA for the e-mail and have HelpDesk OSP installed on a server where Outlook is running 24/7. We can always access the tickets from our smartphones, which is a big advantage for those of us who travel a lot.
Even if we don't use all the possibilities SharePoint gives - because we don't need them - we are very satisfied with our software and with having this connection between our e-mail and our intranet. Since we often get questions about how to use HelpDesk OSP for a distributed group, we have made a faq that explains how we have set it up. Welcome to read more about our way of using HelpDesk OSP!