And, you can change the default to Outlook anytime. Things may have changed, but I researched this one for months.
It works the way most major hospitals work. Your email goes to their secure server encrypted. The person you send to gets an email notification. They only see the email on the server. They can download it encrypted if they wish. You can also at any time take the message back. You also know the exact time they pick up the email or open it.
I believe they have a thirty day trial which you can set up on rather quickly.