I have further clarity on the message refresh functionality. The results refresh byproduct I describe above is correct but that is server based only to process your lab results but refreshes only the email grid on the server itself. A separate service was added back in version 10 specifically to refresh your individual mailboxes on each workstation. It's hard coded to run every 15 minutes and is not editable in the current version. It serves a purpose but obviously with a 15 minute interval it certainly won't keep your inbox current and hence the need to manually refresh until we can decide on a more appropriate solution that will not have a negative impact elsewhere; Some practices have enormous inboxes and constant refreshes can be a drain on performance. Manual refreshes keep this to a minimum controlled by the user on an as-needed basis. Not an easy nut to crack given the current architecture.
