Health and activity tracking is good tool, because You can see how the messages and orchestrations are doing their work. It is extremelly good, but maybe it is not that comfortable for the daily operations.
Yeat another tool is available: BizTalk Server 2004 Health Monitor Windows Service
Does only basic task - checks for messages older than specified SLA level. This tool may be not suitable in all cases, because You may have different types of processes with very long transactions and the short ones. But this sample can be a good startup for simple monitoring tool.