UNITED STATES SECURITIES AND
    EXCHANGE COMMISSION
    Washington, DC 20549
    Form 10-K
 (Mark One)þ

ANNUAL REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE
    SECURITIES EXCHANGE ACT OF 1934For the fiscal year ended
    January 31, 2010oro

TRANSITION REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE
    SECURITIES EXCHANGE ACT OF 1934For the transition period
    from          to   Commission File
    Number: 0-28132
  Streamline Health Solutions,
    Inc.
 (Exact name of registrant as
    specified in its charter)
  Delaware(State or other jurisdiction
    of
    incorporation or organization)

31-1455414(I.R.S. Employer
    Identification No.)  10200 Alliance Road, Suite 200
 Cincinnati, OH
    45242-4716
 (Address of principal executive
    offices) (Zip Code)
 (513) 794-7100
 (Registrants telephone
    number, including area code)
  Securities registered pursuant to Section 12 (b) of
    the Act:
  Common Stock, $.01 par value
  ( Title of Class )
  The NASDAQ Stock Market, Inc. (Name of exchange on which
    listed) Securities registered pursuant to Section 12
    (g) of the Act:
    None
  o þ
  o þ
  þ o
  Regulation S-T o o
  Regulation S-K Form 10-K, Form 10-K. þ
   Large
    accelerated
    filer o
    Accelerated
    filer o
    Non-accelerated
    filer o
    Smaller
    reporting
    company þ   Rule 12b-2 o þ
        DOCUMENTS
    INCORPORATED BY REFERENCE
  Form 10-K Form 10-K,




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##### 





FORWARD-LOOKING
    STATEMENTS
  Form 10-K Form 10-Q Form 8-K.
     PART I
  Item 1.
    Business  Company
    Overview
  ®
     1




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##### 



work-in-process,
            Form 10-K, Form 10-Q, Form 8-K, www.streamlinehealth.net http://www.sec.gov/cgi-bin/srch-edgar.
 2




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##### 



Form 10-K
    Products
      
    Easy to navigate, real-time computerized interfaces that are
    physician-oriented and can be used at the point of patient care
    Secured access to data under HIPAA standards to protect
    patients healthcare information
    Enterprise-wide access to patient lifetime medical records,
    which assist in making informed clinical and financial decisions
    Reduced costs for administrative personnel due to increased
    workflow efficiency, as documents can be scanned, indexed, and
    routed within an organization to all users who need to process
    that information simultaneously, or in sequence as required
    Increased productivity through the elimination of file
    contention by providing multiple users simultaneous access to
    patient medical records
    Reduced costs and improved care through the reduction of
    unnecessary testing and admissions
    Improved cash flow through accelerated account receivable
    collections and reductions in technical denials
    (which occur when a third-party payer refuses payment because of
    the providers inability to substantiate billing claims due
    to loss of portions or all of the patient record)
    Expedited treatment decisions, and fewer redundant tests as a
    result of timely access to complete information
    Fewer medical record errors by minimizing misfiled, lost and
    improperly completed records; and
    Increased security of patient information through improved
    controls on access to confidential data and the creation of
    audit trails that identify the persons who accessed or even
    tried to access such information.   3




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##### 



e-health
  state-of-the-art
  accessANYwareTM
     4




---



##### 




    STRM-IT and accessANYware are now one product
    Within the one application many modules may be added on to fit
    customer needs, including custom workflows & uses
    Migration of platform from Java to Microsoft.NET
    Patient worklist divided into filtering section and document grid
    Role-based, LDAP compliant security function built in, makes for
    easier administration
    Microsoft SQL Server Capable (Future)    
    Cutting-edge service oriented architecture
    Enhanced database design better enforces table relationships and
    constraints, prevents orphan records
    Multi-entity, multi-timezone, and
    multi-language
    functionality
    Provides for a higher level of integration with 3rd party
    applications
    Customizable user interfaces, sorts, grouping, filtering, and
    workflow creation
    Vastly improved product stability, which allows easier
    support & troubleshooting, at less cost
    Platform enables future expansion and easier integration with
    customers existing systems
    Shorter testing cycles
    Faster
    time-to-market
    Simplified installation    
    accessANYware  HIM is an enterprise wide,
    HIPAA/HITECH secure application that provides hospital
    organizations the ability to electronically store, search and
    retrieve medical records from any location within the facility,
    physician offices, off-site clinics and even from home. In
    addition, accessANYware  HIM provides a complete
    chart deficiency management system that includes analysis,
    electronic signature and management reports  all from
    a single login. accessANYware  HIM allows the user to
    securely view the entire medical record from a visit view or a
    category-based longitudinal view of historical patient
    information.
    accessANYware  PFS is a HIPAA/HITECH secure
    application that allows any department of a healthcare
    organization the ability to store, retrieve and process
    document-centric information using a site-defined electronic
    folder hierarchy with a user-friendly interface.
    accessANYware  PFS provides document management and
    workflow capabilities for a hospital organizations
    enterprise-wide departmental needs, such as Patient Financial
    Services, Business Office, Human Resources, Materials
    Management, and virtually any other department that has document
    intensive storage, retrieval and processing needs.
    Streamline Health Integration Tools 
    STRM-ITtm

    supports powerful image-enabling and workflow technology that
    allows healthcare users to immediately and simultaneously access
    any patient information, including multimedia and paper-based
    information, through their existing third-party clinical, HR
    administrative or billing applications. STRM-IT also supports
    direct, secure access to the entire patient chart and physician
    inbox via integration. As a result, any application across the
    entire enterprise can be image-enabled, including the host
    Healthcare Information Systems, Patient Billing Systems,
    Clinical Data Repositories and others. When the Clinical Data
    Repository is image-enabled, users can access any piece of
    information on the same workstation and from the same screen
    display, including the point of patient care. 5




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##### 



This means users can view traditional electronic data and images
    simultaneously on the same screen without signing in and out of
    multiple applications.  FolderView
    Workflow
    Solutions
      
    Cash Management Workflow focuses on improving and
    enhancing the cash posting, including the researching and follow
    up functions within the business office for received
    non-standard paper remittances. By scanning the documents into
    the workflow, the manual posting is done from the image,
    allowing the page to be captured and stored to the account level
    in the customers accounting system.
    Referral Order Workflow allows hospitals the ability to
    electronically manage their inbound physician referral orders
    through a workflow process from receipt through
    pre-registration, and ultimately indexing into a central
    electronic repository, accessANYware.
    Chart Completion Workflow is a chart deficiency
    management workflow that provides management reporting along
    with providing analysts and clinicians the ability to remotely
    analyze, electronically sign and complete deficient records. In
    addition to a single login, Chart Completion Workflow delivers a
    single user interface and integrated database. Therefore, from a
    single system login, users with appropriate security have the
    ability to search and retrieve information regarding patients
    and cases (for chart analysis), view, print and fax patient
    documents, as well as analyze or complete deficient documents.
    The functions presented to the user vary with the users
    security. For example, if the user is a clinician, they are
    presented with an inbox function that displays a list of
    incomplete charts (awaiting completion) and a list of
    linked patients assigned to them. The clinician then
    has the option to complete deficient charts or retrieve patient
    information via searching or by clicking on the
    linked patients within their inbox. This access may
    occur from any workstation within the facility, the
    physicians office, or some other remote site. With proper
    security, the user is able to view, print and fax patient
    information.
    Coding Workflow provides workflow automation of the
    coding and abstracting process by allowing hospital personnel to
    electronically access documents to be coded and abstracted from
    remote locations, including the employees home. It may
    also be integrated with third-party encoding or abstracting
    software, avoiding redundant data entry. Due to an acute
    shortage of available coding personnel, there currently exists a
    great demand for solutions to attract and retain qualified
    coders and to make the coding process more efficient. 6




---



##### 




    Release of Information Workflow fulfills internal and
    external requests for patient information and allows for
    automatic invoicing capability. It also provides the ability to
    electronically search for, print, mail or fax information to
    third parties that request copies of patient records.
    Chart Tracking Workflow provides the ability to manage
    requests for and track the physical location of paper records.
    This workflow also allows the user to define the retention and
    destruction of these paper records.
    Financial Screening Workflow manages the rising number of
    self-pay accounts that healthcare providers are experiencing by
    forwarding the financial documents at the time of receipt to
    insurance specialists to expedite charity care program analysis.
    Pre-Operative Workflow manages patient documents and
    reduces cancelled/rescheduled surgeries by proactively providing
    required document sets for the scheduled surgery facilitating
    those that are missing.
    RAC/AMP Audit Workflow helps reduce
    and/or
    eliminate default states (absent documents, missed document
    deadlines) and improve efficiency and productivity in managing
    the federal governments Recovery Audit Contractor program
    to minimize Medicare fraud and abuse.
    FMLA/LOA Workflow tracks Family Medical Leave (FMLA) and
    leave of absence requests (LOA) and helps to determine
    eligibility, calculates employee payment for continued benefits.
    creates notification letters, tracks expected return to work
    date, and integrates with Lawson software.
    Contract Management Workflow stores and retrieves
    approved contracts with hospital vendors in FolderView database.
    The workflow will track contracts and notify materials
    management at user-specified intervals, as contracts are about
    to expire. The workflow can be configured to track contracts
    throughout the approval process. It will also maintain an
    archive of expired and terminated contracts.
    Contractor Management Workflow stores and retrieves
    approved contractor documents. The workflow integrates
    contractor data within the Contract Management Workflow. It will
    notify at specific intervals materials management, department
    heads, and contractors as documentation data about to expire,
    and then archive expired documentation and terminated
    contractors. It provides an interface for the providers
    badge system to upload contractor photos. In addition, it allows
    security to access contractor information, and make
    determination on whether a contractor is cleared to work (OSHA).  Health
    Information Management Suites
    
    HIM Suite includes accessANYware  Patient
    Folders, Chart Completion Workflow, Release of Information
    Workflow, Coding Workflow and Chart Tracking Workflow.
    The PFS Suite includes accessANYware  Non
    Patient Folders, and a choice of three among the following
    workflows: Referral Order Workflow, Pre-Operative Workflow,
    Financial Screening Workflow and Cash Management Workflow, and
    administrative workflows.
    The Enterprise Suite is a full offering of Streamline
    Health solutions including the HIM Suite, the PFS Suite, and the
    Streamline Health Integration Tools (STRM-IT).  Professional
    Services & Business Process Management
    Consulting
   7




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##### 



Competition
          Healthcare
    Industry Trends Impacting Streamline Health
  Rapid
    Technological Change and Evolving Market
   8




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##### 



Changes
    and Consolidation in the Healthcare Industry
    The
    U.S. Healthcare System, U.S. Government Policy and Legislative
    Initiatives
        
    Intends to modernize U.S. healthcare system with health
    information technology (HIT) investments to reduce cost and
    improve quality of patient care, focusing on preventable errors
    and inefficient paper billing systems
    Goal of full deployment of EHR by 2014
    $19B investment in HITECH Provision includes $40 thousand per
    physician in EHR adoption incentives beginning in 2011 payable
    through 2016
    HIT extension programs for regional adoption via Regional Health
    Information Organizations (RHIO)
    Funds earmarked to states to promote interoperable EHRs
    Education programs to train clinicians in EHRs
    Dramatically increase the number of HIT professionals (current
    shortage to meet aggressive EHR adoption plans) 9




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##### 




    Create HIT grant and loan programs
    Accelerate construction of National Health Information Network
    (NHIN)        Contracts
    Overview
           10




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##### 



Signed
    Agreements  Backlog
  and/or
     11




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##### 



License
    fees
    Employees
    Key
    Personnel
    Regulatory
    Matters
    Regulations
    Relating to Confidentiality
     12




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##### 



Limited
    Protection of Proprietary Technology
    Item 1A
    Risk
    Factors    and/or
  The
    variability of the Companys quarterly operating results
    can be significant.
  quarter-to-quarter Form 10-K
  The
    Companys sales have been concentrated in a small number of
    customers.
   13




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##### 



In
    addition to direct sales, the Company relies on third party
    remarketing alliances for a substantial portion of its revenues.
    The
    Company could be less profitable than
    expected.
    The
    Company needs to manage its costs while planning for
    growth.
    The
    potential impact on the Company of new or changes in existing
    federal, state, and local regulations governing healthcare
    information could be substantial.
    While
    provisions in the American Recovery and Reinvestment Act of
    2009 may increase the demand for healthcare information
    technology, including the solutions offered by the Company, such
    laws and regulations may have adverse consequences on the
    Company.
  time-to-time
 14




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##### 



While
    provisions in the Patient Protection and Affordable Care Act may
    increase the demand for healthcare information technology,
    including the solutions offered by the Company, such laws and
    regulations may have adverse consequences on the
    Company.
  time-to-time
  Streamline
    Health faces significant competition, including from companies
    with significantly greater resources.
    The
    healthcare industry is evolving rapidly, which may make it more
    difficult for the Company to be competitive in the
    future.
   15




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##### 



Rapid
    technology changes and short product life cycles could harm
    Streamline Healths business.
  and/or
  Streamline
    Healths intellectual property rights are valuable, and any
    inability to protect them could reduce the value of Streamline
    Healths solutions and services.
      The
    Company could be subjected to claims of intellectual property
    infringement, which claims could be expensive to
    defend.
   16




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##### 



The
    Companys customers must comply with extensive regulations
    relating to confidentiality and, accordingly, the Companys
    solutions must be able to assist its customers in complying with
    such regulations.
      Third
    party products are essential to Streamline Healths
    software.
    Streamline
    Healths solutions may not be error free and could result
    in claims of breach of contract and
    liabilities.
    The
    Company could be liable to third parties from the use of the
    Companys solutions.
   17




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##### 



The
    Companys remote application hosting services and support
    services could experience interruptions.
    The
    Companys remote application hosting services are provided
    over an internet connection. Any breach of security or
    confidentiality of protected health information could expose the
    Company to significant expense, and harm to the Companys
    reputation.
    The
    loss of key personnel could adversely affect Streamline
    Healths business.
    The
    Company may not have access to sufficient capital to be
    competitive in its markets.
    The
    Company must maintain compliance with the terms of its existing
    credit facilities. The failure to do so could have a material
    adverse effect on the Companys ability to finance its
    ongoing operations and the Company may not be able to find an
    alternative lending source if a default would
    occur.
   18




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##### 



Potential
    disruptions in the credit markets may adversely affect our
    business, including the availability and cost of short-term
    funds for liquidity requirements and our ability to meet
    long-term commitments, which could adversely affect our results
    of operations, cash flows and financial
    condition.
    Current
    economic conditions in the United States and globally may have
    significant effects on the Companys customers and
    suppliers that would result in material adverse effects on the
    Companys business, operating results and stock
    price.
  and/or
    The
    market price of the Companys common stock is likely to be
    highly volatile as the stock market in general can be highly
    volatile.
    
    General economic and market conditions;
    Actual or anticipated variations in quarterly operating results;
    Lack of research coverage by securities analysts;
    Conditions or trends in the healthcare information technology
    industry;
    Changes in the market valuations of other companies in the
    Companys industry;
    Announcements by the Company or its competitors of significant
    acquisitions, strategic partnerships, divestitures, joint
    ventures or other strategic initiatives;
    Capital commitments; 19




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##### 




    Additional or departures of key personnel; and
    Sales and repurchases of the Companys common stock.    The
    preparation of the Companys financial statements requires
    the use of estimates that may vary from actual
    results.
    Changes
    in accounting standards could impact the Companys reported
    earnings and financial condition.
    Failure
    to improve and maintain the quality of internal controls over
    financial reporting could materially and adversely affect the
    Companys ability to provide timely and accurate financial
    information about the Company.
    Foreign
    currency risk
    These
    risks are not exhaustive.
  Form 10-K
 20




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##### 



Item 1B.
    Unresolved
    Staff Comments    Item 2.
    Properties  OH 45242-4716.
    Item 3.
    Legal
    Proceedings    Item 4.
    (Removed
    and Reserved)  EXECUTIVE
    OFFICERS OF THE REGISTRANT
    First Appointed asName

Age

Position(1)

Executive Officer(2)J. Brian Patsy


59


President, Chief Executive Officer, and Director


1989Gary M. Winzenread


44


Senior Vice President Product Development and Strategy


2007Joseph O. Brown, II


49


Vice President Administrative Services and Chief Information
    Officer


2007B. Scott Boyden, Jr.


45


Senior Vice President Sales and Marketing


2008Donald E. Vick, Jr.


46


Controller, Interim Chief Financial Officer, Interim Treasurer
    and Interim Corporate Secretary


2002     (1)
    
    All current officers of Streamline Health hold office until
    their successors are elected and qualified or until any removal
    or resignation. Officers of Streamline Health are elected by the
    Board of Directors and serve at the discretion of the Board. For
    purposes of the descriptions of the background of Streamline
    Healths Executive Officers, the term Company
    refers to both Streamline Health Solutions, Inc. and its
    predecessors LanVision Systems, Inc. and LanVision, Inc.(2)
    
    Represents date of appointment to Registrant or its predecessor.   21




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PART II
  ITEM 5.
    Market
    For Registrants Common Equity, Related Stockholder Matters
    And Issuer Purchases Of Equity Securities    Fiscal Year 2009

High


Low4th Quarter (November 1, 2009 through January 31, 2010)

$
2.58


$
2.063rd Quarter (August 1, 2009 through October 31, 2009)


2.94



2.102nd Quarter (May 1, 2009 through July 31, 2009)


3.58



1.981st Quarter (February 1, 2009 through April 30, 2009)


2.30



1.15   22




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##### 



Fiscal Year 2008

High


Low4th Quarter (November 1, 2008 through January 31, 2009)

$
2.50


$
1.423rd Quarter (August 1, 2008 through October 31, 2008)


2.66



0.722nd Quarter (May 1, 2008 through July 31, 2008)


2.39



1.391st Quarter (February 1, 2008 through April 30, 2008)


2.88



1.68        23




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##### 



MARKET
    PRICE OF AND DIVIDENDS ON THE REGISTRANTS COMMON EQUITY
    AND RELATED STOCK MATERS
      
   1/31/051

1/31/061

1/31/071

1/31/081

1/31/091

1/31/101Streamline Health Solutions, Inc. Common Stock

$
100.00


$
228.01


$
183.71


$
86.32


$
57.33


$
71.99NASDAQ U.S. Total Return Index

$
100.00


$
112.50


$
120.66


$
115.89


$
57.60


$
83.33NASDAQ Computer and Data Processing Services Stock Index

$
100.00


$
112.10


$
124.44


$
130.34


$
81.47


$
127.91     1

    
    Assumes that $100.00 was invested on January 31, 2005 in
    Common Stock at the closing price of $3.07 per share and at the
    closing sales price of each index on that date and that all
    dividends were reinvested. No dividends have been declared on
    Common Stock. Stockholder returns over the indicated period
    should not be considered indicative of future stockholder
    returns.  Regulation S-K
 24




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##### 



Item 6.
    Selected
    Financial Data  Form 10-K.
  Fiscal
    Year(1)2009


2008


2007


2006


2005(In thousands, except per share data)INCOME STATEMENT DATA:Total
    revenues(2)

$
18,208


$
16,286


$
16,684


$
15,961


$
16,185Total operating expenses


16,855



17,632



17,388



15,779



14,447Operating profit
    (loss)(3)


1,353



(1,346
)


(704
)


182



1,738Net earnings
    (loss)(3 &

    4)


1,288



(1,375
)


(736
)


96



2,551Basic net earnings (loss) per share of Common stock


.14



(.15
)


(.08
)


.01



.28Diluted net earnings (loss) per share of Common stock


.14



(.15
)


(.08
)


.01



.27Shares used in computing basic per share data


9,381



9,286



9,234



9,195



9,121Shares used in computing diluted per share data


9,531



9,286



9,234



9,722



9,425BALANCE SHEET DATA (at end of the year):Cash

$
1,025


$
3,129


$
2,189


$
3,317


$
4,634Working capital (deficit)


(1,263
)


(781
)


267



2,748



3,347Total assets


17,525



16,732



16,099



15,301



16,433Long-term debt, including current portion


900



800







1,000



2,000Total stockholders equity


8,731



7,097



8,193



8,644



8,351Cash dividends declared


















     (1)
    
    All references to a fiscal year refer to the fiscal year of
    Streamline Health commencing February 1 of that calendar year
    and ending on January 31 of the following year.(2)
    
    During fiscal 2008, the Company revised its historical financial
    statements to reclassify revenue and costs related to certain
    maintenance services. During a review of the accounting
    treatment of its revenue recognition policies, the Company
    determined that certain revisions to the accounting treatment of
    its revenue recognition for royalty commissions paid to GE
    Healthcare were necessary. The selected financial data presented
    above reflect the revised amounts.(3)
    
    Operating profit (loss) and net earnings (loss) includes a
    $100,000, $100,000, and $41,000 reduction in reserves due to
    changes in estimates, in 2006, 2007, and 2008, respectively.(4)
    
    Net earnings in 2005 includes a tax benefit of $897,000 relating
    to the reduction in the valuation allowances for the deferred
    tax assets relating to the net operating loss carry forward
    based upon reasonable future earnings before income tax
    projections. 25




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##### 



Item 7.
    Managements
    Discussion And Analysis Of Financial Condition And Results Of
    Operations    EXECUTIVE
    OVERVIEW
  Company
    Initiatives and Strategy
          Highlight
    Customer Satisfaction
    Focus
    on Sales and Marketing
    Building
    the Recurring Revenue Stream
      1.
    Hosted services are now becoming more main stream, and market
    adoption has increased dramatically over the past few years. 26




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##### 



2.
    Small to mid-sized healthcare organizations do not have the
    capital, or the information technology staffs to support
    complex, locally installed software.3.
    Economic conditions, and reduced access to credit have forced
    hospital organizations to reconsider their capital purchases and
    look to operating lease alternatives, such as our hosted
    services, to meet their software needs.4.
    Hosted services are an excellent hedge against future
    obsolescence, and provide a lower-risk alternative to
    traditional licensed models.      Expand
    Distribution Channels
    Execute
    on Product Development Goals
      Continued
    Research and Development
   27




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##### 



Results
    of Operations
      Statement
    of Operations(1)
  Fiscal Year(2)2009


2008Systems sales


20.2
%


20.0
%Services, maintenance and support


61.7



62.1Application-hosting services


18.1



17.9Total revenues


100.0



100.0Cost of sales


53.1



54.5Selling, general and administrative


30.2



39.9Product research and development


9.2



13.9Total operating expenses


92.5



108.3Operating profit (loss)


7.4



(8.3
)Other income (expense), net


(.3
)


(.1
)Income tax net benefit






Net earnings(loss)


7.1
%


(8.4
)%Cost of systems sales


81.5
%


102.4
%Cost of services, maintenance and support


44.8
%


42.8
%Cost of application-hosting services


49.7
%


41.5
%     (1)
    
    Because a significant percentage of the operating costs are
    incurred at levels that are not necessarily correlated with
    revenue levels, a variation in the timing of systems sales and
    installations and the resulting revenue recognition can cause
    significant variations in operating results. As a result,
    period-to-period
    comparisons may not be meaningful with respect to the past
    operations nor are they necessarily indicative of the future
    operations of Streamline Health in the near or long-term. The
    data in the table is presented solely for the purpose of
    reflecting the relationship of various operating elements to
    revenues for the periods indicated.(2)
    
    All references to a fiscal year refer to the fiscal year
    commencing on February 1 of that calendar year and ending on
    January 31 of the following year.  Comparison
    of fiscal year 2009 with 2008
       28




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##### 



Revenues
    For the Years Ended January 31,


Dollars


Percent2009


2008


Change


ChangeProprietary software(1)

$
2,438


$
1,565


$
873



56
%Hardware & third party software(1)


1,236



1,684



(448
)


(27
)%Professional services(2)


3,713



2,794



919



33
%Maintenance & support(2)


7,520



7,331



189



3
%Application hosting services


3,301



2,912



389



13
%Total Revenues

$
18,208


$
16,286


$
1,922



12
%     (1)
    
    Proprietary software and hardware are the components of the
    system sales line item(2)
    
    Professional services and maintenance & support are
    the components of the service, maintenance and support line
    item. This includes BPM consulting services.    Proprietary software
  Hardware and third party software
  Maintenance and support
  Professional services
 29




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##### 



Application hosting
  Revenues from remarketing partners
      Cost
    of Sales
    For the YearsEnded January 31,


Dollars


Percent2009


2008


Change


ChangeCost of system sales

$
2,993


$
3,328


$
(335
)


(10
)%Cost of services, maintenance and support


5,033



4,329



704



16
%Cost of application hosting


1,642



1,208



434



36
%Total cost of sales

$
9,668


$
8,865


$
803



9
%   period-to-period period-to-period
     30




---



##### 



Selling,
    General and Administrative Expense
  For the YearsEnded January 31,


Dollars


Percent2009


2008


Change


Change(In thousands):Selling, general, and administrative

$
5,504


$
6,503


$
(999
)


(15
)%     Product
    Research and Development Expense
  For the YearsEnded January 31,


Dollars


Percent2009


2008


Change


Change(In thousands):Research and development

$
1,683


$
2,264


$
(581
)


(26
)%     Operating
    Profit (loss)
    Other
    Income (Expense)
    Provision
    for Income Taxes
   31




---



##### 



Net
    Earnings (loss)
    Backlog
      January 31, 2010


January 31, 2009Streamline Health Software Licenses

$
201,000


$
1,027,000Custom Software


105,000



278,000Hardware and Third Party Software


171,000



562,000Professional Services


3,977,000



4,691,000Application Hosting Services


9,414,000



13,043,000Recurring Maintenance


5,987,000



6,578,000TOTAL

$
19,855,000


$
26,179,000       Outlook
    for 2010
   32




---



##### 



Application
    of Critical Accounting Policies
      Revenue
    Recognition
    ASC 985-605, Software-Revenue Recognition ASC 605-25 Revenue Recognition  Multiple-element
    arrangements
  
    Persuasive evidence of an arrangement exists,
    Delivery has occurred or services have been rendered,
    The arrangement fees are fixed or determinable, and
    Collection is considered probable    Multiple Element Arrangements  and/or
  Software License Arrangements 
 33




---



##### 



and/or
      Allowance
    for Doubtful Accounts
    Capitalized
    Software Development Costs
  ASC 985-20 Software  Costs of Software to be Sold, Leased or
    Marketed
 34




---



##### 



product-by-product
      Equity
    Awards  Stock-Based Compensation
  Compensation  Stock
    Compensation
    Income
    Taxes
  Income Taxes
   35




---



##### 



Fair
    Value Measurements
    Liquidity
    and Capital Resources
  quarter-to-quarter.
         36




---



##### 



Contractual
    Obligations
    Fiscal YearTotal


2010


2011


2012


2013Revolving note

$
900,000


$



$
900,000


$



$
Operating leases


328,759



261,844



43,125



19,032



4,758Capital lease


460,944



230,472



230,472







Total

$
1,689,703


$
492,316


$
1,173,597


$
19,032


$
4,758   Working
    Capital Facility
    
    The maximum principal amount that can be borrowed has increased
    to $2,750,000 from the prior maximum amount of $2,000,000;
    The maturity date of the loan has been extended to
    October 1, 2011 from August 1, 2010; and
    The interest rate on the outstanding principal balance will
    accrue at an annual floating rate of interest equal to the
    Adjusted Libor Rate (as defined in the revolving note) plus
    3.25%;
    The requirement to maintain certain levels of tangible net worth
    has been eliminated.   37




---



##### 



Operating
    Leases
    Capital
    Lease
    Off
    Balance Sheet Arrangements
    Contingencies
    Item 7A.
    Quantitative
    And Qualitative Disclosures About Market Risk  across-the-board
     38




---



##### 



ITEM 8.
    Financial
    Statements and Supplementary Data  INDEX TO
    CONSOLIDATED FINANCIAL STATEMENTS AND SCHEDULE COVERED BY
    REPORT OF REGISTERED PUBLIC ACCOUNTING FIRM
  
  Report of Independent Registered Public
    Accounting Firm


40Consolidated Balance Sheets at January 31,
    2010 and 2009


41Consolidated Statements of Operations for the two
    years ended January 31, 2010


42Consolidated Statements of Changes in
    Stockholders Equity for the two years ended
    January 31, 2010


43Consolidated Statements of Cash Flows for the two
    years ended January 31, 2010


44Notes to Consolidated Financial Statements


45Schedule II  Valuation and
    Qualifying Accounts


59     39




---



##### 



REPORT OF
    INDEPENDENT REGISTERED PUBLIC ACCOUNTING FIRM               BDO
    Seidman, LLP
 40




---



##### 



CONSOLIDATED
    BALANCE SHEETS  January 31,2010


2009ASSETSCurrent assets:Cash and cash equivalents

$
1,025,173


$
3,128,801Accounts receivable, net of allowance for doubtful accounts of
    $100,000


1,922,279



1,328,508Contract receivables


1,182,308



502,373Prepaid hardware and third party software for future delivery


149,281



681,540Prepaid other, including prepaid customer maintenance contracts


1,363,332



802,951Deferred income taxes


224,000



247,000Total current assets


5,866,373



6,691,173Property and equipment:Computer equipment


2,987,039



2,475,928Computer software


1,816,397



1,405,407Office furniture, fixtures and equipment


747,867



737,344Leasehold improvements


574,257



574,2576,125,560



5,192,936Accumulated depreciation and amortization


(4,344,432
)


(3,625,408
)1,781,128



1,567,528Contract receivables, less current portion


146,093



321,500Capitalized software development costs, net of accumulated
    amortization of $10,411,828 and $8,311,760, respectively


8,049,292



6,481,360Other, including deferred taxes of $1,651,000 and $1,628,000,
    respectively


1,681,661



1,670,891$
17,524,547


$
16,732,452LIABILITIES AND STOCKHOLDERS EQUITYCurrent liabilities:Accounts payable

$
887,928


$
759,577Accrued compensation


559,235



299,000Accrued other expenses


476,504



472,113Current portion of capital lease obligations


249,309



Current portion of deferred revenues


4,956,303



5,941,837Total current liabilities


7,129,279



7,472,527Deferred revenues, less current portion


602,239



1,313,977Line of credit


900,000



800,000Capital lease obligation, less current portion


161,666



Other






48,842Total liabilities


8,793,184



9,635,346Stockholders equity:Convertible redeemable preferred stock, $.01 par value per
    share, 5,000,000 shares authorized, no shares issued






Common stock, $.01 par value per share,
    25,000,000 shares authorized, 9,436,824 and
    9,354,782 shares issued and outstanding, respectively


94,368



93,548Additional paid in capital


36,160,126



35,820,417Accumulated other comprehensive income


5,620



Accumulated (deficit)


(27,528,751
)


(28,816,859
)Total stockholders equity


8,731,363



7,097,106$
17,524,547


$
16,732,452    41




---



##### 



CONSOLIDATED
    STATEMENTS OF OPERATIONS  Fiscal Year2009


2008Revenues:Systems sales

$
3,673,522


$
3,249,270Services, maintenance and support


11,233,183



10,124,829Application-hosting services


3,301,493



2,911,559Total revenues


18,208,198



16,285,658Operating expenses:Cost of systems sales


2,993,442



3,327,944Cost of services, maintenance and support


5,033,145



4,329,026Cost of application-hosting services


1,641,576



1,207,590Selling, general and administrative


5,503,580



6,503,465Product research and development


1,682,773



2,264,332Total operating expenses


16,854,516



17,632,357Operating profit (loss)


1,353,682



(1,346,699
)Other income (expense):Interest income






7,865Interest expense


(43,823
)


(24,436
)Other income (expenses)


18,749



Earnings (loss) before income taxes


1,328,608



(1,363,270
)Income tax (expense)


(40,500
)


(11,700
)Net earnings (loss)

$
1,288,108


$
(1,374,970
)Basic net earnings (loss) per common share

$
.14


$
(.15
)Number of shares used in basic per common share computation


9,381,285



9,286,261Diluted net earnings (loss) per common share

$
.14


$
(.15
)Number of shares used in diluted per common share computation


9,530,891



9,286,261    42




---



##### 






CONSOLIDATED
    STATEMENTS OF CHANGES IN
    STOCKHOLDERS EQUITY   AccumulatedConvertible





Additional


other





Totalredeemable


Common


paid in


comprehensive


Accumulated


stockholderspreferred stock


stock


capital


income


(deficit)


equityBalance at January 31, 2008






92,603



35,542,222







(27,441,889
)


8,192,936Stock issued to Employee Stock Purchase Plan and exercise of
    stock options






945



119,448











120,393Share-based compensation expense










158,747











158,747Net (loss)


















(1,374,970
)


(1,374,970
)Balance at January 31, 2009






93,548



35,820,417







(28,816,859
)


7,097,106Stock issued to Employee Stock Purchase Plan and exercise of
    stock options






465



65,435











65,900Restricted stock issued






355



(355
)










Share-based compensation expense










274,629











274,629Unrecognized benefit of foreign currency forward contracts














5,620







5,620Net (loss)


















1,288,108



1,288,108Balance at January 31, 2010

$



$
94,368


$
36,160,126


$
5,620


$
(27,528,751
)

$
8,731,363     43




---



##### 



CONSOLIDATED
    STATEMENTS OF CASH FLOWS  Fiscal Year2009


2008Operating activities:Net earnings (loss)

$
1,288,108


$
(1,374,970
)Adjustments to reconcile net earnings(loss) to net cash provided
    by operating activities:Depreciation and amortization


2,868,997



2,369,670Impairment loss on capitalized software development costs






408,809Loss on disposal of fixed assets


4,308



Share-based compensation expense


274,629



158,747Change in assets and liabilities:Accounts, contract and installment receivables


(1,098,299
)


2,514,313Other assets


54,664



(498,441
)Accounts payable


174,020



(759,105
)Accrued expenses


264,627



(286,697
)Deferred revenues


(1,697,272
)


2,072,481Net cash provided by operating activities


2,133,782



4,604,807Investing activities:Purchases of property and equipment


(698,698
)


(794,950
)Capitalization of software development costs


(3,668,000
)


(3,680,000
)Other


(36,612
)


(110,459
)Net cash used in investing activities


(4,403,310
)


(4,585,409
)Financing activities:Net change under revolving credit facility


100,000



800,000Proceeds from exercise of stock options and stock purchase plan


65,900



120,393Net cash provided by (used in) financing activities


165,900



920,393(Decrease) Increase in cash and cash equivalents


(2,103,628
)


939,791Cash and cash equivalents at beginning of year


3,128,801



2,189,010Cash and cash equivalents at end of year

$
1,025,173


$
3,128,801Supplemental cash flow disclosures:Interest paid

$
34,507


$
23,883Income taxes paid (refunded)

$
7,265


$
(3,278
)Property and equipment additions financed by capital leases

$
410,975


$
    44




---



##### 



NOTES TO
    CONSOLIDATED FINANCIAL STATMENTS  NOTE A 
    ORGANIZATION
    AND DESCRIPTION OF BUSINESS    Fiscal
    Year
    NOTE B 
    SIGNIFICANT
    ACCOUNTING POLICIES  Basis of
    Presentation
    Use of
    Estimates
    Cash and
    Cash Equivalents
    Receivables
    Allowance
    for Doubtful Accounts
   45




---



##### 



NOTES TO
    CONSOLIDATED FINANCIAL
    STATMENTS  (Continued)
  Other
    Current Assets
    Property
    and Equipment
    Computer equipment and software


3-4 yearsOffice equipment


5 yearsOffice furniture and fixtures


7 yearsLeasehold improvements


Term of lease           Impairment
    of Long-Lived Assets
    Capitalized
    Software Development Costs
   46




---



##### 



NOTES TO
    CONSOLIDATED FINANCIAL
    STATMENTS  (Continued)
    product-by-product
    Fair
    Value of Financial Instruments
    Revenue
    Recognition
    ASC 985-605, Software-Revenue Recognition ASC 605-25 Revenue Recognition  Multiple-element
    arrangements
  
    Persuasive evidence of an arrangement exists,
    Delivery has occurred or services have been rendered,
    The arrangement fees are fixed or determinable, and
    Collection is considered probable    Multiple Element Arrangements  and/or
  Software License Arrangements 
 47




---



##### 



NOTES TO
    CONSOLIDATED FINANCIAL
    STATMENTS  (Continued)
  and/or
    Concentrations
        Equity
    Awards
        Foreign
    Currency
   48




---



##### 



NOTES TO
    CONSOLIDATED FINANCIAL
    STATMENTS  (Continued)
      Income
    Taxes
      Comprehensive
    Income
      Fiscal Year2009


2008Net earnings (loss)

$
1,288,108


$
(1,374,970
)Net unrecognized gain (loss) on foreign currency hedges


5,620



Total comprehensive income (loss)

$
1,293,728


$
(1,374,970
)   Net
    Earnings (loss) Per Common Share
   49




---



##### 



NOTES TO
    CONSOLIDATED FINANCIAL
    STATMENTS  (Continued)
    Fiscal Year2009


2008Net earnings (loss)

$
1,288,108


$
(1,374,970
)Average shares outstanding used in basic per common share
    computations


9,381,285



9,286,261Stock options and restricted stock


149,606



Number of average shares used in diluted per common share
    computation


9,530,891



9,286,261Basic net earnings (loss) per share of common stock

$
.14


$
(.15
)Diluted net earnings (loss) per share of common stock

$
.14


$
(.15
)     Recent
    Accounting Pronouncements
  2009-01, Amendments based on Statement of Financial Accounting
    Standards No. 168  The and the Hierarchy of Generally
    Accepted Accounting Principles. Generally Accepted Accounting Principles
  Fair Value Measurements and
    Disclosures  Overall,
  Financial Instruments,
  Subsequent Events
 50




---



##### 



NOTES TO
    CONSOLIDATED FINANCIAL
    STATMENTS  (Continued)
  2010-09.
  2009-13 Revenue Recognition (Topic 605)
  2009-14 Software (Topic 985),
  NOTE C 
    LEASES    Fiscal YearTotal


2010


2011


2012


2013


ThereafterFacilities

$
266,906


$
242,813


$
24,093


$



$



$
Equipment & services


61,854



19,032



19,032



19,032



4,758



$
328,760


$
261,845


$
43,125


$
19,032


$
4,758


$
      51




---



##### 



NOTES TO
    CONSOLIDATED FINANCIAL
    STATMENTS  (Continued)
    Fiscal Year2009Computer equipment

$
215,427Computer software


118,381Other


77,167Total

$
410,975Accumulated depreciation


Net value of leased property

$
410,975     NOTE D 
    DEBT             52




---



##### 



NOTES TO
    CONSOLIDATED FINANCIAL
    STATMENTS  (Continued)
  NOTE E 
    INCOME
    TAXES    Fiscal Year2009


2008Federal tax expense:Current

$
(26,000
)

$
Deferred






(26,000
)


State tax expense:Current


(14,500
)


(11,700
)Deferred






(14,500
)


(11,700
)Federal and state income tax (expense)

$
(40,500
)

$
(11,700
)     Fiscal Year2009


2008Federal tax (expense) benefit at Statutory rate

$
(448,461
)

$
463,512State and local taxes, net of federal (expense) benefit


(11,428
)


7,722Change in valuation allowance


585,217



(351,282
)Permanent items


(128,473
)


(125,142
)Alternative minimum tax expense


(26,000
)


Other


(11,355
)


(6,510
)Income tax expense

$
(40,500
)

$
(11,700
)     Fiscal Year2009


2008Deferred tax assets:Net operating loss carry forwards

$
9,881,084


$
10,456,072Accounts payable and accrued expenses


172,833



170,026Property and equipment


99,829



92,386Other


53,070



73,54910,206,816



10,792,033Less valuation allowance


(8,331,816
)


(8,917,033
)Net deferred tax assets


1,875,000



1,875,000Deferred tax liabilities:






Net deferred tax asset

$
1,875,000


$
1,875,000    53




---



##### 



NOTES TO
    CONSOLIDATED FINANCIAL
    STATMENTS  (Continued)
          NOTE F 
    MAJOR
    CUSTOMERS      NOTE G 
    EMPLOYEE
    RETIREMENT PLAN    NOTE H 
    EMPLOYEE
    STOCK PURCHASE PLAN         54




---



##### 



NOTES TO
    CONSOLIDATED FINANCIAL
    STATMENTS  (Continued)
  NOTE I 
    STOCK
    BASED COMPENSATION  Stock
    Option Plans
          Fiscal Year2009


2008Weighted





Weightedaverage





averageexercise





exerciseOptions


price


Options


priceOutstanding  beginning of year


634,882


$
2.21



409,000


$
2.46Granted


29,000



2.09



355,382



1.89Exercised


(11,000
)


1.50



(57,000
)


1.11Expired


(15,000
)


1.90



(72,500
)


2.80Forfeited














Outstanding  end of year


637,882



2.22



634,882



2.21Exercisable  end of year


361,954


$
2.39



237,830


$
2.29Aggregate intrinsic value of outstanding options at year end

$
1,409,719






$
1,117,392Aggregate intrinsic value of exercisable options at year end

$
799,918






$
418,851Weighted average grant date fair value of options granted during
    year

$
1.33






$
1.23Total intrinsic value of Options exercised during the year

$
24,310






$
100,320    55




---



##### 



NOTES TO
    CONSOLIDATED FINANCIAL
    STATMENTS  (Continued)
    AverageNumber of

exercise

Remainingoptions

price

life in yearsOutstanding


637,882


$
2.22
(1)


8Exercisable


361,954


$
2.39
(2)


4     (1)
    
    The exercise prices range from $0.53 to $6.03, of which
    405,882 shares are between $0.53 and $1.95 per share,
    187,000 shares are between $2.08 and $4.35 per share, and
    45,000 shares are between $5.17 and $6.03 per share.(2)
    
    The exercise prices range from $0.53 to $6.03, of which
    211,959 shares are between $0.53 and $1.95 per share,
    104,995 shares are between $2.08 and $4.35 per share, and
    45,000 shares are between $5.17 and $6.03 per share.    WeightedNon-vested


averagenumber of


grant-dateshares


fair valueBalance at January 31, 2008


86,672


$
2.78Granted


344,382



1.23Vested


(45,002
)


2.59Forfeited






Balance at January 31, 2009


397,052



1.82Granted


29,000



1.33Vested


(145,124
)


1.95Forfeited


(5,000
)


1.80Balance at January 31, 2010


275,928


$
1.79          56




---



##### 



NOTES TO
    CONSOLIDATED FINANCIAL
    STATMENTS  (Continued)
  Restricted
    Stock
    WeightedNon-vested


averagenumber of


grant dateshares


fair valueNon-vested balance at January 1, 2009





$
Granted


35,502



2.82Vested






Forfeited






Non-vested balance at January 31, 2010


35,502


$
2.82       NOTE J 
    COMMITTMENTS
    AND CONTINGENCIES  Application
    Hosting Services
    Employment
    Agreements
    Reserved
    Common Stock
    Litigation
   57




---



##### 



NOTES TO
    CONSOLIDATED FINANCIAL
    STATMENTS  (Continued)
  NOTE K 
    QUARTERLY
    RESULTS OF OPERATIONS (UNAUDITED)    First


Second


Third


FourthQuarter


Quarter


Quarter


Quarter


2009(In thousands, except per share data)Revenues

$
3,751


$
4,069


$
4,106


$
6,282


$
18,208Gross profit


1,589



1,622



1,722



3,607



8,540Operating profit (loss)


30



(17
)


(285
)


1,628



1,354Net earnings (loss)


16



(18
)


(296
)


1,585



1,288Basic net (loss) earnings per share(a)


.00



(.00
)


(.03
)


.17



.14Diluted net (loss) earnings per share(a)


.00



(.00
)


(.03
)


.17



.14Weighted average shares outstanding


9,355



9,371



9,398



9,401



9,381Stock Price(b)High

$
2.30


$
3.58


$
2.94


$
2.58


$
3.58Low

$
1.15


$
1.98


$
2.10


$
2.06


$
1.15Quarter and year-end close

$
2.21


$
2.79


$
2.35


$
2.21


$
2.21Cash dividends declared(c)

$



$



$



$



$
   First


Second


Third


FourthQuarter


Quarter


Quarter


Quarter


2008(In thousands, except per share data)Revenues

$
3,604


$
4,837


$
4,379


$
3,466


$
16,286Gross profit


1,505



2,467



2,089



1,360



7,421Operating profit (loss)(d)


(813
)


(427
)


26



(132
)


(1,346
)Net earnings (loss)(d)


(815
)


(429
)


15



(146
)


(1,375
)Basic net (loss) earnings per share(a)


(.09
)


(.05
)


.00



(.02
)


(.15
)Diluted net (loss) earnings per share(a)


(.09
)


(.05
)


.00



(.02
)


(.15
)Weighted average shares outstanding


9,260



9,275



9,303



9,306



9,286Stock Price(b)High

$
2.88


$
2.39


$
2.66


$
2.50


$
2.88Low

$
1.68


$
1.39


$
0.72


$
1.42


$
0.72Quarter and year-end close

$
2.21


$
2.02


$
2.42


$
1.76


$
1.76Cash dividends declared(c)

$



$



$



$



$
     (a)
    
    Quarterly amounts may not be additive.(b)
    
    Based on data available through The NASDAQ Stock Market, Inc.(c)
    
    Streamline Health has not paid a dividend on its Common Stock
    since its inception and does not intend to pay any cash
    dividends in the foreseeable future.(d)
    
    Includes in the fourth quarter of fiscal year 2008, a $409,000
    impairment charge of capitalized software development costs. 58




---



##### 



Schedule II  Valuation and Qualifying Accounts and Reserves
  Streamline
    Health Solutions, Inc.
    For the two years ended January 31, 2010
  AdditionsBalance at


Charged to


Charged toBeginning


Costs and


Other





Balance atDescription

of Period


Expenses


Accounts


Deductions


End of Period(In thousands)Year ended January 31, 2010:Allowance for doubtful accounts

$
100


$











$
100Year ended January 31, 2009:Allowance for doubtful accounts

$
100


$











$
100   ITEM 9.
    Changes
    in and Disagreements with Accountants on Accounting and
    Financial Disclosures    ITEM 9A(T)
    Controls
    and Procedures  Rules 13a-15(e) 15d-15(e).
   59




---



##### 



MANAGEMENTS
    REPORT ON INTERNAL CONTROL OVER FINANCIAL REPORTING
  Rule 13a-15(f)
  ,
  Internal Control Integrated Framework
  Regulation S-K)
   60




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##### 



ITEM 9B.
    Other
    Information    PART III
  ITEM 10.
    Directors,
    Executive Officers and Corporate Goverance  Regulation S-K Form 10-K
  Regulation S-K Form 10-K.
  ITEM 11.
    Executive
    Compensation  Regulation S-K
  ITEM 12.
    Securities
    Ownership of Certain Beneficial Owners and Management and
    Related Stockholder Matters  Regulation S-K
  Regulation S-K
  Number of





Number of securitiessecurities to be





remaining availableissued upon


Weighted-average


for future issuanceexercise of


exercise price of


under equityoutstanding


outstanding


compensation plansoptions, warrants


options, warrants


(excluding securitiesPlan category

and rights


and rights


reflected in column (a))(a)


(b)


(c)Equity compensation plans approved by security holders


637,882(1, 2

    & 3
)

$
2.22



460,116(3
)Total


637,882(1, 2

    & 3
)

$
2.22



460,116(3
)     (1)
    
    Includes 15,000 options that can be exercised under the 1996
    non-employee Directors Stock Option Plan and 118,500
    options that can be exercised under the 1996 Employee Stock
    Option Plan.(2)
    
    Includes 504,382 options that can be exercised under the 2005
    Incentive Compensation Plan.(3)
    
    Excludes 248,945 shares that can be issued under the 1996
    Employee Stock Purchase Plan, which is more fully described in
    footnote J of the enclosed Notes to Consolidated Financial
    Statements.(4)
    
    The Company does not have any equity compensation plans that
    have not been approved by the Companys Stockholders. 61




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##### 



ITEM 13.
    Certain
    Relationships, Related Transactions and Directors
    Independence  Regulation S-K
  ITEM 14.
    Principal
    Accounting Fees and Services    2009


2008Audit Fees

$
173,000


$
159,000Audit-Related Fees






Tax Fees


10,000



10,000All Other Fees






Total Fees

$
183,000


$
169,000     PART IV
  ITEM 15.
    Exhibits,
    Financial Statement Schedules  Financial
    Statements
           62




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##### 



SIGNATURES
    Streamline Health
    Solutions, Inc.
  By:
    /s/  J.
    Brian Patsy   Chief Executive Officer
      /s/  J.
    Brian PatsyJ.
    Brian Patsy

Chief Executive Officer 
    And Director 
    (Principal Executive Officer)

April 16, 2010/s/  Jonathan
    R. PhillipsJonathan
    R. Phillips

Director

April 15, 2010/s/  Edward
    J. VonderBrinkEdward
    J. VonderBrink

Director

April 15, 2010/s/  Richard
    C. Levy,Richard
    C. Levy, M.D.

Director

April 15, 2010/s/  Andrew
    L. TurnerAndrew
    L. Turner

Director

April 15, 2010/s/  Jay
    D. MillerJay
    D. Miller

Director

April 15, 2010/s/  Donald
    E. Vick, Jr.Donald
    E. Vick, Jr.

Interim Chief Financial Officer 
    (Principal Financial and Accounting Officer)

April 15, 2010  63




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##### 



INDEX TO
    EXHIBITS
  EXHIBITS
  Exhibit No.

Description of Exhibit3.1(a)

Certificate of Incorporation of Streamline Health Solutions,
    Inc. f/k/a/ LanVision Systems, Inc. (Previously filed with the
    Commission and incorporated herein by reference from, the
    Registrants (LanVision System, Inc.) Registration
    Statement on
    Form S-1,
    File Number
    333-01494,
    as filed with the Commission on April 15, 1996.)3.1(b)

Certificate of Incorporation of Streamline Health Solutions,
    Inc. f/k/a LanVision Systems, Inc., amendment No. 1.
    (Previously filed with the Commission and incorporated herein by
    reference from the Registrants
    Form 10-Q,
    as filed with the Commission on September 8, 2006.)3.2

Bylaws of Streamline Health Solutions, Inc. (Previously filed
    with the Commission and incorporated herein by reference from,
    the Registrants
    Form 10-Q,
    as filed with the Commission on June 5, 2007.)3.3

Certificate of the Designations, Powers, Preferences and Rights
    of the Convertible Preferred Stock (Par Value $.01 Per Share) of
    Streamline Health Solutions, Inc. f/k/a/ LanVision Systems, Inc.
    (Previously filed with the Commission, and incorporated herein
    by reference from, the Registrants (LanVision Systems,
    Inc.) Registration Statement on
    Form S-1,
    File Number
    333-01494,
    as filed with the Commission on April 15, 1996.)4.1

Specimen Common Stock Certificate of Streamline Health
    Solutions, Inc. f/k/a LanVision Systems, Inc. (Previously filed
    with the Commission, and incorporated herein by reference from,
    the Registrants (LanVision Systems, Inc.) Registration
    Statement on
    Form S-1,
    File Number
    333-01494,
    as filed with the Commission on April 15, 1996.)4.2

Specimen Preferred Stock Certificate of Streamline Health
    Solutions, Inc. f/k/a LanVision Systems, Inc. (Previously filed
    with the Commission, and incorporated herein by reference from,
    the Registrants (LanVision Systems, Inc.) Registration
    Statement on
    Form S-1,
    File Number
    333-01494,
    as filed with the Commission on April 15, 1996.)10.1#

Streamline Health Solutions, Inc. f/k/a LanVision Systems, Inc.
    1996 Employee Stock Option Plan. (Previously filed with the
    Commission, and incorporated herein by reference from, the
    Registrants (LanVision Systems, Inc.) Registration
    Statement on
    Form S-1,
    File Number
    333-01494,
    as filed with the Commission on April 15, 1996.)10.2(a)#

Streamline Health Solutions, Inc. f/k/a LanVision Systems, Inc.
    1996 Non-Employee Directors Stock Option Plan. (Previously filed
    with the Commission, and incorporated herein by reference from,
    the Registrants (LanVision Systems, Inc.) Registration
    Statement on
    Form S-1,
    File Number
    333-01494,
    as filed with the Commission on April 15, 1996.)10.2(b)#

First Amendment to Streamline Health Solutions, Inc.
    f/k/a/LanVision Systems, Inc. 1996 Non-Employee Directors Stock
    Option Plan. (Previously filed with the Commission, and
    incorporated herein by reference from, Exhibit 4.1(b) of,
    the Registrants (LanVision Systems, Inc.) Registration
    Statement on
    Form S-8,
    file number
    333-20765,
    as filed with the Commission on January 31, 1997.)10.2(c) #

Second Amendment to Streamline Health Solutions, Inc. f/k/a
    LanVision Systems, Inc. 1996 Non-Employee Directors Stock Option
    Plan. (Previously filed with the Commission, and incorporated
    herein by reference from, Amendment No. 1 to the
    Registrants (LanVision Systems, Inc.) Statement on
    Form S-8,
    file number
    333-20765,
    as filed with the Commission on March 1, 2001.)10.3#

Streamline Health Solutions, Inc. f/k/a LanVision Systems, Inc.
    1996 Employee Stock Purchase Plan. (Previously filed with the
    Commission, and incorporated herein by reference from, the
    Registrants (LanVision Systems, Inc. ) Registration
    Statement on
    Form S-1,
    File Number
    333-01494,
    as filed with the Commission on April 15, 1996.)10.4#

2005 Incentive Compensation Plan of Streamline Health Solutions,
    Inc. f/k/a LanVision Systems, Inc. (Previously filed with the
    Commission, and incorporated herein by reference from,
    Exhibit 10.1 of the Registrants (LanVision Systems,
    Inc.)
    Form 8-K,
    as filed with the Commission on May 26, 2005.)10.5#

Employment Agreement between Streamline Health, Inc. f/k/a
    LanVision, Inc. and Donald E. Vick effective December 3,
    1996. (Previously filed with the Commission, and incorporated
    herein by reference from, Exhibit 10.5 of the
    Registrants (LanVision Systems, Inc.)
    Form 10-K
    for the fiscal year ended January 31, 2002, as filed with
    the Commission on April 29, 2002.) 64




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##### 



Exhibit No.

Description of Exhibit10.5(a)#

Amendment No. 1 to the Employment Agreement between
    Streamline Health, Inc. f/k/a LanVision, Inc. and Donald E. Vick
    effective January 27, 2006 (Previously filed with the
    Commission, and incorporated herein by reference from,
    Exhibit 10.4 of the Registrants (LanVision Systems,
    Inc.)
    Form 8-K,
    as filed with the Commission on January 31, 2006.)10.6#

Employment Agreement among Streamline Health Solutions, Inc.
    f/k/a LanVision Systems, Inc., Streamline Health, Inc. f/k/a
    LanVision, Inc. and Paul W. Bridge, Jr., effective
    February 1, 2004 (Previously filed with the Commission, and
    incorporated herein by reference from, Exhibit 10.1 of the
    Registrants (LanVision Systems, Inc.)
    Form 10-Q
    for the fiscal quarter ended July 31, 2004, as filed with
    the Commission on September 10, 2004.)10.6(a)#

Amendment No. 1 to the Employment Agreement between
    Streamline Health, Inc. f/k/a LanVision, Inc. and Paul W.
    Bridge, Jr. effective January 27, 2006 (Previously filed
    with the Commission, and incorporated herein by reference from,
    Exhibit 10.3 of the Registrants (LanVision Systems,
    Inc.)
    Form 8-K,
    as filed with the Commission on January 31, 2006.)10.7#

Employment Agreement among Streamline Health, Inc. f/k/a/
    LanVision Systems, Inc., Streamline Health, Inc. f/k/a
    LanVision, Inc. and J. Brian Patsy effective February 1,
    2003 (Previously filed with the Commission, and incorporated
    herein by reference from, Exhibit 10.7 of the
    Registrants (LanVision Systems, Inc.)
    Form 10-K
    for the fiscal year ended January 31, 2004, as filed with
    the Commission on April 8, 2004.)10.7(a)#

Amendment No. 1 dated January 27, 2005 to the
    Employment Agreement among J. Brian Patsy, Streamline Health
    Solutions, Inc. f/k/a LanVision Systems, Inc. and Streamline
    Health Inc. f/k/a LanVision, Inc. (Previously filed with the
    Commission, and incorporated herein by reference from,
    Exhibit 10.1 of the Registrants (LanVision Systems,
    Inc.)
    Form 8-K,
    as filed with the Commission on February 1, 2005.)10.7(b)#

Amendment No. 2 dated January 27, 2006 to the
    Employment Agreement among J. Brian Patsy, Streamline Health
    Solutions, Inc. f/k/a LanVision Systems, Inc. and Streamline
    Health, Inc. f/k/a LanVision, Inc. (Previously filed with the
    Commission, and incorporated herein by reference from,
    Exhibit 10.1 of the Registrants (LanVision Systems,
    Inc.)
    Form 8-K,
    as filed with the Commission on January 31, 2006.)10.8(a)#

Employment Agreement among Streamline Health Solutions, Inc.
    f/k/a/ LanVision Systems, Inc., Streamline Health, Inc. f/k/a
    LanVision, Inc. and Joseph O. Brown, II, effective
    February 1, 2004. (Previously filed with the Commission,
    and incorporated herein by reference from, Exhibit 10.1 of
    the Registrants
    Form 10-Q,
    as filed with the Commission on December 7, 2007.)10.8(b)#

Amendment No. 1 dated November 27, 2007 to the
    Employment Agreement among Joseph O. Brown, II, Streamline
    Health Solutions, Inc. f/k/a LanVision Systems, Inc. and
    Streamline Health, Inc. f/k/a LanVision, Inc. (Previously filed
    with the Commission, and incorporated herein by reference from,
    Exhibit 10.8(b) of the Registrants (Streamline Health
    Solutions, Inc.)
    Form 10-K
    for the fiscal year ended January 31, 2008, as filed with
    the Commission on April 7, 2008.)10.9#

Employment agreement between Streamline Health, Inc. and Gary M.
    Winzenread effective June 18, 2007. (Previously filed with
    the Commission, and incorporated herein by reference from,
    Exhibit 10.1 of the Registrants
    Form 10-Q,
    as filed with the Commission on December 7, 2007.)10.9(b)#

Employment agreement between Streamline Health, Inc. and Gary M.
    Winzenread effective June 1, 2008. (Previously filed with
    the Commission, and incorporated herein by reference from,
    Exhibit 10 of the Registrants (Streamline Health
    Solutions, Inc.)
    Form 8-K,
    as filed with the Commission on June 11, 2008.)10.10#

Employment agreement between Streamline Health, Inc. and B.
    Scott Boyden, Jr. effective June 16, 2008. (Previously
    filed with the Commission, and incorporated herein by reference
    from, Exhibit 10 of the Registrants (Streamline
    Health Solutions, Inc.)
    Form 8-K,
    as filed with the Commission on June 26, 2008.) 65




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##### 



Exhibit No.

Description of Exhibit10.11

Registrants Guarantee of Lease Agreement between
    Streamline Health, Inc. f/k/a LanVision, Inc. and The Western
    and Southern Life Insurance Company (Previously filed with the
    Commission, and incorporated herein by reference from,
    Exhibit 10.1 of the Registrants (LanVision Systems,
    Inc.)
    Form 10-Q
    for the fiscal quarter ended July 31, 2004, as filed with
    the Commission on September 10, 2004.)10.12(c)

First Amendment to Lease and Acceptance of Indemnification
    Agreement for office space between Streamline Health, Inc. f/k/a
    LanVision, Inc. (a wholly owned subsidiary) and The Western and
    Southern Life Insurance Company, effective January 31,
    2005. (Previously filed with the Commission, and incorporated
    herein by reference from, Exhibit 11.11(c) of the
    Registrants (LanVision Systems, Inc.)
    Form 10-K
    for the fiscal year ended January 31, 2005, as filed with
    the Commission on April 8, 2005.)10.13(a)**

Reseller Agreement between IDX Information Systems Corporation
    and Streamline Health, Inc. f/k/a LanVision, Inc. entered into
    on January 30, 2002. (Previously filed with the Commission,
    and incorporated herein by reference from, Exhibit 10.11 of
    the Registrants (LanVision Systems, Inc.)
    Form 10-K
    for the fiscal year ended January 31, 2002, as filed with
    the Commission on April 29, 2002.)10.13(b)

First Amendment to the Reseller Agreement between IDX
    Information Systems Corporation and Streamline Health, Inc.
    f/k/a LanVision, Inc. entered into on January 30, 2002
    (Previously filed with the Commission, and incorporated herein
    by reference from, Exhibit 10 of the Registrants
    (LanVision Systems, Inc.)
    Form 10-Q
    for the quarter ended April 30, 2002, as filed with the
    Commission on June 4, 2002.).10.14

Form of Indemnification Agreement for all directors and
    officers. (Previously filed with the Commission, and
    incorporated herein by reference from, Exhibit 10.1 of the
    Registrants (LanVision Systems, Inc.)
    Form 8-K,
    as filed with the Commission on June 7, 2006.10.15***#

Directors Compensation10.16(a)

Amended and Restated Revolving Note, dated October 21,
    2009, between Streamline Health, Inc. (a wholly owned subsidiary
    of the Registrant) and the Fifth Third Bank. (Previously filed
    with the Commission, and incorporated herein by reference to
    exhibit 10.1 of the Registrants
    Form 8-K,
    as filed with the Commission on October 26, 2009.)10.16(b)

Amended and Restated Guaranty Agreement, dated October 21,
    2009, between Streamline Health, Inc. (a wholly owned subsidiary
    of the Registrant) and the Fifth Third Bank. (Previously filed
    with the Commission, and incorporated herein by reference to
    exhibit 10.2 of the Registrants
    Form 8-K,
    as filed with the Commission on October 26, 2009.)10.16(c)

Security Agreement, dated October 21, 2009, between
    Streamline Health, Inc. (a wholly owned subsidiary of the
    Registrant) and the Fifth Third Bank. (Previously filed with the
    Commission, and incorporated herein by reference to
    exhibit 10.3 of the Registrants
    Form 8-K,
    as filed with the Commission on October 26, 2009.)10.17(a)

Term Lease Master Agreement, and associated documents, dated
    January 19, 2010 between Streamline Health, Inc. (a wholly
    owned subsidiary of the Registrant) and IBM Credit LLC.
    (Previously filed with the Commission, and incorporated herein
    by reference from, Exhibit 10.1 of the Registrants
    Form 8-K,
    as filed with the Commission on January 22, 2010.)10.17(b)

Term Supplement, dated January 19, 2010, between Streamline
    Health, Inc. (a wholly owned subsidiary of the Registrant) and
    IBM Credit LLC. (Previously filed with the Commission, and
    incorporated herein by reference from, Exhibit 10.2 of the
    Registrants
    Form 8-K,
    as filed with the Commission on January 22, 2010.)11.1

Statement Regarding Computation of Per Share Earnings***14.1

Code of Ethics (Previously filed with the Commission, and
    incorporated herein by reference from, Exhibit 14.1 of the
    Registrants (LanVision Systems, Inc.)
    Form 10-K
    for the fiscal year ended January 31, 2004, as filed with
    the Commission on April 8, 2004.)21.1

Subsidiaries of the Registrant***23.1

Consent of Independent Registered Public Accounting
    Firm  BDO Seidman, LLP***31.1

Certification by Chief Executive Officer pursuant to
    Section 302 of the Sarbanes-Oxley Act of 2002.***31.2

Certification by Chief Financial Officer pursuant to
    Section 302 of the Sarbanes-Oxley Act of 2002.*** 66




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##### 



Exhibit No.

Description of Exhibit32.1

Certification by Chief Executive Officer pursuant to U.S.C.
    Section 1350, as adopted pursuant to Section 906 of
    the Sarbanes-Oxley Act of 2002.***32.2

Certification by Chief Financial Officer pursuant to U.S.C.
    Section 1350, as adopted pursuant to Section 906 of
    the Sarbanes-Oxley Act of 2002.***     **
    
    The Company has applied for Confidential Treatment of portions
    of this agreement with the Securities and Exchange Commission***
    
    Included herein#
    
    Management Contracts and Compensatory Arrangements. 67