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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, 2009oro

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

31-1455414(State or other jurisdiction
    of
    incorporation or organization)

(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-K Form 10-K, Form 10-K. þ
  Rule 12b-2
 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,




---





TABLE OF CONTENTS  FORWARD-LOOKING STATEMENTSPART IItem 1. BusinessItem 1A Risk FactorsItem 1B. Unresolved staff CommentsItem 2. PropertiesItem 3. Legal ProceedingsItem 4. Submission of Matters to a Vote of Security HoldersEXECUTIVE OFFICERS OF THE REGISTRANTPART IIItem 5. Market for Registrants Common Equity, Related Stockholder Matters and Issuer Purchases of Equity SecuritiesMARKET PRICE OF AND DIVIDENDS ON THE REGISTRANTS COMMON EQUITY AND RELATED STOCK MATERSItem 6. Selected Financial DataItem 7. Managements Discussion and Analysis of Financial Condition and Results of OperationsItem 7A. Quantitative and Qualitative Disclosures About Market RiskItem 8. Financial Statements and Supplementary DataINDEX TO CONSOLIDATED FINANCIAL STATEMENTS AND SCHEDULE COVERED BY REPORT OF REGISTERED PUBLIC ACCOUNTING FIRMREPORT OF INDEPENDENT REGISTERED PUBLIC ACCOUNTING FIRMCONSOLIDATED BALANCE SHEETSCONSOLIDATED STATEMENTS OF OPERATIONSCONSOLIDATED STATEMENTS OF CHANGES IN STOCKHOLDERS EQUITYCONSOLIDATED STATEMENTS OF CASH FLOWSNOTES TO CONSOLIDATED FINANCIAL STATEMENTSSchedule II Valuation and Qualifying Accounts and ReservesItem 9. Changes in and Disagreements with Accountants on Accounting and Financial DisclosuresItem 9A(T) Controls and ProceduresMANAGEMENTS REPORT ON INTERNAL CONTROL OVER FINANCIAL REPORTINGItem 9B Other InformationPART IIIItem 10. Directors, Executive Officers and Corporate GoveranceItem 11. Executive CompensationItem 12. Securities Ownership of Certain Beneficial Owners and management and Related Stockholder MattersItem 13. Certain Relationships, Related Transactions and Directors IndependenceItem 14. Principal Accounting Fees and ServicesPART IVItem 15. Exhibits, Financial Statement SchedulesSIGNATURESINDEX TO EXHIBITSEX-11EX-21.1EX-23.1EX-23.2EX-31.1EX-31.2EX-32.1EX-32.2    Table of Contents  
  FORWARD-LOOKING
    STATEMENTS
  Form 10-K Form 10-Q Form 8-K.
     
 PART I
 
  Item 1.
    Business  General
  ® TM
     1




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work-in-process,
            Regulation S-K Form 10-K.
 2




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e-Health
   3




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TM
    TM
     4




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Healthcare
    Industry Trends impacting Streamline Health
            U.S.
    Government Policy and Legislative Initiatives
     5




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
    Primary focus in 2009 will be Electronic Health Records (EHR)
    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 (5 years)
    $19 billion 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)
    Create HIT grant and loan programs
    Accelerate construction of National Health Information Network
    (NHIN)         6




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To Err is Human: Building a
    Better Health System
  Regulatory
    Matters
    Regulations
    Relating to Confidentiality
     7




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Rapid
    Technological Change and Evolving Market
    Changes
    and Consolidation in the Healthcare Industry
    Key
    Personnel
    Limited
    Protection of Proprietary Technology
   8




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Warranties
    and Indemnities
    Competition
          The
    Streamline Health Solution
   9




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The
    Streamline Health Strategy
    SaaS-based
    Hosting Services
  e-health
   10




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Expand
    Distribution Channels
   11




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®
  TM
        Maintain
    Technological Leadership Through the Development of New Software
    Applications and Increased Functionality of Existing
    Applications
     12




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Document
    Image-Enable Clinical Data Repositories and Other Applications
    Software
    Systems
    and Services
    A brief description of Streamline Healths solutions
    follows:
      
    The ability to gain seamless electronic access to medical
    records, business office documents and medical images
    (unstructured data);
    Workflow-based automated chart deficiency analysis and
    completion;
    Workflow-based automated release of information and billing;
    Workflow-based remote coding and seamless integration to
    third-party encoder and abstracter software; 13




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
    Workflow-based referral order capture;
    Workflow-based financial screening and routing of patient
    financial ability to pay information;
    Workflow-based Preoperative document capture and routing for
    operating room scheduling systems;
    Workflow-based RAC (Recovery Audit Contractor) document tracking
    and release to facilitate RAC audit mitigation; and
    Computer-aided data extraction solutions using OCR technology to
    scan, extract, verify, and input into existing information
    systems data.    TM
    HEALTH
    INFORMATION MANAGEMENT SUITE
    accessANYware 
    Health Information Management (HIM)
    Chart
    Completion Workflow
   14




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he/she
  Release
    of Information Workflow
    Coding
    Workflow
    Chart
    Tracking Workflow
    PATIENT
    FINANCIAL SERVICES SUITE
    accessANYware 
    Patient Financial Services (PFS)
    Cash
    Management Workflow
   15




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Referral
    Order Workflow
    Financial
    Screening Workflow
    Pre-Operative
    Workflow
    RAC
    Audit Workflow
    Enterprise
    Suite
  TM
  The
    Streamline Health Integration Tools
    (STRM-ITTM)
    ASPeN...Application
    Service Provider eHealth Network
  start-up
  Professional
    Services
   16




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Business
    Process Management Services (BPM)
    Research
    and Development
      Existing
    Customers
    
  ASPeN
  
       17




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Signed
    Agreements  Backlog
    and/or
    2009-2011.
    Royalties
    and license fees
  and/or
 18




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Employees
    Information
  Form 10-K, Form 10-Q, Form 8-K, www.streamlinehealth.net http://www.sec.gov/cgi-bin/srch-edgar
  Form 10-K
 
  Item 1A
    Risk
    Factors    and/or
  The
    variability of the Companys quarterly operating results
    can be
    significant.
  Form 10-K
  The
    Companys sales have been concentrated in a small number of
    customers.
   19




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Sales
    to the Companys largest application hosting client ceased
    at the end of July
    2008.
    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.
   20




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The
    potential impact on the Company of new or changes in existing
    federal, state, and local regulations governing healthcare
    information could be
    substantial.
    While
    new laws and regulations 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.
    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.
   21




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##### Table of Contents



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.
   22




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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.
   23




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The
    Companys remote application hosting services and support
    services could experience
    interruptions.
    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.
   24




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If
    the national and global financial crisis intensifies, 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.
    The
    current financial crisis 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;
    Additional or departures of key personnel; and
    Sales and repurchases of the Companys common stock.   25




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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.
    These
    risks are not
    exhaustive.
  Form 10-K
 
  Item 1B.
    Unresolved
    staff Comments   
  Item 2.
    Properties  45242-4716.
 26




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Item 3.
    Legal
    Proceedings   
  Item 4.
    Submission
    of Matters to a Vote of Security Holders   
  EXECUTIVE
    OFFICERS OF THE REGISTRANT
    First Appointed asName

Age

Position(1)

Executive Officer(2)J. Brian Patsy


58


Chairman of the Board, President, Chief Executive Officer, and
    Director


1989Gary M. Winzenread


44


Senior Vice President Product Development and Strategy


2007Joseph O. Brown, II


48


Vice President Consulting Services and Chief Information Officer


2007B. Scott Boyden, Jr.


44


Senior Vice President Sales and Marketing


2008Donald E. Vick, Jr.


45


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.     27




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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 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   Fiscal Year 2007

High


Low4th Quarter (November 1, 2007 through January 31,
    2008)

$
4.00


$
1.753rd Quarter (August 1, 2007 through October 31, 2007)


3.88



2.572nd Quarter (May 1, 2007 through July 31, 2007)


5.00



3.301st Quarter (February 1, 2007 through April 30, 2007)


5.80



3.54    28




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29




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MARKET
    PRICE OF AND DIVIDENDS ON THE REGISTRANTS COMMON EQUITY
    AND RELATED STOCK MATERS
      
  1/31/041

1/31/051

1/31/061

1/31/071

1/31/081

1/31/091Streamline Health Solutions, Inc. Common Stock

$
100.00


$
99.68


$
227.27


$
183.12


$
86.04


$
57.14NASDAQ U.S. Total Return Index

$
100.00


$
100.20


$
112.72


$
120.91


$
116.12


$
57.70NASDAQ Computer and Data Processing Services Stock Index

$
100.00


$
103.24


$
115.73


$
128.48


$
134.57


$
84.11     1

    
    Assumes that $100.00 was invested on January 31, 2004 in
    Common Stock at the closing price of $3.08 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
 30




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Item 6.
    Selected
    Financial Data  Form 10-K.
  Fiscal Year(1)2008


2007


2006


2005


2004(In thousands, except per share data)INCOME STATEMENT DATA:Total revenues(2)

$
16,286


$
16,684


$
15,961


$
16,185


$
12,794Total operating expenses


17,632



17,388



15,779



14,447



11,858Operating profit (loss)(3)


(1,346
)


(704
)


182



1,738



936Net earnings (loss)(3) &(4)


(1,375
)


(736
)


96



2,551



558Basic net earnings (loss) per share of Common stock


(.15
)


(.08
)


.01



.28



.06Diluted net earnings (loss) per share of Common stock


(.15
)


(.08
)


.01



.27



.06Shares used in computing basic per share data


9,286



9,234



9,195



9,121



9,068Shares used in computing diluted per share data


9,286



9,234



9,722



9,425



9,233BALANCE SHEET DATA (at end of the year):Cash

$
3,129


$
2,189


$
3,317


$
4,634


$
4,181Working capital


(781
)


267



2,748



3,347



3,892Total assets


16,732



16,099



15,301



16,433



11,993Long-term debt, including current portion


800







1,000



2,000



2,000Total stockholders equity


7,097



8,193



8,644



8,351



5,712Cash 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 impact of the revision was an
    increase in total Net Revenues and a corresponding increase in
    Cost of Sales, see Note 1 to Consolidated Financial
    Statements. The selected financial data presented above reflect
    the revised amounts.(3)
    
    Operating profit (loss) and net earnings (loss) includes a
    $300,000, $100,000, $100,000, and $41,000 reduction in reserves
    due to changes in estimates, in 2004, 2006, 2007, and 2008,
    respectively.(4)
    
    Net earnings in 2005 and 2004 include a tax benefit of $897,000
    and $420,000, respectively, 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. 31




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Item 7.
    Managements
    Discussion and Analysis of Financial Condition and Results of
    Operations      Application
    of Critical Accounting Policies (See also Notes to Consolidated
    Financial Statements)
      Revenue
    Recognition
  97-2, Software Revenue Recognition 98-9, Revenue Recognition No. 00-21, Revenue Arrangements with Multiple Deliverables
      Bad
    Debts
   32




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Capitalized
    Software Development Costs
  Accounting for the Costs of Software to be Sold, Leased or
    Otherwise Marketed
    product-by-product
     33




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Equity
    Awards  Stock-Based Compensation
  Accounting for Stock-Based Compensation,
  Income
    Taxes
  Accounting for Uncertainties in Income
    Taxes Accounting
    for Income Taxes
             34




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Contractual
    Obligations
  Payments by Fiscal YearTotal


2009


2010


2011


2012


2013Line of Credit


800,000







800,000











Operating Leases


677,823



448,336



204,979



24,508







Total

$
1,477,823


$
448,336


$
1,004,979


$
24,508


$



$
   Working
    Capital Facility
        Period

Min. Amount10/31/08 through 01/30/09

$
1,000,000.0001/31/09 through 04/29/09

$
1,500,000.0004/30/09 through 07/30/09

$
1,750,000.0007/31/09 through 10/30/09

$
2,000,000.0010/31/09 through 01/30/10

$
2,250,000.0001/31/09 and thereafter

$
2,500,000.00       Operating
    Leases
   35




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Warranties
    and Indemnities
  e e
  Off
    Balance Sheet Arrangements
    Results
    of Operations
    Statement
    of Operations(1)
  Fiscal Year(2)2008


2007


2006Systems sales


20.0
%


18.1
%


26.8
%Services, maintenance and support


62.1



60.7



52.7Application-hosting services


17.9



21.2



20.5Total revenues


100.0



100.0



100.0Cost of sales


54.5



49.1



45.5Selling, general and administrative


39.9



36.3



36.4Product research and development


13.9



18.8



17.0Total operating expenses


108.3



104.2



98.9Operating profit (loss)


(8.3
)


(4.2
)


1.1Other income (expense), net


(.1
)


(.2
)


(.5
)Income tax net benefit










Net earnings(loss)


(8.4
)%


(4.4
)%


0.6
%Cost of systems sales


102.4
%


96.3
%


56.7
%Cost of services, maintenance and support


42.8
%


41.7
%


44.0
%Cost of application-hosting services


41.5
%


30.6
%


34.5
%     (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 36




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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 2008 with 2007
            Revenues
         37




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Cost
    of Sales
    Selling,
    General and Administrative
    Product
    Research and Development
   38




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Operating
    Profit (loss)
    Other
    Income (Expense)
    Provision
    for Income Taxes
    Net
    Earnings (loss)
    Comparison
    of fiscal year 2007 with 2006
  Revenues
       39




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Cost
    of Sales
    Selling,
    General and Administrative
    Product
    Research and Development
   40




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Operating
    Profit (loss)
    Other
    Income (Expense)
    Provision
    for Income Taxes
  1/31/08,
  Net
    Earnings (loss)
    Backlog
   41




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January 31, 2009


January 31, 2008Streamline Health Software Licenses

$
1,027,454


$
1,414,196Custom Software


278,416



338,583Hardware and Third Party Software


561,941



1,467,340Professional Services


4,691,309



4,797,638Application Hosting Services


13,042,472



3,027,688Recurring Maintenance


6,577,704



4,921,371TOTAL

$
26,179,296


$
15,966,816              42




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Liquidity
    and Capital Resources
               43




---



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Item 7A.
    Quantitative
    and Qualitative Disclosures About Market Risk       44




---



##### Table of Contents



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


46Consolidated Balance Sheets at January 31, 2009 and 2008


48Consolidated Statements of Operations for the three years ended
    January 31, 2009


49Consolidated Statements of Changes in Stockholders Equity
    for the three years ended January 31, 2009


50Consolidated Statements of Cash Flows for the three years ended
    January 31, 2009


51Notes to Consolidated Financial Statements


52Schedule II  Valuation and Qualifying Accounts


65    45




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REPORT OF
    INDEPENDENT REGISTERED PUBLIC ACCOUNTING FIRM
              BDO
    Seidman, LLP
 46




---



##### Table of Contents



REPORT OF
    INDEPENDENT REGISTERED PUBLIC ACCOUNTING FIRM
           Ernst &
    Young LLP
 47




---



##### Table of Contents



CONSOLIDATED
    BALANCE SHEETS
  January 31,2009


2008ASSETSCurrent assets:Cash and cash equivalents

$
3,128,801


$
2,189,010Accounts receivable, net of allowance for doubtful accounts of
    $100,000


1,328,508



2,832,852Contract receivables


502,373



1,833,842Prepaid hardware and third party software for future delivery


681,540



484,247Prepaid other, including prepaid customer maintenance contracts


802,951



501,803Deferred income taxes


247,000



185,000Total current assets


6,691,173



8,026,754Property and equipment:Computer equipment


2,475,928



2,235,104Computer software


1,405,407



1,086,691Office furniture, fixtures and equipment


737,344



731,346Leasehold improvements


574,257



574,2575,192,936



4,627,398Accumulated depreciation and amortization


(3,625,408
)


(3,153,675
)1,567,528



1,473,723Contract receivables, less current portion


321,500



Capitalized software development costs, net of accumulated
    amortization of $8,311,760 and $6,643,235, respectively


6,481,360



4,878,694Other, including deferred taxes of $1,628,000 and $1,690,000,
    respectively


1,670,891



1,720,114$
16,732,452


$
16,099,285LIABILITIES AND STOCKHOLDERS EQUITYCurrent liabilities:Accounts payable

$
759,577


$
1,518,682Accrued compensation


299,000



536,599Accrued other expenses


472,113



521,210Deferred revenues


5,941,837



5,183,333Total current liabilities


7,472,527



7,759,824Deferred revenues, less current portion


1,313,977



Line of credit


800,000



Other


48,842



146,525Total liabilities


9,635,346



7,906,349Stockholders 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, 9,354,782 and
    9,260,320 shares issued, respectively


93,548



92,603Additional paid in capital


35,820,417



35,542,222Accumulated (deficit)


(28,816,859
)


(27,441,889
)Total stockholders equity


7,097,106



8,192,936$
16,732,452


$
16,099,285    48




---



##### Table of Contents



CONSOLIDATED
    STATEMENTS OF OPERATIONS
  Fiscal Year2008


2007


2006Revenues:Systems sales

$
3,249,270


$
3,016,095


$
4,278,792Services, maintenance and support


10,124,829



10,125,485



8,409,320Application-hosting services


2,911,559



3,543,067



3,273,202Total revenues


16,285,658



16,684,647



15,961,314Operating expenses:Cost of systems sales


3,327,944



2,904,077



2,426,595Cost of services, maintenance and support


4,329,026



4,220,093



3,703,727Cost of application-hosting services


1,207,590



1,083,141



1,130,583Selling, general and administrative


6,503,465



6,048,214



5,802,656Product research and development


2,264,332



3,132,809



2,716,163Total operating expenses


17,632,357



17,388,334



15,779,724Operating profit (loss)


(1,346,699
)


(703,687
)


181,590Other income (expense):Interest income


7,865



22,256



77,337Interest expense


(24,436
)


(26,221
)


(131,286
)Other income (expenses)






(16,510
)


Earnings (loss) before income taxes


(1,363,270
)


(724,162
)


127,641Income tax (expense)


(11,700
)


(11,400
)


(31,180
)Net earnings (loss)

$
(1,374,970
)

$
(735,562
)

$
96,461Basic net earnings (loss) per common share

$
(.15
)

$
(.08
)

$
.01Number of shares used in basic per common share computation


9,286,261



9,234,313



9,195,415Diluted net earnings (loss) per common share

$
(.15
)

$
(.08
)

$
.01Number of shares used in diluted per common share computation


9,286,261



9,234,313



9,722,346  49




---



##### Table of Contents



CONSOLIDATED
    STATEMENTS OF CHANGES IN
    STOCKHOLDERS EQUITY
  Convertible





Additional





Totalredeemable


Common


paid in


Accumulated


stockholderspreferred stock


stock


capital


(deficit)


equityBalance at January 31, 2006

$



$
91,595


$
35,090,302


$
(26,830,579
)

$
8,351,318Stock issued to Employee Stock Purchase Plan and exercise of
    stock options






519



84,799







85,318Share-based compensation expense










111,137







111,137Net earnings














96,461



96,461Balance at January 31, 2007






92,114



35,286,238



(26,734,118
)


8,644,234Stock issued to Employee Stock Purchase Plan and exercise of
    stock options






489



113,342







113,831Share-based compensation expense










142,642







142,642FIN 48 tax adjustment














27,791



27,791Net (loss)














(735,562
)


(735,562
)Balance 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
)

$
7,097,106    50




---



##### Table of Contents



CONSOLIDATED
    STATEMENTS OF CASH FLOWS
  Fiscal Year2008


2007


2006Operating activities:Net earnings (loss)

$
(1,374,970
)

$
(735,562
)

$
96,461Adjustments to reconcile net earnings(loss) to net cash provided
    by operating activities:Depreciation and amortization


2,369,670



2,189,981



1,819,233Impairment loss on capitalized software development costs


408,809







Loss on sale of fixed assets






16,510



Share-based compensation expense


158,747



142,642



111,137Provision for allowance for doubtful accounts






(100,000
)


Change in assets and liabilities:Accounts, contract and installment receivables


2,514,313



(373,060
)


921,315Other assets


(498,441
)


(440,620
)


(178,699
)Accounts payable


(759,105
)


899,320



(436,177
)Accrued expenses


(286,697
)


111,555



(909,653
)Deferred revenues


2,072,481



1,489,665



1,076,484Net cash provided by operating activities


4,604,807



3,200,431



2,500,101Investing activities:Purchases of property and equipment


(794,950
)


(715,053
)


(610,353
)Proceeds from disposal of property and equipment






138,775



Capitalization of software development costs


(3,680,000
)


(2,652,000
)


(2,130,000
)Other


(110,459
)


(66,537
)


(77,720
)Net cash used in investing activities


(4,585,409
)


(3,294,815
)


(2,818,073
)Financing activities:Proceeds from revolving credit facility


2,000,000







1,000,000Repayment of long-term debt and revolving credit facility


(1,200,000
)


(1,000,000
)


(2,000,000
)Payment of capitalized leases






(147,051
)


(84,951
)Proceeds from exercise of stock options and stock purchase plan


120,393



113,831



85,318Net cash provided by (used in) financing activities


920,393



(1,033,220
)


(999,633
)Increase (Decrease) in cash and cash equivalents


939,791



(1,127,604
)


(1,317,605
)Cash and cash equivalents at beginning of year


2,189,010



3,316,614



4,634,219Cash and cash equivalents at end of year

$
3,128,801


$
2,189,010


$
3,316,614Supplemental cash flow disclosures:Interest paid

$
23,883


$
27,832


$
129,674Income taxes paid (refunded)

$
(3,278
)

$
9,202


$
66,537    51




---



##### Table of Contents



NOTES TO
    CONSOLIDATED FINANCIAL STATEMENTS
  1.
    Organization
    and Summary of Significant Accounting Policies    Fiscal
    Year
    Consolidation
    Use of
    Estimates
    Revenue
    Recognition
  97-2, Software Revenue Recognition 98-9, Revenue Recognition No. 00-21, Revenue Arrangements with Multiple Deliverables
   52




---



##### Table of Contents



NOTES TO
    CONSOLIDATED FINANCIAL
    STATEMENTS  (Continued)
    Cash and
    Cash Equivalents
    Receivables
    Concentrations
  Disclosure of
    Information about Financial Instruments with Off-Balance-Sheet
    Risk and Financial Instruments with Concentrations of Credit
    Risk
      Other
    Current Assets
   53




---



##### Table of Contents



NOTES TO
    CONSOLIDATED FINANCIAL
    STATEMENTS  (Continued)
  Property
    and Equipment
    Computer equipment and software


3-4 yearsOffice equipment


5 yearsOffice furniture and fixtures


7 yearsLeasehold improvements


Life of lease           Capitalized
    Software Development Costs
  Accounting for the Costs of Software to be Sold, Leased or
    Otherwise Marketed
    product-by-product
 54




---



##### Table of Contents



NOTES TO
    CONSOLIDATED FINANCIAL
    STATEMENTS  (Continued)
      Impairment
    of Long-Lived Assets
    Fair
    Value of Financial Instruments
    Income
    Taxes
  Accounting for Income Taxes
  Accounting for Uncertainties in Income
    Taxes Accounting
    for Income Taxes
  Stock
    Options and Stock Appreciation Rights
  Accounting for Stock-Based Compensation
  Accounting
    for Stock-Based Compensation,
 55




---



##### Table of Contents



NOTES TO
    CONSOLIDATED FINANCIAL
    STATEMENTS  (Continued)
      Net
    Earnings (loss) Per Common Share
  Earnings per Share
    Fiscal Year2008


2007


2006Net earnings (loss)

$
(1,374,970
)

$
(735,562
)

$
96,461Average shares outstanding used in basic per common share
    computations


9,286,261



9,234,313



9,195,415Stock options










428,976Warrants assumed converted










750,000Assumed treasury stock buyback










(652,045
)Convertible redeemable preferred stock assumed converted










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


9,286,261



9,234,313



9,722,346Basic net earnings (loss) per share of common stock

$
(.15
)

$
(.08
)

$
.01Diluted net earnings (loss) per share of common stock

$
(.15
)

$
(.08
)

$
.01     Recent
    Accounting Pronouncements
   56




---



##### Table of Contents



NOTES TO
    CONSOLIDATED FINANCIAL
    STATEMENTS  (Continued)
        157-2
    2.
    Operating
    Leases    3.
    Long-term
    Debt and Capitalized Leases   57




---



##### Table of Contents



NOTES TO
    CONSOLIDATED FINANCIAL
    STATEMENTS  (Continued)
        Period

Min. Amount10/31/08 through 01/30/09

$
1,000,000.0001/31/09 through 04/29/09

$
1,500,000.0004/30/09 through 07/30/09

$
1,750,000.0007/31/09 through 10/30/09

$
2,000,000.0010/31/09 through 01/30/10

$
2,250,000.0001/31/09 and thereafter

$
2,500,000.00           4.
    Income
    Taxes     58




---



##### Table of Contents



NOTES TO
    CONSOLIDATED FINANCIAL
    STATEMENTS  (Continued)
    Fiscal Year2008


2007


2006Federal tax expense:Current

$



$



$
Deferred


















State tax expense:Current


(11,700
)


(11,400
)


(31,180
)Deferred










(11,700
)


(11,400
)


(31,180
)Federal and state income tax (expense)

$
(11,700
)

$
(11,400
)

$
(31,180
)     Fiscal Year2008


2007


2006Federal tax (expense) benefit at Statutory rate

$
463,512


$
246,215


$
(43,398
)State and local taxes, net of federal benefit


7,722



7,527



(28,224
)Change in valuation allowance


(351,282
)


(256,800
)


37,943Stock based compensation expense


(125,142
)






Other


(6,510
)


(8,342
)


2,499$
(11,700
)

$
(11,400
)

$
(31,180
)     Fiscal Year2008


2007Deferred tax assets:Net operating loss carry forwards

$
10,456,072


$
10,092,028Accounts payable and accrued liabilities


170,026



202,622Property and equipment


92,386



72,536Other


73,549



73,56510,792,033



10,440,751Less valuation allowance


(8,917,033
)


(8,565,751
)Net deferred tax assets


1,875,000



1,875,000Deferred tax liabilities:






Net deferred tax asset

$
1,875,000


$
1,875,000    59




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##### Table of Contents



NOTES TO
    CONSOLIDATED FINANCIAL
    STATEMENTS  (Continued)
    5.
    Retirement
    Plan    6.
    Major
    Customers        7.
    Stock-based
    Compensation Plans  Accounting for
    Stock-Based Compensation
           60




---



##### Table of Contents



NOTES TO
    CONSOLIDATED FINANCIAL
    STATEMENTS  (Continued)
        Fiscal Year2008


2007


2006Weighted





Weighted





Weightedaverage





average





averageexercise





exercise





exerciseOptions


price


Options


price


Options


priceOutstanding  beginning of year


409,000


$
2.46



461,500


$
2.50



476,167


$
2.76Granted


355,382



1.89



40,000



3.79



45,000



5.74Exercised


(57,000
)


1.11



(31,500
)


1.64



(24,667
)


.97Expired


(72,500
)


2.80



(61,000
)


4.04



(35,000
)


11.61Forfeited






















Outstanding  end of year


634,882



2.21



409,000



2.46



461,500



2.50Exercisable  end of year


237,830


$
2.29



322,334


$
1.97



373,169


$
2.04Aggregate intrinsic value of outstanding options at year end

$
1,117,392






$
1,083,850Aggregate intrinsic value of exercisable options at year end

$
418,581






$
854,212Weighted average grant date fair value of options granted during
    year

$
1.23






$
2.51






$
3.31Total intrinsic value of Options exercised during the year

$
100,320






$
83,475






$
139,122       AverageNumber of

exercise

RemainingOptions

options

price

life in yearsOutstanding


634,882



2.21
(1)


8Exercisable


237,830


$
2.29



4     (1)
    
    The exercise prices range from $0.53 to $6.03, of which
    414,882 shares are between $0.53 and $1.95 per share,
    175,000 shares are between $2.08 and $4.35 per share, and
    45,000 shares are between $5.17 and
    $6.03 per share. 61




---



##### Table of Contents



NOTES TO
    CONSOLIDATED FINANCIAL
    STATEMENTS  (Continued)
     WeightedaverageGrant-dateNonvested Shares

Shares


Fair ValueBalance Beginning of year


86,672



2.78Granted


355,382



1.23Vested


(45,002
)


2.59Forfeited






Balance End of year


397,052



1.82           8.
    Employee
    Stock Purchase Plan          9.
    Commitments
    and Contingencies  Maintenance
    Agreements, Warranties, and Indemnities
   62




---



##### Table of Contents



NOTES TO
    CONSOLIDATED FINANCIAL
    STATEMENTS  (Continued)
    AdditionsBalance at


Charged to


Charged toBeginning


costs


Other





Balance atDescription

of Period


and Expenses


Accounts


Deductions


End of Period(In thousands)Year ended January 31, 2009:Warranty reserve


196











(66
)


130Year ended January 31, 2008:Warranty reserve


250











(54
)


196   Application-hosting
    Services
    Employment
    Agreements
    Reserved
    Common Stock
    Litigation
   63




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##### Table of Contents



NOTES TO
    CONSOLIDATED FINANCIAL
    STATEMENTS  (Continued)
  10.
    Quarterly
    Results of Operations (Unaudited)    First


Second


Third


FourthQuarter


Quarter


Quarter


Quarter


2008(In thousands, except per share data)Revenues(g)

$
3,604


$
4,837


$
4,379


$
3,466


$
16,286Gross profit


1,505



2,467



2,089



1,360



7,421Operating profit (loss) (e, f)


(813
)


(427
)


26



(132
)


(1,347
)Net earnings (loss) (e, f)


(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)

$



$



$



$



$
   First


Second


Third


FourthQuarter


Quarter


Quarter


Quarter


2007(In thousands, except per share data)Revenues(g)

$
3,809


$
3,234


$
3,974


$
5,667


$
16,684Gross profit


1,777



1,299



2,137



3,264



8,477Operating profit (loss)(d)


(447
)


(1,054
)


16



781



(704
)Net earnings (loss)(d)


(443
)


(1,071
)


3



776



(736
)Basic net (loss) earnings per share(a)


(.05
)


(.12
)


.00



.08



(.08
)Diluted net (loss) earnings per share(a)


(.05
)


(.12
)


.00



.08



(.08
)Weighted average shares outstanding


9,211



9,225



9,245



9,254



9,234Stock Price(b)High

$
5.80


$
5.00


$
3.88


$
4.00


$
5.80Low

$
3.54


$
3.30


$
2.57


$
1.75


$
1.75Quarter and year-end close

$
4.72


$
3.80


$
2.94


$
2.65


$
2.65Cash 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 third quarter of fiscal year 2007, a $100,000
    favorable change in the allowance for doubtful accounts.(e)
    
    Includes in the fourth quarter of fiscal year 2008, a $41,000
    favorable change in the estimate for miscellaneous reserves.(f)
    
    Includes in the fourth quarter of fiscal year 2008, a $408,000
    impairment charge of capitalized software development costs.(g)
    
    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 impact of the revision was an
    increase in total Net Revenues and a corresponding increase in
    Cost of Sales, see Note 1 to Consolidated Financial
    Statements. The quarterly financial data presented above reflect
    the revised amounts. 64




---



##### Table of Contents



Schedule II
  Valuation and Qualifying Accounts and Reserves
  Streamline
    Health Solutions, Inc.
    For the three years ended January 31, 2009
  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, 2009:Allowance for doubtful accounts

$
100


$



$



$



$
100Year ended January 31, 2008:Allowance for doubtful accounts

$
200


$








(100
)


100Year ended January 31, 2007:Allowance for doubtful accounts


200


$












200  
  Item 9.
    Changes
    in and Disagreements with Accountants on Accounting and
    Financial Disclosures        Regulation S-K.
    Form 10-K
    Regulation S-K regulation S-K, Regulation S-K.
 65




---



##### Table of Contents



Item 9A(T)
    Controls
    and Procedures  Rules 13a-15(e) 15d-15(e).
   66




---



##### Table of Contents



MANAGEMENTS
    REPORT ON INTERNAL CONTROL OVER FINANCIAL REPORTING
  Rule 13a-15(f)
  ,
  Internal Control Integrated Framework
  Regulation S-K)
   67




---



##### Table of Contents



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


634,882(1, 2 & 3
)

$
2.21



519,618(3
)Total


634,882(1, 2 & 3
)

$
2.21



519,618(3
)     (1)
    
    Includes 15,000 options that can be exercised under the 1996
    non-employee Directors Stock Option Plan and 139,500
    options that can be exercised under the 1996 Employee Stock
    Option Plan.(2)
    
    Includes 480,382 options that can be exercised by directors
    under the 2005 Incentive Compensation Plan.(3)
    
    Excludes 284,447 shares that can be issued under the 1996
    Employee Stock Purchase Plan, which is more fully described in
    footnote 8 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. 68




---



##### Table of Contents



Item 13.
    Certain
    Relationships, Related Transactions and Directors
    Independence  Regulation S-K
 
  Item 14.
    Principal
    Accounting Fees and Services    2008


2007Audit Fees

$
159,000


$
112,000Audit-Related Fees






Tax Fees


10,000



35,000All Other Fees






Total Fees

$
169,000


$
147,000    
  PART IV
 
  Item 15.
    Exhibits,
    Financial Statement Schedules  Financial
    Statements
           69




---



##### Table of Contents



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, 2009/s/  Jonathan
    R. PhillipsJonathan
    R. Phillips

Director

April 16, 2009/s/  Edward
    J. VonderBrinkEdward
    J. VonderBrink

Director

April 16, 2009/s/  Richard
    C. LevyRichard
    C. Levy, M.D.

Director

April 14, 2009/s/  Andrew
    L. TurnerAndrew
    L. Turner

Director

April 15, 2009/s/  Jay
    D. MillerJay
    D. Miller

Director

April 16, 2009/s/  Donald
    E. Vick, Jr.Donald
    E. Vick, Jr.

Interim Chief Financial Officer
    (Principal Financial and Accounting Officer)

April 16, 2009  70




---



##### Table of Contents



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.)4.3

Revolving Note, and associated documents, dated January 7, 2008,
    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 from,
    Exhibit 10.1 and 10.2 of the Registrants Form 8-K, as
    filed with the Commission on January 8, 2008.)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.) 71




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Exhibit No.

Description of Exhibit10.5#

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.)10.5(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.) 72




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##### Table of Contents



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#

Schedule of Directors Compensation (Previously filed with the
    Commission, and incorporated herein by reference from, Exhibit
    10.14 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.)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***23.2

Consent of Independent Registered Public Accounting
    Firm  Ernst & Young, 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.***32.1

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. 73