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, 2011oro

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

(I.R.S. Employerincorporation or
    organization)

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
  Rule 12h-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,




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##### 





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




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##### 



Form 10-K, Form 10-Q, Form 8-K, www.streamlinehealth.net http://www.sec.gov/ Form 10-K
    Products
   2




---



##### 




    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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##### 



accessANYwaretm
        
    STRM-IT and accessANYware are now one product
    Within the one application many modules may be added on to fit
    customer needs, including selected functionality and workflows
    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 database 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 more
    cost-effective support & troubleshooting
    Platform enables future expansion and easier integration with
    customers existing systems
    Shorter testing cycles
    Faster
    time-to-market
    Simplified installation 4




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##### 




    accessANYware  HIM is an enterprise wide,
    HIPAA and 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 and 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 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. 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
      
    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. 5




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##### 




    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.
    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.
    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.
    AuditACE 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.  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 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
   6




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##### 



Competition
          Healthcare
    Industry Trends impacting Streamline Health
  Rapid
    Technological Change and Evolving Market
    Changes
    and Consolidation in the Healthcare Industry
   7




---



##### 



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) 8




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##### 




    Create HIT grant and loan programs
    Accelerate construction of National Health Information Network
    (NHIN)          Contracts
    Overview
       9




---



##### 



tm
    ®
  ®
      ®
   10




---



##### 



Signed
    Agreements  Backlog
  and/or
        License
    fees
    Employees
    Key
    Personnel
     11




---



##### 



Regulatory
    Matters
    Regulations
    Relating to Confidentiality
        Limited
    Protection of Proprietary Technology
   12




---



##### 



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.
    In
    addition to direct sales, the Company relies on third party
    remarketing alliances for a substantial portion of its
    revenues.
    If
    we are unable to maintain and grow the Companys
    remarketing relationship with GE Healthcare or enter into new
    remarketing agreements, or similar alliances, failure to do so
    could be materially adverse to the growth of our base
    business.
   13




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##### 



A
    significant increase in new application hosting services
    contacts could reduce near term profitability and require a
    significant cash outlay which could adversely affect near term
    cash flow.
    Unsuccessful
    implementation of the Companys products and services with
    our customers may harm our future financial
    success.
    If
    we are forced to reduce our prices, our business, financial
    condition and results of operations could
    suffer.
    The
    Company needs to manage its costs while planning for
    growth.
   14




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##### 



Consolidation
    in the healthcare industry could adversely affect the
    Companys business, financial condition and results of
    operations.
    The
    potential impact on the Company of new or changes in existing
    federal, state, and local regulations governing healthcare
    information could be substantial.
    The
    healthcare industry is highly regulated. Any material changes in
    the political, economic or regulatory healthcare environment
    that affect the group purchasing business or the purchasing
    practices and operations of healthcare organizations, or that
    lead to consolidation in the healthcare industry, could require
    us to modify the Companys services or reduce the funds
    available to providers to purchase our products and
    services.
       15




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##### 



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.
   16




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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.
    Third
    party products are essential to Streamline Healths
    software.
   17




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##### 



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.
    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.
   18




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##### 



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.
    Potential
    disruptions in the credit markets may adversely affect the
    Companys 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.
   19




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##### 



Adverse
    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;
    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.
   20




---



##### 



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
    A
    limited number of stockholders have the ability to influence the
    outcome of director elections and other matters requiring
    stockholder approval.
      These
    risks are not exhaustive.
  Form 10-K
 21




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##### 



Item 1B.
    Unresolved
    Staff Comments    Item 2.
    Properties  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)Robert E. Watson


54


President, Chief Executive Officer, and Director


2011Gary M. Winzenread


45


Chief Operating Officer, and Senior Vice President of Product
    Development and Implementation Services


2007Richard D. Leach


55


Senior Vice President and Chief Marketing Officer


2011Donald E. Vick, Jr.


47


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.   22




---



##### 



start-up
     23




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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 2010

High


Low4th Quarter (November 1, 2010 through January 31, 2011)

$
1.99


$
1.133rd Quarter (August 1, 2010 through October 31, 2010)


1.49



1.002nd Quarter (May 1, 2010 through July 31, 2010)


1.98



0.961st Quarter (February 1, 2010 through April 30, 2010)


2.74



1.90   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          24




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##### 



MARKET
    PRICE OF AND DIVIDENDS ON THE REGISTRANTS COMMON EQUITY
    AND RELATED STOCK MATTERS
      
   1/31/061

1/31/071

1/31/081

1/31/091

1/31/101

1/31/111Streamline Health Solutions, Inc. Common Stock

$
100.00


$
80.57


$
37.86


$
25.14


$
31.57


$
26.57NASDAQ U.S. Total Return Index

$
100.00


$
107.25


$
103.01


$
51.20


$
74.73


$
95.43NASDAQ Computer and Data Processing Services Stock Index

$
100.00


$
111.01


$
116.27


$
72.68


$
114.09


$
141.46     1

    
    Assumes that $100.00 was invested on January 31, 2006 in
    Common Stock at the closing price of $7.00 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
 25




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##### 



Item 6.
    Selected
    Financial Data  Form 10-K.
  Fiscal
    Year(1)2010


2009


2008


2007


2006(In thousands, except per share data)INCOME STATEMENT DATA:Total
    revenues(2)

$
17,606


$
18,208


$
16,286


$
16,684


$
15,961Total operating expenses


19,457



16,855



17,632



17,388



15,779Operating profit
    (loss)(3,4)


(1,851
)


1,353



(1,346
)


(704
)


182Net earnings
    (loss)(3, 4

    & 5)


(2,951
)


1,288



(1,375
)


(736
)


96Basic net earnings (loss) per share of Common stock


(.31
)


.14



(.15
)


(.08
)


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


(.31
)


.14



(.15
)


(.08
)


.01Shares used in computing basic per share data


9,505



9,381



9,286



9,234



9,195Shares used in computing diluted per share data


9,505



9,531



9,286



9,234



9,722BALANCE SHEET DATA (at end of the year):Cash

$
1,404


$
1,025


$
3,129


$
2,189


$
3,317Working capital (deficit)


(2,222
)


(1,263
)


(781
)


267



2,748Total assets


16,015



17,525



16,732



16,099



15,301Long-term debt, including current portion


1,200



900



800







1,000Total stockholders equity


6,594



8,731



7,097



8,193



8,644Cash 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 fiscal 2006, 2007, and 2008,
    respectively;(4)
    
    Operating loss in fiscal 2010 includes an impairment charge to
    capitalized software development costs of $755,000, and other
    asset write-offs of $260,000.(5)
    
    Net loss in fiscal 2010 includes an incremental increase in the
    valuation allowance for deferred tax assets of $997,000, which
    is recorded as income tax expense. 26




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##### 



Item 7.
    Managements
    Discussion and Analysis of Financial Condition and Results of
    Operations    EXECUTIVE
    OVERVIEW
  Company
    Initiatives and Strategy
        time-to-market
    Building
    the Recurring Revenue Stream
   27




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1.
    Cloud computing systems are becoming more main stream and market
    adoption has increased dramatically over the past few years.2.
    Small to mid-sized healthcare organizations do not have the
    capital or the information technology staff to support complex,
    locally installed software.3.
    Economic and regulatory factors, along with reduced access to
    credit, have forced hospital organizations to reconsider their
    capital purchases and look to operating lease alternatives, such
    as Streamline Health 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.    Product
    Research & Development, Planning, &
    Evaluation
      Strategic
    Partnerships
  and/or
 28




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##### 



Results
    of Operations
    Fiscal Year2010


2009


Change


% ChangeSystems sales

$
2,558


$
3,674


$
(1,116
)


(30
)%Services, maintenance and support


11,498



11,233



265



2
%Application-hosting services


3,550



3,301



249



8
%Total revenues


17,606



18,208



(602
)


(3
)%Cost of sales


11,291



9,668



1,623



17
%Selling, general and administrative


6,406



5,504



902



16
%Product research and development


1,760



1,683



77



5
%Total operating expenses


19,457



16,855



2,602



15
%Operating profit (loss)


(1,851
)


1,353



(3,204
)


(237
)%Other income (expense), net


(83
)


(25
)


(58
)


(232
)%Income tax expense


(1,017
)


(40
)


(977
)


(2443
)%Net earnings(loss)

$
(2,951
)

$
1,288


$
(4,239
)


(329
)%Adjusted EBITDA(1)

$
2,886


$
4,416


$
(1,530
)


(35
)%     (1)
    
    Non-GAAP measure meaning, Earnings before interest, Tax,
    Depreciation, Amortization, and Stock-based compensation
    expense. See Use of Non-GAAP Financial
    Measures for additional information and reconciliation.    Statement
    of Operations(1)
  Fiscal Year2010


2009Systems sales


14.5
%


20.2
%Services, maintenance and support


65.3



61.7Application-hosting services


20.2



18.1Total revenues


100.0



100.0Cost of sales


64.1



53.1Selling, general and administrative


36.4



30.2Product research and development


10.0



9.2Total operating expenses


110.5



92.5Operating profit (loss)


(10.5
)


7.4Other income (expense), net


(.5
)


(.3
)Income tax net loss


(5.8
)


Net earnings(loss)


(16.8
)%


7.1
%Cost of systems sales


149.6
%


81.5
%Cost of services, maintenance and support


48.4
%


44.8
%Cost of application-hosting services


53.6
%


49.7
%  29




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##### 



(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.      Comparison
    of fiscal year 2010 with 2009
             30




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##### 



Revenues
    Fiscal Year


Dollars


Percent2010


2009


Change


ChangeProprietary software(1)

$
1,674


$
2,438


$
(764
)


(31
)%Hardware & third party software(1)


884



1,236



(352
)


(28
)%Professional services(2)


3,641



3,713



(72
)


(2
)%Maintenance & support(2)


7,857



7,520



337



4
%Application hosting services


3,550



3,301



249



8
%Total Revenues

$
17,606


$
18,208


$
(602
)


(3
)%     (1)
    
    Proprietary software, third-party software and third-party
    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 and Revenue Cycle Management
    Consulting services.  Proprietary software
  Hardware and third party software
  Professional services
  Maintenance and support
  Application hosting
  Revenues from remarketing partners
 31




---



##### 



Cost
    of Sales
    Fiscal Year


Dollars


Percent2010


2009


Change


ChangeCost of system sales

$
3,827


$
2,993


$
834



28
%Cost of services, maintenance and support


5,561



5,033



528



10
%Cost of application hosting


1,903



1,642



261



16
%Total cost of sales

$
11,291


$
9,668


$
1,623



17
%   period-to-period
     32




---



##### 



Selling,
    General and Administrative Expense
  Fiscal Year


Dollars


Percent2010


2009


Change


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

$
6,406


$
5,504


$
902



16
%     Product
    Research and Development
  Fiscal Year


Dollars


Percent2010


2009


Change


Change(In thousands):Research and development expense

$
1,760


$
1,683


$
77



5
%Capitalized research and development cost


2,701



3,668



(967
)


(26
)%Total R&D Cost(1)

$
4,461


$
5,351


$
(890
)


(17
)%     (1)
    
    Total cash spend on research and development    Operating
    Profit (Loss)
    Other
    Income (Expense)
   33




---



##### 



Provision
    for Income Taxes
    Net
    Earnings (Loss)
    Backlog
      January 31, 2011


January 31, 2010Streamline Health Software Licenses

$
121,000


$
201,000Custom Software


42,000



105,000Hardware and Third Party Software


66,000



171,000Professional Services


4,629,000



3,977,000Application Hosting Services


7,362,000



9,414,000Recurring Maintenance


5,384,000



5,987,000Total

$
17,604,000


$
19,855,000      34




---



##### 



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 
 35




---



##### 



and/or
      Allowance
    for Doubtful Accounts
    Capitalized
    Software Development Costs
  ASC 985-20 Software  Costs of Software to be Sold, Leased or
    Marketed product-by-product
     36




---



##### 



Equity
    Awards  Stock-Based Compensation
  Compensation  Stock
    Compensation
    Income
    Taxes
  Income Taxes
   37




---



##### 



Fair
    Value Measurements
    Use of
    Non-GAAP Financial Measures
  Form 10-K
    EBITDA,
    Adjusted EBITDA, Adjusted EBITDA Margin, and Adjusted EBITDA per
    diluted share
       38




---



##### 



Form 10-K,
  
    EBITDA does not reflect our cash expenditures or future
    requirements for capital expenditures or contractual commitments;
    EBITDA does not reflect changes in, or cash requirements for,
    our working capital needs;
    EBITDA does not reflect the interest expense, or the cash
    requirements to service interest or principal payments under our
    credit agreement;
    EBITDA does not reflect income tax payments we are required to
    make; and
    Although depreciation and amortization are non-cash charges, the
    assets being depreciated and amortized often will have to be
    replaced in the future, and EBITDA does not reflect any cash
    requirements for such replacements.  Form 10-K, Form 10-K.
   39




---



##### 



Fiscal YearAdjusted EBITDA Reconciliation

2010


2009Net earnings (loss)

$
(2,951
)

$
1,288Interest expense


117



44Tax expenses
    (1)


1,017



40Depreciation and other amortization


850



769Amortization of capitalized software development costs
    (2)


3,175



2,100EBITDA


2,208



4,241Stock-based compensation expense


678



275Adjusted EBITDA

$
2,886


$
4,516Adjusted EBITDA
    Margin(3)


16.4
%


24.8
%   Adjusted EBITDA per diluted share

2010


2009Earnings (loss) per share  diluted

$
(0.31
)

$
0.14Interest
    expense(4)


0.01



0.00Tax
    expenses(4)


0.11



0.00Depreciation and other
    amortization(4)


0.09



0.08Amortization of capitalized software development costs
    (4)(2)


0.33



0.22Stock-based compensation
    expense(4)


0.07



0.03Adjusted EBITDA per adjusted diluted share

$
0.30


$
0.47Diluted weighted average shares


9,504,986



9,530,891Includable incremental shares  adjusted
    EBITDA(5)


83,353



Adjusted diluted shares

$
9,588,339


$
9,530,891     (1)
    
    Includes a non-cash increase to the valuation allowance of
    $997,000 during fiscal 2010(2)
    
    Fiscal 2010 amortization expense includes $755,000 of impairment
    charges for certain capitalized software development costs(3)
    
    Adjusted EBITDA as a percentage of GAAP revenues(4)
    
    Per adjusted diluted weighted average shares(5)
    
    The number of incremental shares that would be dilutive under
    profit assumption, only applicable under a GAAP net loss. If
    GAAP profit is earned in the current period, no additional
    incremental shares are assumed  Liquidity
    and Capital Resources
  quarter-to-quarter.
   40




---



##### 



41




---



##### 



Contractual
    Obligations
    Line of Credit


Operating Leases


Capital Lease


Fiscal Year Totals2011(1)

$
1,206,000


$
396,000


$
198,000


$
1,800,0002012






334,000







334,0002013






320,000







320,0002014






329,000







329,0002015






164,000







164,000Thereafter














Total

$
1,206,000


$
1,543,000


$
198,000


$
2,947,000     (1)
    
    In the first quarter of fiscal 2011, the Company agreed to an
    amendment extending the line of credit term to mature on
    October, 31, 2013  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.       42




---



##### 



Operating
    Leases
    Capital
    Lease
    Off
    Balance Sheet Arrangements
    Contingencies
    Item 7A.
    Quantitative
    and Qualitative Disclosures About Market Risk  across-the-board
     43




---



##### 



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


45Consolidated Balance Sheets at January 31,
    2011 and 2010


46Consolidated Statements of Operations for the two
    years ended January 31, 2011


47Consolidated Statements of Changes in
    Stockholders Equity for the two years ended
    January 31, 2011


48Consolidated Statements of Cash Flows for the two
    years ended January 31, 2011


49Notes to Consolidated Financial Statements


50Schedule II  Valuation and
    Qualifying Accounts


65     44




---



##### 



REPORT OF
    INDEPENDENT REGISTERED PUBLIC ACCOUNTING FIRM               BDO
    USA, LLP
 45




---



##### 



CONSOLIDATED
    BALANCE SHEETS  January 31,2011


2010ASSETSCurrent assets:Cash and cash equivalents

$
1,403,949


$
1,025,173Accounts receivable, net of allowance for doubtful accounts of
    $100,000


2,620,756



1,922,279Contract receivables


680,096



1,182,308Prepaid hardware and third party software for future delivery


72,259



149,281Prepaid customer maintenance contracts


794,299



1,058,282Other prepaid assets


200,056



305,050Deferred income taxes


167,000



224,000Total current assets


5,938,415



5,866,373Property and equipment:Computer equipment


2,708,819



2,987,039Computer software


1,947,135



1,816,397Office furniture, fixtures and equipment


747,867



747,867Leasehold improvements


639,864



574,2576,043,685



6,125,560Accumulated depreciation and amortization


(4,517,860
)


(4,344,432
)1,525,825



1,781,128Contract receivables, less current portion


241,742



146,093Capitalized software development costs, net of accumulated
    amortization of $12,832,347 and $10,411,828, respectively


7,575,064



8,049,292Other, including deferred taxes of $711,000 and $1,651,000,
    respectively


734,376



1,681,661$
16,015,422


$
17,524,547LIABILITIES AND STOCKHOLDERS EQUITYCurrent liabilities:Accounts payable

$
565,252


$
887,928Accrued compensation


1,163,843



559,235Accrued other expenses


480,422



476,504Current portion of capital lease obligations


183,637



249,309Current portion of deferred revenues


5,766,795



4,956,303Total current liabilities


8,159,949



7,129,279Deferred revenues, less current portion






602,239Line of credit


1,200,000



900,000Lease incentive liability, less current portion


61,034



Capital lease obligation, less current portion






161,666Total liabilities


9,420,983



8,793,184Stockholders 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, 9,856,517 and
    9,436,824 shares issued and outstanding, respectively


98,565



94,368Additional paid in capital


36,975,242



36,160,126Accumulated other comprehensive income






5,620Accumulated (deficit)


(30,479,368
)


(27,528,751
)Total stockholders equity


6,594,439



8,731,363$
16,015,422


$
17,524,547    46




---



##### 



CONSOLIDATED
    STATEMENTS OF OPERATIONS  Fiscal Year2010


2009Revenues:Systems sales

$
2,557,797


$
3,673,522Services, maintenance and support


11,497,969



11,233,183Application-hosting services


3,550,225



3,301,493Total revenues


17,605,991



18,208,198Operating expenses:Cost of systems sales


3,827,313



2,993,442Cost of services, maintenance and support


5,561,578



5,033,145Cost of application-hosting services


1,902,521



1,641,576Selling, general and administrative


6,406,190



5,503,580Product research and development


1,759,694



1,682,773Total operating expenses


19,457,296



16,854,516Operating profit (loss)


(1,851,305
)


1,353,682Other income (expense):Interest expense


(116,392
)


(43,823
)Other income (expenses)


34,080



18,749Earnings (loss) before income taxes


(1,933,617
)


1,328,608Income tax (expense)


(1,017,000
)


(40,500
)Net earnings (loss)

$
(2,950,617
)

$
1,288,108Basic net earnings (loss) per common share

$
(.31
)

$
.14Number of shares used in basic per common share computation


9,504,986



9,381,285Diluted net earnings (loss) per common share

$
(.31
)

$
.14Number of shares used in diluted per common share computation


9,504,986



9,530,891    47




---



##### 






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, 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 income


















1,288,108



1,288,108Balance at January 31, 2010






94,368



36,160,126



5,620



(27,528,751
)


8,731,363Stock issued to Employee Stock Purchase Plan and exercise of
    stock options






1,335



139,306











140,641Restricted stock issued






2,862



(2,362
)










500Share-based compensation expense










678,172











678,172Recognized benefit of foreign currency forward contracts














(5,620
)






(5,620
)Net (loss)


















(2,950,617
)


(2,950,617
)Balance at January 31, 2011

$



$
98,565


$
36,975,242


$



$
(30,479,368
)

$
6,594,439     48




---



##### 



CONSOLIDATED
    STATEMENTS OF CASH FLOWS  Fiscal Year2010


2009Operating activities:Net earnings (loss)

$
(2,950,617
)

$
1,288,108Adjustments to reconcile net earnings (loss) to net cash
    provided by operating activities:Depreciation and amortization


3,270,902



2,868,997Impairment loss on capitalized software development costs


754,709



Deferred tax provision


997,000



Loss on disposal of fixed assets


1,050



4,308Share-based compensation expense


678,172



274,629Change in assets and liabilities:Accounts, contract and installment receivables


(291,914
)


(1,098,299
)Other assets


440,379



54,664Accounts payable


(322,676
)


174,020Accrued expenses


608,526



264,627Deferred revenues


208,253



(1,697,272
)Net cash provided by operating activities


3,393,784



2,133,782Investing activities:Purchases of property and equipment


(530,434
)


(698,698
)Capitalization of software development costs


(2,701,000
)


(3,668,000
)Other


2,622



(36,612
)Net cash used in investing activities


(3,228,812
)


(4,403,310
)Financing activities:Net change under revolving credit facility


300,000



100,000Proceeds from exercise of stock options and stock purchase plan


141,141



65,900Payments on capital lease


(227,337
)


Net cash provided by financing activities


213,804



165,900(Decrease) Increase in cash and cash equivalents


378,776



(2,103,628
)Cash and cash equivalents at beginning of year


1,025,173



3,128,801Cash and cash equivalents at end of year

$
1,403,949


$
1,025,173Supplemental cash flow disclosures:Interest paid

$
74,898


$
34,507Income taxes paid

$
47,658


$
7,265Property and equipment additions financed by capital leases

$



$
410,975    49




---



##### 



NOTES TO
    CONSOLIDATED FINANCIAL STATEMENTS
  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
   50




---



##### 



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


Term of lease           Impairment
    of Long-Lived Assets
    Capitalized
    Software Development Costs
    product-by-product
 51




---



##### 



NOTES TO
    CONSOLIDATED FINANCIAL
    STATEMENTS  (Continued)
          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 
 52




---



##### 



NOTES TO
    CONSOLIDATED FINANCIAL
    STATEMENTS  (Continued)
  and/or
    Concentrations
        Equity
    Awards
        Income
    Taxes
   53




---



##### 



NOTES TO
    CONSOLIDATED FINANCIAL
    STATEMENTS  (Continued)
      Comprehensive
    Income (Loss)
      Fiscal Year2010


2009Net earnings (loss)

$
(2,950,617
)

$
1,288,108Change in unrecognized gain on foreign currency hedges


(5,620
)


5,620Total comprehensive income (loss)

$
(2,956,237
)

$
1,293,728   Net
    Earnings (Loss) Per Common Share
      Fiscal Year2010


2009Net earnings (loss)

$
(2,950,617
)

$
1,288,108Weighted average shares outstanding used in basic per common
    share computations


9,504,986



9,381,285Stock options and restricted stock






149,606Number of average shares used in diluted per common share
    computation


9,504,986



9,530,891Basic net earnings (loss) per share of common stock

$
(.31
)

$
.14Diluted net earnings (loss) per share of common stock

$
(.31
)

$
.14    54




---



##### 



NOTES TO
    CONSOLIDATED FINANCIAL
    STATEMENTS  (Continued)
    Recent
    Accounting Pronouncements
  2009-13 Revenue Recognition (Topic 605)
  2009-14 Software (Topic 985),
    NOTE C 
    CHANGE
    IN ACCOUNTING ESTIMATE     55




---



##### 



NOTES TO
    CONSOLIDATED FINANCIAL
    STATEMENTS  (Continued)
      NOTE D 
    LEASES    Facilities


Equipment


Fiscal Year Totals2011

$
377,000


$
19,000


$
396,0002012


315,000



19,000



334,0002013


315,000



5,000



320,0002014


329,000







329,0002015


164,000







164,000Thereafter










Total

$
1,500,000


$
43,000


$
1,543,000       Fiscal Year2010


2009Computer equipment

$
215,427


$
215,427Computer software


118,381



118,381Other


77,167



77,167Total


410,975



410,975Accumulated depreciation


122,035



Net value of leased property

$
288,940


$
410,975    56




---



##### 



NOTES TO
    CONSOLIDATED FINANCIAL
    STATEMENTS  (Continued)
  NOTE E 
    DEBT               57




---



##### 



NOTES TO
    CONSOLIDATED FINANCIAL
    STATEMENTS  (Continued)
  NOTE F 
    INCOME
    TAXES    Fiscal Year2010


2009Federal tax expense:Current

$



$
(26,000
)Deferred


(997,000
)


(997,000
)


(26,000
)State tax expense:Current


(20,000
)


(14,500
)Deferred






(20,000
)


(14,500
)Federal and state income tax expense

$
(1,017,000
)

$
(40,500
)     Fiscal Year2010


2009Federal tax benefit (expense) at statutory rate

$
664,230


$
(448,461
)State and local taxes, net of federal benefit (expense)


(12,135
)


(11,428
)Change in valuation allowance


(1,698,071
)


585,217Permanent items


(43,445
)


(128,473
)Alternative minimum tax expense






(26,000
)Other


72,421



(11,355
)Income tax expense

$
(1,017,000
)

$
(40,500
)     Fiscal Year2010


2009Deferred tax assets:Net operating loss carry forwards

$
10,278,852


$
9,881,084Accrued expenses


133,081



75,065Stock compensation expenses


308,728



97,768Property and equipment


151,626



99,829Other


35,600



53,07010,907,887



10,206,816Less valuation allowance


(10,029,887
)


(8,331,816
)Net deferred tax assets


878,000



1,875,000Deferred tax liabilities:






Net deferred tax asset

$
878,000


$
1,875,000  58




---



##### 



NOTES TO
    CONSOLIDATED FINANCIAL
    STATEMENTS  (Continued)
      and/or
      NOTE G 
    MAJOR
    CUSTOMERS      NOTE H 
    EMPLOYEE
    RETIREMENT PLAN    NOTE I 
    EMPLOYEE
    STOCK PURCHASE PLAN   59




---



##### 



NOTES TO
    CONSOLIDATED FINANCIAL
    STATEMENTS  (Continued)
          NOTE J 
    STOCK
    BASED COMPENSATION  Stock
    Option Plans
         60




---



##### 



NOTES TO
    CONSOLIDATED FINANCIAL
    STATEMENTS  (Continued)
    Fiscal Year2010


2009Weighted





Weightedaverage





averageexercise





exerciseOptions


price


Options


priceOutstanding  beginning of year

$
637,882


$
2.22


$
634,882


$
2.21Granted


549,916



2.26



29,000



2.09Exercised


(102,000
)


1.00



(11,000
)


1.50Expired


(143,734
)


1.87



(15,000
)


1.90Forfeited














Outstanding  end of year


942,064


$
2.42



637,882


$
2.22Exercisable  end of year


352,646


$
2.72



361,954


$
2.39Aggregate intrinsic value of outstanding options at year end

$
1,752,239






$
1,409,719Aggregate intrinsic value of exercisable options at year end

$
655,922






$
799,918Weighted average grant date fair value of options granted during
    year

$
.84






$
1.33Total intrinsic value of Options exercised during the year

$
189,720






$
24,310     AverageNumber of

exercise

Remainingoptions

price

life in yearsOutstanding


942,064


$
2.42
(1)


8.5Exercisable


352,646


$
2.72
(2)


6.8     (1)
    
    The exercise prices range from $1.46 to $6.03, of which
    586,398 shares are between $1.46 and $2.00 per share,
    310,666 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 $1.46 to $6.03, of which
    176,985 shares are between $1.46 and $2.00 per share,
    130,661 shares are between $2.08 and $4.35 per share, and
    45,000 shares are between $5.17 and $6.03 per share. 61




---



##### 



NOTES TO
    CONSOLIDATED FINANCIAL
    STATEMENTS  (Continued)
     WeightedNon-vested


averagenumber of


grant-dateshares


fair valueBalance 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



1.30Granted


549,916



0.84Vested


(129,492
)


1.35Forfeited


(106,934
)


1.13Balance at January 31, 2011


589,418


$
0.91           Restricted
    Stock
   62




---



##### 



NOTES TO
    CONSOLIDATED FINANCIAL
    STATEMENTS  (Continued)
    WeightedNon-vested


averagenumber of


grant dateshares


fair valueNon-vested balance at January 1, 2009

$



$
Granted


35,502



2.82Vested






Forfeited/expired






Non-vested balance at January 31, 2010


35,502



2.82Granted


289,548



1.40Vested


(98,613
)


2.22Forfeited/expired


(3,347
)


2.00Non-vested balance at January 31, 2011

$
223,090


$
1.25       NOTE K 
    COMMITMENTS
    AND CONTINGENCIES  Application
    Hosting Services
    Employment
    Agreements
        Reserved
    Common Stock
   63




---



##### 



NOTES TO
    CONSOLIDATED FINANCIAL
    STATEMENTS  (Continued)
  Litigation
    NOTE L 
    QUARTERLY
    RESULTS OF OPERATIONS (UNAUDITED)    First


Second


Third


FourthQuarter


Quarter


Quarter


Quarter


2010(In thousands, except per share data)Revenues

$
3,544


$
4,676


$
4,470


$
4,916


$
17,606Gross profit


967



2,044



1,906



1,397



6,315Operating profit (loss)(d)


(1,200
)


(28
)


144



(767
)


(1,851
)Net earnings (loss)(e)


(1,176
)


(76
)


95



(1,793
)


(2,951
)Basic net (loss) earnings per share(a)


(.12
)


(.01
)


.01



(.18
)


(.31
)Diluted net (loss) earnings per share(a)


(.12
)


(.01
)


.01



(.18
)


(.31
)Weighted average shares outstanding


9,413



9,507



9,753



9,561



9,505Stock Price(b)High

$
2.74


$
1.98


$
1.49


$
1.99


$
2.74Low

$
1.90


$
0.96


$
1.00


$
1.13


$
0.96Quarter and year-end close

$
1.93


$
1.24


$
1.27


$
1.86


$
1.86Cash dividends declared(c)

$



$



$



$



$
   First


Second


Third


FourthQuarter


Quarter


Quarter


Quarter


2010(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)

$



$



$



$



$
     (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 2010, a $755,000
    impairment charge of capitalized software development costs(e)
    
    Includes $997,000 incremental increase to the valuation
    allowance for deferred tax assets, recorded as income tax
    expense in the fourth quarter of fiscal 2010 64




---



##### 



Schedule II  Valuation and Qualifying Accounts and Reserves
  Streamline
    Health Solutions, Inc.
    For the two years ended January 31, 2011
  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, 2011:Allowance for doubtful accounts

$
100


$











$
100Year ended January 31, 2010:Allowance for doubtful accounts

$
100


$
50







50


$
100   ITEM 9.
    Changes
    in and Disagreements with Accountants on Accounting and
    Financial Disclosures    ITEM 9A
    Controls
    and Procedures  Rules 13a-15(e) 15d-15(e).
   65




---



##### 



MANAGEMENTS
    REPORT ON INTERNAL CONTROL OVER FINANCIAL REPORTING  Rule 13a-15(f)
  ,
  Internal Control Integrated Framework
       66




---



##### 



ITEM 9B.
    Other
    Information    PART III
  ITEM 10.
    Directors,
    Executive Officers and Corporate Governance  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


542,064
(1, 2)

$
2.44



421,186
(5)Equity compensation plans not approved by security holders


400,000
(3)

$
2.38




(4)Total


942,064
(1, 2 &

    3)

$
2.42



421,186     (1)
    
    Includes 17,500 options that can be exercised under the 1996
    Employee Stock Option Plan.(2)
    
    Includes 524,564 options that can be exercised under the 2005
    Incentive Compensation Plan.(3)
    
    Includes 400,000 options granted under an inducement grant with
    terms as nearly as practicable identical to the terms and
    conditions of the Companys 2005 Incentive Compensation
    Plan. The share and option awards are inducement grants,
    pursuant to Nasdaq Marketplace Rule 5635(c)(4). 67




---



##### 



(4)
    
    The Companys Board of Directors has not established any
    specific number of shares that could be issued without
    stockholder approval. Inducement grants to new key employees
    will be determined on a
    case-by-case
    basis. Other than possible inducement grants, the Company
    expects that all equity awards will be made under stockholder
    approved plans(5)
    
    Includes 203,733 shares to be issued from the 2005
    Incentive Compensation Plan, and 217,453 shares to be
    issued from the Employee Stock Purchase Plan  ITEM 13.
    Certain
    Relationships, Related Transactions and Directors
    Independence  Regulation S-K
  ITEM 14.
    Principal
    Accounting Fees and Services    2010


2009Audit Fees

$
194,000


$
173,000Audit-Related Fees






Tax Fees


15,000



10,000All Other Fees






Total Fees

$
209,000


$
183,000     PART IV
  ITEM 15.
    Exhibits,
    Financial Statement Schedules  Financial
    Statements
           68




---



##### 



SIGNATURES
    Streamline Health
    Solutions, Inc.
  By:
    /s/  Robert
    E. Watson   Chief Executive Officer
      /s/  Robert
    E. Watson/s/
    Robert E. Watson

Chief Executive Officer
    And Director
    (Principal Executive Officer)

April 12, 2011/s/  Jonathan
    R. PhillipsJonathan
    R. Phillips

Director

April 12, 2011/s/  Edward
    J. VonderBrinkEdward
    J. VonderBrink

Director

April 12, 2011/s/  Richard
    C. LevyRichard
    C. Levy, M.D.

Director

April 12, 2011/s/  Andrew
    L. TurnerAndrew
    L. Turner

Director

April 12, 2011/s/  Jay
    D. MillerJay
    D. Miller

Director

April 12, 2011/s/  Donald
    E. Vick, Jr.Donald
    E. Vick, Jr.

Interim Chief Financial Officer
    (Principal Financial and Accounting Officer)

April 12, 2011  69




---



##### 



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. as amended and
    restated on July 22, 2010, and previously filed with the
    Commission and incorporated herein by reference from the
    Registrants
    Form 10-Q,
    as filed with the Commission on September 9, 20103
.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

Form of Warrant Agreement (including Form of Warrant
    Certificate) of Streamline Health Solutions, Inc. with respect
    to Warrants to purchase Common Stock (Previously filed with the
    Commission and incorporated herein by reference from, the
    Registrants Registration Statement on
    Form S-3,
    File Number
    333-166843,
    as filed with the Commission on May 14, 2010.)4
.3

Form of Unit Agreement (including Form of Unit Certificate) of
    Streamline Health10
.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.)




---



##### 



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
.5(b)#

Employment Agreement among Streamline Health Solutions, Inc.,
    Streamline Health, Inc. and Donald E. Vick effective
    August 9, 2010 (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 August 10, 2010.)10
.6#

Employment Agreement dated January 31, 2011 between
    Streamline Health Solutions, Inc. and Robert E. Watson,
    (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 February 3, 2011.)10
.7#

Employment Agreement among Streamline Health Solutions, 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
    for the fiscal quarter ended October 31, 2007, 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. and Streamline Health, Inc. (Previously
    filed with the Commission, and incorporated herein by reference
    from, Exhibit 10.8(b) of the Registrants
    Form 10-K
    for the fiscal year ended January 31, 2008, as filed with
    the Commission on April 7, 2008.)10
.9#

Employment agreement among Streamline Health Solutions, Inc.
    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
    Form 8-K,
    as filed with the Commission on June 12, 2008.)10
.10#

Employment agreement among 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
    Form 8-K,
    as filed with the Commission on June 26, 2008.)10
.11

Lease Agreement dated July 30, 2004 between Streamline
    Health, Inc. f/k/a LanVision, Inc. and The Western and Southern
    Live Insurance Company (Previously filed with the Commission,
    and incorporated herein by reference from, Exhibit 10.1 of
    the Registrants (LanVision Systems, Inc.)
    Form 10-Q
    for the fiscal quarter ended July 31, 2004, as filed with
    the Commission on September 10, 200410
.11(b)

First Amendment to Lease and Acceptance of Delivery 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 10.11(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.)




---



##### 



Exhibit No.

Description of Exhibit10
.11(c)

Second Amendment to Lease Agreement for office space between
    Streamline Health, Inc. f/k/a LanVision, Inc. and Alliance
    Street, LLC, a Delaware limited liability company, successor in
    interest to The Western and Southern Life Insurance Company, by
    assignment, effective June 21, 2010 (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 June 22, 2010.)10
.12

Streamline Health Solutions, Inc. f/k/a LanVision Systems, Inc.
    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 10.2 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
.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
    of Streamline Health Solutions, 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 June 7, 200610
.15***#

Directors Compensation10
.16(a)

Amended and Restated Revolving Note, dated October 21,
    2009, between Streamline Health, Inc. and 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 Continuing Guaranty Agreement, dated
    October 21, 2009, between Streamline Health Solutions, Inc.
    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 Solutions, Inc. and 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 Lease Supplement, dated January 19, 2010, between
    Streamline Health, Inc. 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.)10
.18#

Separation Agreement dated January 31, 2011 by and between
    Streamline Health Solutions, Inc. and J. Brian Patsy (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 February 3, 201110
.19#

Employment agreement among Streamline Health Solutions Inc.,
    Streamline Health, Inc. and Rick Leach effective March 8,
    2011. (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 March 14, 2011.)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***




---



##### 



Exhibit No.

Description of Exhibit23
.1

Consent of Independent Registered Public Accounting
    Firm  BDO USA, 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.