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Exhibit 19

To Our
Shareholders, Employees, Suppliers and Customers:

Fiscal 2009 was a tumultuous
year for Biotel. Biotel attained the highest sales levels in our companys
history, yet entered a merger agreement with CardioNet that was subsequently
terminated and abandoned. We expect fiscal 2010 to be a challenging year for
the Company.

Fiscal 2009 Operations

Fiscal year 2009 revenue was
up 10% to $12.6 million. Net income rose to $944,000, a 42% gain over last
year. Profitability has grown steadily, with a 3-year compound growth rate of
28%. Biotel enjoyed revenue and earnings gains arising from sales to a major
customer who was stocking and launching the Braemar wireless ER920W product in
the arrhythmia service industry.

ER920W is an advanced device
that integrates cardiac arrhythmia monitoring and wireless data transmission
and analysis in one unit. The ER920W is a digital loop recorder with automatic
detection, recording and transmission of patient symptoms and arrhythmias to
service centers for analysis and physician attention.

Biotels increasing
commitment to research and development resulted in the development of important
new advances in our product technology.

| |                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
| | ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
| | The next generation of ambulatory cardiac monitoring,
 named Fusion is just reaching customer sites for evaluation. Fusion is a
 robust and capable MCT (mobile cardiac telemetry) system expected to be
 available for clinical use in the first calendar quarter of 2010. The Fusion
 system will allow patient ECG signals, data and alerts to be automatically
 transferred from the patients home, office or remote location to the
 monitoring center without patient knowledge or interaction. Fusion monitors
 employ concurrent computerized real time ECG analysis with secure, redundant
 ECG telecommunications, allowing remote patient surveillance for up to 30
 days and technician retrievable access to multiple days of stored ECG
 records. The Fusion system also includes proprietary, PC-based software that
 is installed at the monitoring center.
| |                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
| | Fusion ECG monitoring procedures are more robust and
 comprehensive than with traditional event recording. Fusion monitoring
 procedures are also eligible for higher reimbursement. Presently, MCT
 procedures are covered by local carriers who may vary procedure payments from
 region to region. There are substantial differences in allowed reimbursement
 among the regions. Medicare has retained the local carrier system for 2010
 rather than implement a national reimbursement rate.                                                                                                                                                                                                                                                                                                                                                                            

These new product
introductions position Biotel for success in the next generation of ambulatory
cardiac monitoring products and services.

Financial Performance

Fiscal 2009 marks our
seventh consecutive year of profitable growth. Key metrics are as follows:

|  |                                                                                     
|- | ------------------------------------------------------------------------------------
| | Net income of $944,000, up
 42% from $666,000 in 2008                               
| | Strong commitment to
 innovation with R&D of $1.6 million, or 12.8% of 2009 revenues
| | Year-end cash of
 $1,160,000, up from $945,000 last year                            

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CardioNet Termination and Lawsuit

Following negotiation and
due diligence, Biotel entered a Merger Agreement with CardioNet, Inc. on April
2, 2009. The agreement called for an all cash payment to Biotel shareholders of
$4.82 per share. On July 14, 2009, CardioNet notified Biotel that it was
terminating the Merger Agreement. Biotel believes CardioNets actions in
terminating the business combination were without merit and that Biotels
business has been severely damaged as a result of CardioNets actions. We have
commenced a lawsuit against CardioNet for wrongful termination of the Merger Agreement
seeking specific performance by CardioNet to complete the planned business
combination with Biotel or, alternatively, damages.

Customers and Reimbursement

The Medicare MCT
reimbursement climate varies from region to region. Presently, Biotel is not
forecasting major national customers for its Fusion MCT products but instead
will market Fusion and ER920W systems to regional scanning services. While
Biotel is hopeful for a strong market for its Fusion MCT and ER920W wireless
devices, the prospective regional customers presently have a minimal market
share in this business sector. Regional scanning services do not have the
purchasing power of national scanning services, but they maintain strong
relationships with their end users. Because of the patchwork of reimbursement
pricing among Medicare local carriers, some regional customers may prefer
ER920W wireless event recorders while others prefer Fusion products.

Following a strong fiscal
year 2009 selling ER920W devices to a major customer, Biotel is expecting
diminished wireless sales activity in the current fiscal year. In the US region
in which MCT procedures are primarily reimbursed, Medicare reduced the payment
for this procedure by 33% effective September 1, 2009. Medicare has recently
announced that event recorder reimbursement will diminish 7% and Holter
reimbursement will diminish 16% effective January 1, 2010. This will place
downward pressure on pricing and sales of Biotels product lines.

Expense Reductions

In view of current business
projections, Biotel has made non-personnel expense cuts and reduced personnel
by six employees. These combined expenditure reductions have a projected annual
impact of $600,000. Biotel will also need to pay for an elevated level of legal
expenses as projected in coming quarters. Biotel is promoting its traditional
product lines and new technologies for maximal impact, but there can be no
assurances that its plans or the level of expenditure reductions properly match
the resultant demand for Biotel products in upcoming quarters.

Looking Ahead

Biotel expects to incur
operating losses through the remainder of the current fiscal year but is
working to return to profitability on a diminished sales projection following
the launch and acceptance of our Fusion MCT products. We are committed to
aggressively pursuing our claims against CardioNet, re-structuring our business
for upcoming opportunities, and maximizing value for Biotel shareholders.

Sincerely,


-s- STEVE SPRINGROSE


Steve Springrose
Biotel President, CEO and Secretary
November 11, 2009


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