Document:

Exhibit
4.1

 

	
  016570|
  003590|127C|RESTRICTED||4|057-423

  	
   

  
	
   

  	
   

  	
   

  
	
  COMMON STOCK

  	
  

  	
  COMMON STOCK

  
	
  

  PAR VALUE $.01

  	
   

  
	
   

  	
   

  	
   

  
	
   

  	
  PICIS, INC.

  	
   

  
	
  INCORPORATED
  UNDER THE LAWS OF THE STATE OF DELAWARE

  125,000,000 AUTHORIZED SHARES $.01 PAR VALUE

  
	
   

  	
   

  	
   

  
	
  Certificate

  Number

  ZQ 000000

  	
   

  	
  Shares

  **600620******

  ***600620*****

  ****600620****

  *****600620***

  ******600620**

  
	
   

  	
   

  	
   

  
	
  THIS CERTIFIES THAT

  	
  MR. SAMPLE & MRS. SAMPLE &

  	
  CUSIP
  71956K 10 0

  
	
   

  	
  MR. SAMPLE & MRS. SAMPLE

  	
   

  
	
   

  	
   

  	
  SEE
  REVERSE FOR CERTAIN DEFINITIONS

  
	
   

  	
  *** SIX HUNDRED THOUSAND

  	
   

  
	
  is the owner of

  	
  SIX HUNDRED AND TWENTY ***

  	
   

  

 

 

FULLY-PAID
AND NON-ASSESSABLE SHARES OF THE COMMON STOCK OF

 

Picis, Inc. (hereinafter called
the "Company"),
transferable on the books of the Company in person or by duly authorized
attorney, upon surrender of this Certificate properly endorsed. This
Certificate and the shares represented hereby, are issued and shall be held
subject to all of the provisions of the Certificate of Incorporation, as
amended, and the By-Laws, as amended, of the Company (copies of which are on
file with the Company and with the Transfer Agent), to all of which each
holder, by acceptance hereof, assents. This Certificate is not valid unless
countersigned and registered by the Transfer Agent and Registrar.

 

Witness the
facsimile seal of the Company and the facsimile signatures of its duly
authorized officers.

 

	
  /s/
  Todd C. Cozzens

  	
   

  	
  

  	
   

  	
  DATED <<Month Day,
  Year>>

  
	
  President

  	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  	
  COUNTERSIGNED AND
  REGISTERED:

  
	
  /s/
  R. Scott Lentz

  	
   

  	
   

  	
  COMPUTERSHARE TRUST COMPANY, INC.

  
	
  Treasurer

  	
   

  	
   

  	
  (DENVER)

  
	
   

  	
   

  	
   

  	
  TRANSFER AGENT AND
  REGISTRAR,

  
	
   

  	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  	
   

  	
  By

  	
   

  
	
   

  	
   

  	
   

  	
   

  	
   

  	
  AUTHORIZED
  SIGNATURE

  
	
   

  	
   

  	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  	
   

  	
   

  

 

SECURITY
INSTRUCTIONS ON REVERSE

 

 

 

PICIS,
INC.

TRANSFER FEE $25.00

 

	
       The following abbreviations, when used
  in the inscription on the face of this certificate, shall be construed as
  though they were written out in full according to applicable laws or
  regulations:

  
	
   

  	
   

  	
   

  	
   

  	
   

  
	
  TEN COM

  	
  —

  	
  as tenants in common

  	
  UNIF GIFT MIN ACT —

  	
  Custodian

  
	
  TEN ENT

  	
  —

  	
  as tenants by the entireties

  	
   

  	
  (Cust)

  	
   

  	
  (Minor)

  
	
  JT TEN

  	
  —

  	
  as joint tenants with right of

  	
   

  	
   

  
	
   

  	
   

  	
  survivorship and not as tenants

  	
   

  	
  under Uniform Gifts to Minors Act

  	
   

  
	
   

  	
   

  	
  in common

  	
   

  	
   

  	
  (State)

  
	
   

  	
   

  	
   

  	
  UNIF TRF MIN ACT —

  	
  Custodian (until age   )

  
	
   

  	
   

  	
   

  	
   

  	
  (Cust)

  	
   

  	
  (Minor)

  
	
   

  	
   

  	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  	
   

  	
  under Uniform Transfers to Minors Act

  	
   

  
	
   

  	
   

  	
   

  	
   

  	
   

  	
  (State)

  
	
   

  	
   

  	
   

  	
   

  	
   

  
	
   

  	
   

  	
  Additional abbreviations may also be used though not in the above
  list.

  
										

 

 

THE COMPANY WILL FURNISH WITHOUT CHARGE TO
EACH SHAREHOLDER WHO SO REQUESTS, A SUMMARY OF THE POWERS, DESIGNATIONS,
PREFERENCES AND RELATIVE, PARTICIPATING, OPTIONAL OR OTHER SPECIAL RIGHTS OF
EACH CLASS OF STOCK OF THE COMPANY AND THE QUALIFICATIONS, LIMITATIONS OR
RESTRICTIONS OF SUCH PREFERENCES AND RIGHTS, AND THE VARIATIONS IN RIGHTS,
PREFERENCES AND LIMITATIONS DETERMINED FOR EACH SERIES, WHICH ARE FIXED BY THE
ARTICLES OF INCORPORATION OF THE COMPANY, AS AMENDED, AND THE RESOLUTIONS OF
THE BOARD OF DIRECTORS OF THE COMPANY, AND THE AUTHORITY OF THE BOARD OF
DIRECTORS TO DETERMINE VARIATIONS FOR FUTURE SERIES. SUCH REQUEST MAY BE MADE
TO THE OFFICE OF THE SECRETARY OF THE COMPANY OR TO THE TRANSFER AGENT. THE
BOARD OF DIRECTORS MAY REQUIRE THE OWNER OF A LOST OR DESTROYED STOCK
CERTIFICATE, OR HIS LEGAL REPRESENTATIVES, TO GIVE THE COMPANY A BOND TO
INDEMNIFY IT AND ITS TRANSFER AGENTS AND REGISTRARS AGAINST ANY CLAIM THAT MAY
BE MADE AGAINST THEM ON ACCOUNT OF THE ALLEGED LOSS OR DESTRUCTION OF ANY SUCH
CERTIFICATE.

 

 

	
   

  	
  PLEASE INSERT SOCIAL
  SECURITY OR OTHER

  
	
   

  	
  IDENTIFYING NUMBER OF
  ASSIGNEE

  
	
  For value received, __________________ hereby sell, 

  	
   

  
	
  assign and transfer unto

  	
   

  

 

	
   

  
	
  (PLEASE PRINT OR TYPEWRITE NAME AND ADDRESS, INCLUDING ZIP CODE, OF
  ASSIGNEE)

  

 

	
   

  

 

	
   

  

 

	
   

  	
  Shares

  
	
  of the capital stock represented by the within Certificate, and do
  hereby irrevocably constitute and appoint

  

 

	
   

  	
  Attorney

  
	
  to transfer the said stock on the books of the within-named
  Corporation with full power of substitution in the premises.

  

 

	
  Dated:

  	
   

  	
   20

  	
   

  	
   

  	
  Signature(s) Guaranteed:
  Medallion Guarantee Stamp

   

  THE SIGNATURE(S) SHOULD BE GUARANTEED BY AN ELIGIBLE GUARANTOR
  INSTITUTION (Banks, Stockbrokers, Savings and Loan Associations and Credit
  Unions) WITH MEMBERSHIP IN AN APPROVED SIGNATURE GUARANTEE MEDALLION PROGRAM,
  PURSUANT TO S.E.C. RULE 17Ad-15.

  
	
   

  	
   

  	
   

  
	
  Signature:

  	
   

  	
   

  
	
   

  	
   

  	
   

  
	
  Signature:

  	
   

  	
   

  
	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  
	
   

  	
   

  	
   

  	
   

  	
   

  
	
   

  	
  Notice:

  	
  The signature to this assignment must correspond with the name as
  written upon the face of the certificate, in every particular, without
  alteration or enlargement, or any change whatever.

  	
   

  	
   

  
	
   

  	
   

  	
   

  	
   

  	
   

  
							

 

 

SECURITY INSTRUCTIONS

 

THIS IS WATERMARKED PAPER. DO NOT ACCEPT
WITHOUT NOTING [GRAPHIC]

WATERMARK. HOLD TO LIGHT TO VERIFY WATERMARK.<Page>

                                                                Exhibit 10.23

                 SETTLEMENT AGREEMENT AND NON-EXCLUSIVE LICENSE

     This Settlement and License Agreement ("Agreement") is entered into as of
November __, 2006, (the "Effective Date") between (1) Picis, Inc., a Delaware
company, with an address at 100 Quannapowitt Pkwy Suite 405, Wakefield, MA,
01880 (hereinafter "Picis, Inc.") and Picis, S.A., a societe anonyme organized
under the laws of France, having a principal place of business at 38 rue de
Berri, Paris, France, 75008 (hereinafter "Picis, S.A."); Picis, Inc. and Picis,
S.A. collectively hereinafter "Picis"); and (2) Surgical Information Systems,
LLC (hereinafter "SIS"), a Georgia limited liability company having a principal
place of business at 3650 Mansell Road, Suite 300, Alpharetta, GA 30022 and (3)
Capsule Technologie, a French corporation, with an address at 79, rue du
Faubourg Poissonniere, Paris, France 75009 (hereinafter "Capsule"; SIS and
Capsule collectively hereinafter "Companies").

                                   BACKGROUND

     A. Picis has filed a legal action against Companies in the United States
District Court for the Northern District of Georgia under Case No. 1-04-CV-1870
("Patent Infringement Suit") alleging that the manufacture, use, offer for sale,
and sale by Companies of the Licensed Products (as defined in Section 1.4 below)
in the absence of a license from Picis constitutes infringement of one or more
claims of the Licensed Patent (as defined in Section 1.1 below) under one or
more of the provisions of 35 U.S.C. ss. 271, including, but not limited to,
ss.ss. 271(a), (b), (c) and/or (g); and SIS has filed a counterclaim in the
Patent Infringement Suit alleging that Picis has committed acts of unfair
competition against SIS;

     B. Without admitting infringement or liability, Companies desire to settle
the Patent Infringement Suit and obtain a license under the Licensed Patent in
connection with the manufacture, use, distribution or license by Companies of
the Licensed Products; and without admitting liability, Picis desires to settle
the counterclaim brought by SIS in the Patent Infringement Suit; and

     C. This Agreement is for settlement purposes only and does not alter or
reflect the merits of either Picis' or Companies' substantive claims,
counterclaims, or defenses and, if subsequent litigation arising out of or
relating to the same or similar subject matter is brought by either party, the
other party reserves completely all of its arguments and positions.

     NOW, THEREFORE, in consideration of the above premises and the mutual
covenants of the parties to be faithfully performed, Picis, SIS, and Capsule,
intending to be legally bound, agree as follows:

1.   DEFINITIONS

     In addition to the terms defined above and elsewhere in this Agreement, as
used in this Agreement:

     1.1  "LICENSED PATENT" shall mean U.S. Patent No. 5,161,222.

<Page>

     1.2  "AFFILIATE" as applied to a first entity shall mean any other entity
          controlling or controlled by or under common control with such first
          entity where "control" is defined as the ownership of at least fifty
          percent (50%) of the equity or beneficial interests of an entity.

     1.3  "LICENSED PRODUCTS" shall mean SIS and Capsule's software for medical
          device data integration, including components of DataCaptor, and any
          other software that has been, is, or will be developed, used,
          marketed, licensed and/or sold by Companies and which is covered by
          one or more claims of the Licensed Patent.

     1.4  "CAPSULE DRIVERS" shall mean software that enables data to be
          transferred to and from peripheral devices and Capsule's DataCaptor
          software, including Capsule's DataCaptor Device Interfaces (DDIs) and
          any related source code.

     1.5  "CAPSULE SOFTWARE ENGINE" shall mean the data acquisition and
          distribution software engine used in conjunction with "Capsule
          Drivers" to collect data from medical devices including Capsule's
          DataCaptor product.

     1.6  "PICIS PRODUCTS" shall mean Picis' software products, which includes
          software that automates the collection of information from multiple
          sensors for the Perioperative, ICU, and/or emergency departments

2.   LICENSE AND PATENT MARKING

     2.1  LICENSE GRANT BY PICIS. Picis hereby grants to Companies, and SIS and
          Capsule hereby accept, a royalty-free, nonexclusive, nontransferable,
          fully paid-up license under the Licensed Patent for the manufacture,
          use, sale, distribution or license of the Licensed Products, for the
          term of the Licensed Patent, in the geographic areas covered by the
          Licensed Patent. The license granted under this Section 2.1 shall
          include the right to grant sublicenses only to the extent necessary
          for (i) use of the Licensed Products by customers purchasing the
          Licensed Products from Companies or distributors or customers of
          Companies, and (ii) resale or license of the Licensed Products by
          distributors or customers of Companies where such resale or license of
          the Licensed Products may be incorporated with additional software or
          services of such customer of Companies.

     2.2  LICENSE AND DISTRIBUTION RIGHT GRANT BY CAPSULE. Capsule hereby grants
          to Picis, and Picis hereby accepts:

          2.2.1 a royalty-free, nonexclusive, nontransferable, fully paid-up
               license for the, use, sale, distribution or sub-license of up to
               seventy (70) Capsule Drivers ("DDI"). Picis may select the
               seventy Capsule Drivers to be licensed hereunder among all DDIs
               existing in the DataCaptor library at the time of the request at
               any time beginning with the Effective Date and for five (5) years
               thereafter by notifying Capsule of its selection. Capsule does
               not warrant and makes no representation regarding the
               compatibility and/or usefulness of Capsule Drivers with the Picis
               Products.

                                       2

<Page>

          2.2.2 a nonexclusive, nontransferable, license for the, use, sale,
               distribution or sub-license of copies of the Capsule Software
               Engine purchased from Capsule pursuant to Section 4.3, for a
               period of five (5) years from the Effective Date.

          2.2.3 The license granted under Section 2.2.1 and 2.2.2 shall include
               the right to grant sublicenses only to the extent necessary for
               use of the Capsule products to collect data from medical devices
               into the Picis Products that cover Perioperative/ICU or emergency
               department systems or their equivalents. The license granted
               under Section 2.2.1 and 2.2.2 does not include the right to grant
               sublicenses to collect data from medical devices into a
               Third-Party system, i.e. into a software product that is not a
               Picis Products. Any sublicense granted pursuant to the rights in
               this Section 2.2 shall be commensurate in scope with any related
               license granted by Picis for the Capsule products.

          2.2.4 PATENT MARKING. Capsule shall, during the term of this
               Agreement, mark its primary Internet website and its primary
               brochure distributed with respect to the Licensed Products, with
               a notice of the Licensed Patents, as appropriate under statutory
               patent provisions, in the following form: "DataCaptor is
               protected under Picis U.S. Patent No. 5,161,222".

     3.   RELEASES

          3.1  Except for the obligations set forth in this Agreement, each
               party to this Agreement, for itself and its officers, directors,
               shareholders, employees, successors, assigns, agents, attorneys,
               and representatives, and for distributors and customers of
               Licensed Products or the Picis Products, hereby forever and
               irrevocably releases, discharges, and acquits every other party
               to this Agreement and their officers, directors, shareholders,
               employees, successors, assigns, agents, attorneys, and
               representatives from any and all claims, counterclaims, actions,
               causes of action, demands, rights, damages and costs of
               whatsoever kind or nature, whether at law, in equity, or mixed,
               known or unknown, whether based on statutory or regulatory
               authority, common law, contract, tort or other basis, that any
               party to this Agreement may have, may have had, or hereafter may
               have, arising from or in any way related to any acts or omissions
               occurring prior to the date of this Agreement in connection with
               the Licensed Patent or the use, marketing, licensing and/or sale
               of the Licensed Products that were or could have been asserted in
               the Patent Infringement Suit, including, but not limited to, all
               claims asserted in Picis' Complaint filed on June 28, 2004, all
               counterclaims asserted by SIS in its Answer filed on April 7,
               2005, and any claim related to the involvement of former Picis
               employees and/or consultants, including, but not limited to
               Steven Forrester, in the development of the Capsule Drivers or
               the Capsule Software Engine.

                                       3

<Page>

     4.   CONSIDERATION AND TERMINATION OF SUIT

          4.1  Picis acknowledges and agrees that Companies shall not be
               required to make any payments to Picis for rights granted in this
               Agreement under the Licensed Patent.

          4.2  Within ten (10) days of the execution of this Agreement, Capsule
               shall deliver to Picis a complete set of the currently utilized
               Capsule Drivers, on CD-ROMs or DVDs, to the address identified in
               the opening paragraph of this Agreement. Picis shall receive the
               materials as the property and trade secrets of Capsule, shall
               protect the material in the same fashion that Picis protects its
               own trade secrets, and shall make no use of such materials
               received from Capsule except in accordance with this Agreement.
               Capsule further agrees to provide all updates to the Capsule
               Drivers to Picis for a period of four (4) years from the date of
               this Agreement. Picis acknowledges and agrees that Capsule shall
               not be required to make any other deliveries to Picis for rights
               granted in this Agreement to the Capsule Drivers. Picis may
               within the option period select within the licensed number of
               Capsule Drivers, and shall retrieve and return to Capsule all
               other Capsule Drivers, including all copies thereof, received
               from Capsule, so that no further remnant of such non-selected
               Capsule Drivers shall be accessible or available at or to Picis.

          4.3  For a period of five (5) years from the date of this agreement,
               Capsule agrees to sell the "CAPSULE SOFTWARE ENGINE" and the
               maintenance and support program to Picis, for Picis' use and
               resale as authorized in Section 2.2 above, and to provide
               standard maintenance and support contracts, at a price that is no
               more than the "most favored nation" pricing for the "CAPSULE
               SOFTWARE ENGINE," i.e. no direct competitor of Picis will have
               better pricing than Picis for similar purchased volumes and
               commitments. Capsule further agrees to provide all updates to the
               "CAPSULE SOFTWARE ENGINE," as long as Picis purchases the
               maintenance and support program.

          4.4  Picis and Capsule will discuss business relationships, including
               a reseller/vendor relationship. Should a reseller agreement be
               reached, Capsule agrees that Picis will receive "most favored
               nation" pricing for the "CAPSULE SOFTWARE ENGINE," after the
               initial five (5) year period described above in Section 4.3, i.e.
               no vendor will have better pricing than Picis, provided that
               Picis accepts the same terms and conditions as such vendor or
               customer.

          4.5  Upon signature of this Agreement by Companies, Picis and
               Companies shall file within three (3) court days a joint motion
               to dismiss, with prejudice, the Patent Infringement Suit, all
               claims asserted by Picis against Companies in the Patent
               Infringement Suit, and all claims and counterclaims asserted by
               Companies against Picis in the Patent Infringement Suit.

                                       4

<Page>

     5.   REPRESENTATIONS, WARRANTIES AND COVENANTS

          5.1  REPRESENTATIONS, WARRANTIES, AND COVENANTS OF COMPANIES. SIS and
               Capsule each represent, warrant, and covenant to Picis that: (i)
               they have the full legal authority necessary to enter into this
               Agreement and perform the duties and obligations outlined in this
               Agreement; and (ii) the execution of this Agreement by them and
               the performance of their obligations hereunder will not violate
               any agreement, whether written or oral, to which SIS or Capsule
               is a party. THIS AGREEMENT, AND THE LICENSES OR RIGHTS GRANTED
               HEREUNDER, DO NOT AND SHALL NOT BE INTERPRETED OR CONSTRUED TO
               INCLUDE: (A) ANY WARRANTY OR REPRESENTATION AS TO THE VALIDITY,
               ENFORCEABILITY, OR SCOPE OF THE LICENSED RIGHTS, (B) ANY WARRANTY
               OR REPRESENTATION THAT ANY USE OF THE LICENSED RIGHTS WILL NOT
               INFRINGE ANY PATENT, COPYRIGHT, TRADEMARK OR OTHER PROPRIETARY
               RIGHT OF ANY THIRD PARTY, (C) ANY OBLIGATION TO FURNISH ANY
               TECHNICAL OR SUPPORT INFORMATION, (D) ANY LICENSE OR RIGHT BY
               IMPLICATION OR ESTOPPEL, OR (E) ANY WARRANTY REGARDING
               IMPLEMENTATIONS OF THE LICENSED RIGHTS AND ANY AND ALL IMPLIED OR
               EXPRESS WARRANTIES OF MERCHANTABILITY OR FITNESS FOR ANY
               PARTICULAR PURPOSE OR USE ARE DISCLAIMED.

          5.2  REPRESENTATIONS, WARRANTIES, AND COVENANTS OF PICIS. Picis
               represents and warrants that it (i) owns or has exclusive control
               over all rights, title and interest in the Licensed Patent and
               has the right to grant licenses, covenants not to sue, and
               releases thereunder, and (ii) has the necessary rights, powers,
               and authority to enter into this Agreement. This Agreement does
               not and shall not be interpreted or construed to include: (a) any
               warranty or representation as to the validity, enforceability, or
               scope of the Licensed Patent, (b) any warranty or representation
               that any use of the Licensed Patent in connection with the use
               and distribution of the Licensed Products will not infringe any
               patent, copyright, trademark or other proprietary right of any
               third party, (c) any obligation to furnish any technical or
               support information, (d) any license or right by implication or
               estoppel, or (e) any warranty regarding implementations of the
               Licensed Patent with respect to MERCHANTABILITY,
               NON-INFRINGEMENT, OR FITNESS FOR ANY PARTICULAR PURPOSE OR USE.

     6.   CONFIDENTIALITY

     6.1  PRESS RELEASE. A press release in the form attached hereto as Exhibit
          A may be released by Picis, SIS, and/or Capsule at their discretion,
          any time after the joint motion to dismiss of Section 4.5 has been
          filed. Picis, SIS, and Capsule agree and undertake that all future
          statements by any of them to the public, the media or business
          associates shall be entirely consistent with the Press Release as
          mutually approved.

                                       5

<Page>

          6.2  CONFIDENTIALITY. Except as stated in Section 6.1, all information
               provided pursuant to this Agreement, including without
               limitation, the terms of this Agreement, shall be regarded as
               confidential information ("Confidential Information"). The
               parties agree that, other than as required by law (including (i)
               applicable securities laws, rules or other regulations or (ii) in
               response to a valid discovery request or subpoena in connection
               with a legal proceeding and subject to the terms of a non
               disclosure agreement, confidentiality agreement, or applicable
               protective order), they shall not disclose the terms of this
               Agreement and shall use information provided pursuant to this
               Agreement only for the purposes set forth herein. Notwithstanding
               the foregoing, the parties further agree that they may disclose,
               including through disclosures made by their Affiliates, the
               existence of this Agreement and the parties thereto.

     7.   TERM AND TERMINATION

          7.1  TERM. This Agreement shall commence upon Picis' countersignature
               of this Agreement after being signed by SIS and Capsule, shall be
               effective as of the Effective Date, and shall terminate upon the
               expiration of the Licensed Patent.

     8.   MISCELLANEOUS

          8.1  ASSIGNMENT. None of the parties shall assign, delegate, sell,
               transfer, or otherwise dispose of, voluntarily or involuntarily,
               by operation of law or otherwise, any of the rights or
               obligations under this Agreement to any other person, business,
               or entity. Notwithstanding the foregoing, any party to this
               Agreement, may, without any other party's consent, assign, sell,
               transfer, or continue this Agreement and its rights hereunder to
               a successor to its entire business or the portion of its business
               which is engaged in providing Licensed Products or the CareSuite
               System, including where any party undergoes a "change-in-control"
               such as may result from a public or private offering of
               securities or other transaction involving a change in 50% or more
               of the voting power or other transfer of rights effecting a
               change in operational control, (collectively "Successor"),
               provided that such Successor abides by the terms and conditions
               of this Agreement. Any attempted assignment in contravention of
               this provision shall be deemed void ab initio.

          8.2  NON-AGENCY. Nothing in this Agreement is intended or shall be
               deemed to constitute a partnership, agency, employer-employee, or
               joint venture relationship between Picis and Companies. Neither
               Picis nor Companies shall incur any debts or make any commitments
               for the other.

          8.3  ENTIRE AGREEMENT, AMENDMENTS, AND WAIVERS. This Agreement
               constitutes and contains the entire agreement between Picis and
               Companies, and supersedes any and all prior negotiations,
               conversations, correspondence, understandings, and letters
               respecting the subject matter hereof. This Agreement may be
               amended or modified, or one or more provisions hereof waived,
               only by a written instrument signed by the parties. No delay or
               omission by any party in exercising any right

                                       6

<Page>

               or power arising from any default by the other party shall be
               construed as a waiver of such default, nor shall any single or
               partial exercise thereof preclude any further exercise thereof or
               the exercise of any other right or power arising from any default
               by a party. No waiver of any breach of any covenant or other
               condition shall be construed to be a waiver of or consent to any
               previous or subsequent breach of the same or of any other
               covenant or condition.

          8.4  SEVERABILITY AND CAPTIONS. If one or more provisions of this
               Agreement are held to be invalid or unenforceable under
               applicable law, such provision shall be excluded from this
               Agreement and the balance of the Agreement shall be interpreted
               as if such provision were so excluded. In the event a part or
               provision of this Agreement is held to be invalid or
               unenforceable or in conflict with law for any reason, the parties
               shall replace any invalid part or provision with a valid
               provision which most closely approximates the intent and economic
               effect of the invalid provision. The captions to this Agreement
               are for convenience only and are to be of no force or effect in
               construing and interpreting the provisions of this Agreement.

          8.5  GOVERNING LAW AND CONSENT TO JURISDICTION. This Agreement shall
               be governed by and construed under applicable federal law and the
               laws of the State of Massachusetts, excluding any conflict of
               law provisions. Companies and Picis each irrevocably consent to
               the exclusive jurisdiction of Massachusetts state or federal
               court sitting in the District of Massachusetts, over any
               suit, action or proceeding arising out of or relating to this
               Agreement.

          8.6  NOTICES. Any notice required or permitted under this Agreement
               shall be given in writing and shall be sent via overnight carrier
               to the addresses indicated in the opening paragraph of this
               Agreement above, and by email to the extent the email addresses
               of the responsible persons are reasonably available, or at such
               other postal or email addresses as the parties may provide.

          8.7  THIRD PARTY BENEFICIARIES. Nothing in this Agreement shall be
               construed to give rise to any obligation on either party hereto
               for the benefit of a third party or to confer any rights on any
               party other than Picis or the Companies.

          8.8  SURVIVAL. Section 3.1 shall survive the expiration or termination
               of this Agreement. In addition, Sections 5.1, 6.1 and 6.2 of this
               Agreement shall survive the expiration or termination of this
               Agreement.

          8.9  EXECUTION. This Agreement may be executed in counterparts. This
               Agreement may be executed and delivered by each Party by
               facsimile and such a facsimile shall be binding as an original.

                                       7

<Page>

     IN WITNESS WHEREOF, the parties have executed this Agreement on the dates
set forth below.

                               PICIS, INC. AND PICIS, S.A.

                               By:   /s/ Todd Cozzens

                               Print Name:  Todd Cozzens
                                          --------------------------------------

                               Title:       CEO
                                          --------------------------------------

                               Date:        November 3, 2006
                                          --------------------------------------

                               SURGICAL INFORMATION SYSTEMS, LLC

                               By:  /s/ George Pazwiniak

                               Print Name:  George Pazwiniak
                                          --------------------------------------

                               Title:       Counsel
                                          --------------------------------------

                               Date:        November 3, 2006
                                          --------------------------------------

                               CAPSULE TECHNOLOGIE

                               By:  /s/ George Pazwiniak

                               Print Name:  George Pazwiniak
                                          --------------------------------------

                               Title:       Counsel
                                          --------------------------------------

                               Date:        November 3, 2006
                                          --------------------------------------

                                       8

<Page>

                           EXHIBIT A - PRESS RELEASES

PICIS, INC. AND CAPSULE TECHNOLOGIE ENTER A CROSS-LICENSING AGREEMENT RELATING
TO AUTOMATION OF PATIENT VITAL SIGNS COLLECTION

Picis, Inc. announced today that it has entered into a cross-licensing agreement
with Capsule Technologie ("Capsule Tech"), whereby Picis has agreed to grant
Capsule Tech a nonexclusive license to its patent relating to systems for
automating data communication between external software programs and sensors.
Capsule Tech has agreed to grant Picis nonexclusive rights relating to its
software products. The subject technology generally relates to systems for
automating patient vital signs collection into a Clinical Information System.
The financial terms of the agreement are confidential. The agreement resolves a
patent infringement lawsuit initiated by Picis that was pending in the District
Court for the Northern District of Georgia and related counterclaims.

PICIS, INC. AND CAPSULE TECHNOLOGIE ENTER A CROSS-LICENSING AGREEMENT RELATING
TO AUTOMATION OF PATIENT VITAL SIGNS COLLECTION

Capsule Technologie ("CapsuleTech") announced today that it has entered into a
cross-licensing agreement with Picis, Inc., whereby Picis has agreed to grant
Capsule Tech a nonexclusive license to its patent relating to systems for
automating data communication between external software programs and sensors.
Capsule Tech has agreed to grant Picis nonexclusive rights relating to its
software products. The subject technology generally relates to systems for
automating patient vital signs collection into a Clinical Information System.
The financial terms of the agreement are confidential. The agreement resolves a
patent infringement lawsuit initiated by Picis that was pending in the District
Court for the Northern District of Georgia and related counterclaims.

                                       9

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