Document:

<PAGE>

                                             Agreement Number:
 [STENTOR LOGO]                             (Stentor will complete)

MASTER AGREEMENT

This Stentor Master Agreement ("Master Agreement") is between the Stentor entity
as identified below ("Stentor") and the customer as identified below
("Customer").

The Effective Date of this Master Agreement will be January 1, 2005. Each party
agrees to notify the other in accordance with Section 10.8 if the information
below changes during the Term.

<TABLE>
<S>                                                    <C>
Customer:  UNIVERSITY OF PITTSBURGH MEDICAL CENTER     Name of contracting Stentor Affiliate: STENTOR, INC.

Street Address: 200 LOTHROP STREET                     Street Address: 5000 MARINA BOULEVARD

City and State / Province: PITTSBURGH, PA              City and State / Province: BRISBANE, CA

Country and Postal Code: USA 15213                     Country and Postal Code: USA  94005-1811

Contact Name:                                          Stentor Customer Advocate Name and Email Address:

Phone Number:                                          Phone Number: 650-228-5555

Fax Number:                                            Fax Number: 650-228-5566

Email Address:                                         Email Address:

For the Attention of:

Accounts Payable Contact Name, Phone Number and
Email Address:

CUSTOMER NOTICES INFORMATION (IF DIFFERENT FROM        ALL NOTICES MUST ALSO BE SENT TO:
ABOVE):

Customer Name, Street Address and/or post office       Stentor, Inc., Legal Department
box, City and State / Province, Country and Postal     5000 Marina Boulevard
Code:                                                  Brisbane, CA  94005-1811

Fax Number:                                            Fax Number: 650-228-5566

For the Attention of:                                  For the Attention of: Corporate Counsel
</TABLE>

CUSTOMER                                     STENTOR, INC.

By (sign): [Signature by Authorized          By (sign): [Signature by Authorized
            Agent]                                       Agent]

Name (print):__________________________      Name (print):______________________

Title:_________________________________      Title:_____________________________

Stentor Master Agreement v1.0 9.20.2004                             Page 1 of 29

<PAGE>

                                MASTER AGREEMENT

                                    RECITALS

                  A. Stentor develops and markets software and services to
automate the viewing and/or archiving of medical images.

                  B. Customer and Stentor entered into a Service Provider
Agreement dated February 1, 2002 (the "SPA") pursuant to which Customer and
various Customer affiliates have obtained medical image archiving and viewing
services from Stentor.

                  C. The parties wish to enter into a new master agreement,
effective January 1, 2005, that will supersede and replace the SPA in its
entirety thereby terminating the SPA in its entirety and provide Customer and
its affiliates access to Stentor's software and services to automate the viewing
and/or archiving of medical images [**].

            In consideration of the mutual representations, warranties,
covenants, conditions and other terms set forth below, the parties agree as
follows:

                              TERMS AND CONDITIONS

1     PRODUCTS AND SERVICES

      1.1 System. Stentor will provide Customer with the additional Stentor
Software and Server Hardware set forth on Rider PS-1 in addition to the Stentor
Software and Hardware currently provided to Customer under the terms of the SPA
(together, the "System").

      1.2 Fees. Applicable fees are set forth on Rider PS-1 and any subsequent
Rider(s) PS-n.

      1.3 License Terms. Applicable System license terms are set forth on Rider
IFS-1 and any subsequent Rider(s) IFS-n.

      1.4 Implementation. Stentor and Customer will implement the System in
accordance with the provisions set forth on Rider IFS-1 and any additional
Riders IFS-n.

      1.5 System Hardware. Minimum hardware requirements as of the Effective
Date are set forth on Rider IFS-1, and may be updated in subsequent Rider(s)
IFS-n.

      1.6 Service Level. Stentor shall provide Customer with a service level
commitment as set forth on Rider SL.

2     CUSTOMER REQUIREMENTS

      2.1 Operating Environment. Customer agrees to provide a suitable location
to install the System that meets the minimum operating environment as set forth
on Rider IFS-1 or any subsequent Riders IFS-n.

      2.2 Access to System. Customer agrees to provide Stentor with access to
the System as set forth on Rider IFS-1 and any subsequent Riders IFS-n.

      2.3 Export Restrictions. The System is of U.S. origin for purposes of U.S.
export control laws. Customer agrees to comply with all applicable international
and national laws that apply to the System, including the U.S. Export
Administration Regulations, as well as end-user, end-use and destination
restrictions issued by U.S. and other governments.

      2.4 Customer Facilities. For the purposes of this Master Agreement, a
Customer "Facility" is defined as: [**]

3     COMPLIANCE WITH LAWS

      3.1 FDA. The System is subject to regulation by the U.S. Food and Drug
Administration ("FDA"). The parties agree to cooperate fully to meet and FDA
regulatory compliance obligations at Stentor's expense. Pursuant to the Safe
Medical Devices Act (SMDA) of 1990, if Customer has information that reasonably
suggests that the

Stentor Master Agreement v1.0 9.20.2004                             Page 2 of 29

<PAGE>

System has or may have caused a death or serious injury, Customer shall submit a
report to Stentor on FDA Form 3500A
(http://www.fda.gov/medwatch/safety/3500a.pdf) within ten (10) working days.

      3.2 HIPAA. Stentor is Customer's "Business Associate" as such term is
defined by the Health Insurance Portability and Accountability Act of 1996
("HIPAA"). The parties agree to the HIPAA Business Associate terms set forth at
http://purchasing.upmc.com, provided that Customer agrees that any provisions in
such terms that make Customer's patients and other individuals subject to PHI
(protected health information) third-party beneficiaries of the terms shall be
deemed of no force and effect, and deleted, with respect to Stentor.

      3.3 Regulatory Compliance. Stentor shall take such actions as are
necessary to comply with federal, state or local statutes, or regulations
promulgated by regulatory and accreditation agencies (including JCAHO), and any
current requirements or future changes after the date of any legal or regulatory
change, including without limitation, all HIPAA regulations and requirements.
[**] Such actions will be completed within [**]. [**]. [**]. Customer, at
Customer's expense, shall be permitted to [**] notice to Stentor, and no more
frequently than [**] every [**], to ensure that the Customer information stored
by Stentor, or its contractors is secured consistent with regulatory
requirements and that appropriate controls have been established by Stentor so
that data management and use is consistent with the terms of this Agreement.
Based on such audits Customer may request Stentor to [**] to comply with any of
Customer's requested changes.

4     TERM AND TERMINATION

      4.1 Term. Unless earlier terminated pursuant to the provisions of Rider
PS-1, the initial term of this Master Agreement shall commence upon the
Effective Date and end on [**] (the "Term"). The Term may be extended as set
forth in Rider PS-1.

      4.2 Termination. The parties may terminate this Master Agreement as set
forth on Rider PS-1 or any subsequent Rider PS-n.

5     LIMITED WARRANTIES AND EXCLUSION OF WARRANTIES

      5.1 Viruses and Time Bombs. The term "Virus" means any computer code
intentionally designed to (a) disrupt, disable, harm, or otherwise impede in any
manner the proper operation of a computer program or computer system, (b) damage
or destroy any data files residing on a computer system without the user's
consent, or (c) permit Stentor personnel or other individuals to access any
portion of the System without Customer's consent. Stentor warrants that it will
use a commercially-available, industry-standard anti-virus screening program to
screen the Stentor Software and/or the media containing the Stentor Software if
applicable before delivery of the Stentor Software to Customer and regularly
during operation and maintenance of the System. Stentor further warrants that it
shall not intentionally introduce Viruses into Customer's network or computing
environment. Customer acknowledges that not all Viruses can be detected by such
programs and, therefore, Stentor does not represent or warrant that such media
and/or the Stentor Software will be free of Viruses. Stentor's sole obligation
if Customer's screening procedures detect a Virus on or in such media or the
Stentor Software, or if Customer is otherwise able to demonstrate that Stentor
Software as supplied by Stentor is the source of a Virus introduced into
Customer's computing environment, will be to remove such Virus and repair damage
caused thereby. Stentor warrants that it will not knowingly include in the
Stentor Software any time bombs, trap doors, usage locks or other mechanisms
limiting access to, use of, or the security of, the Stentor Software.

      5.2 Ownership; Non-Infringement. Stentor is the sole and exclusive owner
of and/or has all rights necessary to all intellectual property rights in and to
the System and the Stentor services developed by or on behalf of Stentor;
Stentor has all legal right and authority to grant and convey to Customer the
rights and licenses contained in this Agreement without violation of any
contract or conflict with any law; there is no action, suit, claim, arbitration,
or other proceeding pending or threatened that questions this Agreement or
Stentor's ownership of the System or any intellectual property rights therein;
and the System and Stentor services do not infringe upon any proprietary right
or intellectual property right of any third party. Customer's exclusive remedy,
and Stentor's exclusive liability, for breach of this Section 5.2 shall be the
obligations specified in Section 6.1 below.

      5.3 No Self-Help Remedy. Under no circumstances will Stentor disrupt the
functioning of, or prevent Customer from gaining access to, the System or any
component of any of the System.

      5.4 Exclusion of Warranties. THE WARRANTIES SET FORTH IN SECTION 5 AND IN
SECTION 3.3(A) AND SECTION 6 OF RIDER SL ARE CUSTOMER'S EXCLUSIVE WARRANTIES AND
ARE PROVIDED INSTEAD OF ANY WARRANTY OF MERCHANTABILITY, FITNESS FOR A
PARTICULAR PURPOSE, OR ANY OTHER WARRANTY, STATUTORY, EXPRESS OR IMPLIED. THERE
IS NO WARRANTY THAT THE

Stentor Master Agreement v1.0 9.20.2004                             Page 3 of 29

<PAGE>

STENTOR SOFTWARE IS FREE FROM PROGRAMMING ERRORS. Customer acknowledges that the
price of the System reflects this negotiated limited warranty.

      5.5 Disclaimer of Oral Warranties. No employee or other representative of
Stentor has any authority to make any other promise regarding Stentor's
obligations for a failure of the System to conform to specifications or
expectations.

      5.6 No Warranty Provided by Stentor for Third-Party Products. "Third-Party
Products" are products that Stentor provides to Customer that are not
manufactured by Stentor. Stentor acts as a distributor/reseller of Third Party
Products. Stentor agrees to transfer, assign or "pass through" to Customer any
transferable warranty made to Stentor by suppliers to the extent transferable
and permitted by law. Except as indicated otherwise in a Third Party Product
exhibit, Customer agrees to look solely to the supplier of Third Party Products
for all claims arising from breach of the supplier's warranty for Third Party
Products; provided, however, that to the extent Stentor cannot "pass through" or
assign any third party warranty, Customer may enforce these warranties directly
against Stentor and Stentor may seek recourse against the applicable supplier.
Stentor makes no representation, covenant or warranty with respect to the extent
or enforceability of a supplier's warranty. Notwithstanding anything to the
contrary herein, Stentor shall be solely responsible for correcting any problems
or unavailability of the System and the Stentor services, regardless of whether
such problems or unavailability are attributable to Third Party Products
supplied or utilized by Stentor.

6     INDEMNIFICATION

      6.1 Intellectual Property. Stentor shall, [**] Customer and its Affiliates
harmless against [**] resulting from any third-party claim against Customer: (X)
alleging that the Stentor Software infringes any [**]; provided that, (a)
Customer promptly notifies Stentor in writing of such claim, (b) Stentor has
sole control of the defense and all related settlement negotiations of such
claim, and (c) Customer gives Stentor prompt reasonable assistance at Stentor's
expense to assist in the defense or settlement of such claim, or [**]. If there
is a claim or Stentor reasonably believes a claim is possible hereunder under
clause (X) above, Stentor may either (i) procure for Customer the right to
continue using the Stentor Software or (ii) modify or replace the Stentor
Software so that it no longer creates liability under any such claim, but only
if doing so shall not result in a material adverse change in the material
operational characteristics of the Stentor Software. If the alternatives in the
immediately preceding sentence are not commercially feasible, Stentor may
terminate this Master Agreement or applicable licenses; provided that Stentor
shall be obligated to continue to provide Customer with access to, and use of,
the System for purposes of accessing prior Studies and migrating the existing
Studies to a different system, and [**]. Stentor will have no liability to the
extent a claim of infringement is made against Customer arising out of (A) work
performed by Stentor to specifications provided by Customer, (B) modifications
made to the Stentor Software that were not performed by Stentor, or (C) the
combination of the Stentor Software with other software or hardware not provided
by Stentor. In the event that Customer continues to utilize an infringing
version of the System after Stentor has provided written notice of infringement,
Stentor shall not be liable for any infringement arising after Stentor has: (1)
provided a non-infringing version with no material change in functionality, (2)
provided Customer with a reasonable opportunity to test such version and to
verify its functionality, and (3) [**]. The foregoing indemnity is Customer's
sole and exclusive remedy for any claim that the Stentor Software or its use
infringes or misappropriates any third party intellectual property right or for
any breach of the representations and warranties in Section 5.2.

      6.2 By Customer. Customer shall indemnify and hold Stentor, its officers,
agents, and employees harmless, from and against all liability, loss, cost,
damages, claims or expenses (including reasonable attorneys fees) arising out of
any claims or suits, whatever their nature and however arising, that may be
brought or made against Stentor by reason or arising from data corrupted prior
to receipt by the System or Customer's use of the System outside of the scope of
the license granted under this Agreement, provided that, (A) Stentor promptly
notifies Customer in writing of such claim, (B) Customer has sole control of the
defense and all related settlement negotiations of such claim, and (C) Stentor
gives Customer prompt reasonable assistance at Customer's expense to assist in
the defense or settlement of such claim.

7     LIMITATION OF LIABILITY

      7.1 Disclaimer of Consequential Damages. [**] TO THE MAXIMUM EXTENT
PERMITTED BY APPLICABLE LAW, [**] SHALL BE LIABLE TO [**] FOR ANY LOST PROFITS,
LOSS OF BUSINESS OR FOR INDIRECT, INCIDENTAL, EXEMPLARY, CONSEQUENTIAL, PUNITIVE
OR SPECIAL DAMAGES, WHETHER BASED UPON A CLAIM OR ACTION OF TORT, CONTRACT,
WARRANTY, NEGLIGENCE, STRICT LIABILITY, BREACH OF STATUTORY DUTY, OR ANY OTHER
LEGAL THEORY OR CAUSE OF ACTION, EVEN IF ADVISED OF THE POSSIBILITY OF SUCH
DAMAGES. Customer acknowledges that the price of the System reflects this
negotiated disclaimer of consequential damages.

Stentor Master Agreement v1.0 9.20.2004                             Page 4 of 29

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      7.2 Maximum Damages. [**] IN NO EVENT WILL [**] TOTAL LIABILITY FOR ANY
AND ALL CLAIMS ARISING FROM OR RELATED TO THIS MASTER AGREEMENT EXCEED [**]
($[**]). THIS LIMIT IS CUMULATIVE. ALL CLAIMS WILL BE AGGREGATED TO DETERMINE
SATISFACTION OF THIS LIMIT, AND THE EXISTENCE OF MORE THAN ONE CLAIM WILL NOT
ENLARGE THIS LIMIT. Customer acknowledges that the price of the System reflects
this negotiated limitation of liability.

      7.3 Limitation of Liability of Third Party Products Vendors. EXCEPT AS
SPECIFICALLY SET FORTH IN ANY THIRD PARTY PRODUCT EXHIBIT, IN NO EVENT SHALL
STENTOR'S THIRD PARTY PRODUCTS SUPPLIERS AND LICENSORS BE LIABLE FOR ANY DAMAGES
OF ANY KIND OR NATURE, INCLUDING DIRECT, INDIRECT, INCIDENTAL, SPECIAL,
PUNITIVE, EXEMPLARY OR CONSEQUENTIAL, ARISING OUT OF THE USE OF THE SYSTEM OR
ANY THIRD PARTY PRODUCTS SUPPLIED BY STENTOR, ITS SUPPLIERS OR LICENSORS.
Notwithstanding anything to the contrary herein, this Section 7.3 shall not
relieve Stentor of any liability with respect to performance of the System or
its obligations hereunder, regardless of whether caused by a third party or
Third Party Product, and Stentor shall be solely liable for all Third Party
Products.

      7.4 Exclusions. The limitation of liability and disclaimer of damages in
Section [**] shall not apply to: (i) obligations under [**], (ii) obligations
under [**], (iii) [**], (iv) [**]; and (v) [**]. Stentor's liability with
respect to ANY AND ALL CLAIMS ARISING FROM OR RELATED TO ITS OBLIGATIONS UNDER
[**], AND CUSTOMER'S LIABILITY WITH RESPECT TO ANY AND ALL CLAIMS ARISING FROM
OR RELATED TO ITS OBLIGATIONS UNDER [**], SHALL NOT EXCEED THE HIGHER OF [**]
($[**]) OR THE [**] BY CUSTOMER TO STENTOR PURSUANT TO THIS AGREEMENT AS OF THE
DATE THE FIRST SUCH CLAIM ARISES. THIS LIMIT IS CUMULATIVE. ALL CLAIMS WILL BE
AGGREGATED TO DETERMINE SATISFACTION OF THIS LIMIT, AND THE EXISTENCE OF MORE
THAN ONE CLAIM WILL NOT ENLARGE THIS LIMIT.

8     CONFIDENTIALITY

      8.1 Confidential Information. Each party will protect the Confidential
Information of the other party from disclosure with the same degree of care that
such party uses to protect its own like information, but at least a reasonable
degree of care, provided that a party may disclose Confidential Information to a
third party in connection with performance of its obligations or exercise of its
rights hereunder, if such third party is required to treat the Confidential
Information in the same manner as the comparable information of the party
disclosing such Confidential Information to such third party. "Confidential
Information" of a party means information and material disclosed by one party
("disclosing party") to the other party ("recipient") (a) in written, graphic,
electronic or any other tangible form that is marked in writing as confidential
or proprietary, or (b) in oral or other intangible form that is (i) identified
as confidential at the time of the initial disclosure in oral or other
intangible form and (ii) documented in a writing that is so marked and
transmitted to the recipient within thirty (30) days after such initial
disclosure. Customer's "Confidential Information" includes all Studies and data
entered into the System by Customer and its Authorized Users (as defined below).
Stentor's "Confidential Information" includes all Stentor Source Code and Source
Code Documentation. Notwithstanding the foregoing, "Confidential Information"
does not include any information or material which (A) now is or hereafter
becomes available to the public other than as the result of a disclosure by the
recipient in breach hereof, (B) is developed by the recipient independently of
any Confidential Information provided hereunder by the disclosing party, (C) was
known by the recipient prior to any disclosure of the information or material
made by the other party to the recipient, (D) is disclosed with the written
consent of the disclosing party, or (E) becomes rightfully known to the
recipient from a source, other than the disclosing other party, that does not
owe a duty of confidentiality to the disclosing party with respect to such
information or material. In addition, the recipient will have the right to
disclose Confidential Information (1) to the extent required by order of a
court, administrative agency or governmental body, or by any law, rule or
regulation, or by subpoena, or any other administrative or legal process,
provided that the recipient shall give the disclosing party, to the extent
reasonable, prompt notice of the pending disclosure so that the other party may
seek a protective order or other appropriate protection; (2) in confidence, to
lawyers and accountants and to banks, underwriters and other financing sources
(and their advisors); and (3) in connection with the enforcement of this Master
Agreement or any rights hereunder.

      8.2 Confidentiality of Master Agreement. Customer may not disclose to any
third party a copy of this Master Agreement or the terms and conditions hereof,
except (a) to the extent required by order of a court, administrative agency or
governmental body, or by any law, rule or regulation, or by subpoena, or any
other administrative or legal process, provided that Customer will give Stentor,
to the extent reasonable, prompt notice of the pending disclosure so that
Stentor may seek a protective order or other appropriate protection (including,
without limitation of the generality of the foregoing, to the extent required by
the applicable securities laws, including requirements to file a copy of this
Master Agreement (redacted to the extent reasonably permitted by applicable law)
or to disclose information regarding the provisions hereof to applicable
regulatory authorities); (b) in confidence, to lawyers and accountants and to
banks, underwriters and other financing sources (and their advisors); or (c) in
connection with the enforcement of this Master Agreement or any rights
hereunder.

Stentor Master Agreement v1.0 9.20.2004                             Page 5 of 29

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      8.3 Protected Health Information. Protection and disclosure of protected
health information (as defined by HIPAA) is governed by the HIPAA Business
Associate terms set forth at http://purchasing.upmc.com.

      8.4 Injunctive Relief. Each party acknowledges that any breach of the
obligations specified in this Section 8 (including, without limitation, the
obligations specified in Sections 3.2 and 8.3) without the other party's prior
written consent would cause continuing, substantial and irreparable injury to
the other party and that remedies at law for such disclosure will not be
adequate. Accordingly, each party agrees that the other party shall be entitled
to immediate injunctive relief against the breach or threatened breach of this
Section 8, and that such rights shall be in addition to, and not in limitation
of, any other rights or remedies to which the party may be entitled at law or
equity.

      8.5 Data Ownership. Customer and its Affiliates shall be and remain the
sole and exclusive owners of any and all data entered into the System by
Customer, its Affiliates and Authorized Users, including but not limited to all
Studies and Protected Health Information ("Data"). Neither Stentor nor any of
its employees, agents, consultants or assigns shall have any rights in any of
the Data or to use any of the Data in any form except as necessary to fulfill
Stentor's obligations under this Agreement. Notwithstanding anything to the
contrary herein, Stentor may perform statistical and other sorts of analysis of
other data generated by the System, such as usage data, billing data and other
System data that does not incorporate the Data. Stentor may use the results of
such analysis for the purpose of developing product features and functionality
and assessing System performance, provided that Stentor may not disclose such
results to a third party in any manner that would identify Customer, its
Affiliates, Authorized Users or patients.

9     FORCE MAJEURE

      9.1 Definition. Force Majeure Event means any act or event, whether
foreseen or unforeseen, that meets all three of the following tests: (a) The act
or event prevents a party (the "Nonperforming Party"), in whole or in part, from
(A) performing its obligations to the other party (the "Performing Party") under
this Master Agreement, or (B) satisfying any conditions to the Performing
Party's obligations under this Master Agreement; (b) The act or event is beyond
the reasonable control of and not the fault of the Nonperforming Party; (c) The
Nonperforming Party has been unable to avoid or overcome the act or event by the
exercise of due diligence. Despite the preceding definition of a Force Majeure
Event, a Force Majeure Event excludes economic hardship, changes in market
conditions or insufficiency of funds.

      9.2 Suspension of Performance. If a Force Majeure Event occurs, the
Nonperforming Party is excused from (a) whatever performance is prevented by the
Force Majeure Event to the extent prevented until such time the Force Majeure
Event is eliminated; and (b) satisfying whatever conditions precedent to the
Performing Party's obligations that cannot be satisfied, to the extent they
cannot be satisfied. Despite the preceding sentence, a Force Majeure Event does
not excuse any obligation of either the Performing Party or the Nonperforming
Party to make any payment required under this Master Agreement or any obligation
under Rider SL to perform disaster recovery and restore data existing prior to
the Force Majeure Event.

      9.3 Resumption of Performance. When the Nonperforming Party is able to (a)
resume performance of its obligations under this Master Agreement, or (b)
satisfy the conditions precedent to the Performing Party's obligations, it shall
immediately give the Performing Party written notice to that effect and shall
resume performance under this Master Agreement no later than five working days
after the notice is delivered.

      9.4 Exclusive Remedy. In the event that the Nonperforming Party is not
able to restore performance within [**] ([**]) days of the force Majeure Event,
the Performing Party may terminate this Agreement upon written notice to the
Nonperforming Party. The relief offered by this Force Majeure provision is the
exclusive remedy available to the parties with respect to a Force Majeure Event.

10    GENERAL PROVISIONS

      10.1 Choice of Law. The laws of the Commonwealth of Pennsylvania (without
giving effect to its conflicts of law principles that would result in the
application of the law of another jurisdiction) govern all matters arising out
of or relating to this Master Agreement, including, without limitation, its
interpretation, construction, performance, and enforcement.

      10.2 Dispute Resolution. For any dispute arising under or in connection
with this Master Agreement, the agree to seek to resolve the dispute, subject to
each party's right to immediately seek injunctive or other equitable relief from
a court of competent jurisdiction to protect its Confidential Information,
Protected Health Information and intellectual property rights, by engaging in
good faith negotiations between progressively more senior representatives of
each party as follows:

Stentor Master Agreement v1.0 9.20.2004                             Page 6 of 29

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<TABLE>
<CAPTION>
LEVEL                    NEGOTIATING PARTIES                             MAXIMUM DURATION PRIOR TO ESCALATION
-----       ----------------------------------------------------         ------------------------------------
<S>         <C>                                                          <C>
  1         Customer Project Manager and Stentor Account Manager                        15 days
  2         Customer CIO and Stentor SVP of Customer Operations                         15 days
  3         Customer's and Stentor's legal counsel                                      15 days
</TABLE>

If the dispute is unresolved after Level 3 negotiations, the dispute shall be
resolved by final and binding arbitration before a single arbitrator
("Arbitrator") selected from and administered by the American Arbitration
Society ("AAA") (the "Administrator") in accordance with its then existing
Commercial Arbitration Rules, provided however, upon the written demand of
either party to the arbitration, the arbitration shall be conducted by and
submitted to three Arbitrators selected from and administered by the AAA
Commercial Arbitration Rules, and further subject to each party's right to
immediately seek injunctive or other equitable relief from a court of competent
jurisdiction to protect its Confidential Information and intellectual property
rights. The arbitration hearing shall be held in Pittsburgh, Pennsylvania. The
Arbitrator shall be authorized to award compensatory damages, but shall not be
authorized (i) to award non-economic damages, such as for emotional distress,
pain and suffering, or loss of consortium, (ii) to award punitive damages, or
(iii) to reform, modify or materially change this Agreement or any other
agreements contemplated hereunder; however, the damage limitations described in
parts (i) and (ii) of this sentence will not apply if such damages are
statutorily imposed. The Arbitrator also shall be authorized to grant any
temporary, preliminary or permanent equitable remedy or relief he or she deems
just and equitable and within the scope of this Agreement, including, without
limitation, an injunction or order for specific performance. Each party shall
bear its own attorney's fees, costs, and disbursements arising out of the
arbitration, and shall pay an equal share of the fees and costs of the
Administrator and the Arbitrator; however, the Arbitrator shall be authorized to
determine whether a party is the prevailing party, and if so, to award to that
prevailing party reimbursement for its reasonable attorneys' fees, costs and
disbursements (including, for example, expert witness fees and expenses,
photocopy charges, travel expenses, etc.), and/or the fees and costs of the
Administrator and the Arbitrator. The Arbitrator shall, within fifteen (15)
calendar days after the conclusion of the arbitration hearing, issue a written
award and statement of decision describing the material factual findings and
conclusions on which the award is based, including the calculation of any
damages awarded. Absent the filing of an application to correct or vacate the
arbitration award pursuant to the provisions of Pennsylvania law, each party
shall fully perform and satisfy the arbitration award within 15 days of the
service of the award. Judgment on the award of the arbitrator may be entered by
any court of competent jurisdiction.

      10.3 Amendments and Waivers. The parties may not amend or waive this
Master Agreement, except pursuant to a writing executed by the party or parties
against whom any amendment or waiver is sought to be enforced. A waiver made in
writing on one occasion is effective only in that instance and only for the
purpose that it is given and is not to be construed as a waiver on any future
occasion or against any other person.

      10.4 Assignment. No party may assign any of its rights or delegate any
performance under this Master Agreement without the prior written consent of the
other party, not to be unreasonably withheld, except by way of merger,
consolidation, dissolution, operation of law, sale of all or substantially all
assets, or assignment to an Affiliate. Any purported assignment of rights or
delegation of performance in violation of this section is void. For the purposes
of this Agreement, an "Affiliate" means a legal entity that (a) Controls the
assigning party or (b) is Controlled by the assigning party, or (c) is under
common Control with the assigning party, and "Control" means control of more
than 50% of the voting stock or other securities or interests that confer the
right to direct the affairs of the entity.

      10.5 Successors and Assigns. This Master Agreement binds and benefits the
parties and their respective permitted successors and assigns.

      10.6 Integration. This Master Agreement constitutes the final agreement
between the parties. It is the complete and exclusive expression of the parties'
agreement on the matters contained in this Master Agreement. All prior and
contemporaneous proposals, sales quotes, negotiations, documents and agreements
(whether or not signed) between the parties on the matters contained in this
Master Agreement are expressly merged into and superceded by this Master
Agreement, including the Service Provider Agreement dated June 30, 2004 ("SPA")
between Stentor and UPMC-Northwest (the "Northwest SPA") and the SPA which are
terminated without cause or obligation by either Party as of the Effective Date
of this Agreement. Notwithstanding anything to the contrary in the SPA and the
Northwest SPA regarding the survival of any of the SPA's or the Northwest SPA's
terms and conditions, all of the provision of the SPA and Northwest SPA are
terminated and of no further force and effect as of the Effective Date. The
provisions of this Master Agreement may not be explained, supplemented, or
qualified through evidence of trade usage or a prior course of dealings. In
entering into this Master Agreement, neither party has relied upon any
statement, representation, warranty, nor agreement of the other party except for
those expressly contained in this Master Agreement. There are no conditions
precedent to the effectiveness of this Master Agreement other than those
expressly stated in this Master Agreement. Any additional or different terms on
or in any Customer purchase order, acknowledgement or other document submitted
to Stentor shall be of no force or effect.

Stentor Master Agreement v1.0 9.20.2004                             Page 7 of 29

<PAGE>

      10.7 Release of Claims. Each party hereby forever generally and completely
releases and discharges the other party and its servants, agents, directors,
officers, employees, predecessors, successors in interest, and assigns, of and
from any and all claims and demands of every kind and nature, in law, equity or
otherwise, known and unknown, suspected and unsuspected, disclosed and
undisclosed, and in particular of and from all claims and demands of every kind
and nature, known and unknown, suspected and unsuspected, disclosed and
undisclosed, for damages actual and consequential, past, present and future,
arising out of or in any way related to: [**], including, without limitation,
claims related to: (i) [**], and (ii) any [**] related to [**] under the [**].
It is understood and agreed that this is a full, complete and final general
release of any and all claims described as aforesaid, and each Party agrees that
it shall apply to all unknown, unanticipated, unsuspected and undisclosed
claims, demands, liabilities, actions or causes of action, in law, equity or
otherwise, as well as those which are now known, anticipated, suspected or
disclosed. This release is not intended to affect either Party's rights or
obligations under the provisions in this Master Agreement.

      10.8 Notices. Any party giving or making any notice, request, demand, term
extension or other communication (each, a "Notice") pursuant to this Master
Agreement shall give the Notice in writing and use one of the following methods
of delivery, each of which for purposes of this Master Agreement is a writing:
personal delivery, Registered or Certified Mail (in each case, return receipt
requested and postage prepaid), or nationally recognized overnight courier (with
all fees prepaid), with such notice being effective upon receipt.

      Each party giving a Notice shall address the Notice to the appropriate
person at the receiving party at the address listed on the cover page of this
Master Agreement.

      Except as provided elsewhere in this Master Agreement, a Notice is
effective only if the party giving the Notice has complied with this Section
10.8 and if the addressee has received the Notice.

      10.9 Survival. The following Sections of the Master Agreement shall
survive expiration or termination of the Master Agreement: 5.2, 5.4, 5.5, 5.6,
6, 7, 8 and 10.

      10.10 Third Party Beneficiaries. This Master Agreement does not confer any
enforceable rights or remedies upon any person other than the parties, except
that third party software vendors may enforce this Master Agreement as it
applies to their products distributed in connection with this Master Agreement.
The parties reserve the power to modify or terminate this Master Agreement
without the consent of any third party software vendor.

      10.11 Relationship of Parties. This Master Agreement does not create a
partnership or joint venture relationship between Customer and Stentor. The
parties are independent contractors with entirely separate businesses. Neither
Customer nor Stentor have any right or authority to assume, create or incur any
liability or any obligation of any kind or character, express or implied,
against or on behalf of the other party to this Master Agreement. Neither party
is responsible for any employee compensation, worker's compensation, benefits,
taxes or other employee-related costs or obligations incurred on behalf of or
with respect to the other party's employee.

      10.12 Severability. If any provision of this Master Agreement is
determined to be invalid, illegal or unenforceable, the remaining provisions of
this Master Agreement remain in full force, if the essential terms and
conditions of this Master Agreement for each party remain valid, binding and
enforceable.

      10.13 Captions. The captions to this Master Agreement are for reference
only and in no way define, limit or describe the scope or intent of this Master
Agreement or any part hereof, nor in any way affect this Master Agreement or any
part hereof.

      10.14 Allocation of Risk. The parties agree that they have had they
opportunity to consult counsel and to negotiate the terms and conditions of this
Master Agreement. The prices paid, the warranty and warranty disclaimers and
limitations, as well as the limitations of liability and the remedy limitations,
and all other provisions of this Master Agreement, were negotiated to reflect
and support an informed and voluntary allocation of risks between Customer and
Stentor under this Master Agreement.

      10.15 Counterparts. The parties may execute this Master Agreement in
multiple counterparts, each of which constitutes an original, and all of which,
collectively, constitute one and the same agreement. The signatures of all of
the parties need not appear on the same counterpart, and delivery of an executed
counterpart signature page by facsimile is as effective as executing and
delivering this Master Agreement in the presence of the other parties to this
Master Agreement. In proving this Master Agreement, a party must produce or
account only for the executed counterpart of the party to be charged.

      10.16 Conflicts. In the event of any inconsistencies between this Master
Agreement and the Riders attached hereto, the Rider shall govern but only for
the subject matter of the Rider.

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<PAGE>

      10.17 Organization, Power and Authority, Corporate Action. Each party
represents that such party: (a) is duly organized, validly existing and in good
standing; (b) has the corporate power and authority to execute, deliver and
perform the Master Agreement; (c) has taken all necessary corporate action to
authorize the execution, delivery and performance of the Master Agreement; and
(d) has duly executed the Master Agreement by an authorized officer of such
party.

      10.18. Debarment. Stentor certifies that neither it nor its Affiliates,
nor any of either entities' employees is excluded, debarred, or otherwise
ineligible for participation in any federal health care program (or any
applicable successor statutory section) or in any other governmental payment
program. If Stentor, or any employee of Stentor, is excluded or debarred from
participation in any federal health care program or other government payment
program, or becomes otherwise ineligible to participate in any such program,
Stentor will notify Customer in writing within three (3) business days after
learning of such event, and if an employee is at issue, will remove such
employee from working on the project. If Stentor becomes excluded, debarred or
ineligible, whether or not such notice is given to Customer, Customer may [**],
if Stentor does not cure such exclusion, debarment or ineligibility within [**]
([**]) days following its commencement. If subcontracting is permitted under
this Agreement, Stentor will include this clause in all subcontract agreements.

      10.19 Subcontracting. All subcontractors and independent contractors used
by Stentor in the course of this Agreement shall be subject to written
confidentiality requirements substantially similar to those set forth in this
Agreement. The acts and omissions of the subcontractors of and independent
contractors engaged by Stentor will be deemed to be the acts and omissions of
Stentor.

      10.20 Access to Books and Records. Stentor shall maintain, and shall cause
each of its subcontractors to maintain, complete and accurate accounting records
in a form in accordance with generally accepted accounting principles, to permit
substantiation of the charges and prices of Stentor and Stentor's subcontractors
hereunder and to permit verification of and compliance by Stentor with the terms
of this Agreement. Stentor shall retain, and shall cause each of Stentor's
subcontractors to retain, such records for a period of five (5) years from the
date to which each such record pertains. Until at least the fourth (4th)
anniversary of its last having received any payment or furnished any service
pursuant to this Agreement, Stentor shall make available, upon written request
of the Secretary of Health and Human Services, the Comptroller General of the
United States of America, any of their duly authorized representatives, or any
other federal, state, or local governmental agency authorized to review records
in connection with any reimbursement to Customer or to any Affiliate, copies of
this Agreement and any books, documents, and records of Stentor that are
necessary to certify the nature and extent of the costs incurred by Customer or
by any Affiliate for such services.

      10.21 Non-Discrimination. Stentor shall perform its obligations under this
Agreement without discrimination toward any employees or other persons
regardless of their race, color, sex, age, religion, national origin, sexual
orientation, marital status, disability, or in any other manner prohibited by
law.

      10.22 Non-Solicitation. For the duration of the Agreement and for a period
of [**] ([**]) months following its termination, neither party will directly or
indirectly, for its benefit or for the benefit of any other entity, employ or
solicit any employee of the other party or its subsidiaries, without the other
party's consent, in order to cause the termination of said employee's employment
with the other party or its subsidiaries.

      10.23 Source Code Escrow. Contemporaneously with the execution of this
Agreement, Stentor will establish Customer as the beneficiary of an escrow
agreement (the "Escrow Agreement") with Stentor and DSI Technology Escrow
Services, Inc. (the "Escrow Agent"). Stentor shall maintain or deposit with the
Escrow Agent copies of all of the human-readable form of the Stentor Software
which, when compiled or interpreted, renders the executable version of the
Stentor Software then used by Customer, as well as any newer versions released
by Stentor as more fully described below (the "Source Code"), together with all
documentation for the source code (the "Source Code Documentation"), such that a
reasonably skilled programmer could understand and use the Source Code and the
Source Code Documentation to maintain, support, modify and otherwise use the
Stentor Software. Stentor will deliver to the Escrow Agent the Source Code and
Source Code Documentation for all new major releases (defined as a release with
a change of version number before the decimal point or one number to the right
of the decimal point, e.g., 2.4 to 3.0 or 3.2 to 3.3) to the Stentor Software
within sixty (60) days of the time that such Stentor Software is available for
general release. Customer will be entitled to receive all Source Code and Source
Code Documentation from the Escrow Agent in the event that: (i) Stentor files
for bankruptcy under Chapter 7 of the U.S. Bankruptcy Code, or (ii) Stentor
[**]. Stentor grants to Customer a license to use the Source Code to support the
use of the System by Customer hereunder. The parties acknowledge and agree that
this Agreement is intended to be covered under 11 U.S.C. 365(n) and that the
Escrow Agreement is "supplementary" to this Agreement as that term is used in 11
U.S.C. 365(n). Upon written request of Customer to Stentor or to such trustee,
neither Stentor nor such trustee will interfere with the rights granted in this
Agreement, including the right to obtain the Source Code and the Source Code

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<PAGE>

Documentation from the Escrow Agent. Customer will pay the actual third party
costs of establishing and maintaining the Escrow Agreement.

      10.24 Development of Intellectual Property. The parties acknowledge and
agree that this Agreement does not cover any development of technology or
improvements related to the System. Any such development, and the assignment of
any rights therein, shall be subject to a separate written agreement between the
parties.

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<PAGE>

                                   RIDER PS-1

                              PRODUCTS AND SERVICES
                              TERMS AND CONDITIONS

1.    STENTOR SOFTWARE

A. Existing Applications

iSite(R) Radiology
iVault(TM)

Customer and Stentor acknowledge that the following Facilities have already had
Server Hardware (as defined in Rider IFS-1) installed at their facility and
obtained access to the iSite Radiology and/or iVault software pursuant to the
SPA or other agreements as of the Effective Date, and that their ongoing access
to such software shall be governed, as of the Effective Date, by this Master
Agreement.

*    UPMC Presbyterian Hospital
*    UPMC Braddock
*    UPMC Children's Hospital
*    UPMC Horizon
*    UPMC Magee Women's Hospital
*    UPMC McKeesport
*    UPMC Passavant
*    UPMC Shadyside
*    UPMC South Side
*    UPMC St. Margaret's
*    UPMC Lee
*    UPMC Northwest

The Facilities shall include all additional Facilities described in Section 2.4
of the Agreement. Stentor shall provide all additional Server Hardware necessary
to provide access to and performance of the System as Stentor provides prior to
the Effective Date.

The System and all future releases of the System during the term will continue
to maintain and support an open API approach which allows users to develop
self-supported System modifications or enhancements which integrate into the
System pursuant to Stentor's interface standards. In the event that a new
release of the System eliminates any material functionality which Customer views
as critical, Stentor will, upon Customer's request, provide Customer with
reasonable access to information to support Customer's development of comparable
functionality through use of the open API structure.

B. Additional Applications

Customer may elect to license under the terms of this Master Agreement if and
when available, any new software application developed by or for Stentor for any
medical field that uses diagnostic images and which Stentor makes commercially
available during the Term ("Additional Applications"). Such Additional
Applications shall be deemed part of the Stentor Software licensed hereunder if
and when delivered to Customer, and the fees due hereunder shall [**]. Stentor
shall implement the Additional Applications and any required hardware at its
sole expense. The Additional Applications shall be described in Rider(s) PS-x-n,
and any infrastructure requirements for such Additional Applications not already
described in Rider IFS-1 shall be described in Rider(s) IFS-x-n.

2.    FEES

      2.1 Study Definition. A "Study" means a collection of one or more medical
images generated for a single patient from a single Modality (as defined below)
as a single Digital Imaging and Communication in Medicine unique identifier
(DICOM UID) or other unique identifier based on a different data standard used
by Stentor to track images and transformed into a flexible hierarchical
representation using the System. In sizing the Server Hardware, Stentor assumes
a cumulative average Study size of [**]MB (uncompressed). If Customer's
cumulative average Study size exceeds [**]MB per Study during the PS-1 Term,
then at such point as total System storage is exceeded, Customer shall reimburse
Stentor for Stentor's actual cost of procuring, installing and configuring
additional required storage for:

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(1) the number of Studies then currently stored in the System, multiplied by (2)
the number of megabytes by which the cumulative average Study size exceeds
[**]MB. Alternatively, Customer may purchase the additional storage according to
Stentor's approved configuration from a third party. Stentor shall install and
configure such storage at its then-current time and materials rates for work
actually performed.

      2.2 Fixed Fee. Customer shall pay a total of [**] Dollars ($[**]) in [**]
as set forth below for the right for Customer to create, archive, access and
otherwise use [**] Studies using the System during the Term (the "Fixed Fee"),
subject to the following limitations and exclusions:

      (a) The Fixed Fee does not include any of the following:

            (i) License fees for Third Party Products and support services
            therefor; provided, however, that if Stentor changes any Third Party
            Products necessary to utilize the System from those identified in
            this Agreement as of the date of execution, or in any applicable
            Rider at the time of execution thereof, Stentor shall procure the
            Third Party Products at its sole expense. For purposes of
            clarification, Customer shall be responsible for, and the Fixed Fee
            does not include, any additional licenses to SQL Server required to
            support additional hardware hereunder.

            (ii) Any professional services (including but not limited to HL7
            integration services) provided by Stentor which are not required
            under this Agreement

            (iii) Bandwidth costs as described in Section 2.6 of this Rider PS-1

            (iv) Any additional storage costs to be paid by Customer pursuant
            Section 2.1 of this Rider PS-1 due to average Study size exceeding
            [**]MB.

            (v) Fees for Studies conducted at Non-Owned Facilities in excess of
            an aggregate of [**] ([**]) Studies per year for all such Non-Owned
            Facilities. For each such Study in excess of the annual limit,
            Customer shall pay a fixed fee of [**] Dollars and [**] Cents
            ($[**]) per Study. Customer shall take the necessary steps to enable
            Customer and Stentor to identify such Studies so that any fees due
            therefor can be properly invoiced. Once the annual Study threshold
            has been exceeded in any given year of the Term, Stentor shall
            invoice Customer monthly in arrears for fees due for additional
            Studies in accordance with Section 4.1 of this Rider PS-1.

<TABLE>
<CAPTION>
                YEAR 1  YEAR 2   YEAR 3  YEAR 4   YEAR 5
                (2005)  (2006)   (2007)  (2008)   (2009)
                ------  ------   ------  ------   ------
<S>             <C>     <C>      <C>     <C>      <C>
ANNUAL
INSTALLMENT
OF FIXED FEE    $[**]   $[**]    $[**]   $[**]    $[**]
</TABLE>

      2.3 Microsoft SQL Server. Microsoft SQL Server is a required database
component of the System. Stentor acknowledges that Customer has already obtained
and paid the license fees for copies of Microsoft SQL Server running on the
Server Hardware installed at the Facilities listed in this Rider PS-1 as of the
Effective Date. Customer will be obligated to acquire a license for additional
copies of Microsoft SQL Server for each instance of additional Server Hardware
added to the System after the Effective Date for Stentor's actual cost to
procure such licenses from Microsoft. During the Rider PS-1 Term Stentor will
provide Customer with support for Microsoft SQL Server as a component of the
System. Microsoft will not provide Customer with support for SQL Server. In
consideration for providing Microsoft Software Assurance support for Microsoft
SQL Server during the Rider PS-1 Term, Customer shall pay Stentor's then-current
annual support fee for Microsoft SQL Server. Customer agrees to the terms of the
Microsoft SQL Server end user license agreement attached hereto as Exhibit A.

      2.4 Implementation and Training Fees. In consideration for any
implementation and training services outlined in the Implementation Steps and
Timetable which may be attached to a Rider IFS-x, Customer shall pay Stentor the
fee set forth in such Rider IFS-x on the terms set forth in such Rider IFS-x.

      2.5 HL7 Integration Fee. HL7 integration services include integrating the
System to handle HL7 messages for a single MRN/Accession issuer (RIS) and
possibly related HL7 messages from a HIS:

            A. ADT (Patient demographic - usually from HIS)

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<PAGE>

                  -     Updates patient demographics real-time

                  -     Facilitates patient merges

            B. ORM (Order - usually from RIS)

                  -     Facilitates technologist worklist

                  -     Updates order status real-time

                  -     Facilitates patient worklist filtering by referring
                        physician

            C. ORU (Diagnostic report - usually from RIS)

                  -     Facilitates display of diagnostic reports with images

      All functionality listed above is dependent upon receipt of HL7 messages
that contain appropriate data. For example, Stentor cannot provide filtering by
referring physician if the referring physician information is not included in
the ORM messages. Customer is responsible for third-party fees, if any, charged
by RIS or HIS vendors. Stentor will modify without charge the integration as
required as a result of upgrades or modifications to the HIS or RIS during the
Rider PS-1 Term.

      In the event that Customer requires integration of the System with RIS at
a new facility, Stentor shall provide such services as may be reasonable
requested. With respect to integration of IDX RIS products, Customer shall not
be charged if Stentor provides such services remotely. If Customer requests
Stentor to provide the integration services for IDX products at Customer's
Facilities, or if Customer requests integration with any other third party RIS
product, Customer shall pay Stentor [**] per integration.

      2.6 Bandwidth to Datacenter. In consideration for providing bandwidth
connections between the System and Stentor's datacenter in connection with the
iVault service, Customer shall pay Stentor all bandwidth charges and bandwidth
related hardware fees as a pass through.

      2.7 Addition/Divestiture of Facilities.

            (a) In the event that Customer acquires an additional inpatient
facility during the Term, Customer may add such facility as a Facility using the
System under this Agreement. The parties shall determine the proposed Facility's
Study volume for the preceding twelve (12) months as a percentage of Study
volume for Customer during the preceding twelve (12) months. Upon integration of
the proposed Facility into the System, the annual fee paid by Customer hereunder
shall be increased by such percentage.

            (b) In the event that Customer divests itself of one or more
inpatient facilities during the Term (such that it no longer owns or operates
such Facility), the parties shall [**]. Upon closing of the divestiture, the
annual fee paid by Customer hereunder shall be [**]. During the first [**]
([**]) months after divestiture of a Facility, authorized users affiliated with
such Facility may continue to utilize the System to view and input new Studies
by paying an amount equal to [**]. If Stentor and the divested Facility are
unable to mutually agree upon fees for continued use of the System during that
[**] month period, Stentor may notify the divested Facility that its full access
to the System will be terminated [**] ([**]) months thereafter. The divested
Facility may continue to use the System for the purpose of viewing Studies
through different PACS systems and migrating the Studies for a period of up to
[**] ([**]) months from the date of divestiture. During any month in which the
Facility is making full use of the System (including adding new Studies and
viewing Studies through Stentor's software), the Facility shall pay [**]. During
any month in which the Facility is only utilizing the System for viewing through
third party systems or migration purposes, the Facility shall pay [**] percent
([**]%) of such [**].

3.    RIDER PS-1 TERM

      3.1 Rider PS-1 Term. The term of this Rider PS-1 (the "Rider PS-1 Term")
shall commence upon the Effective Date of this Master Agreement and shall
continue for a period of five (5) years unless earlier terminated as set forth
below.

4.    PAYMENT TERMS

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                                  CONFIDENTIAL

<PAGE>

      4.1 Payments Due. Each [**] of the Fixed Fee shall be paid [**]. All
payments due to Stentor hereunder shall be due and payable in full by Customer
within [**] ([**]) days of the date of Stentor's invoice, which shall be
presented on the first day of each month during the Term. All past due payments
will accrue interest at a rate of one and one-half percent (1.5%) per month (or
the maximum amount permitted by applicable law) on the unpaid balance from the
due date until paid in full. In the event that any payment is disputed by
Customer in good faith, such interest shall not accrue until [**] ([**]) days
after the original due date. If the parties resolve the dispute prior to the
expiration of such [**] ([**]) day period, the interest shall not apply to any
related payments.

      4.2 Survival of Obligations. All obligations with respect to the amounts
due either party shall survive any expiration or termination of this Rider PS-1
or the Master Agreement.

      4.3 Taxes, Duties, etc. All payments by Customer to Stentor under this
Rider PS-1 for any fees due will be exclusive of any sales, use, service, value
added or withholding taxes, or any other levy, tariff, duty or tax of any kind
whatsoever imposed by any governmental authority with respect to the services
rendered or expenses incurred by Stentor hereunder (other than a tax imposed
upon Stentor's income). Customer agrees to pay, within thirty (30) days of the
date of the applicable Stentor invoices, any tax whenever a governmental
authority imposes such tax. Customer's failure to pay Stentor the Service Fee as
defined herein or the taxes described above constitutes a material breach of
this Master Agreement.

5.    TERMINATION; RENEWAL

      5.1 Termination. Either party may terminate this Rider PS-1 if the other
party materially breaches a material term of this Rider PS-1 and does not cure
such breach within the following number of days after receiving written notice
from the non-breaching party specifying the nature of such breach: (i) [**]
([**]) days for breaches of confidentiality obligations, (ii) [**] ([**]) days
if Customer breaches a payment obligation, (iii) [**] ([**]) days for other
materials breaches; provided, however, that such [**] day period may be extended
an additional [**] ([**]) days if the breaching party demonstrates that it began
working on the cure promptly after receipt of notice and has worked to cure the
breach on a continuous best efforts basis during the first [**] days and
continues to do so for the remaining period. Either party may terminate this
Rider PS-1 immediately if the other party makes an assignment for the benefit of
creditors, files a petition in bankruptcy or is adjudged bankrupt (unless the
party continues to pay all debts when they become due), becomes insolvent or is
placed in the hands of a receiver.

      5.2 Renewal Term. Customer may renew this Agreement upon written notice
for one five-year term or additional consecutive one-year terms upon written
notice to Stentor. To renew the Agreement for one five-year term, Customer must
give Stentor written notice no later than six (6) months before expiration of
the initial Term. To renew the Agreement for one or more one-year terms,
Customer must give Stentor written notice no later than six (6) months before
expiration of the initial Term and no later than three (3) months before the end
of any subsequent renewal term.

      If Customer elects to renew for a five-year term, the fixed fee for the
renewal term shall be, subject to adjustment pursuant to Section 2.7 of this
Rider, [**] Dollars ($[**]), payable in five annual installments as follows:

<TABLE>
<CAPTION>
                YEAR 1   YEAR 2   YEAR 3  YEAR 4  YEAR 5
                (2010)   (2011)   (2012)  (2013)  (2014)
                ------   ------   ------  ------  ------
<S>             <C>      <C>      <C>     <C>     <C>
ANNUAL
INSTALLMENT
OF FIXED FEE    $[**]    $[**]    $[**]   $[**]   $[**]
</TABLE>

If Customer elects to renew for consecutive one-year terms, the annual fee for
each such renewal term shall be [**] Dollars ($[**]) per year.

      5.3 Post Expiration / Termination Obligations.

      (a) Following expiration or termination of this Master Agreement for any
reason, Customer may continue to utilize the System for a reasonable period of
time not to exceed [**] ([**]) years (the "Transition Period") to transition to
a different image storage system and to migrate data and images on the Server
Hardware to a DICOM-compliant PACS, or another DICOM-compliant data and image
storage distribution system. During the Transition Period, Customer shall pay
Stentor the then-applicable Fixed Fee, if the Master Agreement is terminated
during the Initial Term or the then-applicable annual fee for a renewal term,
subject to adjustment as follows: (i) pursuant to Section 2.7 of this Rider; and
(ii) in the event that a given Facility transitions to a "dormant archive"
option (in which new

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                                  CONFIDENTIAL
<PAGE>

Studies are not created and stored, but existing Studies are retrieved and
viewed) as further described in subsection (b) below. If a Facility transitions
to the dormant archive mode during the Transition Period, the parties shall
determine the Study volume of the Facility or Facilities electing the dormant
archive option as a percentage of Study volume for Customer during the preceding
twelve (12) months. Upon such Facility or Facilities entering into dormant
archive mode, the annual fee paid by Customer during the Transition Period shall
be decreased prospectively by such percentage, and Customer shall pay the
dormant archive fee for such Facility or Facilities as set forth below.

      (b) As an alternative to full use of the System for new and archived
Studies, Customer may elect, on a per-Facility basis, for a fee of equal to such
Facility's pro-rata share (as determined on the basis of the ratio of Facilities
in the Migration Period, as defined below, to Facilities still in the Transition
Period) of [**] percent ([**]%) of (i) the then-applicable Fixed Fee if the
Master Agreement is terminated during the Initial Term or (ii) the
then-applicable annual fee for a renewal term, to utilize the System solely to
access and migrate Studies that were archived on the System prior to expiration
or termination of the Master Agreement (the "Migration Period"). Once a Facility
has elected to enter into a Migration Period, such Migration Period shall not
exceed [**] ([**]) years. Customer will not be permitted to utilize the System
to view or archive new Studies during the Migration Period for the applicable
Facility or Facilities if it elects this dormant archive option.

      (c) Upon the completion of migration of data or expiration of the
Migration Period, Customer shall cease using and return to Stentor or destroy
all copies of the Stentor Software and certify to Stentor in writing that such
return or destruction has occurred. This Section shall survive the expiration or
termination of this Master Agreement.

      (d) The following example is included solely for purposes of clarifying
the application of Sections 5.3(a) and (b). If a single Facility accounts for
[**] percent ([**]%) of the Study volume for Customer, the Facility's active
fees during the Transition Period under Section 5.3(a) would be $[**] per year
during the original Term and $[**] per year thereafter. Once Customer shifts
such Facility to "dormant mode," the applicable fees for such Facility under
Section 5.3(b) would be $[**] per year for years falling during the original
Term and $[**] per years falling after the original Term.

      5.4 Post-Termination Hardware Option. Upon expiration of the initial Rider
PS-1Term, Customer may elect to purchase all (and only all) of the Server
Hardware using a [**]. In such case, Customer shall be solely responsible for
maintaining all equipment required to operate the Stentor Software and Stentor
will no longer be obligated to provide Server Hardware obsolescence protection
pursuant to Rider IFS, Section 3.2. If Customer exercises this hardware purchase
option and renews the Rider PS-1 Term pursuant to Section 5.2 above, the annual
maintenance fee for continued use of the System shall be $[**] per year in lieu
of the annual renewal fees set forth in Section 5.2. If Customer exercises this
hardware purchase option and elects the dormant archive option pursuant to
Section 5.3(b) of this Rider PS-1, the dormant archive fee shall be reduced by
[**]%.

      5.5 Migration of Data.

      (a) Customer may migrate data and images on the Server Hardware to a
DICOM-compliant PACS, or another DICOM-compliant data and image storage
distribution system using the DICOM export tool included with the System. If
Stentor owns a software tool which supports bulk migration of image objects,
DICOM and related DICOM header data and all other Customer data in the System
database, it will provide this tool to Customer at no charge to use for this
purpose. If Stentor has access to a third party tool for such purposes that
Stentor may sublicense to Customer, Customer shall have the option to sublicense
such tool at Stentor's actual cost for providing such sublicense. In addition,
Stentor shall provide (subject to appropriate restrictions on use and
nondisclosure provisions pursuant to this Agreement) a data dictionary that
describes Stentor's database structure (e.g., field descriptions and information
on the relationship between database indexes and tables) in sufficient detail to
enable Customer or a designee of Customer (provided such designee is subject to
a written nondisclosure agreement containing substantively similar restrictions
and confidentiality provisions as provided in this Agreement) to write automated
migration scripts to accomplish the migration of all Customer data in the System
database and migration of DICOM header data (if such DICOM header data is not
migrated pursuant to use of the conversion tool described above) in an
efficient, automated manner; provided, however, that in lieu of providing such
information, Stentor may in its sole discretion elect, at no additional charge,
to provide such scripts to Customer to enable automated migration of all
Customer data in the System database and all DICOM and DICOM header data (not
otherwise migrated pursuant to use of the above-referenced bulk migration tool).

      (b) Customer may also elect to have Stentor migrate data and images on the
Server Hardware to a DICOM-compliant PACS, or another DICOM-compliant data and
image storage distribution system for a fee equal to Stentor's then current time
and materials rate and Stentor's reasonable out of pocket expenses incurred in
connection with migration.

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                                    EXHIBIT A

                MICROSOFT(R) SQL SERVER(TM) 2000 STANDARD EDITION

                         RUNTIME-RESTRICTED USE SOFTWARE

LICENSES: [2]

END-USER LICENSE AGREEMENT (Per Processor)

IMPORTANT -- READ CAREFULLY: This End-User License Agreement ("EULA") is a legal
agreement between you (either an individual or a single entity) and the licensor
("Licensor") of the software application or suite of applications with which you
acquired the Microsoft software product identified above, which includes
computer software and may include associated media, printed materials, and
"online" or electronic documentation ("Product"). An amendment or addendum to
this EULA may accompany the Product. Microsoft Corporation or one of its
affiliates (collectively, "Microsoft") has licensed the Product to Licensor. YOU
AGREE TO BE BOUND BY THE TERMS OF THIS EULA BY INSTALLING, COPYING, OR OTHERWISE
USING THE PRODUCT. IF YOU DO NOT AGREE, DO NOT INSTALL OR USE THE PRODUCT; YOU
MAY RETURN IT TO YOUR PLACE OF PURCHASE FOR A FULL REFUND.

The Product may contain the following software:

      -           "Server Software" provides services or functionality on your
              server (your computers capable of running the Server Software are
              "Servers");

      -           "Client Software" allows an electronic device ("Device") to
             access or utilize the Server Software.

1.    GRANT OF LICENSE. Licensor grants you the following rights provided you
      comply with all terms and conditions of this EULA:

      a.    SERVER SOFTWARE. You may install one copy of the Server Software on
            a single Server. If the Server has more than one processor, you must
            obtain a separate license for each processor on that Server. You may
            use the Server Software only with that number of processors for
            which you are properly licensed, as set forth above. You may install
            and use additional copies of the Server Software on additional
            Servers, and/or use the Server Software with additional processors.
            However, the sum of the total number of processors with which the
            Server Software is used and the total number of Devices on which SQL
            Server Personal Edition is installed pursuant to Section 1(h) below
            may not exceed the number of "Licenses" specified above. If a number
            of "Licenses" is not indicated above, then you are licensed to use
            either (i) one copy of the Server Software with one processor, or
            (ii) one copy of SQL Server Personal Edition on one Device pursuant
            to Section 1(h) below. You may use the Management Tools,
            Books-Online, and Development Tools components of Microsoft SQL
            Server (collectively "Tools") solely for internal use in conjunction
            with your Server Software. SQL SERVER, ENTERPRISE EDITION. If you
            have acquired the Enterprise Edition of the Server Software, you may
            also install any number of instances of the Server Software on the
            Server for use by any processor for which you have acquired a
            license. An "instance" shall mean a running copy of the Server
            Software.

      b.    CLIENT SOFTWARE. You may either (i) install and use the Client
            Software (SQL Server Personal Edition) on any number of internal
            Devices so long as it is being used only in conjunction with the
            Server Software and the integrated software turnkey application or
            suite of applications delivered by or on behalf of Licensor of the
            Product (such application or applications referred to as the
            "Integrated Application") as part of the Integrated Application, or
            (ii) install and use SQL Server Personal Edition without installing
            the Server Software as specified in Section 1(h) below so long as
            SQL Server Personal Edition is used only in conjunction with the
            Integrated Application as part of the Integrated Application.

      c.    SQL SERVER 2000 DEVICE ACCESS. Any number of Devices may use or
            access the services of the Server Software in conjunction with the
            Integrated Application so long as you have acquired a valid license
            for each processor running such Server Software. This EULA grants
            you the right to permit Devices to access or use only the services
            of the Server Software provided with the Integrated Application.

      d.    USE OF REDISTRIBUTABLE CODE. In addition to the rights granted
            above, Licensor grants you the nonexclusive, royalty-free right to
            use, reproduce and distribute the Microsoft SQL Server Desktop
            Engine ("MSDE") and the files listed in the REDIST.TXT contained in
            the Product (collectively, the "Redistributable Code"), provided
            that you also comply with the following:

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            i.    GENERAL REQUIREMENTS. If you choose to redistribute any
                  portion of the Redistributable Code, you agree:

                  A. to distribute the Redistributable Code in object code form
            and only in conjunction with and as a part of a software application
            product developed by you that adds significant and primary
            functionality to the Product ("Application");

                  B. not to use Microsoft's name, logo, or trademarks to market
            the Application;

                  C. to include a valid copyright notice in your name on the
            Application;

                  D. to indemnify, hold harmless, and defend Licensor and
            Microsoft from and against any claims or lawsuits, including
            attorney's fees, that arise or result from the use or distribution
            of the Application; and

                  E. to otherwise comply with the terms of this EULA.

            You also agree not to permit further distribution of the
      Redistributable Code by your end users except you may permit further
      redistribution of the Redistributable Code by your distributors if they
      only distribute the Redistributable Code in conjunction with, and as part
      of, the Application and you and your distributors comply with all other
      terms of this EULA.

            ii.   ADDITIONAL REQUIREMENTS FOR MSDE. If you choose to
                  redistribute MSDE, you also agree:

                  A. that your Application shall not substantially duplicate the
            capabilities of Microsoft Access or, in the reasonable opinion of
            Microsoft, compete with same; and

                  B. that unless your Application requires your customers to
            license Microsoft Access in order to operate, you shall not
            reproduce or use MSDE for commercial distribution in conjunction
            with a general purpose word processing, spreadsheet or database
            management software product, or an integrated work or product suite
            whose components include a general purpose word processing,
            spreadsheet, or database management software product except for the
            exclusive use of importing data to the various formats supported by
            Microsoft Access. NOTE: A product that includes limited word
            processing, spreadsheet or database components along with other
            components which provide significant and primary value, such as an
            accounting product with limited spreadsheet capability, is not
            considered to be a "general purpose" product.

      e.    RESERVATION OF RIGHTS. Licensor and Microsoft reserve all rights not
            expressly granted to you in this EULA.

      f.    BENCHMARK TESTING. You may not disclose the results of any benchmark
            test of either the Server Software or Client Software to any third
            party without Microsoft's prior written approval.

      g.    DOWNGRADES. Instead of installing and using the Server Software, you
            may install and use one copy of an earlier version of the Server
            Software on a single Server, provided that you completely remove
            such earlier version and install the original Server Software within
            a reasonable time. Your use of such earlier version shall be
            governed by this EULA, and your rights to use such earlier version
            shall terminate when you install the original Server Software.

      h.    USE OF SQL SERVER PERSONAL EDITION NOT IN CONJUNCTION WITH SERVER
            SOFTWARE. You may install and use one copy of SQL Server Personal
            Edition on one internal Device without installing or using the
            Server Software in conjunction with that copy of SQL Server Personal
            Edition so long as SQL Server Personal Edition is used only in
            conjunction with the Integrated Application. You may install
            additional copies of SQL Server Personal Edition on additional
            Devices without installing the Server Software provided that such
            copies of SQL Server Personal Edition are used only in conjunction
            with the Integrated Application. However, you must acquire a
            separate SQL Server processor license for each Device on which you
            install SQL Server Personal Edition that is not used in conjunction
            with the Server Software. Furthermore, the sum of the total number
            of processors with which the Server Software is used and the total
            number of Devices on which SQL Server Personal Edition is installed
            pursuant to this Section 1(h) may not exceed the number of
            "Licenses" specified above. If a number of "Licenses" is not
            indicated above, then you are licensed to use either (i) one copy of
            the Server Software with one processor, or (ii) one copy of SQL
            Server Personal Edition on one Device pursuant to this Section 1(h).
            Any number of Devices may use or access the services of a Device
            running SQL Server Personal Edition that is not used in conjunction
            with the Server Software and that is used in conjunction with the
            Integrated Application so long as you have acquired a separate,
            valid processor license for the Device being used or accessed.

      i.    RUNTIME-RESTRICTED USE SOFTWARE. The Product is "Runtime-Restricted
            Use" software; as such, the Product may only be used to run the
            Integrated Application as part of the Integrated Application. The
            Product may not be used either (i) to develop and/or (ii) in
            conjunction with, new applications, databases or tables other than
            those contained in the Integrated Application. The foregoing
            provision, however, does not prohibit you from using a tool to run
            queries or reports from existing tables, and/or from using a
            development environment or workbench which is part of the Integrated
            Application to configure or extend such Integrated Application.
            Notwithstanding any provision of this EULA, you may only transfer
            the "Runtime-Restricted Use" Product as part of the Integrated
            Application, subject to the terms and conditions specified in
            Section 5 below.

2.    INSTALLATION OF SERVER SOFTWARE ON PASSIVE FAIL-OVER SERVER. If the Server
      Software is used in a clustered environment, you may use the Server
      Software on a temporary basis on a Server that is employed only for
      fail-over support (the "Passive Server") so long as the number of
      processors on the Passive Server does not exceed the number of processors
      on your primary active Server.

3.    NO RENTAL/NO COMMERCIAL HOSTING. You may not rent, lease, lend, or provide
      commercial hosting services with the Product.

4.    ADDITIONAL SOFTWARE/COMPONENT LICENSES. This EULA applies to updates or
      supplements to the original Product provided by Licensor or Microsoft,
      unless Licensor or Microsoft provides other terms along with the update or
      supplement. The Product may contain certain components (each, a
      "Component") that included a separate end user license agreement (a
      "Component Agreement"). The terms of any Component Agreement are herein
      incorporated by reference to this EULA; in the event of any
      inconsistencies between this EULA and any Component Agreement, the terms
      of this EULA shall control.

5.    TRANSFER -- INTERNAL. You may move the Server Software to a different
      Server or SQL Server Personal Edition (installed and used pursuant to
      Section 1(h) above) to a different Device. TRANSFER TO THIRD PARTY. The
      initial user of the Product may make a one-time transfer of the Product to
      another end user. The transfer has to include all component parts, media,
      printed materials, this EULA, and if applicable, the Certificate of
      Authenticity. The transfer may not be an indirect transfer, such as a
      consignment. Prior to the transfer, the end user receiving the transferred
      Product must agree to all the EULA terms.

6.    LIMITATION ON REVERSE ENGINEERING, DECOMPILATION, AND DISASSEMBLY. You may
      not reverse engineer, decompile, or disassemble the Product, except and
      only to the extent that it is expressly permitted by applicable law
      notwithstanding this limitation.

7.    TERMINATION. Without prejudice to any other rights, Licensor or Microsoft
      may cancel this EULA if you do not abide by the terms and conditions of
      this EULA, in which case you must destroy all copies of the Product and
      all of its component parts.

8.    CONSENT TO USE OF DATA. You agree that Microsoft and its affiliates may
      collect and use technical information you provide as a part of support
      services related to the Product. Microsoft agrees not to use this
      information in a form that personally identifies you.

9.    NOT FOR RESALE SOFTWARE. Product identified as "Not for Resale" or "NFR,"
      may not be resold, transferred or used for any purpose other than
      demonstration, test or evaluation.

10.   EXPORT RESTRICTIONS. You acknowledge that Product is subject to U.S.
      export jurisdiction unless otherwise indicated by Microsoft. You agree to
      comply with all applicable international and national laws that apply to
      the Product, including the U.S. Export Administration Regulations, as well
      as end-user, end-use and destination restrictions issued by U.S. and other
      governments. For additional information, see
      <http://www.microsoft.com/exporting/>.

11.   U.S. GOVERNMENT LICENSE RIGHTS. All Product provided to the U.S.
      Government pursuant to solicitations issued on or after December 1, 1995
      is provided with the commercial license rights and restrictions described
      elsewhere herein. All Product provided to the U.S. Government pursuant to
      solicitations issued prior to December 1, 1995 is provided with
      "Restricted Rights" as provided for in FAR, 48 CFR 52.227-14 (JUNE 1987)
      or DFAR, 48 CFR 252.227-7013 (OCT 1988), as applicable.

12.   The Product is protected by copyright and other intellectual property laws
      and treaties. Microsoft or its suppliers own the title, copyright, and
      other intellectual property rights in the Product. THE PRODUCT IS
      LICENSED, NOT SOLD.

13.   NOT FAULT TOLERANT. THE PRODUCT IS NOT FAULT TOLERANT. LICENSOR HAS
      INDEPENDENTLY DETERMINED HOW TO USE THE PRODUCT IN THE INTEGRATED SOFTWARE
      APPLICATION OR SUITE OF APPLICATIONS THAT IT IS LICENSING TO YOU, AND
      MICROSOFT HAS RELIED ON LICENSOR TO CONDUCT SUFFICIENT TESTING TO
      DETERMINE THAT THE PRODUCT IS SUITABLE FOR SUCH USE.

14.   NO WARRANTIES BY MICROSOFT. YOU AGREE THAT IF YOU HAVE RECEIVED ANY
      WARRANTIES WITH REGARD TO EITHER (A) THE PRODUCT, OR (B) THE SOFTWARE
      APPLICATION OR SUITE OF APPLICATIONS WITH WHICH YOU ACQUIRED THE PRODUCT,
      THEN THOSE WARRANTIES ARE PROVIDED SOLELY BY THE LICENSOR AND DO NOT
      ORIGINATE FROM, AND ARE NOT BINDING ON, MICROSOFT.

15.   NO LIABILITY OF MICROSOFT FOR CERTAIN DAMAGES. TO THE MAXIMUM EXTENT
      PERMITTED BY APPLICABLE LAW, MICROSOFT SHALL HAVE NO LIABILITY FOR ANY
      INDIRECT, SPECIAL, CONSEQUENTIAL OR INCIDENTAL DAMAGES ARISING FROM OR IN
      CONNECTION WITH THE USE OR PERFORMANCE OF THE PRODUCT OR THE SOFTWARE
      APPLICATION OR SUITE OF APPLICATIONS WITH WHICH YOU ACQUIRED THE PRODUCT.
      THIS LIMITATION WILL APPLY EVEN IF ANY REMEDY FAILS OF ITS ESSENTIAL
      PURPOSE. IN NO EVENT SHALL MICROSOFT BE LIABLE FOR ANY AMOUNT IN EXCESS OF
      TWO HUNDRED FIFTY U.S. DOLLARS (US$250.00).

       Microsoft is a registered trademark of Microsoft Corporation in the
                      United States and/or other countries.

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                                   RIDER IFS-1

                                 INFRASTRUCTURE

1     CLIENT HARDWARE

      1.1 Client Devices. A "Client Device" means a computer, workstation,
terminal, or other electronic device used to access the server hardware.
Customer is responsible for procuring, maintaining and upgrading all Client
Devices for use with the System.

      1.2 Minimum Requirements for Client Devices. System performance requires
that Client Devices meet the minimum requirements set forth in the current
product documentation and posted on Stentor's website at
http://www.stentor.com/Corp_MinimumSpecs.htm. Minimum requirements for Client
Devices may change (e.g., operating systems, processor speed, internet software)
throughout the Term. Stentor shall provide Customer at least [**] ([**]) months
notice of any increase in the minimum requirements required to support
then-existing features and performance levels and shall continue to support
prior versions of the System for up to [**] ([**]) months after the date of such
notice if so requested by Customer. Stentor shall provide Customer at least [**]
([**]) months notice of any increase in the minimum requirements required to
support a new feature, provided that the new requirements do not affect
then-existing features and performance levels, and shall continue to support
prior versions of the System for up to [**] ([**]) months after the date of such
notice if so requested by Customer Thereafter, Customer may use any
non-compliant Client Devices, provided that Stentor shall not be obligated to
deliver the system response times specified in Rider SL in connection with such
Client Devices.

2     USE OF SERVICES

      2.1 Services. Customer hereby agrees to retain Stentor to: (i) install new
elements of the System after the Effective Date as described in Implementation
Steps and Timetable set forth in Section 7 below; (ii) to provide the System
during the Term at the performance levels specified in Rider SL; and (iii) to
provide customer support, Heartbeat monitoring, Updates and training as
described on Rider SL. Stentor shall provide all of these services at no expense
to Customer.

      2.2 Client Software. "Client Software" means the portion of the Stentor
Software installed on a Client Device that enables a Client Device to access the
Stentor Software operating on the Server Hardware.

      2.3 Permitted Use of Services. Subject to the terms and conditions of the
Master Agreement, Stentor hereby grants Customer a non-exclusive,
non-transferable (except in accordance with Section 10.5 of the Master
Agreement), non-sublicensable, limited right during the Term to access and use
the System solely to permit Authorized Users to view, manipulate, distribute and
otherwise use Studies in connection with Customer's and its Affiliates internal
business purposes (including, without limitation, research and educational
purposes). Customer will not provide access to any portion of the System to any
person or entity other than its Authorized Users who are bound by
confidentiality provisions as protective of Stentor's confidential information
as those contained in the Master Agreement. An "Authorized User" shall be
limited to the following: a current employee or independent contractor of
Customer or its Affiliates, or a health care professional, clinician, student
(or their staff) with privileges at Customer's or its Affiliates' facilities and
researchers that (a) have been assigned a unique password or other identifier by
Customer, and (b) use the Client Software solely to perform duties within the
scope of Customer's, its Affiliates' or the applicable user's internal business
purposes. Authorized Users may access the System locally or remotely to view
Studies. Customer may reproduce and install the Client Software on an unlimited
number of Client Devices for use in connection with the System, provided that
all such copies bear all of the proprietary notices on or in the original.
Stentor retains title to all such copies.

3     SERVER HARDWARE

      3.1 Server Hardware Provided. Stentor shall provide Customer with all
required hardware to operate the Server Software during the Term (the "Server
Hardware") to support the service levels as set forth on Rider SL. Stentor
maintains all right, title and interest in and to the Server Hardware. Customer
agrees to keep the Server Hardware free and clear from all claims, liens, and
encumbrances and will not assign, sublet, or grant a security interest in the
Server Hardware. Customer shall pay for directly or through insurance for up to
the replacement cost if the Server Hardware is stolen, damaged, destroyed, or
otherwise rendered inoperable.

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      3.2 Server Hardware Obsolescence Protection. Stentor shall upgrade or
replace the Server Hardware, at Stentor's sole expense, as necessary during the
term (a) to support the service levels as set forth on Rider SL, and (b) if
required to support an Update of the Server Software.

      3.3 Server Hardware Operating Environment. Server Hardware will be
installed and connected to Customer's network at Customer's site. Customer is
responsible for providing, without charge, an adequate operating environment for
Server Hardware during the Term as set forth on Exhibit B. In the event that
multiple server racks are required to support the System Customer shall provide,
without charge, contiguous rack space at Customer's site.

      3.4. Facilities Consolidation. The parties acknowledge that circumstances
may arise that would make the consolidation of multiple Facilities' access to
Server Hardware beneficial to both parties in terms of managing workflow and
costs. Customer agrees to negotiate in good faith with Stentor if Stentor
reasonably proposes such a consolidation of Server Hardware to a single server
accessed by multiple Facilities and such consolidation will not result in
degradation of services or performance. In addition, if Customer adds a
Facility, Customer will use reasonable commercial efforts to enable such
Facility to access the System via Server Hardware already installed at an
existing Facility.

      3.5 Network, Email, and Physical Access to Server Hardware.

            (a) Consistent with Customer's reasonable security requirements,
Customer shall provide remote network access to the Server Hardware to enable
Stentor to monitor, maintain, upgrade and support the System. Customer shall
provide Stentor with the necessary security information to access the Server
Hardware over a network.

            (b) Customer shall allow outgoing e-mail from the Server Hardware
consistent with Customer's reasonable security requirements either through
Customer's SMTP e-mail services or shall allow the Server Hardware to access the
Stentor SMTP e-mail service. Email access is required in order for Stentor to
monitor, maintain, upgrade and support the System.

            (c) Upon reasonable advance notice, Customer shall provide Stentor
personnel or subcontractors with physical access to all Server Hardware to
support, maintain and upgrade such Server Hardware.

      3.6 No Modification of Server Hardware. Customer may not modify, relocate,
or install third-party software on the Server Hardware without Stentor's prior
written consent.

      3.7 Modalities. A "Modality" means a device used to capture medical images
in a DICOM 3.0 format or in a generally accepted industry standard format that
is a successor to the DICOM 3.0 format. Each Customer Modality connected to the
System must have a published DICOM 3.0 (or successor industry standard)
conformance statement. Stentor will provide connectivity testing for all
Modalities without charge. Stentor will not validate the quality of the data
generated by Customer Modalities. Stentor will confirm that the Modality will
connect to the System and the System will be able to store and display the data
as delivered by the Modality. Stentor will cooperate with Customer's Modality
vendors without charge to troubleshoot any Modality connectivity issues.

      3.8 Print Capabilities. Customer must retain film print capabilities for
use in the event of a catastrophic failure of the System.

      3.9 Return of Server Hardware. Upon expiration or termination of the
Agreement, Customer shall return the Server Hardware in the same condition as
when received by Customer, reasonable commercial wear and tear excepted.

4     RESTRICTIONS ON SYSTEM USE

      4.1 Diagnostic Use. iSite Radiology is the only Stentor product provided
for diagnostic use as of the Effective Date. Customer may only use iSite
Radiology for diagnostic purposes if Customer's diagnostic workstations utilize
diagnostic quality monitors (as determined by Customer) and Customer maintains
the diagnostic quality monitors in accordance with the monitor manufacturer's
specifications. Additional Applications are subject to FDA approval before they
may be used for diagnostic purposes. Customer undertakes any diagnostic use of
the System other than as described above at its own risk and responsibility.

      4.2 Restrictions on Use of Stentor Software. Customer shall not:

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            (a) decompile, reverse engineer, disassemble or otherwise reduce the
Stentor Software to a human perceivable form or permit any other party to do so;

            (b) sublicense, lease, rent, loan, time-share, operate as a service
bureau or otherwise distribute or otherwise provide access to the Service to
anyone other than Authorized Users; or

            (c) remove, modify or obscure any copyright, trademark or other
proprietary rights notices that appear on the Stentor Software or that appear
during the use of the Stentor Software.

5     THIRD PARTY HARDWARE AND SOFTWARE REQUIREMENTS

      N/A as of the Effective Date

6     NETWORK

      6.1 Customer Network Requirements. Customer must provide a switched
100Mbit local area network for iSite Radiology Client Software and a switched
10Mbit local area network for iSite Enterprise Client Software.

7     IMPLEMENTATION

      7.1 Cooperation. The parties shall use commercially reasonable efforts and
work in good faith to implement any additions to the System in accordance with
an implementation timetable to be mutually agreed upon at a project initiation
workshop. The Stentor implementation services shall be provided to Customer at
no additional expense unless expressly stated otherwise in this Agreement.

      7.2 Customer requirements. Customer shall provide the following resources

      (a)   Customer shall provide a dedicated project manager to act as a
            single point of contact with authority to make decisions and execute
            documents on behalf of Customer. The Customer project manager is:

                  Customer Project Manager:

                  Name:
                  Title:
                  Address:

                  Telephone:
                  Fax:
                  Email:

      (b)   Customer shall provide an HL7 feed from Customer's RIS to be
            integrated with the System.

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                                    EXHIBIT B

                  INSTALLATION AND ENVIRONMENTAL SPECIFICATIONS

             ISITE ENTERPRISE, ISITE RADIOLOGY, & IVAULT 42U MODULE
                           ENVIRONMENTAL REQUIREMENTS

                            QA4.09-16 - REV. 12/20/01

<TABLE>
<CAPTION>
DIMENSIONS                        TOTAL CABINET                            SHIPPING
<S>                            <C>                                     <C>
Height                         79.5 in/202 Cm                          85.5 in/220 Cm
Depth                          43.3 in/110 Cm                          50 in/129 Cm
Width                          25.6 in/68 Cm                           32 in/92 Cm
Weight                         2042 lbs/930 kg (Max. w/UPS)            2500 lbs/1136 kg (Max. w/UPS)
</TABLE>

-     Physical space required for Operation & Service:
      The server will require a minimum unrestricted working space of
      82 in/211 Cm x 42 in/108 Cm.

-     Building structural requirements:
      See weight above.

-     Raised floor requirements:
      See weight above.

-     Power requirements:

INPUT REQUIREMENTS WITHOUT UPS

Range Line Voltage         90 to132 VAC
Nominal Line Voltage       220 to 240 VAC
Rated Input Current        2 30A (220V) NEMA L6-30R Twist lock receptacles
Rated Input Frequency      50 to 60 Hz
Rated Input Power          1850W
BTU RATING                 13,500 BTU/HR

INPUT REQUIREMENTS WITH UPS OR WHEN CUSTOMER REQUIRES 30 AMP POWER

Range Line Voltage         180 to 265 VAC
Nominal Line Voltage       220 to 240 VAC
Rated Input Current        2 30A (220V) NEMA L6-30R Twist lock receptacle
Rated Input Frequency      50 to 60 Hz
Rated Input Power          1850W
BTU RATING                 13,740 BTU/HR

-     Power conditioning requirements, including the need for UPS None. UPS will
      be supplied if location does not have provided UPS power to server
      location.

-     Air-conditioning requirements

TEMPERATURE RANGE

Operating                  50(degree)to 95(degree)F/10(degree)to 35(degree)C
Shipping                   - 22(degree)to 122(degree)F/ - 30(degree)to
                           50(degree)C

RELATIVE HUMIDITY
      (non-condensing)
                Operating                 8% to 90%
                Non-operating             5% to 95%

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MAXIMUM WET BULB TEMPERATURE

                101.7(degree)F/38.7(degree)C

THERE ARE NO SPECIAL REQUIREMENTS FOR EXHAUST, WATER, WASTE OR CHEMICAL

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                                    RIDER SL

                             SERVICE LEVEL AGREEMENT

1.    CUSTOMER SUPPORT

      1.1 General. Stentor strives to deliver world-class customer support.
Customer and Stentor must work together in order to achieve the most effective
support.

      1.2 Support Hours. The Stentor customer support center is available 24
hours per day 7 days per week via telephone at 877-328-2808.

      1.3 Customer Requirements. Stentor's provision of customer support is
conditioned upon the following Customer requirements:

            (a) Customer Personnel. Customer must staff a system administrator
to serve as the primary Customer technical contact for the System.

            (b) Training. Customer must ensure that Customer's Authorized Users
are properly trained in the use and operation of the Stentor Software.

            (c) System Access. Customer must provide Stentor with 24x7 direct
VPN access to all Server Hardware. Additionally, the Customer must provide
Stentor with administrator access to all Stentor Software and Third Party
Software that exist on all Server Hardware. Customer will provide Stentor with
24x7 contact information for a system administrator in case on-site assistance
is necessary to resolve a critical issue. Customer will also provide Stentor
with a direct dial-in (via 56K modem) solution to access all Server Hardware.

            (d) Software Updates. Stentor supports the current product release
and one prior product release. A prior product release is the most recent
product release with a lower release number than the current product release.
Stentor shall support the prior release for at least 90 days after the date of
the subsequent release to permit Customer reasonable time to implement and test,
and train staff with respect to, the new release, and up to a period of 180 days
in the event that the new release materially changed the functionality of the
System and Customer requires time to develop enhancements through use of the
System's open API structure. In any event, if a Critical bug (as defined below)
is reported for the new version during the foregoing 90 or 180 notice periods,
Stentor will continue to support the prior version(s) until after Stentor has
resolved such Critical bug in the new version.

1.4   Issue Levels.

            ISSUE TYPE

                  -     QUESTION: Any inquiry about the basic functionality of
                        the Stentor Software

                  -     PROBLEM: A non-critical issue in which the Stentor
                        Software is not working as it was designed (as described
                        in the applicable Documentation), but does not prohibit
                        the Customer from performing critical functions.

                  -     REQUEST: a need for additional or modified Stentor
                        Software capabilities or Stentor services (e.g., a
                        custom interface, System Manager training).

      1.5 Response Times.

<TABLE>
<CAPTION>
ISSUE TYPE             PRIORITY                                    RESPONSE
----------             --------         ------------------------------------------------------------------------
<S>                    <C>              <C>
Problem                Critical         Stentor acknowledges receipt and begins diagnosis and resolution within
                                        [**] and communicates the status of the problem to the Customer.
                                        Stentor applies continuous, sustained effort on a twenty-four by seven
                                        basis until the criticality is resolved.  If the criticality can only be
                                        diminished by a code change, Stentor considers hot-fix solutions.
</TABLE>

Stentor Rider BA v1.0  9/2/04                                      Page 25 of 29

<PAGE>

<TABLE>
<S>                    <C>              <C>
                       High             Stentor acknowledges the receipt and
                                        begins diagnosis and resolution within
                                        [**] and communicates the status of the
                                        problem with an update within 8 business
                                        hours. Stentor applies continuous,
                                        sustained effort on a twenty-four by
                                        seven basis until the criticality is
                                        resolved.

                       Medium           Stentor acknowledges receipt within [**]
                                        and enters a note with the assigned
                                        support team. If the problem results in
                                        the need for a Stentor Software
                                        correction, Stentor queues the issue for
                                        Development to evaluate for inclusion in
                                        a future Release.

                       Low              Stentor acknowledges receipt within [**]
                                        and enters a note with the assigned
                                        support team.

*Question              All              Responsiveness is on a case-by-case basis.

*Request               All              Due to the varying nature of these service requests, responsiveness and
                                        resolve time for additional service requests are on a case-by-case
                                        basis.  The Customer should submit the request with as much advance
                                        notice as possible, providing responsiveness expectations within the
                                        request for the Stentor support center to use as a guideline.  Factors
                                        for responsiveness for these additional service requests include current
                                        software/system support activities, other scheduled service requests,
                                        and the urgency of the request within the Customer's deployment plans.
</TABLE>

Issues related to image quality resulting from the System (and not caused by the
modalities or workstation monitors) shall be treated as Critical issues. If
these issues are not resolved within [**] ([**]) hours of reporting, the issues
shall be escalated to Stentor's Vice-President of Operations, who shall then be
directly involved in ongoing resolution efforts.

2.    HEARTBEAT SUPPORT

Heartbeat support by the Stentor support center actively monitors Customer
systems, including server and application health indicators. When Heartbeat
support detects a fault, Stentor immediately opens a new trouble ticket in
Stentor's internal support system for resolution.

3     UPTIME WARRANTY

      3.1 Definitions.

      (a) "Unscheduled Downtime" means all time that, solely due to a cause that
originates with the Server Hardware or the Server Software: (i) the Server
Software on a single Server (and any applicable back-up thereof) cannot be
accessed by [**]; or (ii) the Authorized Users are unable to [**]. Unscheduled
Downtime does not include Scheduled Downtime or External Downtime. Measurement
of Unscheduled Downtime begins when Customer notifies Stentor customer support
of the existence of Unscheduled Downtime. Stentor customer support will
immediately issue and log a trouble ticket upon confirmation of Unscheduled
Downtime. Unscheduled Downtime ends when Stentor customer support confirms and
records the resumption time of the availability of the Server Software and/or
receives one heartbeat report back from the Server Hardware confirming Server
Software availability; provided, however, that if a heartbeat report would have
been received but for external problems that prevent the heartbeat report from
reaching Stentor, downtime ends as is reasonably determined by Stentor.

      (b) "Scheduled Downtime" means all time that the Server Software cannot be
accessed due to scheduled maintenance including, but not limited to,
preventative maintenance, updates, upgrades, scheduled reboots and restarts.
Stentor will work with Customer to determine a mutually agreeable time for
Scheduled Downtime; however, in the event that downtime is required to remedy a
critical issue, including without limitation a patient-care issue, FDA
reportable event or HIPAA related issue, Stentor has the sole discretion in
determining the final timing of Scheduled Downtime.

      (c) "External Downtime" means all time that the Server Software cannot be
accessed due to causes beyond Stentor's reasonable control and occurring without
its fault or negligence, including, without limitation,

Stentor Rider BA v1.0  9/2/04                                      Page 26 of 29

<PAGE>

war, terrorism, strikes, fires, floods, acts of God, governmental restrictions,
power failures or surges, disruptions in telephone service or manual shutdowns
by Customer, subject to Stentor's obligations under Section 7.

      3.2 Warranty Commencement. The uptime performance warranty shall apply
during the Term.

      3.3 Uptime Warranty.

      (a) Stentor warrants that the System will be available [**]% of the time
during any given month. Uptime for a given month is measured using the following
formula:

  TOTAL NUMBER OF MINUTES IN THE MONTH - MINUTES OF UNSCHEDULED DOWNTIME X 100%
                      TOTAL NUMBER OF MINUTES IN THE MONTH

      (b)   All time is measured in one-minute increments with fractions
            truncated.

      (c)   One month is defined as a calendar month. For purposes of the uptime
            performance guarantee, a 31-day month has 44,640 minutes, a 30-day
            month has 43,200 minutes, a 29-day month has 41,760 and a 28-day
            month has 40,320 minutes.

      (d)   If a recoverable failure occurs on a redundant component, this event
            shall not be considered Unscheduled Downtime. For example, if one
            RAID volume goes down but the System remains available, then the
            System is not considered to be experiencing Unscheduled Downtime.
            Likewise, if Stentor supplies a cluster of redundant servers and one
            of the servers is unavailable, then that event is not considered
            Unscheduled Downtime so long as the user can access the active
            server.

      (e)   The presence of software on the Server Hardware that has not been
            approved by Stentor invalidates this Uptime Warranty.

      3.4 Discount for Unscheduled Downtime. In the event that Stentor is unable
to meet the Uptime Warranty in a particular month with respect to a specific
Facility, Stentor shall discount a pro-rata portion of that month's portion of
the annual installment of the Fixed Fee as follows:

<TABLE>
<CAPTION>
UPTIME PERFORMANCE                                DISCOUNT
<S>                                               <C>
       [**]                                         [**]
       [**]                                         [**]
       [**]                                         [**]
       [**]                                         [**]
       [**]                                         [**]
</TABLE>

If uptime performance is less than [**]% during any month for any Facility,
Customer's obligation to pay the applicable monthly portion of the annual
installment of the Fixed Fee with respect to such Facility shall be waived.

      3.4 Termination Right. Customer has the right to terminate the Master
Agreement for any affected Facility experiencing, or the Master Agreement as a
whole if [**] or more Facilities experience, either (a) [**]% uptime, or (b) any
[**] months in a [**]-month period at < [**]% uptime. The termination right will
automatically cease if not exercised within thirty (30) days after such
termination event occurs unless such period is extended by mutual agreement to
permit Stentor to attempt to further address the issue.

      3.5 Sole and Exclusive Remedy. This Uptime Warranty is Customer's sole and
exclusive remedy related to System availability.

4.    UPDATES

      4.1 Definition. "Updates" means any patch, fix, upgrade, release or update
to the Stentor Software that Stentor makes generally available to its customers
that are under a service or maintenance contract.

      4.2 Provision of Updates. Stentor shall provide Customer with, and
implement, all Updates during the Term without additional charge.

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<PAGE>

      4.3 Third Party Product Updates. Stentor shall provide Customer with, and
promptly implement, all updates, error corrections, security patches and
releases to any Third Party Products residing on the Server Hardware if and when
provided to Stentor with the right to do so.

5.    TRAINING

      5.1 Training Hours. Stentor shall provide the amount of training mutually
agreed upon by the parties. Such training shall, at a minimum, include
train-the-trainer training with respect to use of all Updates to the System, and
all other Stentor products added to the System after the Effective Date.

      5.2 Training Schedule. Stentor and Customer will determine a mutually
agreeable training schedule for an specific installation. Training shall be
performed by qualified Stentor personnel upon completion of installation.
Customer is responsible for attendance by Customer personnel at scheduled
Stentor training sessions. Scheduled training will not be repeated due to low
attendance or now attendance. Any additional training will be billed at
Stentor's then current time and materials rates plus travel and expenses.

Group training shall be accomplished in groups of no more than 10 trainees.
Individual training shall be done with no more than 3 trainees in one group.
Stentor shall customize training to the specific needs of the user groups
defined below:

Frequent User: Radiologists and other frequent clinical users shall be trained
by Stentor to a high proficiency in all aspects of image retrieval and
manipulation.

Occasional User: Stentor shall train occasional users, such as referring
physicians, to operate workstations. Occasional users will be trained to perform
only basic image retrieval and display.

Radiology Technologist User: Stentor shall train radiology technologist users in
the overall operation of the System with all types of workstations and other
System components.

Support Staff Users: Stentor shall train administrative and support staff on all
System capabilities, especially those relating to fault diagnosis, maintenance
of database, and integrity and performance optimization.

6.    SYSTEM RESPONSE TIME

Stentor warrants that the System will deliver and display the base resolution
image of standard cross-sectional (e.g., CT, MR) single-frame Studies or
standard projection radiography Studies of less than [**]MB (does not include
cine clips) on average in under [**] ([**]) seconds over a [**] minute period,
measured from the time the single exam is selected from the worklist tab or
timeline (the "Performance Warranty"), on the condition that:

      (a) The System is being used under normal use conditions (e.g., excluding
substantial network loads for traffic other than that used for the System); and

      (b) Customer's network is properly configured, and not oversubscribed, as
described below.

The Performance Warranty applies for up to [**] concurrent iSite Radiology users
on a switched 100 Mbit LAN and up to [**] concurrent iSite Enterprise users on a
switched 10 Mbit LAN. "Concurrent users" means the identified number of users
logged on to and using the System simultaneously under normal use conditions as
defined by that type of user.

If the System does not satisfy this Performance Warranty, Customer's sole remedy
and Stentor's exclusive obligation will be for Stentor to (1) begin system
diagnostics within [**] ([**]) hours after receiving notice from Customer, and
(2) to use commercially reasonable efforts to remedy the System to satisfy the
Performance Warranty within [**] ([**]) days after commencing system diagnostics
if the response time is under [**] ([**]) seconds and within [**] ([**]) hours
if the response time is [**] ([**]) seconds or greater. If the System is not
remedied to satisfy the Performance Warranty within those specified timeframes,
the System will be considered to be experiencing Unscheduled Downtime for
purposes of the Uptime Warranty in Section 3 above.

7.    DISASTER RECOVERY / BUSINESS CONTINUITY

      7.1 Backup of Image Data. Stentor shall backup a copy of all image data
from the Server Hardware to a disaster recovery datacenter to enable the
restoration of image data in the event of a loss of data on the Server Hardware.

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<PAGE>

      7.2 Backup of Database. Stentor shall incrementally backup the database
twice per day and perform a full database backup once per week.

      7.3 Disaster Recovery Warranty. In the event of a loss of data on the
Server Hardware Stentor will use commercially reasonable efforts to restore the
most recent persistent storage module within [**] hours of notice of a loss of
data. Stentor will use commercially reasonable efforts to restore each
additional persistent storage module in [**]-hour increments thereafter until
all persistent storage modules have been restored. Notwithstanding any Force
Majeure Event, if Stentor does not restore the data within the foregoing
timeframes, the System will be considered to be experiencing Unscheduled
Downtime for purposes of the Uptime Warranty in Section 3 above.

      7.4 Disaster Recovery Fees. In the event that Stentor performs disaster
recovery services for a loss of data that was not caused by Stentor or a failure
of the System, Customer shall pay Stentor's then current time and materials
rates to rebuild the persistent storage modules. Customer shall pay Stentor all
costs to replace Server Hardware.

      7.5 Verification of Disaster Recovery. Upon Customer's request, Stentor
shall provide Customer with its then current back-up and disaster recovery plan,
and validate the efficacy of the disaster recovery process by demonstrating
restoration of data to a test server.

Stentor Rider BA v1.0  9/2/04                                      Page 29 of 29<PAGE>

                                                                   EXHIBIT 10.15

                     DISTRIBUTION AND DEVELOPMENT AGREEMENT

            THIS AGREEMENT (this "Agreement") is made and entered into as of
November 15, 2000 (the "Effective Date") by and between STENTOR, INC., a
Delaware corporation ("Stentor") and IDX SYSTEMS CORPORATION, a Vermont
corporation ("IDX").

                                   WITNESSETH

            WHEREAS, Stentor is in the business of developing and marketing
products and services to automate the viewing and archiving of medical images;
and

            WHEREAS, IDX, through its Radiology and Imaging Systems Division,
has developed products and services to automate the management of radiology
practices and departments; and

            WHEREAS, IDX and Stentor desire to develop integration between their
current products and services and certain future products and services to be
developed by Stentor and IDX to create a comprehensive, state-of-the-art medical
image management system, initially applicable to radiology practices, but
possibly extended to cardiology, pathology, opthamology, orthopedics, emergency
departments and other similar practices that could make use of the system;

            NOW, THEREFORE, in consideration of these premises, the mutual
covenants and agreements contained herein, and for other good and valuable
consideration, the receipt and sufficiency of which are hereby acknowledged, the
parties agree as follows:

1. DEFINITIONS

      Capitalized terms used in this Agreement, unless otherwise defined in this
Agreement, shall have the meanings ascribed to them on Schedule 1 attached
hereto.

2. TERM AND TERMINATION

      2.1   Term. This Agreement shall be in effect for an initial term of five
            (5) years (the "Initial Term") and shall automatically renew for
            additional, successive two (2) year terms unless earlier terminated
            by either of IDX or Stentor by giving written notice of such party's
            election not to renew this Agreement not later than one (1) year
            prior to the expiration of the Initial Term or six (6) months prior
            to the expiration of any then current successive term.

      2.2   Termination. Notwithstanding the provisions of Section 2.1, this
            Agreement may be terminated:

            2.2.1 by Stentor if IDX shall have defaulted under or breached any
                  material term of this Agreement and shall not have cured such
                  breach within one hundred twenty (120) days after receiving
                  written notice from Stentor specifying the nature of such
                  default or breach; or

                                        1

<PAGE>

            2.2.2 by IDX if Stentor shall have defaulted under or breached any
                  material term of this Agreement and shall not have cured such
                  breach within one hundred twenty (120) days after receiving
                  written notice from IDX specifying the nature of such default
                  or breach; or

            2.2.3 by either party upon receipt of a notice from the other party
                  that such other party requires a composition or other similar
                  arrangement with creditors, files for bankruptcy or is
                  declared bankrupt.

      2.3   Termination of Restrictions.

            2.3.1 Stentor may elect to terminate Section 6.1.1, as its sole and
                  exclusive remedy in lieu of any damages under this Agreement,
                  if:

                  2.3.1.1 a Material Adverse Change occurs with respect to II)X;
                          or

                  2.3.1.2 IDX fails, for any two (2) consecutive calendar years,
                          to meet the minimum sales goals of sales of the MIMS
                          System to IDXrad Customers or LastWord Customers set
                          forth in Exhibit C and as may be agreed to and set
                          forth in the Marketing Plan.

            2.3.2 If IDX fails after March 31, 2002, to meet the mutually agreed
                  to goals of sales of the MIMS System to IDXrad Customers for a
                  calendar quarter as set forth in the Marketing Plan and does
                  not cure such failure by the end of the next calendar quarter
                  by licensing a MIMS System to that number of IDXrad Customers
                  equal to the sum of the number of IDXrad Customers by which
                  IDX missed the goal plus the goal for the subsequent calendar
                  quarter, then Stentor may elect to terminate Section
                  6.1.1(ii), as its sole and exclusive remedy in lieu of any
                  damages under this Agreement

            2.3.3 If any of [**] is acquired, becomes Controlled by, obtains
                  Control of, or becomes under common Control with a Person that
                  is or becomes authorized to be a distributor of the MIMS
                  System by Stentor as permitted under this Agreement, and such
                  company demonstrates its intention to permanently cease doing
                  business under or market its products under a name or mark
                  similar to [**], as applicable, then Stentor may terminate
                  Section 6.1.1(ii) only with respect to [**] as applicable.

            2.3.4 IDX may elect to terminate Section 6.1.2, as its sole and
                  exclusive remedy in lieu of any damages under this Agreement,
                  if:

                  2.3.4.1 a Material Adverse Change occurs with respect to
                          Stentor; or

                  2.3.4.2 IDX fails, for any two (2) consecutive calendar years,
                          to meet the minimum sales goals of sales of the MIMS
                          System to IDXrad

                                        2

<PAGE>

                          Customers or LastWord Customers set forth in the
                          Exhibit C and as may be agreed to and set forth in
                          the Marketing Plan.

      2.4   Change of Control. If Stentor shall sell all or substantially all of
            its assets or IDX shall sell all or substantially all of the assets
            of its Radiology Information Systems Division business, then upon
            the election of the other party, the party selling its assets shall
            be obligated to assign this Agreement to the successor to its assets
            and to cause such successor to assume its performance under this
            Agreement. Regardless of whether this Agreement is assigned, the
            party not selling its assets may elect to terminate the Agreement
            upon not less than eighteen (18) months prior written notice.

      2.5   Effect of Termination; Survival. In the event that this Agreement is
            validly terminated as provided herein, then each of the parties
            shall be relieved of their duties and obligations arising under this
            Agreement after the date of such termination, except for their
            respective obligations to provide support services to existing
            customers under Section 8.1, and such termination shall be without
            liability to the terminating party; provided, however, that the
            obligations of the parties set forth in Sections 8.1, 9.1, 9.2, 10.1
            - 10.21 hereof shall survive any such termination and shall be
            enforceable hereunder; provided, further, however, that nothing in
            this Section 2.5 shall relieve Stentor or IDX of any liability for a
            breach of this Agreement. Furthermore, termination of this Agreement
            shall not affect i) any license or subscription rights granted by
            either party prior to such termination or ii) a party's right to
            continue providing services pursuant to customer agreements entered
            into prior to such termination, provided, however, that each party
            shall continue to make payments pursuant to Section 7.

      2.6   Intellectual Property. All rights and licenses granted under or
            pursuant to this Agreement are, and shall otherwise be deemed to be,
            for purposes of Section 365(n) of the United States Bankruptcy Code
            (the "Code"), licenses to rights to "intellectual property" as
            defined in the Code. A party receiving such rights under this
            Agreement shall retain and may fully exercise all of its rights and
            elections under the Code. The parties further agree that, in the
            event of the commencement of a bankruptcy proceeding by or against a
            party under the Code, the other party shall be entitled to retain
            all of its rights under this Agreement.

3. OPERATIONAL MANAGEMENT

      Stentor and IDX shall each appoint an executive with the title of vice
president or higher to oversee performance under this Agreement. These two
executives shall meet not less frequently than once each calendar quarter during
the Initial Term (and more frequently as needed) and shall produce not later
than five (5) business days after the end of each such calendar quarter a
written report to the boards of directors of IDX and Stentor setting forth in
detail:

      3.1   the accomplishments of Stentor and IDX during the preceding calendar
            quarter in performing this Agreement;

                                        3

<PAGE>

      3.2   plans for managing the relationship between IDX and Stentor during
            the next calendar quarter;

      3.3   any items of dispute or disagreement between IDX and Stentor;

      3.4   plans for resolving any dispute or disagreement between DX and
            Stentor;

      3.5   any changes proposed to be made to the Marketing Plan or Development
            Plan; and

      3.6   such other items as may be deemed appropriate by such executives.

4. PRODUCT DEVELOPMENT

      4.1   Product Development.

            4.1.1 Development of the MIMS System. It is the goal of this
                  Agreement that the parties shall use their commercially
                  reasonable efforts to develop a comprehensive,
                  state-of-the-art medical image management system for radiology
                  practices and departments with functionality and features
                  substantially equivalent or superior to any competitive
                  medical image management system available during the term of
                  this Agreement. To accomplish that goal, Stentor and IDX shall
                  carry out their obligations to develop the MIMS System
                  pursuant to the Development Plan. A party's material failure
                  to deliver a minimum development requirement (as set forth on
                  Exhibit A) by a milestone set forth in the Development Plan
                  shall constitute a material breach of this Agreement.

            4.1.2 Joint Testing. The parties shall cooperate to jointly test any
                  software used in connection with the MIMS System to ensure the
                  functionality of such software prior to distribution thereof
                  to any customer.

            4.1.3 Development Plan. Within thirty (30) days of the Effective
                  Date, IDX and Stentor shall mutually develop the Development
                  Plan, which shall contain minimum development requirements
                  described on the Development Plan Outline, attached hereto as
                  Exhibit A. IDX and Stentor shall update the Development Plan
                  every calendar quarter during the term of this Agreement
                  unless earlier updated as necessary to maintain the commercial
                  reasonableness thereof. The Development Plan, as updated from
                  time to time, shall describe activities and responsibilities
                  for one-year periods initially commencing on the Effective
                  Date. Not later than three (3) months prior to the expiration
                  of the initial one-year term of the Development Plan, and
                  thereafter not later than three (3) months prior to the
                  expiration of each successive one-year period, the parties
                  shall commence work on a revised Development Plan for the
                  following one-year period. The Development Plan, as updated
                  from time to time, including updating of the minimum
                  development requirements, shall be executed by the parties and
                  shall become subject to this Agreement.

                                        4

<PAGE>

                  Should the parties have failed to agree upon and execute a
                  revised or updated Development Plan at the time of the
                  expiration of the then current Development Plan, the parties
                  shall continue to perform under the terms of the then current
                  Development Plan until such time as the parties shall agree
                  upon a revised Development Plan. Notwithstanding anything
                  contained herein or in any Development Plan to the contrary,
                  at all times during the Term, Stentor shall continue to fund
                  the development and support of the iSite Viewer, iDiagnostic
                  Viewer and iVault products as provided in the Development Plan
                  as initially adopted, and DX shall continue to develop and
                  support Imaging Suite, ConnectR, and the Imaging Suite Lite
                  Version as provided in the Development Plan as initially
                  adopted.

            4.1.4 Early Releases and Testing. DX and Stentor shall deliver to
                  each other for testing, development and integration purposes
                  only, copies of the earliest test releases of all development
                  deliverables provided for in the Development Plan prior to
                  delivery thereof to any other customers or Distribution
                  Partners.

            4.1.5 Demonstration Products. Each party shall develop demonstration
                  versions of its products for use in selling its products to
                  the other party's customers and prospects.

            4.1.6 Resolution of Programming Errors. Stentor shall be responsible
                  for correcting all programming errors in Stentor Products, and
                  IDX shall be responsible for correcting all programming errors
                  in IDX Products. The Development Plan shall designate Stentor
                  and IDX personnel to coordinate the resolution of any
                  programming errors. To accomplish this goal, Stentor and IDX
                  agree to resolve programming errors as follows:

                  Category 1 Programming Error: A Category 1 Programming Error
                  is an error that causes the software to fail to operate. If a
                  category 1 programming error occurs in the MIMS System
                  software, IDX and Stentor agree to conduct a conference call
                  in an effort to resolve the error as soon as possible but no
                  later than one business day.

                  Category 2 Programming Error: A Category 2 Programming Error
                  is an error that substantially affects the proper operation of
                  the main functions of the MIMS System software but does not
                  cause the software to fail to operate. If a Category 2
                  Programming Error occurs, IDX and Stentor agree to conduct a
                  conference call in an effort to resolve the error as soon as
                  possible but no later than one week.

                  Category 3 Programming Error: A Category 3 Programming Error
                  causes the software to function incorrectly under a particular
                  set of circumstances, although the error does not
                  substantially affect the proper operation of the main
                  functions of the MIMS System. If a Category 3

                                        5

<PAGE>

                  Programming error occurs, the party responsible for the
                  programming error agrees to eliminate the programming error in
                  the next software update of the MIMS System.

5. LICENSES AND OWNERSHIP

      5.1   Ownership; In General. Except for the rights expressly granted
            herein to Stentor, IDX reserves and retains all right, title and
            interest (including without limitation patents, trade secrets and
            copyrights) in the IDX Products, and all customizations, additions,
            modifications, changes, enhancements, improvements, and derivative
            works thereof made by IDX or on behalf of IDX, and all rights
            therein and copies thereof. Except for the rights expressly granted
            herein to IDX, Stentor reserves and retains all right, title and
            interest (including without limitation patents, trade secrets and
            copyrights) in the Stentor Products, and all customizations,
            additions, modifications, changes, enhancements, improvements, and
            derivative works thereof made by Stentor, or on behalf of Stentor,
            and all rights therein and copies thereof

      5.2   Ownership to works created under the Development Plan. Any
            Intellectual Property developed by Stentor and any derivative works
            of Stentor Products, whether developed by Stentor, IDX or a
            contractor of either party, pursuant to the Development Plan shall
            be owned by Stentor. Any Intellectual Property developed by IDX and
            any derivative works of IDX Products, whether developed by Stentor,
            IDX or a contractor of either party, pursuant to the Development
            Plan shall be owned by IDX. Any Intellectual Property jointly
            developed by IDX and Stentor pursuant to the Development Plan shall
            be jointly owned by IDX and Stentor and each of IDX and Stentor
            shall be free to use such Intellectual Property without interference
            from the other party and without any obligation to pay any royalties
            or account for any profits, except as otherwise provided for in this
            Agreement. Notwithstanding the foregoing, the parties shall jointly
            own any and all patent rights to any work created pursuant to the
            Development Plan that combines at least one component of the IDX
            Products and one component of the Stentor Products and shall
            cooperate in the filing of any application(s) related to such
            rights, including, without limitation, the choice of counsel to
            prosecute such application(s). Nothing in this Agreement shall
            require either party to create any Intellectual Property not a part
            of the MIMS System. If either party creates any Intellectual
            Property that is not a part of the MIMS System, but may be used in
            connection with the MIMS System without the material assistance of
            the other party, the creating party shall own any and all patent
            rights to the combination of such Intellectual Property and the MIMS
            System, and such patent rights shall not be licensed to the other
            party under this Agreement except by written amendment hereto
            executed by both parties; provided that each party hereby agrees
            that if it offers to license the right to resell or sublicense any
            such Intellectual Property and the patent rights, if any, thereto,
            to any Person, it shall offer to license the right to resell or
            sublicense such Intellectual Property and patent rights, if any, to
            the other party on the most favorable terms offered to any other
            Person.

                                        6

<PAGE>

      5.3   IDX Products.

            5.3.1 IDX hereby grants to Stentor a non-exclusive, non-transferable
                  (except as provided in Sections 2.4 and 10.14) term license to
                  market and sublicense, and in connection therewith to sell,
                  offer for sale, copy, use, distribute, perform, display,
                  modify, make derivative works of and Merge, the IDX Products,
                  in whole or in part, only as they may be Merged into the MIMS
                  System, and only to Persons that are not Stentor License
                  Exclusion Customers. Stentor License Exclusion Customers
                  include all IDXrad Customers and LastWord Customers except:
                  (i) any IDXrad Customer or LastWord Customer that is a
                  Pre-existing Stentor Customer; (ii) any IDXrad Customer or
                  LastWord Customer that does not use IDXrad or LastWord as
                  their primary radiology information system or primary clinical
                  information system, respectively; and (iii) any IDXrad
                  Customer or LastWord Customer that becomes a Stentor Customer
                  prior to becoming an IDXrad Customer or LastWord Customer.
                  Notwithstanding the limited scope of this license, Stentor may
                  communicate with, and demonstrate, perform and display the
                  MIMS System to, Stentor License Exclusion Customers to make
                  them aware of the availability of the MIMS System from IDX and
                  to provide information to Stentor License Exclusion Customers
                  regarding the MIMS System. Stentor License Exclusion Customers
                  that exist as of the Effective Date are listed on the initial
                  Stentor License Exclusion Customer List, attached hereto as
                  Exhibit B. IDX shall provide an updated Stentor License
                  Exclusion Customer List to Stentor within fifteen (15) days of
                  the end of each calendar quarter. If the parties determine
                  that any customers not listed on the initial Stentor License
                  Exclusion Customer List meet the definition of a Stentor
                  License Exclusion Customer, then any such customers shall be
                  added to the Stentor License Exclusion Customer List, or if
                  the parties determine that any customers listed on the initial
                  Stentor License Exclusion Customer List do not meet the
                  definition of a Stentor License Exclusion Customer, then any
                  such customers shall be removed from the Stentor License
                  Exclusion List.

            5.3.2 IDX also hereby grants to Stentor a non-exclusive,
                  non-transferable (except as provided in Sections 2.4 and
                  10.14) term license to sublicense one or more Distribution
                  Partners to market and sublicense, and in connection therewith
                  to sell, offer for sale, copy, use, distribute, perform, and
                  display, the IDX Products, in whole or in part, only as they
                  may be Merged into the MIMS System, to any Person, including
                  Stentor License Exclusion Customers.

      5.4   Stentor Products. Stentor hereby grants to DX a non-exclusive,
            non-transferable (except as provided in Sections 2.4 and 10.14) term
            license to market and sublicense (including through one or more
            Distribution Partners acceptable to Stentor), and in connection
            therewith to sell, offer for sale, copy, use, distribute, perform,
            display, modify, make derivative works of and Merge, the Stentor

                                        7

<PAGE>

            Products, in whole or in part, only as they may be Merged into the
            MIMS System. From the Effective Date until December 31, 2001,
            Stentor's license granted to IDX in Section 5.4 only extends to
            IDXrad Customers and LastWord Customers. IDXrad Customers and
            LastWord Customers that exist as of the Effective Date are listed on
            the initial IDXrad and LastWord Customer List, attached hereto as
            Exhibit B. Any Person that becomes an IDXrad Customer or LastWord
            Customer during the Term shall be added to the IDXrad and LastWord
            Customer List. After December 31, 2001, Stentor's license granted to
            IDX in Section 5.4 extends to any Person. IDX shall provide an
            updated IDXrad and LastWord Customer List to Stentor within fifteen
            (15) days of the end of each calendar quarter. If the parties
            determine that any customers listed on the initial IDXrad and
            LastWord Customer List fail to meet the definition of an IDXrad
            Customer or LastWord Customer, then such customers shall be removed
            from the IDXrad and LastWord Customer List, or if any customers not
            listed on the initial IDXrad and LastWord Customer List do meet the
            definition of an IDXrad Customer or LastWord Customer, then such
            customers shall be added to the IDXrad and LastWord Customer List.

      5.5   Territory. This Agreement and the licenses granted hereunder shall
            apply to the parties only in the [**] (the "Territory"); provided
            that, notwithstanding any restriction to the contrary in this
            Agreement, Stentor may enter into an Agreement with another Person
            to Provide a medical imaging management system for radiology
            practices and departments (that is not the MIMS System) in the [**]
            if (i) it is necessary for Stentor to do so in order for Stentor to
            enter into an agreement encompassing other [**] countries that are
            not at that time included in the Territory and (ii) Stentor offers
            IDX the same terms offered any other Person in the [**] if such
            terms are more favorable than the terms offered hereunder. Neither
            party may distribute or sell the MIMS System in any country not
            included in the Territory without the written consent of the other,
            which shall not be unreasonably withheld. If a party desires to
            extend the Territory to another country, it shall give the other
            party written notice of its request to do so. The party requested to
            extend the Territory to another country shall have one month from
            the date of its receipt of such written notice to elect to extend
            its performance and six months from such election to implement any
            development or business requirements necessary to extend its
            performance under this Agreement to such country. If a party
            withholds its consent, then the other party may enter into an
            agreement with any other Person with respect to the development and
            distribution and sale of a system similar to the MIMS System in such
            country; provided that this Agreement shall remain in full force and
            effect in the Territory.

      5.6   Expansion of Licenses.

            5.6.1 If Stentor notifies IDX that a Stentor License Exclusion
                  Customer is interested in licensing a MIMS System, but not
                  from IDX, then a representative of Stentor's senior management
                  who is at least a Vice President and a representative of IDX's
                  senior management who is at least

                                        8

<PAGE>

                  a Vice President shall jointly contact that Stentor License
                  Exclusion Customer in regard to licensing a MINIS System. If
                  the Stentor License Exclusion Customer does not express an
                  interest in licensing a MIMS System from IDX within thirty
                  (30) days of such joint contact, as determined by a subsequent
                  joint contact by the Stentor and IDX representatives, then
                  such customer shall not be considered an Stentor License
                  Exclusion Customer for purposes of the limitation on the
                  license granted to Stentor in Section 5.3.1 of this Agreement.

            5.6.2 If at the end of any calendar year the number of IDXrad
                  Customers that became IDXrad Customers in that year that have
                  also licensed a MIMS System is less than [**] percent [**]% of
                  the total number of IDXrad Customers that became IDXrad
                  Customers in that year, then the new IDXrad Customers that
                  have not also licensed a MIMS System shall not be considered
                  Stentor License Exclusion Customers for purposes of the
                  limitation on the license granted to Stentor in Section 5.3.1
                  of this Agreement.

            5.6.3 If, prior to December 31, 2001, IDX notifies Stentor that a
                  Person that is neither an IDXrad Customer or LastWord Customer
                  is interested in licensing a MIMS System, but not from
                  Stentor, then a representative of Stentor's senior management
                  who is at least a Vice President and a representative of IDX's
                  senior management who is at least a Vice President shall
                  jointly contact that prospect in regard to licensing a MIMS
                  System. If the prospect does riot express an interest in
                  licensing a MIMS System from Stentor within thirty (30) days
                  of such joint contact, as determined by a subsequent joint
                  contact by the Stentor and IDX representatives, then the
                  license granted to IDX pursuant to Section 5.4 shall extend to
                  such prospect

6. MARKETING OF THE MIMS SYSTEM

      6.1   Certain Restrictions on Marketing Rights.

            6.1.1 Restrictions on Stentor. Stentor shall not (i) Provide to any
                  Person located in the Territory a medical imaging management
                  system for radiology practices or departments other than the
                  MIMS System; or (ii) authorize or license [**], or the
                  successor of any of them, to Provide the MIMS System or the
                  Stentor Products in the Territory. If in a particular
                  instance, the use of ConnectR in the MIMS System as a means to
                  provide data exchange between the MIMS System and a non-IDX
                  system would be technologically impractical, then Stentor may
                  modify the MIMS System in such instance to use a component
                  other than ConnectR as a means to provide such data exchange.
                  The restriction set forth in this Section 6.1.1(i) shall not
                  apply to (a) Stentor's sale or license of the Stentor
                  Component Technology to the extent that the Stentor Component

                                        9

<PAGE>

                  Technology is not used in a medical imaging management system
                  that includes substantially similar functionality to the MIMS
                  System or (b) Stentor's sale or license to non-IDXrad
                  Customers and non-LastWord Customers of a version of iSite
                  that contains only the workflow, worklist and API
                  functionality of the current iSite version 1.1.1 offering
                  (i.e. it shall contain no third party vendor workflow or
                  reconciliation built into iSite), and that cannot be used by a
                  third party to build functionality competitive to the MIMS
                  System other than the functionality substantially similar to
                  that contained in the current iSite version 1.1.1.

            6.1.2 Restrictions on IDX. IDX shall not (i) Provide to any Person
                  located in the Territory a medical imaging management system
                  for radiology practices or departments other than the MIMS
                  System, except that this restriction shall not prohibit IDX
                  from cooperating with any Person that Provides products and
                  services similar to the Stentor Products for the purpose of
                  deploying such products and services to implement a medical
                  imaging management system, on a case-by-case basis to any
                  IDXrad Customer or LastWord Customer, including without
                  limitation by development of data exchange or interfaces, if
                  such IDXrad. Customer or LastWord Customer requests IDX to do
                  so; (ii) Provide Imaging Suite to any Person in the Territory
                  except (A) IDXrad Customers or LastWord Customers and (B) IDX
                  Customers other than IDXrad Customers and LastWord Customers
                  to enable other IDX products to distribute medical images, if
                  only a subset of the components of Imaging Suite is used and
                  the subset of components operates as a background service,
                  such that there is no display of the Imaging Suite brand to
                  the customer; or (iii) market the MIMS System except through
                  IDX's RISD sales organization or with the active involvement
                  of a member of IDX's RISD sales organization in any creation
                  of a sales quote, configuration, or sales demonstration.

            6.1.3 Imaging Suite Workflow Engine. The restrictions contained in
                  Section 6.1.2 shall not apply to the "workflow engine"
                  component of the Imaging Suite when used or licensed by IDX
                  separate from the other components of Imaging Suite as Merged
                  with any other MX application and without the display of the
                  Imaging Suite brand.

      6.2   Marketing Plan; Joint Marketing Duties.

            6.2.1 Marketing Plan. Within thirty (30) days of the Effective Date,
                  IDX and Stentor shall mutually develop and, during the Term,
                  shall regularly update a marketing plan for marketing the MIMS
                  System in general (the "Marketing Plan"). The Marketing Plan
                  shall obligate IDX to make commercially reasonable efforts to
                  make presentations about the MIMS System to appropriate
                  representatives of all of IDX's IDXrad Customers and LastWord
                  Customers before December 31, 2001, and shall describe
                  detailed activities and responsibilities (including without
                  limitation, with respect to implementation) and sales
                  forecasts over the initial two-year

                                       10

<PAGE>

                  period of this Agreement, but shall be updated not less
                  frequently than every three (3) months. Not less than three
                  (3) months prior to the expiration of the initial two-year
                  period, and thereafter three (3) months prior to the
                  expiration of each successive two-year period of the Initial
                  Term, the parties shall commence work on a revised Marketing
                  Plan for the following two-year sales forecast period. The
                  initial and each revised two-year Marketing Plan shall be
                  executed by the parties and shall be subject to the terms of
                  this Agreement. Should the parties have failed to agree upon
                  and execute a revised Marketing Plan at the time of the
                  expiration of the then current Marketing Plan, the parties
                  shall continue to perform under the terms of the then current
                  Marketing Plan until such time as the parties shall agree upon
                  a revised Marketing Plan. When marketing the MIMS System to
                  IDXrad Customers and LastWord Customers, IDX shall be
                  responsible for hardware used during any pilot period offered
                  by IDX. The Marketing Plan shall include sales goals for sales
                  of the MIMS System to IDXrad Customers as set forth on Exhibit
                  C.

            6.2.2 Joint Marketing Materials. At their joint expense, shared
                  equally, Stentor and IDX shall develop and produce product
                  marketing documentation and materials similar in kind and
                  quality to that currently provided by Stentor and DX to their
                  respective sales prospects for the purpose of promoting and
                  marketing the M]MS System.

            6.2.3 User Groups and Trade Shows. Stentor shall provide for
                  featured participation by IDX at Stentor's user group meetings
                  involving the Stentor Products, and IDX shall provide for
                  featured participation by Stentor at IDX's user group meetings
                  involving the IDXrad and LastWord products. In accordance with
                  the Marketing Plan, Stentor and IDX shall publicize the
                  alliance created hereby at appropriate trade shows.

            6.2.4 Non-revenue Arrangements. IDX and Stentor shall each cooperate
                  with the other on any non-revenue generating implementations
                  of the MIMS System for public relations or research purposes,
                  provided that neither party shall be obligated to provide any
                  implementation or support services for a non-revenue
                  generating implementation initiated by the other party.

      6.3   Use of Stentor Names and Marks. IDX may use the following names and
            marks in all customer communications pertaining to the marketing,
            support and distribution of the MIMS System and in accordance with
            Stentor's reasonable branding standards in effect from time to time:
            Stentor, iSite, iSyntax, and DTS. IDX shall use the mark "Stentor"
            and applicable Stentor Product marks, without alteration of the
            graphical representation of such marks specified by Stentor, in
            connection with all sales of the MIMS System containing any Stentor
            Products in addition to any other marks or tradenames that IDX
            chooses to use in connection with the MIMS System. Stentor shall
            provide to IDX, for IDX's use in accordance with this Section,
            additional proprietary trademarks, as developed, for the Stentor
            Products.

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<PAGE>

      6.4   Use of IDX Names and Marks. Stentor may use the following names and
            marks in all customer communications pertaining to the marketing,
            support and distribution of the MIMS System and in accordance with
            IDX's reasonable branding standards in effect from time to time:
            Imaging Suite and ConnectR. Stentor shall use the mark "Imaging
            Suite", without alteration of the graphical representation of such
            mark specified by IDX, in connection with all sales of the MIMS
            System and Stentor Products containing the Imaging Suite in addition
            to any other marks or tradenames that Stentor chooses to use in
            connection with the MIMS System and Stentor Products. IDX shall
            provide to Stentor, for Stentor's use in accordance with this
            Section, additional proprietary trademarks, as developed, for the
            IDX Products.

      6.5   License Terms. Each party shall have the authority, to the extent
            expressly provided in this Agreement, to market, sell, resell and
            distribute the MIMS System pursuant to its own terms and conditions
            so long as such terms and conditions contain provisions as
            protective of the other party as those set out in Exhibit D. Each
            party shall obligate its Distribution Partners to license the MIMS
            System under terms that are protective as those set forth in Exhibit
            D.

7. COMPENSATION

      7.1   Compensation; Payment. IDX and Stentor shall be entitled to
            compensation for their respective licensing to the other of their
            respective rights and technology incorporated into the MIMS System
            as set forth in Exhibit E. The Royalties set forth in Exhibit E only
            apply to the MIMS System. Stentor hereby warrants that the
            compensation retained by or paid to any Person authorized by Stentor
            to distribute the MIMS System shall not exceed [**]% of Net Revenue
            for an existing customer of the Person and [**]% of Net Revenue for
            other customers.

      7.2   Payments. Any payment to be made by a party pursuant to this
            Agreement shall be made no later than sixty (60) days after payment
            is due from the customer on which the payment is based, and shall be
            made by delivery of a check, payable to the order of the party
            entitled to payment or by wire transfer of immediately available
            funds to an account designated by such party.

      7.3   Late Fees. Each party agrees to pay late fees equal to one and
            one-half percent (1 1/2%) per month on all amounts due but not paid
            within the time provided in Section 7.2.

      7.4   Certification; Independent Auditor. Not later than the fifteenth
            (15th) day after the end of each calendar quarter, each party shall
            deliver to the other a statement setting forth the customers to
            which the MIMS System was licensed in such quarter and the
            calculation of the payments due for the previous quarter, or if none
            so stating, and signed by an executive officer of the party
            furnishing the statement. Stentor and DX agree to permit the other
            party, annually at its own expense, to engage a mutually acceptable
            independent auditor to confirm the accuracy of any payments made
            under this Agreement. Stentor and MX each

                                       12

<PAGE>

            agree to maintain books and records of its sales required to conduct
            such audit and to cooperate with the independent auditor in auditing
            such books and records.

8. SERVICES

      8.1   Customer Implementation and Support Services. Each of IDX and
            Stentor shall implement the MIMS System for their respective
            customers without the assistance of the other. Stentor and MX shall
            each provide to the other party reasonable assistance in the
            distribution of hardware from. those hardware manufacturers with
            which they each have reseller or distributor relationships so long
            as doing so does not violate the applicable reseller or distributor
            agreement or applicable law. IDX shall provide the first line of
            support for all customers to which IDX has sold the MIMS System,
            provided that Stentor shall provide the second line of support for
            any issue requiring access to or modification of the Source Code to
            any Stentor Product. Stentor shall provide the first line of support
            for all customers to which Stentor has sold the MIMS System,
            provided that IDX shall provide the second line of support for any
            issue requiring access to or modification of the Source Code to any
            DX Product. Stentor and IDX shall each comply with the other party's
            implementation requirements with respect to the other party's
            products and each shall use commercially reasonable efforts to
            provide support for its products in accordance with its internal
            support procedures. IDX and Stentor shall each provide the other
            sufficient training to ensure proper implementation of each party's
            component portions of the MIMS System.

      8.2   Service Quality. All support services provided by either party shall
            be performed in a good and workmanlike manner and consistent with
            standards generally applicable in the healthcare clinical
            information systems industry and consistent with the reasonable and
            customary support standards maintained in the healthcare clinical
            information systems industry.

      8.3   Uptime Performance Guarantee.

            8.3.1 Stentor Uptime Performance Guarantee. After March 31, 2001, if
                  Stentor elects to offer an "uptime performance guarantee" and
                  a defect in an IDX Product is the sole cause of "unscheduled
                  downtime" (as defined in the Stentor Uptime Performance
                  Guarantee attached hereto as Exhibit F), then DX shall use its
                  commercially reasonable efforts to cure such defect. IDX's
                  obligation to use its commercially reasonable efforts to cure
                  such defect shall be Stentor's sole and exclusive remedy, in
                  lieu of any damages that might be caused by breach of this
                  Agreement arising from or related to unscheduled downtime
                  caused by a defect in an IDX Product.

            8.3.2 IDX Uptime Performance Guarantee. If IDX elects to offer an
                  "uptime performance guarantee" substantially equivalent to the
                  Stentor Uptime Performance Guarantee, and a defect in a
                  Stentor Product is the sole cause of "unscheduled downtime"
                  (as defined in the IDX uptime performance guarantee), then
                  Stentor shall use its commercially reasonable efforts to

                                       13

<PAGE>

                  cure such defect. Stentor's obligation to use its commercially
                  reasonable efforts to cure such defect shall be Stentor's sole
                  and exclusive remedy, in lieu of any damages that might be
                  caused by breach of this Agreement arising from or related to
                  unscheduled downtime caused by a defect in an Stentor Product.

      8.4   Reference Sites. IDX agrees to introduce Stentor to Stentor License
            Exclusion Customers reasonably acceptable to both IDX and Stentor so
            that Stentor may request that such customers act as reference sites
            for the MIMS System for potential Stentor MIMS System prospects.

9. WARRANTIES

      THE PARTIES MAKE THE FOLLOWING REPRESENTATIONS AND WARRANTIES, ALL OF
WHICH SHALL BE FOR AND COMPLETE AS OF THE EFFECTIVE DATE AND THE DATE OF ANY AND
ALL DELIVERIES HEREIN. EXCEPT FOR THE EXPLICIT WARRANTIES MADE IN THIS
AGREEMENT, THERE ARE NO WARRANTIES MADE BY EITHER PARTY IN CONNECTION WITH THE
SUBJECT MATTER OF THIS AGREEMENT AND EACH PARTY SPECIFICALLY DISCLAIMS ANY
IMPLIED WARRANTIES, INCLUDING WITHOUT LIMITATION, THE IMPLIED WARRANTIES OF
MERCHANTABILITY, FITNESS FOR A PARTICULAR PURPOSE AND TITLE.

      9.1   IDX Warranties.

            9.1.1 Encumbrances. The IDX Products shall be free and clear of all
                  liens, restrictions, claims, charges, security interests, or
                  other encumbrances of any nature whatsoever which might affect
                  or adversely impact on Stentor's use of the IDX Products as
                  permitted under this Agreement.

            9.1.2 Ownership; Right to License. IDX owns or otherwise has
                  adequate rights to make the grants of the licenses to the IDX
                  Products to Stentor hereunder and possesses all rights and
                  interests in the IDX Products necessary to enter into this
                  Agreement; provided that Stentor acknowledges that licenses to
                  certain products of Microsoft, Oracle and Amzi used with the
                  IDX Products must be obtained directly by Stentor or customers
                  to which Stentor sells the MIMS System.

            9.1.3 No Infringement. IDX Products and all components thereof do
                  not infringe upon the intellectual property rights, including
                  without limitation the patent, copyright, trademark or trade
                  secret rights, of any third parties. The sole and exclusive
                  remedy for breach of this warranty shall be as set forth in
                  Section 10.6.

            9.1.4 Functional Performance. The DX Products shall perform
                  substantially as described in their documentation.

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<PAGE>

            9.1.5 Anti-Virus Testing. IDX represents and warrants that the IDX
                  Products will be tested prior to shipping for known computer
                  viruses in accordance with commercially reasonable industry
                  standards, including the use of industry standard anti-virus
                  detection software, and IDX represents and warrants that the
                  IDX Products shall be free of viruses.

      9.2   Stentor Warranties.

            9.2.1 Encumbrances. The Stentor Products shall be free and clear of
                  all liens, restrictions, claims, charges, security interests,
                  or other encumbrances of any nature whatsoever which might
                  affect or adversely impact on IDX's use of the Stentor
                  Products as permitted under this Agreement.

            9.2.2 Ownership; Right to License. Stentor owns or otherwise has
                  adequate rights to make the grants of the licenses to the
                  Stentor Products to IDX hereunder and possesses all rights and
                  interests in the Stentor Products necessary to enter into this
                  Agreement.

            9.2.3 No Infringement. Stentor Products and all components thereof
                  do not infringe upon the intellectual property rights,
                  including without limitation the patent, copyright, trademark
                  or trade secret rights, of any third parties. The sole and
                  exclusive remedy for breach of this warranty shall be as set
                  forth in Section 10.6.

            9.2.4 Functional Performance. The Stentor Products shall perform
                  substantially as described in their documentation.

            9.2.5 Anti-Virus Testing. Stentor represents and warrants that the
                  Stentor Products will be tested prior to shipping for known
                  computer viruses in accordance with commercially reasonable
                  industry standards, including the use of industry standard
                  anti-virus detection software, and Stentor represents and
                  warrants that the Stentor Products shall be free of viruses.

10. MISCELLANEOUS

      10.1  Confidentiality.

            10.1.1 Confidential Information. Each of IDX and Stentor will
                  receive or learn from, information, both orally and in
                  writing, concerning the business of Stentor or IDX,
                  respectively, including, without limitation, financial,
                  technical and marketing information, data, and information
                  related to the development of technology and services relating
                  to business plans, customers, and markets, which information
                  is deemed, in the case of Stentor, proprietary to Stentor and,
                  in the case of IDX, proprietary to DX. Both parties hereby
                  agree, as set forth below, to protect such information,
                  whether furnished before, on or after the date of this
                  Agreement, as it protects its own similar confidential
                  information, but never less than by commercially reasonable
                  efforts, and not to disclose such information to

                                       15

<PAGE>

                  anyone except as otherwise provided for in this Agreement.
                  Such information, in whole or in part, together with analyses,
                  compilations, programs, reports, proposals, studies or any
                  other documentation prepared by the parties, as the case may
                  be, which contain or otherwise reflect or make reference to
                  such information, is hereinafter referred to as "Confidential
                  Information". Each party hereby agrees that the Confidential
                  Information will be used solely for the purpose of this
                  Agreement and not for any other purpose. Each party further
                  agrees that any Confidential Information pertaining to the
                  other party is the sole and exclusive property of such other
                  party, and that the receiving party shall not have any right,
                  title, or interest in or to such Confidential Information
                  except as expressly provided in this Agreement. Each party
                  further agrees to protect and not to disclose to anyone
                  (except as provided in this Agreement) for any reason
                  Confidential Information pertaining to the other party;
                  provided, however, that: (a) such Confidential Information may
                  be disclosed to the receiving party's respective officers,
                  directors, employees, agents, or representatives
                  (collectively, "Representatives") on a "need to know" basis
                  for the purpose of this Agreement on the condition that (i)
                  each of such Representatives will be informed by the receiving
                  party of the confidential nature of such Confidential
                  Information and will agree to be bound by the terms of this
                  Agreement and not to disclose the Confidential Information to
                  any other person and (ii) each party agrees to accept full
                  responsibility for any breach of this Section 10.1.1 by its
                  respective Representatives; and (b) Confidential Information
                  pertaining to the other party may be disclosed upon the prior
                  written consent of the other party. Each party hereby agrees,
                  upon the request of the other party, to promptly deliver to
                  the other party at the other party's cost the Confidential
                  Information pertaining to such other party, without retaining
                  any copies thereof. Specifically and without limitation, each
                  party agrees to notify the other party promptly in writing
                  upon any officer or director learning of any unauthorized
                  disclosure or use of the Confidential Information.

            10.1.2 Non-Confidential Information. The term "Confidential
                  Information" shall not include any information: (i) which at
                  the time of disclosure or thereafter is generally available to
                  or known by the public (other than as a result of a disclosure
                  directly or indirectly by the receiving party); (ii) is
                  independently developed by the receiving party, without
                  reference to or use of, the Confidential Information of the
                  other party; (iii) was known by the receiving party as of the
                  time of disclosure without a breach of confidentiality; (iv)
                  is lawfully learned from a third party not under obligation to
                  the disclosing party; or (v) is required to be disclosed
                  pursuant to a subpoena, court order or other legal process,
                  whereupon the receiving party shall provide prompt written
                  notice to the other party prior to such disclosure.

                                       16

<PAGE>

            10.2  No-Solicitation. During the first year of the term of this
                  Agreement; neither party, nor any Affiliate within its
                  Control, shall solicit to hire any individual who had been in
                  the employ of the other party or any of the other party's
                  Affiliates until such time as one (1) year has passed since
                  such individual was in the employ of the other party.

            10.3  Regulatory Matters. Each party shall adopt, implement, and
                  maintain appropriate and compliant policies, procedures, and
                  practices necessary to comply with laws and regulations
                  (including without limitation the Health Insurance Portability
                  and Accountability Act of 1996 ("HIPAA") and the Federal Food,
                  Drug and Cosmetic Act (the "FDA Act")) applicable to it in its
                  business and applicable to it as a business partner of a
                  customer of the other to whom products or services are
                  provided under this Agreement. The parties agree to amend this
                  Agreement to contain any provisions necessary to be included
                  as a result of such business partner status. Each party agrees
                  to timely develop and include in its respective products
                  covered by this Agreement the functionality required to
                  support the minimum necessary standards applicable users of
                  its products as required by HIPAA.

            10.4  No Consequential Damages. In no event shall either party or
                  any Affiliate of either party be liable hereunder for any
                  consequential, special, incidental, punitive or indirect
                  damages (including without limitation loss of profit, revenue,
                  business opportunity or business advantage), whether based
                  upon a claim or action of tort, contract, warranty,
                  negligence, strict liability, breach of statutory duty, or any
                  other legal theory or cause of action, even if advised of the
                  possibility of such damages.

            10.5  Limitation of Liability. Neither party shall be liable to the
                  other for damages or costs under this Agreement in excess of
                  payments received from the other under this Agreement;
                  provided that this limitation shall not apply to either
                  party's indemnification obligation pursuant to Section
                  10.6(iii), and further provided that the limitation of
                  liability applicable to either party's indemnification
                  obligation pursuant to Section 10.6(i) shall be an aggregate
                  of Ten Million Dollars ($10,000,000) and each party shall
                  carry liability insurance against all risks sufficient to
                  cover such indemnification obligation. Each party must provide
                  certificates of such insurance coverage upon request of the
                  other and shall not change or alter such coverage without
                  notice to the other party.

            10.6  Indemnification. Each party (an "Indemnifying Party") will
                  indemnify the other party, its officers, employees, and agents
                  (each an "Indemnified Party" and, collectively, the
                  "Indemnified Parties") against, and hold each Indemnified
                  Party harmless from, all claims, suits, judgments, losses,
                  damages, fines or costs (including reasonable legal fees and
                  expenses) ("Losses") resulting from any claim, suit, or demand
                  by any third party ("Third Party Claim") for injuries to or
                  deaths of persons or loss of or damage to property arising out
                  of: (i) the Indemnifying Party's products or services as
                  marketed by the Indemnified Parties, unless the Indemnified
                  Parties shall have acted outside the scope of their rights

                                       17

<PAGE>

                  under this Agreement; (ii) the Indemnifying Party's
                  performance or willful misconduct of the Indemnifying Party,
                  its employees, officers, or agents in connection with the
                  Indemnifying Party's performance, of this Agreement, except to
                  the extent caused by the negligence of any Indemnified Party,
                  and (iii) that the Indemnifying Party's products, or any
                  component thereof, whether used alone or in combination with
                  any other item as intended, designed, suggested or induced by
                  the Indemnifying Party or its agents, infringes or violates
                  any patents, copyrights, trademarks, trade secrets, licenses,
                  or other proprietary rights of any third party.

                  10.6.1   The Indemnifying Party's obligations under this
                           Section 10.6 will survive the termination of this
                           Agreement.

                  10.6.2   Each Indemnified Party shall give an Indemnifying
                           Party prompt written notice of any Third Party Claim
                           of which such Indemnified Party has knowledge
                           concerning any Losses as to which such Indemnified
                           Party may request indemnification hereunder. If the
                           Indemnifying Party acknowledges in writing its
                           obligation to indemnify the Indemnified Party
                           hereunder against any Losses that may result from
                           such Third Party Claim, then the Indemnifying Party
                           shall be entitled to assume and control the defense
                           of such Third Party Claim at its expense and through
                           counsel of its choice if it gives notice of its
                           intention to do so to the Indemnified Party within
                           five (5) days of the receipt of such notice from the
                           Indemnified Party; provided, however, that if there
                           exists or is reasonably likely to exist a conflict of
                           interest that would make it inappropriate in the
                           judgment of the Indemnified Party, in its sole and
                           absolute discretion, for the same counsel to
                           represent both the Indemnified Party and the
                           Indemnifying Party, then the Indemnified Party shall
                           be entitled to retain its own counsel, at the expense
                           of the Indemnifying Party. In the event the
                           Indemnifying Party exercises the right to undertake
                           any such defense against any such Third Party Claim
                           as provided above, the Indemnified Party shall
                           cooperate with the Indemnifying Party in such defense
                           and make available to the Indemnifying Party, at the
                           Indemnifying Party's expense, all witnesses,
                           pertinent records, materials and information in the
                           Indemnified Party's possession or under the
                           Indemnified Party's control relating thereto as is
                           reasonably required by the Indemnifying Party.
                           Similarly, in the event the Indemnified Party is,
                           directly or indirectly, conducting the defense
                           against any such Third Party Claim, the Indemnifying
                           Party shall cooperate with the Indemnified Party in
                           such defense and make available to the Indemnified
                           Party, at the Indemnified Party's expense, all such
                           witnesses, records, materials and information in the
                           Indemnifying Party's possession or under the
                           Indemnifying Party's control relating thereto as is
                           reasonably required by the Indemnified Party. No such
                           Third Party Claim may be settled by the Indemnifying
                           Party without the prior written consent of the
                           Indemnified Party.

                                       18

<PAGE>

                  10.6.3   In no event shall the Indemnifying Party be liable to
                           an Indemnified Party for any indirect, incidental,
                           special, punitive, exemplary or consequential damages
                           arising out of or otherwise relating to this
                           Agreement, even if the Indemnifying Party has been
                           advised of the possibility or likelihood of such
                           damages.

                  10.6.4   The Indemnifying Party's obligations to indemnify as
                           set forth in Section 10.6(iii) shall not apply to any
                           claim to the extent that it arises from (i) any
                           modifications, changes, additions, or enhancements to
                           the Indemnifying Party's products that have not been
                           made directly by the Indemnifying Party or have not
                           been made at its express direction or under its
                           direct oversight, control or supervision, (ii) any
                           such modifications made by the Indemnifying Party at
                           the request or to the specification of the
                           Indemnified Party, the Indemnified Party's Customers,
                           or any of their agents.

            10.7  Expenses. Except as otherwise specified in this Agreement, all
                  costs and expenses, including, without limitation, fees and
                  disbursements of counsel, financial advisors and accountants,
                  incurred in connection with this Agreement and the
                  transactions contemplated hereby shall be paid by the party
                  incurring such costs and expenses.

            10.8  Further Assurances and Documents. IDX and Stentor shall take
                  all actions and do all things, including without limitation
                  the execution and delivery of instruments and documents,
                  necessary to effectuate the purposes and intent of this
                  Agreement.

            10.9  Notices. All notices, requests, claims, demands and other
                  communications hereunder shall be in writing and shall be
                  given or made (and shall be deemed to have been duly given or
                  made upon receipt) by delivery in person, by courier service,
                  by telecopy or by registered or certified mail (postage
                  prepaid, return receipt requested) to the respective parties
                  at the following addresses (or at such other address for a
                  party as shall be specified in a notice given in accordance
                  with this Section 10.9):

                        (a)     if to Stentor:

                                Stentor, Inc.
                                385 Oyster Point Boulevard, Suite 8B
                                South San Francisco, CA  94080
                                Attention: Oran Muduroglu
                                Facsimile: 650-866-4197

                                       19

<PAGE>

                       (b)     if to DX:

                               IDX Systems Corporation
                               1400 Shelburne Road
                               South Burlington, VT  05403
                               Attention: Walt Marti
                               Facsimile: 802-865-3489
                               With a copy to: General Counsel at the same
                                               address

            10.10 Public Announcements. Except as required by law, governmental
                  regulation or by the requirements of any securities exchange
                  on which the securities of a party hereto are listed, no party
                  to this Agreement shall make, or cause to be made, any press
                  release or public announcement, not including routine
                  advertisements subsequent to an initial joint announcement, in
                  respect of this Agreement or the transactions contemplated
                  hereby or otherwise communicate with any news media without
                  the prior written consent of the other party, consent which
                  shall not be unreasonably withheld, and the parties shall
                  cooperate as to the timing and contents of any such press
                  release or public announcement.

            10.11 Headings. The descriptive headings contained in this Agreement
                  are for convenience of reference only and shall not affect in
                  any way the meaning or interpretation of this Agreement.

            10.12 Severability. If any term or other provision of this Agreement
                  is invalid, illegal or incapable of being enforced by any law,
                  governmental regulation or public policy, all other terms and
                  provisions of this Agreement shall nevertheless remain in full
                  force and effect so long as the economic or legal substance of
                  the transactions contemplated hereby is not affected in any
                  manner materially adverse to any party. Upon such
                  determination that any term or other provision is invalid,
                  illegal or incapable of being enforced, the parties hereto
                  shall negotiate in good faith to modify this Agreement so as
                  to effect the original intent of the parties as closely as
                  possible in an acceptable manner in order that the
                  transactions contemplated hereby are consummated as originally
                  contemplated to the greatest extent possible.

            10.13 Entire Agreement. This Agreement constitutes the entire
                  agreement of the parties hereto with respect to the subject
                  matter hereof and supersede all prior agreements and
                  undertakings, both written and oral, with respect to the
                  subject matter hereof.

            10.14 Assignment. This Agreement shall be binding upon the parties
                  and their respective successors, representatives and permitted
                  assigns and their Affiliates Controlled by them, respectively.
                  Except as provided in Section 2.4, neither party may assign
                  this Agreement without the prior written consent of the other
                  party, except that either party hereto may assign its rights
                  hereunder to an Affiliate of such party and IDX may assign
                  this Agreement to any Person that acquires all or
                  substantially all of the assets of IDX's Radiology Information
                  Systems Division

                                       20

<PAGE>

                  and IDX shall be relieved of any obligation or liability
                  hereunder. If IDX shall sell or transfer any of its assets,
                  other than the assets of IDX's Radiology Information Systems
                  Division, to a Person that is not an Affiliate of IDX, then
                  such Person shall not have any obligations or liabilities
                  under this Agreement and the assets transferred shall not be
                  encumbered by or subject to this Agreement in any way.

            10.15 No Third Party Beneficiaries. This Agreement shall be binding
                  upon and inure solely to the benefit of the parties hereto and
                  their permitted assigns and successors and nothing herein,
                  express or implied, is intended to or shall confer upon any
                  other person or entity, any legal or equitable right, benefit
                  or remedy of any nature whatsoever under or by reason of this
                  Agreement.

            10.16 Amendment. This Agreement may not be amended or modified
                  except by an instrument in writing signed by, or on behalf of,
                  each of the parties.

            10.17 Governing Law. This Agreement shall be governed by the laws of
                  the State of California without regard to its conflict of laws
                  provisions.

            10.18 Counterparts. This Agreement may be executed in one or more
                  counterparts, and by the different parties hereto in separate
                  counterparts, each of which when executed shall be deemed to
                  be an original but all of which taken together shall
                  constitute one and the same agreement.

            10.19 Dispute Resolution. If a dispute, controversy; or claim
                  arising out of or related to this Agreement or with the
                  relationship of the parties arises, then the parties shall
                  attempt to resolve the dispute by means of the procedure set
                  forth in this Section. The party believing itself aggrieved
                  (the "Requesting Party") will call for progressive management
                  involvement in the negotiation of the dispute by notice to the
                  other party. Such a notice will be without prejudice to the
                  Requesting Party's right to any other remedy permitted by this
                  Agreement. The parties will use their best efforts to arrange
                  personal meetings or telephone conferences as needed, at
                  mutually convenient times and places, between negotiators for
                  the parties at the following successive management levels,
                  each of which will have a period of allotted time as specified
                  below in which to attempt to resolve the dispute:

<TABLE>
<CAPTION>
Level              Stentor                    IDX                    Allotted Time
-----       ----------------------    ----------------------       ----------------
<S>         <C>                       <C>                          <C>
First       Stentor Vice President    Vice President of            10 Business Days
                                      Development for RISD

Second              CEO               General Manager of RISD      10 Business Days

Third               CEO               President                    30 Days
</TABLE>

                  The allotted time for the first-level negotiators will begin
                  on the effective date of the Requesting Party's notice. If a
                  resolution is not achieved by negotiators at any

                                       21

<PAGE>

                  given management level at the end of their allotted time, then
                  the allotted time for the negotiators at the next management
                  level, if any, will begin immediately. If a resolution is not
                  achieved by negotiators at the final management level within
                  their allotted time, then the parties' CEO's shall engage in a
                  mediation session using one or more third-party mediators
                  mutually acceptable to the parties within thirty (30) days.
                  The dispute resolution requirements set forth in this Section
                  10.19 shall not apply to claims arising out of or related to:
                  (a) any infringement or misappropriation of Stentor's or IDX's
                  Intellectual Property, and (b) any violation of the
                  confidentiality obligations set forth in Section 10.1.

            10.20 Waiver of Jury Trial. Each of the parties hereto irrevocably
                  and unconditionally waives trial by jury in any legal action
                  or proceeding relating to this Agreement or the transactions
                  contemplated hereby and for any counterclaim therein.

            10.21 No Joint Venturer Status. None of the provisions of this
                  Agreement is intended to create, nor shall any provision in
                  this Agreement be deemed or construed to create, any
                  relationship between Stentor and IDX other than that of
                  independent entities contracting with each other under this
                  Agreement solely for the purpose of effecting the provisions
                  of this Agreement. Neither of the parties, nor any of their
                  employees, shall be construed to be the partner, joint
                  venturer, agent, employer or representative of the other.

                  IN WITNESS WHEREOF, the parties hereto have caused this
Agreement to be duly executed by their respective authorized signatories
thereunto duly authorized as of the day and year first above written.

IDX SYSTEMS CORPORATION                      STENTOR, INC.

By: __________________________________       By: _______________________________
    [Signature of Authorized Agent]              [Signature of Authorized Agent]

Print Name and Title:                        Print Name and Title:

                                       22

<PAGE>

                                   SCHEDULE 1

                                       TO

                     DEVELOPMENT AND DISTRIBUTION AGREEMENT

                                   DEFINITIONS

"AFFILIATE" means, with respect to any specified Person, any other Person that
directly, or indirectly through one or more intermediaries, Controls, is
Controlled by, or is under common Control with, such specified Person.

"CHANGE OF CONTROL" means any event, transaction or occurrence, with the
exception of an initial public offering, as a result of which either of IDX or
Stentor (i) shall cease to own or control, directly or indirectly through any of
its respective Affiliates, a majority of the voting rights associated with
ownership of its respective voting stock or (ii) shall cease to have the
ability, directly or indirectly, through one or more of its Affiliates, to elect
a majority of its respective board of directors.

"CONNECTR" means the product currently marketed by IDX under the trademark
"ConnectR."

"CONTROL" including the terms "Controlling," "Controlled by," and "under common
Control with," means the possession, direct or indirect, of the power to direct
or cause the direction of the management and policies of a Person, whether
through the ownership of voting securities, by contract, or otherwise, with the
exception of an initial public offering.

"DEVELOPMENT PLAN" means the Development Plan to be created pursuant to the
Development and Distribution Agreement.

"IDIAGNOSTIC VIEWER" means the product to be developed under the Development
Plan and currently referred to as iDiagnostic Viewer.

"DISTRIBUTION PARTNER" means any Person that has the right to market,
cooperatively market, distribute, resell, sublicense, license, sell or otherwise
provide a party's products or services, including by way of example and not in
limitation, any reseller, distributor, licensee, customer, contractor, service
provider, co-marketer, outsourcing vendor, or other information technology
company.

"DYNAMIC TRANSFER SYNTAX" or "DTS" means the product currently marketed by
Stentor under the marks Dynamic Transfer Syntax or DTS.

"IDX" means IDX Systems Corporation, IDX Information Systems Corporation, IDX
Investment Corporation, and their present and future Affiliates.

"IDX CUSTOMER" means any customer of DX that is licensed to use any product sold
by DX and any and all entities that have access to such product through such
customer, including without limitation IDXrad Customers and LastWord Customers.

                                        1

<PAGE>

"IDX DRIVERS" means the DX modality drivers for downloading demographics and
exam information to the imaging scanners in accordance with DICOM Modality
Worklist standard, and the uploading of study specific information from the
imaging scanner to the Imaging Suite in accordance with the DICOM Perform
Procedure Step standard.

"IDX PRODUCTS" means the products currently marketed as Imaging Suite and
ConnectR, the DX Drivers, and any derivative works or future versions thereof.

"IDXRAD" means the products currently marketed by DX under the mark IDXrad and
future versions thereof containing substantially similar functions.

"IDXRAD CUSTOMER" means (i) any customer of IDX that is licensed to use IDXrad
and (ii) any and all entities that have access to IDXrad databases through such
customer.

"IMAGING SUITE" means the product currently marketed by DX under the mark
Imaging Suite.

"IMAGING SUITE LITE VERSION" means a version of Imaging Suite for installation
by Stentor at a non-IDXrad or LastWord site that does not require the
installation and configuration of the IDXrad system, but that can be operated in
concert with a pre-existing non-IDX radiology information system or healthcare
information system.

"ISITE" means the product currently marketed by Stentor under the mark iSite.

"ISYNTAX SERVER" means the product currently marketed by Stentor under the mark
iSyntax Server.

"IVAULT" means the product to be developed under the Development Plan and
currently referred to as the iVault.

"INTELLECTUAL PROPERTY" means, without limitation, know-how, trade secrets,
inventions (whether or not patentable), ideas, materials, discoveries,
techniques, plans, designs, formulas, processes, invention disclosures,
technology, data or information, software and documentation therefor, hardware,
source code (including all programmers' notes), procedures, methods, works and
other documentation and information and the right. to sue and recover damages
for past, present and future infringement of such intellectual property.

"LASTWORD" means the product currently marketed by IDX under the trademark
LastWord and future versions thereof containing substantially similar functions.

"LASTWORD CUSTOMER" means (i) any customer of IDX that is licensed to use
LastWord and (ii) any and all entities that have access to LastWord databases
through such customer.

"MATERIAL ADVERSE CHANGE" means any material adverse change in the business,
properties, results of operations, condition (financial or otherwise) of an
applicable Person (other than changes that are the result of economic factors
affecting the economy as a whole or changes that are the result of factors
generally affecting the specific industry or markets in which a party competes).

                                        2

<PAGE>

"MERGE" means the process of merging all or a portion of existing software or
documentation into other software or documentation or adding to existing
software or documentation, including without limitation by application program
interfaces, so that the resulting software or documentation contains
functionality that is substantially more or different from that of the existing
software or documentation.

"MIMS SYSTEM" means the medical imaging management system consisting of the
combination of both Imaging Suite and ConnectR and at least one of the Stentor
Products, as described in the Development Plan and on the diagram attached to
the Agreement as Exhibit G. The MIMS System shall not include any products,
features or functionality not described in either the Development Plan or the
diagram attached as Exhibit G.

"PERSON" means any individual, partnership, firm, corporation, association,
trust, limited liability company, limited liability partnership, unincorporated
organization or other entity, as well as any syndicate or group that would be
deemed to be a person under Section 13(d)(3) of the Securities Exchange Act of
1934, as amended.

"PRE-EXISTING STENTOR CUSTOMER" means any Stentor Customer that existed as of
the Effective Date of this Agreement.

"PROVIDE" means to market, sell, license, cooperatively market, or otherwise
distribute, including through one or more Distribution Partners.

"REGULATORY REQUIREMENTS" means all federal and state laws and regulatory
requirements applicable to the use by IDX, IDX Customers, Stentor, and Stentor
Customers of the MIMS System from time to time during the term of the
Development and Distribution Agreement, including without limitation those
applicable to billing and claims submittal, managed care, data transmission,
security and privacy, and program requirements generally applicable to
healthcare organizations, such as those involving accreditation.

"STENTOR COMPONENT TECHNOLOGY" means Stentor's proprietary technology to
distribute data and images, including enhancements and improvements thereto,
including, but not limited to, technology used in iSyntax to distribute
image(s), or portions thereof, by transforming the image(s) into a flexible
hierarchical representation and by distributing, to a client, only the transform
data necessary to reconstruct the portion(s) of the image(s) desired at the
client.

"STENTOR CUSTOMER" means any customer of Stentor that is licensed to use any
product sold by Stentor and any and all entities that have access to such
product through such customer, but shall not include any customer that is in an
evaluation period and not obligated to pay fees to Stentor for the Stentor
Product.

"STENTOR LICENSE EXCLUSION CUSTOMER" means all IDXrad Customers and LastWord
Customers except: (i) any IDXrad Customer or LastWord Customer that is a
Pre-existing Stentor Customer; (ii) any IDXrad Customer or LastWord Customer
that does not use IDXrad or LastWord as their primary radiology information
system or primary clinical information system, respectively; (iii) any IDXrad
Customer or LastWord Customer that becomes a Stentor Customer prior to becoming
an IDXrad Customer or LastWord Customer; or (iv) any IDXrad Customer or

                                        3

<PAGE>

LastWord Customer that ceases to remain a Stentor License Exclusion Customer
pursuant to Section 5.6.

"STENTOR PRODUCTS" means the products marketed by Stentor and currently known as
the iDiagnostic Viewer, DTS, iSite Viewer, iSyntax Server, iVault, any future
versions thereof, and any derivative works or future versions thereof.

                                        4

<PAGE>

                                    EXHIBIT A

MINIMUM DEVELOPMENT REQUIREMENTS

[**]

<PAGE>

EXHIBIT B

IDX CONFIDENTIAL AND PROPRIETARY
IDXrad and LastWord Customer List

IDX HOUSE ACCOUNTS LISTING                                    STATE

      IDXRAD CUSTOMERS

[**]

                      IDX SYSTEMS CORPORATION CONFIDENTIAL

                                     Page 1
<PAGE>

[**]

                      IDX SYSTEMS CORPORATION CONFIDENTIAL

                                     Page 2
<PAGE>

[**]

                      IDX SYSTEMS CORPORATION CONFIDENTIAL

                                     Page 3
<PAGE>

[**]

                      IDX SYSTEMS CORPORATION CONFIDENTIAL

                                     Page 4
<PAGE>

[**]

                      IDX SYSTEMS CORPORATION CONFIDENTIAL

                                     Page 5
<PAGE>

                                    EXHIBIT C

                               Minimum Sales Goals

The Marketing Plan shall include the following minimum sales goals:

Sale of the MINIS System, or any component thereof, by either party to IDXrad
Customers or LastWord Customers as follows:

[**]

These sales goals assume that Stentor has developed iSite Version 2.0 as
described in the Development Plan and that it is available for general release
no later than March 31, 2001. The timing of these sales goals shall be delayed
by one month for each month or portion of a month that the general release of
iSite Version 2.0 is delayed beyond March 31, 2001.

<PAGE>

                                    EXHIBIT D

                     REQUIRED END USER AGREEMENT PROVISIONS

End user agreements shall contain provisions as protective of the parties as the
following provisions:

1.    IN NO EVENT SHALL [IDX's/Stentor's] SUPPLIERS AND LICENSORS BE LIABLE FOR
ANY DAMAGES OF ANY KIND OR NATURE, INCLUDING DIRECT, INDIRECT, INCIDENTAL,
SPECIAL, PUNITIVE, EXEMPLARY OR CONSEQUENTIAL, ARISING OUT OF THE USE OF ANY
SOFTWARE SUPPLIED BY COMPANY, ITS SUPPLIERS OR LICENSORS. THE LICENSEE
UNDERSTANDS AND AGREES THAT THE SOFTWARE PROVIDED BY [IDX/Stentor] TO LICENSEE
CONTAINS SOFTWARE THAT IS THE COPYRIGHTED PRODUCT AND A TRADE SECRET OF
[IDX/Stentor] OR ITS SUPPLIERS AND LICENSORS, AND THAT LICENSEE WILL NOT USE ANY
SUCH SOFTWARE IN VIOLATION OF THE RESTRICTIONS CONTAINED IN THIS AGREEMENT AND
WILL NOT DISCLOSE THE SOFTWARE TO ANYONE OTHER THAN ITS EMPLOYEES OR AGENTS AS
REASONABLY NECESSARY FOR THE PURPOSE OF THIS AGREEMENT AND ON THE CONDITION THAT
IT ACCEPTS FULL RESPONSIBILITY FOR ANY BREACH HEREOF BY ANY SUCH INDIVIDUAL. THE
FOREGOING AGREEMENTS ARE FOR THE EXPRESS BENEFIT OF [IDX/Stentor], ITS SUPPLIERS
AND LICENSORS, AND MAY BE ENFORCED BY [IDX/Stentor], AND ITS SUPPLIERS AND
LICENSORS.

2.    QUALIFIED MODALITY

[IDX/STENTOR] shall provide Customer a list of medical imaging equipment or
modalities ("Qualified Modalities") for Customer's use with the MIMS System
Software/Services. Customer shall contact [IDX/Stentor] immediately if any
additional modalities are added or a modification to an existing Qualified
Modality occurs. A modification to a Qualified Modality includes any type of
change, enhancement or upgrade to that modality, including software upgrades or
revisions. Customer accepts full responsibility for any failure or any other
adverse consequences that may occur if Customer uses MIMS System Software with
any modality other than a Qualified Modality.

3.    SERVICE EQUIPMENT

Service Equipment: shall mean all equipment supplied to or used by Customer in
conjunction with the MIMS System Software/Services.

Access To Service Equipment: Customer shall provide remote network access to the
Service Equipment and MIMS System Software, including providing to [IDX/Stentor]
the necessary security information to access the Service Equipment over a
network. In addition, Customer shall provide to [IDX/Stentor] personnel physical
access to all Service Equipment and MIMS System Software subsequent to receipt
of reasonable notice by [IDX/Stentor].

E-Mail Services: The Customer shall allow outgoing e-mail from Service Equipment
either through the customers SMTP e-mail services or shall allow service
equipment to access the [IDX/Stentor] SMTP e-mail service.

                                                               November 15, 2000

                                        1

<PAGE>

No Modification to Service Equipment: Customer agrees not to modify, in any way,
or tamper with the Service Equipment and any software operating on the Service
Equipment. Customer may access Service Equipment during installation, in
accordance with specific instructions from [IDX/Stentor] personnel. In addition,
Customer may access Service Equipment for system administration of MIMS System
Software to assign user identifications and grant user passwords. Customer
agrees not to load any additional software on Service Equipment.

4.    PROPRIATARY RIGHTS AND CONFIDENTIALITY

Ownership: Customer acknowledges and agrees that Stentor-IDX owns the sole and
exclusive worldwide right, title and interest in and to the MIMS System
Software/Services, and MIMS Documentation as well as all worldwide intellectual
property rights therein and all copies thereof, in whole and in part, subject
only to Customer's limited licensed rights to receive and use such MIMS System
Software/Services, and MIMS Documentation as permitted by this Agreement.

Duty of Confidentiality: To protect [IDX/Stentor] Proprietary Information,
Customer agrees that Customer will not decompile, reverse engineer, disassemble
or otherwise reduce the MIMS System Software/Services to a human perceivable
form or permit any other party to do so. Customer may not modify, adapt,
translate, rent, lease, sell, sublicense, loan, resell for profit, distribute,
time-share [except as either IDX or Stentor specifically allows customer to
allow access to third parties] or create any derivative works based upon, the
MIMS System Software/Services, and otherwise any and all information, regardless
of form, that is confidential, proprietary and/or a trade secret of
[IDX/Stentor] ("[IDX/Stentor] Proprietary Information") or any portion thereof
or permit any other party to do so.

Customer shall limit disclosure of [IDX/Stentor] Proprietary Information to its
employees who have a need to know the information in connection with the receipt
of the MIMS System Software/Services. Customer may permit members of its medical
community to observe operation of the MIMS System Software/Services on a limited
basis if they have a need to do so. In no event and under no circumstances shall
Customer reproduce, in any form, MIMS System Software and Documentation. In
addition, Customer shall not reproduce computer screen displays generated by the
iSiteTM client software. Customer shall not disclose [IDX/Stentor] Proprietary
Information to other parties (except members of its medical community as
described above) or use [IDX/Stentor] Proprietary Information for purposes other
than use of the MIMS System Software/Services, except that it may disclose or
use:

      a)    any information that [IDX/Stentor] expressly authorizes it, in
            writing, to disclose;

      b)    any information that is, through no breach of this or any other
            agreement with [IDX/Stentor], in the public domain; and any
            information that it is required by law to disclose.

Customer agrees to take appropriate action to bind all employees and consultants
regarding their obligations under this Agreement with respect to use, copying,
modification, confidentiality, protection and security of the [IDX/Stentor]
Proprietary Information. Customer agrees that any use or attempted use of
[IDX/Stentor] Proprietary Information in violation of the restrictions of this
Agreement is a material breach of the Agreement which will cause irreparable
harm to [IDX/Stentor], entitling [IDX/Stentor] to injunctive relief in addition
to all legal remedies. The

                                                               November 15, 2000

                                        2

<PAGE>

duty of confidentiality set forth in this Section shall survive three (3) years
subsequent to termination the agreement.

5.    WARRANTY DISCLAIMER:

EXCEPT FOR THE FOREGOING EXPRESS WARRANTIES OF ANY), [IDX/STENTOR] MAKES NO
WARRANTIES, EITHER EXPRESS OR IMPLIED, UNDER THIS AGREEMENT AND HEREBY DISCLAIMS
ALL IMPLIED WARRANTIES, INCLUDING ANY WARRANTIES REGARDING MERCHANTABILITY,
FITNESS FOR PURPOSE OR CORRESPONDENCE WITH DESCRIPTION. THERE IS NO WARRANTY
THAT THE [IDX/STENTOR] PROPRIETARY SOFTWARE IS FREE FROM PROGRAMMING ERRORS.

[IDX/Stentor] shall have no liability and responsibility under the [express
warranties] if:

      a)    The MIMS Licensed Software/Service has been altered or damaged by
            accident, neglect, misuse or other abuse;

      b)    Customer has failed to provide an operating environment (e.g., air
            temperature, electrical surge protection, etc.) for the computer
            equipment operating the MIMS System that complies with general
            industry standards for the safe operation of computer equipment;

      c)    Customer has loaded unauthorized software onto the computer
            equipment operating the MIMS System;

      d)    The MIMS Licensed Software/Service is operating in conjunction with
            a modality that is not a Qualified Modality;

      e)    The MIMS Licensed Software/Service is not the latest update released
            to Customer; or

      f)    The Customer has failed to notify [IDX/Stentor] in writing, during
            the License Term, of any defect Customer contends is a breach of
            warranty.

6.    LIMITED LIABILITY:

IN NO EVENT SHALL EITHER PARTY BE LIABLE TO THE OTHER FOR ANY LOST PROFITS, LOSS
OF BUSINESS OR FOR INDIRECT, INCIDENTAL, EXEMPLARY, CONSEQUENTIAL, PUNITIVE OR
SPECIAL DAMAGES SUFFERED BY CUSTOMER, IT'S CUSTOMERS, EMPLOYESS AND PATIENTS OR
OTHERS ARISING OUT OF OR RELATED TO THIS AGREEMENT, THE MIMS SYSTEM SOFTWARE /
SERVICES, DOCUMENTATION OR ANY OTHER STENTOR PRODUCTS OR SERVICES, FOR ALL
CAUSES OF ACTION OF ANY KIND (INCLUDING BUT NOT LIMITED TO TORT, CONTRACT,
NEGLIGENCE, STRICT PRODUCT LIABILITY AND BREACH OF WARRANTY) EVEN IF SUCH PARTY
HAS BEEN ADVISED OF THE POSSIBILITY OF SUCH DAMAGES. STENTOR'S LIABILITY WILL IN
NO EVENT EXCEED THE TOTAL DOLLARS PAID BY CUSTOMER FOR MIMS SYSTEM
SOFTWARE/SERVICES.

                                                               November 15, 2000

                                       3
<PAGE>
CONFIDENTIAL                                                              Page 1

                                    EXHIBIT E

 To Distribution and Development Agreement by and between Stentor, Inc. and IDX
                               Systems Corporation

                               COMPENSATION TERMS

1.    Stentor shall pay Royalties to IDX on sale of MIMS Systems by Stentor or a
Stentor Distribution Partner, as follows:

            A.    If Stentor Provides a MIMS System to any End User, Stentor
                  shall pay IDX an amount equal to [**]% of the greater of (i)
                  [**] for such MIMS System and (ii) [**]; provided that if
                  after the Effective Date but prior to December 31, 2001, IDX
                  Provides IDXrad or LastWord to the same customer after Stentor
                  Provides a MIMS System to that customer, Stentor shall pay IDX
                  an amount equal to 45% of the greater of (i) [**] for such
                  MIMS System or (ii) [**] to such customer.

            B.    If a Stentor Distribution Partner Provides a MIMS System to an
                  IDXrad Customer or a LastWord Customer that is a Stentor
                  License Exclusion Customer, Stentor shall pay IDX an amount
                  equal to [**]% of the greater of (i) [**] for such MIMS System
                  or (ii) [**].

            C.    If a Stentor Distribution Partner Provides a MIMS System to
                  any person who (i) is not an IDXrad Customer or a LastWord or
                  (ii) an IDXrad or LastWord Customer that is not a Stentor
                  License Exclusion Customer, Stentor shall pay IDX an amount
                  equal to [**]% of the greater of (i) [**] for such MIMS
                  System, or (ii) [**].

2.    IDX shall pay Royalties to Stentor on sale of MIMS Systems by IDX or an
IDX Distribution Partner, as follows:

            A.    If IDX Provides a MIMS System to an IDXrad Customer or
                  LastWord Customer, IDX shall pay Stentor an amount equal to
                  [**]% of the greater of (i) Net Revenue of IDX for such MIMS
                  System or ii) [**].

            B.    If IDX or an IDX Distribution Partner Provides a MIMS System
                  to any person who is not an IDXrad Customer or LastWord
                  Customer, IDX shall pay Stentor an amount equal to [**]% of
                  the greater of (i) [**] for such MIMS System or (ii) [**].

3.    Stentor in its discretion shall determine its own List Price for a MIMS
System not later than December 31 of each Calendar year during the term of this
Agreement. This Stentor List Price will be used to calculate [**] as set forth
below. The sole effect of the Stentor List Price on IDX will be to make this
royalty calculation. IDX retains complete discretion over prices relating to the
MIMS System licensed by IDX.

4.    For the purposes of this Exhibit E the defined terms set forth below shall
apply. In the case of any conflict or inconsistency between the defined terms in
this Exhibit and those defined in the Agreement, those set forth in this Exhibit
shall govern and control with respect to this Exhibit, and those set forth in
the Agreement shall govern and control with respect to the Agreement.

The following table is provided for convenience in applying the above payment
obligations and is intended to be duplicative. If there is any conflict between
the above rules and this table, the above rules shall govern and control.

                                                               November 15, 2000

<PAGE>

CONFIDENTIAL                                                              Page 2

<TABLE>
<CAPTION>
                                                               Royalty
              End User                    Sold By              Paid To   Royalty
---------------------------------------------------------------------------------------------------------------------------------
<S>                                       <C>                  <C>      <C>
IDXrad Customer or LastWord Customer      IDX                  Stentor  [**]% of the greater of [**] OR [**]

IDXrad Customer or LastWord Customer that Stentor Distribution IDX      [**]% of the greater of [**] OR [**]
is a Stentor License Exclusion Customer   Partner

Any End User (but see the last row in     Stentor              IDX      [**]% of the greater of [**] OR [**]
this table if such customer subsequently
becomes an IDXrad Customer or LastWord
Customer between the Effective Date and
December 31, 2001)

Not an IDXrad Customer or LastWord        IDX                  Stentor  [**]% of the greater of [**] OR [**]
Customer

Not an IDXrad Customer or LastWord        Stentor Distribution IDX      [**]% of the greater of [**] OR [**]
Customer or an IDXrad Customer or         Partner
LastWord Customer that is not a Stentor
License Exclusion Customer

Pre-existing Stentor Customer who becomes IDX                  Stentor  [**]% of the greater of [**] OR [**]
an IDXrad Customer or LastWord Customer
and subsequently or concurrently buys all
or part of a MIMS System

Stentor Customer who becomes an IDXrad    Stentor              IDX      [**]% of the greater of [**] or [**]
Customer or LastWord Customer after the                                 paid for all MIMS System components (regardless of their
Effective Date but prior to December 31,                                date of sale) and payments are made from the date the
2001                                                                    customer becomes an IDX Customer
</TABLE>

5.    Stentor shall pay a royalty to IDX for each IDX Driver licensed to an End
User by either Stentor or a Stentor Distribution Partner equal to the greater of
(i) [**]% of [**] or (ii) $[**] (the "Driver Minimum") for each imaging
device to which such IDX Driver(s) is connected. IDX in its discretion shall set
the [**] not later than December 31 of each Calendar year during the
term of this Agreement provided that the [**] shall not be increased
by more than the annual increase in the Consumer Price Index, all items, all
urban consumers, U.S. city average for such year + [**]%.

                                  DEFINED TERMS

   Exhibit E to Distribution and Development Agreement by and between Stentor,
                        Inc. and IDX Systems Corporation

"AGREEMENT" means the Development and Distribution Agreement between IDX and
      Stentor of which this Exhibit E is a part.

"AUTHORIZED LICENSOR" means a Party or a Distribution Partner of a Party
      authorized pursuant to the Agreement.

"CONTROL" (including similar terms such as "Controlling," "Controlled by") shall
      have the meaning set forth in Rule 12b-2 promulgated under the Securities
      and Exchange Act of 1934.

"DISTRIBUTION PARTNER" means a person authorized by a Party to distribute the
      MIMS System pursuant to the Agreement.

"END USER" means a person to whom an Authorized Licensor Provides a MIMS System.

"GROSS REVENUE" means [**] charged by an Authorized Licensor to an End User for
      [**]. "Revenue" does not include [**] charged by an Authorized Licensor to
      an End User for [**]. "IDXRAD

                                                               November 15, 2000

<PAGE>

CONFIDENTIAL                                                              Page 3

      CUSTOMER" means (i) any customer of IDX that is licensed
      to use IDXrad and (ii) any and all entities that have access to IDXrad
      databases through such customer.

"LASTWORD CUSTOMER" means (i) any customer of IDX that is licensed to use
      LastWord and (ii) any and all entities that have access to LastWord
      databases through such customer.

"IDX DRIVER" shall have the meaning set forth in the Agreement.

"MAINTAINING" means error correction, updates, and new versions of the MIMS
      System and its components.

"MIMS SYSTEM" means a system consisting of the MIMS System (as defined in the
      Agreement), plus all other component items Provided by an Authorized
      Licensor in connection therewith, such as equipment, software, and
      services obtained from a Third Party.

"MINIMUM ROYALTY BASE" in connection with [**].

"NET REVENUE" [**].

"PARTY" means IDX Systems Corporation or Stentor Incorporated.

"PRE-EXISTING STENTOR CUSTOMER" means any Stentor Customer that existed as of
      the Effective Date of this Agreement.

"PROVIDE" (and similar terms such as "Providing") shall have the meaning set
      forth in the Agreement.

"ROYALTY" means the fee to be paid to a Party by a Party when such Party
      Provides a MIMS System under the Agreement.

"STENTOR CUSTOMER" means any customer of Stentor that is licensed to use any
      product sold by Stentor and any and all entities that have access to such
      product through such customer, but shall not include any customer that is
      in an evaluation period and not obligated to pay fees to Stentor for the
      Stentor Product

"STENTOR LICENSE EXCLUSION CUSTOMER" means all IDXrad Customers and LastWord
      Customers except: (i) any IDXrad Customer or LastWord Customer that is a
      Pre-existing Stentor Customer; (ii) any IDXrad Customer or LastWord
      Customer that does not use IDXrad or LastWord as their primary radiology
      information system or primary clinical information system, respectively;
      (iii) any IDXrad Customer or LastWord Customer that becomes a Stentor
      Customer prior to becoming an IDXrad Customer or LastWord Customer; or
      (iv) any IDXrad Customer or LastWord Customer that ceases to remain a
      Stentor License Exclusion Customer pursuant to Section 5.6.

"STENTOR LIST PRICE" means the price that Stentor lists for retail sale of a
      MIMS System as set pursuant to this Exhibit E.

"THIRDPARTY", when referred to in the context of a discussion of a particular
      Authorized Licensor, means any person not Controlled by, Controlling, or
      under common Control with such Authorized Licensor, as the context
      requires.

"THIRDPARTY COSTS" means all of the actual costs of any good or services of a
      MIMS System Provided by an Authorized Licensor, if such costs are payable
      to a Third Party, but does not include royalties paid to IDX or Stentor.

                                                               November 15, 2000

<PAGE>

    Exhibit E to the Amendment to the Distribution and Development Agreement

I.    SCOPE.

      A.    Payment Structure

Payments between the parties will consist of four components: (1) Initiation
Royalties paid upon execution of a new customer agreement, (2) Sustaining
Royalties paid over the life of a customer agreement, (3) a fee for dormant
archives and (4) one-time true-up payments for outstanding liabilities.

      B.    Transition to New Payment Structure

Contracts signed after June 30, 2003 will be covered solely by the provisions
described in this Exhibit and not by the payment provisions of the un-amended
Agreement. Contracts signed prior to July 1, 2003 will be treated as follows:

         1. All royalties recorded and paid prior to July 1, 2003 will be
            retained.

         2. Royalties paid since July 1, 2003 shall be reversed as described in
            Section V.C.1 below

         3. Contracts signed prior to July 1, 2003 will not be subject to an
            Initiation Royalty or any Sustaining Royalty for Managed Study
            Volume incurred prior to July 1, 2003

         4. Contracts signed prior to July 1, 2003 will be subject to Sustaining
            Royalties beginning July 1, 2003. Their studies will be included in
            Managed Study Volume for purposes of determining the Sustaining Tier
            Rate.

II.   CALCULATING INITIATION ROYALTIES.

The party entering into a contract subject to these terms (the "Contracting
Party") will pay to the other party an "Initiation Royalty" at the end of each
calendar quarter. Such Initiation Royalty will be based on new customer
contracts (both ASP and capital purchase contracts for the MIMS System) that the
Contracting Party enters into during the year. The Initiation Royalty will be
calculated by multiplying the "Average Annual Studies" times the "Initiation
Tier Rate."

       Initiation Royalty = Average Annual Studies x Initiation Tier Rate

      A.    Definition of Average Annual Studies

Average Annual Studies is the sum of projected average annual studies for all
MIMS System contracts for Diagnostic and/or Archive products signed during a
quarter.

Contracts shall include both (1) new contracts and (2) additional
volume/duration contracts for an existing customer. For each contract included
in the calculation, its contribution shall be the higher of total DICOM
forecasted diagnostic or stored studies, summed for all years of the

                                        1

<PAGE>

contract term (not to exceed 7 years), divided by the years of the contract term
(not to exceed 7 years). Such projection will be based on the Contracting
Party's good faith estimate at the time of execution of the agreement. Each
Party shall estimate in advance the Average Annual Studies it expects to sign
during the ensuing year ("Estimated Average Annual Studies"). That estimate
shall be the basis for determining the Initiation Tier Rate as defined below.

      Average Annual Studies =Total of (Number of estimated studies under a
 given contract or up to seven years) / number of years in contract (for up to
                                 seven years))

      Example for 3 contracts signed in Q1'2004 (studies in thousands):

<TABLE>
<CAPTION>
                  Avg.    Yrl   Yr2    Yr3     Yr4          Yr5
<S>              <C>      <C>   <C>    <C>     <C>          <C>
Contract #1       125      75   100    150     150          150
Contract #2       300     300   300    300     300
Contract #3       267     100   300    400
                  ---
                  692
</TABLE>

      Average Annual Studies = 692

      B.    Definition of Initiation Tier Rate

For Diagnostic and/or Archive Contracts:

The Initiation Tier Rate is the rate charged per Average Annual Study to compute
the Initiation Royalty each quarter. The rate for Diagnostic and/or Archive
contracts will be based on Estimated Average Annual Studies as follows:

<TABLE>
<CAPTION>
Average Annual Studies (thousands)      IDX                        Stentor
---------------------------------       -----                      -------
<S>                                     <C>                        <C>
           0-1,000                      $1.50                       $0.50
         1,000-1,999                    $1.25                       $0.42
         2,000-2,999                    $1.00                       $0.33
         3,000-3,999                    $0.75                       $0.25
            4,000+                      $0.50                       $0.17
</TABLE>

Assuming that IDX and Stentor each projected an Estimated Average Annual Study
of 2,250K, then using the example above, IDX would pay Stentor an Initiation
Royalty of 692,000 x $1.00 = $692,000. If Stentor had signed the same number of
Average Annual Studies, it would pay IDX an Initiation Royalty of 692,000 x
$0.33 = $228,000.

If a portion of Average Annual Studies were for contracts that are either
"Diagnostic-only Studies" or "Stored-only Studies", the Initiation Royalty for
that portion would be the applicable Initiation Tier Rate times 50%.

      C.    Adjustment to actual signed Average Annual Studies

At the end of each calendar year the parties shall compare "Actual Average
Annual Studies" to Estimated Average Annual Studies. If Actual Average Annual
Studies places the party in a different Initiation Tier Rate than it used during
the year to pay Initiation Royalties, the party

                                        2

<PAGE>

shall make an adjustment payment to the other in the amount of Actual Average
Annual Studies times the difference in the Initiation Tier Rates.

For Enterprise Contracts:

For Enterprise contracts, the calculations would be made as above, except the
Initiation Tier Rate would be based on Diagnostic and/or Archive Average Annual
Studies for that quarter, the Initiation Royalty per study would be [**]% of the
Diagnostic and/or Archive amount, and the Enterprise studies used to compute the
royalty will be based on viewed studies rather than total DICOM studies (the
Average Annual Viewed Enterprise Studies). For example, if two Enterprise
contracts were signed in the same quarter as the above example, and the Average
Annual Viewed Studies totaled [**], then the Initiation Royalty for IDX would
be: [**] x ($[**] x [**]%) = $[**]. A similar adjustment to actual studies would
be made as described above.

III   CALCULATING SUSTAINING ROYALTY.

A Contracting Party will pay to the other party an ongoing royalty each quarter
based on total new managed studies for that quarter, whether from ASP or Capital
contracts for the MIMS System, (the "Sustaining Royalty"). The Sustaining
Royalty is separate from and in addition to the Initiation Royalty. The
Sustaining Royalty will be calculated by multiplying the [**] times the
Sustaining Tier Rate.

        Sustaining Royalty = [**] x [**]

      A.    Definition of Managed Study Volume

Managed Study Volume means the quarterly sum, across all customers who are in
live clinical use of total MIMS System DICOM actual new stored Studies plus, for
customers which are not archiving, [**]. Managed Study Volume excludes totals
from customer contracts that have been terminated, under which the customer is
not paying maintenance, or dormant archives that are subject to the dormant
archive fee described below. Studies that the Contracting Party deems to be
"Diagnostic-only Volume" or "Stored-only Volume" will be itemized separately.

      B.    Definition of Sustaining Tier Rate

The Sustaining Tier Rate is the per study royalty rate applied to Managed Study
Volume to compute the Sustaining Royalty each quarter. The Sustaining Tier Rate
is based on Quarterly Managed Study Volume as follows:

      Managed Study Volume

<TABLE>
<CAPTION>
                                                         IDX                     Stentor
<S>                                                     <C>                      <C>
0-625,000                                               $[**]                     $[**]
626,000-1,249,000                                       $[**]                     $[**]
1,250,000-1,875,000                                     $[**]                     $[**]
1,876,000-2,499,000                                     $[**]                     $[**]
2,500,000+                                              $[**]                     $[**]
</TABLE>

                                       3

<PAGE>

For Diagnostic-only Volume and Stored-only Volume:

For the portion(s) of Managed Study Volume that were either "Diagnostic-only
Volume" or "Stored-only Volume," the Sustaining Royalty will be the applicable
Sustaining Tier Rate times [**]%.

For Enterprise Contracts:

For Enterprise contracts, the calculations will be done as above, except the
Sustaining Tier Rate will be based on Diagnostic and/or Archive Managed Study
Volume for that quarter, the Sustaining Royalty per study will be [**]% of the
Diagnostic and/or Archive amount, and the Enterprise studies used to compute the
royalty will be based on [**] rather than [**]. For example, if the Enterprise
Viewed Studies Volume totaled [**] for the quarter, then the Enterprise
Sustaining Royalty for IDX would be: [**] x ($[**] x [**]%) = $[**].

Example of Sustaining Royalty.

For the example outlined below, a Managed Study Volume of [**] studies for the
quarter is assumed, broken down as follows:

<TABLE>
<S>                                                                  <C>
Managed Study Volume:                                                     [**]
                                                                     ---------
Stored Volume                                                             [**]
Diagnostic-only Volume                                                    [**]
Stored-only Volume                                                        [**]
</TABLE>

The Managed Study Volume of [**] would result in a Sustaining Tier rate of $[**]
for TDX and $[**] for Stentor, and the Sustaining Royalty payable by IDX and
Stentor would be:

<TABLE>
<CAPTION>
                                                          IDX                     Stentor
                                                       ---------                  -------
<S>                                                    <C>                        <C>
Stored Volume                                          $    [**]                  $   [**]
    [**]
Diagnostic-only Volume                                 $    [**]                  $   [**]
    [**]
Stored-only Volume                                     $    [**]                  $   [**]
    [**]
                                                       ---------                  -------
TOTAL SUSTAINING ROYALTY                               $    [**]                  $   [**]
</TABLE>

V.    ADDITIONAL FEES.

      A.    MIMS System Dormant Archive Fee

In the event that a customer's MIMS System archive is a "Dormant Archive" as
defined by either (1) no longer storing new MIMS System studies or (2) storing
new studies at a quarterly rate of 10 percent or less of their highest quarterly
Managed Study Volume (the "Maximum Managed Study Volume"); an ongoing quarterly
payment will be owed to the supporting party until such time that the archive is
no longer on-line. The Dormant Archive Fee shall be based on the

                                        4

<PAGE>

customer's highest annual [**] volume during its contract term, divided by [**]
(the "Dormant Archive Volume") and then multiplied by the following fee per
study:

      1. For Stentor Customers: $[**] per quarter per Dormant Archive Volume
      ($[**] per year).

      2. For IDX Customers: $[**] per quarter per Dormant Archive Volume ($[**]
      per year).

      B.    Prior Contract "True Up"

         1. IDX and Stentor have agreed to a one-time correction of outstanding
            royalty compensation and service fees for 2003. The following
            corrections represent both parties' best efforts to a) reconcile
            royalty calculations (including restatement of net revenue as
            required) that were exchanged prior to July 1, 2003 under the
            previous agreement, b) calculate royalty compensation under this new
            agreement for July 1, 2003 through September 30, 2003, including
            royalties paid from July 1, 2003 to September 30, 2003, c) finalize
            service fees associated with Stentor Disaster Recovery Service, and
            reconcile outstanding fees owed to Stentor by IDX for these services
            in 2003. The parties agree that all royalties through September 30,
            2003 are therefore paid in full and not subject to future
            adjustments.

         2. Summary of one-time corrections.

            a. June 30,2003 and Prior royalty compensation corrections:

               i. IDX has a debit to Stentor in the amount of $ [**]

               ii. Stentor has a debit to IDX in the amount of $ [**]

            b. July 1, 2003 through September 30, 2003, previous contract
               payment reversal:

               i. IDX has a credit to Stentor in the amount of $ [**]

               ii. Stentor has a credit to IDX in the amount of $ [**]

            c. July 1,2003 through September 30, 2003 new royalty
               compensations:

               i. IDX has a debit to Stentor in the amount of $[**]

               ii. Stentor has a debit to IDX in the amount of $ [**]

            d. Device Driver royalty compensation correction:

               i. Stentor has a debit to IDX in the amount of $ [**]

            e. Service Fees for Stentor Disaster Recovery Service

               i. IDX has a debit to Stentor in the amount of $ [**]

                                        5

<PAGE>

         2. Stentor agrees to pay the balance of $[**] in cash within 60 days of
         the Amendment Effective Date.

                                        6

<PAGE>

                                    EXHIBIT F

                      STENTOR UPTIME PERFORMANCE GUARANTEE

As an Application Service Provider (ASP), Stentor, Inc. provides image
distribution on a per-use basis. The ASP model insulates the institution from
hardware and software obsolescence and enables Stentor to guarantee [**]% uptime
performance for iSite.

IN THE EVENT THAT STENTOR IS UNABLE TO MEET OUR [**]% UPTIME PERFORMANCE
GUARANTEE PER MONTH, WE WILL DISCOUNT THAT MONTH'S FEE AS FOLLOWS:

<TABLE>
<CAPTION>
UPTIME PERFORMANCE                DISCOUNT
------------------                --------
<S>                         <C>
      [**]                         [**]
      [**]                         [**]
      [**]                         [**]
      [**]                         [**]
      [**]                         [**]
      [**]                         [**]
      [**]                         [**]
      [**]                         [**]
      [**]                         [**]
      [**]                         [**]
      [**]                         [**]
      [**]                         [**]
      [**]                         [**]
      [**]                         [**]
      [**]                         [**]
      [**]                         [**]
      [**]                         [**]

</TABLE>

      1)    Every [**]% deviation will provide a [**]% discount for that month's
            fee

      2)    Uptime performance less than [**]% will provide [**]

SYSTEM UPTIME TERMS AND DEFINITIONS

      -     STENTOR guarantees it's authorized and licensed users of iSite
            server that the product is [**]% available per month as defined in
            the following terms and conditions.

      -     All time is measured in an increment of one-hour units. Fractions
            are truncated.

      -     One month is defined as a calendar month. For example, April has 30
            days but May has 31 days, therefore, actual required time for this
            guarantee will be variable.

      -     Customer supplied equipment refers to any devices that STENTOR did
            not supply directly to customers (network cables, fibers, hubs,
            hospital network, telephone lines etc.)

      -     STENTOR CUSTOMER SUPPORT REPRESENTATIVES are anyone who is
            authorized to respond to customer outage situations (e.g., This can
            include third party agents who are authorized to perform the
            response tasks).

Stentor Uptime Performance Guarantee - Confidential - 9/18/2000     November 15,
                                                                          2000

                                        1

<PAGE>

      -     [**]% UPTIME means the Stentor iSite system is functionally
            accessible by all authorized users for [**]% of the time when an
            access is requested by the devices that are connected to the server.
            Availability is measured AT THE STANDARD POINT OF DEMARCATION
            (SPOD), AND outside of the scheduled and external downtime periods
            as defined in this document.

      -     CUSTOMER'S DESIGNATED CONTACT is a contact person at the customer
            site that shall judge STENTOR's uptime claims.

      -     The STANDARD POINT OF DEMARCATION (SPOD) is defined at the network
            connection interface installed at the iSite server computer
            hardware. For example if 100 Base T network hardware is being used,
            the Ethernet contact pins on the Ethernet card installed on the
            iSite server shall be "our" uptime responsibility. The pins on the
            connector and beyond are customer's uptime domains. This is the
            demarcation point that QA procedure uses.

      -     DOWNTIME shall be categorized into three modes: Unscheduled
            Downtime, Scheduled Downtime, and External Downtime.

      -     UNSCHEDULED DOWNTIME shall begin upon notification of Stentor by an
            authorized customer representative that the iSite server could not
            be accessed beyond the SPOD. This instance of unscheduled downtime
            shall be predicated on the fact that there was no advance
            notification by STENTOR in the 24-hour period prior to the outage.
            The cause of outage must be originated within the STENTOR supplied
            equipment and software. The unscheduled downtime shall commence upon
            the first response by a STENTOR customer service representative to
            the notification from the authorized customer representative
            regarding the down system issue and a trouble ticket has been logged

      -     SCHEDULED DOWNTIME shall be defined as the period that iSite servers
            are inaccessible due to scheduled system maintenance. Scheduled
            downtime shall be scheduled at STENTOR's discretion with
            notification to the customer's designated contact. Typical scheduled
            downtime includes preventative maintenance and system upgrades.
            Automatic and scheduled re-boot and restart shall be categorized
            under the scheduled down time so long as the frequency and time of
            occurrence has been communicated to the customer's designated
            contact. The scheduled downtime shall begin when access to the iSite
            server is completely impaired, and does not include the duration of
            notification period.

      -     EXTERNAL DOWNTIME shall be defined as when iSite servers are
            inaccessible due to events that are not in STENTOR's control. These
            events shall include, but are not limited to, events due to natural
            causes such as prolonged power failures, electrical surges due to
            lightening, flood, fire, and manual shutdowns at the sole discretion
            of the customer without prior notification to Stentor, Inc. Note,
            however, that any failure in the iSite server computer that STENTOR
            supplies is subject to Unscheduled Downtime measurement.

      -     STENTOR shall express uptime and downtime metrics based on a
            percentage number based on hourly increments through one calendar
            month.

      -     All downtime ENDS when a STENTOR customer support representative has
            confirmed and recorded the resumption time of the availability
            and/or received one heartbeat report back from the server, provided
            there are not external problems beyond the SPOD which prevent the
            heartbeat report from reaching STENTOR.

      -     Uptime metrics shall be measured in "total round-trip" manner. A
            system is considered "up" if an image can be "pushed" to the iSite
            server and the same image can be

Stentor Uptime Performance Guarantee - Confidential - 9/18/2000     November 15,
                                                                      2000

                                        2

<PAGE>

            accessible within 30 minutes of the initial "push". If there is
            criteria is not met than the system shall be considered down.

      -     Uptime percentage (measured in hours) = (Unscheduled Downtime
            hours)/(Number of hours in a given month) * 100.

Informational:  Aggregate Uptime Table

<TABLE>
<CAPTION>
ANNUAL                                                                   ... AND IN ONE CALENDAR MONTH,
UPTIME           APPROXIMATE DURATION THAT CAN BE                        WE CAN AFFORD TO GO DOWN
RATE             DOWN PER ASTRONOMICAL YEAR.                             APPROXIMATELY THIS LONG.
-----            --------------------------------                        ------------------------------
<S>              <C>                                                     <C>
[**]             [**]                                                    [**]
[**]             [**]                                                    [**]
[**]             [**]                                                    [**]
[**]             [**]                                                    [**]
[**]             [**]                                                    [**]
[**]             [**]                                                    [**]
[**]             [**]                                                    [**]
</TABLE>

ASSUMPTIONS

The following assumptions are being made:

      -     There is a way to continuously measure and monitor the uptime in a
            round-trip manner. The proposal for this is included in my
            "Heart-Beat" monitor definitions.

      -     We assume that hardware is sufficiently reliable and do not perform
            hardware specific tests other than setting up an acceptable
            selection criteria. The computer hardware we have chosen has a
            minimum MTBF value of 45,000 hours or greater (approximately 5
            years). The system MTBF for the purpose of uptime guarantee shall be
            based on the minimum MTBF component installed on the entire system.
            For example, if an Ethernet card has a MTBF of 20,000 hours but the
            rest of the systems have a MTBF of 100,000 hours then the entire
            system is deem to fail within 20,000 hours, and we shall reject a
            choice of such hardware. Under these selection criteria, this author
            assumes that more than 99.99% of the hardware in the field shall
            operate continuously.

      -     If a recoverable failure occurs on a redundant component, this event
            shall not be considered a downtime. For example, if a one of the
            RAID-5 volume goes down, but the system is available, then that is
            not considered as a system failure so long as we are meeting the
            Uptime criteria, and we can recover from this condition during the
            Scheduled downtime. Likewise, if we supply a cluster of redundant
            servers and one of the server goes down, that is not considered as a
            down-time so long as the user can access the active server
            transparently.

      -     All iSite Server hardware is supplied to the customer as part of the
            Stentor Service Agreement. The supplied hardware is covered under
            Stentor's Service Agreement with [**].

                  *     Only Stentor approved software may be resident on the
                        iSite Server. The presence of non Stentor approved
                        software residing on the iSite Server will invalidate
                        the [**]% uptime guarantee.

Stentor Uptime Performance Guarantee - Confidential - 9/18/2000     November 15,
                                                                      2000

                                        3
<PAGE>

                  *     If the customer is supplying their own hardware for the
                        iSite Server, that hardware must be purchased to
                        Stentor's specification, only Stentor approved software
                        applications may reside on said server, and the customer
                        must provide a [**] service agreement equivalent to
                        Stentor's service agreement with [**].

Stentor Uptime Performance Guarantee - Confidential - 9/18/2000     November 15,
                                                                      2000

                                        4

<PAGE>

                                    EXHIBIT G

            CONPONENTS OF THE IDX/STENTOR INTEGRATED PRODUCT OFFERING

    [FLOW CHART OF CONPONENTS OF THE IDX/STENTOR INTEGRATED PRODUCT OFFERING]

<PAGE>

               AMENDMENT TO DISTRIBUTION AND DEVELOPMENT AGREEMENT

            This Amendment ("Amendment") is made effective as of January 1, 2004
      (the "Amendment Effective Date") by and between, STENTOR, INC., a Delaware
      corporation ("Stentor"), and IDX SYSTEMS CORPORATION, a Vermont
      corporation ("IDX").

                                    RECITALS

            A. Stentor and IDX entered into a Distribution and Development
      Agreement dated November 15, 2000 (the "Original Agreement"), pursuant to
      which they agreed (i)i to engage in development to facilitate the
      integration of certain Stentor products for archiving and viewing medical
      images and certain IDX products for automating the management of work flow
      in radiology practices and departments, and (ii) thereby to offer an
      integrated system for medical image management.

            B. The parties have succeeded in offering such integrated system in
      North America, and now wish to amend certain provisions of the Original
      Agreement (as amended, including as amended by this Amendment, the
      "Agreement") for the remainder of the Initial Term, ending November 15,
      2005.

            C. Among other things, the parties wish to continue their
      relationship during the remainder of the Initial Term (from January 1,
      2004 to November 15, 2005) on a different basis such that, subject to the
      terms and conditions of the Agreement, (i) each party (each a "Licensee
      Party") would have the worldwide right (but no obligation) to distribute
      the designated products of the other party (each a "Licensor Party") as
      part of the MIMS System on a nonexclusive basis using the Licensee Party's
      own branding, (ii) each Licensor Party would use commercially reasonable
      efforts to make available APIs to allow the Licensee Party to make calls
      to data elements of such Licensor Party products as part of the MIMS
      System, and (iii) each Licensor Party would continue to provide
      second-level support to the Licensee Party.

            NOW, THEREFORE, in consideration of the mutual covenants and other
      terms and conditions set forth herein, the parties hereby agree as
      follows:

                                    AGREEMENT

1. Sections 4.1.1 through 4.1.5 will be deleted in their entirety and replaced
   with the following:

      4.1.1 Additional API Request Process.

            (a)   As soon as reasonably practicable, but in no event later than
      January 9, 2004, IDX may provide to Stentor a detailed list of Stored Data
      Elements of Stentor to which IDX would like to interface. As soon as
      reasonably practicable, but in no event later than January 30, 2004,
      Stentor shall respond to

                                        1

<PAGE>

      such list with an indication as to (a) whether it believes it is
      commercially practicable to permit IDX to interface to such Stored Data
      Elements and (b) if so, the estimated schedule for any development that
      would reasonably be required in connection with making available access to
      such Stored Data Elements (e.g., developing the related APIs). If the
      parties cannot agree on the commercial practicability and development
      schedule for the requested Stored Data Elements, the parties shall meet no
      later than February 9, 2004 and use commercially reasonable efforts to
      reach agreement by February 13, 2004. If the parties cannot agree by
      February 13, 2004, each party may escalate the matter, and the parties
      will engage in mediation to resolve the dispute, in accordance with the
      process set forth in Section 10.19. Stentor shall undertake commercially
      reasonable efforts to implement the mutually agreed APIs by version 3.5 of
      the Stentor Products, which Stentor anticipates being released in
      approximately the third calendar quarter of 2004, and to the extent
      commercially reasonable efforts would not allow inclusion in version 3.5
      but would in the subsequent version, by such subsequent version. The
      period between the Amendment Effective Date and the release of version 3.5
      of the Stentor Product is referred to herein as the "Catch-Up Period".
      Thereafter, during the remainder of the Initial Term, each party (as
      Licensee Party) may (no more often than twice a year) make a request for
      additional Stored Data Elements of the Licensor Party to which the
      Licensee would like to interface, and the Licensor Party will respond with
      an indication as to (i) whether it believes it is commercially practicable
      to permit the Licensee Party to interface to such Stored Data Elements,
      and (ii) if so, the estimated schedule for any development that would be
      reasonably required in connection with making available such Stored Data
      Elements (e.g., developing related APIs). If the parties cannot agree on
      such issues, each party may escalate the matter, and the parties will
      engage in mediation to resolve the dispute, in accordance with the process
      set forth in Section 10.19. The parties anticipate that the work described
      above will require approximately one engineer (full-time equivalent) after
      the Catch-Up Period, and that Stentor likely will need to devote
      additional resources during the Catch-Up Period. For purposes of this
      Section 4.1.1, "Stored Data Elements" means (A) in the case of Stentor,
      data elements stored by Stentor that are received by Stentor either
      through interface messaging, such as HL7, or through DICOM messages
      associated with an image, or the Stentor-stored output of functional
      events generated by routines provided or accessed by Stentor (e.g.,
      measurements, 3D analysis outputs), and (B) in the case of IDX, data
      elements stored by IDX that are received by IDX or the IDX-stored output
      of functional events generated by routines provided or accessed by IDX.

            (b)   Each party (as Licensee Party) shall, at the Licensor Party's
      request, dedicate resources to be and remain knowledgeable about and up to
      date on the products of the other party (i.e., the Stentor Products or IDX
      Products, as applicable), including their APIs. Such efforts shall include
      dedicating no less than one (1) person to working on APIs with the
      Licensor Party and having such person(s) attend training sessions at the
      Licensor Party's request regarding APIs.

                                        2

<PAGE>

            (c)   Each party (as Licensee Party) shall use commercially
      reasonable efforts to make use of existing APIs of the Licensor Party
      before requesting access to additional data elements or the development of
      any new APIs of the Licensor Party. In any event, the Licensor Party will
      have no obligation to make available any data element, provide any API or
      engage in any other activity that would or could reasonably affect the
      existing or future integrity, stability, compatibility, functionality or
      performance of any product (including any data used by a product).

            (d)   Each party (as Licensee Party) may use data elements and APIs
      made available by the Licensor Party (including any related materials or
      information) solely as part of the MIMS System to allow the Licensee Party
      products included in the MIMS System to interface to data stored by the
      Licensor Party's products included in the MIMS System. The above
      limitation shall not apply to data elements and APIs supporting industry
      standards, e.g., DICOM Query Retrieve.

            (e)   Should either party (as Licensee Party) enter into any
      agreement with a third party that involves access to or use of any data
      element or APIs of the Licensor Party by a product or service of the third
      party, the Licensee Party shall not include any exclusivity or other
      similar provision affecting the right of the third party and the Licensor
      Party to work together or to have the third-party product or service
      interface with products of the Licensor Party.

      4.1.2 Early Test Participation. To the extent consistent with third-party
      contractual obligations, each Licensor Party shall provide to the Licensee
      Party the opportunity to participate in early testing programs for new
      releases of the Stentor Products (in the case of Stentor) or IDX Products
      (in the case of IDX) to be available to the Licensee Party for use as part
      of the MIMS System. The parties acknowledge and agree that the purpose of
      such participation is intended to permit the Licensee Party to provide
      feedback at the alpha or beta product stage no later than any other
      customer of the Licensor Party. The parties also acknowledge and agree
      that participation in such early testing is subject to the reasonable
      requirements of the Licensor Party, including, but not limited to, testing
      only in a non-production environment on a separate server, appropriate
      disclaimers of liability and warranties, reasonable confidentiality and
      security terms, the receipt of useful feedback from the Licensee Party,
      and the availability of a competent technical coordinator at the Licensee
      Party for such testing.

      4.1.3 Web Compatibility. IDX acknowledges that Stentor is migrating to a
      Web services-based platform that will not support existing APIs. The
      general release of the version of the Stentor Products that does not
      support existing APIs will in no event occur earlier than November 15,
      2005. IDX acknowledges that for Stentor Products not on the
      above-mentioned Web services-based platform, Stentor's commercially
      reasonable efforts to provide support, as specified in Section 8.1 of the
      Agreement, shall thereafter be limited to bug fixes (i.e., correction of
      errors and nonconformity with Stentor' s published documentation). Stentor

                                        3

<PAGE>

      acknowledges and agrees that it will maintain backwards compatibility of
      existing APIs from the Amendment Effective Date until November 15, 2005,
      except for reasonable changes required for maintenance or support purposes
      (e.g., to resolve unintended API conflicts).

2. Sections 5.1 and 5.2 shall be replaced in their entirety with the following,
   which shall be deemed to be effective as of the Effective Date of the
   Original Agreement:

      5.1   Ownership; In General. Except for the rights expressly granted
      herein to Stentor, IDX reserves and retains all right, title and interest
      (including without limitation patents, trade secrets and copyrights) in
      the IDX Products, and all customizations, additions, modifications,
      changes, enhancements, improvements, and derivative works thereof made by
      IDX or by a third party on behalf of IDX, and all rights therein and
      copies thereof. Except for the rights expressly granted herein to IDX,
      Stentor reserves and retains all right, title and interest (including
      without limitation patents, trade secrets and copyrights) in the Stentor
      Products, and all customizations, additions, modifications, changes,
      enhancements, improvements, and derivative works thereof made by Stentor,
      or by a third party on behalf of Stentor, and all rights therein and
      copies thereof.

      5.2   Ownership to Works Created Under the Development Plan.

            (a)   Any Intellectual Property developed by Stentor and any
      derivative works of Stentor Products developed by Stentor or a third party
      contractor of Stentor pursuant to the Development Plan shall be owned by
      Stentor. Any Intellectual Property developed by IDX and any derivative
      works of IDX Products developed by IDX or a third party contractor of IDX
      pursuant to the Development Plan shall be owned by IDX. Any Intellectual
      Property jointly developed by IDX and Stentor (i.e., patents or trade
      secrets as to which employees or contractors of both parties are joint
      inventors or copyrightable subject matter as to which the parties or their
      employees or contractors are joint authors) pursuant to the Development
      Plan shall be jointly owned by IDX and Stentor and each of IDX and Stentor
      (or any successor to, or assignee of, or licensee of IDX or Stentor) shall
      be free to use such Intellectual Property without interference from the
      other party and without any obligation to make any payment or account for
      any profits, except as otherwise provided for in this Agreement. Such
      joint ownership shall apply only to the specific modules, elements or
      other subject matter that are the result of the joint development, and not
      to other modules, elements or other subject matter. Notwithstanding any
      previous assertions by the parties to the contrary, the provisions in this
      Amendment set forth the parties' understanding and intent with respect to
      the ownership of Intellectual Property.

            (b)   Each party believes that it has not made and that it will not
      make any patent application for a patent constituting a Conflicting Patent
      that covers the core technology of the other party. "Conflicting Patent"
      means such a patent that is applied for before or within one year after
      the Amendment Effective Date for an invention made before the Amendment
      Effective Date resulting from joint

                                        4

<PAGE>

      development efforts under the Development Plan where the invention (i) is
      based on the technology of the other party and (ii) is directed toward and
      embodied in a PACS system (in the case of IDX as patent holder) or a
      product for automating the management of work flow in radiology practices
      and departments (in the case of Stentor as patent holder). If a party
      believes that an issued patent of the other party is a Conflicting Patent,
      then the parties shall discuss in good faith the facts and circumstances
      regarding such patent and whether such patent constitutes a Conflicting
      Patent and, if so, the possibility of a license of such patent. If the
      parties cannot reach agreement as to the appropriate treatment of such
      patent, then either party may submit the matter to a mutually agreeable
      third party for nonbinding mediation in accordance Section 10.19.

3. Section 5.3.1 shall be replaced in its entirety with the following:

      5.3.1 IDX hereby grants to Stentor a non-exclusive, non-transferable
      (except as provided in Sections 2.4 and 10.14) term license to market and
      sublicense, and in connection therewith to sell, offer for sale, copy,
      use, distribute, perform, display, modify, make derivative works of and
      Merge, the IDX Products, only as they may be Merged into the MIMS System,
      provided that (subject to Section 5.6) Stentor may do so only to Persons
      that are not Stentor License Exclusion Customers. Notwithstanding the
      limited scope of this license, Stentor may communicate with, and
      demonstrate, perform and display the MIMS System to, Stentor License
      Exclusion Customers to make them aware of the availability of the MIMS
      System from IDX and to provide information to Stentor License Exclusion
      Customers regarding the MIMS System. "Stentor License Exclusion Customers"
      shall mean those customers in the Territory or [**] that meet the
      definition of "Stentor License Exclusion Customers" in the Agreement and
      have been included in the parties' list of Stentor License Exclusion
      Customers as of the Amendment Effective Date (an initial version of which
      shall be provided by the parties no later than fifteen (15) business days
      after execution of this Amendment), as such list may be modified by the
      parties from time to time in accordance with the Agreement.

4. Section 5.4 and 5.5 shall be replaced in their entirety with the following:

      5.4   Stentor Products. Stentor hereby grants to IDX a non-exclusive,
      non-transferable (except as provided in Sections 2.4 and 10.14) term
      license to market and sublicense (including through one or more
      Distribution Partners acceptable to Stentor), and in connection therewith
      to sell, offer for sale, copy, use, distribute, perform, display, modify,
      make derivative works of and Merge, the Stentor Products, only as they may
      be Merged into the MIMS System.

      5.5   Territory. This Agreement, including the licenses granted hereunder,
      shall apply to the parties worldwide, provided that the Parties will be
      subject to certain restrictions in the Territory (as well as in [**] as
      set forth in Section 6.1. The "Territory" is redefined to mean [**].

                                        5

<PAGE>

5. The parties acknowledge and agree that nothing in the Agreement restricts the
   use of the MIMS System by either party (as Licensee Party) to, or changes the
   pricing for, any particular field of use (i.e., there is no restriction on
   use in, or difference in pricing for use in, medical specialties other than
   radiology), provided that the foregoing will not imply any obligation to
   provide (a) additional support as a result of use outside radiology, (b) any
   APIs to support use outside radiology, or (c) any products designed for use
   outside radiology (i.e., other than the Stentor Products and IDX Products
   included in the MIMS System).

6. Section 5.6 shall be replaced in its entirety with the following:

      5.6   Treatment of Stentor License Exclusion Customers. If a Stentor
      License Exclusion Customer (other than existing customers of Stentor as
      set forth in Attachment A, which Attachment A will be completed within
      fifteen (15) business days after execution of this Amendment) seeks to
      acquire the MIMS System from Stentor, Stentor will inform the customer
      that it should contact IDX:. If the customer nonetheless expresses an
      interest in acquiring the MIMS System from Stentor, Stentor will notify
      IDX and will refrain for a period of forty-five (45) days (after such
      notice) from sales activities targeted at the customer. Forty-five (45)
      days after Stentor has provided the above-referenced notice to IDX,
      Stentor may contact the customer and, if the customer remains interested
      in acquiring the MIMS System from Stentor, the customer shall be deemed
      not to be a Stentor License Exclusion Customer. Should the customer (other
      than the customers set forth in Attachment A) then purchase the MIMS
      System from Stentor, Stentor shall (unless the parties otherwise agreed)
      pay IDX [**] percent [**%] above the normal royalty for such MIMS System
      for the remainder of the Interim Term, and shall further pay IDX half of
      the commission that would normally be payable to Stentor's sales force for
      making such sale if the customer were not a Stentor License Exclusion
      Customer. This Section 5.6 shall apply to customers within the Territory
      and [**] but not elsewhere. Stentor acknowledges that it will provide IDX
      with appropriate current and future product information required for IDX
      to effectively represent the MIMS System to prospective customers, when
      Stentor provides such information generally to Stentor's own sales force,
      and promptly respond to IDX inquiries regarding the MIMS System, with the
      objective that IDX sales representatives should be no less informed about
      the MIMS System than their Stentor counterparts. IDX acknowledges that
      Stentor will provide the information and related training to IDX's sales
      trainers and that IDX is responsible for disseminating the information to
      IDX's sales representatives.

7. The following Section 5.7 will be added to the Agreement: 6

      Each party (as Licensee Party) acknowledges that the other party (as
      Licensor Party) will have control over its own APIs, including the right
      to negotiate licenses for the APIs with third parties. Notwithstanding the
      above, this Section 5.7 shall not be construed to prevent, or require
      additional payment for, any APIs licensed or otherwise provided by the
      Licensor Party to the Licensee Party from being used by the Licensee Party
      in connection with Providing a MIMS System

                                        6

<PAGE>

      under the Agreement, even if such use includes providing the APIs to a
      third party, provided that such third party has entered into the Licensor
      Party's form of license agreement with respect to such APIs (which form
      will not require third party-by-third party execution by the Licensor
      Party) and provided that a copy of each such license agreement is
      delivered to the Licensor Party. The parties acknowledge that the
      foregoing does not apply to industry standard interfaces such as DICOM
      Query Retrieve.

8. The parties agree that the IDX Drivers (including any updates and upgrades to
   IDX Drivers and any new IDX Drivers) will, effective as of the Amendment
   Effective Date, be included in the licenses granted and the services provided
   by IDX to Stentor (to the same extent as the other IDX Products) and that no
   separate license or maintenance fees will be payable with respect thereto.

9. The following sentences shall be added to Section 6.1.1 after the first
   sentence of Section 6.1.1 (i.e., the sentence beginning "Stentor shall not
   (i) Provide" and ending "Stentor Products in the Territory"):

      Stentor shall not authorize or license [**], or the successor of any of
      them, to Provide the MIMS System or the Stentor Products in [**]. Nothing
      in this Section 6.1.1 shall be construed to prohibit or disturb any
      relationship between Stentor and any third party (including a third party
      that may become a successor to [**]) to the extent such relationship was
      not and is not formed in breach of the Agreement (and, for purposes of
      this Section 6.1.1, "successor" of an entity means the business operation
      of such entity, but does not include the other business operations of such
      third party).

10. Section 6.2 is deleted in its entirety.

11.   The obligations set forth in Sections 6.3 and 6.4 regarding the use of the
      other party's marks are no longer in effect. The rights set forth in
      Sections 6.3 and 6.4 regarding the use of the other party's marks will
      remain in effect only until December 31, 2004. After such time, the
      affected party shall not use any of the names, marks or branding of the
      other party in or with the affected party's products or in marketing,
      support or distribution activities (including press or public relations
      materials). Nothing in the foregoing shall be deemed to prohibit a party
      from making factual descriptions regarding the other party's products in
      general materials about such party and its products (provided that the
      materials are not designed for marketing, press or public relations
      purposes).

12. Section 7.1 shall be replaced in its entirety with the following:

      7.1   Compensation; Payment. IDX and Stentor shall be entitled to
      compensation for their respective licensing to the other of their
      respective rights and technology incorporated into the MIMS System as set
      forth in the amended Exhibit E attached to the Amendment. The compensation
      schedule set forth in the amended Exhibit E will become effective as of
      December 31, 2003 (and the "true

                                        7

<PAGE>

      ups" contemplated by such amended Exhibit E will constitute the final
      resolution of any royalties, reimbursements or other payments required for
      the period before December 31, 2003 and are due and payable as of December
      31, 2003).

13. The parties acknowledge that, while their rights under this Agreement with
    respect to the other's products (i.e., the IDX Products and Stentor
    Products) are worldwide as of the Amendment Effective Date, the parties'
    support obligations as to countries outside the Territory will not be
    materially greater than such obligations as to countries in the Territory
    (e.g., IDX would not be obligated to fix a [**] bug, but would be obligated
    to address a technical error that could also occur in a country in the
    Territory) unless the other party agrees to pay for the additional support
    work (the cost of which additional work the parties will negotiate in good
    faith, and, if the parties are unable to agree on such cost, the party will
    carry out the work on a time and materials basis, at reasonable rates and on
    other terms and conditions which are, as a whole, no less favorable to the
    other party than those made available to comparable customers of the party
    doing the work for comparable work).

14. IDX and Stentor represent and warrant that their statements in Sections
    9.1.3 and 9.2.3, respectively, with respect to patents are true, to such
    party's knowledge, up to and as of the Amendment Effective Date, and the
    parties make no further representations and warranties as to
    noninfringement of patents.

15. Section 10.1 shall be replaced in its entirety with the following, which
    shall be deemed to be effective as of the Effective Date of the Original
    Agreement:

      10.1.1 Confidential Information. Each Party (as "Receiving Party") shall
      use the same care and measures to prevent the unauthorized disclosure and
      dissemination of the Confidential Information of the other Party (as
      "Disclosing Party") as the Receiving Party uses for its own confidential
      information or material of a similar nature. Such measures may include
      instructing and requiring recipients of Confidential Information to
      maintain the confidentiality of such Confidential Information and
      restricting disclosure of such Confidential Information to those
      representatives of the Receiving Party and its affiliates, its and their
      contractors, suppliers and licensees, and other authorized third parties
      who have a "need to know" consistent with the purposes for which such
      Confidential Information is disclosed, if and to the extent the Receiving
      Party uses such measures for its own confidential information or material
      of a similar nature. The Receiving Party further agrees not to remove or
      destroy any proprietary rights or confidentiality legends or markings
      placed upon any documentation or other materials by the Disclosing Party.

      "Confidential Information" means any technology, information and materials
      related to research, products, services, hardware or software, inventions,
      processes, designs, drawings, engineering or other technology that is
      supplied or licensed by either party after the Effective Date (as the
      Disclosing Party) to the other party (as the Receiving Party) and which is
      designated in writing as proprietary or confidential (or with a similar
      designation) or, if disclosed orally or by demonstration, is designated as
      confidential or proprietary at the time of

                                        8

<PAGE>

      disclosure and summarized in a writing so designated within thirty (30)
      days of the initial disclosure.

      10.1.2 Non-Confidential Information; Permitted Disclosures. Confidential
      Information shall not include, however, information or material which (i)
      is or becomes available to the relevant public other than as a result of a
      wrongful act or omission by the Receiving Party, (ii) was available to the
      Receiving Party (without a duty of confidentiality owed to the Disclosing
      Party with respect to such information or material) prior to its receipt
      from the Disclosing Party, (iii) becomes available to the Receiving Party
      from a Person not otherwise bound by a confidentiality agreement with the
      Disclosing Party with respect to such information or material, or (iv) was
      independently developed by the Receiving Party without use of the
      Disclosing Party's Confidential Information. Further, notwithstanding
      Section 10.1.1, the Receiving Party may disclose the Disclosing Party's
      Confidential Information in the event that the Receiving Party is required
      (by the disclosure requirements of any rule, regulation, or form of any
      governmental authority or securities exchange or by interrogatories,
      requests for information or request for documents by any governmental
      authority or other party in legal proceedings, subpoenas, civil
      investigative demands, or other similar processes) to disclose such
      Confidential Information, provided that the Receiving Party so required
      shall provide the Disclosing Party with prompt written notice of any such
      requirement so that the Disclosing Party may object to production and seek
      a protective order or other appropriate remedy, and/or waive compliance
      with the provisions of this Agreement. If the Disclosing Party objects to
      production and seeks a protective order or other appropriate remedy, the
      Receiving Party shall exercise commercially reasonable efforts (at the
      sole expense of the Disclosing Party) to cooperate, including, without
      limitation, by cooperating with the Disclosing Party to obtain an
      appropriate protective order or other reasonable assurance that
      confidential treatment will be accorded such Confidential Information.

      10.1.3 Residuals. Notwithstanding anything in the Agreement to the
      contrary, either party may use or disclose residual information for any
      purpose, including without limitation use in development, manufacture,
      promotion, sale and maintenance of its products and services, provided
      that this right to residual information does not constitute and shall not
      imply a license under any patents or copyrights of the other party.
      "Residual information" means any information that is retained in the
      unaided memories of a party's personnel without ongoing use of the
      tangible embodiment of the other party's Confidential Information. An
      individual's memory is unaided if the individual has not intentionally
      memorized the Confidential Information for the purpose of retaining and
      subsequently using or disclosing it.

16. The following sentences shall be added to the end of Section 10.3:

      Each party shall apply for and use commercially reasonable efforts to
      obtain by December 2004 the necessary regulatory and other approvals and
      clearances (e.g.,

                                        9

<PAGE>

      Food and Drug Administration 510(k) premarketing approvals or clearances
      or the equivalent) required for its activities hereunder (including the
      sale or license of the MIMS System) at each party's own sole expense and
      responsibility. Each party shall reasonably confer and cooperate with the
      other party to assist the other party in complying with any applicable
      export control regulations. Each party agrees that, if and for so long as
      it uses or operates under any regulatory or other approvals or clearances
      of the other (a) it will comply strictly with the other party's quality
      system requirements, including those for integration, installation,
      training and support, as required to maintain the MIMS System in
      compliance with such regulatory or other approvals or clearances, and (b)
      it will not Provide the MIMS Systems unless it is in compliance with the
      regulatory or other approvals or clearances.

17. Section 10.6 (but not Section 10.6.1 through 10.6.4) shall be replaced in
    its entirety with the following:

      Each party (an "Indemnifying Party") will defend the other party, its
      officers, employees, and agents (each an "Indemnified Party") against, and
      pay any damages (including costs and attorneys' fees) awarded against an
      Indemnified Party by a court of competent jurisdiction (or pay any
      settlement of such claim agreed to by the Indemnifying Party) ("Losses")
      resulting from, any claim, suit, or demand by any third party ("Third
      Party Claim") (i) for injuries to or deaths of persons or loss of or
      damage to property arising out of the Indemnifying Party's products or
      services as provided to the Indemnified Party, unless the Indemnified
      Parties shall have acted outside the scope of their rights under this
      Agreement or the injuries, death, loss or damage results from an act or
      omission of the Indemnified Party; (ii) for injuries to or deaths of
      persons or loss of or damage to property arising out of the willful
      misconduct of the Indemnifying Party, its employees, officers, or agents
      in connection with the Indemnifying Party's performance of this Agreement,
      except to the extent caused by the negligence of any Indemnified Party;
      and (iii) that the Indemnifying Party's products, or any component
      thereof, as provided to the Indemnified Party infringes any patents,
      copyrights, trademarks, trade secrets or other proprietary rights of the
      third party.

18. Section 10.6.2 shall be replaced in its entirety with the following:

      An Indemnified Party shall notify the Indemnifying Party promptly of any
      claim for which the Indemnifying Party is responsible and shall cooperate
      with the Indemnifying Party in every commercially reasonable way to
      facilitate the defense of any such claim, provided that the Indemnified
      Party's failure to notify the Indemnifying Party shall not diminish the
      Indemnifying Party's obligations under this Section except to the extent
      that the Indemnifying Party is materially prejudiced as a result of such
      failure. The Indemnified Party shall authorize and allow Indemnifying
      Party to have sole control of the defense and settlement of the claim,
      provided that that the Indemnifying Party shall not, without the consent
      of the Indemnified Party, enter into any settlement or agree to any
      disposition that imposes an obligation on the Indemnified Party that is
      not wholly discharged or dischargeable by the Indemnifying Party, or
      imposes any conditions or

                                       10

<PAGE>

      obligations on the Indemnified Party other than the payment of monies that
      are readily measurable for purposes of determining the monetary
      indemnification or reimbursement obligations of Indemnifying Party. An
      Indemnified Party shall at all times have the option to participate in any
      matter or litigation through counsel of its own selection and at its
      expense.

19.   The addresses for the parties in Section 10.9 shall be replaced with the
      following:

      Stentor, Inc.
      5000 Marina Boulevard
      Brisbane, CA 94005-1811
      Attention: Oran Muduroglu
      Facsimile: 650-228-5566

      With a copy to the Corporate Counsel of Stentor.

      IDX Systems Corporation 40 IDX Drive
      P.O. Box 1070
      Burlington, VT 05402-1070
      Attention: President
      Facsimile: 802-865-3681
      With a copy to the General Counsel of IDX.

20.   The following sentences shall be added to the end of Section 10.10:

      Without limitation of the generality of the foregoing, the parties
      acknowledge that the requirements of this Section 10.10 apply to
      statements concerning the relationship between IDX and Stentor--for
      example "end-of-life" plans for the MIMS System, limitations on further
      development of the MIMS System, and limitations on support for the MIMS
      System. The parties will work together to agree on how such matters will
      be described and will instruct appropriate marketing and sales personnel
      to be consistent with such mutually agreed to descriptions in their
      marketing and sales activities.

21.   Section 10.14 shall be replaced in its entirety with the following:

      10.14 Assignment. This Agreement shall be binding upon the parties and
      their respective successors and permitted assigns and their Affiliates
      Controlled by them, respectively. Neither party may assign this Agreement
      without the prior written consent of the other party, except that either
      party hereto may assign this Agreement to any Person that acquires all or
      substantially all of the assets of (i) in the case of IDX, IDX's Radiology
      Information Systems Division, and IDX shall be relieved of any obligation
      or liability hereunder, or (ii) in the case of Stentor, Stentor's PACS
      business, and Stentor shall be relieved of any obligation or liability
      hereunder. If (i) IDX shall sell or transfer any of its assets, other than
      the assets of IDX's Radiology Information Systems Division, to a Person
      that is not an Affiliate of IDX, or if (ii) Stentor shall sell or transfer
      any of its assets, other than the assets of the PACS business, to a Person
      that is not an Affiliate of Stentor, then such Person shall not have any
      obligations or liabilities under this

                                       11

<PAGE>

      Agreement and the assets transferred shall not be encumbered by or subject
      to this Agreement in any way.

22.   The following sentence shall be added to the end of Section 10.19:

      Except as provided herein, no civil action with respect to any dispute,
      claim or controversy arising out of or relating to this Agreement may be
      commenced until the matter has been submitted for mediation as described
      below. Either party may commence such mediation by providing to the other
      party a written request for mediation, setting forth the subject of the
      dispute, claim or controversy and the relief requested. The parties will
      cooperate with one another in selecting a mediator and in scheduling the
      mediation proceedings. The parties covenant that they will participate in
      the mediation in good faith, and that they will share equally in its
      costs. All offers, promises, conduct and statements, whether oral or
      written, made in the course of the mediation by any of the parties, their
      agents, employees, experts and attorneys, and by the mediator, are
      confidential, privileged and inadmissible for any purpose, including
      impeachment, in any litigation or other proceeding involving the parties,
      provided that evidence that is otherwise admissible or discoverable shall
      not be rendered inadmissible or non-discoverable as a result of its use in
      the mediation. Notwithstanding the foregoing, either party may seek
      equitable relief, whether or not prior to commencement of the mediation
      (e.g., to preserve the status quo pending the completion of the mediation
      process or to prevent irreparable harm). Except for such an action to
      obtain equitable relief, neither party may commence a civil action with
      respect to the matters submitted to mediation until after the completion
      of the initial mediation session, or forty-five (45) days after the filing
      of the written request for mediation, whichever occurs first. Mediation
      may continue after the commencement of a civil action, if the parties so
      desire. The provisions of this Section 10.19 may be enforced by any court
      of competent jurisdiction, and the party prevailing in the enforcement
      action shall be entitled to an award of fees, costs and expenses,
      including attorney's fees, as the court ordering the enforcement may
      determine to be equitable.

23. Continuation of Provisions. Except as expressly set forth herein, all other
    terms and conditions of the Original Agreement shall remain in full force
    and effect. In the event of any inconsistency or conflict between this
    Amendment and the Original Agreement, the terms, conditions and provisions
    of this Amendment shall supersede the Original Agreement and shall govern
    and control. Except as expressly defined or otherwise modified herein, all
    capitalized terms in this Amendment have the same meanings as set forth in
    the Original Agreement. If a defined term is defined both in this Amendment
    and in the Original Agreement, then the term shall have the meaning set
    forth in this Amendment.

24. Authorization. Each party represents and warrants that it possesses the
    right and capacity to enter into this Amendment. Each party represents and
    warrants to the other party that this Amendment has been duly authorized,
    executed and delivered by it and constitutes its valid and legally binding
    agreement with respect to the subject matter contained herein.

25. Entire Agreement. The Original Agreement, as amended by this Amendment,
    constitutes the complete and exclusive statement of the agreement between
    the parties and supersedes all

                                       12

<PAGE>

    prior and contemporaneous proposals and understandings, oral and written,
    relating to the subject matter contained therein.

IN WITNESS THEREOF, the parties have executed this Amendment by their duly
authorized representatives.

STENTOR, INC.                                    IDX SYSTEMS CORPORATION
[Signature of Authorized Agent]                  [Signature of Authorized Agent]

                                       13
<PAGE>

    Exhibit E to the Amendment to the Distribution and Development Agreement

I.    SCOPE.

      A.    Payment Structure

Payments between the parties will consist of four components: (1) Initiation
Royalties paid upon execution of a new customer agreement, (2) Sustaining
Royalties paid over the life of a customer agreement, (3) a fee for dormant
archives and (4) one-time true-up payments for outstanding liabilities.

      B.    Transition to New Payment Structure

Contracts signed after June 30, 2003 will be covered solely by the provisions
described in this Exhibit and not by the payment provisions of the un-amended
Agreement. Contracts signed prior to July 1, 2003 will be treated as follows:

         1. All royalties recorded and paid prior to July 1, 2003 will be
            retained.

         2. Royalties paid since July 1, 2003 shall be reversed as described in
            Section V.C.1 below

         3. Contracts signed prior to July 1, 2003 will not be subject to an
            Initiation Royalty or any Sustaining Royalty for Managed Study
            Volume incurred prior to July 1, 2003

         4. Contracts signed prior to July 1, 2003 will be subject to Sustaining
            Royalties beginning July 1, 2003. Their studies will be included in
            Managed Study Volume for purposes of determining the Sustaining Tier
            Rate.

II.   CALCULATING INITIATION ROYALTIES.

The party entering into a contract subject to these terms (the "Contracting
Party") will pay to the other party an "Initiation Royalty" at the end of each
calendar quarter. Such Initiation Royalty will be based on [**] and [**] for the
MIMS System) that the Contracting Party enters into during the year. The
Initiation Royalty will be calculated by multiplying the "Average Annual
Studies" times the "Initiation Tier Rate."

       Initiation Royalty = [**] x [**]

      A.    Definition of Average Annual Studies

Average Annual Studies is the sum of [**] for all
MIMS System contracts for Diagnostic and/or Archive products signed during a
quarter.

Contracts shall include both (1) new contracts and (2) additional
volume/duration contracts for an existing customer. For each contract included
in the calculation, its contribution shall be the higher of [**] summed for all
years of the

                                        1

<PAGE>

contract term (not to exceed 7 years), divided by the years of the contract term
(not to exceed 7 years). Such projection will be based on the Contracting
Party's good faith estimate at the time of execution of the agreement. Each
Party shall estimate in advance the Average Annual Studies it expects to sign
during the ensuing year ("Estimated Average Annual Studies"). That estimate
shall be the basis for determining the Initiation Tier Rate as defined below.

      Average Annual Studies =Total of (Number of estimated studies under a
 given contract or up to seven years) / number of years in contract (for up to
                                 seven years))

      Example for 3 contracts signed in Q1'2004 (studies in thousands):

<TABLE>
<CAPTION>
                  Avg.    Yr1   Yr2    Yr3     Yr4          Yr5
<S>              <C>      <C>   <C>    <C>     <C>          <C>
Contract #1       [**]    [**]  [**]   [**]    [**]         [**]
Contract #2       [**]    [**]  [**]   [**]    [**]         [**]
Contract #3       [**]    [**]  [**]   [**]
                  ---
                  [**]
</TABLE>

      Average Annual Studies = 692

      B.    Definition of Initiation Tier Rate

For Diagnostic and/or Archive Contracts:

The Initiation Tier Rate is the rate charged [**] to compute the Initiation
Royalty each quarter. The rate for Diagnostic and/or Archive contracts will be
based on Estimated Average Annual Studies as follows:

<TABLE>
<CAPTION>
Average Annual Studies (thousands)      IDX                        Stentor
---------------------------------       -----                      -------
<S>                                     <C>                        <C>
           0-1,000                      $[**]                       $[**]
         1,000-1,999                    $[**]                       $[**]
         2,000-2,999                    $[**]                       $[**]
         3,000-3,999                    $[**]                       $[**]
            4,000+                      $[**]                       $[**]
</TABLE>

Assuming that IDX and Stentor each projected an Estimated Average Annual Study
of [**], then using the example above, IDX would pay Stentor an Initiation
Royalty of [**] x $[**] = $[**]. If Stentor had signed the same number of
Average Annual Studies, it would pay IDX an Initiation Royalty of [**] x $[**] =
$[**].

If a portion of Average Annual Studies were for contracts that are either
"Diagnostic-only Studies" or "Stored-only Studies", the Initiation Royalty for
that portion would be the applicable Initiation Tier Rate times [**]%.

      C.    Adjustment to actual signed Average Annual Studies

At the end of each calendar year the parties shall compare "Actual Average
Annual Studies" to Estimated Average Annual Studies. If Actual Average Annual
Studies places the party in a different Initiation Tier Rate than it used during
the year to pay Initiation Royalties, the party

                                        2

<PAGE>
                                SECOND AMENDMENT
                    TO DISTRIBUTION AND DEVELOPMENT AGREEMENT

      This Second Amendment (the "Second Amendment") of the Distribution and
Development Agreement (the "Original Agreement") between STENTOR, INC., a
Delaware corporation ("Stentor") and IDX SYSTEMS CORPORATION, a Vermont
corporation ("IDX") is made effective as of November 16, 2004 (the "Second
Amendment Effective Date").

                                    RECITALS

      A. Stentor and IDX entered into the Original Agreement on November 15,
2000.

      B. The parties amended the Original Agreement effective January 1, 2004
(the "First Amendment").

      C. The parties wish to further amend the Original Agreement as amended.

      NOW, THEREFORE, in consideration of the mutual covenants and other terms
and conditions set forth below, the parties agree as follows:

                                SECOND AMENDMENT

1. Section 2.1 of the Original Agreement is hereby deleted in its entirety and
replaced with the following:

      2.1 Term. This Agreement shall be in effect for an initial term beginning
      on the Effective Date and ending November 15, 2015 (the "Initial Term")
      and shall automatically renew for additional successive two (2) year terms
      unless earlier terminated by either of IDX or Stentor by giving written
      notice of such party's election not to renew this Agreement not later than
      one (1) year prior to the expiration of the Initial Term or six (6) months
      prior to the expiration of any then current successive term.

2. As of the Second Amendment Effective Date, Section 2.3 of the Original
Agreement shall be of no force and effect and shall be deleted in its entirety.

3. Section 4.1.3 of the Original Agreement, as amended by the First Amendment,
is hereby deleted in its entirety and replaced with the following:

      4.1.3 Support Commitments.

          4.1.3.1 IDX shall use Stentor's client-side ActiveX API for Stentor
                  Products and IDX Products developed for release subsequent to
                  November 15, 2005. IDX acknowledges that Stentor's obligation
                  to provide support for Stentor Products released prior to
                  November 15, 2005 (i.e, the 3.x versions), as specified in
                  Section 8.1 of the Agreement, shall thereafter be limited to
                  commercially reasonable efforts to provide bug fixes (i.e.,
                  correction of errors and nonconformity with Stentor's
                  published documentation). Stentor acknowledges and agrees that
                  it will maintain backwards compatibility of

                                       1.
<PAGE>
                  existing APIs as it pertains to support of 3.x versions from
                  the Amendment Effective Date until November 15, 2005, except
                  for reasonable changes required for maintenance or support
                  purposes (e.g., to resolve unintended API conflicts).

          4.1.3.2 Each party shall use commercially reasonable efforts to
                  develop and, not later than the dates specified in Exhibit
                  4.1.3.2, include in a commercially-ready new version or
                  versions of the MIMS System to be delivered by Stentor, the
                  enhancements and other features described in Exhibit 4.1.3.2
                  attached hereto. For the avoidance of doubt, the term
                  "commercially-ready" means that the new version shall have
                  successfully exited alpha and beta testing and be suitable in
                  quality for general release to customers.

          4.1.3.3 The parties shall work to close any missing material
                  functionality in current server-side APIs of the MIMS System
                  that have not yet been replicated to client-side APIs or MSMQ
                  methods by November 15, 2005. To facilitate this process, IDX
                  shall provide an interim material gap analysis of IDX version
                  10.4 relative to Stentor release 3.5 based on IDX's
                  then-current knowledge no later than December 31, 2004 and
                  March 31, 2005, with a complete and final material gap
                  analysis delivered to Stentor by June 30, 2005.

          4.1.3.4 Stentor shall provide reasonable resources to accomplish the
                  work required by this Section 4.1.3 of the Original Agreement,
                  as amended by this Second Amendment, and shall keep IDX
                  informed on a current basis of Stentor's resource planning and
                  actual work progress. Stentor's current plans call for the
                  dedication of three FTEs (full-time equivalents) to the work.
                  The parties shall meet on a quarterly basis to discuss
                  staffing and resource allocation with respect to these
                  obligations. Furthermore, (1) Stentor shall ensure that its
                  variable bonus programs at both the executive and engineering
                  level carry a reasonable level of financial incentives with
                  respect to these obligations (of approximately 20% of the
                  variable bonus amount), (2) the Stentor CEO shall provide to
                  the IDX CEO a monthly status report regarding the progress of
                  the work described in this Section 4.1.3, and (3) the Stentor
                  CEO shall engage a mutually acceptable strategic relationship
                  consultant (a) the fees for whom the parties will equally
                  share, and (b) with whom the parties agree to meet at least
                  three times during 2005.

4. As of November 15, 2005, Sections 5.3.1 and 5.3.2 of the Original Agreement,
as amended by the First Amendment, shall be of no force and effect, and shall be
deleted in their entirety and replaced with the following:

      5.3.1 IDX hereby grants to Stentor a non-exclusive, non-transferable
      (except as provided in Sections 2.4 and 10.14) term license to market and
      sublicense, and in connection therewith to sell, offer for sale, copy,
      use, distribute, perform, display, modify, make derivative works of and
      Merge, the IDX Products, in whole or in part, only as they may be Merged
      into the MIMS System.

                                       2.
<PAGE>
      5.3.2. IDX also hereby grants to Stentor a non-exclusive, non-transferable
      (except as provided in Sections 2.4 and 10.14) term license to sublicense
      one or more Distribution Partners to market and sublicense, and in
      connection therewith to sell, offer for sale, copy, use, distribute,
      perform, and display, the IDX Products, in whole or in part, only as they
      may be Merged into the MIMS System, to any Person.

5. As of November 15, 2005, Section 5.5 of the Original Agreement, as amended by
the First Amendment, shall be of no force and effect, and shall be deleted in
its entirety and replaced with the following:

      5.5 Territory. This Agreement, including the licenses granted hereunder,
      shall apply to the parties worldwide. The "Territory" shall mean the [**].
      Notwithstanding anything to the contrary in the Original Agreement, as
      amended by the First Amendment, the following process shall be added to
      the provisions of Section 5.6 of the Original Agreement, as amended by the
      First Amendment, in order to give full effect to that Section. Stentor's
      Chief Executive Officer shall implement a process (which shall include a
      written policy, for all sales personnel, that will be distributed within
      twenty days of the execution and delivery of this Second Amendment and
      will include a warning that a violation of this policy may result in
      termination of employment) by which Stentor personnel will make him aware,
      within 5 working days of learning that a Stentor Exclusion Customer is
      considering or has expressed an interest in, acquiring the MIMS System
      from Stentor. Upon learning of such interest, Stentor's Chief Executive
      Officer shall promptly telephone or otherwise contact IDX's Chief
      Executive Officer to discuss how best to address any concerns the customer
      may have with the products or services such customer is receiving from
      IDX. Stentor's sole activity with respect to such customer during the
      45-day period referenced in Section 5.6 shall be working with IDX to
      address and resolve such concerns, and Stentor's sole contact with such
      customer during such 45-day period shall be at IDX's specific request,
      except that Stentor may return the calls and emails of the customer solely
      in order to direct the customer to IDX. Through November 15, 2005, Stentor
      shall take all commercially reasonable steps to respond to IDX's requests
      for Stentor to assist IDX in strengthening IDX's relationships with any
      Stentor Exclusion Customer, and Stentor shall refrain from any activity
      that would disturb or otherwise adversely affect IDX's relationships with
      such Stentor Exclusion Customer. As of November 15, 2005, Section 5.6 of
      the Original Agreement, as amended by the First Amendment, shall be of no
      force and effect and shall be deleted in its entirety, and the preceding
      sentences in this Section 6 shall be of no further force and effect and
      shall be deleted in their entirety.

6. As of May 31, 2005, Section 6.1.1 of the Original Agreement, as amended by
the First Amendment, shall be of no force and effect and shall be deleted in its
entirety.

7. Sections 6.1.2 and 6.1.3 of the Original Agreement are hereby deleted in
their entirety.

8. Section 7.1 of the Original Agreement, as amended by the First Amendment, is
hereby deleted in its entirety and replaced with the following:

      7.1 Compensation Payment. IDX and Stentor shall be entitled to
      compensation for their respective licensing to the other of their
      respective rights and technology incorporated into the MIMS System as set
      forth in Exhibit E as amended by this Second

                                       3.
<PAGE>
      Amendment. The amendments to Exhibit E as set forth in this Second
      Amendment shall become effective on January 1, 2005.

9.  As of November 15, 2004, Section 8.4 of the Original Agreement shall be of
no force and effect and shall be deleted in its entirety.

10. Section 16 of the First Amendment is hereby amended by changing in the first
sentence thereof, "December 2004" to "December 2005" and by inserting, at the
end of the said first sentence, the phrase, "with regard to the version 4.x and
higher".

      In addition, the parties will work in good faith to address the parties'
respective regulatory compliance obligations in light of the new API structure
in version 4.x (and later) of the Stentor product. The parties shall apply their
mutual best efforts for 45 days following the execution and delivery of this
Second Amendment to reach agreement on the question of whether the most
effective way to ensure legal compliance by IDX in distributing version 4.x (and
later), while at the same time achieving an efficient operational solution for
both IDX and Stentor, would be either (a) for IDX to obtain its own clearance
for the sale of version 4.x and higher or (b) to sell under a new clearance, to
be obtained by Stentor, for the elements of version 4.x and higher to be
provided to IDX by Stentor.

      If, after such 45 days, the parties have not reached agreement by
executing and delivering a further addendum to the Original Agreement to
evidence such agreement, the parties shall submit the dispute to a neutral third
party attorney selected by counsel for each of the parties, who shall have
significant applicable regulatory experience (the "Arbitrator"). Within 30 days
thereafter the Arbitrator shall decide upon and produce a written plan for
regulatory compliance by IDX and Stentor in distributing version 4.x and higher,
with a view towards creating the most efficient operational processes for both
IDX and Stentor, and the parties shall thereafter be bound to follow such plan
at their own expense.

      The parties shall each be responsible for their own costs in this process
and shall each be responsible to pay one-half of the costs of the Arbitrator.
The parties shall each make available to each other and to the Arbitrator their
respective experts, including attorneys, managers, technicians and consultants
to assist them in their work under this process.

11. Section 20 of the First Amendment is hereby amended by deleting all but the
last sentence thereof. The following sentences are hereby added to the end of
Section 10.10 of the Original Agreement as amended by the First Amendment:

       In recognition that it is important to avoid confusion among customers
       and prospects, and to afford the parties opportunity to prepare for
       announcements, the parties shall, when practicable and feasible, provide
       advance notice and opportunity for comment to each other prior to all
       public announcements concerning the subject matter of this Agreement and
       the subject of IDX's or Stentor's strategy affecting sale of the MIMS
       System. In making any such announcements, the parties shall endeavor,
       consistent with their business interests and legal requirements, to be
       attentive to the business concerns of the other.

                                       4.
<PAGE>
12. As of November 15, 2005, the following defined terms shall be deleted from
Schedule 1 of the Original Agreement: "Pre-Existing Stentor Customer" and
"Stentor License Exclusion Customer."

13. Exhibit E of the Original Agreement, as amended by the First Amendment, is
hereby amended as follows: Beginning January 1, 2005, and for each calendar year
thereafter during the Initial Term, each Initiation Tier Rate used to calculate
the per-quarter Initiation Royalty payable by a party, and each Sustaining Tier
Rate used to calculate the per-quarter Sustaining Royalty payable by such party
each quarter, as set forth in Exhibit E, shall be reduced by [**] per cent [**]%
once such party has paid the other party total compensation with respect to
Exhibit E that equals the amounts set forth in the table below for the
applicable calendar year:

<TABLE>
<CAPTION>
CALENDAR YEAR   2005        2006         2007          2008         2009-2014
                                                                    (AND FOR
                                                                    ANY RENEWAL
                                                                    TERM
                                                                    CALENDAR
                                                                    YEARS)
<S>             <C>         <C>          <C>           <C>          <C>
Total IDX       $[**]       $[**]        $[**]         $[**]        $[**]
payments to
Stentor that
trigger [**]%
per-study
royalty
reduction
Total Stentor   $[**]       $[**]        $[**]         $[**]        $[**]
payments to
IDX that
trigger [**]%
per-study
royalty
reduction
</TABLE>

For the avoidance of doubt, such reductions shall not be cumulative. For
example, if Stentor has paid IDX a total of $[**] of Exhibit E-based
compensation in calendar 2005 by June 30, 2005, the Initiation Tier Rate for
Average Annual Studies in the [**] unit tier would drop from $[**] to $[**] for
the purposes of calculating the Initiation Royalty for the remaining portion of
2005. Beginning on January 1, 2006, this Initiation Tier Rate would be reset at
$[**] unless and until Stentor had paid IDX total compensation of $[**] under
Exhibit E in calendar 2006, at which point the rate would be reduced to $[**]
for the remainder of 2006, and so on for each subsequent calendar year. With
respect to calculation of the Sustaining Royalty as set forth in Exhibit E, the
Managed Study Volume shall be deemed to be the highest Managed Study Volume
achieved by a party in any quarter prior to such calculation.

14. Except as expressly set forth herein, all other terms and conditions of the
Original Agreement, as amended by the First Amendment, shall remain in full
force and effect. In the event of any inconsistency or conflict between this
Second Amendment and the Original Agreement as amended by the First Amendment,
the terms and conditions of this Second Amendment shall govern and control.
Except as expressly defined or modified herein, all capitalized terms in this
Second Amendment shall have the same meanings as set forth in the Original
Agreement as amended by the First Amendment. If a defined term is defined both
in this Second Amendment and in the Original Agreement as amended by the First
Amendment, then the term shall have the meaning set forth in this Second
Amendment.

                                       5.
<PAGE>
15. Each party represents and warrants that it possesses the right and capacity
to enter into this Second Amendment. Each party represents and warrants that
this Second Amendment has been duly authorized, executed and delivered by it and
constitutes its valid and legally binding agreement with respect to the subject
matter contained herein.

16. The Original Agreement, as amended by the First Amendment and this Second
Amendment, constitutes the complete and exclusive statement of the agreement
between the parties and supersedes all prior and contemporaneous proposals and
understandings, oral and written, relating to the subject matter contained
therein.

17. Notwithstanding anything to the contrary, nothing contained in this Second
Amendment shall have any effect upon any undertaking, commitment, or agreement
made by Stentor to any IDX customer, and by this Agreement, IDX does not
undertake to perform any such obligation of Stentor.

18. The exchange of signed, faxed copies (including counterparts) of this Second
Amendment is sufficient for this Second Amendment to be effective.

      IN WITNESS WHEREOF, the parties' duly authorized representatives have
executed this Second Amendment.

STENTOR, INC.                            IDX SYSTEMS CORPORATION
Title:
[Signature of Authorized Agent]          [Signature of Authorized Agent]

                                       6.
<PAGE>
                                 EXHIBIT 4.1.3.2

                               SUPPORT OBLIGATIONS

The following obligations will be performed by Stentor, unless otherwise
provided in this Exhibit 4.1.3.2.

-------------------------------------------------------------------------------

                    DELIVERY [**]-TARGETED FOR STENTOR [**]

-------------------------------------------------------------------------------

1. iExport [**]:

   1.1 iExport will [**] Stentor shall [**]. Stentor shall [**]. Stentor will
       [**]. In any event, the companies shall [**].

   1.2 iExport shall [**]. iExport will [**].

   1.3 iExport queue shall [**].

-------------------------------------------------------------------------------

2. [**], will be made available to IDX [**] to make it available to IDX.

-------------------------------------------------------------------------------

3. [**]:

   3.1. [**] that indicates [**] in the [**].

   3.2. [**] an event that is [**]. The event will include:

       3.2.1. [**]

       3.2.2. [**]

       3.2.3. [**]

       3.2.4. [**]

       3.2.5. [**]

   3.3. [**]

       3.3.1. [**]

       3.3.2. [**]

       3.3.3. [**]

   3.4. [**].

   3.5. [**] the system.

   3.6. [**] that is [**].

-------------------------------------------------------------------------------

4. [**]:

   4.1. [**].

-------------------------------------------------------------------------------

5. [**] in the First Amendment.

-------------------------------------------------------------------------------

                                       7.
<PAGE>
-------------------------------------------------------------------------------

                    DELIVERY [**]- TARGETED FOR STENTOR [**]
-------------------------------------------------------------------------------
6.   Stentor will [**].
-------------------------------------------------------------------------------
7.   Support for [**].
     7.1. Support for [**].
-------------------------------------------------------------------------------
8.   [**] will be [**] within which [**] will be [**].
-------------------------------------------------------------------------------
9.   Stentor will [**]. Stentor also [**]. Stentor [**].
-------------------------------------------------------------------------------
10.  [**].
     10.1. Provide [**].
     10.2. Provide [**].
-------------------------------------------------------------------------------
     10.3. IDX and Stentor [**].
     10.4. [**], Stentor will [**]:
           10.4.1. [**] information.
           10.4.2. [**] information.
           10.4.3. [**] information.
           10.4.4. [**] information.
     10.5. [**] information [**].
     10.6. [**], IDX will [**].
-------------------------------------------------------------------------------

Source: [{"source": "alea-institute/alea-institute/kl3m-data-edgar-agreements/train-00074-of-00352.parquet"}, [{"source": "alea-institute/alea-institute/kl3m-data-edgar-agreements/train-00074-of-00352.parquet"}]]