PATIENT INFOSYSTEMS INC
10-K, 1999-04-13
MISC HEALTH & ALLIED SERVICES, NEC
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                                    FORM 10-K
              ANNUAL AND TRANSITION REPORTS PURSUANT TO SECTIONS 13
                OR 15(d) FOR THE SECURITIES EXCHANGE ACT OF 1934

                                   (Mark One)
[X] Annual Report Pursuant to Section 13 or 15(d) of the Securities Exchange 
Act of 1934

                  For the fiscal year ended December 31, 1998
                                   
                                       or

[ ] Transition Report Pursuant to Section 13 or 15(d) of the Securities Exchange
Act of 1934

For the transition period from_________________to_______________________________

Commission file number              0-22319                                     

                            PATIENT INFOSYSTEMS, INC.
             (Exact name of registrant as specified in its charter)

                  Delaware                               16-1476509             
                  --------                               ----------             
       (State or other jurisdiction of      (I.R.S. Employer Identification No.)
         incorporation or organization)

      46 Prince Street, Rochester, NY                              14607        
      -------------------------------                              -----        
(Address of principal executive offices)                         (Zip Code)

Registrant's telephone number, including area code            (716) 242-7200    
                                                     --------------------------

Securities registered pursuant to Section 12(b) of the Act:

Title of each class registered          Name of each exchange on which
                                        registered

                                           None                      
                                           ----                      

Securities registered pursuant to Section 12(g)
of the Act:

                     Common Stock, $.01 Par Value Per Share 
                     -------------------------------------- 
                                (Title of Class)


     Indicate by check mark  whether the  registrant:  (1) has filed all reports
required to be filed by Section 13 or 15(d) of the  Securities  Exchange  Act of
1934  during  the  preceding  12 months  (or for such  shorter  period  that the
registrant was required to file such reports),  and (2) has been subject to such
filing requirements for the past 90 days.
 Yes [X]     No

     Indicate by check mark if disclosure of delinquent  filers pursuant to Item
405 of Regulation S-K is not contained herein, and will not be contained, to the
best  of  the  registrant's   knowledge,  in  definitive  proxy  or  information
statements  incorporated  by  reference  in Part  III of this  Form  10-K or any
amendment to this Form 10-K. [X]

     As of February 28, 1999, 8,020,042 shares of common stock were outstanding,
and the aggregate market value of the common shares of Patient Infosystems, Inc.
held by non-affiliates was approximately $8 million.

                       DOCUMENTS INCORPORATED BY REFERENCE

     Portions of the Proxy Statement for the Registrant's 1998 Annual Meeting of
Stockholders  to be filed prior to April 30, 1999 are  incorporated by reference
in Part III.


<PAGE>


                                     PART I


Item 1.   Description of Business.

General

     Patient  Infosystems,  Inc. (the  "Company" or "Patient  Infosystems")  was
incorporated  in the State of Delaware on February  22, 1995 under the name DSMI
Corp.,  changed its name to Disease State Management,  Inc. on October 13, 1995,
and then changed its name to Patient  Infosystems,  Inc. on June 28,  1996.  The
Company's   principal  executive  offices  are  located  at  46  Prince  Street,
Rochester, New York 14607 and its telephone number is 716-242-7200.

     Patient  Infosystems  provides  patient-centered  health  care  information
systems and  services to manage,  collect  and  analyze  information  to improve
patient compliance with prescribed treatment  protocols,  to improve the process
of off-site patient management and to enhance patient and provider  information.
The  Company's  technology  platform  integrates an advanced  voice  recognition
telephone system, high speed data processing and analysis capability, and demand
publishing and information distribution capabilities, utilizing the Internet and
Internet  technologies.  The system  utilizes  trained  telephone  operators and
computerized  interactive  voice response  technology and behavior  modification
based treatment to communicate  via telephone  directly with the patient at home
in order to gather relevant  patient data.  This data is subsequently  evaluated
and  automatically  transmitted  via computer  generated  reports to health care
payors,  providers  and  patients,  with these  reports  being  tailored  to the
specific  needs  of  each  recipient.   The  Company  markets  its  services  to
pharmaceutical manufacturers, pharmacy benefit managers ("PBMs") and health care
payors,  such  as  managed  care  organizations  ("MCOs"),  integrated  delivery
networks ("IDNs") and insurance companies and health care providers,  to collect
data  outside  of the  physician  office  and  institutional  setting to enhance
compliance  by patients  with  prescribed  treatment  protocols.  The  Company`s
systems may also be used to address the full spectrum of health care information
needs  with  respect to care  quality,  patient  satisfaction  and  patient  and
provider education. 

     During  its first two  years of  operations,  the  Company  emphasized  the
development of disease  management  programs,  which accounted for a substantial
portion of its revenue during 1997.  However,  during 1997 and 1998, the Company
devoted  increased  resources to the  development of other  applications  of its
technology platform,  including demand management,  patient surveys and outcomes
analysis.

Information Capture, Delivery and Analysis Technologies Utilizing the Internet

     The Company's  technology platform integrates an advanced voice recognition
telephone  system,  high speed data processing and analysis  capability,  demand
publishing and information  distribution  capabilities and behavior modification
based  compliance  algorithms  with a real time Internet  on-line  communication
system . The  system  utilizes  trained  telephone  operators  and  computerized
interactive voice response technology to communicate via telephone directly with
the patient at home as well as with payors and  providers in order to gather and
deliver  relevant  patient  data.  In order to  minimize  costly  live  operator
interaction,  a  computer  initiates  each call to the  patient,  which  call is
automatically  transferred  to an operator  and finally  routed to an  automated
speech  application.  Patients  respond to the recorded  speech  application  by
speaking  normally.  This  approach  is  designed  to enable a wider  variety of
possible  responses than is achievable  via telephone key pad.  Depending on the
patient's response,  situation-specific  algorithms are applied to modify future
questions and thus help customize the collection of data.

     The Company's  system analyzes and prepares the captured data for automatic
delivery  to the payor,  provider  and  patient  using the  Internet  and demand
publishing  capabilities.  The Company's new Internet capabilities acquired with
the  HealthDesk  purchase  enables the Company's  systems to interface on a real
time basis with patients,  payors and providers.  Demand  publishing  technology
enables  the  creation  of highly  individualized  reports by  inserting  stored
graphic images and text which can be customized for race,  gender and age. These
reports are also customized to the patient's specific situation,  and the system
utilizes the  information  received  during contacts with the patient to further
customize the content of the report.  The data  relevant to the separate  report
for  health  care   providers  is  formatted  in  a  customized   report  to  be
automatically transmitted via mail, fax or on-line.

     Each  contact  with  a  patient  contributes  to  the  establishment  of  a
longitudinal  data base  which can be  analyzed  to  provide  information  about
treatment modalities for patients, providers and payors. The Company's system is
designed to analyze  patient  compliance  to prescribed  treatment  regimens and
gather additional clinical information so that improvements in such regimens can
be developed.

Internet Capabilities

     On February 26, 1999, the Company,  through its newly formed,  wholly-owned
subsidiary, Patient Infosytems Acquisition Corp., acquired substantially all the
assets of HealthDesk Corporation ("HealthDesk"),  a consumer healthcare software
company that focuses on general health and chronic  disease  management  through
ongoing  targeted  support for patients,  families and caregivers.  The acquired
assets include  HealthDesk OnLine and HealthDesk OnLine for Diabetes,  which are
both  accessible  through the Internet and on CD-ROM.  The Company also acquired
HealthDesk's  Care Team Connect  product,  which is accessible over the Internet
and provides a communication  mechanism  between patients and their  caregivers.
The Company uses the core technologies associated with these products to support
the Company's other programs which include disease management,  case management,
demand  management,  patient  surveys  and  clinical  studies.  (See  Note 10 to
financial statements)

Integrated Disease State Management System

     The Company's first application of its integrated  information  capture and
delivery  technology is its integrated  disease state  management  system.  This
system is designed  to provide  caregivers  with the  ability to  monitor,  on a
cost-effective  basis,  patient  condition  and  behavior  while the  patient is
between  physician  consultations.  The Company  believes  that this will permit
caregivers to improve patient compliance and, as a consequence,  improve patient
outcomes.

     The Company's disease state management system has three primary components.
First,  using a panel of recognized  medical and clinical  experts,  the Company
develops a  disease-specific  patient  intervention and compliance  program that
includes a template  for the  integration  of each  patient's  history,  current
medical status and treatment  protocol.  If the program is being  developed on a
custom basis for a particular customer, the program is developed in consultation
with  the  customer's  clinical  staff  and  consultants.  Second,  the  Company
establishes  periodic  telephone  contacts  with each  patient  to  monitor  the
patient's  compliance  with  prescribed  therapies  as  well  as  the  patient's
treatment progress.  Third, using the information obtained from patient contacts
and other available  information regarding the patient and his or her treatment,
such as physician  records and pharmacy  information,  personalized  reports are
prepared,  typically  following  each patient  contact,  for  evaluation  by the
patient, the patient's health care provider and, on a routine basis, payors.

     Development of Disease-Specific Protocols

     The  Company's  disease-specific  compliance  programs  are  developed  for
targeted  diseases  either on a customized or  standardized  basis.  The Company
retains  an  internal  clinical  staff and  panels of  independent  medical  and
clinical  experts  to  identify   guidelines  of  generally  accepted  treatment
protocols and diagnostic interventions for particular diseases. These guidelines
serve as a template for  information  to be gathered from each  patient.  If the
program is being  developed  on a custom basis for a  particular  customer,  the
program is developed in  consultation  with the  customer's  clinical  staff and
consultants.  In  addition,  the  Company's  internal  clinical  staff  conducts
research of  available  databases  and gathers  information  provided by medical
experts, insurance providers,  governmental agencies,  Medicare and Medicaid and
other sources to develop with the medical experts the  disease-specific  program
structure. The resulting compliance protocols are designed to enable the Company
to gather  the  necessary  patient  information  to  determine  the  extent of a
patient's compliance with his or her prescribed treatment,  the effectiveness of
treatment and the progress of the patient's  disease.  As the Company's database
of disease-specific  treatments expands, the Company intends to use that data to
modify,  update and enhance its own disease state management compliance programs
and assist health care providers in improving treatment protocols.

     Patient Enrollment

     When a patient is enrolled in one of the Company's disease state management
programs a patient  history is obtained,  including the histories of the chronic
illness,  medications,  and  surgical  procedures  as well as other  information
deemed relevant by the disease-specific  compliance program. This information is
included  in the  Company's  database  for each  patient  and is used to  create
customized  reports  for  distribution  to each  of the  patient's  health  care
provider  and payor as well as the  patient.  The  patient  report  can  include
information on the prescribed  treatment of the patient's disease as well as the
use of the program and social support  services to improve  compliance  with the
patient's  treatment  regimen.  In addition,  the  Company's  demand  publishing
technology provides personalized behavior modification and educational materials
for the patient.  The health care provider report contains the relevant clinical
and behavioral information gathered from the patient.

     The  Company has found  patient  enrollment  to be one of the  particularly
challenging components to establishing effective programs.  Although the Company
has  completed the  development  of several  disease  management  programs,  the
Company's customers have been able to provide only limited patients to enroll in
the  programs.  To the extent that the Company's  revenue is dependent  upon the
number of contacts it is able to  achieve,  it will be required to work  closely
with its customers to develop methods to increase patient enrollment.

     Patient Contacts

     In accordance with a designated  patient contact  schedule,  a patient will
periodically  receive telephone calls from a live operator who, after confirming
the identity of the patient,  will  transfer the patient to an automated  system
that  will  ask  specific   questions   determined   in   accordance   with  the
disease-specific  compliance  program and provide  information and  motivational
feedback.  Patient  contact  schedules  are  established  for each disease state
management  program,  with the  frequency  of patient  contact  varying with the
disease under management and the goal of the applicable  treatment and occurring
as often as daily or as infrequently as on a quarterly  basis. The data gathered
from the patient  during each contact is processed  and stored in the  Company's
database.

     The compliance  program takes into account  patient  responses to treatment
follow-up  questions and initiates  specific courses of action which can include
positive reinforcement messages,  confirmation of prescription  instructions and
scheduled  callbacks  to  remind  the  patient  of the  need to take  prescribed
medication.  In  addition,  questions  to be asked in future  calls are modified
based upon the patient's responses during previous calls.

     The Company's  disease state  management  system captures and processes the
information  obtained from the patient  during the contact and  integrates  this
information  with the other data  maintained  by the  Company,  including  prior
patient responses,  patient medical history, treatments administered to date and
the mandated  treatment  protocols  for the disease.  This system  automatically
prepares distinct reports using the Company's demand publishing technologies for
the patient and for the  physician or other  caregiver.  Each report is tailored
for the particular  requirements of each recipient.  The patient's  report,  for
example, may include pictures,  diagrams and informative discussions relating to
the treatment  course  intended to modify or reinforce  certain  behaviors.  The
physician's  report would likely be more  factual and direct and  summarize  the
clinical and behavioral information that has been gathered.

     On a routine  basis the Company will provide data to the  patient's  health
care payor with respect to that patient's progress.  The Company will be able to
include  information  from various data sources in these reports for the purpose
of providing additional  information with respect to a patient. For example, the
Company may be able to interact with the pharmacy  services  division of a payor
to  determine  the  renewal  frequency  of  prescriptions,   which  provides  an
indication  of whether a patient is taking his or her  medication.  In addition,
the system provides the flexibility to allow other  information from physicians'
reports and hospital tests to be included in the periodic reports.

     Compliance  Assistance

     The Company assists payors and health care providers in monitoring  patient
compliance  and works with  health  care  providers  to develop  compliance  and
education  programs that can be implemented  through the Company's  system.  The
Company's   publishing   technology  enables   production  of   patient-specific
compliance  and  education  literature  that  is  customized  for an  individual
patient.  Once this  literature  is prepared it may be delivered to a patient by
mail, facsimile or on-line. In addition,  the Company can implement a variety of
procedures including medication reminders via wireless two-way communication and
more frequent telephone  communications  for non-compliant  patients or patients
with more  difficult  treatment  regimens.  The Company  can provide  additional
support services,  such as an 800 number that will provide recorded  information
with respect to a variety of patient education topics or other support messages.

Patient Infosystems Programs

     The Company is  developing  customized  disease state  management  and risk
assessment  programs  in  conjunction  with a number  of  customers,  as well as
standardized disease state management programs in the areas of asthma,  diabetes
and hypertension.  Each of the Company's customer  agreements for its customized
programs  provide  for  development  fees  to be paid to the  Company  upon  the
achievement of certain  milestones.  In addition,  the agreements for customized
disease  state  management  programs  may provide  for some form of  exclusivity
period, during which the Company is prohibited from engaging or participating in
other projects involving the specific disease target that is the subject of that
program.  The exclusivity  periods extend until,  in general,  a certain date or
certain period (ranging from eight to 24 months)  following the achievement of a
specified  milestone in the development or  implementation  of the program.  The
Company  enrolled its first  patients in a disease state  management  program in
October  1996,  and has less than 20,000  patients  currently  enrolled in those
programs.

     All of the Company's customer  agreements,  which are typically  terminable
without cause by either  party,  require  payment to the Company of  operational
fees per enrolled patient. The amount of the per patient program operational fee
varies with the length, complexity and frequency of patient contacts as dictated
by the respective program protocols. Patient enrollment in each of the Company's
programs  will  depend upon the  identification  and  referral by the  Company's
customers  of patients to the  Company's  system which will vary from program to
program.

     The Company has developed or is developing programs in the following areas:

     Asthma

     The Company has developed a disease state management  program for asthmatic
patients that has been marketed to payors and other  participants  in the health
care  industry,  and such program has been  provided to patients  since  January
1997.   Through  February  1999,  the  Company  has  had   approximately   4,100
interventions   with  patients   participating   in  these  programs.   American
HomePatient,  Inc. ("American  HomePatient"),  Centra Healthcare  Administrative
Services, Inc. ("Centra"), Harris Methodist Health Plan ("Harris Methodist") and
Health  Alliance,  a Division of Astra  Pharma  Inc.  ("Health  Alliance")  have
retained the Company to provide disease state  management  programs for patients
who are suffering from asthma and are enrolled in health care programs for which
these companies provide services.

     Congestive Heart Failure

     The  Company  has a  services  agreement  with  Bristol-Myers  to  develop,
implement and operate a disease state management program to aid in the treatment
of patients  suffering from congestive heart failure.  The Company has completed
the  development  of the  program in  congestive  heart  failure in the  English
language, and is currently developing the program in the Spanish language.  This
program has been  provided to patients  since April 1997,  and through  February
1999,  the Company  has had  approximately  9,900  interventions  with  patients
participating in this program.

     Diabetes

     The Company has developed a disease state  management  program for diabetic
patients that has been marketed to payors and other  participants  in the health
care  industry.  Bristol-Myers,  Centra and Health  Resources  have retained the
Company to provide this disease  state  management  program for patients who are
suffering from diabetes and are enrolled in health care programs for which these
companies provide services.  These programs have been provided to patients since
August of 1997, and through  February  1999,  the Company has had  approximately
2,600 interventions with patients participating in these programs.

     Secondary Cardiovascular Disease

     The Company has entered into a services  agreement  with  Bristol-Myers  to
develop,  implement and operate a disease state  management  program relating to
the  prevention  of  cardiovascular  sequelae  in  patients  who  have  recently
experienced  certain  cardiovascular  illnesses  or  treatments  such as angina,
cardiac bypass surgery or myocardial  infarction.  The Company has completed the
development of this program in the English language and is continuing to develop
the program in the Spanish language.  This program has been provided to patients
since  January  1997,  and  through  February  1999,  the  Company  has  had 115
interventions with patients participating in this program.

     Hypertension

     The Company has  completed  the  development  of a  compliance  program for
patients  with   hypertension  that  has  been  marketed  to  payors  and  other
participants in the health care industry. Bristol-Myers has retained the Company
to  provide  this  compliance  program  for  patients  who  are  suffering  from
hypertension  and are enrolled in health care programs for which these companies
provide services. Patients are currently being enrolled into this program. 

     Additional Disease Targets

     The  Company  has  identified  additional  opportunities  in large  chronic
disease markets,  including in the treatment of, chronic  obstructive  pulmonary
disease,  depression,  cancer,  osteoporosis,  arthritis, HIV infection and high
risk   pregnancy.   Each  of  these  targets  has  been   identified  as  having
characteristics   which  make  them  attractive  candidates  for  the  Company's
programs.  The Company is currently  involved in discussions  with customers for
the development of programs in a variety of these areas.

     Significant Customer Concentration

     The  Company's  current  contracts  are  concentrated  in a small number of
customers,  with several of the Company's most significant  contracts being with
Bristol-Myers and Aetna U.S.  HealthCare.  The Company expects that its sales of
services will be concentrated in a small number of customers for the foreseeable
future. Consequently, the loss of any one of its customers could have a material
adverse effect on the Company and its operations. There can be no assurance that
customers will maintain their  agreements with the Company,  enroll a sufficient
number of patients in the  programs  developed by the Company for the Company to
achieve or maintain profitability,  or that customers will renew their contracts
upon expiration or on terms favorable to the Company. 

Other Applications of the Integrated Information Capture and Delivery Technology

     Demand Management

     Demand  management  involves  assisting  providers  in  evaluating  patient
treatment  needs to identify  those  patients  who may not require  immediate or
intensive services.  The goal of demand management is to reduce the need for and
use of costly,  often  clinically  unnecessary,  medical  services and arbitrary
managed-care  interventions  while  improving  the  overall  quality  of life of
patients.  The Company believes that its system can be used to provide automated
or semi-automated demand management services. The Company is currently providing
demand management to approximately  150,000 patients for Kentucky Medicaid,  CHA
HMO, Inc. and Managed Care Assistance Corporation.

     Outcomes Analysis

     The Company intends to utilize information  gathered from patients enrolled
in its programs to serve two purposes.  First,  information  regarding treatment
results,  success of the  compliance  program and patient  reaction to differing
treatments or compliance protocols may be used by the Company to further improve
each disease-specific  compliance program.  Second, this information may be used
by payors,  pharmaceutical  companies and health care providers to assist in the
development  of  improved  treatment  modalities.   The  Company  has  developed
analytical methodologies using database management and information technologies.
The Company intends to use these data analysis  technologies to predict the best
treatment methodologies for patients.
         
     Clinical Studies

     Many  pharmaceutical  companies  and contract  research  organizations  are
seeking more  economical,  efficient  and  reliable  methods for  compiling  and
analyzing clinical data in conducting  clinical trials.  Furthermore,  many drug
development  protocols have begun to emphasize  subjective criteria and outcomes
information.  The  Company  believes  that its  system  will allow it to develop
programs tailored to the measurement of outcomes data relating to the conduct of
later  stage  clinical  trials.  The Company  believes  that its system can also
assist  pharmaceutical  companies  in studying and  documenting  the efficacy of
approved  products  in  order  to  provide  ongoing  information  to  FDA or for
marketing purposes.

     Patient Surveys

     Organizations  in many different  areas of the health care industry  survey
users regarding  their products and services for a variety of reasons  including
regulatory,  marketing and research purposes. The Company's information systems,
with their ability to proactively  contact patients in a cost-efficient  manner,
may be used for this type of application.  The Company has developed a series of
10  automated   surveys   ranging  from  general  health  to  disease   specific
instruments.   The  product  line  includes  surveys  for  SF-12;  child  health
questionnaire;  patient satisfaction;  asthma;  diabetes; back pain; depression;
prostatis;  maternity; and the Pra Plus for elderly populations. The Company has
completed approximately 125,000 surveys during 1998 through February 1999.

     Case Management

     Patients who are  prescribed  complex or high cost  treatment  regimens may
require  a  higher  level  of   monitoring,   interaction,   care  planning  and
reassessment than patients with less complicated treatment regimens. The Company
believes that its system is capable of providing these enhanced services to such
patients to eliminate or minimize the  unnecessary  costs and medical  attention
that result from a patient's  lack of  compliance  with a  prescribed  treatment
regimen.

Sales and Marketing

     Through 1997, the Company's efforts focused primarily on the development of
disease  management  programs.  During  1998,  the  Company  began  aggressively
marketing the other services that its technology  platform can provide including
demand management,  patient surveys and outcomes  analysis.  The Company markets
its  integrated  disease state  management  system to  organizations  within the
health care industry that are involved in the treatment of disease or payment of
medical  services  for  patients  who  require  complex  or  long-term   medical
therapies.   These  industry   organizations   include  five  distinct   groups:
pharmaceutical  companies,  medical service companies,  PBMs, health care payors
and employer  groups.  The Company employs a sales and marketing staff of twelve
persons to market the Company's systems. In addition,  the senior members of the
Company's management are actively engaged in marketing the Company's programs.

     The  Company has  expanded  its  marketing  efforts by  conducting  patient
surveys,  clinical studies and implementing  other measures designed to document
the clinical and cost benefits it believes will result from the  application  of
its integrated  information  capture and delivery system. In collaboration  with
the members of its expert panels who are retained to develop  program  protocols
and other research and clinical technicians,  the Company intends to promote the
benefits  of  its  system   through   publication   in  clinical   journals  and
presentations  at scientific  conferences of the results of these  studies.  The
Company is conducting such studies  designed to produce  significant  short-term
data with respect to its asthma, diabetes and cardiac programs.

     The Company  entered into a joint  venture  agreement  with MacLean  Hunter
Publishing Limited, an Ontario,  Canada corporation,  in November 1998 to market
and sell, on an exclusive  basis in Canada,  products and services  developed by
the Company and to manage  jointly,  finance  and  operate the  business  entity
Patient  Infosystems  Canada,  Inc.,  which is dedicated to the development of a
commercially viable business built around the sale, marketing and service of the
Company's products and services.

Research and Development

     Research and development expenses consist primarily of salaries and related
benefits  and  administrative  costs  allocated  to the  Company's  research and
development  personnel for  development of certain  components of its integrated
information capture and delivery system, as well as development of the Company's
standardized disease state management  programs.  Research and development costs
have  decreased  as the Company has  completed  the  development  of its primary
disease  management   programs.   The  Company  anticipates  that  research  and
development expenses will continue to decrease in future periods, as the Company
continues to expand its operations.

     The  development  and  maintenance of the  telecommunications  and computer
publishing systems through which the Company operates its integrated information
capture  and  delivery  system  is  a  major  component  of  its  business.  The
communications  and information  technology  industries are subject to rapid and
significant  technological change, and the ability of the Company to operate and
compete is  dependent in  significant  part on its ability to update and enhance
its system continuously.  In order to do so, the Company must be able to utilize
effectively  its  research  and  development   capabilities  and  implement  new
technology in order to enhance its systems.  At the same time,  the Company must
not  jeopardize  its  ability to contact  patients  and to process  and  publish
patient information or adapt to customer  preferences or needs. The Company will
maintain a significant investment in its technology, and therefore is subject to
the risk of technological obsolescence.
Competition

     The market for health care  information  products and services is intensely
competitive.  Competitors  vary in size and in scope and breadth of products and
services offered, and the Company competes with various companies in each of its
disease target markets.  Many of the Company's  competitors  have  significantly
greater financial,  technical,  product development and marketing resources than
the Company.  Furthermore,  other major  information,  pharmaceutical and health
care companies not presently  offering  disease state management or other health
care information  services may enter the markets in which the Company intends to
compete.  In addition,  with sufficient  financial and other resources,  many of
these  competitors may provide  services similar to those of the Company without
substantial  barriers.  The Company does not possess any patents with respect to
its  integrated  information  capture and delivery  system,  and although it has
filed a patent  application  with respect to certain  aspects of its  integrated
information  capture  and  delivery  system  and its  integrated  disease  state
management  system,  there can be no assurance that this application will result
in the  issuance  of a patent,  or if issued,  that a patent  would  provide the
Company with any competitive advantage.

     The  Company's   potential   competitors   include  specialty  health  care
companies,  health care  information  system and software  vendors,  health care
management  organizations,  pharmaceutical companies and other service companies
within the health care  industry.  Many of these  competitors  have  substantial
installed  customer  bases in the health care  industry  and the ability to fund
significant product development and acquisition  efforts.  The Company will also
compete  against other  companies that provide  statistical  and data management
services, including clinical trial services to pharmaceutical companies.

     The Company is aware of several large  pharmaceutical  and medical  service
companies that have publicly stated that they intend to be involved in providing
comprehensive  disease state management services.  The Company believes that the
principal  competitive  factors in its market are the ability to link  patients,
health  care  providers  and  payors,  and  provide  the  relevant  health  care
information at an acceptable  cost. In addition,  the Company  believes that the
ability to anticipate  changes in the health care industry and identify  current
needs are important competitive factors.

Quality Control

     The Company has developed  quality control measures designed to insure that
information  obtained  from  patients is  accurately  transcribed,  that reports
covering  each  patient  contact  are  delivered  to health care  providers  and
patients and that the  Company's  personnel  and  technologies  are  interacting
appropriately  with patients and health care providers.  Quality control systems
include random monitoring of telephone calls, patient surveys to confirm patient
participation  and  effectiveness  of the particular  program,  and  supervisory
reviews of telephone agents.

Government Regulation

     The health care  industry,  including the current and proposed  business of
the Company,  is subject to extensive  regulation  by both the Federal and state
governments.  A number of states have extensive  licensing and other  regulatory
requirements   applicable  to  companies  that  provide  health  care  services.
Additionally,  services  provided to health  benefit  plans in certain cases are
subject  to the  provisions  of the  Employee  Retirement  Income  Security  Act
("ERISA")  and may be affected by other state and Federal  statutes.  Generally,
state laws prohibit the practice of medicine and nursing without a license. Many
states  interpret  the practice of nursing to include  health  teaching,  health
counseling,  the provision of care supportive to or restorative of life and well
being  and  the  execution  of  medical  regimens  prescribed  by  a  physician.
Accordingly,  to the extent  that the Company  assists  providers  in  improving
patient  compliance by publishing  educational  materials or providing  behavior
modification training to patients, such activities could be deemed by a state to
be the practice of medicine or nursing. Although the Company has not conducted a
survey  of the  applicable  law in all 50  states,  it  believes  that it is not
engaged in the  practice  of medicine  or  nursing.  There can be no  assurance,
however,  that the Company's  operations  will not be challenged as constituting
the  unlicensed  practice of medicine or nursing.  If such a challenge were made
successfully  in any state,  the Company  could be subject to civil and criminal
penalties  under such  state's  law and could be  required  to  restructure  its
contractual  arrangements  in that  state.  Such  results  or the  inability  to
successfully  restructure  its  contractual  arrangements  could have a material
adverse effect on the Company.

     The  confidentiality  of patient  information  is subject to  regulation by
state law. A variety of statutes and regulations exist safeguarding  privacy and
regulating the disclosure and use of medical  information.  State  constitutions
may provide  privacy rights and states may provide  private causes of action for
violations  of an  individual's  "expectation  of privacy."  Tort  liability may
result from unauthorized access and breaches of patient confidence.  The Company
intends to comply with state law and regulations  governing medical  information
privacy.

     In  addition,  on August 21,  1996  Congress  passed  the Health  Insurance
Portability  and  Accountability  Act of  1996  ("HIPAA"),  P.L.  104-191.  This
legislation  requires  the  Secretary  of the  Department  of  Health  and Human
Services to adopt national standards for electronic health  transactions and the
data  elements  used in such  transactions.  The  Secretary is required to adopt
safeguards  to  ensure  the  integrity  and   confidentiality   of  such  health
information.  Violation of the standards is punishable by fines and, in the case
of  wrongful   disclosure  of  individually   identifiable  health  information,
imprisonment.  The  Secretary  has  promulgated  and  published  proposed  rules
addressing  the  standards,  however,  no final rules have been adopted to date.
Final rules may be adopted during 1999.

     The Company and its  customers may be subject to Federal and state laws and
regulations  which govern financial and other  arrangements  between health care
providers. These laws prohibit certain fee splitting arrangements between health
care  providers,  as well as direct and  indirect  payments,  referrals or other
financial  arrangements that are designed to induce or encourage the referral of
patients  to,  or the  recommendation  of, a  particular  provider  for  medical
products and services.  Possible  sanctions for violation of these  restrictions
include civil and criminal penalties.  Specifically,  HIPAA increased the amount
of civil monetary  penalties from $2,000 to $10,000.  Criminal  penalties  range
from  misdemeanors,  which carry fines of not more than $10,000 or  imprisonment
for not more than one year, or both, to felonies,  which carry fines of not more
than $25,000 or  imprisonment  for not more than five years,  or both.  Further,
criminal violations may result in permanent mandatory  exclusions and additional
permissive exclusions from participation in Medicare and Medicaid programs.

     Furthermore,  the Company and its  customers  may be subject to federal and
state laws and regulations  governing the submission of false healthcare  claims
to the government and private payers. Possible sanctions for violations of these
laws and regulations include minimum civil penalties between  $5,000-$10,000 for
each false claim and treble damages.

     Regulation in the health care field is constantly evolving.  The Company is
unable to predict what government  regulations,  if any,  affecting its business
may be  promulgated  in the future.  The Company's  business  could be adversely
affected by the failure to obtain required licenses and governmental  approvals,
comply with applicable regulations or comply with existing or future laws, rules
or regulations or their interpretations.

Intellectual Property

     The Company  considers  its  methodologies,  processes  and  know-how to be
proprietary.  The Company seeks to protect its proprietary  information  through
confidentiality  agreements with its employees.  The Company's policy is to have
employees   enter  into   confidentiality   agreements   containing   provisions
prohibiting  the  disclosure of  confidential  information to anyone outside the
Company,  requiring  employees  to  acknowledge,  and, if  requested,  assist in
confirming the Company's ownership of any new ideas,  developments,  discoveries
or inventions  conceived  during  employment,  and  requiring  assignment to the
Company of proprietary  rights to such matters that are related to the Company's
business.

Employees

     As of February 28, 1999, the Company had 121 full and part-time employees.

Financial Information

         For financial  information  concerning  the Company,  see the financial
statements and the notes thereto included elsewhere herein.


Item 2.   Description of Properties.

     The Company's executive and corporate offices are located in Rochester, New
York in  approximately  13,000  square  feet of  leased  office  space  under an
operating  lease that expires on November 30, 1999.  The Company  leases  office
space  for  its  Demand  Management  call  center  in  Wayne,   Pennsylvania  in
approximately  2,047 square feet of leased office space under a lease  agreement
that expires in May 2001.  The Company  leases  office  space for its  Berkeley,
California office in approximately  2,800 square fee of lease office space under
a lease agreement that expires in October 1999.

     The Company  believes its plants and  facilities are suitable and adequate,
and have sufficient productive capacity, to meet its current needs.


Item 3.    Legal Proceedings.

     The Company is not a party to any material legal proceedings.

Item 4.    Submission of Matters To A Vote Of  Security Holders.

     No matters were  submitted to a vote of security  holders during the fourth
quarter ended December 31, 1998.
<PAGE>


                                     PART II



Item 5. Market Price of and  Dividends  on the  Registrant's  Common  Equity and
Related Stockholder Matters.

(a)  Market Information

     The Company's  common stock is traded on the NASDAQ  National Market System
under the symbol  "PATI".  The  following  table  sets  forth,  for the  periods
indicated,  the range of the high and low closing  sale price for the  Company's
Common Stock as reported on the NASDAQ National Market.

                                        High              Low

       1997
       First Quarter                    $9.25             $6.38
       Second Quarter                   $6.25             $4.50
       Third Quarter                    $5.00             $2.88
       Fourth Quarter                   $4.38             $2.63

       1998
       First Quarter                    $4.50             $2.63
       Second Quarter                   $5.00             $2.50
       Third Quarter                    $3.44             $1.81
       Fourth Quarter                   $1.88             $1.00


(b)  Holders

     The approximate  record number of holders of the Company's  common stock as
of February  28, 1999 is 87.  However,  the Company  believes  that there are in
excess of 400 beneficial holders of Common Stock of the Company.

(c)  Dividends

     The Company has never paid cash dividends on its capital stock and does not
anticipate  paying any cash  dividends in the  foreseeable  future.  The Company
currently intends to retain all future earnings, if any, to fund the development
and growth of its business.  Any future determination to pay cash dividends will
be at the discretion of the Board of Directors.

(d)  Use of Proceeds

     The Company has used and  continues  to use the  proceeds  from its initial
public  offering of common stock in December 1996 for capital  improvements  and
expansion of its telephone and computer capabilities for sales and marketing and
for general corporate  purposes as more fully discussed in financial  statements
and notes  thereto  appearing  elsewhere  herein.  Recently,  the  Company  used
$761,000 in connection with the acquisition of the assets of HealthDesk.

<PAGE>

Item 6.  Selected Financial Data.
<TABLE>
<CAPTION>

                                                                                     Period from
                                                                                  February 22, 1995
                                                                                   (Inception) to
                                               Year Ended December 31,               December 31,
                                               -----------------------               ------------
                                          1998            1997            1996            1995
                                          ----            ----            ----            ----
<S>                                       <C>             <C>             <C>              <C>
                              

Statement of Operations Data:

Revenues ........................... $ 2,344,072    $  2,062,373    $    845,412    $    113,000

Costs and Expenses:
  Cost of Sales .....................  2,529,619       1,629,128         748,322         111,870
  Sales and Marketing ...............  1,795,921       1,609,837         913,547         375,384
  General and Administrative ........  3,062,204       2,442,269       1,759,044         678,498
  Research and Development ..........    298,686         489,115         310,552          89,909
                                         -------         -------         -------          ------

    Total Costs and Expenses ........  7,686,430       6,170,349       3,731,465       1,255,661
                                       ---------       ---------       ---------       ---------

Operating Loss ...................... (5,342,358)     (4,107,976)     (2,886,053)     (1,142,661)

Other Income and Expenses ...........    556,592         835,116          81,333          26,009

Provision for taxes .................     43,701          (9,509)          1,716            --
                                          ------          ------           -----          -----

Net Loss ..........................  $(4,829,467)   $ (3,263,351)   $ (2,806,436)   $ (1,116,652)
                                     ============    ============    ============    ============ 


Net Loss Per Share - Basic 
and Diluted ........................$      (0.60)   $      (0.41)   $      (0.44)   $      (0.18)
                                    ============    ============    ============    ============ 

Weighted Average Common
  and Potential Common Shares ......   8,018,398       7,980,094       6,347,716       5,954,299
                                       =========       =========       =========       =========
</TABLE>

<TABLE>
<CAPTION>
                                                        Year Ended December 31,
                                                        -----------------------
                                                                              
                                          1998            1997            1996            1995
                                          ----            ----            ----            ----
<S>                                       <C>             <C>             <C>             <C> 

Balance Sheet Data:

Cash and Cash Equivalents .......   $  6,316,955    $    779,317    $ 15,666,609    $  1,182,080
Working Capital .................      7,992,894      13,242,387      14,591,700         611,655
Total Assets ....................     10,519,727      15,036,473      17,085,387       1,763,629
Total Liabilities ...............        894,339         587,728       1,631,650         598,464
Total Stockholders' Equity ......      9,625,388      14,448,745      15,453,737       1,165,165
</TABLE>

<PAGE>


Item 7. Management's  Discussion and Analysis of Financial Condition and Results
of Operations.

     Management's  discussion  and analysis  provides a review of the  Company's
operating  results for the years ended December 31, 1998, 1997 and 1996, and its
financial  condition at December  31,  1998.  The focus of this review is on the
underlying  business  reasons for significant  changes and trends  affecting the
revenues,  net  earnings,  and financial  condition of the Company.  This review
should be read in conjunction with the accompanying financial statements.

     In an effort to give investors a well-rounded view of the Company's current
condition  and future  opportunities,  this Annual  Report on Form 10-K includes
forecasts by the  Company's  management  about future  performance  and results.
Because they are forward-looking,  these forecasts involve  uncertainties.  They
include risks of market  acceptance of or preference  for the Company's  systems
and  services,  competitive  forces,  the impact of, and changes in,  government
regulations,  general  economic  factors in the healthcare  industry,  and other
factors  discussed in the  Company's  filings with the  Securities  and Exchange
Commission.

Overview

     The  Company was formed on  February  22, 1995 and has a limited  operating
history  from which to  evaluate  its  performance.  Although  the  Company  has
completed the  development  of its integrated  information  capture and delivery
system and has developed several disease state management  programs for specific
diseases, the  Company is  continuing  to refine its  products  for  additional
applications.  In October 1996 the Company began enrolling patients in its first
disease state  management  program and only began  substantial  patient contacts
during  1998.  The  Company  currently  has  patients  enrolled  in  five of its
disease-specific  programs. Through February 1999, an aggregate of approximately
350,000  persons  have  enrolled  and  participated  in  Company  programs.  The
enrollment  of patients in the  Company's  programs  has been limited by several
factors,  including  the limited  ability of clients to provide the Company with
accurate information with respect to the specific patient populations, including
coding errors that necessitated  extensive labor intensive data processing prior
to program  implementation.  In addition, the Company has encountered resistance
from patients and other sources of information to the Company's systems.

     In  response  to these  market  dynamics,  the  Company  has taken  several
tactical and strategic steps including, formal designation of internal personnel
at customer sites to assist clients with  implementation;  closer integration of
Company  systems  personnel with clients to facilitate  accurate data transfers;
and most  importantly,  promotion of a broader product line to enable clients to
enter the Company's disease  management  programs through a variety of channels.
The Company now markets two additional services,  demand management services and
automated  surveys  (general  health  and  disease-specific),  both of which can
provide mechanisms for enrollment to the Company's disease management  programs.
Nevertheless,  no assurance can be given that the Company's efforts will succeed
in increasing patient enrollment in Company programs.

     The Company has entered into services agreements to develop,  implement and
operate  programs  for:  (i)  patients  who have  recently  experienced  certain
cardiovascular  events;  (ii)  patients  who have been  diagnosed  with  primary
congestive  heart failure;  (iii)  patients  suffering from anorexia or cachexia
secondary to diagnosis of cancer or AIDS;  (iv) patients  suffering from chronic
pain, and (v) patients who are at increased risk of suffering from epilepsy.  In
addition,  the Company  has  entered  into  services  agreements  to operate its
disease  management  programs for patients  suffering from asthma,  diabetes and
hypertension.  These contracts provide for, and the Company  anticipates  future
contracts will provide for, fees paid by its customers  based upon the number of
patients  participating  in each of its  programs,  as well as  initial  program
development  fees  from  customers  for the  development  of a  disease-specific
program.  To the extent that the Company has had limited  enrollment of patients
in its programs,  the Company's operations revenue has been, and may continue to
be limited.  Moreover,  as the  Company has  completed  the  development  of its
primary disease  management  programs,  it anticipates that development  revenue
will also  decline  over the next  twelve  months  unless and until the  Company
enters  into new  development  agreements.  The  Company's  program  development
contracts  typically  require  payment  from the  customer  at the time that the
contract is  executed,  with  additional  payments  made as certain  development
milestones are met.  Development  contract revenue is recognized on a percentage
of completion  basis,  in accordance  with the ratio of total  development  cost
incurred  to the  estimated  total  development  costs for the  entire  project.
Losses,  if any,  related to program  development  will be recognized in full as
identified.  The Company's contracts call for a fixed program operational fee to
be paid by the  customer  for each  patient  enrolled  for a series  of  program
services as defined in the  contract.  The timing of customer  payments  for the
delivery  of  program  services  varies  by  contract.   Revenues  from  program
operations are  recognized  ratably as the program  services are delivered.  The
amount of the per patient fee varies from program to program  depending upon the
number of patient contacts required, the complexity of the interventions and the
detail of the  reports  generated.  The Company  has not  capitalized  any costs
related to the  development of software for use in its disease state  management
programs since all of such software has been developed for internal use. 

     Revenues from  Operations,  which includes fees received by the Company for
operating  its  programs  has  increased  substantially  and has become the most
significant  source of the  Company's  revenues.  Furthermore,  as enrollment in
Company operated disease management programs continues to increase,  the Company
anticipates  that these  revenue  sources will become the primary  source of the
Company's revenues. Currently, the Company's demand management programs generate
more  revenue than the  Company's  disease  management  programs.  However,  the
Company is continuing to devote significant  marketing efforts to increasing the
number of disease management programs that are in operation.  Nevertheless,  the
Company is still  supporting a substantial  infrastructure  in  maintaining  the
capacity  necessary  to deliver its  services  and to offer its  services to new
customers. Therefore, the Company will be required to increase substantially the
number of patient contacts and management  programs to cover the costs necessary
to maintain the  capability  to service its  customers.  In that the Company has
only begun substantial  patient contacts during 1998, the Company is continually
examining its costing  structures to determine the levels that will be necessary
to achieve profitability.

     The sales cycle for the  Company's  programs may be extensive  from initial
contact to contract  execution.  During  these  periods,  the Company may expend
substantial  time, effort and funds to prepare a contract proposal and negotiate
the contract. The Company may be unable to consummate a commercial  relationship
after the expenditure of such time, effort and financial resources. 

     The Company began to provide other  services to customers in the healthcare
industry during 1997 which included new applications of its information  capture
and  delivery  system.   These  consisted  of  patient   surveys,   health  risk
assessments,  nursing  support  lines and  marketing  support  functions.  

     In February,  1999,  the Company,  through its newly  formed,  wholly-owned
subsidiary, Patient Infosystems Acquisition Corp., acquired substantially all of
the assets of HealthDesk  Corporation,  a consumer  healthcare software company,
primarily  engaged in the business of designing and  developing  Internet  based
products in the  healthcare,  wellness  and disease  management  industries  for
$761,463.  The Company  obtained funds for the HealthDesk  acquisition  from its
available cash. The assets that were acquired by the Company included inventory,
intellectual property, hardware and software.

Results of Operations

Year Ended December 31, 1998 Compared to Year Ended December 31, 1997

     Revenues

     Revenues are comprised of revenues from operations  fees,  development fees
and licensing  fees.  Revenues  increased 14% from $2,062,373 for the year ended
December 31, 1997 to $2,344,072  for the year ended December 31, 1998. A summary
of these revenues by category is as follows:
                                                                December 31,
                                                                ------------
                                                             1998         1997
                                                             ----         ----
Revenues 
- -------- 
Operations Fees ......................................   $1,385,720   $  735,841
Development Fees .....................................      689,157      826,532
Licensing Fees .......................................      269,195      500,000
                                                            -------      -------

Total Revenues .......................................   $2,344,072   $2,062,373
                                                         ==========   ==========

     Revenues  from  operations  increased  88% from $735,841 for the year ended
December 31, 1997 to $1,385,720 for the year ended December 31, 1998. Operations
revenues are  generated as the Company  provides  services to its  customers for
their disease-specific programs.  Operations revenues increased significantly in
1998,  as the  Company  continues  to  increase  the  membership  levels  in the
Company's  disease state  management  programs and primarily  from the Company's
demand  management  programs.  The demand  management  programs operate from the
Company's  medical  call center  which was  established  in May 1998,  in Wayne,
Pennsylvania  The medical  call center is staffed by  registered  nurses on a 24
hour, 7 day a week schedule.

     Revenues  from  development  fees  decreased 17% from $826,532 for the year
ended  December 31, 1997 to $689,157 for the year ended  December 31, 1998.  The
Company  received  $689,157 in development  revenues for the year ended December
31, 1998, related almost entirely to fees from Bristol-Myers for the development
of disease state management  agreements.  The Company also received  development
revenues   from  a  small   number   of  other   customers   related   to  other
disease-specific  programs. The Company has completed substantially all services
under these  agreements and is currently  receiving  revenues in connection with
only the development of three programs.  Development  revenues include clinical,
technical  and  operational  design or  modification  of the  Company's  primary
disease management  programs.  Development  revenue declined from the year ended
December  31, 1997 to December 31, 1998 as the Company  reduced its  development
fees charged to certain  customers.  The Company  anticipates  that revenue from
development  fees will  continue to decline  unless the Company  enters into new
development agreements.

     Revenues from licensing fees decreased 46% from $500,000 for the year ended
December  31, 1997 to $269,195 for the year ended  December 31, 1998.  Licensing
revenue represents amounts that the Company charges its customers, on a one-time
fee basis,  for the right to enroll  patients  in or the right to license  other
entities  certain of its  programs,  primarily but not limited to, the Company's
standardized  asthma and diabetes  programs.  The Company had licensing  fees of
$99,750 from the sale of consumer  healthcare  software which are Internet based
products. 

     The Company also  provides  other  services to customers in the  healthcare
industry which involve new applications of its information  capture and delivery
system. These services include patient surveys, health risk assessments, patient
satisfaction  surveys,   physician  education  programs  and  marketing  support
functions.

     Costs and Expenses

     Cost of sales include salaries and related  benefits,  services provided by
third  parties,  and  other  expenses  associated  with the  development  of the
Company's customized disease state management programs, as well as the operation
of each of its disease state management programs. 

     Cost of sales increased 55% from $1,629,128 for the year ended December 31,
1997 to $2,529,619  for the year ended  December 31, 1998. The increase in these
costs  primarily  reflects  an  increased  level  of  program   development  and
operational  activities,  as  well as the  Company's  creation  of the  capacity
necessary to handle  anticipated  increases in the number of individuals to whom
the Company provides services.

     Sales and marketing  expenses  increased 12% from  $1,609,837  for the year
ended  December  31, 1997 to  $1,795,921  for the year ended  December 31, 1998.
These costs consist  primarily of salaries,  related  benefits and travel costs,
sales materials and other marketing related expenses.  Spending in this area has
remained  consistent as the Company's sales and marketing staff has not expanded
during  the  twelve  month  period  ended  December  31,  1998.  However,  it is
anticipated  that the Company will continue to invest in the sales and marketing
process, and that such expenses will increase in future periods.

     General  and  administrative   expenses  include  the  costs  of  corporate
operations,  finance and accounting, human resources and other general operating
expenses of the Company.  General and administrative expenses increased 25% from
$2,442,269 for the year ended December 31, 1997 to $3,062,204 for the year ended
December 31, 1998.  These  expenditures  were  incurred to develop the corporate
infrastructure   necessary  to  support   anticipated  program  development  and
operations.  The  increase  in these  costs  was  caused by an  increase  in the
Company's   level  of   business   activity,   and  the   addition  of  required
administrative  personnel.  The Company expects that general and  administrative
expenses will continue to increase in future periods.

     Research and development expenses consist primarily of salaries and related
benefits  and  administrative  costs  allocated  to the  Company's  research and
development  personnel for  development of certain  components of its integrated
information capture and delivery system, as well as development of the Company's
standardized  disease  state  management  programs.   Research  and  development
expenses  decreased  39% from  $489,115 for the year ended  December 31, 1997 to
$298,686  for the year ended  December  31,  1998.  The decrease in research and
development expenses reflects the Company's completion of the development of its
primary disease management  programs.  

     The Company  generates net investment  income  primarily from cash balances
and  investments.  Investment  income  decreased  to $556,592 for the year ended
December  31, 1998 from  $835,116  for the year ended  December  31,  1997.  The
decrease in interest  income  reflects  the use by the Company of its  available
cash and the reduction of proceeds that can earn interest.

     The Company had a net loss of  $4,829,467  for the year ended  December 31,
1998  compared  to  $3,263,351  for the  year  ended  December  31,  1997.  This
represents a loss of $.60 per share for 1998 and $.41 for 1997. 

Year Ended December 31, 1997 Compared to Year Ended December 31, 1996

     Revenues

     Revenues are comprised of revenues from development  fees,  operations fees
and licensing  fees.  Revenues  increased  144% from $845,412 for the year ended
December 31, 1996 to $2,062,373  for the year ended December 31, 1997. A summary
of these revenues by category is as follows:

                                                                December 31,
                                                                ------------
Revenues                                                      1997        1996
- --------                                                      ----        ----
     
Development Fees .....................................   $  826,532   $  798,138
Operations Fees ......................................      735,841       11,718
Licensing Fees .......................................      500,000       35,556
                                                            -------       ------

Total Revenues .......................................   $2,062,373   $  845,412
                                                         ==========   ==========

     Revenues from  development  fees  increased 3.6% from $798,138 for the year
ended  December 31, 1996 to $826,532 for the year ended  December 31, 1997.  The
Company  received  $826,532 in development  revenues for the year ended December
31, 1997,  primarily  related to fees from  Bristol-Myers for the development of
six disease state management  contracts.  The Company also received  development
revenues   from  a  small   number   of  other   customers   related   to  other
disease-specific  programs. The Company has completed substantially all services
under these  agreements and is currently  receiving  revenues in connection with
only the development of three  programs.  

     The Company's development contracts generally require that payments be made
by the  customer at the time of contract  execution  and at the  achievement  of
certain  milestones  in the  development  process.  These  payments are normally
received in advance of the Company's  recognition of the associated revenue. The
timing of customer payments for program  operation  services varies by contract,
but  typically  occurs prior to the  associated  services  being  provided.  The
Company  recognizes  deferred  revenue for amounts  billed for these services in
advance of the  rendering  of the  services.  The advance  payments  have been a
source of liquidity for the Company.  

     Revenues from  operations  increased  6180% from $11,718 for the year ended
December 31, 1996 to $735,841 for the year ended  December 31, 1997.  Operations
revenues are  generated as the Company  provides  services to its  customers for
their disease-specific programs.  Operations revenues increased significantly in
1997, as the Company began enrolling patients and implementing its disease state
management  programs  during 1997.  Operations  revenue  consisted  primarily of
$440,000  in  fees  received  from  Abbott  Laboratories  in  connection  with a
teleconference  program  completed  during the year ended December 31, 1997. 

     Revenues  from  licensing  fees  increased  1306% from $35,556 for the year
ended  December  31,  1996 to $500,000  for the year ended  December  31,  1997.
Licensing revenue  represents amounts that the Company charges its customers for
the right to enroll patients in or the right to market to other entities certain
of its  programs,  primarily  the  Company's  standardized  asthma and  diabetes
programs,  and the right to have access to data collected from patients enrolled
in such programs.  The Company did not initiate any licensing activity until the
second quarter of 1996, therefore licensing revenues for the year ended December
31, 1997 were  significantly  higher that those generated  during the year ended
December 31, 1996. In 1997, the Company received  licensing revenues of $150,000
from the  PulseGroup,  Inc. for a licensing  contract  related to the  Company's
asthma and diabetes programs.

     The Company began to provide other  services to customers in the healthcare
industry during 1997 which involve new  applications of its information  capture
and  delivery  system.  These  services  include  patient  surveys,  health risk
assessments,  nursing  support lines and  marketing  support  functions.  

     Costs and Expenses

     Cost of sales include salaries and related  benefits,  services provided by
third  parties,  and  other  expenses  associated  with the  development  of the
Company's customized disease state management programs, as well as the operation
of each of its disease state management programs. In addition, cost of sales for
1997 and 1996 includes accrued losses on program  development in accordance with
the Company's policy of recognizing such losses,  if any, in full as identified.
The  accrued  loss for 1997 and 1996 is a result of a  particular  contract  for
which the amount of the program development fee is based upon the success of the
program,  and the fact that the guaranteed  development revenue for this program
is less than the  estimated  cost of its  development.  To the  extent  that the
Company  enters into any  contracts  of this type in the future,  and that those
contracts  provide for  guaranteed  development  revenue  which is less than the
estimated cost of program development,  such losses will continue to be accrued.

     Cost of sales  increased 118% from $748,322 for the year ended December 31,
1996 to $1,629,128  for the year ended  December 31, 1997. The increase in these
costs  primarily  reflects  an  increased  level  of  program   development  and
operational activities.

     Sales and marketing expenses increased 76% from $913,547 for the year ended
December 31, 1996 to  $1,609,837  for the year ended  December  31, 1997.  These
costs consist  primarily of salaries,  related benefits and travel costs.  These
expenditures  allowed  the Company to  undertake  initial  marketing  efforts to
pharmaceutical  companies,  payors and other health care services organizations.
The  increase in these costs  reflects an increase in the size of the  Company's
sales and marketing staff.

     General  and  administrative   expenses  include  the  costs  of  corporate
operations,  finance and accounting, human resources and other general operating
expenses of the Company.  General and administrative expenses increased 39% from
$1,759,044 for the year ended December 31, 1996 to $2,442,269 for the year ended
December 31, 1997.  These  expenditures  were  incurred to develop the corporate
infrastructure   necessary  to  support   anticipated  program  development  and
operations.  The  increase  in these  costs  was  caused by an  increase  in the
Company's   level  of   business   activity,   and  the   addition  of  required
administrative  personnel.  

     Research and development expenses consist primarily of salaries and related
benefits  and  administrative  costs  allocated  to the  Company's  research and
development  personnel for  development of certain  components of its integrated
information capture and delivery system, as well as development of the Company's
standardized  disease  state  management  programs.   Research  and  development
expenses  increased  57% from  $310,552 for the year ended  December 31, 1996 to
$489,115  for the year ended  December  31,  1997.  The  increase in these costs
reflects initiation of development of the Company's  standardized  disease state
management programs for patients suffering from asthma and diabetes.

     The Company  generates net interest income primarily from cash balances and
investments.  Interest income  increased to $835,116 for the year ended December
31, 1997 from  $81,333 for the year ended  December  31,  1996.  The increase in
interest  income  reflects  the  additional  funds  available to the Company for
investment as a result of its initial public offering on December 19, 1996.

     The Company had a net loss of  $3,263,351  for the year ended  December 31,
1997  compared  to  $2,806,436  for the  year  ended  December  31,  1996.  This
represents a loss of $.41 per share for 1997 and $.44 for 1996. 


     Liquidity and Capital Resources

     At December  31, 1998 the Company  had working  capital of  $7,992,894,  as
compared to  $13,242,387  at December 31, 1997.  Since its inception the Company
has  primarily  funded  its  operations,   working  capital  needs  and  capital
expenditures  from the sale of  equity  securities.  On  December  19,  1996 the
Company completed an initial public offering of its common stock which generated
net proceeds to the Company of  $14,082,048.  On January 8, 1997,  an additional
300,000   shares  of  common  stock  were  sold  pursuant  to  an   underwriters
over-allotment  provision,  which  generated  net  proceeds  to the  Company  of
$2,232,000. The Company has continued to expend increasing amounts to expand its
operational  capabilities  including increasing its administrative and technical
costs.  To the extent that revenues do not increase,  the Company's  losses will
increase,  creating an increased burden on the Company's  available capital.  If
the  Company  is  not  able  to  operate  profitably  or to  reduce  its  losses
significantly,  it will be  required  to seek  additional  capital or reduce its
operations.

     Capital expenditures during 1998 were $594,663, as compared to expenditures
of $394,161 during 1997 and $494,577 during 1996. The expenditures  during these
periods  represented  the  purchase  of  the  significant   technology  platform
components of the integrated  information capture and delivery system as well as
purchases required to support the Company's growing employee base.

     The Company has been  substantially  dependent  upon the public and private
sale of securities to fund its research and  development  activities and working
capital  requirements.  In order  to  implement  programs  using  the  Company's
integrated information capture and delivery system, the Company will be required
to devote  substantial  additional assets to the development of technology,  the
construction  of  physical  facilities  and the  acquisition  of  telephone  and
computer equipment.  The Company will also be required to retain the services of
employees in advance of obtaining contracts to provide services.

     Inflation

     Inflation did not have a significant  impact on the Company's  costs during
1998, 1997 or 1997. The Company  continues to monitor the impact of inflation in
order  to  minimize  its  effects  through  pricing   strategies,   productivity
improvements and cost reductions.

     Recent Accounting Pronouncements

     In June 1998, the Financial Accounting Standards Board issued SFAS No. 133,
Accounting for Derivative Instruments and Hedging Activity, which is required to
be adopted by the Company in 2001.  The  Statement  will  require the Company to
recognize all derivatives on the balance sheet at fair value.  Derivatives  that
are not hedges of underlying transactions must be adjusted to fair value through
income.  If the  derivative  is a hedge,  depending  on the nature of the hedge,
changes in the fair  value of  derivatives  will  either be offset  against  the
change in fair  value of the  hedged  assets,  liabilities  or firm  commitments
through  earnings or recognized in other  comprehensive  income until the hedged
item is recognized in earnings. The ineffective portion of a derivative's change
in fair value will be immediately recognized in earnings. Management has not yet
determined  the  effect  SFAS  No.  133  will  have,  if any,  on the  Company's
consolidated financial position, results of operations or cash flows.
     Year 2000 Issues

     The Year 2000 issue  refers to the  inability of  computerized  systems and
technologies  to  recognize  and process  dates beyond  December  31, 1999.  The
Company has reviewed the Company's information technology systems, cable network
equipment  and  other  embedded  technologies.  A  significant  portion  of  the
Company's  computerized systems and technologies have been developed,  installed
or upgraded in recent years and are generally more likely to be Year 2000 ready.
The Company is also evaluating the potential  impact as a result of its reliance
on third-party systems that may have year 2000 issues.

     Computerized  business applications that could be adversely affected by the
year 2000 issue include:

* information  processing and financial reporting systems,
* customer  billing  systems,  
* customer  service  systems, 
* telecommunication transmission and reception systems, and
* facility systems.

     System  failure or  miscalculation  could result in an inability to process
transactions,  send invoices,  accept customer orders or provide  customers with
products and services.  Customers could also experience a temporary inability to
receive or use the Company's products and services.

     The  Company  has  developed  a program to assess and address the year 2000
issue. This program consists of the following phases:

* inventorying  and assessing the impact on affected  technology and systems, 
* developing  solutions  for  affected  technology  and  systems,  
* modifying  or replacing  affected  technology and systems
* testing and verifying  solutions 
* implementing solutions, and
* developing contingency plans.

     The Company has  substantially  completed  inventorying  and  assessing the
affected computerized systems and technologies. The Company is in various stages
of its year 2000 compliance  program with respect to the remaining  phases as it
relates to the  affected  systems and  technologies.  The Company has  completed
adaptation  of all  internally  created  systems  and has  begun  surveying  its
customers  and suppliers  regarding  their  readiness  for the year 2000.  Final
testing to  independently  validate  readiness  will begin when the  Company has
received all third party hardware and software promised to date.

     Costs  incurred to date directly  related to  addressing  the year 2000 are
approximately  $50,000.  The Company  currently  estimates the total cost of its
year 2000 remediation program to be approximately $60,000.  Although the Company
will continue to incur substantial  capital  expenditures in the ordinary course
of meeting its telecommunications  system upgrade through the year 2000, it will
not specifically  accelerate its expenditures to facilitate year 2000 readiness,
and accordingly such expenditures are not included in the above estimate.

     The  Company  has  begun  communicating  with  others  with  whom  it  does
significant business to determine their year 2000 readiness and to determine the
extent to which the Company is vulnerable  to year 2000 issues  related to those
third parties.  The Company purchases much of its technology from third parties.
There can be no  assurance  that the  systems  of other  companies  on which the
Company's  systems rely will be year 2000 ready or timely converted into systems
compatible with the Company's systems.  The Company's failure or a third party's
failure  to  become  year  2000  ready  or the  Company's  inability  to  become
compatible   with  third   parties   with  which  the  Company  has  a  material
relationship,  may have a  material  adverse  effect on the  Company,  including
significant  service  interruption  or  outages,  however,  the  Company  cannot
currently estimate the extent of any such adverse effects.

     The Company is in the process of  identifying  secondary  sources to supply
its systems or services in the event it becomes probable that any of its systems
will not be year 2000 ready prior to the end of 1999. The Company is also in the
process of identifying  secondary vendors and service providers to replace those
vendors and service  providers whose failure to be year 2000 ready could lead to
a  significant  delay in the  Company's  ability to provide  its  service to its
customers.

     Forward Looking Statements

     When used in this and in future  filings by the Company with the Securities
and Exchange Commission,  in the Company's press releases and in oral statements
made with the approval of an authorized  executive  officer of the Company,  the
words or phrases "will likely result,"  "expects," "plans," "will continue," "is
anticipated,"  "estimated,"  "project,"  or  "outlook"  or  similar  expressions
(including  confirmations by an authorized  executive  officer of the Company of
any such  expressions  made by a third party with  respect to the  Company)  are
intended  to  identify  "forward-looking  statements"  within the meaning of the
Private Securities  Litigation Reform Act of 1995. The Company wishes to caution
readers not to place undue reliance on any such forward-looking statements, each
of which speak only as of the date made.  Such statements are subject to certain
risks and  uncertainties  that could cause actual  results to differ  materially
from  historical  earnings and those  presently  anticipated  or projected.  The
Company has no obligation to publicly  release the result of any revisions which
may  be  made  to any  forward-looking  statements  to  reflect  anticipated  or
unanticipated  events  or  circumstances   occurring  after  the  date  of  such
statements.

Item 7A.  Quantitative and Qualitative Disclosures About Market Risk

     The Company is exposed to changes in interest  rates  primarily in its cash
transactions.  The Company  does not believe it is exposed to changes in foreign
currently  exchange  rates  because  it does not  currently  invest  in  foreign
currency  instruments.  A discussion  of the Company's  accounting  policies for
financial  instruments  is  included in the  Summary of  Significant  Accounting
Policies in the Notes to the Financial  Statements.  The Company  currently does
not have  any  international  operations  nor does  invest  its cash in  foreign
currency  instruments.  The balances the Company has in cash or cash equivalents
are generally  available  without legal  restrictions to fund ordinary  business
operations.  The Company regularly invests excess operating cash in certificates
of deposit and U.S. government bonds and other bonds that are subject to changes
in short-term interest rates. Accordingly,  the Company believes that the market
risk arising from its holding of these  financial  instruments  is minimal.  The
Company  made  purchases  of  available-for-sale  securities  in the  amounts of
$7,826,910 in 1998 and $18,121,444 in 1997.

<PAGE>

Item 8. Financial Statements And Supplemental Data




         Index to Financial Statements                         Page

         Independent Auditors' Report                            26
         Balance Sheets                                          27
         Statements of Operations                                28
         Statements of Stockholders' Equity                      29
         Statements of Cash Flows                                30
         Notes to Financial Statements                           31-40

<PAGE>










INDEPENDENT AUDITORS' REPORT


To the Board of Directors and Stockholders
  of Patient Infosystems, Inc.:

We have audited the accompanying balance sheets of Patient Infosystems,  Inc. as
of  December  31,  1998 and  1997  and the  related  statements  of  operations,
stockholders'  equity,  and cash flows for each of the three years in the period
ended December 31, 1998. These financial  statements are the  responsibility  of
the Company's  management.  Our responsibility is to express an opinion on these
financial statements based on our audits.

We  conducted  our  audits  in  accordance  with  generally   accepted  auditing
standards.  Those standards require that we plan and perform the audit to obtain
reasonable assurance about whether the financial statements are free of material
misstatement.  An audit includes examining, on a test basis, evidence supporting
the amounts and disclosures in the financial statements.  An audit also includes
assessing the  accounting  principles  used and  significant  estimates  made by
management,  as well as evaluating the overall financial statement presentation.
We believe that our audits provide a reasonable basis for our opinion.

In our  opinion,  such  financial  statements  present  fairly,  in all material
respects,  the financial position of Patient  Infosystems,  Inc. at December 31,
1998 and 1997,  and the results of its operations and its cash flows for each of
the three  years in the  period  ended  December  31,  1998 in  conformity  with
generally accepted accounting principles.





Deloitte & Touche LLP
Rochester, New York
February 5, 1999
(February 26, 1999 as to Note 10)



<PAGE>

<TABLE>
<CAPTION>

PATIENT INFOSYSTEMS, INC 

BALANCE SHEETS
DECEMBER 31, 1998 AND 1997


                                                                           

                                                                 1998             1997
                                                                 ----             ----
<S>                                                              <C>             <C>  
ASSETS ..................................................          

CURRENT ASSETS:
  Cash and cash equivalents .............................   $  6,316,955    $    779,317
  Available-for-sale securities .........................      1,029,674      12,232,335
  Accounts receivable, net ..............................      1,320,626         412,956
  Prepaid expenses and other current assets .............        219,978         405,507
                                                                 -------         -------
                                                                            
        Total current assets ............................      8,887,233      13,830,115

PROPERTY AND EQUIPMENT, net .............................      1,182,494         958,965

OTHER ASSETS ............................................        450,000         247,393
                                                                 -------         -------
                                                                          
TOTAL ASSETS ............................................   $ 10,519,727    $ 15,036,473
                                                            ============    ============
                                                                           

LIABILITIES AND STOCKHOLDERS' EQUITY

CURRENT LIABILITIES:
  Accounts payable ......................................   $    304,436    $     89,674
  Accrued salaries and wages ............................        277,931         320,272
  Accrued expenses ......................................         58,904          79,236
  Deferred revenue ......................................        253,068          67,549
  Accrued loss on development contracts .................           --            30,997
                                                                 -------          ------
                                                                 
        Total current liabilities .......................        894,339         587,728

COMMITMENTS  (Note 7)

STOCKHOLDERS' EQUITY:
  Common stock - $.01 par value:  shares - authorized:
    20,000,000; issued and outstanding:  1998 - 8,020,042
    1997 - 8,011,522 ....................................         80,200          80,115
  Additional paid-in capital ............................     21,561,094      21,550,009
  Other comprehensive income ............................           --             5,060
  Accumultated deficit ..................................    (12,015,906)     (7,186,439)
                                                             -----------      ---------- 
                                                                            
        Total stockholders' equity ......................      9,625,388      14,448,745
                                                               ---------      ----------
                                                              
TOTAL LIABILITIES AND STOCKHOLDERS' EQUITY ..............   $ 10,519,727    $ 15,036,473
                                                            ============    ============
                                                                            
</TABLE>

See notes to financial statements.
<PAGE>

<TABLE>
<CAPTION>

PATIENT INFOSYSTEMS, INC 

STATEMENTS OF OPERATIONS
YEARS ENDED DECEMBER 31, 1998, 1997 AND 1996
                                                                             

                                                   1998           1997           1996
                                                   ----           ----           ----

<S>                                            <C>            <C>            <C>   

REVENUES ...................................   $ 2,344,072    $ 2,062,373    $   845,412
                                               -----------    -----------    -----------
                                                                             

COSTS AND EXPENSES:
  Cost of revenue ..........................     2,529,619      1,629,128        748,322
  Sales and marketing ......................     1,795,921      1,609,837        913,547
  General and administrative ...............     3,062,204      2,442,269      1,759,044
  Research and development .................       298,686        489,115        310,552
                                                   -------        -------        -------
                                                                          
        Total costs and expenses ...........     7,686,430      6,170,349      3,731,465
                                                 ---------      ---------      ---------
                                                                          
OPERATING LOSS .............................    (5,342,358)    (4,107,976)    (2,886,053)

Other income ...............................       556,592        835,116         81,333
                                                   -------        -------         ------
                                                                          
Loss before income taxes ...................    (4,785,766)    (3,272,860)    (2,804,720)

Income taxes ...............................        43,701         (9,509)         1,716
                                                    ------         ------          ----- 

NET LOSS ...................................   $(4,829,467)   $(3,263,351)   $(2,806,436)
                                               ===========    ===========    =========== 
                                                                           
NET LOSS PER SHARE - BASIC
   AND DILUTED .............................   $      (.60)   $      (.41)   $      (.44)
                                               ===========    ===========    =========== 
                                                                       
WEIGHTED AVERAGE COMMON
   AND POTENTIAL COMMON SHARES .............     8,018,398      7,980,094      6,347,716
                                                 =========      =========      =========
                                                                             
</TABLE>

See notes to financial statements 
<PAGE>

<TABLE>
<CAPTION>

PATIENT INFOSYSTEMS, INC

STATEMENTS OF STOCKHOLDERS' EQUITY
YEARS ENDED DECEMBER 31, 1998, 1997 AND 1996
                                                                                                                                 

                                                                         Additional     Other                         Total
                             Preferred Stock        Common Stock         Paid-in     Comprehensive    Accumulated   Stockholders'
                            Shares     Amount     Shares      Amount     Capital        Income          Defict        Equity
                            ------     ------     ------      ------     -------        ------          ------        ------

<S>                        <C>         <C>      <C>         <C>        <C>          <C>           <C>             <C>

Balances, January 1, 1996   1,800,000  $18,000  3,602,880   $36,029    $ 2,227,788  $     --      $(1,116,652)    $ 1,165,165

Sale of Series B convertible
preferred stock at $5.00 per share
in May and June 1996 
(net of issuance costs
of $3,250)                    600,000    6,000       --         --       2,990,750        --              --        2,996,750

Compensation expense related to
issuance of stock warrants     --        --          --         --          13,208        --              --           13,208

Exercise of stock warrants     --        --         4,322        43          2,959        --              --            3,002

Sale of common stock at $8.00
per share in December 1996
(net of issuance costs
of $1,917,952)                 --        --     2,000,000    20,000     14,062,048        --              --       14,082,048

Conversion of Series A and B
convertible preferred stock to
common stock               (2,400,000)(24,000)  2,046,000    20,460          3,540        --              --              --

Comprehensive Income (loss)
   Net loss for the year end
       December 31, 1996       --        --         --         --             --          --       (2,806,436)     (2,806,436)
                                                                                                                                   
                              -----------------------------------------------------------------------------------------------
Total Comprehensive loss       --        --         --         --             --          --              --       (2,806,436)
                              -----------------------------------------------------------------------------------------------     
  
Balances, December 31, 1996    --        --     7,653,202    76,532     19,300,293        --       (1,116,652)     15,453,737

Sale of common stock at $8.00
per share in January 1997
(net of issuance costs
of $168,000)                   --        --       300,000     3,000      2,229,000        --              --        2,232,000

Compensation expense related
to issuance of stock warrants  --        --         --          --           8,283        --              --            8,283

Exercise of stock options      --        --        58,320       583         12,433        --              --           13,016

Comprehensive Income (loss)
   Unrealized gain on investments
      available-for-sale       --        --         --          --            --         5,060            --            5,060

   Net loss for the year end
      December 31, 1997        --        --         --          --            --          --       (3,263,351)     (3,263,351)
                              -----------------------------------------------------------------------------------------------
Total Comprehensive loss       --        --         --          --            --          --              --       (3,258,291)
                              -----------------------------------------------------------------------------------------------
                                                                                                                                   
Balances, December 31, 1997    --        --     8,011,522    80,115     21,550,009       5,060     (1,116,652)     14,448,745

Compensation expense related
to issuance of stock warrants  --        --         --          --           7,388        --              --            7,388

Exercise of stock options      --        --         8,520        85          3,697        --              --            3,782

Comprehensive Income (loss)
   Unrealized loss on investments
      available-for-sale       --        --         --          --            --          --              --           (5,060)

   Net loss for the year end
      December 31, 1998        --        --         --          --            --          --       (4,829,467)     (4,829,467)
                                                                                                                                   
                              -----------------------------------------------------------------------------------------------
Total Comprehnsive loss        --        --         --          --            --        (5,060)           --       (4,834,527)
                              -----------------------------------------------------------------------------------------------       
Balances, December 31, 1998    --      $ --     8,020,042   $80,200    $21,561,094   $    --      $(1,116,652)    $ 9,625,388
                              ===============================================================================================
                             
</TABLE>
                                                                                
See notes to financial statements.
<PAGE>

<TABLE>
<CAPTION>

PATIENT INFOSYSTEMS, INC.

STATEMENTS OF CASH FLOWS
YEARS ENDED DECEMBER 31, 1998, 1997 AND 1996
                                                                                      1998            1997            1996
                                                                                      ----            ----            ----
<S>                                                                                <C>           <C>             <C>
OPERATING :
  Net loss ..................................................................   $ (4,829,467)   $ (3,263,351)   $ (2,806,436)
  Adjustments to reconcile net loss to net cash used in
    operating activities:
      Depreciation and amortization .........................................        366,474         293,763         186,050
      Loss on sale of property ..............................................          1,350           2,171            --
      Amortization of premiums and discounts on available-for-sale securities       (142,054)       (209,832)           --
      Compensation expense related to issuance of stock warrants ............          7,388           8,283          13,208
      Increase in accounts receivable .......................................       (907,670)        (26,741)       (382,160)
      Decrease (increase) in prepaid expenses and other current assets ......        185,529        (234,980)       (146,542)
      Increase (decrease) in accounts payable ...............................        214,762        (107,000)       (166,095)
      (Decrease) increase in accrued salaries and wages .....................        (42,341)        193,243          78,770
      (Decrease) increase in accrued expenses ...............................        (20,332)       (132,221)        192,076
      Increase (decrease) in deferre+d revenue ...............................        185,519        (515,234)        414,728
      (Decrease) increase in accrued loss on development contracts ..........        (30,997)        (36,142)         67,139
                                                                                     -------         -------          ------
                                                                             
            Net cash used in operating activities ...........................     (5,011,839)     (4,028,041)     (2,549,262)
                                                                                  ----------      ----------      ----------        
INVESTING:
  Property and equipment additions ..........................................       (594,663)       (394,161)       (494,577)
  Proceeds from sale of property ............................................          3,310           1,299            --
  Purchases of available-for-sale  securities ...............................     (7,826,910)    (18,121,444)           --
  Maturities of available-for-sale securities ...............................     19,166,565       6,104,000            --
  Increase in other assets ..................................................       (202,607)       (247,393)           --
                                                                                    --------        --------         --------      
                                                                                                             
          Net cash provided by (used in) investing activities ...............     10,545,695     (12,657,699)       (494,577)
                                                                                  ----------     -----------        -------- 
 FINANCING:
  Proceeds from issuance of common and preferred stock, net .................          3,782       2,245,016      17,081,800
  (Decrease) increase in accrued initial public offering costs ..............           --          (446,568)        446,568
                                                                                       -----        --------         -------
                                                                                                               
            Net cash provided by financing activities .......................          3,782       1,798,448      17,528,368
                                                                                       -----       ---------      ----------
                                                                                                           
NET INCREASE (DECREASE) IN CASH AND CASH  EQUIVALENTS .......................      5,537,638     (14,887,292)     14,484,529

CASH AND CASH EQUIVALENTS AT
  BEGINNING OF YEAR .........................................................        779,317      15,666,609       1,182,080
                                                                                     -------      ----------       ---------
  CASH AND CASH EQUIVALENTS AT
  END OF YEAR ...............................................................   $  6,316,955    $    779,317    $ 15,666,609
                                                                                ============    ============    ============
  
Supplemental disclosures of cash flow information
   Cash paid (received) for income taxes, net ...............................   $     43,701    $     (9,509)   $      1,716
                                                                                ============    ============    ============
                                                                                                                
</TABLE>

See notes to financial statements.

<PAGE>
         PATIENT INFOSYSTEMS, INC.


         NOTES TO FINANCIAL STATEMENTS
         YEARS ENDED DECEMBER 31, 1998, 1997 AND 1996                          


1.       BUSINESS AND SIGNIFICANT ACCOUNTING POLICIES

         Organization - Patient  Infosystems,  Inc. ("the Company")  designs and
         develops  health  care  information  systems  and  services  to manage,
         collect  and analyze  patient-related  information  to improve  patient
         compliance with  prescribed  treatment  protocols.  Through its various
         patient compliance  programs for disease state management,  the Company
         provides important  benefits for the patient,  the health care provider
         and the payor. The Company was incorporated in Delaware on February 22,
         1995  under the name DSMI  Corp.,  changed  its name to  Disease  State
         Management,  Inc. on October 13, 1995, and on June 28, 1996 changed its
         name to Patient Infosystems, Inc. Prior to January 1, 1997, the Company
         was a development stage enterprise.

         Use of  Estimates  in the  Preparation  of  Financial  Statements - The
         preparation  of  financial  statements  in  conformity  with  generally
         accepted  accounting  principles  requires management to make estimates
         and  assumptions  that  affect  the  reported  amounts  of  assets  and
         liabilities and disclosure of contingent  assets and liabilities at the
         date of the financial  statements and the reported  amounts of revenues
         and expenses during the reporting  period.  Actual amounts could differ
         from those estimates.

         Fair  Value  of  Financial   Instruments  -  The  Company's   financial
         instruments consist of cash and cash equivalents and available-for-sale
         securities.  The  carrying  values  of cash  and cash  equivalents  and
         available-for-sale securities approximate fair value.

         Revenue  Recognition  and Deferred  Revenue - The  Company's  principal
         source  of  revenue  to date  has  been  from  contracts  with  various
         pharmaceutical   companies  and  managed  care  organizations  for  the
         development  and operation of disease  management  programs for chronic
         diseases, disease management programs and other health care information
         system  applications.  Deferred  revenue  represents  amounts billed in
         advance under these contracts.

         Development  Contracts - The Company's  program  development  contracts
         typically  require  payment  from the  customer  at the  time  that the
         contract  is  executed,   with  additional  payments  made  as  certain
         development   milestones  are  met.  Development  contract  revenue  is
         recognized on a percentage of completion  basis, in accordance with the
         ratio  of  total  development  cost  incurred  to the  estimated  total
         development  costs  for  the  entire  project.   Losses,  if  any,  are
         recognized in full as identified.

         Program Operations - The Company's program operation contracts call for
         a per  enrolled  patient fee to be paid by the customer for a series of
         program  services  as defined in the  contract.  The timing of customer
         payments  varies by contract,  but  typically  occurs in advance of the
         associated  services being provided.  Revenues from program  operations
         are recognized ratably as the program services are delivered.

         Cash and Cash  Equivalents  - Cash and  cash  equivalents  include  all
         highly liquid debt instruments with original maturities of three months
         or less.

         Concentrations of Credit Risk - Financial instruments which potentially
         subject the Company to concentration of credit risk consist principally
         of cash and cash  equivalents  and  accounts  receivable.  The  Company
         places  its  cash  and  cash   equivalents  with  high  credit  quality
         institutions.

         The Company's  current  contracts are concentrated in a small number of
         customers,  consequently,  the loss of any one of its  customers  could
         have a  material  adverse  effect on the  Company  and its  operations.
         During  the years  ended  December  31,  1998 and  1997,  approximately
         $755,000  (33%) and  $925,800  (45%),  respectively,  of the  Company's
         revenues arose from  contracts with one customer.  At December 31, 1998
         and  1997,  accounts  receivable  included  balances  of  $736,650  and
         $231,484, respectively, from contracts with that customer.

         Property  and  Equipment - Property and  equipment  are stated at cost.
         Depreciation  is  computed  using  the  straight-line  method  over the
         estimated useful lives of the assets, which range from 3 to 10 years.

         The  Company  regularly  assesses  all of its  long  lived  assets  for
         impairment  and  recognizes a loss when the carrying  value of an asset
         exceeds its fair value. The Company  determined that no impairment loss
         need be recognized for applicable assets in 1998 or 1997.

         Research and  Development  - Research  and  development  costs  consist
         principally of compensation and benefits paid to Company employees. All
         research and development costs are expensed as incurred.

         Income  Taxes - The  Company  uses the  asset and  liability  method of
         accounting  for income taxes in accordance  with Statement of Financial
         Accounting  Standards  (SFAS) No. 109,  "Accounting  for Income Taxes".
         Under the asset and liability  method,  deferred  income tax assets and
         liabilities are recognized for the future tax consequences attributable
         to  differences  between the financial  statement  carrying  amounts of
         existing assets and liabilities and their  respective tax bases and net
         operating loss and tax credit carryforwards.

         Net Loss  Per  Share - Net  loss  per  share  is based on the  weighted
         average number of common shares outstanding subsequent to the Company's
         initial  public  offering in 1996.  Pursuant to rules of the Securities
         and Exchange  Commission  Staff, all common and potential common shares
         issued by the Company at a price less than the initial public  offering
         price during at least the 12 months  preceding the offering date (using
         the treasury  stock method until shares are issued) have been  included
         in the  calculation of common and potential  common shares  outstanding
         for all periods  presented  prior to the December  1996 initial  public
         offering. (See Note 8)

         Retirement  Plan - The Company has a  retirement  plan which  qualifies
         under Section 401(k) of the Internal  Revenue Code This retirement plan
         allows eligible  employees to contribute 1% to 15% of their income on a
         pretax basis to the plan. The Company's annual contribution to the plan
         is at the  discretion  of the Board of  Directors.  The Company made no
         contributions to this plan in 1998 or 1997.

         Stock Split - On November  22, 1996,  the Company  effected a .72-for-1
         reverse stock split of all outstanding shares of common stock.

         Statement  of Financial  Accounting  Standards  No. 130 - In 1998,  the
         Company  adopted  SFAS No. 130,  "Reporting  Comprehensive  Income" and
         restated the prior years'  financial  statements  to conform to the new
         reporting standard.  This Statement establishes standards for reporting
         and display of comprehensive income and its components in a full set of
         general-purpose financial statements.  This Statement requires that all
         items that are required to be recognized under accounting  standards as
         components of comprehensive income be reported in a financial statement
         that  is  displayed  with  the  same   prominence  as  other  financial
         statements.  Comprehensive income for the Company includes net loss and
         the unrealized gain or loss on available-for-sale securities.

         Statement  of Financial  Accounting  Standards  No. 131 - In 1998,  the
         Company  adopted  SFAS  No.  131,  "Disclosures  about  Segments  of an
         Enterprise  and Related  Information."  The  Statement  requires that a
         public company report financial and descriptive  information  about its
         reportable operating segments using the management approach.  SFAS also
         requires  that  segment  information  of earlier  years be  restated to
         conform to the new standard. The adoption of SFAS No. 131 had no effect
         on the consolidated financial position,  results of operations, or cash
         flows of the Company.

         Statement of Position 97-2 - In 1998, the Company adopted  Statement of
         Position (SOP) 97-2,  "Software  Revenue  Recognition,"  which provides
         guidance  on  applying  generally  accepted  accounting  principles  in
         recognizing revenue on software transactions. The implementation of SOP
         97-2  did not have a  material  effect  on the  Company's  revenues  or
         earnings.

         Statement of Financial Accounting Standards No. 133 - In June 1998, the
         Financial Accounting Standards Bard issued SFAS No. 133, Accounting for
         Derivative  Instruments and Hedging  Activity,  which is required to be
         adopted by the Company in 2001.  The Statement will require the Company
         to  recognize  all  derivatives  on the  balance  sheet at fair  value.
         Derivatives  that are not  hedges of  underlying  transactions  must be
         adjusted to fair value through  income.  If the  derivative is a hedge,
         depending  on the  nature of the  hedge,  changes  in the fair value of
         derivatives  will either be offset  against the change in fair value of
         the hedged assets,  liabilities or firm commitments through earnings or
         recognized  in other  comprehensive  income  until the  hedged  item is
         recognized  in  earnings.  The  ineffective  portion of a  derivative's
         change  in fair  value  will be  immediately  recognized  in  earnings.
         Management has not yet determined the effect SFAS No. 133 will have, if
         any,  on the  Company's  consolidated  financial  position,  results of
         operations or cash flows.

         Reclassifications   -  Certain   1997  and  1996   amounts   have  been
         reclassified to conform with 1998 presentations.

2.       AVAILABLE -FOR-SALE SECURITIES 

         The following is a summary of available-for-sale securities at December
         31: 

                                                     1998           1997
                                                     ----           ----

          Certificates of Deposit                $1,029,674    $     -
          U.S. Government Securities                  -         12,232,335
                                                 ----------     ----------
                                                 

          Total Available-for-Sale Securities    $1,029,674    $12,232,335
                                                 ==========    ===========
                                                   
         Realized  and  unrealized   gains  and  losses  on   available-for-sale
         securities  were  immaterial as of and for the years ended December 31,
         1998, 1997 and 1996.

         The cost and estimated fair value of  available-for-sale  securities by
         contractual maturity at December 31, 1998 and 1997 are as follows:

<TABLE>
<CAPTION>
                                                                                             
                                          Amortized        Fair       Amortized        Fair
                                             Cost          Value         Cost          Value
                                             ----          -----         ----          -----
<S>                                       <C>            <C>            <C>        <C>  
Due in one year or less ................ $ 1,029,674   $ 1,029,674   $ 2,824,280   $ 2,823,704
Due after one year through two years ...        --            --       9,400,389     9,408,631
                                           ---------     ---------     ---------     ---------
                                                                                                  
                                         $ 1,029,674   $ 1,029,674   $12,224,669   $12,232,335
                                         ===========   ===========   ===========   ===========
</TABLE>
                                                                                

3.       PROPERTY AND EQUIPMENT

         Property and equipment are summarized as follows at December 31:
<TABLE>
<CAPTION>


                                                     1998         1997
                                                     ----         ----
<S>                                               <C>         <C>    

Computer software ............................   $  545,467   $  380,831
Computer equipment ...........................      795,996      600,279
Telephone equipment ..........................      301,172      189,479
Leasehold improvements .......................       43,979       41,504
Office furniture and equipment ...............      363,387      249,291
                                                    -------      -------
                                                              
                                                  2,050,001    1,461,384

Less accumulated depreciation and amortization      867,507      502,419
                                                    -------      -------
                                                              
Property and equipment, net ..................   $1,182,494   $  958,965
                                                 ==========   ==========
</TABLE>
                                                            

4. INCOME TAXES

         Income tax expense for the years ended December 31, 1998, 1997 and 1996
         consists of:
<TABLE>
<CAPTION>

                                 1998      1997       1996
                                 ----      ----       ----
<S>                            <C>       <C>         <C> 
Current:
  U.S. federal ............   $  --     $  --      $  --
  State and local .........    43,701    (9,509)     1,716

Deferred:
  U.S. federal ............      --        --         --
  State and local .........      --        --         --
                              -------   -------     ------

Income Tax Expense (Credit)   $43,701   $(9,509)   $ 1,716
                              =======   =======    =======
</TABLE>
                                                   

 
         Income tax expense for the years ended December 31, 1998, 1997 and 1996
         differed from the amounts  computed by applying the U.S. federal income
         tax rate of 34 percent as a result of the following:
<TABLE>
<CAPTION>
                                                        1998           1997           1996
                                                        ----           ----           ----
<S>                                                 <C>            <C>            <C>    
Computed "expected" tax expense .................   $(1,627,160)   $(1,109,539)   $  (953,605)

Increase in income taxes resulting from:

     Change in the valuation allowance
       for deferred tax assets ..................     1,628,997      1,094,833        949,726

     State and local income taxes, net of federal
       income tax benefit .......................        28,843         (6,276)         1,133

     Other, net .................................        13,021         11,473          4,462
                                                         ------         ------          -----
                                                                                 
                                                    $    43,701    $    (9,509)   $     1,716
                                                    ===========    ===========    ===========
                                                                                  
</TABLE>


<PAGE>


         The tax effects of temporary  differences that give rise to significant
         portions of the deferred tax assets and  deferred  tax  liabilities  at
         December 31, 1998 and 1997 are presented below.
<TABLE>
<CAPTION>

                                                                              1998           1997
                                                                              ----           ----
<S>                                                                     <C>             <C>   
Deferred tax assets: .................................................      
Accounts receivable, principally due
  to allowance for doubtful accounts .................................   $    20,000    $    20,000
Deferred revenue .....................................................       101,000         27,000
Compensation .........................................................        89,000         67,000
Net operating loss carryforwards .....................................     4,569,000      2,711,000
Tax credit carryforwards .............................................        59,000         59,000
Other ................................................................        20,000         12,000
                                                                              ------         ------
     Total gross deferred tax assets .................................     4,858,000      2,896,000

     Less valuation allowance ........................................    (4,711,000)    (2,737,000)
                                                                          ----------     ---------- 

     Net deferred tax assets .........................................       147,000        159,000
                                                                             -------        -------

Deferred tax liabilities:

Property and equipment, principally due to differences in depreciation
  and amortization ...................................................       (69,000)       (66,000)
Other ................................................................       (78,000)       (93,000)
     Total gross deferred tax liability ..............................      (147,000)      (159,000)
                                                                            --------       -------- 

     Net deferred tax assets .........................................   $    --        $    --
                                                                         ===========    ===========
</TABLE>
 
         At December 31, 1998, the Company has net operating loss carryforwards
         for federal income tax purposes of approximately  $11,437,000 which are
         available to offset future  federal  taxable  income,  if any,  through
         2018.  The Company also has  investment  tax credit  carryforwards  for
         federal  income  tax  purposes  of  approximately   $59,000  which  are
         available to reduce future federal income taxes, if any, through 2018.

5.       PUBLIC OFFERING OF COMMON STOCK

         In December  1996,  the Company sold  2,000,000  shares of common stock
         through an initial  public  offering  which  generated  net proceeds of
         $14,082,048 after deducting applicable issuance costs and expenses.  On
         January 8, 1997, an additional 300,000 shares of common stock were sold
         pursuant to an underwriters  over-allotment provision,  which generated
         net proceeds to the Company of $2,232,000 after deducting  underwriting
         discounts and commissions.

         In  connection  with  this  initial  public  offering,   the  Company's
         outstanding  shares of Series A and B convertible  preferred stock were
         converted into 2,046,000 shares of common stock.

6.       STOCK OPTIONS AND WARRANTS

         The Company has an Employee Stock Option Plan (the "Stock Option Plan")
         for the benefit of certain employees,  non-employee directors,  and key
         advisors.  The Company has adopted the  disclosures-only  provision  of
         SFAS  No.  123,   "Accounting   for   Stock-Based   Compensation".   No
         compensation  cost has been  recognized for the Stock Option Plan as it
         relates to  employees  since the  exercise  price of the options on the
         date of grant approximated fair market value. Had compensation cost for
         the Company's stock option plan been determined based on the fair value
         at the date of grant for awards  consistent with the provisions of SFAS
         No. 123, the  Company's net loss and net loss per share would have been
         increased to the pro forma amounts indicated below:

<TABLE>
<CAPTION>


                                    1998             1997             1996
                                    ----             ----             ----
<S>                           <C>              <C>               <C>    

Net loss - as reported ....   $  (4,829,467)   $  (3,263,351)   $  (2,806,436)

Net loss - pro forma ......   $  (4,849,320)   $  (3,406,973)   $  (2,879,457)


Net loss per share - basic
  and diluted - as reported   $       (0.60)   $       (0.41)   $        (.44)


Net loss per share - basic
  and diluted - pro forma .   $       (0.60)  $        (0.43    $        (.46)

</TABLE>
         The fair value of each option  grant is  estimated on the date of grant
         using the Black-Scholes option-pricing model using an assumed risk-free
         interest rates of 5.32% for year ended December 31, 1998, 5.98% for the
         year ended  December  31, 1997 and 7% for the year ended  December  31,
         1996  and an  expected  life  of 7  years.  As the  Company  was  still
         considered a private  company for the purposes of applying SFAS No. 123
         for the period from  Inception  to June 30,  1996,  the Company did not
         include a volatility factor assumption in its fair value model. For the
         options  granted after July 1, 1996,  the Company has used a volatility
         factor of .94 for year  ended  December  31,  1998,  .53 for year ended
         December  31,  1997 and .60 for  year  ended  December  31,  1996.  For
         purposes  of pro forma  disclosure,  the  estimated  fair value of each
         option is amortized to expense over that option's  vesting period.  The
         Stock  Option Plan  authorizes  1,080,000  shares of common stock to be
         issued.

         Stock options  granted under the Stock Option Plan may be of two types:
         (1) incentive  stock options and (2)  nonqualified  stock options.  The
         option price of such grants shall be  determined  by a Committee of the
         Board of Directors  (the  "Committee"),  but shall not be less than the
         estimated  fair market value of the common stock at the date the option
         is granted.  The terms of the grants  shall be fixed by the  Committee,
         with no term  lasting  longer  than ten years.  The ability to exercise
         such options shall be determined by the Committee  when the options are
         granted.  All of the  outstanding  options  vest at the rate of 20% per
         year with the  exception of 36,000  options which were vested as of the
         date of grant.

         A summary of stock option activity follows:
<TABLE>
<CAPTION>

                                                           Outstanding  Weighted-Average
                                                             Options     Exercise Price
                                                             -------     --------------
<S>                                                          <C>        <C>    
Options outstanding at January 1, 1996 ..................    590,400    $   0.33

Options granted during the year ended December 31, 1996
  (weighted average fair value of $3.24) ................    365,400    $   5.32

Options forfeited by holders during the year
  ended December 31, 1996 ...............................    (63,840)   $   0.87
                                                             -------    
Options outstanding at December 31, 1996 ................    891,960    $   2.34

Options granted during the year ended December 31, 1997
  (weighted average fair value of $5.16) ................    307,000    $   4.39

Options forfeited by holders during the year
  ended December 31, 1997 ...............................   (342,580)   $   4.83

Options exercised during the year ended December 31, 1997    (58,320)   $   0.22
                                                             -------   
Options outstanding at December 31, 1997 ................    798,060    $   2.21

Options granted during the year ended December 31, 1998
  (weighted average fair value of $1.38) ................    399,200    $   1.38

Options forfeited by holders during the year
  ended December 31, 1998 ...............................   (320,820)   $   3.15

Options exercised during the year ended December 31, 1998     (8,520)   $   0.44
                                                              ------   
Options outstanding at December 31, 1998 .................   867,920    $   0.91
                                                             -------    

Options exercisable at December 31, 1998 .................   290,816    $   0.49
                                                             -------    

Options available for grant at December 31, 1998 ........    212,080
                                                             -------
</TABLE>

         The following table summarizes  information  concerning outstanding and
         exercisable options at December 31, 1998:
<TABLE>
<CAPTION>
                                         Options Outstanding            Options Exercisable
                                         -------------------            -------------------
                                              Average    Weighted                    Weighted
                                             Remaining   Average                     Average
   Range of                      Number     Contractual  Exercise        Number      Exercise
Exercise Price                Outstanding      Life       Price       Exercisable     Price
- --------------                -----------      ----       -----       -----------     -----
<S>                             <C>              <C>     <C>           <C>          <C>   

  $.14 - $.99                   376,200          1.29   $      .30      240,120   $     0.29

 $1.00 - $1.99                  488,740          4.07   $     1.37       47,716   $     1.36

 $2.00 - $4.99                    2,980          --     $     3.15        2,980   $     3.15
                                  -----                                   -----  
                                867,920                                 290,816
                                =======                                 =======
</TABLE>

         The Company also has outstanding stock purchase warrants  entitling the
         holders to purchase a total of 23,400 shares of common stock at a price
         of $1.38 per share  (weighted  average  exercise  price of  $1.38).  At
         December 31, 1998, 9,360 of these warrants are currently  vested,  with
         the remaining  14,040 warrants vesting at 20% per year. The Company has
         recorded  compensation  costs in connection  with the issuance of these
         warrants for the years ended  December  31, 1998,  1997 and 1996 in the
         amount of $7,388, $8,283 and $13,208 respectively.

7.       COMMITMENTS

         The Company  leases  office  space for its main  operating  facility in
         Rochester,  New York,  under an operating lease  agreement  expiring in
         November 1999. Additionally, the Company subleases office space for its
         Wayne,   Pennsylvania  facility  under  an  operating  lease  agreement
         expiring  in May  2001  and  leases  office  space  for  its  Berkeley,
         California  facility  under an operating  lease  agreement  expiring in
         October  1999.  Rent  expense  from these  leases  for the years  ended
         December 31,  1998,  1997 and 1996 was  $210,375,  $154,907 and $70,479
         respectively.

         At December 31, 1998,  future minimum lease payments under these leases
         are summarized as follows:


                       1999                                     $ 253,301
                       2000                                        40,200
                       2001                                        16,750
                                                                   ------
                                                                $ 310,251
                                                                =========

8.       NET LOSS PER SHARE

         Net loss per share is based on weighted average number of common shares
         outstanding  subsequent to the  Company's  initial  public  offering in
         1996.  Pursuant  to rules of the  Securities  and  Exchange  Commission
         Staff,  all common and potential common shares issued by the Company at
         a price less than the initial public offering price during at least the
         12 months  preceding the offering date (using the treasury stock method
         until  shares are  issued)  have been  included in the  calculation  of
         common  and  potential  common  shares   outstanding  for  all  periods
         presented prior to the December 1996 initial public  offering.  Because
         the Company  incurred a loss in 1998 and 1997,  outstanding  options to
         purchase  867,920 and 798,060  shares of common  stock at $.14 to $4.99
         per share,  were not  included in the  computation  of diluted loss per
         share as they would be antidilutive.
<TABLE>
<CAPTION>

                                                                           Net Loss         Shares     Per-Share
                                                                           Numerator      Denominator    Amount
                                                                           ---------      -----------    ------
<S>                                                                                 <C>             <C>           <C>  
For the year ended December 31, 1998
     Basic and diluted ................................................   $(4,829,467)     8,018,398   $  (0.60)
                                                                          ===========      =========   ======== 
                                                                                                                 
For the year ended December 31, 1997
     Basic and diluted ................................................   $(3,263,351)     7,980,094   $  (0.41)
                                                                          ===========      =========   ======== 
                                                                                                                 
For the year ended December 31, 1996
     Loss available to Common Shareholders ............................   $(2,806,436)

     Weighted average common stock outstanding ........................                    3,678,435

     Series A Convertible Preferred Stock .............................                    1,296,000

     Series B Convertible Preferred Stock .............................                      437,500

     Potential common shares calculated
     using the treasury stock method:
          Series B Convertible Preferred
            Stock issued May and June 1996 ............................                      177,365
          Common stock options ........................................                      758,416
                                                                          -------------------------------------

     Basic and diluted ................................................   $(2,806,436)     6,347,716   $  (0.44)
                                                                          ===========      =========   ======== 
</TABLE>

9.       JOINT VENTURE

         On  November  12,  1998,  the  Company  entered  into a  joint  venture
         agreement with MacLean Hunter Publishing Limited to market and sell, on
         an exclusive  basis in Canada,  products and services  developed by the
         Company and to jointly manage,  finance and operate the business entity
         Patient Infosystems Canada, Inc., which is dedicated to the development
         of a commercially viable business built around the sale,  marketing and
         service of the Company's products and services.

10.      SUBSEQUENT EVENT

         On  February  26,  1999,   the  Company,   through  its  newly  formed,
         wholly-owned   subsidiary,   Patient  Infosystems   Acquisition  Corp.,
         acquired substantially all of the assets of HealthDesk  Corporation,  a
         consumer  healthcare software company primarily engaged in the business
         of designing and developing  Internet based products in the healthcare,
         wellness and disease management industries. The acquired assets include
         inventory,  intellectual property, hardware and software. The principal
         consideration  paid for the transaction was $761,463.  The Company paid
         for the acquisition using its available cash.

11.      QUARTERLY RESULTS (UNAUDITED)

         The  following  is a  summary  of  the  unaudited  interim  results  of
         operations by quarter:

<TABLE>
<CAPTION>
                                                                      First         Second         Third         Fourth
                                                                      -----         ------         -----         ------
<S>                                                              <C>            <C>            <C>            <C>   
Year ended December 31, 1998:
Revenues .....................................................   $   290,354    $   874,119    $   465,181    $   714,418
Gross margin .................................................       (94,933)       324,848       (243,116)      (172,346)
Net loss .....................................................    (1,055,038)      (680,017)    (1,348,843)    (1,745,569)
Net loss per common share ....................................         (0.13)         (0.08)         (0.17)         (0.22)

Year ended December 31, 1997:
Revenues .....................................................   $   523,477    $   570,330    $   433,059    $   535,507
Gross margin .................................................       172,407         35,839         34,363        190,636
Net loss .....................................................      (588,524)      (892,906)    (1,097,562)      (684,359)
Net loss per common share ....................................         (0.07)         (0.11)         (0.14)         (0.09)

</TABLE>

<PAGE>

     Item 9. Changes in and  Disagreements  With  Accountants  on Accounting and
     Financial Disclosures.
                  None

<PAGE>
                                    PART III


     Item 10. Directors and Executive Officers of the Registrant.
                 
     Incorporated  by  reference to the  Company's  Proxy  Statement  for Annual
Meeting of Stockholders to be filed with the Securities and Exchange  Commission
within 120 days after the close of the fiscal year ended December 31, 1998.

     Item 11. Executive Compensation.

     Director Compensation

     Incorporated  by  reference to the  Company's  Proxy  Statement  for Annual
Meeting of Stockholders to be filed with the Securities and Exchange  Commission
within 120 days after the close of the fiscal year ended December 31, 1998.

     Executive Compensation

     Incorporated  by  reference to the  Company's  Proxy  Statement  for Annual
Meeting of Stockholders to be filed with the Securities and Exchange  Commission
within 120 days after the close of the fiscal year ended December 31, 1998.


     Item 12.  Security Ownership of Certain Beneficial Owners and Management.
  
     Incorporated  by  reference to the  Company's  Proxy  Statement  for Annual
Meeting of Stockholders to be filed with the Securities and Exchange  Commission
within 120 days after the close of the fiscal year ended December 31, 1998.

     Item 13.  Certain Relationships and Related Transactions

     Incorporated  by  reference to the  Company's  Proxy  Statement  for Annual
Meeting of Stockholders to be filed with the Securities and Exchange  Commission
within 120 days after the close of the fiscal year ended December 31, 1998.
                                                          
                                    PART IV


     Item 14. Exhibits, Financial Statement Schedules and Reports on Form 8-K

         (a) Financial Statements:

         The  financial  statements of the Company are included in Part II, Item
         8.

         (b) Reports on Form 8 - K:

         No reports on Form 8-K were filed during the fourth quarter of the year
         ended December 31, 1998.

         (c) Exhibits:


         Exhibit #         Description of Exhibits


         (3)      Articles of Incorporation and By-Laws:

                  Certificate of Incorporation
                  Incorporated  herein by reference from Exhibit 3.1 on Form S-1
                  Registration   Statement  of  the  Company,   filed  with  the
                  Commission on December 17, 1996.

                  By-Laws
                  Incorporated  herein by reference from Exhibit 3.3 on Form S-1
                  Registration   Statement  of  the  Company,   filed  with  the
                  Commission on December 17, 1996.

         (10)     Material contracts:

               10.15 Asset  Purchase  Agreement  dated as of September  29, 1998
               among  Patient  Infosystems  Acquisition  Corp.,  the Company and
               HealthDesk Corporation.

               10.16 Amendment to Asset Purchase  Agreement dated as of December
               1, 1998 among Patient Infosystems  Acquisition Corp., the Company
               and HealthDesk Corporation.

               10.17 Second  Amendment to Asset Purchase  Agreement  dated as of
               February 1, 1999 among Patient Infosystems Acquisition Corp., the
               Company and HealthDesk Corporation.

               10.18 Sublease dated as of September 29, 1998 between  HealthDesk
               Corporation and Patient Infosystems Acquisition Corporation.

               10.19 Consulting  Agreement dated as of March 8, 1999 between the
               Company and John V. Crisan.

               10.20 Lease  Agreement  dated as of February 22, 1995 between the
               Company and Conifer Prince Street Associates.

               10.21 First  Addendum to Lease  Agreement  dated as of August 22,
               1995 between the Company and Conifer Prince Street Associates.

               10.22 Second Addendum to Lease Agreement dated as of November 17,
               1995 between the Company and Conifer Prince Street Associates.

               10.23  Third  Addendum to Lease  Agreement  dated as of March 28,
               1996 between the Company and Conifer Prince Street Associates.

               10.24 Fourth  Addendum to Lease Agreement dated as of October 29,
               1996 between the Company and Conifer Prince Street Associates.

               10.25 Fifth Addendum to Lease  Agreement dated as of November 30,
               1996 between the Company and Conifer Prince Street Associates.

               10.26 Sixth Addendum to Lease  Agreement dated as of November 24,
               1997 between the Company and Conifer Prince Street Associates.

               10.27 Sublease  Agreement  dated as of March 30, 1998 between the
               Company and Medecision, Incorporated.

               10.28  Joint  Venture  and  Stockholders  Agreement  dated  as of
               November  12,  1998  between  the  Company  and  Maclean   Hunter
               Publishing Limited.

               10.29 Lease  Agreement  dated as of October 12, 1998  between the
               Company and Parker Associates.

         (11)     Statement of Computation of Per Share Earnings


         (21)     Subsidiaries

         (27)     Financial Data Schedule
         Filed electronically

         All other  exhibits are omitted  because they are not applicable or the
         required  information is shown  elsewhere in this Annual Report on Form
         10-K.

<PAGE>

         Pursuant to the  requirements  of Section 13 or 15(d) of the Securities
         Exchange Act of 1934,  the registrant has duly caused this report to be
         signed on its behalf by the undersigned, thereunto duly authorized.


         PATIENT INFOSYSTEMS, INC.

         By:      /s/ Donald A. Carlberg          April 13, 1999
                  ----------------------          --------------
                  Donald A. Carlberg              Date
                  Director, President, and Chief Executive Officer



         Pursuant to the  requirements  the Securities and Exchange Act of 1934,
         this report has been signed below by the following persons on behalf of
         the registrant and in the capacities and on the dates indicated.


By: /s/ Donald A. Carlberg                        April 13, 1999
- --------------------------                        --------------
Donald A. Carlberg                                Date
Director, President and Chief Executive Officer
(Principal Executive Officer)

By: /s/ John V. Crisan                            April 13, 1999
- ----------------------                            --------------
John V. Crisan                                    Date
Chief Financial Officer
(Principal Financial and Accounting Officer)

By: /s/ Derace L. Schaffer, M.D.                  April 13, 1999
- --------------------------------                  --------------
Derace L. Schaffer, M.D.                          Date
Chairman of the Board

By: /s/ John Pappajohn                            April 13, 1999
- ----------------------                            --------------
John Pappajohn                                    Date
Director

By: /s/ Barbara J. McNeil, M.D., Ph.D.            April 13, 1999
- --------------------------------------            --------------
Barbara J. McNeil, M.D., Ph.D.                    Date
Director

By: /s/ Carl F. Kohrt, Ph.D.                      April 13, 1999
- ----------------------------                      --------------
Carl F. Kohrt, Ph.D.                              Date
Director

By: /s/ David B. Nash, M.D.                       April 13, 1999
- ---------------------------                       --------------
David B. Nash, M.D.                               Date
Director




                                                                                
                                  EXHIBIT 10.15

                            ASSET PURCHASE AGREEMENT








                                   DATED AS OF
                               SEPTEMBER 29, 1998



                                      AMONG


                     PATIENT INFOSYSTEMS ACQUISITION CORP.,

                            PATIENT INFOSYSTEMS, INC.

                                       AND

                             HEALTHDESK CORPORATION




<PAGE>


                                TABLE OF CONTENTS


ARTICLE 1. TRANSFER OF ASSETS..................................................1

         1.1      Intellectual Property........................................1
                 
         1.2      Inventories..................................................1
                  
         1.3      Equipment and Packaged Software..............................1
                 
         1.4      Books and Records............................................2
                 
         1.5      Prepaid Expenses.............. ..............................2
                
         1.6      Permits, etc.................................................2
                  
         1.7      All Property Not Elsewhere Described.........................2
                  
         1.8      Excluded Assets..............................................2
                  

ARTICLE 2. PURCHASE PRICE......................................................2

         2.1      Payment of Purchase Price....................................2
                 
         2.2      Allocation of Purchase Price.................................3
                  

ARTICLE 3. THE CLOSING............................................ ............3


ARTICLE 4. ASSUMPTION OF LIABILITIES...........................................3


ARTICLE 5. EXCISE AND PROPERTY TAXES...........................................3

ARTICLE 6. REPRESENTATIONS AND WARRANTIES OF SELLER............................3

         6.1      Organization, Good Standing and Qualification................4
                 
         6.2      Financial Statements............................. ...........4
                 
         6.3      Absence of Specified Changes.................................4
                  
         6.4      Taxes......................................  ................5
                  
         6.5      Real Property................................................6
                   
         6.6      Inventories..................................................6
                  
         6.7      Intellectual Property.......................... .............6
                 
         6.8      Trade Secrets................................................6
                  
         6.9      Title to Assets................................. ............6
                  
         6.10     Customers and Sales..........................................7
                  
         6.11     Existing Employment Contracts................................7
                  
         6.12     Insurance Policies...........................................7
                 
         6.13     Other Contracts..............................................7
                 
         6.14     Compliance with Laws............................. ...........7
                  
         6.15     Litigation...................................................7
                
         6.16     Assets Sufficient for Conduct of Business....................8
                 
         6.17     Agreement Will Not Cause Breach or Violation.................8
                  
         6.18     Authority and Consents.......................................8
                  
         6.19     Interest in Customers, Suppliers and Competitors.............8
                  
         6.20     Employee Identification and Compensation.....................8
                 
         6.21     No Subsidiaries..............................................8
                  
         6.22     Environmental Matters........................................8
                  
         6.23     Employee Benefit Plans......................................10
                  
         6.24     Product Warranties..........................................10
                  
         6.25     Software....................................................10
                 
         6.26     Documents Delivered.........................................10
                
         6.27     Full Disclosure.............................................11
                 

ARTICLE 7. REPRESENTATIONS AND WARRANTIES OF BUYER AND PARENT.................11

         7.1      Organization................................................11
                  
         7.2      Authority and Consents.........  ...........................11
                  
         7.3      Agreement Will Not Cause Breach Or Violation................11
                  

ARTICLE 8. OBLIGATIONS OF THE PARTIES BEFORE CLOSING..........................12

         8.1      Buyer's Access to Premises and Information........ .........12
                  
         8.2      Conduct of Business in Normal Course....................  ..12
                
         8.3      Preservation of Business and Relationships..................12
                 
         8.4      Maintenance of Insurance....................................12
                 
         8.5      Employees and Compensation..................................12
                 
         8.6      New Transactions............................................12
                  
         8.7      Payment of Liabilities and Waiver of Claims.................13
                  
         8.8      Existing Agreements............................... .........13
                 
         8.9      Consent of Others...........................................13
                  
         8.10     Representations and Warranties True at Closing..............13
                  
         8.11     Sales and Use Tax on Prior Sales.............. .............13
                  
         8.12     Statutory Filings........................ ..................13
                  
         8.13     Negotiations with Certain Customers.........................13
                  
         8.14     License Agreement...........................................13
                  
         8.15     Sublease....................................................14
                  

ARTICLE 9. CONDITIONS PRECEDENT TO BUYER'S PERFORMANCE........................14

         9.1      Accuracies of Seller's Representations  and Warranties.... .14
                  
         9.2      Absence of Liens............................................14
                  
         9.3      Seller's Performance........................................14
                
         9.4      Certification by Seller......................... ...........14
                 
         9.5      Assignment and Assumption Agreements........................14
                 
         9.6      Bill of Sale................................................14
                  
         9.7      Opinion of Seller's Counsel.................................14
                  
         9.8      Absence of Litigation.......................................14
                  
         9.9      Corporate Approval..........................................15
                 
         9.10     Good Standing Certificate................... ...............15
                 
         9.11     Consents....................................................15
                 
         9.12     Approval of Documentation...................................15
                  
         9.13     Employment Arrangements.....................................15
                  
         9.14     Bulk Transfer Notice........................................15
                
         9.15     Change of Corporate Name....................................15
                  
         9.16     Condition of Assets.........................................15
                  
         9.17     MIIX Agreement..............................................15
                  
         9.18     HBOC Agreement.................................... .........15
                  

ARTICLE 10. CONDITIONS PRECEDENT TO SELLER'S PERFORMANCE......................15

         10.1     Accuracy of Buyer's Representations and Warranties..........15
                  
         10.2     Buyer's and Parent's Performance.........  .................16
                
         10.3     Payment of Purchase Price...................................16
                 
ARTICLE 11. OBLIGATIONS OF THE PARTIES AFTER THE CLOSING......................16

         11.1     Preservation of Goodwill....................................16
                  
         11.2     Change of Name..............................................16
              
         11.3     Access to Records...........................................16
                  
         11.4     Nonsolicitation of Employees................................17
                 
         11.5     Further Assurances..........................................17
                 
         11.6     Termination of IAC Contract.................................17
                 

ARTICLE 12.     INDEMNIFICATION...............................................17

         12.1.    Indemnification by Seller...................................17
         12.2.    Indemnification by Buyer....................................17
         12.3.    Notice and Defense of Third Party Claims....................17

ARTICLE 13.  COSTS............................................................18

         13.1     Finder's or Broker's Fees................. .................18
                 
         13.2     Expenses....................................................18
                 
ARTICLE 14.   FORM OF AGREEMENT...............................................18

         14.1     Headings....................................................18
                
         14.2     Entire Agreement; Modification; Waiver......................18
                  
         14.3     Counterparts................................................18
                  

ARTICLE 15.   PARTIES.........................................................19

         15.1     Parties in Interest.........................................19
                 
         15.2     Assignment..................................................19
                  

ARTICLE 16.   TERMINATION.....................................................19

         16.1.    Termination by Mutual Consent...............................19
         16.2.    Termination by Buyer or Seller..............................19
         16.3.    Effect of Termination..................... .................19

ARTICLE 17. NATURE AND SURVIVAL OF REPRESENTATIONS AND WARRANTIES.............19


ARTICLE 18.   NOTICES.........................................................20


ARTICLE 19.   GOVERNING LAW...................................................20


ARTICLE 20.   MISCELLANEOUS...................................................20

         20.1     Recovery of Litigation Costs.....................   ........20
                  
         20.2     Announcements...............................................20
                 
         20.3     References..................................................21
                 

                                                                                
         This Asset Purchase Agreement (the "Agreement"),  dated as of September
29, 1998 among PATIENT  INFOSYSTEMS  ACQUISITION  CORP., a Delaware  corporation
("Buyer"),  PATIENT INFOSYSTEMS,  INC., a Delaware corporation  ("Parent"),  and
HEALTHDESK CORPORATION, a California corporation ("Seller").

                                   WITNESSETH:

         WHEREAS,  Seller owns certain  assets which it uses in the operation of
its  business  being  generally  the design,  development  and  marketing of the
HealthDesk  Online software,  the CareTeam Connect software and software related
products for use in the healthcare,  wellness and disease management  industries
(such  business  currently  operated by Seller  being  referred to herein as the
"Business").

         WHEREAS,  Buyer desires to purchase  from Seller and Seller  desires to
sell to Buyer,  on the terms and subject to the  conditions  of this  Agreement,
substantially all of the assets and properties used in the Business,  other than
certain excluded assets described below.

         THEREFORE,  in  consideration  of  the  mutual  covenants,  agreements,
representations and warranties contained in this Agreement, the parties agree as
follows:

ARTICLE 1.........TRANSFER OF ASSETS

         Subject to the terms and conditions set forth in this Agreement, Seller
agrees to sell, convey, transfer,  assign and deliver to Buyer, and Buyer agrees
to purchase  from Seller at the Closing  described in Article 3 hereof,  all the
assets,  properties  and  business  of  Seller  of  every  kind,  character  and
description, whether tangible, intangible, real, personal or mixed, and wherever
located  (but  excluding  any  assets  specifically  excluded  in the  following
Sections of this Article 1), all of which are sometimes collectively referred to
in this Agreement as the "Assets," including, but not limited to, the following:

         1.1......Intellectual  Property.  All trade names  (including,  but not
limited  to, the name  "HealthDesk"),  trademarks,  service  marks,  copyrights,
patents, patent rights, inventions,  licenses,  computer programs (regardless of
state of completion and including all work product), brand names, trade secrets,
technical know-how, goodwill and other intangibles (including without limitation
(i) tort or insurance  proceeds  arising out of any damage or destruction of any
of the  Assets  between  the date of this  Agreement  and the  Closing  Date (as
hereinafter  defined),  (ii) all  right,  title  and  interest  of Seller in the
license  and  service   agreements   identified  on  Schedule  1.1(the  "License
Agreements"),  (iii) the intellectual  property  identified on Schedule 6.7, and
(iv) the software  identified  on Schedule  6.25 and all  programs,  designs and
documentation for such software used by Seller in (or owned by Seller and useful
in) the  operation of the Business)  (the assets  described in this Section 1.1,
collectively, the "Intellectual Property");

         1.2......Inventories.  All of Seller's finished goods and raw materials
(whether  expensed or not),  including work in process,  shrink wraps,  CD roms,
spare parts and repair materials that are actually on hand with Seller as of the
Closing  Date,  an  approximate  summary  of which  items  currently  on hand is
attached  hereto as Schedule 1.2  (hereinafter  referred to  collectively as the
"Inventories");

         1.3......Equipment and Packaged Software. Seller's office equipment and
computer  hardware  specifically set forth on Schedule 1.3 (the "Equipment") and
the Packaged Software listed on Schedule 1.3a (the "Packaged Software");

         1.4......Books and Records. All papers,  computerized databases,  files
and records in Seller's care,  custody or control  relating to any or all of the
above described Assets and the operation thereof, including, but not limited to,
all  blueprints  and  specifications,   product  designs,  marketing  materials,
demonstration  packages and product  materials,  environmental  control records,
sales records,  marketing  materials,  maintenance and production  records,  and
plans  and  designs  of  buildings,  structures,  fixtures  and  equipment,  but
excluding  personnel and labor  relations  records and  accounting and financial
records;

         1.5......Prepaid  Expenses.  All prepaid  expenses and  other  prepaid 
items relating to any of the Assets and the operation of the Business;

         1.6......Permits,  etc. All permits, licenses, franchises,  consents or
authorizations   issued  by,  and  all   registrations  and  filings  with,  any
governmental  agency in connection with the Business,  whenever issued or filed,
excepting  only those  which by law or by their terms are  non-transferable  and
those which have expired; and

         1.7......All Property Not Elsewhere Described.  All other properties of
Seller of every  kind,  character  or  description  owned,  used or held for use
(whether or not  exclusively) in connection with the Business,  wherever located
and whether or not similar to the things set forth  elsewhere in this Article 1,
but excluding any assets specifically excluded in this Article 1.

         1.8......Excluded   Assets.   The  following  assets  are  specifically
excluded  from the assets being  purchased by Buyer  pursuant to this  Agreement
(collectively, the "Excluded Assets"):

         (a)......all  furniture,  PCs, laptops   and   office   equipment  not 
specifically set forth on Schedule 1.3;

         (b)......all  cash,  bank  balances,  money in  possession of banks and
other  depositories,  including  security  deposits with landlords and equipment
lessors, and similar cash items held by or for the account of Seller;

         (c)......all of Seller's accounts receivable;

         (d)......Seller's   franchise  as  a   corporation,   its  articles  of
incorporation,  corporate  seal,  minute books and stock books,  stock  transfer
records and similar  records  relating to Seller's  organization,  existence  or
capitalization,  and the  capital  stock of Seller and all other  records  which
Seller is required by law to keep in its possession;

         (e)......Seller's federal, state and local tax returns and rights to 
refunds, if any; and

         (f)......Seller's  rights  relating  to  its  proposed  acquisition  of
MCInformatics   ("MCI")  and  any  assets   acquired  in  connection  with  such
acquisition.  The term "Business" as used herein  expressly  excludes any matter
relating to MCI.

ARTICLE 2.........PURCHASE PRICE

         2.1......Payment  of Purchase Price. In consideration  for the transfer
and   assignment  by  Seller  of  the  Assets  and  in   consideration   of  the
representations,  warranties  and  covenants of Seller set forth  herein,  Buyer
shall, subject to the conditions set forth herein,

                  (a)      deliver  to Seller  at the  Closing  (as  hereinafter
                           defined)  the  sum  of  (i)  $500,000,   representing
                           payment for the Assets other than the Equipment; (ii)
                           $115,040,  representing  payment  for  the  Equipment
                           (such sums collectively  referred to as the "Purchase
                           Price"); and (iii) $11,238,  representing payment for
                           the Packaged Software,  payable in cash as more fully
                           described in Section 10.3 hereof; and

                  (b)      assume  and  discharge,  and shall  indemnify  Seller
                           against,  liabilities and obligations of Seller under
                           the leases,  contracts or other  agreements,  if any,
                           specified on Schedule 1.1. and Schedule 4 but only to
                           the  extent  that  such  liabilities  or  obligations
                           accrue on or after the Closing Date.

         2.2......Allocation  of Purchase Price. The parties shall determine and
agree upon the allocation of the Purchase Price at, or prior to, the Closing and
such  allocation  will be used  by the  parties  in  reporting  the  transaction
contemplated by this Agreement for federal and state tax purposes.

ARTICLE 3.........THE CLOSING.

         The closing of the  purchase  and sale of the Assets by Seller to Buyer
(the  "Closing")  shall take place at the  offices of Gibbons,  Del Deo,  Dolan,
Griffinger & Vecchione, One Riverfront Plaza, Newark, New Jersey 07102-5497,  at
10:00 a.m. local time,  within five days of satisfying the conditions to closing
set forth herein, or at such other place and/or time as the parties may agree in
writing (the "Closing Date").  If on the original or any postponed  Closing Date
Seller  shall have been  unable to obtain all  waivers  and  consents of private
parties and  governmental  agencies  required by this Agreement,  then Buyer, on
written  notice,  may postpone the Closing to a time not later than November 30,
1998.

ARTICLE 4.........ASSUMPTION OF LIABILITIES

         Buyer is not assuming  any debt,  liability  or  obligation  of Seller,
whether known or unknown,  fixed or contingent (including without limitation the
litigation set forth on Schedule 6.15), except as herein specifically  otherwise
provided.  Seller agrees to indemnify and hold Buyer harmless against all debts,
claims,  liabilities  and  obligations of Seller not expressly  assumed by Buyer
hereunder,  and to pay any and all  attorneys'  fees and legal costs  reasonably
incurred by Buyer,  its  successors and assigns in connection  therewith.  Buyer
shall have the benefit of and shall  perform  and assume the License  Agreements
and all  leases,  contracts  and  agreements,  if any,  specifically  listed  on
Schedule 4, in accordance with the terms and conditions  thereof,  except to the
extent modifications are specifically set forth on such Schedule 4 and except to
the extent set forth in the assignments or assignment and assumption  agreements
for such leases, contracts and agreements.

ARTICLE 5.........EXCISE AND PROPERTY TAXES

         Buyer shall pay all sales,  use and transfer  taxes  arising out of the
transfer  of the Assets and shall pay its  portion,  prorated  as of the Closing
Date, of state and local real and personal property taxes of the Business. Buyer
shall not be responsible  for any business,  occupation,  withholding or similar
tax, or for any taxes of any kind related to any period before the Closing Date.

ARTICLE 6.........REPRESENTATIONS AND WARRANTIES OF SELLER.

         Except as set forth in the Schedules  delivered by Seller  concurrently
with the execution of this  Agreement  and  incorporated  herein,  Seller hereby
represents  and  warrants  to Buyer  and  Parent  that the  following  facts and
circumstances  are and,  except as contemplated  hereby,  at all times up to the
Closing Date, will be true and correct,  and hereby  acknowledge that such facts
and  circumstances  constitute the basis upon which Buyer and Parent are induced
to enter  into and  perform  this  Agreement.  Each  warranty  set forth in this
Article 6 shall survive the Closing and any  investigation  made by or on behalf
of Buyer and Parent.

         6.1......Organization,  Good  Standing and  Qualification.  Seller is a
corporation  duly organized,  validly  existing,  and in good standing under the
laws of California, has all necessary corporate powers to own its properties and
to carry on its business as now owned and operated by it, and is duly  qualified
to transact  intrastate business and is in good standing in all jurisdictions in
which the nature of its business or of its properties  makes such  qualification
necessary.

         6.2......Financial Statements.

         (a)      Seller  has  timely  filed with the  Securities  and  Exchange
                  Commission  (i) the balance sheet of Seller as of December 31,
                  1997,  and  the  related  statement  of  income  and  retained
                  earnings  for the year then  ending,  certified  by  Coopers &
                  Lybrand  L.L.P.  (now  known as  PricewaterhouseCoopers  LLP),
                  Seller's  independent  certified public accountants,  and (ii)
                  the  unaudited  balance  sheet of Seller as of June 30,  1998,
                  together  with  related  unaudited  statement  of  income  and
                  retained  earnings  for the three month  period  then  ending,
                  [certified  by the chief  financial  officer of Seller.]  Such
                  financial   statements  are  referred  to  as  the  "Financial
                  Statements."

         (b)      The Financial Statements have been prepared in accordance with
                  generally accepted accounting principles ("GAAP") consistently
                  followed  by Seller  throughout  the  periods  indicated,  and
                  fairly  present  the  financial  position  of Seller as of the
                  respective  dates  of  the  balance  sheets  included  in  the
                  Financial  Statements,  and the results of its  operations for
                  the respective periods indicated. Seller has no liabilities or
                  obligations  of  any  nature  (known  or  unknown,   absolute,
                  accrued,  contingent  or otherwise) of the type required to be
                  reflected  or  disclosed  in a  balance  sheet  (or the  notes
                  thereto)  prepared in accordance with GAAP that were not fully
                  reflected or reserved against in the Financial Statements.

         6.3......Absence of Specified Changes.  Since June 30, 1998, except as
 set forth on Schedule 6.3, there has not been any:
                 

                  (a)      Transaction by Seller except in the ordinary course
                           of business as conducted on that date;

                  (b)      Capital expenditure by Seller exceeding $25,000;

                  (c)      Adverse   change   in   the   financial    condition,
                           liabilities, assets, business or prospects of Seller;

                  (d)      Destruction,  damage  to,  or loss of any  assets  of
                           Seller  (whether  or not covered by  insurance)  that
                           adversely affects the financial  condition,  business
                           or prospects of Seller;

                  (e)      Labor  trouble  or other  event or  condition  of any
                           character    adversely    affecting   the   financial
                           condition, business, assets or prospects of Seller;

                  (f)      Change in accounting methods or practices (including,
                           without  limitation,  any change in  depreciation  or
                           amortization policies or rates) by Seller;

                  (g)      Revaluation by Seller of any of its assets;

                  (h)      Increase in the salary or other compensation  payable
                           or  to  become  payable  by  Seller  to  any  of  its
                           officers, directors or employees, or the declaration,
                           payment or  commitment  or obligation of any kind for
                           the payment by Seller of a bonus or other  additional
                           salary or compensation to any such person;

                  (i)      Sale or transfer of any asset of Seller, except in 
                           the ordinary course of business;

                  (j)      Execution,  creation, amendment or termination of any
                           contract,  agreement  or license to which Seller is a
                           party and which is proposed to be assigned hereunder,
                           except in the ordinary course of business;

                  (k)      Loan by Seller to any person or entity, or guaranty
                           by Seller of any loan;

                  (l)      Waiver or  release  of any right or claim of  Seller,
                           except in the ordinary course of business;

                  (m)      Mortgage, pledge or other encumbrance of any asset of
                           Seller;

                  (n)      Other event or condition of any character that has or
                           might  reasonably  have  an  adverse  effect  on  the
                           financial condition, business, assets or prospects of
                           Seller; or

                  (o)      Agreement by Seller to do any of the things described
                           in the preceding clauses (a) through (n).

         6.4......Taxes.  Seller  has filed or  caused to be filed all  federal,
state and local tax returns and reports that are or were required to be filed by
or with  respect to Seller,  pursuant to  applicable  law. All such returns were
correct and complete in all  respects.  Seller has paid, or has provided for the
payment  of, all taxes that have or may have  become due  pursuant  to those tax
returns or otherwise,  or pursuant to any assessment received by Seller,  except
such taxes,  if any, as are listed in Schedule  6.4 and are being  contested  in
good faith and as to which  adequate  reserves  (determined  in accordance  with
GAAP) have been  provided in the  Financial  Statements.  Except as set forth in
Schedule  6.4,  no audit of any tax  return  of  Seller  is in  progress  or, to
Seller's  knowledge,  threatened;  no  director,  officer or  employee of Seller
responsible  for tax matters  expects any  governmental  authority to assess any
additional  taxes for any period for which tax returns  have been filed;  and no
waiver or  agreement  by Seller  is in force for the  extension  of time for the
assessment or payment of any tax. To Seller's knowledge,  no claim has ever been
made by any governmental  authority in a jurisdiction where Seller does not file
tax returns that it is or may be subject to taxation by that jurisdiction.

     .........Seller  has withheld and paid or collected  and remitted all taxes
required to have been withheld and paid in connection with amounts paid or owing
to any employee, independent contractor, supplier, vendor, creditor, stockholder
or other third party.  There is no dispute or claim concerning any tax liability
of Seller,  (i) claimed or raised by any  governmental  authority  in writing or
(ii) as to which Seller or the directors  and officers of Seller has  knowledge.
As of the date  hereof,  there have been no, and Seller has no knowledge of any,
threatened or intended  reappraisals by any governmental  authority with respect
to the value of the Assets.

         6.5......Real Property.  Seller does not own any real property.

         6.6......Inventories. The Inventories consist of items of a quality and
quantity  useable,  salable or  rentable in the  ordinary  course of business by
Seller,  except for  obsolete  and  slow-moving  items and items below  standard
quality,  all of which  have  been  written  down on the  books of Seller to net
realizable  market  value or have been  provided for by adequate  reserves.  All
items included in the Inventories  are the property of Seller,  except for sales
made in the  ordinary  course of  business;  for each of these sales  either the
purchaser has made full payment or the purchaser's  liability to make payment is
reflected in the books of Seller. No items included in the Inventories have been
pledged as collateral or are held by Seller on consignment from the others.  All
the  Inventories  are free of defects  and, to the extent  that they  consist of
finished or semi-finished  goods, also comply with the specifications  submitted
by the purchasers thereof.

         6.7......Intellectual   Property.   Schedule   6.7  lists  all  of  the
Intellectual  Property  owned or used by Seller in connection  with the Business
(other than shrink wrap software generally  available to the public).  No person
(other  than  Seller)  owns  any  Intellectual  Property,  the use of  which  is
necessary or  contemplated in connection with the performance of any contract to
which Seller is a party,  except  manufacturer's  trademarks  and trade names on
goods sold in Seller's  Business.  Except as set forth in Schedule  6.7 or 6.15,
there have not been any administrative, judicial arbitration, or other adversary
proceedings  concerning the  Intellectual  Property.  Seller does not violate or
infringe on any intellectual  property or personal right of any person,  firm or
corporation,  and  Seller has not  infringed  and is not now  infringing  on any
intellectual   property  or  other  right  belonging  to  any  person,  firm  or
corporation.  Except as set forth in Schedule 6.7 or Schedule 1.1, Seller is not
a party to any license, agreement or arrangement,  whether as licensee, licensor
or otherwise, with respect to any Intellectual Property.

         6.8......Trade  Secrets.  Seller  has  taken  all  reasonable  security
measures to protect the secrecy,  confidentiality and value of all trade secrets
used by Seller (or owned by Seller and useful in) the operation of the Business.
Any of its employees and any other persons who,  either alone or in concert with
others, developed, invented,  discovered,  derived, programmed or designed these
secrets,  or who have  knowledge of or access to  information  relating to them,
have been put on notice and have entered into appropriate  agreements that these
secrets are  proprietary  to Seller and are not to be  divulged or misused.  All
these trade secrets are presently valid and protectible, and are not part of the
public knowledge or literature,  nor to Seller's  knowledge have they been used,
divulged or  appropriated  for the benefit of any past or present  employees  or
other persons, or to the detriment of Seller.

         6.9......Title  to Assets.  Seller has good and marketable title to all
the Assets and its  interests  in the Assets,  whether  real,  personal,  mixed,
tangible or intangible,  which constitute all the Assets and interests in Assets
that are used in the  Business.  All the Assets are free and clear of mortgages,
liens, pledges, charges,  encumbrances,  equities, claims, easements,  rights of
way,  covenants,  conditions or restrictions,  except for (i) those disclosed in
Schedule 6.9; (ii) the lien of current taxes not yet due and payable;  and (iii)
possible minor matters that, in the aggregate, are not substantial in amount and
do not materially  detract from or interfere with the present or intended use of
any of these assets, nor materially impair business  operations.  All the Assets
are in good  operating  condition and repair,  ordinary wear and tear  excepted.
Seller is in  possession of all premises  leased to it from others.  Neither any
officer, director or employee of Seller, nor any spouse, child or other relative
of any of these persons, owns, or has any interest,  directly or indirectly,  in
any of the  real or  personal  property  owned by or  leased  to  Seller  or any
Intellectual Property or trade secrets licensed by Seller.

         6.10.....Customers  and Sales.  Schedule  6.10 to this  Agreement  is a
correct and current  list of all  customers  of Seller.  Except as  indicated in
Schedule  6.10,  Seller  has  no  information  and  is not  aware  of any  facts
indicating  that any of these  customers  intend to cease  doing  business  with
Seller or  materially  alter the amount of the business  that they are presently
doing with Seller.

         6.11.....Existing Employment Contracts. Schedule 6.11 to this Agreement
is a list of all employment contracts and collective bargaining agreements,  and
all  pension,  bonus,  profit-sharing,  stock  option  or  other  agreements  or
arrangements  providing for employee remuneration or benefits to which Seller is
a party or by which Seller is bound. All of these contracts and arrangements are
in full force and effect,  and neither  Seller nor any other party is in default
under them.  There have been no claims of defaults  and, to Seller's  knowledge,
there are no facts or conditions which if continued,  or on notice,  will result
in a default under these contracts or  arrangements.  There is no pending or, to
Seller's knowledge,  threatened labor dispute, strike or work stoppage affecting
the Business.

         6.12.....Insurance  Policies.  Seller has  maintained and now maintains
(i) insurance on all the Assets of a type customarily insured, covering property
damage and loss of income by fire or other casualty, and (ii) adequate insurance
protection  against  all  liabilities,  claims  and  risks  against  which it is
customary to insure,  including without limitation  earthquakes as to properties
located in California.

         6.13.....Other  Contracts.  Except  as set  forth  in  Schedule  1.1 or
Schedule 4,  Seller is not a party to, nor are the Assets  bound by, any license
or service agreement,  any output or requirements  agreement,  any agreement not
entered into in the ordinary course of business, any indenture,  mortgage,  deed
of trust,  lease or any other  agreement that is unusual in nature,  duration or
amount (including without limitation any agreement  requiring the performance by
Seller of any obligation for a period of time extending beyond one year from the
Closing  Date or calling for  consideration  of more than  $25,000 or  requiring
purchases  at prices in excess  of, or sales at prices  lower  than,  prevailing
market  prices).  All  contracts  which will be  assigned to or assumed by Buyer
under this Agreement are valid and binding upon the parties thereto. There is no
default or event that, with notice or lapse of time or both,  would constitute a
default by any party to any of the agreements listed in Schedule 1.1 or Schedule
4. Seller has not received notice that any party to any of the agreements listed
in  Schedule  1.1 or  Schedule  4 intends  to cancel or  terminate  any of these
agreements  or to  exercise  or not  exercise  any  options  under  any of these
agreements.

         6.14.....Compliance  with Laws. Seller has complied with, and is not in
violation of, applicable federal, state or local statutes,  laws and regulations
(including without limitation any applicable  environmental,  health,  building,
zoning or other law,  ordinance or  regulation)  affecting its properties or the
operation of the Business.  Seller is in  possession  of all permits,  licenses,
franchises,  consents or  authorizations  issued by and in  compliance  with all
registrations  and filings required by any governmental  authority in connection
with the Business or the Assets. All of such permits,  licenses,  franchises and
authorizations are valid and in full force and effect.

         6.15.....Litigation.  Except as set forth in Schedule 6.15, there is no
suit,  action,  arbitration or legal,  administrative  or other  proceeding,  or
governmental  investigation,  pending  or,  to  Seller's  knowledge,  threatened
against  or  affecting  Seller,  or any of its  business,  assets  or  financial
condition.  The matters  set forth in Schedule  6.15,  if decided  adversely  to
Seller, will not result in a material adverse change in the business,  assets or
financial  condition of Seller.  Seller has furnished or made available to Buyer
copies of all relevant court papers and other documents  relating to the matters
set forth in Schedule 6.15.  Seller is not in default with respect to any order,
writ,  injunction  or decree of any  federal,  state,  local or  foreign  court,
department,  agency or  instrumentality.  Except as set forth in Schedule  6.15,
Seller is not presently  engaged in any legal action to recover moneys due to it
or damages sustained by it.

         6.16.....Assets   Sufficient  for  Conduct  of  Business.  The  Assets,
together with the Excluded  Assets,  constitute  all of the assets  required for
Buyer to conduct the Business as it is presently conducted.

         6.17.....Agreement  Will Not Cause  Breach or  Violation.  Neither  the
entry into this Agreement nor the consummation of the transactions  contemplated
hereby will result in or constitute  any of the  following:  (i) a breach of any
term or  provision  of this  Agreement;  (ii) a default or an event  that,  with
notice or lapse of time or both, would be a default,  breach or violation of the
certificate  of  incorporation  or bylaws of  Seller or of any  lease,  license,
promissory note, conditional sales contract,  commitment,  indenture,  mortgage,
deed of trust or other agreement, instrument or arrangement to which Seller is a
party or by which  Seller or the  Assets  are  bound;  (iii) an event that would
permit any party to terminate any agreement or to accelerate the maturity of any
indebtedness or other  obligation;  (iv) the creation or imposition of any lien,
charge or  encumbrance  on any of the Assets;  or (v) the  violation of any law,
regulation,  ordinance,  judgment,  order or decree  applicable  to or affecting
Seller or the Assets.

         6.18.....Authority  and Consents.  Seller has the right,  power,  legal
capacity and authority to enter into, and perform its  obligations  under,  this
Agreement,  and,  except as set forth on Schedule 6.18, no approvals or consents
of any persons other than the stockholders of Seller are necessary in connection
with it. The execution and delivery of this  Agreement and the  consummation  of
this  transaction  by Seller have been,  or prior to the Closing will have been,
duly  authorized  by all necessary  corporate  action of Seller  (including  any
necessary action by Seller's stockholders).  This Agreement constitutes a legal,
valid and binding  obligation of Seller enforceable in accordance with its terms
except as limited by bankruptcy and insolvency  laws and by other laws affecting
the rights of creditors generally.

         6.19.....Interest  in Customers,  Suppliers and Competitors.  Except as
set forth in  Schedule  6.19,  neither  Seller nor any  officer or  director  of
Seller, nor, to Seller's knowledge,  any spouse or child of any of them, has any
direct or indirect interest in any competitor, supplier or customer of Seller or
in any person with whom Seller is doing  business  (excluding  ownership of less
than 10% of any corporation or other entity traded publicly).

         6.20.....Employee   Identification  and  Compensation.   Schedule  6.20
contains a list of the names of all current officers,  directors,  employees and
manufacturer's  representatives  of Seller,  stating  the rates of  compensation
payable to each and setting forth all vacation  time,  sick leave and other paid
time off accrued for each of them  through the Closing  Date.  No other  person,
except  accountants,  auditors and  attorneys,  regularly  performs  compensable
services for Seller.

         6.21.....No Subsidiaries.  Seller has no subsidiaries.

         6.22.....Environmental Matters.

         .........(a)  Except  as  set  forth  in  Schedule  6.22,  to  Seller's
knowledge,  there have not been any activities on or at the real property leased
by the Seller at 2560 9th Street,  Suite 220, Berkeley,  California or any other
real  property by Seller (the "Real  Property") or at any time during which such
property  was owned or leased by Seller or at any time prior  thereto  involving
the use, generation, treatment, storage, or Disposal of any Hazardous Substances
or Petroleum Products in violation of applicable  Environmental Laws (as defined
below).

         .........(b)  Except  as  set  forth  in  Schedule  6.22,  to  Seller's
knowledge,  there  have not been any  Releases  or  threatened  Releases  of any
Hazardous  Substances or Petroleum  Products at or from the Real Property at any
time  during  which such  property  was  occupied by Seller or at any time prior
thereto that (i) would be in violation of applicable Environmental Laws; or (ii)
could give rise to an action to compel an investigation and/or cleanup or to pay
material civil administrative fines, penalties or other damages.

         .........(c)  Except  as  set  forth  in  Schedule  6.22,  to  Seller's
knowledge,  there have not been any Hazardous  Substances or Petroleum  Products
located in or on the Real  Property at any time during  which such  property was
leased by Seller or at any time prior  thereto that (i) would be in violation of
applicable Environmental Laws; or (ii) could reasonably be expected to give rise
to  an  action  to  compel  a  investigation  and/or  cleanup  or to  pay  civil
administrative fines, penalties or other damages;

         .........(d)  Except as set forth in Schedule  6.22,  (i) Seller is now
and has been at all times in compliance with all Environmental  Laws; (ii) there
are no pending  environmental  litigation,  enforcement actions,  administrative
orders or notices of violation  brought under any  Environmental  Law and Seller
does  not  know  of  any  threats  of  such  litigation,   enforcement  actions,
administrative orders or notices of violation; (iii) Seller has not received any
request for information,  notice of claim,  demand or other notification that it
may be potentially responsible for any threatened or actual Release of Hazardous
Substance  or  Petroleum  Products;  and (iv) Seller has all  material  permits,
licenses, orders, approvals, authorizations,  concessions or franchises or every
governmental  authority having  jurisdiction under an Environmental Law required
to conduct the Business  substantially as it is currently being  conducted.  All
such permits,  licenses,  orders,  approvals,  authorizations,  concessions  and
franchises are listed on Schedule 6.22 and are in full force and effect, and, to
Seller's  knowledge,  there is no state of facts or event which could reasonably
be expected to form the basis for any revocation, non-renewal or any such permit
or authorization.

     .........(e)  Capitalized  terms used in this  Section  6.22 shall have the
following meanings: 

         "Environmental Laws" means any federal, state or local law, regulation,
ordinance  or order  pertaining  to the  protection  of natural  resources,  the
environment and the health and safety of the public,  including, but not limited
to, the  Comprehensive  Environmental  Response,  Compensation and Liability Act
("CERCLA"), 42 U.S.C. ss.ss.9601 et seq., the Resource Conservation and Recovery
Act ("RCRA"),  as amended, 42 U.S.C.  ss.ss.6901 et seq., the Hazardous Material
Transportation Act, as amended,  49 U.S.C.  ss.ss.1801 et seq., the Occupational
Safety and Health Act,  as amended,  29 U.S.C.  ss.ss.  651 et seq.,  California
Health & Safety Code ss.ss.19015 and ss.ss.25300 et seq.,  California Civil Code
ss.ss.1102 et seq.,  and ss.2079,  California  Civil  Procedure  Code ss.726 and
California Business and Professional Code ss.7180 et seq.

         "Hazardous Substances" means any oil, flammable substances, explosives,
hazardous  wastes or substances  (including  polychlorinated  biphenyls),  toxic
wastes or substances or any other wastes.

         "Hazardous Wastes" means hazardous wastes as defined by RCRA and the 
regulations thereunder.

         "Disposal" means disposal as defined by RCRA and the regulations
 thereunder.

         "Petroleum Products" means petroleum,  gasoline,  oil, fuel oil, diesel
fuel and petroleum solvents.

         "Release"  means any spilling,  leaking,  pumping,  pouring,  emitting,
emptying, placing, discharging,  injecting,  escaping, dumping or disposing into
the environment, whether intentional or unintentional.

         6.23.....Employee Benefit Plans

         .........(a)  Schedule  6.23 sets forth a true and complete list of all
written and oral Employee  Benefit Plans (as defined below) and other  programs,
commitments or funding arrangements maintained by Seller or to which Seller is a
party, in respect of, or which otherwise cover or benefit, any Subject Employees
(as defined below) or their beneficiaries.

         .........(b)  Except  for the  Employee  Benefit  Plans  identified  in
Schedule 6.23, there is no "employee  pension benefit plan",  "employee  welfare
benefit plan" or "employee  benefit  plan" within the meaning of Sections  3(1),
3(2) and 3(3) of the ERISA.  No  Employee  Benefit  Plan to which  Seller or any
ERISA  Affiliate (as  hereinafter  defined) has  maintained or contributed to is
subject  to Title IV of ERISA or Section  412 of the  Internal  Revenue  Code of
1986, as amended (the "Code").

 ..................(c)      Capitalized terms used in this Section 6.23 shall 
have the following meanings:

     ..................   "Employee  Plan"  includes  all  pension,  retirement,
disability,  medical,  dental or other health insurance plans, life insurance or
other death benefit plans, profit sharing, deferred compensation,  stock option,
bonus or other incentive plans, vacation benefit plans, severance plans or other
employee  benefit plans or  arrangements,  including,  without  limitation,  any
pension  plan as defined  in  Section  3(2) of the  Employee  Retirement  Income
Security Act of 1974,  as amended  ("ERISA")  and any welfare plan as defined in
Section 3(1) of ERISA,  whether or not funded,  covering any Subject Employee or
to which Seller is a party or bound or makes or has made any  contribution or by
which Seller may have any liability to any Subject Employee  (including any such
plan  formerly  maintained  by or in  connection  with which Seller may have any
liability to any Subject  Employee,  and any such plan which is a  multiemployer
plan as defined in Section 3(37) (A) of ERISA).

     .................."ERISA  Affiliate" means a trade or business  (whether or
not  incorporated)  which is under common control with Seller within the meaning
of  Sections  414(b)  and  414(c)  of the  Code or the  regulations  promulgated
thereunder.
     .................."Subject   Employee"   includes  all  current  or  former
officers,  directors,  employees  or  consultants  who are or were  employed  or
otherwise  compensated in connection with activities  involving the Assets being
purchased.

         6.24.....Product  Warranties.  To  Seller's  knowledge,  no person  has
asserted  any  claim or has any  reasonable  basis  for any  claim  relating  to
warranties  or guaranties  with respect to any product,  service or contract for
Software (as defined in Section 6.25) sold or provided by Seller.

         6.25.....Software.  Seller  owns or is  licensed  to use  all  computer
software (including databases and related  documentation  ("Software")) which is
material to the conduct of the Business, a list of which is included on Schedule
6.25.  Except  for  non-customized  software  readily  available  from  multiple
sources,  Seller is not subject to any commitment to pay royalties or other fees
for the use of the  Software.  To  Seller's  knowledge,  no  person or entity is
materially  interfering  with or  infringing  upon,  and no person or entity has
misappropriated  any of, the  Software or  source-code  owned by Seller  ("Owned
Software").  To Seller's knowledge,  none of such Owned Software infringes upon,
is a misappropriation  of, or otherwise  conflicts with, any patent,  copyright,
trade secret or other proprietary right of any person.

         6.26.....Documents  Delivered.  Each copy or original of any agreement,
contract or other  instrument  which is identified  in any exhibit  delivered by
Seller or its  counsel  to Buyer (or its  counsel or  representatives),  whether
before or after the execution of this Agreement, is in fact what it is purported
to be by Seller and has not been amended, canceled or otherwise modified.

         6.27.....Full  Disclosure.  None of the  representations and warranties
made by Seller or made in any letter,  certificate or memorandum furnished or to
be  furnished by Seller,  or on its behalf,  contains or will contain any untrue
statement of a material  fact,  or omits any material fact the omission of which
would  make the  statements  made  misleading.  There is no fact known to Seller
which materially  adversely affects,  or in the future may (so far as Seller can
now reasonably  foresee)  materially  adversely affect,  the condition,  Assets,
liabilities,  business,  operations or prospects of Seller that has not been set
forth herein or heretofore communicated to Buyer in writing pursuant hereto.

ARTICLE 7. REPRESENTATIONS AND WARRANTIES OF BUYER AND PARENT 

         Buyer and  Parent  hereby  represent  and  warrant  to Seller  that the
following facts and circumstances are true and correct,  and hereby  acknowledge
that such facts and  circumstances  constitute  the basis  upon which  Seller is
induced to enter into and perform  this  Agreement.  Each  warranty set forth in
this Article 7 shall survive the Closing, as set forth in Article 17.

         7.1......Organization.  Each of Buyer and Parent is a corporation duly
 organized, existing and in good standing under the laws of Delaware.

         7.2......Authority  and  Consents.  Each of Buyer  and  Parent  has the
right,  power,  legal  capacity  and  authority  to enter into,  and perform its
obligations  under, this Agreement,  and no approvals or consents of any persons
other than Buyer and Parent, as applicable, are necessary in connection with it.
The  execution  and  delivery of this  Agreement  and the  consummation  of this
transaction by Buyer or Parent,  as the case may be, has been duly authorized by
all  necessary  corporate  action of Buyer or  Parent,  as the case may be.  The
execution  and  delivery  of  this  Agreement  and  the   consummation  of  this
transaction  by Buyer and  Parent  have been duly  authorized  by all  necessary
corporate  action  of  Buyer or  Parent,  as the  case  may be.  This  Agreement
constitutes  a legal,  valid and binding  obligation of each of Buyer and Parent
enforceable  in accordance  with its terms,  except as limited by bankruptcy and
insolvency laws and by other laws affecting the rights of creditors generally.

         7.3......Agreement  Will Not Cause  Breach Or  Violation.  Neither  the
execution  of  this  Agreement,   nor  the   consummation  of  the  transactions
contemplated  hereby,  will result in or constitute any of the following:  (i) a
default  or an event  that,  with  notice  or lapse of time or both,  would be a
default, breach or violation of the articles of incorporation or bylaws of Buyer
or Parent or of any lease, license, promissory note, conditional sales contract,
commitment, indenture, mortgage, deed of trust or other agreement, instrument or
arrangement  to which  Buyer or Parent is a party or by which Buyer or Parent is
bound;  (ii) an event that would permit any party to terminate  any agreement or
to accelerate the maturity of any indebtedness or other obligation; or (iii) the
violation  of  any  law,  regulation,   ordinance,  judgment,  order  or  decree
applicable to or affecting Buyer or Parent,  other than  violations,  conflicts,
breaches, terminations, accelerations and defaults which could not reasonably be
expected to have a material  adverse  effect on Buyer's or  Parent's  ability to
perform their respective obligations under this Agreement.

ARTICLE 8.........OBLIGATIONS OF THE PARTIES BEFORE CLOSING.

         The parties  covenant  and agree that,  except as  otherwise  agreed in
writing by the parties, from the date of this Agreement until the Closing:

         8.1......Buyer's Access to Premises and Information.  Buyer, Parent and
their counsel,  accountants and other  representatives shall be entitled to have
full access during normal business hours to all of Seller's  properties,  books,
accounts,  records, contracts and documents of or relating to the Assets. Seller
shall   furnish  or  cause  to  be   furnished   to  Buyer,   Parent  and  their
representatives  all data  and  information  concerning  the  Business,  and the
finances and properties of Seller that may reasonably be requested.

         8.2......Conduct  of Business in Normal  Course.  Seller shall carry on
its business and activities  diligently and in substantially  the same manner as
they  previously  have been  carried  on,  and shall not make or  institute  any
unusual or novel methods of  manufacture,  purchase,  sale,  lease,  management,
accounting  or  operation  that will vary  materially  from the methods  used by
Seller as of the date of this Agreement.

         8.3......Preservation  of Business and Relationships.  Seller shall use
its best efforts, without making any commitments on behalf of Buyer, to preserve
its  business  organization  intact,  to keep  available  to Seller its  present
officers  and  employees,   and  to  preserve  its  present  relationships  with
suppliers, customers and others having business relationships with it.

         8.4......Maintenance  of Insurance.  Seller shall continue to carry its
existing  insurance,  subject to variations in amounts  required by the ordinary
operations of the Business. At the request of Buyer and at Buyer's sole expense,
the amount of insurance  against fire and other casualties which, at the date of
this  Agreement,  Seller  carries  on any of the  Assets  or in  respect  of its
operations shall be increased by such amount or amounts as Buyer shall specify.

         8.5......Employees and Compensation.  The parties acknowledge and agree
that certain  employees of Seller  listed in Section 9.11 shall be terminated by
Seller and offered employment by Buyer prior to the Closing. Seller shall permit
Buyer to contact  Seller's  employees at all reasonable times for the purpose of
discussing with such employees  prospective  employment by Buyer on or after the
Closing  Date,  and Seller shall use its best efforts to encourage all employees
of Seller to accept any employment offered by Buyer.

         8.6......New  Transactions.  Except for  transactions  contemplated  by
Seller's proposed  acquisition of MCI, Seller shall not do or agree to do any of
the following acts:

                  (a)      Enter into any contract, commitment or transaction 
                           not in the usual and ordinary course of the Business;
                           or

                  (b)      Enter into any contract, commitment or transaction in
                           the usual and ordinary  course of business  involving
                           an amount exceeding $25,000, individually, or $50,000
                           in the aggregate; or

                  (c)      Make any  capital  expenditures  in excess of $25,000
                           for any single item or $50,000 in the  aggregate,  or
                           enter  into  any  leases  of  capital   equipment  or
                           property  under which the annual  lease  charge is in
                           excess of $25,000; or

                  (d)      Sell or dispose of any capital assets with a net book
                           value in excess of $25,000  individually,  or $50,000
                           in the aggregate.

         8.7......Payment of Liabilities and Waiver of Claims.  Seller shall not
do,  or  agree to do,  any of the  following  acts:  (i) pay any  obligation  or
liability,  fixed or contingent,  other than current liabilities;  (ii) waive or
compromise any right or claim; or (iii) cancel,  without full payment, any note,
loan or other obligation owing to Seller.

         8.8......  Existing Agreements.  Seller shall not modify, amend, cancel
or terminate any of the contracts or agreements to be assigned to Buyer pursuant
to this Agreement, or agree to do any of those acts.

         8.9......Consent  of Others. As soon as reasonably  practical after the
execution  and  delivery  of this  Agreement,  and in any event on or before the
Closing Date,  Seller shall obtain the written consent of the persons  described
in Schedule 6.18 to this Agreement in form and substance  satisfactory  to Buyer
and shall furnish to Buyer executed copies of those consents.

         8.10.....Representations  and Warranties True at Closing.  Seller shall
use its best efforts to assure that all representations and warranties of Seller
set forth in this Agreement and in any written statements  delivered to Buyer by
Seller under this Agreement will also be true and correct as of the Closing Date
as if made on that date and that all conditions  precedent to Closing shall have
been met. Seller shall promptly  disclose to Buyer any information  contained in
the Schedules to this Agreement  which,  because of an event occurring after the
date hereof,  is  incomplete  or is no longer  correct as of all times after the
date  hereof  until  the  Closing  Date;  provided,  however,  that none of such
disclosures shall be deemed to modify,  amend or supplement the  representations
and warranties of Seller or the Schedules  hereto for the purposes of Article 12
hereof, unless Buyer shall have consented thereto in writing.

         8.11.....Sales  and Use Tax on Prior  Sales.  Seller  agrees to use its
best efforts to furnish to Buyer a clearance  certificate  from the  appropriate
governmental  agency and any  related  certificates  that  Buyer may  reasonably
request as evidence that all sales and use and other tax  liabilities  of Seller
(other than income tax  liabilities)  accruing before the Closing Date have been
fully satisfied or provided for.

         8.12.....Statutory  Filings.  Seller  shall file,  and shall  cooperate
fully  with  Buyer in  preparing  and  filing,  all  information  and  documents
necessary or desirable under any statutes or  governmental  rules or regulations
pertaining to the transactions contemplated by this Agreement.

         8.13.....Negotiations   with  Certain   Customers.   Seller  agrees  to
negotiate  with HBO & Company  of Georgia  ("HBOC")  and Intel to  evaluate  the
current state of their respective agreements, contracts and relationships.

         8.14.....License Agreement. Seller and Buyer shall enter into a license
agreement in  substantially  the form of Exhibit A attached hereto (the "Interim
License  Agreement"),  pursuant  to which  Seller  grants to Buyer an  exclusive
license to use the Software  from the date of this  Agreement  until the Closing
Date.

         8.15.....Sublease.  Seller and Buyer  shall  enter  into a Sublease  in
substantially the form of Exhibit B attached hereto (the  "Sublease"),  pursuant
to which Buyer shall  sublease  from Seller the  premises  located at 2560 Ninth
Street,  Suite 220,  Berkeley,  California from the date of this Agreement until
the Closing Date.

ARTICLE 9.........CONDITIONS PRECEDENT TO BUYER'S PERFORMANCE 

         The  obligations  of Buyer to purchase the Assets under this  Agreement
are subject to the satisfaction, at or before the Closing, of all the conditions
set forth in this Article 9. Buyer may waive any or all of these  conditions  in
accordance with Section 15.2 hereof; provided, however, that no such waiver of a
condition  shall  constitute  a waiver  by Buyer of any of its  other  rights or
remedies,  at law or in  equity,  if Seller  shall be in  default  of any of its
representations, warranties or covenants under this Agreement.

         9.1......Accuracies  of Seller's  Representations  and Warranties.  All
representations  and  warranties  by Seller in this  Agreement or in any written
statement that shall be delivered to Buyer by Seller under this Agreement  shall
be true in all material respects on and as of the Closing Date as though made at
that time.

         9.2......Absence of Liens. At or prior to the Closing, Buyer shall have
received a UCC search report dated as soon as  practicable  prior to the Closing
Date issued by the appropriate  governmental  authorities  indicating that there
are no filings under the Uniform  Commercial Code on file with such governmental
authority  which name Seller as debtor or otherwise  indicating  any lien on the
Assets, except for the liens otherwise disclosed in the Schedules hereto.

         9.3......Seller's  Performance.  Seller shall have performed, satisfied
and complied with all  covenants,  agreements  and  conditions  required by this
Agreement to be  performed  or complied  with by Seller on or before the Closing
Date.

         9.4......Certification   by  Seller.   Buyer  shall  have   received  a
certificate,  dated the  Closing  Date,  signed by  Seller's  president  or vice
president or its chief financial  officer,  certifying,  in such detail as Buyer
and its counsel may reasonably request,  that all representations and warranties
of Seller made in Article 6 are true and correct as of the Closing Date and that
the conditions specified in Sections 9.1 and 9.3 have been fulfilled.

         9.5......Assignment  and Assumption Agreements.  Seller and Buyer shall
have  entered  into  assignment  and  assumption   agreements  for  the  License
Agreements and any other  agreements of Seller to be assumed pursuant to Article
4, in form and substance reasonably satisfactory to Buyer's counsel.

         9.6......Bill of Sale.  Seller shall have executed a bill of sale in 
substantially the form of Exhibit C attached hereto,
                  
with respect to the Assets.

         9.7......Opinion  of Seller's  Counsel.  Buyer shall have received from
Gray Cary Ware &  Freidenrich,  LLP,  counsel for Seller,  an opinion  dated the
Closing Date, in form reasonably satisfactory to Buyer's counsel .

         9.8......Absence  of Litigation.  No action,  suit or proceeding before
any court or any governmental  body or authority,  pertaining to the transaction
contemplated  by  this  Agreement  or  to  its  consummation,  shall  have  been
instituted or threatened on or before the Closing Date.

         9.9......Corporate   Approval.  The  execution  and  delivery  of  this
Agreement by Seller,  and the performance of its covenants and obligations under
it, shall have been duly authorized by all necessary corporate action, and Buyer
shall have received  copies of all  resolutions  of directors  and  stockholders
pertaining to that authorization, certified by the secretary of Seller.

         9.10.....Good  Standing  Certificate.  Buyer shall have received a good
standing  certificate  for  Seller  dated  as soon as  practicable  prior to the
Closing Date, issued by the appropriate governmental authorities.

         9.11.....Consents.  All  agreements  and consents of any parties to the
consummation  of the  transaction  set forth on  Schedule  6.18  shall have been
obtained by Seller and delivered to Buyer.

         9.12.....Approval  of  Documentation.  The  form and  substance  of all
certificates, instruments, opinions and other documents delivered to Buyer under
this Agreement shall be satisfactory in all reasonable respects to Buyer and its
counsel.

         9.13.....Employment   Arrangements..  Buyer  shall  have  entered  into
employment  arrangements  with each of Gerald Zieg, James Martin,  Brian Cronin,
Mark Fossen, Vicky Hilton, Jessica Radocy, Jan Maisler and Tim Wheeler.

         9.14.....Bulk Transfer Notice.  Division 6 of the California Uniform 
Commercial Code shall have been complied with or waived.
              
         9.15.....Change of Corporate Name.  Seller shall have changed its 
corporate name to a name not using "HealthDesk" or any similar name.

         9.16.....Condition of Assets. The Assets shall not have been materially
or  adversely  affected in any way as a result of any fire,  accident,  storm or
other casualty or labor or civil disturbance or act of God or the public enemy.

         9.17.....MIIX Agreement..  Buyer shall have entered into a royalty 
agreement with MIIX Healthcare Group, Inc.
              
         9.18.....HBOC  Agreement.  HBOC shall amend its existing agreement with
Seller,  which shall be assigned to Buyer pursuant thereto,  or Buyer shall have
entered into a revised marketing agreement with HBOC.

ARTICLE 10........CONDITIONS PRECEDENT TO SELLER'S PERFORMANCE 

         The  obligations  of Seller to sell and  transfer the Assets under this
Agreement are subject to the satisfaction,  at or before the Closing, of all the
following conditions:

         10.1.....Accuracy   of  Buyer's  and   Parent's   Representations   and
Warranties.  All representations and warranties by Buyer and Parent contained in
this  Agreement or in any written  statement  delivered by Buyer or Parent under
this  Agreement  shall  be true on and as of the  Closing  Date as  though  such
representations and warranties were made on and as of that date.

         10.2.....Buyer's  and Parent's  Performance.  Before or at the Closing,
Buyer and Parent  shall have  performed  and  complied  with all  covenants  and
agreements,  and  satisfied  all  conditions  required by this  Agreement  to be
performed, complied with, or satisfied.

         10.3.....Payment  of  Purchase  Price.  Buyer  shall  deliver to Seller
against  delivery of the items specified in Article 9 hereof a certified or bank
cashier's  check,  or a wire transfer of  immediately  available  funds,  in the
amount of $626,278, payable to Seller.

ARTICLE 11........OBLIGATIONS OF THE PARTIES AFTER THE CLOSING 

         11.1.....Preservation  of Goodwill.  Following the Closing, Seller will
restrict its activities so that Buyer's reasonable  expectations with respect to
the goodwill,  business  reputation,  employee relations and prospects connected
with the Assets  will not be  materially  impaired.  In  furtherance  but not in
limitation of this general obligation, Seller agrees that, for a period of three
years  following the Closing Date, or as long as Buyer or its heirs,  assigns or
successors  in  interest  carry  on a like  business  in the  counties  or areas
specified, whichever is shorter:

         (a)      Seller will not engage in any  business  or activity  which is
                  substantially  the same as, or represents an outgrowth of, any
                  business or  activity  presently  conducted  by Seller if such
                  business or activity  extends to any of the  geographic  areas
                  set forth in  Schedule  11.1 in which  Seller  has  heretofore
                  engaged in business or  otherwise  established  its  goodwill,
                  business reputation, or any customer relations.

                  The  parties  intend  that  the  covenant   contained  in  the
                  preceding  portion of this Section  11.1(a) shall be construed
                  as a series of  separate  covenants,  one for each  geographic
                  area  specified  in  Schedule  11.1.   Except  for  geographic
                  coverage,  each separate covenant shall be deemed identical in
                  terms to the covenant  contained in the  preceding  paragraph.
                  If,  in any  judicial  proceeding,  a court  shall  refuse  to
                  enforce any of the separate  covenants deemed included in this
                  Section,  then  this  unenforceable  covenant  shall be deemed
                  eliminated  from  these  provisions  for the  purpose of those
                  proceedings  to the extent  necessary to permit the  remaining
                  separate covenants to be enforced.

         (b)      Seller will not  disclose  to any  person,  or use for its own
                  benefit,  any price lists,  pricing  data,  customer  lists or
                  similar  matters  possessed by them  relating to the Assets or
                  the  Business  transferred  to Buyer  unless it first  clearly
                  demonstrates  to Buyer that such  matters  are, at the time of
                  the proposed disclosure or use, of common knowledge within the
                  trade.

         11.2.....Change  of Name.  Seller agrees that after the Closing Date it
shall  not use or  employ  in any  manner,  directly  or  indirectly,  the  name
"HealthDesk",  or any variation  thereof,  and that it will take and cause to be
taken all necessary action by Seller's board of directors,  stockholders and any
other  persons in order to make this change in  Seller's  name  effective  on or
before the Closing Date.

         11.3.....Access  to Records.  From and after the Closing,  Seller shall
allow Buyer, and its counsel, accountants and other representatives, such access
to records  which  after the  Closing are in the custody or control of Seller as
Buyer reasonably  requires in order to comply with its obligations under the law
or under contracts assumed by Buyer pursuant to this Agreement.

         11.4.....Nonsolicitation  of Employees.  Seller shall not, prior to the
third anniversary of the Closing,  solicit any employee of Buyer or Parent or of
any direct or indirect subsidiary of Buyer or Parent to leave such employment if
such  employee  was at any time  between  the date  hereof  and the  Closing  an
employee of Seller.

         11.5.....Further  Assurances.  At any time after the Closing Date, each
of Seller,  Buyer and Parent shall execute,  acknowledge and deliver any further
deeds, assignments,  conveyances and other assurances, documents and instruments
of transfer,  reasonably  requested by any other party, and shall take any other
action  consistent  with the  terms of this  Agreement  that may  reasonably  be
requested by such other party in furtherance of the transactions contemplated by
this Agreement.

         11.6.....Termination   of  IAC   Contract.   Buyer  agrees  to  pay  to
Information Access Company ("IAC"), on or about November 15, 1998 or the Closing
Date,  whichever is later, the sum of $65,000 in connection with the termination
of that certain Online Vendor License Agreement,  dated August 12, 1996, between
IAC and Seller, as amended (the "IAC Agreement");  provided,  however,  that IAC
agrees to continue its obligations  under the IAC Agreement,  and Buyer shall be
entitled to all of Seller's  rights under the IAC Agreement,  until February 28,
1999.

         ARTICLE 12.           INDEMNIFICATION

         12.1.....Indemnification  by Seller. Seller shall defend, indemnify and
hold harmless each of Buyer, Parent and their respective  employees,  successors
and assigns (Buyer, Parent and such persons, collectively,  "Buyer's Indemnified
Persons"),  and shall  reimburse  Buyer's  Indemnified  Persons,  for,  from and
against each and every demand,  claim,  loss (which shall include any diminution
in value),  liability,  judgment,  damage, cost and expense (including,  without
limitation, interest, penalties, costs of preparation and investigation, and the
reasonable fees, disbursements and expenses of attorneys,  accountants and other
professional  advisors)  (collectively,  "Losses")  imposed  on or  incurred  by
Buyer's Indemnified Persons, directly or indirectly, relating to, resulting from
or arising out of: (a) any inaccuracy in any representation or warranty,  or any
breach or nonfulfillment  of any covenant,  agreement or other obligation of the
Seller under this  Agreement,  the schedules  hereto or any certificate or other
document delivered or to be delivered pursuant hereto; and (b) any obligation of
Seller  relating to the Assets and any other matter arising out of or related to
the  operation  of the Business  arising  prior to or on the Closing  Date.  The
maximum  liability  of Seller  under this  Section  12.1 shall be limited to the
Purchase Price.

         12.2.....Indemnification  by Buyer and Parent.  Buyer and Parent  shall
defend,  indemnify  and hold  harmless the Seller,  its  successors  and assigns
(Seller and such persons,  collectively,  "Seller's Indemnified  Persons"),  and
shall reimburse Seller's Indemnified  Persons,  for, from and against all Losses
imposed on or incurred by Seller's Indemnified Persons,  directly or indirectly,
relating  to,  resulting  from or  arising  out of:  (a) any  inaccuracy  in any
representation or warranty,  or any breach or  non-fulfillment  of any covenant,
agreement or other  obligation  of Buyer or Parent  under this  Agreement or any
certificate or other document  delivered or to be delivered pursuant hereto; and
(b) any  obligation  of Buyer  relating to the License  Agreements  or any other
matter arising out of or related to the operation of the Business  arising after
the Closing Date.

         12.3.....Notice and Defense of Third Party Claims. If any action, claim
or  proceeding  shall be brought or  asserted  under this  Article 12 against an
indemnified party or any successor thereto (the "Indemnified Person") in respect
of which  indemnity  may be sought  under this  Article 12 from an  indemnifying
person or any successor  thereto (the  "Indemnifying  Person"),  the Indemnified
Person  shall  give  prompt  written  notice  of such  action  or  claim  to the
Indemnifying  Person  who  shall  assume  the  defense  thereof,  including  the
employment of counsel reasonably  satisfactory to the Indemnified Person and the
payment  of all  expenses;  except  that any delay or  failure  to so notify the
Indemnifying  Person shall relieve the  Indemnifying  Person of its  obligations
hereunder only to the extent, if at all, that it is prejudiced by reason of such
delay or failure. The Indemnified Person shall have the right to employ separate
counsel  in  any  of  the  foregoing  actions,  claims  or  proceedings  and  to
participate  in the defense  thereof,  but the fees and expenses of such counsel
shall be at the expense of the  Indemnified  Person unless both the  Indemnified
Person and the  Indemnifying  Person are named as  parties  and the  Indemnified
Person shall in good faith determine that  representation by the same counsel is
inappropriate  due to  material  conflicts  of  interest.  In the event that the
Indemnifying  Person,  within ten days after notice of any such action or claim,
fails to assume the defense thereof, the Indemnified Person shall have the right
to undertake the defense,  compromise  or  settlement  of such action,  claim or
proceeding for the account of the Indemnifying  Person,  subject to the right of
the  Indemnifying  Person to  assume to the  defense  of such  action,  claim or
proceeding with counsel reasonably satisfactory to the Indemnified Person at any
time  prior  to the  settlement,  compromise  or  final  determination  thereof.
Anything in this Article 12 to the contrary  notwithstanding,  the  Indemnifying
Person shall not, without the Indemnified Person's prior written consent, settle
or  compromise  any  action or claim or  proceeding  or  consent to entry of any
judgment  with  respect  to any such  action or claim that  requires  solely the
payment of money  damages by the  Indemnifying  Person and that  includes  as an
unconditional  term thereof the release by the claimant or the  plaintiff of the
Indemnified  Person  from all  liability  in  respect of such  action,  claim or
proceeding.

         ARTICLE 13.  COSTS.

         13.1.....Finder's  or Broker's Fees. Each of the parties represents and
warrants that it has not dealt with any broker or finder in connection  with any
of the transactions contemplated by this Agreement, and, insofar as it knows, no
broker  or other  person  is  entitled  to any  commission  or  finder's  fee in
connection with any of these transactions.

         13.2.....Expenses.  Each  of  the  parties  shall  pay  all  costs  and
expenses,  including  but not  limited to  attorneys'  fees,  incurred  or to be
incurred by it in  negotiating  and preparing  this Agreement and in closing and
carrying out the transactions contemplated by this Agreement.

         ARTICLE 14.         FORM OF AGREEMENT.

         14.1.....Headings. The subject headings of the Articles and Sections of
this  Agreement  are included for purposes of  convenience  only,  and shall not
affect the construction or interpretation of any of its provisions.

         14.2.....Entire  Agreement;   Modification;   Waiver.  This  Agreement,
together with the License  Agreement and the Voting  Agreement,  constitutes the
entire agreement between the parties  pertaining to the subject matter contained
in it and supersedes all prior and contemporaneous  agreements,  representations
and understandings of the parties.  No supplement,  modification or amendment of
this Agreement  shall be binding unless  executed in writing by all the parties.
No waiver of any of the provisions of this Agreement  shall be deemed,  or shall
constitute,  a waiver of any other provision,  whether or not similar, nor shall
any waiver  constitute a continuing  waiver.  No waiver shall be binding  unless
executed in writing by the party making the waiver.

         14.3.....Counterparts. This Agreement may be executed simultaneously in
one or more counterparts,  each of which shall be deemed an original, but all of
which together shall constitute one and the same instrument.

         ARTICLE 15.         PARTIES

         15.1.....Parties  in  Interest.  Nothing  in  this  Agreement,  whether
express or implied,  is  intended  to confer any rights or remedies  under or by
reason of this  Agreement on any persons other than the parties hereto and their
respective successors and assigns, nor is anything in this Agreement intended to
relieve or discharge  the  obligation  or liability of any third  persons to any
party to this  Agreement,  nor shall any  provision  give any third  persons any
right of subrogation or action over against any party hereto.

         15.2.....Assignment. This Agreement shall be binding on and shall inure
to the  benefit  of  the  parties  hereto  and  their  respective  heirs,  legal
representatives, successors and assigns.

         ARTICLE 16.         TERMINATION 

         16.1.....Termination by Mutual Consent.  This Agreement may be 
terminated at any time prior to the Closing Date by the mutual written consent
of Buyer and Seller.

         16.2.....Termination   by  Buyer  or  Seller.  This  Agreement  may  be
terminated  at any time prior to the Closing  Date by Buyer or Seller (i) if the
Closing  has not  occurred  on or before  November  30,  1998,  unless the party
seeking to invoke this  subclause  (i) is then in material  breach of any of its
obligations  hereunder;  (ii)  if a  court  of  competent  jurisdiction  or  any
governmental authority shall have issued an order, decree or ruling or taken any
other  action,  in each case  permanently  restraining,  enjoining  or otherwise
prohibiting the  transactions  contemplated  by this Agreement,  and such order,
decree,  ruling or other action shall have become  final and  nonappealable,  or
(iii) if the other party shall have breached or failed to comply in all material
respects  with  its  representations,   warranties,   covenants  and  agreements
contained in this Agreement;  provided,  however, that if such breach or failure
is  reasonably  capable of being cured on or before  November  30, 1998 and such
party  commences  such cure as soon as  practicable  and  diligently  prosecutes
(subject to any other limitations of this Agreement) such cure, such party shall
be entitled to postpone the Closing Date for a period  reasonably  sufficient to
effect such cure to the  reasonable  satisfaction  of the party  asserting  such
breach or failure, but in no event beyond November 30, 1998.

         16.3.....Effect  of  Termination.  In the event of  termination of this
Agreement  pursuant  to this  Article  16, no party  hereto  (or, in the case of
Buyer,  any of its  directors or officers)  shall have any  liability or further
obligation  to any  other  party  to  this  Agreement,  provided  that,  if this
Agreement is so terminated  by a party because one or more of the  conditions to
such party's  obligations  hereunder  is not  satisfied as a result of the other
party's willful failure to comply with its obligations under this Agreement, the
terminating party's right to pursue all legal remedies for breach of contract or
otherwise,  including, without limitation,  damages relating thereto, shall also
survive such termination unimpaired.

         ARTICLE 17.             NATURE AND SURVIVAL OF
                            REPRESENTATIONS AND WARRANTIES.                     

         All  representations,  warranties,  covenants  and  agreements  of  the
parties contained in this Agreement, or in any instrument,  certificate, opinion
or other writing provided for hereunder,  shall survive the Closing for a period
of one year.

         ARTICLE 18.         NOTICES.

         All  notices,  requests,  demands and other  communications  under this
Agreement shall be in writing and shall be deemed to have been duly given on the
date of service if served personally on the party to whom notice is to be given,
or on the third day after mailing if mailed to the party to whom notice is to be
given,  by first  class mail  registered  or  certified,  postage  prepaid,  and
properly addressed as follows:

         Buyer and Parent:                 Patient InfoSystems, Inc.
                                           Patient InfoSystems Acquisition Corp.
                                           46 Prince Street
                                           Rochester, New York 14607
                                           Attn: Donald A. Carlberg

         with copy to:                     Gibbons, Del Deo, Dolan,
                                           Griffinger & Vecchione
                                           A Professional Corporation
                                           One Riverfront Plaza
                                           Newark, New Jersey 07102-5497
                                           Attn: Jeffrey A. Baumel, Esq.

         Seller:                           HealthDesk Corporation
                                           c/o Equity Dynamics
                                           2116 Financial Center
                                           Des Moines, Iowa 50309
                                           Attn:  Joseph Dunham

         with copy to:                     Gray Cary Ware & Freidenrich, LLP
                                           400 Hamilton Avenue
                                           Palo Alto, California 94301-1825
                                           Attn: Peter M. Astiz, Esq.

         Any party may change its address for purposes of this Article by giving
the other  parties  written  notice of the new  address  in the manner set forth
above.

         ARTICLE 19.         GOVERNING LAW

         This Agreement shall be construed in accordance  with, and governed by,
the laws of the State of New York,  without  giving  effect to conflicts of laws
principles.

         ARTICLE 20.         MISCELLANEOUS

         20.1.....Recovery  of  Litigation  Costs.  If any  legal  action or any
arbitration  or  other  proceeding  is  brought  for  the  enforcement  of  this
Agreement,   or   because   of  an   alleged   dispute,   breach,   default   or
misrepresentation  in connection  with any of the provisions of this  Agreement,
the  successful  or  prevailing  party or parties  shall be  entitled to recover
reasonable   attorneys'  fees  and  other  costs  incurred  in  that  action  or
proceeding, in addition to any other relief to which it or they may be entitled.

         20.2.....Announcements.  Seller shall not make any announcements to the
public or to employees of Seller  concerning this Agreement or the  transactions
contemplated  hereby  without  the prior  approval  of Buyer,  which will not be
unreasonably  withheld.  Notwithstanding  any  failure of Buyer to  approve  it,
Seller  may  make an  announcement  of  substantially  the same  information  as
theretofore  announced to the public by Buyer, or any  announcement  required by
applicable  law,  but Seller  shall in either case notify  Buyer of the contents
thereof reasonably promptly in advance of its issuance.

         20.3.....References.  Unless otherwise specified, references to
Sections or Articles are to Sections or Articles in this Agreement.


<PAGE>



         IN WITNESS WHEREOF, the parties to this Agreement have duly executed it
as of the day and year first above-written.

BUYER:                                              PATIENT INFOSYSTEMS
                                                    ACQUISITION CORP.


                                               By:      /s/  Donald A. Carlberg
                                               Name:    Donald A. Carlberg
                                               Title:   President

PARENT:  PATIENT INFOSYSTEMS, INC.


                                                By:      /s/  Donald A. Carlberg
                                                Name:    Donald A. Carlberg
                                                Title:   President


SELLER:                                         HEALTHDESK CORPORATION


                                                By:      /s/  Terry Brandt
                                                Name:    Terry Brandt
                                                Title:   Chief Technical Officer




                                  EXHIBIT 10.16

                      AMENDMENT TO ASSET PURCHASE AGREEMENT

         THIS AMENDMENT TO ASSET PURCHASE AGREEMENT, effective as of December 1,
1998, by and among PATIENT INFOSYSTEMS ACQUISITION CORP., a Delaware corporation
("Buyer");  PATIENT INFOSYSTEMS,  INC., a Delaware corporation  ("Parent");  and
HEALTHDESK CORPORATION, a California corporation ("Seller").

                                    RECITALS:

         WHEREAS, the parties are parties to an Asset Purchase Agreement,  dated
as of September 29, 1998 (the "Agreement"; capitalized terms used herein and not
otherwise  defined have the meanings  set forth in the  Agreement),  pursuant to
which Seller has agreed to sell to Buyer,  and Buyer has agreed to purchase from
Seller, substantially all of the assets and properties used in the Business;

         WHEREAS,  the  parties  desire to amend  the  Agreement  to extend  the
closing date and termination dates, all as more fully set forth herein.

         NOW, THEREFORE, for good and valuable consideration, the parties hereto
agree as follows:

         1........Article  3 of the Agreement is amended to change the reference
to "November 30, 1998" in the last sentence to "January 31, 1999."

         2........Section 16.2 of the Agreement is amended to change each 
reference to "November 30, 1998" therein to "January 31, 1999."

         3........Except  as specifically  amended by and/or  inconsistent  with
this  Amendment,  all of the terms and conditions of the Agreement  shall remain
unchanged  and in full force and effect and are  hereby  ratified,  adopted  and
confirmed in all  respects.  All  references to the Agreement in any document or
instrument  shall  hereafter  be deemed to refer to the  Agreement as amended by
this Amendment.

         4........This Amendment may be executed in multiple counterparts,  each
of which  shall be deemed an  original,  but all of which taken  together  shall
constitute  one and the same  agreement and shall become  effective  when one or
more counterparts have been executed by each of the parties and delivered to the
others.

         5........This Amendment shall be governed by the laws of the State o
 New York.



<PAGE>


         IN WITNESS WHEREOF,  the parties hereto have executed this Amendment as
of the date and year set forth above.

         .........                                  PATIENT INFOSYSTEMS
         .........                                  ACQUISITION CORP.


         .........                                 By: /s/  Donald A. Carlberg
                                                       -----------------------
         .........                                 Name:  Donald A. Carlberg
         .........                                 Title:   President & CEO


         .........                                 PATIENT INFOSYSTEMS, INC.
 .......                                            By: /s/ Donald A. Carlberg
                                                       ----------------------
         .........                                 Name:  Donald A. Carlberg
         .........                                 Title:  President & CEO

         .........                                 HEALTHDESK CORPORATION

         .........                                 By:  /s/ Joseph R. Dunham II 
                                                      ------------------------
         .........                                 Name:  Joseph R. Dunham II
         .........                                 Title:  Director




                                  EXHIBIT 10.17

                  SECOND AMENDMENT TO ASSET PURCHASE AGREEMENT

         THIS SECOND  AMENDMENT  TO ASSET  PURCHASE  AGREEMENT,  effective as of
February 1, 1999, by and among PATIENT INFOSYSTEMS ACQUISITION CORP., a Delaware
corporation  ("Buyer");  PATIENT  INFOSYSTEMS,   INC.,  a  Delaware  corporation
("Parent"); and HEALTHDESK CORPORATION, a California corporation ("Seller").

                                    RECITALS:

         WHEREAS, the parties are parties to an Asset Purchase Agreement,  dated
as of  September  29,  1998,  as amended by First  Amendment  to Asset  Purchase
Agreement, effective as of December 1, 1998 (the Asset Purchase Agreement, as so
amended,  the  "Agreement";  capitalized  terms used  herein  and not  otherwise
defined have the meanings set forth in the Agreement),  pursuant to which Seller
has  agreed to sell to Buyer,  and Buyer has  agreed to  purchase  from  Seller,
substantially all of the assets and properties used in the Business;

         WHEREAS,  the parties  desire to further  amend the Agreement to extend
the closing date and termination dates, all as more fully set forth herein.

         NOW, THEREFORE, for good and valuable consideration, the parties hereto
agree as follows:

         1........Article  3 of the Agreement is amended to change the reference
to "January 31, 1999" in the last sentence to "March 15, 1999."

         2........Section  16.2 of the  Agreement  is  amended  to  change  each
reference to "January 31, 1999" therein to "March 15, 1999."

         3........Except  as specifically  amended by and/or  inconsistent  with
this Second  Amendment,  all of the terms and conditions of the Agreement  shall
remain unchanged and in full force and effect and are hereby  ratified,  adopted
and confirmed in all respects.  All  references to the Agreement in any document
or instrument  shall hereafter be deemed to refer to the Agreement as amended by
this Second Amendment.

         4........This   Second   Amendment   may  be   executed   in   multiple
counterparts,  each of which shall be deemed an original, but all of which taken
together shall  constitute one and the same agreement and shall become effective
when one or more  counterparts  have been  executed  by each of the  parties and
delivered to the others.

         5........This Second Amendment shall be governed by the laws of the
State of New York.



<PAGE>


         IN WITNESS  WHEREOF,  the  parties  hereto  have  executed  this Second
Amendment as of the date and year set forth above.

         .........                                  PATIENT INFOSYSTEMS
         .........                                  ACQUISITION CORP.


         .........                                  By: /s/  Donald A. Carlberg
                                                        -----------------------
         .........                                  Name:  Donald A. Carlberg
         .........                                  Title:  President & CEO


         .........                                  PATIENT INFOSYSTEMS, INC.


         .........                                  By: /s/  Donald A. Carlberg
                                                        -----------------------
         .........                                  Name:  Donald A. Carlberg
         .........                                  Title:  President & CEO



         .........                                   HEALTHDESK CORPORATION


         .........                                   By: /s/  Terry M. Brandt
                                                         --------------------
         .........                                   Name:  Terry M. Brandt
         .........                                   Title:  Vice President


                                  EXHIBIT 10.18

                                    SUBLEASE

         THIS SUBLEASE (the "Sublease") is made as of the 29th day of September,
1998,  between  HEALTHDESK  CORPORATION,  a California  corporation,  having its
principal  place  of  business  at  2560  Ninth  Street,  Suite  220,  Berkeley,
California 94710  ("Sublandlord") and PATIENT  INFOSYSTEMS  ACQUISITION CORP., a
Delaware  corporation,  having  its  principal  place of  business  at 46 Prince
Street, Rochester, New York 14607 ("Subtenant").

                                    RECITALS:

         A.  Sublandlord  is tenant under an Office Lease (the "Prime  Lease," a
complete copy of which is annexed hereto as Schedule A) dated September 11, 1995
with Parker Associates,  a California limited  partnership (the "Prime Lessor"),
relating to property identified as Suite 220 in Parker Plaza, 2560 Ninth Street,
Berkeley,  California,  more  particularly  described  in the Prime  Lease,  and
referred to herein as the "Premises."

         B. Sublandlord desires to sublet to Subtenant, and Subtenant desires to
sublet from Sublandlord, all of the Premises.

         NOW,  THEREFORE,  for good and valuable  consideration,  the receipt of
which is hereby acknowledged, the parties hereby agree:

         1........Sublease.   Sublandlord   hereby  subleases  the  Premises  to
Subtenant, and Subtenant hereby subleases the Premises from Sublandlord,  on the
terms and conditions hereinafter set forth.

         2........Term  of  Sublease.  The Sublease  shall  commence on the date
hereof  (the  "Commencement  Date")  and  shall  be  a  month-to-month   tenancy
terminable upon 10 business days advance written notice by either party.

         3........Rent.  Subtenant  shall pay Sublandlord the Rent at the office
of Sublandlord first above appearing,  or at such other place as Sublandlord may
designate in writing.  Rent shall be payable in equal  monthly  installments  in
advance on the first day of each calendar month during the Term.

         4........Occupancy. Subject to the terms and provisions hereinafter set
forth,  Subtenant  shall be permitted to enter into occupancy of the Premises on
the Commencement Date.

         5........Prime Lease; Inapplicable Provisions. This Sublease is subject
to and subordinate to the Prime Lease, and all defined terms used herein, unless
otherwise  indicated,  shall have the meanings given to them in the Prime Lease.
The term  "Landlord"  as used in the  Prime  Lease  shall  refer to  Sublandlord
hereunder,  "Tenant"  as  used in the  Prime  Lease  shall  refer  to  Subtenant
hereunder,  "Commencement  Date"  shall refer to the  Commencement  Date of this
Sublease  and  "Term"  shall  refer  to the  Term of this  Sublease,  except  as
otherwise expressly provided in this Sublease. The obligations of Sublandlord in
the Prime Lease shall be the obligations of Subtenant  hereunder,  and Subtenant
assumes and shall perform all of the terms of the Prime Lease to be performed by
Sublandlord  as tenant  thereunder  with respect to the Premises for the term of
this  Sublease,  except to the  extent  the  provisions  of the Prime  Lease are
inconsistent  with or are  superseded  or  supplemented  by  specific  terms and
provisions of this Sublease.  The following  provisions of the Prime Lease shall
not apply to this Sublease:

         .........(a)  The Term (paragraph 3(a));

         .........(b)  Security Deposit (paragraph 15);

         .........(c)  Rental Adjustment (paragraph 29);

         .........(d)  Taxes Payable by Tenant (paragraph 30); and

         .........(e)  Basic Operating Costs (Paragraph 38).

         6.  Prime  Lease  Indemnity.  Subtenant  shall  neither  do nor  permit
anything  to be done  which  would  cause the Prime  Lease to be  terminated  or
forfeited by reason of any right of termination or forfeiture reserved or vested
in the Prime Lessor under the Prime Lease,  and  Subtenant  shall  indemnify and
hold Sublandlord  harmless from and against all claims of any kind whatsoever by
reason of any breach or default on the part of  Subtenant by reason of which the
Prime Lease may be terminated or forfeited.

         7. "As Is" Condition.  Subtenant has inspected the Premises and accepts
the  same  from  Sublandlord  in  its  present   condition  "as  is."  Subtenant
acknowledges  and agrees with  Sublandlord  that  neither  Sublandlord,  nor any
employee of Sublandlord, nor other party claiming to act on Sublandlord's behalf
has made any  representation,  warranty,  estimation,  or promise of any kind or
nature whatsoever relating to the physical condition of the Premises.

         8. Prime Lessor Consent.  The Sublease shall be of no force and effect,
and the parties shall have no rights or liabilities  hereunder,  until the terms
hereof are approved in writing by Prime Lessor.  Either party can terminate this
Sublease if the  contingency  in the prior  sentence  has not been  satisfied or
waived by September 30, 1998.

         9........Miscellaneous.

         .........(a)  Each party warrants that it is authorized to enter into 
the Sublease, that the person signing on its behalf is duly authorized to
execute the Sublease, and that no other signatures are necessary.

     .........(b) All prior  understandings  and agreements  between the parties
with respect to the subject matter hereof are merged within this Sublease, which
alone fully and completely  sets forth the  understanding  of the parties.  This
Sublease  shall  not be  modified,  altered  or  amended  in any way  except  by
agreement in writing, signed by the parties hereto.

     .........(c) The terms, covenants and conditions contained in this Sublease
shall be binding on and inure to the  benefit  of the  parties  hereto and their
respective permitted successors and permitted assigns.

     .........(d)  If any provision of the Sublease is invalid or  unenforceable
to any extent,  then that  provision and the  remainder of this  Sublease  shall
continue in effect and be enforceable to the fullest extent permitted by law.

     .........(e) The parties chose this Sublease document because it is fair to
both parties. Therefore, the parties agree that it shall be construed as if both
parties  were  equally  responsible  for  drafting  the Sublease and the rule of
construction of construing against the drafter shall not apply.

     .........(f)  This  Sublease  shall be governed by the laws of the State of
California.
     .........(g)  This  Sublease  shall not be  binding  unless  signed by both
parties and an originally signed counterpart is delivered to Subtenant.

     .........(h)  Subtenant  warrants and represents to  Sublandlord  that this
Sublease  and the  transaction  contemplated  hereby is legally  binding on, and
enforceable against Subtenant in accordance with its terms.

     .........(i)  Notices  shall  be sent  and  deemed  to have  been  given as
provided in Paragraph 28 of the Prime Lease,  to  Sublandlord  and  Subtenant at
their addresses in the first paragraph of this Sublease.

<PAGE>



         INTENDING TO BE LEGALLY BOUND,  this instrument has been executed as of
the day and year first appearing.

         .........                                SUBLANDLORD:

         .........                                EALTHDESK CORPORATION



         .........                                By: /s/  Terry M. Brandt
                                                      --------------------
         .........                                Name:  Terry M. Brandt
         .........                                Title: Chief Technical Officer
  
         .........                                SUBTENANT:

         .........                                PATIENT INFOSYSTEMS
         .........                                ACQUISITION CORP.



         .........                                 By:  /s/  Donald A. Carlberg
                                                        ----------------------
         .........                                 Name:  Donald A. Carlberg
         .........                                 Title:    President




                                  EXHIBIT 10.19

                              CONSULTING AGREEMENT

                THIS  AGREEMENT  dated  as of  March  8,  1999  between  PATIENT
INFOSYSTEMS,  INC., a Delaware corporation (the "Company"),  and JOHN V. CRISAN,
having an  address  at 591  Fallen  Leaf Way,  Incline  Village,  NV 89451  (the
"Consultant").

                                R E C I T A L S:

                WHEREAS,  the  Company  desires  to retain the  Consultant  as a
consultant  to the Company and a member of the Board of  Directors  on the terms
and conditions set forth herein.

                NOW, THEREFORE,  in consideration of the mutual covenants herein
contained, the parties hereto agree as follows:

1.      DEFINITIONS

        As used in this  Agreement,  the following terms shall have the meanings
set forth below:

        1.1  "Basic Consulting Fee" shall have the meaning assigned to that term
 in Section 5 of this Agreement.

        1.2  "Board"  shall mean the Board of  Directors  of the Company as duly
constituted from time to time.

        1.3   "Business"   shall  mean  the   business  of  the   provision   of
patient-centered health care information systems and services to manage, collect
and analyze information to improve patient compliance with prescribed  treatment
protocols,  to improve the process of off-site patient management and to enhance
patient and provider information.

       1.4  "Cause" shall mean any of the following:

                  (a) The conviction of Consultant for a felony,  or the willful
commission by Consultant  of a criminal act that in the  reasonable  judgment of
the Company,  causes or will likely  cause  substantial  economic  damage to the
Company or substantial injury to the business reputation of the Company;

                  (b)  The   commission  by  Consultant  of  an  act  of  fraud,
misappropriation,  embezzlement,  theft, dishonesty or breach of duty of loyalty
in the performance of Consultant's duties on behalf of the Company; or

                  (c)  The  willful   failure  of   Consultant   to  perform  or
Consultant's  gross  negligence  in the  performance  of the material  duties of
Consultant  to  the  Company  (other  than  any  such  failure   resulting  from
Consultant's  incapacity due to physical or mental illness) after written notice
thereof  (specifying  the  particulars  thereof  in  reasonable  detail)  and  a
reasonable opportunity to be heard and cure such failure are given to Consultant
by the Company.

                  For purposes of this subparagraph,  no act, or failure to act,
on Employee's part shall be considered  "willful"  unless done, or omitted to be
done, by him not in good faith and without  reasonable belief that his action or
omission was in the best interests of the Company.

        1.5 "Code" shall mean the Internal Revenue Code of 1986, as amended, and
the rules, regulations and interpretations issued thereunder.

        1.6  "Confidential  Information"  shall include,  without  limitation by
reason of specification,  any information,  including, without limitation, trade
secrets,  vendor and customer  lists,  pricing  policies,  operational  methods,
methods of doing business,  technical  processes,  formulae,  designs and design
projects,  inventions,  research projects, strategic plans, product information,
manufacturing and advertising  know-how,  possible  acquisition  information and
other business  affairs of the Company,  which (i) is or are designed to be used
in, or are or may be useful in connection  with the  Business,  or which results
from any of the research or development  activities of the Business,  or (ii) is
private or  confidential  in that it is not generally  known or available to the
public,  except  as the  result of  unauthorized  disclosure  by or  information
supplied by the  Consultant,  or (iii) gives the Company an  opportunity  or the
possibility of obtaining an advantage over  competitors  who may not know or use
such information or who are not lawfully permitted to use the same.

        1.7  "Disability"  shall mean the inability of the Consultant to perform
the Consultant's Duties for the Company pursuant to the terms of this Agreement,
because of  physical  or mental  disability,  where such  disability  shall have
existed for a period of more than 180 days in any 365 day period.  The existence
of a Disability  means that the  Consultant's  mental and/or physical  condition
substantially interferes with the Consultant's performance of his Duties for the
Company as specified in this Agreement.  The fact of whether or not a Disability
exists hereunder shall be determined by appropriate  medical experts selected by
the Board.

        1.8  "Duties" shall have the meaning assigned to that term in Section 2 
of this Agreement.

        1.9  "Consulting  Year"  shall mean each  twelve-month  period,  or part
thereof,  during which the Consultant is retained  hereunder,  commencing on the
Commencement Date and ending on the same day of the subsequent calendar year.

        1.10 "Term Date"  shall be the date on which the Term  expires if during
the period of the  initial  Term or the date that the  Renewal  Term  expires if
during the period of the Renewal Term.

        1.11  "Person"   shall  mean  any   individual,   sole   proprietorship,
partnership,  joint venture, trust,  unincorporated  organization,  association,
corporation, limited liability company, institution, public benefit corporation,
entity or  government  (whether  federal,  state,  county,  city,  municipal  or
otherwise, including, without limitation, any instrumentality, division, agency,
body or department thereof).

        1.12 "Term" shall have the meaning assigned to that term in Section 3 of
this  Agreement  and any  renewals  thereof as provided for in Section 7 of this
Agreement.

        1.13  "Renewal  Term"  shall have the  meaning  assigned to that term in
        Section 7 of this  Agreement.  1.14 "Voting Stock" shall mean the Common
        Stock of the Company, par value $.01 per share.

        Wherever  from the context it appears  appropriate,  each word or phrase
stated in either the singular or the plural  shall  include the singular and the
plural,  and each pronoun  stated in the  masculine,  feminine or neuter  gender
shall include the masculine, feminine and neuter.

2.      RETENTION AND DUTIES OF THE CONSULTANT

         The Company agrees to retain the Consultant,  and the Consultant agrees
to be  retained  by the  Company  upon  the  terms  and  conditions  hereinafter
provided. During the Term, the Consultant agrees to serve as a consultant to the
Company  and a member of the Board and will have such  powers  and duties as set
forth  on  Exhibit  A, as are  commensurate  with  such  position  and as may be
conferred upon him by the Board (the "Duties"). The Consultant shall devote such
amount of time, attention, skill and efforts to his duties as a Board member and
to such other Consultant  duties as are reasonably  assigned to him from time to
time by the Board;  provided,  however,  that Consultant  shall not provide less
than 24 nor be  obligated  to  devote  more than 30 weeks  per year  toward  the
performance  of his duties  hereunder.  During the Term,  Consultant:  (i) shall
comply with all laws,  statutes,  ordinances,  rules and regulations relating to
the  Business,  and (ii) shall not  engage in or become  employed,  directly  or
indirectly,  in a business  which  competes  with the  Business of the  Company,
without the prior written consent of the Chief Executive Officer of the Company,
nor shall he act as a consultant  to or provide any  services  to,  whether on a
remunerative basis or otherwise,  the commercial or professional business of any
other Person  which  competes  with the  Business of the  Company,  without such
written consent, which, in both instances, may be given or withheld by the Chief
Executive Officer in his absolute discretion.


3.      TERM OF RETENTION

        The retention of the Consultant  pursuant to this Agreement shall be for
the period of two (2) years (the  "Term")  commencing  on the date  hereof  (the
"Commencement  Date"), unless renewed pursuant to Section 7 or sooner terminated
pursuant to Section 8.

4.      COMPENSATION AND BENEFITS

        The Company shall pay the  Consultant,  as  compensation  for all of the
services to be rendered by him hereunder  during the Term, and in  consideration
of the various  restrictions  imposed upon the  Consultant  during the Term, the
Basic Consulting Fee and other benefits as provided for and determined  pursuant
to Sections 5 and 6, inclusive,  of this Agreement;  provided,  however, that no
compensation shall be paid to the Consultant under this Agreement for any period
subsequent  to the  termination  of the  Consultant  for any reason  whatsoever,
except as provided in Section 8.

5.      BASIC CONSULTING FEE

        The Company shall pay the  Consultant,  as  compensation  for all of the
services to be rendered by him  hereunder  during each Year, a fee of $5,000 per
week during which  services are provided by the  Consultant  to the Company (the
"Basic Consulting Fee"), payable monthly, less such deductions or amounts as are
required  to  be  deducted  or  withheld  by  applicable  laws  or  regulations,
deductions for the Consultant  contributions to welfare benefits provided by the
Company to the Consultant and such other  deductions or amounts,  if any, as are
authorized by the  Consultant.  The Basic  Consulting  Fee shall be prorated for
portions of weeks for which  services are  rendered.  The Basic  Consulting  Fee
shall also be prorated for the month in which retention by the Company commences
or terminates.

6.      ADDITIONAL BENEFITS, REIMBURSEMENT FOR EXPENSES AND STOCK      OPTIONS

         6.1  Additional  Benefits.  Except as provided in Sections  6.2 and 6.3
herein, the Company shall not provide any additional benefits to the Consultant.
It is expressly understood that Consultant is not an employee of the Company and
is therefore not entitled to  participate  or share in the Company's  insurance,
health or other benefit plans.

        6.2 Reimbursement  for Expenses.  The Company shall pay or reimburse the
Consultant for all reasonable business expenses actually incurred or paid by him
during  the  Term in the  performance  of his  services  under  this  Agreement,
including  business-related  travel  expenses to and from his home  inNevada and
Rochester,  New York and temporary housing expenses in Rochester, New York, upon
presentation  of  such  bills,  expense  statements,   vouchers  or  such  other
supporting information as the Board may reasonably require.

        6.3 Stock Options.  (a) On the date hereof,  the Company shall grant the
Consultant options to purchase during a ten (10) year term up to an aggregate of
150,000  shares of Common  Stock of the  Company,  par value $.01 per share (the
"Shares"), at a price of $1.50 per share, which options, to the extent possible,
shall qualify as Incentive  Stock Options under the Company's  Stock Option Plan
and which options shall vest as follows:

                  (i) Options to purchase  first 75,000 Shares shall vest on the
first anniversary of this Agreement;

                  (ii)   Options to purchase the next 37,500 Shares shall vest
on the second anniversary of this Agreement;

                  (iii)  Options to purchase the final 37,500  Shares shall vest
on the third anniversary of this Agreement;

        provided,  however,  that no options shall vest if the Consultant is not
retained by the Company on the date of vesting.

                (b) In the  event of a Change of  Control  of the  Company,  all
options  granted   hereunder  shall  immediately  vest.  For  purposes  of  this
Agreement, a "Change of Control" of the Company shall be deemed to have occurred
upon the earliest of the following events:

                  (i) any  "person,"  as such  term is  defined  under  Sections
                  3(a)(9) and 13(d) of the Securities  Exchange Act of 1934 (the
                  "Exchange Act") who is not an Affiliate of Company on the date
                  hereof,  becomes a "beneficial owner," as such term is used in
                  Rule  13d-3  under the  Exchange  Act,  of a  majority  of the
                  Company's Voting Stock;

                  (ii)   the Company adopts any plan of liquidation providing 
                  for the distribution of all or substantially all of its
                  assets; or

                  (iii) the Company is party to a merger,  consolidation,  other
                  form of business combination or a sale of all or substantially
                  all of its assets, unless the business of Company is continued
                  following any such  transaction  by a resulting  entity (which
                  may be,  but need not be,  Company)  and the  shareholders  of
                  Company  immediately prior to such transaction hold,  directly
                  or indirectly, a majority of the voting power of the resulting
                  entity.

7.      RENEWAL OF TERM

        If  the  Consultant's   retention  hereunder  has  not  previously  been
terminated in accordance with Section 8 hereof,  then the Term shall be extended
only upon the mutual written agreement of the parties.

8.      TERMINATION OF RETENTION

        8.1 Death.  If the Consultant  dies during the Term, his retention under
this  Agreement  shall  automatically  terminate on the date of his death and no
further   compensation   shall  be  due  hereunder  to  the  Consultant  or  the
Consultant's estate.

        8.2  Disability.  If, during the Term,  the Consultant has a Disability,
the Company may, at any time after the  Consultant  has a Disability,  terminate
the  Consultant's  retention  by  written  notice to him.  In the event that the
Consultant's retention is terminated as a result of a Disability, the Consultant
shall cease to receive any further compensation hereunder.

        8.3 Voluntary  Termination.  If the Consultant  terminates his retention
with the  Company at any time  during the term of this  Agreement  and except as
expressly  permitted  under  Section  8.5,  he  shall  be  deemed  to have  been
terminated  by the Company for Cause and shall be subject to the  provisions  of
Section 8.4 hereof.

        8.4  Termination for Cause.  The Company may terminate the  Consultant's
retention  hereunder  for  Cause  at any  time by  written  notice  given to the
Consultant by the Board. If the Consultant's  retention is terminated for Cause,
he shall be entitled to receive  only the  portion of his Basic  Consulting  Fee
accrued  and not  theretofore  paid to him and  reimbursement  for any  expenses
properly incurred by the Consultant and supported by appropriate vouchers, which
expenses  have  been  incurred  prior  to the date of such  termination  and not
theretofore  reimbursed.  Except  as  set  forth  in the  immediately  preceding
sentence,  all of the  Consultant's  rights to  compensation  hereunder shall be
terminated.

        8.5 Termination without Cause. Either party may terminate this Agreement
for any reason and without  liability  for a period of ninety (90) days from the
date of this  Agreement.  The Company may terminate the  Consultant's  retention
hereunder without Cause upon written notice to the Consultant at any time during
the  Term  of  this  Agreement,  provided  that if the  Company  terminates  the
Consultant for any reason after 90 days from the date of this  Agreement,  other
than (i) the  failure  by  Consultant  to perform  his Duties in the  reasonable
judgment of the Board or (ii) for Cause, the Company shall pay to the Consultant
severance  payments  equal to the amount of the Basic  Consulting Fee previously
paid to the Consultant  under this  Agreement up to the date of termination  but
not to exceed $100,000,  to be payable in equal monthly installments of not more
than $20,000  installments as set forth in Section 5. In addition,  in the event
the  Company  terminates  the  Consultant  for any  reason,  the  Company  shall
reimburse the  Consultant for any expenses  properly  incurred by the Consultant
and supported by proper vouchers, which expenses have been incurred prior to the
date of such termination and not theretofore reimbursed.

9.      REPRESENTATION AND WARRANTY BY THE CONSULTANT

        The Consultant hereby  represents and warrants to the Company,  the same
being part of the essence of this Agreement,  that, as of the Commencement Date,
he is not a party to any agreement, contract or understanding, and that no facts
or circumstances  exist,  which would in any way restrict or prohibit him in any
material way from  undertaking or performing any of his  obligations  under this
Agreement.  The  foregoing  representation  and warranty  shall remain in effect
throughout the Term.

10.     CONFIDENTIAL INFORMATION AND PROPRIETARY INTERESTS

        10.1 Acknowledgment of Confidentiality.  The Consultant  understands and
acknowledges that he may obtain  Confidential  Information  during the course of
his  retention by the Company.  The  Consultant  further  acknowledges  that the
services  to be  rendered  by him are of a  special,  unique  and  extraordinary
character  and that, in connection  with such  services,  he will have access to
Confidential  Information  vital to the  Company.  Accordingly,  the  Consultant
agrees that he shall not, during the Term or thereafter, (i) use or disclose any
such  Confidential  Information,  (ii)  furnish to any third  party or allow any
third party to use any such Confidential  Information,  (iii) publish any works,
speeches or articles  with  respect  thereto,  or (iv) except as required in the
proper  performance of his services  hereunder,  remove or aid in the removal of
any Confidential  Information or any property or material  relating thereto from
the premises of the Company.

                The  foregoing  confidentiality  provisions  shall  cease  to be
applicable to any Confidential  Information which becomes generally available to
the  public  (except  by  reason  of or as a  consequence  of a  breach  by  the
Consultant of his obligations under this Section 10).

                In the event the  Consultant is required by law or a court order
to disclose any such  Confidential  Information,  he shall  promptly  notify the
Company of such  requirement  and provide  the Company  with a copy of any court
order or of any law which in his opinion  requires such  disclosure  and, if the
Company so elects,  to the extent that he is legally able, permit the Company an
adequate opportunity, at its own expense, to contest such law or court order.

        10.2 Delivery of Material.  The Consultant  shall promptly,  and without
charge, deliver to the Company on the termination of his retention hereunder, or
at any other time the Company may so request,  all  memoranda,  notes,  records,
reports,  manuals,  computer disks, videotapes,  drawings,  blueprints and other
documents (and all copies  thereof)  relating to the Business,  and all property
associated therewith, which he may then possess or have under his control.

        10.3 Customer and Vendor Lists. The Consultant acknowledges that (i) all
lists of customers and vendors of the Company  developed  prior to or during the
course of the Consultant's  retention and/or by the Company are and shall be the
sole  and  exclusive   property  of  the  Company  and  the  Consultant  further
acknowledges  and agrees that he neither has nor shall have any personal  right,
title  or  interest  therein;  (ii)  such  lists  are and  must  continue  to be
Confidential  Information;  and (iii) such lists are not readily  accessible  to
competitors of the Company or any other third parties.

        10.4 Ideas,  Programs,  Etc. If, during the Term, the Consultant invents
or  develops  any  ideas,  vendor  lists or the like,  relating  to or useful in
connection with the Business,  the same are and shall remain the property of the
Company, and the Consultant shall promptly deliver all copies of the same to the
Company,  assign his interest  therein to the Company and execute such documents
as the Company's counsel may request to convey title thereof to the Company. The
Consultant shall not be entitled to any compensation,  other than as provided in
this  Agreement,  for carrying  out his  obligations  to the Company  under this
Section 10.4 or any other subsection of this Section 10.

        10.5  Extension of Section 10. All of the provisions of Section 10 shall
be deemed to be applicable  to all  Confidential  Information  and to all ideas,
programs, etc., as referred to in Section 10.4, to which the Consultant may have
obtained access or which he may have invented or developed  during his retention
by the Company.

11.     COMPETITIVE ACTIVITY

        The  Consultant  shall  not  engage,   directly  or  indirectly  in  any
Competitive  Activity  for a period  of one (1) year  after the  termination  of
Consultant's  retention  with  the  Company,   provided  however,  that  if  the
Consultant is terminated without Cause as defined in Section 1.4 hereof, he will
not be subject to the  provisions  of this  Section  11.  For  purposes  of this
Agreement,  Consultant  shall be  considered  to have engaged in a  "Competitive
Activity" if Consultant:

         (i)  directly  or   indirectly,   takes  any  action  or  engages,   or
         participates  in or within or becomes  interested in or associated with
         enters into the  employment  of,  renders any service,  engages,  owns,
         manages,  operates,  joins, or otherwise  offers other assistance to or
         participates  in or becomes  connected  with, as an officer,  director,
         employee,  principal,  agent,  creditor,  proprietor,   representative,
         stockholder,  partner,  associate,  consultant or otherwise, any Person
         that  is  engaged  or  becomes  engaged  in  a  business  which  is  in
         competition with the Business;  provided, however, Consultant shall not
         be  prohibited  from making an investment in less than 1% of the equity
         of a public company;

         (ii)  whether  for his own  account or for the  account of any  Person,
         attempts to  solicit,  endeavor  to entice  away from the  Company,  or
         otherwise  interferes  with any  relationship  of the Company  with any
         person who is (i) employed by, or otherwise engaged to perform services
         for,  the  Company or was so employed or engaged by the Company (or any
         of its  predecessors)  at any time during the one year period  prior to
         the date of the termination of Employee's  employment,  including,  but
         not limited to, any independent contractors,  or (ii) any Person who is
         or was,  within the then most  recent  eighteen  (18) month  period,  a
         customer or client of the Company.

          (iii) otherwise interferes with the relationships between the Company
and its employees, customers or suppliers.

12.     DISPUTES AND REMEDIES

        12.1 Injunctive Relief. If the Consultant commits a breach, or threatens
to commit a breach,  of any of the  provisions  of  Sections  8.4, 10 or 11, the
Company  shall have the  following  rights and remedies  (each of which shall be
independent of the other, and shall be severally  enforceable,  and all of which
shall be in  addition  to,  and not in lieu of, any other  rights  and  remedies
available to the Company at law or in equity):

         (i) the  right  and  remedy to have the  provisions  of this  Agreement
         specifically enforced by any court having equity jurisdiction, it being
         acknowledged  by the  Consultant  that any such  breach  or  threatened
         breach  will or may cause  irreparable  injury to the  Company and that
         money  damages  will or may  not  provide  an  adequate  remedy  to the
         Company; and

         (ii) the right and remedy to require the  Consultant to account for and
         pay over to the Company all compensation,  profits, monies, increments,
         things  of  value  or  other  benefits,  derived  or  received  by  the
         Consultant  as the result of any acts or  transactions  constituting  a
         breach of any of the  provisions  of  Sections  8.4,  10 or 11, of this
         Agreement, and the Consultant hereby agrees to account for and pay over
         all such compensation,  profits, monies, increments, things of value or
         other benefits to the Company.

        12.2 Partial Enforceability. If any provision contained in Sections 8.4,
10 or 11, or any part thereof, is construed to be invalid or unenforceable,  the
same shall not affect the remainder of the  Consultant's  agreements,  covenants
and undertakings,  or the other restrictions which he has accepted,  in Sections
8.4, 10 or 11, and the remaining such  agreements,  covenants,  undertakings and
restrictions  shall be given the fullest possible effect,  without regard to the
invalid parts.

        12.3 Intention of Parties.  It is distinctly  understood and agreed that
the  confidentiality,  proprietary right and restrictive  covenant provisions of
this   Agreement  have  been  accepted  and  agreed  to  by  the  Consultant  in
contemplation of this Agreement.  It is therefore the specific  intention of the
parties,   any  general   considerations   of  public  policy  to  the  contrary
notwithstanding,  that  the  provisions  of  Sections  8.4,  10 or 11,  of  this
Agreement shall be enforced as written and to the fullest extent possible.

        12.4 Adjustment of  Restrictions.  Despite the prior  provisions of this
Section 12, if any covenant or agreement contained in Sections 8.4, 10 or 11, or
any  part  thereof,  is  held  by any  court  of  competent  jurisdiction  to be
unenforceable  because of the duration of such provision or the geographic  area
covered  thereby,  the court making such  determination  shall have the power to
reduce the duration or  geographic  area of such  provision  and, in its reduced
form, such provision shall be enforceable.

13.     SURVIVAL

        The  provisions  of Sections 8, 9, 10, 11, 12 and this  Section 13 shall
survive termination of this Agreement and remain enforceable  according to their
terms.

14.     SEVERABILITY

        The  invalidity or  unenforceability  of any provision of this Agreement
shall in no way affect the validity or  enforceability  of any other  provisions
hereof.

15.     NOTICES

        All  notices,  demands and  requests  required or  permitted to be given
under the  provisions  of this  Agreement  shall be deemed duly given if made in
writing and  delivered  personally  or mailed by postage  prepaid  certified  or
registered mail, return receipt requested,  accompanied by a second copy sent by
ordinary mail, which notices shall be addressed as follows:

                If to the Company:

                Patient Infosystems, Inc.
                46 Prince Street
                Rochester, New York 14607


                If to the Consultant:

                John V. Crisan
                591 Fallen Leaf Way
                Incline Village, NV   89451


        By notifying the other parties in writing, given as aforesaid, any party
may from time to time  change  his or its  address  or the name of any person to
whose  attention  notice  is to be  given,  or may add  another  person to whose
attention notice is to be given, in connection with notice to any party.

16.     ASSIGNMENT AND SUCCESSORS

        Neither this Agreement nor any of his rights or Duties  hereunder may be
assigned or delegated by the  Consultant.  This Agreement may not be assigned by
the Company  without the consent of the  Consultant  except to any  successor in
interest  which  takes  over all or  substantially  all of the  business  of the
Company as it is conducted at the time of such assignment.  Any corporation into
or with which the Company is merged or  consolidated  or which takes over all or
substantially  all of the  business  of the  Company  shall  be  deemed  to be a
successor of the Company for purposes  hereof.  This Agreement  shall be binding
upon and,  except as  aforesaid,  shall  inure to the benefit of the parties and
their respective successors and permitted assigns.

17.     ENTIRE AGREEMENT, WAIVER AND OTHER

        17.1.  Integration.  This Agreement contains the entire agreement of the
parties  hereto on its subject  matter and  supersedes  all previous  agreements
between the parties hereto,  written or oral,  express or implied,  covering the
subject matter hereof. No representations,  inducements, promises or agreements,
oral or otherwise, not embodied herein, shall be of any force or effect.

        17.2. No Waiver.  No waiver or  modification of any of the provisions of
this  Agreement  shall be valid  unless in writing and signed by or on behalf of
the party  granting such waiver or  modification.  No waiver by any party of any
breach or default  hereunder  shall be deemed a waiver of any repetition of such
breach or  default or shall be deemed a waiver of any other  breach or  default,
nor shall it in any way  affect  any of the other  terms or  conditions  of this
Agreement or the enforceability  thereof.  No failure of the Company to exercise
any  power  given it  hereunder  or to  insist  upon  strict  compliance  by the
Consultant with any obligation hereunder,  and no custom or practice at variance
with the terms hereof,  shall constitute a waiver of the right of the Company to
demand strict compliance with the terms hereof.

        The  Consultant  shall  not  have  the  right  to  sign  any  waiver  or
modification  of any provisions of this Agreement on behalf of the Company,  nor
shall any  action  taken by the  Consultant  reduce his  obligations  under this
Agreement.

        This Agreement may not be supplemented or rescinded except by instrument
in writing  signed by the parties  hereto  after the date  hereof.  Neither this
Agreement  nor  any  of the  rights  of any  of  the  parties  hereunder  may be
terminated  except  as  provided  herein.  No waiver  of any  provision  of this
Agreement or any amendment of this  Agreement  shall be binding upon the Company
unless approved by the Board.

18.     GOVERNING LAW

        This Agreement  shall be governed by and  construed,  and the rights and
obligations of the parties hereto  enforced,  in accordance with the laws of the
State of New York, without regard to conflicts of laws principles.

19.     HEADINGS

        The Section and subsection  headings  contained herein are for reference
purposes only and shall not in any way affect the meaning or  interpretation  of
this Agreement.


<PAGE>



        IN WITNESS  WHEREOF,  the parties have executed this Agreement as of the
date first written above, to be effective as of the Commencement Date.

                                                  PATIENT INFOSYSTEMS, INC.



                                                  By:  /s/  Donald A. Carlberg
                                                  Name: Donald A. Carlberg
                                                  Title:   President






                                                  /s/  John V. Crisan
                                                  John V. Crisan


<PAGE>


                                    EXHIBIT A

                                     Duties


        - Oversee financial affairs and internal operations of the Company
        - Assist senior and mid-level managers in establishing and achieving
          both corporate and individual goals and objectives
        - Plan for and manage through anticipated growth
        - Achieve and expand Company profitability
        - Establish organizational discipline and focus so as to deliver 
          steadily improving and predictable operating results
        - Assist CEO with investor relations responsibilities



                                 Exhibit 10.20

                                 LEASE AGREEMENT

                        CONIFER PRINCE STREET ASSOCIATES
                                46 PRINCE STREET

         AGREEMENT,  made on the 22nd day of  February  , l995,  by and  between
CONIFER PRINCE STREET ASSOCIATES,  a Limited Partnership  organized and existing
under the laws of the State of New York, 46 Prince Street,  Rochester,  New York
("LANDLORD") and DSMI CORPORATION ("TENANT").

         WITNESSETH:  That the Landlord does hereby let and demise to Tenant and
Tenant  does take from the  Landlord,  the  premises  outlined on the floor plan
designated Exhibit "A" attached hereto, being 3,573 square feet of the 1st floor
of the three story  building known as , 46 Prince  Street,  Rochester,  New York
(hereinafter called the "Building") together with 10 parking spaces.

l.       TERM

         a.) The lease term  shall be for a period of two years  commencing  on
 March 1, l995 and  terminating  on  February  28,  1997  the "Lease Term").

         b.) Tenant shall have a one-time right to extend the Term of this Lease
Agreement  for a  period  of  three  additional  and  consecutive  years.  To be
effective,  Tenant  must  not be in  default  of any of its  lease  obligations.
Furthermore,  Tenant must provide  Landlord with at least 180 days prior written
notice  stating  its  intention  to exercise  this  extension  option.  With the
exception of Rental all other  provisions of this Lease  Agreement  shall remain
unchanged.

         Should Tenant  exercise its extension  option the Base Rent during such
period shall be as follows:

              TERM                          $ per sq. ft.    Annual Base Rent
         --------------                     -------------    ----------------
         3/1/97-2/28/98                        $13.50            $48,235.50
         3/1/98-2/28/99                        $14.00            $50,022.00
         3/1/99-2/28/00                        $14.50            $51,808.50

2.       RENTAL

         The Base Rent during the initial year of the Lease Term shall be $12.50
per square foot per annum.  The Base Rent shall be  increased  by $.50 per annum
per square foot effective  March 1, l996 and again upon Tenants  exercise of its
extension period, as stated above. Refer to Schedule A for details of Annual and
Monthly rent amounts due during the initial term.

         a) The Base Rent will be payable in twelve equal  monthly  installments
         due without demand at its office at 46 Prince Street,  on the first day
         of each month.  Rent for partial months shall be pro-rated based on the
         number of days occupied by Tenant,  due and payable on the first day of
         tenancy.  A penalty of $50.00 will be imposed for rent  received  after
         the 10th day of each month.

         b) Tenant shall pay, as  additional  rent,  all electric  costs for the
leased premises, calculated as follows:

         Heating and Air Conditioning - The air  conditioning  units serving the
         leased  premises shall be individually  gauged.  The actual heating and
         cooling  costs of the air  conditioning  units  will be  calculated  by
         multiplying  the actual  electric  bill to Landlord by a fraction,  the
         numerator  of  which  is  calculated  kilowatt  hours  used  by the air
         conditioning  unit serving the leased  premises for the billing  period
         and the  denominator  of which is the total  kilowatt  hours  billed to
         Landlord for the same period.

         In the event the leased  premises is less than the total area served by
         an air conditioning unit, then tenant shall pay a pro rata share of the
         cost of heat and air  cooling  based  upon the  percentage  of the area
         served by the air conditioning  unit which is occupied by Tenant.  That
         percentage shall be agreed upon at execution of the lease and set forth
         on Schedule A hereto.

         Other  Electric - The remaining  electric cost for the building will be
         calculated by deducting the total heating cost from the total  electric
         bill. Tenants share of the bill will be the electric cost multiplied by
         a fraction, the numerator of which is the square footage covered by the
         Lease and the  denominator  of which is the total rental square footage
         of the building  occupied  during the applicable  billing period as set
         forth in Schedule A hereto.

         c) The additional rent payment for  electricity  will be calculated and
         billed by Landlord  to Tenant,  due and payable on the first day of the
         month following receipt of the bill by Tenant.

         d)  Tenant  shall pay as  additional  rent its  proportionate  share of
         increases in property liability  insurance premiums over a base year of
         1995 and real property taxes,  assessments or government levies in lieu
         of taxes  over a base year of 1995 for City  School and 1995 for County
         as set out on Schedule A.

3.       SECURITY DEPOSIT

     Tenant has this day  deposited  with  Landlord  the sum of  $3,638.54  (the
"Security Deposit") as security for the full and faithful  performance of Tenant
of all the terms,  covenants and  conditions of this Lease upon Tenant's part to
be performed. The Security Deposit may be commingled with other funds and assets
of  Landlord  and it shall be  returned  to Tenant  after the time  fixed as the
expiration of the Term,  provided Tenant has duly and faithfully carried out all
of said terms, covenants and conditions on Tenant's part to be performed. In the
event of a bona fide sale of the Premises subject to this Lease,  Landlord shall
have the right to transfer the Security Deposit to the vendee for the benefit of
Tenant and Landlord  shall be  considered  released by Tenant from all liability
for the return of the  Security  Deposit,  and Tenant  agrees to look to the new
Landlord  solely for the return of the  Security  Deposit  and it is agreed that
this shall apply to every transfer or assignment made of the Security Deposit to
a new  Landlord.  Provided  Tenant has not  defaulted  on its lease  obligations
during the initial twelve months of the Term of the Lease, Landlord shall refund
Tenants'  Security  Deposit  prior to the  completion  of the 13th month of said
Term.



4.       DELAYS

         If Landlord is unable to give possession of the premises on the date of
commencement  of the term of this  Lease by  reason of the  holding  over of any
Tenant or occupant, or because construction,  repairs, or improvements which are
Landlord's  responsibility  are not  completed,  rent shall abate for the period
that possession by Tenant is delayed. If such delay shall continue for more than
sixty (60) days,  then Tenant may,  within thirty (30) days after the expiration
of said sixty (60) day period,  give  Landlord a notice of election to terminate
this lease.  Unless possession of the premises shall sooner be made available to
Tenant,  this  Lease  shall  terminate  on the 30th day after the giving of such
notice and Landlord shall return to Tenant the  consideration  paid and Landlord
shall have no  obligation  to Tenant for  failure to give  possession  except as
provided above.

         In the event Tenant  delays in providing  Landlord  with all  necessary
information  required  for  Landlord  to  construct  tenant  improvements,  then
Landlord shall be entitled to an extension of time to complete such improvements
and rent shall not abate during such extension of time.

5.       SERVICES

         Landlord agrees to furnish electricity for usual office requirements.

         Landlord  agrees to furnish  heat in the leased  premises  adequate and
reasonable  for the business use of premises and through the heating  system and
air cooling to the leased  premises.  Landlord  agrees to provide the additional
services  set  forth on  Schedule  B  attached  hereto,  subject  to the  rules,
regulations and limitations set forth herein.

         Prior to Tenant's  occupancy of the demised  premises,  anticipated  to
take place March 1, 1995,  Landlord  shall shampoo the entire carpet within said
space as well as repaint the suite in a color to be selected by Tenant.

         With the exception of those modifications to the existing floor plan of
the demised premises, the space is leased to Tenant in an "as-is" basis.

6.       USE AND OCCUPANCY

         Tenant  shall  use  and  occupy  the  premises  for  the  business  and
professional office purposes set forth on Schedule C attached hereto, and for no
other use or purpose.

7.       CARE AND REPAIR OF PREMISES

         Tenant  shall  commit no act of waste  and shall  take good care of the
premises and the fixtures and  appurtenances  therein and shall,  in the use and
occupancy of the premises,  conform to all laws,  orders, and regulations of the
Federal, State, and municipal governments or any of their departments.

         Landlord shall make all necessary repairs to the premises, except where
the repair has been made  necessary  by misuse or neglect by Tenant or  Tenant's
agents, servants, visitors, or licensee.

         All  improvements  made by Tenant to the premises which are so attached
to the  premises  that they  cannot be removed  without  material  injury to the
premises, shall become the property of Landlord upon installation.

         Not  later  than the last  day of the  Lease  Term,  Tenant  shall,  at
Tenant's   expense,   remove  all  of  Tenant's   personal  property  and  those
improvements  made by Tenant  which have not become the  property  of  Landlord,
including trade fixtures,  cabinetwork,  movable paneling,  partitions,  and the
like,  repair all  injury  done by or in  connection  with the  installation  or
removal of said property or improvements, and surrender the premises broom clean
in as good condition as they were at the beginning of the term, reasonable wear,
and  damage by fire,  the  elements,  casualty,  or other  causes not due to the
misuse  of  neglect  of  Tenant  or  Tenant's  agents,  servants,  visitors,  or
licensees,  excepted. All property of Tenant remaining on the premises after the
last day of the term of this Lease shall be deemed  abandoned and may be removed
by Landlord, and Tenant shall reimburse Landlord for the cost of such removal.

         Landlord  may  have any  such  property  stored  at  Tenant's  risk and
expense.  Any alternative,  additions,  or improvements to the premises shall be
only with Landlord's prior written consent.

         Tenant  shall not,  without  first  obtaining  the  written  consent of
Landlord,  abandon  the  premises,  or allow the  premises  to become  vacant or
deserted.

8.       ASSIGNMENT OR SUBLEASE

         Tenant  shall not,  without  first  obtaining  the  written  consent of
Landlord, assign, mortgage, pledge, or encumber this Lease, in whole or in part,
or sublet the premises or any part thereof and  Landlord  will not  unreasonably
withhold assignment of this lease.


         Any subletting of the premises shall be further  subject to the written
consent  of  the  University  of  Rochester,  pursuant  to  certain  restrictive
covenants  in the deed of transfer of the premises to  Landlord.  This  covenant
shall be binding upon the legal representatives of Tenant, and upon every person
to whom Tenant's interest under this Lease passes by operation by law.

9.       COMPLIANCE WITH RULES AND REGULATIONS

         Tenant  shall  observe  and  comply  with  the  rules  and  regulations
hereinafter  set  forth,  which are made a part  hereof,  and with such  further
reasonable rules and regulations as Landlord may prescribe, on written notice to
the  Tenant,  for the  safety,  care and  cleanliness  of the  building  and the
comfort, quiet, and convenience of other occupants of the building.

         Tenant  shall  comply  will all present  and future  laws,  ordinances,
rules, regulations, or governmental or quasi-governmental  directives (including
without  limitation  those  requirements of the  Occupational  Safety and Health
Administration  that relate to the Premises) regarding the indoor air quality of
the   Premises  and  the   maintenance   of  any   heating,   ventilating,   and
air-conditioning  equipment  or  system  for which  the  Tenant  is  responsible
pursuant to this Lease.



10.      COMPLIANCE WITH ENVIRONMENTAL RULES AND REGULATIONS

"Environmental Laws" mean all federal, state and local environmental,  land use,
zoning, health,  chemical use, safety and sanitation laws, statutes,  ordinances
and codes relating to the  protection of the  Environment  and/or  governing the
use,  storage,  treatment,  generation,  transportation,  processing,  handling,
production  or  disposal of  Hazardous  Substances  and the rules,  regulations,
policies,  guidelines,  interpretations,  decisions,  orders and  directives  of
federal,  state and local  governmental  agencies and  authorities  with respect
thereto.

"Hazardous  Substance"  means,  without  limitation,  any flammable  explosives,
radon,  radioactive  materials,  asbestos,  urea  formaldehyde  foam insulation,
polychlorinated biphenyls,  petroleum and petroleum products, methane, hazardous
materials, hazardous wastes, hazardous or toxic substances or related materials,
as  defined  in  the  Comprehensive  Environmental  Response,  Compensation  and
Liability  Act of 1980,  as amended  (42 U.S.C.  Sections  9601,  et seq.),  the
Hazardous Materials  Transportation Act, as amended (49 U.S.C. Sections 1801, et
seq.),  the  Resource  Conservation  and  Recovery  Act,  as amended  (42 U.S.C.
Sections 2601, et seq.), the Toxic Substances Control Act, as amended (15 U.S.C.
Sections 2601, et seq.),  Articles 15 and 27 of the New York State Environmental
Conservation Law or any other applicable  Environmental  Law and the regulations
promulgated thereunder.

"Environmental Permits" mean all permits, licenses, approvals, authorizations, 
consents or registrations required by any applicable

Environmental Law in connection with the ownership,  use and/or operation of the
Premises for the storage,  treatment,  generation,  transportation,  processing,
handling,  production or disposal of Hazardous  Substances or the sale, transfer
or conveyance of the Premises.

1.       Lessee  shall  keep,  and shall  cause  all  operators,  licensees  and
         occupants of the Premises to keep the  Premises  free of all  Hazardous
         Substances  and  shall not cause or  permit  the  Premises  or any part
         thereof   to  be  used  for  the   storage,   treatment,   generations,
         transportation,  processing,  handling,  production  or disposal of any
         Hazardous Substances.

2.       Lessee shall comply with, and shall cause all operators,  licensees and
         occupants of the Premises to comply with all  applicable  Environmental
         Laws and shall obtain and comply with,  and shall cause all  operators,
         tenants, subtenants,  licensees and occupants of the Premises to obtain
         and comply with all Environmental Permits.

3.       Lessee  shall not cause or permit any change to be made in the  present
         or intended  use of the  Premises  which would (i) involve the storage,
         treatment, generation, transportation, processing, handling, production
         or disposal of any Hazardous  Substance or the use of the Premises as a
         landfill or other waste disposal site or for military, manufacturing or
         industrial  purposes or for the storage of petroleum or petroleum based
         products,   (ii)  violate  any  applicable   Environmental  Law,  (iii)
         constitute   non-compliance  with  any  Environmental  Permit  of  (iv)
         increase the risk of a release of any Hazardous Substance.

11.      DAMAGE TO BUILDING

         If the  building  is damaged by fire or any other  cause to such extent
that the cost of restoration, as reasonably estimated by Landlord, will equal or
exceed fifty percent (50%) of the  replacement  value of the building just prior
to the  occurrence of the damage,  then Landlord may, no later than the 30th day
following the damage,  give Tenant a notice of election to terminate this Lease.
In such event, this Lease shall be deemed to terminate on the 30th day after the
giving of said notice,  and Tenant shall  surrender  possession  of the premises
within a reasonable  time  thereafter,  and the rent, and any  additional  rent,
shall be  apportioned as of the date of said surrender and any rent paid for any
period beyond said date shall be refunded to Tenant.

         If the cost of restoration,  as estimated by Landlord,  shall amount to
less than fifty percent (50%) of said replacement value of the building,  or if,
despite the cost,  Landlord  does not elect to  terminate  this Lease,  Landlord
shall restore the building and the premises with reasonable promptness,  subject
to delays  beyond  Landlord's  control  and  delays in the  making of  insurance
adjustments between Landlord and his insurance carrier, and Tenant shall have no
right to  terminate  this lease  except as herein  provided.  Landlord  need not
restore fixtures and improvements  owned by Tenant.  In any case in which use of
the premises is affected by any damage to the building, there shall be either an
abatement  or an equitable  reduction in rent  depending on the period for which
and the extent to which the premises are not  reasonably  usable for the purpose
for which they are leased  hereunder.  The words  "restoration" and "restore" as
used in this Paragraph 9 shall include repairs.

         If damage  results  from the fault of the Tenant,  or Tenant's  agents,
servants,  visitors, or licensees, Tenant shall not be entitled to any abatement
or reduction of rent,  except to the extent,  if any, that Landlord receives the
proceeds of rent insurance in lieu of such rent.

         If more than 25 per cent of the premises  leased by Tenant are rendered
untenantable  and  Landlord  fails to  restore  said  premises  to a  tenantable
condition  within ten (10) days,  then and in such event  Tenant may cancel this
lease on notice to Landlord.

12.      WAIVERS OF SUBROGATION

         Notwithstanding  the  provisions  of Paragraph 9 of this Lease,  in the
event of loss or damage to the building, the premises and/or any contents,  each
party shall look first to any  insurance  in its favor  before  making any claim
against the other party;  and, to the extent possible  without  additional cost,
each  party  shall  obtain,  for  each  policy  of  such  insurance,  provisions
permitting waiver of any claim against the other party for loss or damage within
the scope of such insurance, and each party, to the extent permitted, for itself
and its insurers  waives all such insured  claims  against the other party.  The
provisions of this paragraph shall apply only upon the delivery by each party to
the  other of an  effective  endorsement  to this  policy of  insurance  waiving
subrogation and to the extent therein permitted.

13.      CONDEMNATION - TOTAL TAKING

         If the leased premises or any part thereof are taken by eminent domain,
this Lease shall terminate on the date when title vests pursuant to such taking.
The rent, or any additional rent, shall be apportioned as of such terminate date
and any rent paid for any period beyond said date shall be repaid to Tenant.

         Tenant  shall not be  entitled to any part of the award for such taking
or any payment in lieu thereof,  except that Tenant reserves the right to assert
claim against the condemning authority for the cost of removal and relocation.


14.      LESSOR'S REMEDIES IN DEFAULT

         If Tenant  defaults in the payment of rent, or any additional  rent, or
defaults in the performance of any of the other covenants or conditions  hereof,
Landlord may give Tenant  notice of such default and if Tenant does not cure any
rent, or additional rent default within five (5) days, or other default,  within
twenty (20) days,  after the giving of such notice,  or if such other default is
of such nature that it cannot be completely cured within such period,  if Tenant
does not  commence  such curing  within  such  twenty  (20) days and  thereafter
proceed with reasonable  diligence and in good faith to cure such default,  then
Landlord  may  terminate  this  Lease on not less than five (5) days'  notice to
Tenant,  and on the date  specified  in said notice the term of this Lease shall
terminate,  and Tenant shall then quit and  surrender  the premises to Landlord,
but Tenant shall remain liable as hereinafter provided. If this Lease shall have
been so  terminated  by  Landlord,  Landlord may at any time  thereafter  resume
possession  of the  premises  by any  lawful  means and  remove  tenant or other
occupants and their effects.

         In the event  that the  relation  of  Landlord  and Tenant may cease or
terminate  by reason of the re-entry of Landlord  under the terms and  covenants
contained in this Lease or by the ejectment of Tenant by summary  proceedings or
otherwise,  or after the  abandonment  of the  Premises by Tenant,  it is hereby
agreed that, at Landlord's  option,  either (a) the remaining rent to be paid by
Tenant for the term subsequent to the re-entry of Landlord shall  accelerate and
become immediately due and payable,  or (b) Tenant shall remain liable and shall
pay in monthly  payments the rent which  accrues  subsequent  to the re-entry by
Landlord,  and Tenant  expressly  agrees to pay as damages for the breach of the
covenants  herein  contained,  the difference  between the rent reserved and the
rent  collected  and received,  if any, by Landlord  during the remainder of the
unexpired Term,  such difference or deficiency  between the rent herein reserved
and the rent collected, if any, shall become due and payable in monthly payments
during the remainder of the unexpired Term, as the amounts of such difference or
deficiency  shall from time to time be  ascertained;  and it is mutually  agreed
between Landlord and Tenant that the respective  parties hereto shall and hereby
do waive  trial by jury in any action,  proceeding  or  counterclaim  brought by
either of the parties against the other on any matters whatsoever arising out of
or in any wan connected with this Lease,  Tenant's use or occupancy of Premises,
and/or any claim of injury or damage.  The Tenant's  obligation  to pay the rent
accruing or to accrue after Landlord's re-entry shall survive the termination of
this Lease and Landlord's reletting of the Premises,  subject to the credits for
collected rent, if any, as herein set forth.

15.      DEFICIENCY

         In any case where Landlord has recovered  possession of the premises by
reason of Tenant's  default,  Landlord  may, at  Landlord's  option,  occupy the
premises or cause the premises to be redecorated, altered, divided, consolidated
with other adjoining  premises,  or otherwise changed or prepared for reletting,
and may relet the premises or any part  thereof as agent of Tenant,  and receive
the rent  therefor.  Rent so received  shall be applied  first to the payment of
such expenses as Landlord may have  incurred in connection  with the recovery of
possession, redecorating, altering, dividing, consolidating with other adjoining
premises,  or otherwise changing or preparing for reletting,  and the reletting,
including  brokerage and reasonable  attorney's fees, and then to the payment of
damages in amounts  equal to the rent  hereunder and to the cost and expenses of
performance of the covenants of Tenant as herein provided.

         Tenant agrees in any such case,  whether or not Landlord has relet,  to
pay to Landlord  damages  equal to the rent and other sums  herein  agreed to be
paid by Tenant, less the net proceeds of reletting,  if any, as ascertained from
time to time,  and the same shall be payable by Tenant on the several  rent days
above specified.

         In  reletting  the  premises  as  aforesaid,  Landlord  may grant  rent
concessions, and Tenant shall not be credited therewith. No such reletting shall
constitute a surrender and acceptance or be deemed evidence thereof. If Landlord
elects,  pursuant  hereto,  actually to occupy and use the  premises or any part
thereof during any part of the balance of the term as originally  fixed or since
extended, there shall be allowed against Tenant's obligation for rent or damages
as herein defined, during the period of Tenant's occupancy, the reasonable value
for such occupancy, not to exceed in any event the rent herein reserved and such
occupancy shall not be construed as a relief of Tenant's liability hereunder.

         Tenant  hereby  waives all right of  redemption  to which Tenant or any
person  claiming  under  Tenant might be entitled by any law now or hereafter in
force.

         Landlord's  remedies hereunder are in addition to any remedy allowed by
law.

16.      SECURITY INTEREST

         Landlord, subordinate to financial or lending institutions,  shall have
a security  interest  and first lien  paramount  to all other on every right and
interest of Tenant in and of this Lease,  on any building or  improvement  on or
hereafter  placed on the leased  property,  and on all  furnishings,  equipment,
fixtures,  or other personal  property of any kind  belonging to Tenant,  or the
Tenant's equity therein, on the leased property.  The security interest and lien
are granted for the purposes of securing payment of rents,  taxes,  assessments,
charges, liens,  penalties,  and damages, and of securing the performance of all
of Tenant's  obligations  under this Lease. The security interest and lien shall
be in addition to all other rights  granted to Landlord  under present or future
laws of this state.

17.      NO WAIVER OF COVENANTS OR CONDITIONS

         The  failure  of either  party to insist on strict  performance  of any
covenant or condition hereof, or to exercise any option herein contained,  shall
not be construed as a waiver of such covenant, condition, or option in any other
instance. This Lease cannot be changed or terminated orally.


18.      COLLECTION OF RENT FROM ANY OCCUPANT

         If the  premises are sublet or occupied by anyone other than Tenant and
Tenant is in default hereunder, or if this lease is assigned by Tenant, Landlord
may collect rent from the assignee,  subtenant,  or occupant,  and apply the net
amount  collected  to the rent therein  reserved.  No such  collection  shall be
deemed a waiver of the covenant herein against assignment and subletting, or the
acceptance of such assignee,  subtenant,  or occupant as Tenant, or a release of
Tenant from further performance of the covenants herein contained.

19.      SUBORDINATION OF LEASE

         This lease shall be subject and  subordinate to all  underlying  leases
and mortgages  and trust deeds which may now or hereafter  affect such leases or
the real property of which the premises  form a part,  and also to all renewals,
modifications,  consolidations,  and  replacements  of said  underlying  leases,
mortgages,  and trust deeds. Although no instrument or act on the part of Tenant
shall be necessary to effectuate such subordination,  Tenant will, nevertheless,
execute and deliver such further  instruments  confirming such  subordination of
this lease as may be desired by the holders of said mortgages and trust deeds or
by any of the Landlords under any such underlying leases. Tenant hereby appoints
Landlord  attorney  in  fact,  irrevocably,  to  execute  and  deliver  any such
instrument for Tenant.

20.      RIGHT TO-CURE TENANT'S BREACH

         If Tenant  breaches any  covenant or condition of this Lease,  Landlord
may, after giving Tenant twenty days notice of the covenant or condition claimed
to have been breached,  and upon Tenant's failure to cure the same, (except that
no notice need be given in case of emergency) cure such breach at the expense of
Tenant and the reasonable  amount of all expenses,  including  attorney's  fees,
incurred  by  Landlord  in so doing  (whether  paid by Landlord or not) shall be
deemed additional rent payable on demand.

21.      MECHANIC'S LIENS

         Tenant shall within ten (10) days after notice from Landlord  discharge
any mechanics' liens for material or labor claimed to have been furnished to the
premises on Tenant's behalf.

22.      NOTICES

         Any notice by either  party to the other  shall be in writing and shall
be deemed  to have  been duly  given  only if  delivered  personally  or sent by
registered or certified mail in a postpaid envelope addressed;  if to Tenant, at
the above described building; if to Landlord, at Landlord's address as set forth
above; or, to either, at such other address as Tenant or Landlord, respectively,
may designate in writing.

23.      RIGHT TO INSPECT AND REPAIR

         Landlord  may,  but shall not,  except as  required  by  provisions  of
Paragraph 6, be obligated  to, enter the premises at any  reasonable  times,  on
reasonable  notice to  Tenant  (except  that no notice  need be given in case of
emergency)  for the  purpose  of  inspection  or the  making  of  such  repairs,
replacements,  or addition in, to, on or about the premises or the building,  as
Landlord  deems  necessary or desirable.  Tenant shall have no claim or cause of
action  against  Landlord by reason  thereof  except as provided in Paragraph 25
hereof.

24.      INTERRUPTION OF SERVICES OR USE

         Interruption or curtailment of any service  maintained in the building,
if caused by strikes,  mechanical difficulties,  or any causes beyond Landlord's
control  whether  similar or dissimilar to those  enumerated,  shall not entitle
Tenant to any claim against  Landlord or to any abatement in rent, and shall not
constitute constructive or partial eviction,  unless Landlord fails to take such
measures  as may be  reasonable  in the  circumstances  to restore  the  service
without undue delay.

25.      CONDITIONS OF LESSOR'S LIABILITY

         Tenant shall not be entitled to claim a constructive  eviction from the
premises  unless  Tenant  shall have first  notified  Landlord in writing of the
condition or conditions giving rise hereto, and, if the complaints be justified,
unless Landlord shall have failed within a reasonable time after receipt of such
notice to remedy such conditions.

26.      RIGHT TO SHOW PREMISES

         Landlord may show the premises to prospective purchasers and mortgagees
and,  during  the six  (6)  months  prior  to  termination  of  this  lease,  to
prospective tenants, during business hours on reasonable notice to Tenant.

27.      NO OTHER REPRESENTATIONS

         No  representations  or promises shall be binding on the parties hereto
except those  representations  and promises  contained herein or in some further
writing signed by the party making such representations or promises.

28.      QUIET ENJOYMENT

         Landlord  covenants  that if, and so long as, Tenant pays the rent, and
any  additional  rent as herein  provided,  and performs the  covenants  hereof,
Tenant shall  peaceably and quietly have,  hold,  and enjoy the premises for the
term herein mentioned, subject to the provisions of this Lease.

29.      TENANT'S ESTOPPEL

         Tenant shall,  from time to time, on not less than ten (10) days' prior
written  request by Landlord,  execute,  acknowledge,  and deliver to Landlord a
written statement  certifying that the Lease is unmodified and in full force and
effect,  and that the Lease is in full force and effect as modified  and listing
the instruments or modification;  the dates to which the rents and other charges
have been paid; and whether or not to the best of Tenant's knowledge Landlord is
in default  hereunder and, if so,  specifying  the nature of the default.  It is
intended that any such  statement  delivered  pursuant to this  Paragraph may be
relied upon by a prospective  purchaser of  Landlord's  interest or mortgagee of
Landlord's  interest or assignee of any mortgage upon Landlord's interest in the
building.

30.      WAIVER OF JURY TRIAL

         To the extent such waiver is permitted by law, the parties  waive trial
by jury in any action or proceeding brought in connection with this lease or the
premises.

31.      PARAGRAPH HEADINGS

         The paragraph  headings in this Lease are intended for convenience only
and shall not be taken into  consideration in any construction or interpretation
of this Lease or any of its provisions.


32.      APPLICABILITY TO HEIRS AND ASSIGNS

         The  provision  of this lease  shall apply to,  bind,  and inure to the
benefit of Landlord and Tenant,  and their respective heirs,  successors,  legal
representatives,  and assigns. It is understood that the term "Landlord" as used
in this Lease means only the owner, a mortgagee in possession,  or a term Tenant
of the  building,  so that in the  event of any sale of the  building  or of any
lease  thereof,  or if a mortgagee  shall take  possession of the premises,  the
Landlord  named herein  shall be and hereby is entirely  freed of relief and all
covenants and  obligation of Landlord  hereunder  occurring  thereafter,  and it
shall be deemed without further agreement that the purchaser, the term Tenant of
the building, or the mortgagee in possession has assumed and agreed to carry out
any and all covenants and obligations of the Landlord hereunder.

33.      FIRST RIGHT TO LEASE

         Provided  Tenant is not in  default  of any of its  lease  obligations,
Tenant shall have the Right to Lease the remaining balance of space on the first
floor of 46 Prince Street,  Rochester,  New York 14607. At the time the Landlord
enters into serious  conversation  with  regards to leasing  said  approximately
3,741 square feet or any portion  thereof,  on the first floor,  it must provide
Tenant with written  notice that said space is being  considered  for lease by a
third party.  Tenant has five (5) business days to inform Landlord,  in writing,
of its  intention  to either  expand  into  said  space or  reject  leasing  the
additional space at that time. Should Tenant elect to lease the additional space
it must agree to extend the  remaining  Term of its lease so that at least three
(3) years remain at the time of Tenants  occupancy of the additional  space with
the exception of the initial two years of the lease term. The three year minimum
extension  period shall apply to the entire amount of space Tenant leases at the
time of the expansion.  Landlord agrees to repaint and shampoo carpet within the
expansion  space.  The Base Rent for the  expansion  space shall be equal to the
Tenant's then-current Base Rent Per Square Foot Rate.

34. Landlord shall recarpet the main stairwell within the building prior to June
1, 1995  notwithstanding  any delays caused by actions or lack of actions beyond
Landlord's control.

         IN WITNESS WHEREOF, the parties hereto have duly executed in this Lease
the 22nd day of February, l995.

LANDLORD:                                                     TENANT:

CONIFER PRINCE ST. ASSOCIATES               DSMI CORPORATION


BY:/s/ Richard C. Crossed                   BY:      /s/ Donalrd A. Carlberg   
         Richard C. Crossed                          Donald A. Carlberg, CEO

TITLE President                             TITLE Agent for Corporation in     
 formation and without individual liability



<PAGE>



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

                      RULES AND REGULATIONS
- -------------------------------------------------------------------

1.       OBSTRUCTION OF PASSAGEWAYS

         The sidewalks,  entrances,  passages,  courts,  elevators,  vestibules,
         stairways,  corridors  and public  parts of the  building  shall not be
         obstructed  or  encumbered  by Tenant or used by Tenant for any purpose
         other than ingress and egress.

2.       PROJECTIONS FROM BUILDING

         No awning, air conditioning  units, or other fixtures shall be attached
         to the outside walls or the  windowsills of the building,  or otherwise
         affixed so as to project from the  building,  without the prior written
         consent of Landlord.

3.       SIGNS

         No sign or  lettering  shall be  affixed  by  Tenant to any part of the
         inside of the premises so as to be clearly  visible from the outside of
         the premises  without the prior written  consent of Landlord.  However,
         Tenant  shall have the right to place its name on any door leading into
         the premises;  the size,  color,  and style thereof is to be subject to
         Landlord's approval, which approval shall not be unreasonably withheld.
         Landlord shall place Tenant's name on the directory in the lobby of the
         building.  Tenant  shall  not have the right to have  additional  names
         placed on the  directory  without  Landlord's  prior  written  consent;
         however, such consent shall not be unreasonably withheld.

4.       WINDOWS

         Windows in the premises shall not be obstructed by Tenant.  No bottles,
         parcels,or  other articles shall be placed on the  windowsills,  in the
         halls,  or in any other  part of the  building  other  than the  leased
         premises. No article shall be thrown out of the doors or windows of the
         premises.  All window treatments must be white or beige to the exterior
         and shall be subject to Landlord's approval.

5.       FLOOR COVERING

         Tenant shall not lay linoleum or other similar  floor  covering so that
         the same shall come in direct  contract with the floor of the premises.
         If linoleum or other similar  floor  covering is desired to be used, an
         interlining  of  builder's  deadening  felt first shall be fixed to the
         floor by a paste or other  material  that may  easily be  removed  with
         water,  the use of  cement or other  similar  adhesive  material  being
         expressly prohibited.


6.       INTERFERENCE WITH OCCUPANTS OR BUILDING

         Tenant shall not make, or permit to be made, any unseemly or disturbing
         noises  and shall not  interfere  with other  tenants  or those  having
         business with them.

7.       LOCKS: KEYS

         No additional  locks or bolts of any kind shall be placed on any of the
         doors or  windows  by  Tenant.  Tenant  shall,  on  termination  of its
         tenancy, deliver to Landlord all keys to any space within the building;
         either furnished to or otherwise  procured by Tenant,  and in the event
         of the loss of any keys  furnished,  Tenant  shall pay to Landlord  the
         cost thereof.

8.       MOVEMENT OF FURNITURE, FREIGHT, OR BULKY MATTER

         The  carrying in or out of freight,  furniture,  or bulky matter of any
         description must take place during such hours as Landlord may from time
         to time  reasonably  determine  and only  after  advance  notice to the
         superintendent of the building.  The person employed by Tenant for such
         work must be reasonably acceptable to Landlord.  Tenant may, subject to
         such  provisions,  move freight,  furniture,  bulky  matter,  and other
         material into or out of the premises on Saturdays  between the hours of
         eight (8) a.m. and six (6) p.m., provided Tenant pays additional costs,
         if any, incurred by Landlord for elevator operators or security guards,
         and for other expenses occasioned by such activity by Tenant.

9.       SAFES AND OTHER HEAVY EQUIPMENT

         Landlord reserves the right to prescribe the weight and position of all
         safe and other heavy equipment so as to distribute  properly the weight
         thereof  and to present any unsafe  condition  from  arising.  Business
         machines and other  equipment  shall be placed and maintained by Tenant
         at Tenant's  expense in settings  sufficient in  Landlord's  reasonable
         judgment  to absorb  and  prevent  unreasonable  vibrations,  noise and
         annoyance.

10.      ADVERTISING

         No advertising, publication, sign or other form of communication by the
         Tenant  shall  utilize the name of the  University  of Rochester or the
         Memorial Art  Gallery,  or make  reference  to any art exhibit,  shows,
         exhibitions  or  other  activities   conducted  by  the  University  of
         Rochester or the Memorial Art Gallery,  for the purpose of  identifying
         the location of the premises or for the purpose of promoting or selling
         goods, products or services offered by the Tenant.



<PAGE>


                                   SCHEDULE A

                                    BASE RENT

              TERM                            ANNUAL                    MONTHLY 
         3/1/95-2/28/96                     $44,662.50                 $3,721.88
         3/1/96-2/28/97                     $46,449.00                 $3,870.75


                                                    COMMON AREA MAINTENANCE

                                                       ADDITIONAL RENT

                                                          UTILITIES



         Total Square Footage of building             30,375 

         Square Footage Covered by Lease               3,573 

         Tenant's Share Electric                       11.76%


                                                        ADDITIONAL RENT


Heating and Air Conditioning

The heat pump units serving the leased premises shall be individually gauged and
the monthly charges shall be calculated as set forth on the attached and further
explained as follows:

l. The heat pump units serving the leased  premises shall be identified by model
number.

2. The actual heat pump operating  hours will be recorded for each month (column
3) and  multiplied  by the energy use factor  (column 4)  applicable to the heat
pump model to establish the total energy units (column 5)

3. The  total  energy  units  for all  heat  pumps  is then  added to the  total
auxiliary  usage to establish  the grand total usage and energy cost (total KWH)
for the building.

4. The grand total usage and energy cost is multiplied by the utility  company's
rate per KWH to establish the total cost for kilowatt hours.

5. The total  KWH are  divided  by the total  heat  pump  usage and  charges  to
establish the heat pump hourly rate (column 6).

6. The monthly  tenant  charge is the heat pump hourly  rate  multiplied  by the
total energy units (column 5).

7. Tenant will also pay 11.76% of general usage/common area electric.


                                 ADDITIONAL RENT

                      Real Estate and Insurance Escalation


In  addition  to the  rents  set  forth in the  Lease,  and  heretofore  in this
Schedule, with 1995 as the base year, Tenant shall pay 11.76% of the increase in
real  estate  taxes and other  government  levies in lieu of taxes  (payable  in
October of the  following  year),  and 11.76% of the  increase in  property  and
liability insurance premiums (payable in February of the following year).



<PAGE>




                                   SCHEDULE B

                          SERVICES PROVIDED BY LANDLORD



1.       Housekeeping of the common area.

2. Building, landscape and elevator maintenance.

3. Snow removal and the removal of trash from a common receptacle.

4. Automatic operatorless passenger elevator.

5. Common lavatory facilities, including supplies.

6. Parking for 10 cars.



<PAGE>





                                   SCHEDULE C

                        USE AND OCCUPANCY OF LEASED-SPACE



                            Professional Office Space




                                  EXHIBIT 10.21

                             FIRST ADDENDUM TO LEASE



This First  Addendum to Lease is made and  entered  into the 22nd day of August,
1995,  between Conifer Prince Street Associates  (Landlord) and DSMI Corporation
(Tenant).

WITNESSETH: that Tenant currently leases and occupies approximately 3,573 square
feet of office space at 46 Prince Street,  Rochester, New York 14607 pursuant to
a Lease Agreement dated February 22, 1995 (Lease).  WHEREAS, Tenant and Landlord
desire to expand Tenant's Leased Premises as illustrated on Exhibit A-1 attached
hereto, and made a part of the First Addendum to Lease.

NOW,  THEREFORE,  it is mutually  agreed  upon by Landlord  and Tenant to modify
certain provisions of the Lease as follows:

     1. Effective upon full execution of this First Addendum to Lease,  Tenant's
leased premises shall be approximately 5,504 rentable square feet.

     2. Effective  upon full execution of this First Addendum to Lease,  Section
1, "TERM",  Paragraph A, of the Lease Agreement  shall be modified,  in part, to
read "... and  terminating on September 30,  1999..."  Additionally,  Tenant has
hereby exercised a modification of the extension period as stated within Section
1, Paragraph B, of the Lease Agreement.  Therefore, the provisions of Section 1.
"TERM", Paragraph B, of the Lease Agreement shall now be null and void.

     3. Effective  upon full execution of this First Addendum to Lease,  Section
2, "RENTAL",  of the Lease Agreement shall be modified, in part, as follows "...
the Base Rent shall be increased as follows:
             Period                 $/Sq.ft.           Monthly        Annual  
                                                      Base Rent      Base Rent 
         10/1/95-2/28/96            $12.50           $ 5,136.46*        N/A
         3/1/96-2/28/97             $13.00           $ 5,962.67     $ 71,552.00
         3/1/97-2/28/98             $13.50           $ 6,192.00     $ 74,304.00
         3/1/98-2/28/99             $14.00           $ 6,421.33     $ 77,055.96
         3/1/99-9/30/99             $14.50           $ 6,650.67         N/A

     * Landlord  agrees to abate the Base Rent for 573 square  feet of the newly
created demised  premises during the period of October 1, 1995 through  February
28, 1996. Therefore, Base Rent is based on 4,931 square feet during such period.

     4. Effective  upon full execution of this First Addendum to Lease,  Section
5,  "Services",  of the Lease  Agreement shall be modified to include Exhibit AA
"Landlord/Tenant  Work Letter"  attached to and made part of this First Addendum
to Lease.

     5. Effective  upon full execution of this First Addendum to Lease,  Section
33, "First Right To Lease",  of the Lease Agreement shall be modified,  in part,
to read"...space within the building..." and the words "said approximately 3,741
square feet or any portion  thereof on the first floor" shall be replaced by the
following, "space within the Building"

     6. Effective upon full execution of this First Addendum to Lease,  Schedule
A, of the Lease Agreement shall be replaced by Schedule A-2, attached and made a
part of this First Addendum to Lease.

     7. Effective upon full execution of this First Addendum to Lease,  Schedule
B "Services Provided by Landlord" of the Lease Agreement,  shall be modified, in
part, to read "...Item 6, Parking for 17 effective October 1, 1995 and increased
to 25 effective February 1, 1996".

     8.  Tenant  shall  have a  one-time  opportunity  to  terminate  the  Lease
Agreement  effective  September  30, 1998.  Tenant must provide  Landlord with a
minimum of 120 days written notice of its intention to exercise its  termination
option.  Furthermore, in order for Tenant's option to be effective, it's written
notice must be delivered to Landlord together with an early termination  penalty
equal to $10,500.00.

     9. Prior to Tenant's  occupancy  of the  expansion  space,  Landlord  shall
relocate the ground wire connection servicing Tenant's electrical panel from its
current  position,  so that it connects  directly  into a ground pole within the
panel.

     Except as  modified  above,  all other  terms and  conditions  of the Lease
Agreement  dated February 22, 1995 shall remain  unchanged and in full force and
effect.


Agreed to by:                                        Agreed to by:

DSMI CORPORATION  CONIFER PRINCE STREET ASSOCIATES



By:  /s/ Gregory D. Brown                        By:  /s/ C. Terrance Butwid    


Date:  August 18, 1995                           Date:   August 22, 1995      
    --------------------------------             ------------------------------





                                  EXHIBIT 10.22

                            SECOND ADDENDUM TO LEASE



This Second Addendum To Lease is made and entered into the 17th day of November,
1995,  between Conifer Prince Street Associates  (Landlord) and DSMI Corporation
(Tenant).

WITNESSETH: that Tenant currently leases and occupies approximately 5,504 square
feet of office space at 46 Prince Street,  Rochester, New York 14607 pursuant to
a Lease  Agreement  and First  Addendum To Lease,  dated  February  22, 1995 and
August 18, 1995, respectively.

WHEREAS, Tenant and Landlord desire to expand Tenant's Lease Premises to include
approximately  1,720 square feet of office  space  located on the lower level of
the Building as illustrated by Exhibit A-2 attached hereto and made part of this
Second Addendum To Lease.

NOW,  THEREFORE,  it is mutually  agreed  upon by Landlord  and Tenant to modify
certain provisions of the Lease as follows:

1.       Effective  upon full  execution  of this Second  Addendum To Lease, 
 Tenant's  lease  premises  shall be  approximately  7,224 rentable square feet.

2.       Effective  December 1, 1995,  Tenant  agrees to pay, in addition to its
         Base  Rent as  stated in the First  Addendum  To Lease,  the  following
         monthly Base Rent:

                       Period                        $/Sq.ft.          Monthly 
                  ---------------                    --------          --------
                  Month-to-Month                                      Base Rent
                  --------------                                      ---------
                  12/1/95-2/28/96                    $12.50            $1,096.88
                  3/1/96-2/28/97                      $13.00           $1,140.75
                  3/1/97-2/28/98                      $13.50           $1,184.63
                  3/1/98-2/28/99                      $14.00           $1,228.50
                  3/1/99-9/30/99                      $14.50           $1,272.38

4.       Landlord  or Tenant may  terminate  this  Second  Addendum  To Lease by
         providing the other with thirty (30) days prior  written  notice of its
         desire to terminate the provisions of this Second Addendum To Lease.

5.       Effective  upon  full  execution  of this  Second  Addendum  To  Lease,
         Schedule A-2 of the Lease  Agreement shall be replaced by Schedule A-3,
         attached and made a part of this Second Addendum To Lease.

Except as modified above,  all other terms and conditions of the Lease Agreement
and First  Addendum  To Lease,  dated  February  22,  1995 and August 18,  1995,
respectively, shall remain unchanged and in full force and effect.

Agreed to by:                                                   Agreed to by:
DSMI CORPORATION                               CONIFER PRINCE STREET ASSOCIATES


By:  /s/ Donald A. Carlberg             By:  /s/ Thomas L. Fountain 
                                        Agent for Owner 

Date:  November 17, 1995                Date:  November 17, 1995              
       
<PAGE>




                                  SCHEDULE A-3

                             COMMON AREA MAINTENANCE

                                 ADDITIONAL RENT

                                    UTILITIES


Total Square Footage of Building            30,375

Square Footage Covered by Lease              7,224

Tenant's Share Electric                     23.78%


                                                        ADDITIONAL RENT

Heating and Air Conditioning

The heat pump units serving the leased premises shall be individually gauged and
the monthly charges shall be calculated as set forth on the attached and further
explained as follows:

1. The heat pump units serving the lease  premises  shall be identified by model
number.

2. The actual heat pump operating  hours will be recorded for each month (column
3) and  multiplied  by the energy use factor  (column 4)  applicable to the heat
pump model to establish the total energy units (column 5).

3. The  total  energy  units  for all  heat  pumps  is then  added to the  total
auxiliary  usage to establish  the grand total usage and energy cost (total KWH)
for the building.

4. The grand total usage and energy cost is multiplied by the utility  company's
rate per KWH to establish the total cost for kilowatt hours.

5. The total  KWH are  divided  by the total  heat  pump  usage and  charges  to
establish the heat pump hourly rate (column 6).

6. The monthly  tenant  charge is the heat pump hourly  rate  multiplied  by the
total energy units (column 5).

7. Tenant will also pay 23.78% of general usage/common area electric.


<PAGE>


                                 ADDITIONAL RENT

                      Real Estate and Insurance Escalation

In  addition  to the  rents  set  forth in the  Lease,  and  heretofore  in this
Schedule, with 1995 as the base year, Tenant shall pay 23.78% of the increase in
real  estate  taxes and other  government  levies in lieu of taxes  (payable  in
October of the  following  year),  and 23.78% of the  increase in  property  and
liability insurance premiums (payable in February of the following year).







                                  EXHIBIT 10.23

                             THIRD ADDENDUM TO LEASE

This Third  Addendum  To Lease is made and  entered  into the 28th day of March,
1996,  between Conifer Prince Street Associates  (Landlord) and DSMI Corporation
(Tenant).

WITNESSETH: that Tenant currently leases and occupies approximately 7,224 square
feet of office space at 46 Prince Street,  Rochester, New York 14607 pursuant to
a Lease Agreement; First and Second Addendums To Lease, dated February 22, 1995,
August 18, 1995 and November 17, 1995, respectively.

WHEREAS,  Tenant and Landlord  desire to increase the Base Rent  associated with
the 1,720 square feet leased and occupied by Tenant,  located on the lower level
of the Building as illustrated by Exhibit A-2 of the Second Addendum To Lease.

NOW,  THEREFORE,  it is mutually  agreed  upon by Landlord  and Tenant to modify
certain provisions of the Lease as follows:


1.       Effective April 1, 1996,  Tenant agrees to pay, in addition to its Base
         Rent as stated in the First  Addendum To Lease,  the following  monthly
         Base Rent:

                       Period                        $/Sq.ft.           Monthly 
                  Month-to-Month                                       Base Rent

                  4/1/96-2/28/97                      $12.00           $1,720.00
                  3/1/97-2/28/98                      $12.50           $1,791.67
                  3/1/98-2/28/99                      $13.00           $1,863.33
                  3/1/99-9/30/99                      $13.50           $1,935.00

2.       Landlord  or Tenant may  terminate  this  Second  Addendum  To Lease by
         providing  the  other  with  prior  written  notice  of its  desire  to
         terminate  the  provisions  of  this  Second  Addendum  To  Lease.  The
         effective  date of  termination  will be the last day of the first full
         month following the receipt of said written notice.

Except as modified above, all other terms and conditions of the Lease Agreement,
First and Second  Addendums To Lease,  dated February 22, 1995 , August 18, 1995
and March 23, 1996,  respectively,  shall remain unchanged and in full force and
effect.

Agreed to by:                                      greed to by:
DSMI CORPORATION                           CONIFER PRINCE STREET ASSOCIATES
                                              Home Properties of New York

By:  /s/ Gregory D. Brown                    By:  /s/ Thomas L. Fountain        

Date:  March 28, 1996                        Date:  April 1, 1996               
      






                                  EXHIBIT 10.24

                            FOURTH ADDENDUM TO LEASE

This Fourth  Addendum To Lease is made and entered into the 29th day of October,
1996,   between  Conifer  Prince  Street   Associates   (Landlord)  and  Patient
Infosystems, Inc. formerly DSMI Corporation (Tenant).

WITNESSETH: that Tenant currently leases and occupies approximately 7,224 square
feet of office space at 46 Prince Street,  Rochester, New York 14607 pursuant to
a Lease Agreement and First, Second and Third Addendums To Lease, dated February
22, 1995, August 18, 1995, November 17, 1995 and March 28, 1996, respectively.

WHEREAS, Tenant and Landlord desire to expand Tenant's Lease Premises to include
approximately  5,893 square feet of office space located on the third and fourth
levels of the Building as  illustrated  by Exhibit A-4 attached  hereto and made
part of this  Fourth  Addendum  To Lease  and  certain  provisions  of the Lease
Agreement and First, Second and Third Addendums To Lease stated above.

NOW,  THEREFORE,  it is mutually  agreed  upon by Landlord  and Tenant to modify
certain provisions of the Lease as follows:

1. Effective  December 1, 1996,  Tenant's lease premises shall be  approximately
13,117 rentable square feet.

2. Effective  December 1, 1996, Tenant agrees to pay, Base Rent for space leased
on the lower level of the  Building,  consisting of  approximately  1,720 square
feet as follows:

                       Period                        $/Sq.ft.           Monthly
                  Month-to-Month                     Base Rent         Base Rent
                  12/1/96-2/28/97                    $12.00            $1,720.00
                  3/1/97-2/28/98                      $12.50           $1,791.67
                  3/1/98-2/28/99                      $13.00           $1,863.33
                  3/1/99-11/30/99                     $13.50           $1,935.00

3.  Landlord or Tenant may  terminate the  obligations  of the Lease  Agreement,
First,  Second and Third  Addendums To Lease stated  above.  related to Tenant's
lower  level space of the  Building,  as stated in  Paragraph  2 above,  without
penalty, by providing the other with a minimum of thirty (30) days prior written
notice of its desire to terminate said obligations.

4. Effective  December 1, 1996, Tenant agrees to pay, Base Rent for space leased
on  the  first,  third  and  fourth  levels  of  the  Building,   consisting  of
approximately 11,397 square feet as following:

                       Period                        $/Sq.ft.           Monthly
                  Month-to-Month                     Base Rent         Base Rent
                  12/1/96-2/28/97                    $13.00           $12,346.75
                  3/1/97-2/28/98                      $13.50          $12,821.63
                  3/1/98-2/28/99                      $14.00          $13,296.50
                  3/1/99-11/30/99                     $14.50          $13,771.38

5. Effective upon the full  execution of this Fourth  Addendum To Lease,  Tenant
hereby exercises it extension  option, as stated in Paragraph  1,"TERM",  of the
Lease  Agreement,  with the  exception  that the term of said  extension  option
period is modified, in part, to provide for a lease termination date of November
30, 1999.

6. Effective upon the full execution of this Fourth Addendum To Lease, Paragraph
8 of the First  Addendum To Lease will become null and void and the Lease,  with
the exception of the provisions stated as in Paragraph 3 of this Fourth Addendum
To Lease,  shall no longer provide  Tenant with a right to early  termination of
the Lease.

7. Landlord will patch and paint the walls, doors and trim within Tenant's space
located on the third and fourth levels of the Building. Tenant and Landlord must
agree upon paint color(s) prior to October 17, 1996. Additionally, Landlord will
install,  within the third level area of Tenant's  demised  premises  only,  new
carpet in the common hallways,  receptionist  desk area,  internal  stairway and
private  offices.  Landlord  shall also  replace  existing  VCT  flooring in the
receptionist/storage area. Provided Landlord has enough carpet, Tenant agrees to
allow Landlord to install carpet,  in the common hallways and internal  stairway
of Tenant's  third level space,  that  matches the existing  carpet in the suite
adjacent to Tenant's  third level  space.  Carpet to be installed in the private
offices and receptionist area, stated above,  shall be a "Patcraft  Einstein" 28
ounce grade carpet or equal. If determined by Landlord's contractor, there is an
insufficient amount of the matching carpet stated above,  "Patcraft Einstein" 28
ounce  carpet or equal will be used as a substitute  in the common  hallways and
internal  stairway  mentioned above.  Landlord and Tenant must agree upon carpet
selection by October 17, 1996.  Landlord shall have the carpet in the large open
section of Tenant's fourth level space professionally  stretched.  Landlord will
also  professionally  shampoo the carpet on the entire  fourth  level and in the
third level conference  room.  Provided the above dates are adhered to, Landlord
will completed said work prior to December 1, 1996.

8. Effective December 1, 1996, Tenant's parking allowance will be increased from
25 on-site spaces to 41.

9. Effective December 1, 1996, Schedule A-3 of the Second Addendum To Lease will
be replaced by Schedule A-4, attached and made a part of this Fourth Addendum To
Lease .

Except as modified above,  all other terms and conditions of the Lease Agreement
and First,  Second and Third Addendus To Lease,  dated February 22, 1995, August
18,  1995,  November  17, 1995 and March 28,  1996,  respectively,  shall remain
unchanged and in full force and effect.

Agreed to by:                                       Agreed to by:
PATIENT INFOSYSTEMS                            CONIFER PRINCE STREET ASSOCIATES
FORMERLY DMSI CORPORATION

By:  /s/ Donald A. Carlberg                    By:  /s/ Dick Crossed           


Date:  October 25, 1996                        Date:  October 29, 1996         
   


<PAGE>


                                  SCHEDULE A-4

                             COMMON AREA MAINTENANCE

                                 ADDITIONAL RENT

                                    UTILITIES


                     Total Square Footage of Building 30,375

                     Square Footage Covered by Lease 13,117

                          Tenant's Share Electric 43.2%

                                                                ADDITIONAL RENT

Heating and Air Conditioning

The heat pump units serving the leased premises shall be individually gauged and
the monthly charges shall be calculated as set forth on the attached and further
explained as follows:

1. The heat pump units serving the lease  premises  shall be identified by model
number.

2. The actual heat pump operating  hours will be recorded for each month (column
3) and  multiplied  by the energy use factor  (column 4)  applicable to the heat
pump model to establish the total energy units (column 5).

3. The  total  energy  units  for all  heat  pumps  is then  added to the  total
auxiliary  usage to establish  the grand total usage and energy cost (total KWH)
for the building.

4. The grand total usage and energy cost is multiplied by the utility  company's
rate per KWH to establish the total cost for kilowatt hours.

5. The total  KWH are  divided  by the total  heat  pump  usage and  charges  to
establish the heat pump hourly rate (column 6).

6. The monthly  tenant  charge is the heat pump hourly  rate  multiplied  by the
total energy units (column 5).

7. Tenant will also pay 43.2% of general usage/common area electric.

         ADDITIONAL RENT

         Real Estate and Insurance Escalation

In  addition  to the  rents  set  forth in the  Lease,  and  heretofore  in this
Schedule,  with 1995 as the base year, Tenant shall pay 43.2% of the increase in
real  estate  taxes and other  government  levies in lieu of taxes  (payable  in
October of the  following  year),  and 43.2% of the  increase  in  property  and
liability insurance premiums (payable in February of the following year).






                                  EXHIBIT 10.25

                             FIFTH ADDENDUM TO LEASE


This Fifth  Addendum To Lease is made and entered into the 30th day of November,
1996,   between  Conifer  Prince  Street   Associates   (Landlord)  and  Patient
Infosystems, Inc. formerly DSMI Corporation (Tenant).


WITNESSETH:  that Tenant  currently  leases and  occupies  approximately  13,117
square  feet of office  space at 46 Prince  Street,  Rochester,  New York  14607
pursuant to a Lease Agreement and First,  Second,  Third and Fourth Addendums To
Lease,  dated February 22, 1995;  August 18, 1995;  November 17, 1995; March 28,
1996 and October 29, 1996 respectively.


WHEREAS,  Tenant and Landlord desire to terminate it lease obligation  regarding
the space leased on the lower level of the Building  thereby reducing the amount
of square footage and corresponding its rental obligation  effective December 1,
1996.


NOW,  THEREFORE,  it is mutually  agreed  upon by Landlord  and Tenant to modify
certain provisions of the Lease as follows:


1. Effective  December 1, 1996,  Tenant's lease premises shall be  approximately
11,397 rentable square feet.


2.  Effective  December 1, 1996,  Tenant shall no longer be obligated  for costs
associated  with  space  previously  leased by Tenant on the lower  level of the
Building,  consisting of approximately 1,720 square feet. However,  Tenant shall
remain  responsible  for all appropriate  charges  incurred prior to December 1,
1996.


3. Effective  December 1, 1996, Tenant agrees to pay, Base Rent for space leased
on  the  first,  third  and  fourth  levels  of  the  Building,   consisting  of
approximately 11,397 square feet as following:

                       Period                        $/Sq.ft.           Monthly
                  Month-to-Month                     Base Rent         Base Rent
                  12/1/96-2/28/97                     $13.00          $12,346.75
                  3/1/97-2/28/98                      $13.50          $12,821.63
                  3/1/98-2/28/99                      $14.00          $13,296.50
                  3/1/99-11/30/99                     $14.50          $13,771.38


4.  Effective  December 1, 1996,  Schedule  A-5 shall  replace  Schedule A-4 and
Tenant's pro rata share of taxes, utilities and insurance will be 37.5%.


Except as modified above,  all other terms and conditions of the Lease Agreement
and First, Second, Third and Fourth Addendums To Lease, dated February 22, 1995;
August 18,  1995;  November  17,  1995;  March 28,  1996 and  October  29,  1996
respectively, shall remain unchanged and in full force and effect.

Agreed to by:                                        Agreed to by:
PATIENT INFOSYSTEMS, INC.           CONIFER PRINCE STREET ASSOCIATES
formerly DSMI CORPORATION



By:  /s/ Gregory D. Brown                   By:  /s/ Thomas L. Fountain        
Date:  November 30, 1996                    Date:  November 26, 1996          

<PAGE>


                                  SCHEDULE A-4

                             COMMON AREA MAINTENANCE

                                 ADDITIONAL RENT

                                    UTILITIES

                     Total Square Footage of Building 30,375

                     Square Footage Covered by Lease 11,397

                          Tenant's Share Electric 37.5%

                                 ADDITIONAL RENT

Heating and Air Conditioning

The heat pump units serving the leased premises shall be individually gauged and
the monthly charges shall be calculated as set forth on the attached and further
explained as follows:

1. The heat pump units serving the lease  premises  shall be identified by model
number.

2. The actual heat pump operating  hours will be recorded for each month (column
3) and  multiplied  by the energy use factor  (column 4)  applicable to the heat
pump model to establish the total energy units (column 5).

3. The  total  energy  units  for all  heat  pumps  is then  added to the  total
auxiliary  usage to establish  the grand total usage and energy cost (total KWH)
for the building.

4. The grand total usage and energy cost is multiplied by the utility  company's
rate per KWH to establish the total cost for kilowatt hours.

5. The total  KWH are  divided  by the total  heat  pump  usage and  charges  to
establish the heat pump hourly rate (column 6).

6. The monthly  tenant  charge is the heat pump hourly  rate  multiplied  by the
total energy units (column 5).

7. Tenant will also pay 37.5% of general usage/common area electric.

                                 ADDITIONAL RENT

                      Real Estate and Insurance Escalation

In  addition  to the  rents  set  forth in the  Lease,  and  heretofore  in this
Schedule,  with 1995 as the base year, Tenant shall pay 37.5% of the increase in
real  estate  taxes and other  government  levies in lieu of taxes  (payable  in
October of the  following  year),  and 37.5% of the  increase  in  property  and
liability insurance premiums (payable in February of the following year).





                                  EXHIBIT 10.26

                             SIXTH ADDENDUM TO LEASE


This Sixth  Addendum To Lease is made and entered into the 24th day of November,
1997,   between  Conifer  Prince  Street   Associates   (Landlord)  and  Patient
Infosystems, Inc. formerly DSMI Corporation (Tenant).


WITNESSETH:  that Tenant  currently  leases and  occupies  approximately  11,397
square  feet of office  space at 46 Prince  Street,  Rochester,  New York  14607
pursuant  to a Lease  Agreement  and  First,  Second,  Third,  Fourth  and Fifth
Addendus To Lease, dated February 22, 1995; August 18, 1995;  November 17, 1995;
March 28, 1996; October 29, 1996 and November 30, 1997, respectively.


WHEREAS, Tenant and Landlord desire to expand Tenant's leased premises by Tenant
leasing additional office space,  consisting of approximately 1,557 square feet,
on the Building's lower level (Expansion Space).


NOW,  THEREFORE,  it is mutually  agreed  upon by Landlord  and Tenant to modify
certain provisions of the Lease as follows:

1.  Effective  February 1, 1998,  Tenant's  lease premises shall be increased to
include  approximately 1,557 rentable square feet of office space located on the
lower level of the  Building.  Therefore,  effective  February 1, 1998  Tenant's
leased premises will consist of approximately 12,954 rentable square feet.


2.  Tenant agrees to pay, Base Rent for its' leased premises, consisting of
 approximately 12,954 square feet as following:

                       Period                        Per Sq.ft.         Monthly
                  Month-to-Month                     Base Rent         Base Rent
                     2/28/98                           $13.50         $14,573.26
                  3/1/98-02/28/99                     $14.00          $15,113.00
                  3/1/99-11/30/99                     $14.50          $15,652.76

3.  Effective  February 1, 1998,  Schedule  A-6 shall  replace  Schedule A-4 and
Tenant's pro rata share of taxes, utilities and insurance will be 42.65%.

4. Prior to Tenant's  occupancy of the Expansion Space,  Landlord shall, at its'
sole cost and expense, complete the Scope of Work, as stated on Exhibit A-6.

Except as modified above,  all other terms and conditions of the Lease Agreement
and First, Second, Third, Fourth and Fifth Addendus To Lease, dated February 22,
1995; August 18, 1995;  November 17, 1995; March 28, 1996;  October 29, 1996 and
November 30, 1997,  respectively,  shall remain  unchanged and in full force and
effect.

Agreed to by:                                        Agreed to by:
PATIENT INFOSYSTEMS, INC.           CONIFER PRINCE STREET ASSOCIATES
formerly DSMI CORPORATION

By:  /s/ Donald A. Carlberg         By:   /s/ Thomas L. Fountain    

Date:   November 24, 1997           Date:    November 25, 1997      
     --------------------------          ---------------------------


<PAGE>


                                  SCHEDULE A-6

                             COMMON AREA MAINTENANCE

                                 ADDITIONAL RENT

                                    UTILITIES

Total Square Footage of Building                     30,375

Square Footage Covered by Lease                      12,954

Tenant's Share Electric                              42.65%

                                                        ADDITIONAL RENT

Heating and Air Conditioning

The heat pump units serving the leased premises shall be individually gauged and
the monthly charges shall be calculated as set forth on the attached and further
explained as follows:

1. The heat pump units serving the lease  premises  shall be identified by model
number.

2. The actual heat pump operating  hours will be recorded for each month (column
3) and  multiplied  by the energy use factor  (column 4)  applicable to the heat
pump model to establish the total energy units (column 5).

3. The  total  energy  units  for all  heat  pumps  is then  added to the  total
auxiliary  usage to establish  the grand total usage and energy cost (total KWH)
for the building.

4. The grand total usage and energy cost is multiplied by the utility  company's
rate per KWH to establish the total cost for kilowatt hours.

5. The total  KWH are  divided  by the total  heat  pump  usage and  charges  to
establish the heat pump hourly rate (column 6).

6. The monthly  tenant  charge is the heat pump hourly  rate  multiplied  by the
total energy units (column 5).

7. Tenant will also pay 42.65% of general usage/common area electric.

                                 ADDITIONAL RENT

                      Real Estate and Insurance Escalation

In  addition  to the  rents  set  forth in the  Lease,  and  heretofore  in this
Schedule, with 1995 as the base year, Tenant shall pay 42.65% of the increase in
real  estate  taxes and other  government  levies in lieu of taxes  (payable  in
October of the  following  year),  and 42.65% of the  increase in  property  and
liability insurance premiums (payable in February of the following year).




                                  EXHIBIT 10.27

                               SUBLEASE AGREEMENT
                                     BETWEEN
                                MEDECISION, INC.
                                       AND
                            PATIENT INFOSYSTEMS, INC.


                              DATED: March 30, 1998



MEDecision,  Inc.  ("MED") is the tenant  under that  certain  office  lease (as
amended  from time to time)  dated as of August  4, 1995 (the  "Lease"  attached
hereto as Exhibit A) with EOP - One Devon Square, L.P. as landlord  ("Landlord")
respecting a portion of the second  floor (the  "Leased  Space") of the building
commonly  known  as One  Devon  Square  (the  "Building"),  situate  at 724 West
Lancaster  Avenue,  Wayne, PA 19087.  MED hereby agrees to sublease a portion of
the Leased Space to Patient InfoSystems, Inc. ("Subtenant") and Subtenant hereby
agrees to sublease such space from MED, on the following terms and conditions:


    1) The Space:

    The subleased space (the "Premises") will consist of a portion of the second
    floor consisting of approximately 2,047 rentable square feet as shown on the
    attached floor plan entitled Exhibit B.


    2) The Term:

    The term of the sublease  agreement (the  "Sublease")  shall commence on the
    later of June 1, 1998, or upon MED's  occupancy of the  premises,  and shall
    terminate at midnight at the close of May 31, 2001  without the  requirement
    of any further notice thereof by either party to the other, except as may be
    provided elsewhere in this Sublease.


    3) Sublease Rent:

    Sublease rent payable by the  Subtenant to MED shall be $3,350.00 per month.
    Rent shall be paid monthly in advance of the first of each month, without
    demand or set-off.


    4) Additional Rent:

    Notwithstanding anything contained in the Lease between MED and the Landlord
    to the contrary or in the Sublease  herein,  the Subtenant shall be directly
    responsible  for the cost of  electricity  which will be billed to Subtenant
    according to paragraph  5.03 of the Lease between MED and Landlord,  and for
    their  proportionate share (according to the formula in paragraph 5.04(a) of
    the Lease  between MED and  Landlord)  of increases in the cost of operating
    and  maintaining  the Building  during all or part of any  calendar  year in
    which this Sublease is in effect.

5) Improvements:

Subtenant  acknowledges  that it has inspected the Premises and agrees to accept
the Premises in their present "as-is"  condition and any improvements will be at
the sole cost of the Subtenant,


6) Insurance:

Subtenant shall maintain,  with MED and Landlord named as additional  insured's,
such liability and other  insurance as is required to be maintained by MED under
the Lease, with such limits and otherwise in accordance such requirements as are
set forth in the Lease.
Subtenant  shall  provide a  Certificate  of  Insurance to MED  indicating  such
coverage.


7) Further Subletting:

Subtenant shall not have the right to further sublease of the Premises.


8) MED Lease:

This Sublease is subject to all of the terms and  conditions of the Lease,  each
of which is hereby incorporated herein by reference and made a part thereof, and
the parties agree that:

(a)   Subtenant shall fully and faithfully perform, with regard to the Premises,
      all of the duties and  obligations  contained in the terms,  covenants and
      conditions  of the Lease to be performed  by MED as tenant.  Each event of
      default set forth in the Lease  respecting  MED and the Leased Space shall
      be equally applicable to Subtenant and the Premises.

(b)   MED, in its  relations  with  Subtenant  hereunder,  shall have all of the
      rights and  remedies  afforded  to Landlord  in it  relations  with MED as
      tenant as set forth in the Lease.  Without  limiting the generality of the
      foregoing,  the  consent  of MED  shall  be  required  for any  action  of
      Subtenant which,  pursuant to the Lease, would require consent of Landlord
      as to the tenant.

(c)   MED is hereby  released  and  relieved  of (i) all of the  obligations  of
      Landlord  as set  forth in the Lease  other  than any  obligation  to give
      notice prior to exercising its rights and remedies, and (ii) any liability
      to Subtenant for any default by Landlord under the Lease or any failure by
      landlord to perform any of its obligations  thereunder,  but MED agrees to
      reasonably cooperate with Subtenant, upon the written request of Subtenant
      and at Subtenant's sole expense,  in enforcing any of such obligations and
      causing landlord to perform same; provided, however, that MED shall not be
      liable to Subtenant in damages if, after reasonable  diligence on the part
      of MED, landlord shall fail to perform such obligations.

(d)     Subtenant acknowledges that the rights granted to it under this Sublease
        agreement  are not in any  sense  greater  or  broader  than the  rights
        granted to MED as tenant under the Lease.


9)      Indemnification:

Subtenant agrees to indemnify and save harmless MED against and from any and all
claims by or on behalf of any person or persons,  firm or firms,  corporation or
corporations, arising from Subtenant's use of the Premises (or the Leased Space)
or the  conduct  of its  business  or from any  activity,  work or  thing  done,
permitted  or suffered by  Subtenant,  in or about the  Premises  (or the Leased
Space),  and from any and all  claims  arising  from any  breach or  default  on
Subtenant's  part in the performance of any covenant or agreement on Subtenant's
part to be performed pursuant to the terms of this Sublease agreement, or any of
its agents, contractors, servants, employees or licensees.


10) Damage to Property:

Neither MED nor its agents or  employees  shall be liable for (a) any damages to
property of Subtenant or of others  entrusted to employees of Landlord,  nor (b)
any  injury  or  damage  to  persons  or  property  resulting  from any cause of
whatsoever  nature unless caused by or due to the negligence of MED, its agents,
servants, or employees, nor (c) any damage caused by other tenants or persons in
the building, nor (d) any latent defects in the Premises or in the Building.


11) Effective Date:

This Sublease  agreement  shall not be effective until it is executed by MED and
Subtenant and approved by Landlord.


12) Time:

Time is of the essence of this  Sublease  Agreement  and of the  performance  by
Subtenant of each and every term and condition hereof and of each and every term
and  condition  of the  Lease  which  Subtenant  has  herein  agreed to keep and
perform.


13) Expiration and Termination:

This Sublease Agreement will become null and void unless executed by all parties
on or before April 3, 1998.

After the first  twenty-four  months of the sublease term has expired,  or after
May 31, 2000,  Subtenant  shall have the right to submit  written  notice to MED
requesting early  termination of the Sublease  agreement  conditioned upon MED's
need for the Leased Space. MED, in its sole discretion,  will determine its need
for the  Leased  Space at that time.  If MED elects to occupy the Leased  Space,
Subtenant  will be granted early  termination  and be released from the Sublease
Agreement. If MED decides it does not need additional Leased Space at that time,
MED will so notify  Subtenant  and  Subtenant  will  continue to be bound by the
terms  and  conditions  of this  Sublease  agreement  for the  remainder  of the
Sublease term.

MED shall have the right,  at any time  after the first  eighteen  months of the
sublease term has expired, or after November 30, 1999, to give six months notice
of termination of this Sublease agreement to Subtenant.

14) Complete Agreement:

This Sublease agreement contains all of the agreements between MED and Subtenant
respecting the subject  matter hereof and may not be modified  except by written
instrument duly executed by the parties.

The terms and  conditions  of this  Sublease  agreement  shall  extend to and be
binding upon the successors and permitted assigns of MED and Subtenant.




By signing in the spaces  provided  below,  MED and Subtenant agree to the terms
and conditions herein set forth, intending to be legally bound thereby.



TENANT
MEDECISION, INC.
BY:   /s/ David St. Claire
ITS:-CEO

SUBTENANT
PATIENT INFOSYSTEMS, INC.
BY:   /s/ Donald A Carlberg
ITS: President & CEO




                                  EXHIBIT 10.28

                    JOINT VENTURE AND STOCKHOLDERS AGREEMENT

        AGREEMENT  made as of the  12th  day of  November,  1998,  by and  among
Maclean Hunter Publishing Limited, an Ontario  corporation  ("MHPL"),  having an
address at 777 Bay Street,  Toronto,  Ontario and Patient  InfoSystems,  Inc., a
Delaware corporation ("PATI"), having an address at 46 Prince Street, Rochester,
New York (both of the foregoing are hereinafter  sometimes  collectively  called
"Stockholders",  and individually called "Stockholder"); and Patient InfoSYSTEMS
Canada Inc.,  an Ontario  corporation  with offices at 777 Bay Street,  Toronto,
Ontario (hereinafter sometimes called the "Corporation").

                                   WITNESSETH

        WHEREAS, the Stockholders own all of the issued and outstanding common 
shares (the "Common Shares") of the Corporation; and

        WHEREAS,  the Stockholders  wish to enter into a joint venture to market
and sell, on an exclusive  basis in Canada,  products and services  developed by
PATI and to jointly manage,  finance and operate the Corporation as set forth in
this Agreement; and

        WHEREAS,  the  Stockholders  desire  to  make  certain  provisions  with
reference to their respective stock holdings in the Corporation;

        NOW  THEREFORE,  in  consideration  of the mutual  promises  hereinafter
contained,  and other good and valuable consideration,  the parties hereto agree
as follows:

I     Definitions

When used in this Agreement,  the following words and phrases shall be deemed to
have the following meanings:

        (a) "transfer", "dispose" and any other term or terms of similar purpose
shall,  without  limitation,  be deemed to include the making or granting of any
sale, exchange,  assignment,  gift, pledge,  hypothecation,  mortgage,  security
interest,  encumbrance or other transfer or disposition  whatsoever,  voluntary,
involuntary  or by  operation  of law,  affecting  title to or the  right to the
possession of, any shares of stock of the Corporation or any interest therein.

        (b) "Stock",  "Shares" and "Shares of Stock" (unless expressly otherwise
stated)  shall be deemed to mean all the Common Shares of the  Corporation,  now
owned or  hereafter  acquired  by the  parties  hereto  or by  persons,  who may
hereafter become a party or agree to be bound by the terms hereof,  irrespective
of the time and manner of such acquisition,  including,  without limitation, any
shares resulting from a split-up, stock dividend or exchange of any stock.

2 .     The Corporation

        (a) Election of  Directors.  The board of  directors of the  Corporation
(the "Board of Directors")  shall consist of four directors and each Stockholder
shall have the right to designate two  representatives to the Board of Directors
to serve  as a  director  of the  Corporation.  In the  event  any  directorship
occupied  becomes  vacant for any reason,  such  vacancy  shall be filled by the
party having the right to designate such director.
        (b)  Directors'  Proceedings.  Unless  waived  in  writing  by  all  the
directors  of the  Corporation,  not less than four  Business  Days (being a day
which is not a  Saturday,  Sunday or public  holiday  in  Toronto,  Ontario  and
Rochester,  New York)  notice  shall be given of all  meetings.  of the Board of
Directors.  A  quorum  for  meetings  of the  Board  of  Directors  shall be two
directors,  including  at least one  nominee of each  Stockholder,  in each case
present  in person or present by means of such  telephone,  electronic  or other
communications  facilities as permit all persons participating in the meeting to
communicate with each other simultaneously and instantaneously (and, for greater
certainty,  a meeting of the Board of Directors may be constituted at which some
directors are present in person and other directors are present by means of such
communication  facilities),  All  questions  proposed for  consideration  of the
directors at a meeting of the Board of  Directors  shall be  determined  and all
resolutions shall be passed, in order to be effective,  by the votes of not less
than a majority of the directors  present at such meeting,  provided that if one
but not both of the designees of either Stockholder is present at any meeting of
the Board of Directors,  the designee of such Stockholder who is present at such
meeting may cast, in addition to his own vote, an additional vote.

        (c) Matters  reserved to  Shareholders.  Notwithstanding  any statute or
other law to the contrary, none of the following matters shall be carried out or
effected  by  the  Corporation  without  the  prior  written  approval  of  both
Stockholders:

         (i)    any  amendments to the articles of  incorporation  or by-laws of
                the Corporation or any amalgamation,  arrangement,  continuance,
                winding up,  dissolution,  liquidation or  reorganization of the
                Corporation;

         (ii)   any  issue of  Shares  or the  granting  of any  option or right
                (including  convertible  securities,  warrants,  or  convertible
                obligations  of any nature) for the  purchase or issuance of any
                Shares  or  other  securities  of  the  Corporation,  except  as
                expressly permitted by any other provisions of this Agreement;

         (iii)  any  transfer  of Shares of the  Corporation  by a  Stockholder,
                except as expressly  permitted by any other  provisions  of this
                Agreement;

         (iv)   any purchase by the Corporation of any of its Shares or any 
other return of capital of the Corporation;

         (v)    any material change in the business of the Corporation from the 
Business defined in section 3(b);

         (vi)   the change in number of directors on the Board of Directors;

         (vii)  any appointment or removal of the accountants or auditors of the
Corporation;

         (viii)   the  approval of any Budget,  or the  approval of any material
                  alteration  in any Budget  previously  approved in  accordance
                  with section 2(g);

         (ix)   any  purchase  of any  shares  or  any  material  assets  by the
                Corporation,  including without limitation any investments in or
                purchase of any business by the Corporation, whether directly or
                by  acquiring  the entity  through or by which the  business  is
                operated or in any other manner;
         (x)    any borrowing or financing by the Corporation or the application
                for, or obtaining of, any line of credit by the Corporation from
                any financial institution or any material alteration in any such
                financing arrangements;
(xi)     any capital or other  expenditures  in excess of $10,000 for any single
such  expenditure or any leasing of capital  equipment
              by the Corporation, in each case
               unless provided for in a Budget previously approved in accordance
with section 2(g);

        (xii)  any  proposed  sale,  lease,  exchange  or other  disposition  of
property or assets of the Corporation;

        (xiii)  any  assignment,  mortgage,  charge,  pledge,  encumbrance of or
                grant of any  security  interest  in,  property or assets of the
                Corporation;

        (xiv)   any provision of any guarantee, indemnity or other financial
support by or to the Corporation; and

        (xv)   any  transactions  between  the  Corporation  and any  person not
               dealing  at  arm's  length  with  the  Corporation  or any of the
               Stockholders, except as specifically referred to in any paragraph
               of this  Agreement  or as  provided  for in a Budget  approved in
               accordance with section 2(g).

        (d)  Stockholders'  Proceedings.  Unless waived in writing by all of the
Stockholders,  not less  than ten  Business  Days  notice  shall be given of any
meeting of the  Stockholders.  A quorum for meetings of the  Stockholders  shall
require the attendance of each Stockholder present in person or by proxy.

        (e) No Casting  Vote.  Neither the President of the  Corporation  or the
chairman of any meeting of the Board of Directors of the  Corporation  or of the
Shareholders shall by virtue of his office,  position or for any other reason be
entitled to any second or casting vote in respect of any matters  coming  before
such meeting.

        (f) Accountants. Until changed in accordance with section 2(c)(vii), the
accountants of the Corporation shall be KPMG.

        (g) Annual Budget.  Not less than 45 days prior to the  commencement  of
each fiscal year of the  Corporation,  the  officers  of the  Corporation  shall
prepare and deliver to the Board of Directors and to the Stockholders a proposed
business  plan and budget for such fiscal year,  which  business plan and budget
shall  set  out  in  reasonable-  detail  the  projected  revenue  and  proposed
expenditures of the Corporation for such fiscal year. The Board of Directors and
the  Stockholders  shall meet prior to the  commencement  of such fiscal year to
consider and approve such  business  plan and budget,  with such  amendments  or
modifications  thereto  as the  Board of  Directors  and the  Stockholders  deem
appropriate (which business plan and budget, as approved,  is herein referred to
as a "Budget").

        (h) Election of 0fficers  Until changed by the Board of  Directors,  the
following persons shall be elected as officers of the Corporation:

                    President                            Allan Cook
                    Vice President, Finance              Timothy L. Root
                    Secretary/Controller                 Barbara Angier

        (i) Compensation and Duties of President.  Allan Cook,- the President of
the Corporation,  will continue to be employed on a full-time basis by PATI. Mr.
Cook's  compensation will be the sole  responsibility of PATI; provided that the
Corporation will reimburse PATI for a pro rata portion of Mr. Cook's base salary
for a year based on the  percentage  of Mr.  Cook's time spent on the affairs of
the  Corporation  in such  year,  but in no  event  shall  MHPL be  required  to
reimburse  PATI for an amount in respect of Mr.  Cook's  salary in excess of the
amount specified in the Budget approved in accordance with Section 2(g) for such
year. In providing his services as President of the  Corporation,  Mr. Cook will
perform such duties for the Corporation and its subsidiaries as may from time to
time be  assigned to him by the Board of  Directors  and he will devote the time
necessary  and exercise the power and  authority to fulfil the  responsibilities
conferred upon him, honestly, diligently, in good faith and in the best interest
of the  Corporation  and its  subsidiaries.  For so long as this Agreement is in
effect, Mr. Cook agrees that any business  opportunity or proposal originated or
offered to Mr. Cook that could reasonably be considered  related to the Business
of  the  Corporation  shall  constitute  and  be  considered   property  of  the
Corporation  and shall be referred to and brought to the  attention of the Board
of Directors of the Corporation at the earliest possible  opportunity.  Mr. Cook
covenants and agrees that in addition to any and all terms of this Agreement, he
shall fulfil all fiduciary obligations that he owes to the Corporation by virtue
of his  position  with the  Corporation  and that  the duty to  fulfil  all such
obligations  shall survive the  termination  of his tenure as President and such
termination  of his tenure  shall not operate as a waiver or release of any such
duty.

3 .    Covenants

        (a) Disclosure of Trade  Secrets.  During the term of this Agreement and
thereafter, each Stockholder will not, except as properly required in conducting
the  Business of the  Corporation,  disclose or utilize,  or  authorize or cause
anyone  else to  disclose  or utilize  for the  profit of anyone  other than the
Corporation, any trade secret or confidential information,  knowledge or data of
the Corporation of which it has knowledge,  including,  without limitation,  any
customer lists not made public by the Corporation.

                  (b)  Covenant Not to Compete Each  Stockholder  covenants  and
agrees with the  Corporation and the other  Stockholder  that it will not during
the term of this Agreement and for so
long as it owns Stock (the "Term') directly or indirectly own, manage,  operate,
control,  finance or otherwise be interested or  participate  in the  ownership,
management,  operation or control of any person, corporation or other entity or,
sell or produce  products  in Canada  which are  directly  competitive  with the
Business of the Corporation.  Each of the Stockholders  hereby acknowledges that
the provisions of this  subparagraph  3(b) shall serve as a prohibition  against
directly or  indirectly  hiring,  offering to hire,  enticing away or in any way
persuading  or  attempting  to  persuade  any  officers,  employees,  agents or,
customers or  prospective  customers of the  Corporation to discontinue or alter
his or its relationship  with the Corporation  during the Term. For the purposes
hereof,  the "Business" of the Corporation shall mean the business carried on by
the  Corporation  consisting  of the  provision  to  patients  and  health  care
providers  in Canada of  patient-directed  health care  information  systems and
services  to  manage,   collect  and  analyze  information  to  improve  patient
compliance  with  prescribed  treatment  protocols,  to improve  the  process of
off-site   management   and  to  enhance   patient  and  provider   information.
Notwithstanding the foregoing, neither Stockholder shall be precluded from:

     (i) carrying on any business  currently  carried on by such  Stockholder or
any  successor to such business or from  continuing  to publish any  publication
currently published by such Stockholder, or successor to any such publication;

     (ii)  acquiring  securities of a class which are traded on a stock exchange
or over the counter as long as such  securities  represent  not more than_20% of
the issued. and outstanding securities of such class; or

     (iii)  acquiring an interest in a business,  either through the acquisition
of shares,  assets or  otherwise,  where the acquired  business  (the  "Acquired
Business") contains, as a part hereof, a business (the "Competing Segment"), the
operation of which would cause the Stockholder to be in breach of the provisions
of this section 3,  providedthat  this exception shall only apply so long as the
following  conditions are applicable:  (A) the Competing Segment did not, in the
financial  year  preceding the  acquisition  by Stockholder or in any subsequent
financial year, account for 40% or more of the revenue of the Acquired Business;
and (B) if the  Competing  Segment  did, in the  financial  year  preceding  the
acquisition by the Stockholder or in any subsequent  financial year, account for
10% or more of the revenues of the Acquired  Business,  the Stockholder uses its
reasonable  efforts  to  dispose of the  Competing  Segment to a third  party on
normal  commercial  terms  within a  reasonable  period of time  following  such
acquisition or following such subsequent financial year, as the case may

        (c) Further  Assurances.  The parties hereto covenant and agree to do or
cause to be done all acts and  things,  whether  by the  Board of  Directors  or
otherwise, to execute and deliver or cause to be executed and delivered all such
instruments  and to exercise or cause to be exercised  any and all voting rights
attaching to the Common Shares of the Corporation  held by each of them in order
that all provisions of this  Agreement  shall be fully and  effectively  carried
out, implemented and given effect to in accordance with the term hereof.

4 .   Stock of the Corporation

        (a) Ownership of Stock. The parties acknowledge and agree that as of the
date hereof there are 100 Common  Shares issued and  outstanding  (and no more),
which are owned as follows:

                    Stockholder                       No. of Common Shares Owned
                    Maclean Hunter Publishing Limited        50
                    Patient InfoSystems, Inc.                50

The  Stockholders  represent and warrant that they are the legal and  beneficial
owners of such Stock and hold such  Stock free and clear of all liens,  security
interests, claims or encumbrances whatsoever.

        (b)  Restrictions  on  Transfer  of Stock.  Except as  provided  in this
Agreement,  no Stockholder  shall transfer or dispose of any of the Stock of the
Corporation  now or  hereafter  owned or held by it  without  the prior  written
consent of the other  Stockholder.  Any attempted or purported transfer of Stock
by any Stockholder in violation of the terms of this Agreement shall be void and
the Corporation shall reject and refuse to transfer on the books any Stock which
may have been transferred in violation of the provisions of this Agreement,  and
the  Corporation  shall  not  recognize  any  person  receiving  any  Stock as a
Stockholder  nor shall any such person have any rights as a  Stockholder  of the
Corporation. Notwithstanding the foregoing, either Stockholder shall be entitled
to,  without the consent of the other  Stockholder,  transfer  all (but not less
than all) of the Stock owned by such  Stockholder to an affiliate (as defined in
the Business Corporations Act (Ontario)) of such Stockholder; provided that such
affiliate  agrees  in  writing  to be bound by the terms of this  Agreement  and
further   provided  that   notwithstanding   such  transfer,   the  transferring
Stockholder shall continue to be bound by the terms of this Agreement.

        (c) Negotiated Sale. If, at any time following the second anniversary of
the date of this Agreement, either Stockholder shall desire to transfer all (but
not part) of its Stock to the other  Stockholder,  the  Stockholder  desiring to
transfer   ("Selling   Stockholder")   shall  give  written   notice   ("Selling
Stockholder's  Notice") to the Corporation and the remaining  Stockholder of the
Corporation  ("Purchasing  Stockholder"),  stating that the Selling  Stockholder
desires to transfer all of the Stock owned by it to the Purchasing  Stockholder.
Following  the  delivery  of  a  Selling   Stockholder's   Notice,  the  Selling
Stockholder  and  the  Purchasing   Stockholder  shall,  in  good  faith,conduct
negotiations  with a view to agreeing upon the terms of the sale of the Stock of
the Selling Stockholder to the Purchasing Stockholder including the price, which
the parties  agree shall be based on the fair market  value of such Stock at the
time of  delivery  of the  Selling  Stockholder's  Notice  and the  terms of any
ongoing  services to be provided by the Selling  Stockholder to the  Corporation
following such sale.  The  Selling-Stockholder  and the  Purchasing  Stockholder
shall also,  in good faith,  consider  alternative  methods by which the Selling
Stockholder may dispose of its interest in the Corporation,  including by way of
the wind up and  dissolution of the  Corporation as  contemplated by paragraph 7
and by way of the sale of all of the Stock of the Selling Stockholder only or of
both the Selling  Stockholder and the Purchasing  Stockholder or of the property
and assets of the Corporation to a third party.  If the Selling  Stockholder and
the Purchasing  Stockholder are unable,  following such good faith negotiations,
to reach an  agreement  for the sale of the Selling  Stockholder's  Stock to the
Purchasing  Stockholder or an agreement as to an alternative manner in which the
Selling  Stockholder  may dispose of its interest in the  Corporation  within 60
days  following the delivery of the Selling  Stockholder's  Notice,  the Selling
Stockholder and the Purchasing Stockholder shall continue as Stockholders, shall
not be required to continue to negotiate and the terms of this  Agreement  shall
continue in full force and effect.  MHPL and PATI agree that neither one of them
shall be  permitted  to deliver a Selling  Stockholder's  Notice until after 180
days following the delivery of a previous Selling Stockholder's Notice.

5 .     Legend on Certificate

        There shall be endorsed upon the Certificate of Stock of the Corporation
heretofore  or  hereafter  issued to the  Stockholders  or to any  other  person
acquiring Stock pursuant to this Agreement, an endorsement reading as follows:


         "The sale, transfer, pledge, assignment granting of a security interest
         in, or other  disposition or  encumbrance of all shares  represented by
         this  Certificate  are subject to the terms and conditions of a certain
         Agreement  entered  into  between  this  Corporation  and  all  of  its
         Stockholders  as of the 12th day of  November,  1998,  for the purposes
         therein  provided,  and any owner hereof is subject to the  obligations
         therein set forth and contained."

  6 .          Contributions of the Stockholders

  (a) Each of the Stockholders agrees to make the following  contribution to the
  Corporation of materials, services and facilities:

               (A) Contributions by PATI.

                      (i)  PATI  agrees  to  provide  to the  Corporation  on an
               exclusive  basis within Canada all products and services  offered
               by PATI  throughout  the world for use by the  Corporation in the
               conduct of its Business. The fees and costs to be charged by PATI
               for such  products and services  shall be at a discount  from the
               lowest  costs  and fees  charged  by PATI for such  products  and
               services to any of its third party customers,  with the amount of
               such discount in each  particular case to be as agreed to between
               MHPL and PATI, acting reasonably.
                      (ii) PATI will  provide all product,  services,  hardware,
               software,  and  support  (the  "Products")  necessary  to operate
               programs  sold  to  the   Corporation  by  PATI.   PATI  will  be
               responsible for all such Products,  including the content thereof
               and will indemnifyand hold harmless MHPL and the Corporation from
               any claim or loss suffered by MHPL or the Corporation relating to
               such Products or the content thereof.

         (iii)  PATI  will  provide  on an  ongoing  basis,  at no charge to the
Corporation, training and marketing expertise as needed by the Corporation.

        (iv) PATI  agrees to offer to the  Corporation,  on an  exclusive  basis
within Canada,  all products and services developed by PATI for which it has the
right under development  agreements,  to the extent  appropriate,  to offer such
rights to the Corporation.  If any such products or services are not accepted by
the  Corporation,  PATI  shall be free to offer and sell any such  products  and
services to any third parties. The fees and costs to be charged by PATI for such
products  and  services  shall be at a discount  from the lowest  costs and fees
charged  by PATI  for such  products  and  services  to any of its  third  party
customers,  with the amount of such  discount in each  particular  case to be as
agreed to between MHPL and PATI, acting reasonably.

        (v) PATI, at its own cost and expense, agrees to support the development
of new products and services unique to the Canadian market.

        (vi) PATI agrees to provide such capital  contributions as are agreed to
by the Board of Directors and  contemplated  by a Budget  approved in accordance
with  section  2(g) hereof with such  capital  contributions  to be equal to the
capital contributions of MHPL.

(B) Contributions to the Corporation by MHPL.

        (i) MHPL will provide sales, sales support and marketing services to the
Corporation through its Customer Communications Division. All commission payment
rates and other  payments to be charged by MHPL for such services  shall be at a
discount  from the lowest rates  charged by MHPL for such services to any of its
third party customers,  with the amount of such discount in each particular case
to be as agreed to between MHPL and PATI, acting reasonably.

        (ii) MHPL will provide to the  Corporation  all required  infrastructure
support  for  the  Corporation,   including,  but  not  limited  to,  occupancy,
telephone,   secretarial,   accounting,  billing,  collection,  reporting,  cash
management,   tax  and  regulatory  requirements.   The  costs  payable  by  the
Corporation  for such  support  shall be $20,000  for the  initial  year of this
Agreement,  and for subsequent  years,  shall be such amount as is provided in a
Budget for such year approved in accordance with section 2(g) hereof.

        (iii) MHPL will generate content for use by the Corporation. The fees to
be charged by MHPL for such content  hall be at a discount  from the lowest fees
charged by MHPL for such content to any of its third party  customers,  with the
amount of such discount in each  particular case to be as agreed to between MHPL
and PATI, acting reasonably.  MHPL will be responsible for all such content, and
will indemnify and hold harmless PATI and the Corporation from any claim or loss
suffered by PATI or the Corporation relating to such content.

        (iv)  MHPL  agrees  to use  its  reasonable  best  efforts  to  identify
opportunities  for the  Corporation  to develop new products and services  using
technology  of PATI that  could be unique to the  Canadian  market.  Where  such
products and services are sold outside  Canada by PATI or its  affiliates,  PATI
agrees to pay to the Corporation a royalty to be agreed upon at the time of such
offer and sale by the Corporation and PATI, acting reasonably.

       (v) MHPL agrees to provide such capital contributions as are agreed to by
        the  Board  of  Directors  and  contemplated  by a  Budget  approved  in
        accordance with section 2(g) hereof with such capital  contributions  to
        be equal to the capital contributions of PATI.

(b)     Equity Option

     PATI hereby grants to MHPL an irrevocable  option (the "Option") to acquire
     200,000 shares of Common Stock of PATI (the "Option Shares") at an exercise
     price of $3.50  per share  exercisable  over a period  of five  years.  The
     parties acknowledge that the Option Shares represent 2.5% of the issued and
     outstanding  shares of PATI on the date  hereof.  PATI agrees that if after
     the date  hereof,  it  completes  a  reconstruction  or  reorganization  or
     recapitalization  of  PATI  or if PATI  amalgamates  into  or with  another
     corporation    or   if   it   completes   a   redivision,    consolidation,
     reclassification,  subdivision  or other change of the common stock of PATI
     (the "Reorganization"), the Option shall, without further act or formality,
     be deemed to be amended in order to provide to MHPL upon  exercise with the
     same number and class of  securities as would have been received by MHPL if
     the Option had been  exercised  immediately  prior to such  Reorganization.
     Upon the termination of this Agreement, MHPL may exercise the Option at any
     time  during  the  period  of 30 days  following  the  termination  of this
     Agreement  provided that at the end of such 30 day period,  the unexercised
     portion of the Option shall  expire.  PATI shall  forthwith  after the date
     hereof deliver to MHPL an option  agreement  reflecting the foregoing terms
     of the Option and shall obtain all  necessary  regulatory  approvals to the
     granting  of the  Option,  and shall  arrange for the listing of the Option
     Shares on the applicable exchange.

7 .     Duration of Agreement

     This Agreement shall remain in full force and effect for as long as both of
     the  Stockholders  own  Stock of the  Corporation  and the  Corporation  is
     actively engaged in the Business;  provided that: (a) if both  Stockholders
     agree in writing,  the  Corporation  may at any time be  dissolved  and its
     business and assets  liquidated in an orderly wind-up of the affairs of the
     Corporation,  with all  benefits  or costs to be shared  equally,  and this
     Agreement shall terminate  effective upon such dissolution;  and (b) at any
     time after the second  anniversary  of the date of this  Agreement,  either
     Stockholder (the "Electing Stockholder") may, by delivery of written notice
     to the  Corporation  and to the other  Stockholder,  elect to surrender its
     Stock to the Corporation for cancellation,  and upon receipt of such notice
     and the certificate of the Electing Stockholder representing the Stock, the
     Corporation  shall  forthwith  distribute  to  the  Stockholders  by way of
     dividend the balance of the retained  earnings of the  Corporation and both
     parties shall be released from their obligations under this Agreement.

8 .     Miscellaneous Provisions

       (a) All prior  agreements  with  regard to the shares of Stock are hereby
cancelled.

        (b) The captions of the various  paragraphs herein are inserted only for
reference and for the convenience of the parties, and in no way define, limit or
describe the scope of this  Agreement,  nor the intent of any of the  provisions
thereof.

        (c) This  Agreement is made under,  and shall be governed by the laws of
the  Province of Ontario in all  respects,  including  matters of  construction,
validity and performance.

        (d) This Agreement  cannot be changed or terminated  orally. A waiver in
one  instance  shall not be  effective  unless it is in writing and shall not be
deemed a continuing waiver.

        (e) This Agreement and the confidentiality agreement between the parties
hereto constitute the entire Agreement between the parties.

        (f) All  pronouns  and words  shall be read in  appropriate  number  and
gender, the
masculine,  feminine and neuter  shall be  interpreted  interchangeably  and the
singular  shall  include the plural and vice  versa,  as the  circumstances  may
require.

9 .     Notice

               Any notice permitted to be given pursuant to this Agreement shall
be in writing  addressed  as follows,  and given by prepaid  private  courier or
otherwise  hand  delivered  or sent by  telecopier  or  other  similar  means of
electronic communication:

                If to MHPL or the Corporation:

                Maclean Hunter Publishing Limited
                Maclean Hunter Building
                777 Bay Street
                Toronto, Ontario
                M5W IA7

                Attention:    Mr. James 0. Hall, Vice-President

                Telecopier:   (416) 596-5901
                and
                Attention:    Mr. Timothy L. Root, Vice President, Finance
                Telecopier-.  (416) 593-3175
                with a copy to:
                Rogers Communications Inc.
                333 Bloor Street
                10th Floor
                Toronto, Ontario
                M4W I G9

                Attention:      Mr. David P. Miller
                                Vice-President, General Counsel

                Telecopier:    (416) 935-3546
                If to PATI or Allan Cook:
                46 Prince Street
                Rochester, New York 14607
                Attention:    Mr. Allan Cook and Mr. Don Carlberg
                Telecopier:    (716) 244-1367

               with a copy to:

               Gibbons, DelDeo, Dolan, Giffinger and Vecchione
               One Riverfront Plaza
               Newark, New Jersey 07102

               Attention:    Mr. Jeffrey A. Baumel

               Telecopier:    (973) 639-6260

Any notice given in  accordance  with the  provisions of this section 9 shall be
deemed  to  have  been  given  and  received  when  so  delivered  or if sent by
telecopier  or  other  electronic  means  of   communication,   on  the  day  of
transmission  thereof if given on a Business Day and during the normal  business
hours of the recipient and if not so given,  on the next Business Day. Any party
hereto may change its address  for notice by notice to the other  parties in the
manner as aforesaid.

10.     Extent Obligations

     This Agreement shall be binding, not only upon the parties hereto, but also
upon their successors and permitted assigns, and they severally agree to execute
any instrument in writing which shall be necessary or proper in carrying out the
purposes and intent of this Agreement.

        IN WITNESS WHEREOF,  the parties hereto have executed this Agreement the
day and year first above written.

                        Maclean Hunter Publishing Limited
                                                     Per:  /s/  Timothy Root
                                                     Per:  /s/  Jim Hall

                            Patient InfoSystems, Inc.
                             Per: /s/ Don A Carlberg
                                                     Per:  /s/ Kent A Tapper


                         Patient InfoSYSTEMS Canada Inc.

                                                     Per:  /s/ Jim Hall

                                                     Per:  /s/ Allan Cook

  The  provisions  of section  2(i) are hereby  accepted and agreed to as of the
12th day of November, 1998.

  /s/ Allan Cook                                      /s/   Marc Thibideau  
  --------------                                      --------------------  
Allan Cook                                             Witness





                                  EXHIBIT 10.29

                             BASIC LEASE INFORMATION
                                  OFFICE LEASE
Lease Date: October 7, 1998
Landlord: Parker Associates
Address of Landlord:    2560 Ninth Street, Suite 117
                      Berkeley, California 94710

                      Tenant: Patient Infosystems

                      Address of Tenant: Suite 220
                      @ Parker Plaza
                     Contact: James Martin       Telephone: 883-2160 x134

                      Premises: Suite 110 in Parker Plaza
                     2560 Ninth Street
                     Berkeley, California

Scheduled Term Commencement Date:  October 26, 1998
Scheduled Length of Term: 1 year
Scheduled Term Expiration Date:  October 25, 1999
Rent:
         Base Rent                  $4,200.00      /month
         Estimated                  $              /month
         Basic Operating Costs.     $              /month

Total Rent                          $_____________/month
Security Deposit and Last Month's Rent:      $6300.00
Tenant's Proportionate Share:
Permitted Use: General Office
Occupancy Density: N/A

The foregoing Basic Lease  Information it  Incorporated  Into and made a part of
this Lease.  Each reference in this Lease to any of the Basic Lease  Information
shall mean the respective  information above set forth and shall be construed to
incorporate  all of the terms  provided  under the  particular  Lease  paragraph
pertaining to such  information.  In the event of any conflict between the Basic
Lease Information and the Lease the latter shall control.

LANDLORD: Parker Associates                          TENANT
                                                     Patient Infosystems
By: /s/  Michael Haimovitz                           By:  /s/ Donald A Carlberg
Its General Partner                                           Its C.E.O.
Date:  10/19/98                                      Date: 10/12/98
forth in any statement provided by landlord under paragraph 29(C) above.  Tenant
shall  have the right not later  than (20) days  following  the  receipt of such
statement,  and upon condition that Tenant shall first deposit with Landlord the
full amount in dispute,  to cause  Landlord's  books and records with respect to
such calendar  year to be audited by certified  public  accountants  selected by
Tenant subject to Landlord's  reasonable right of approval.  The Basic Operating
Cost Adjustment shall be  appropriately  adjusted on the basis of such audit. If
such audit discloses a liability for a refund or credit by Landlord to Tenant in
excess of (10%) of  Tenant's  Proportionate  Share of the Basic  Operating  Cost
Adjustment  previously  reported,  the  cost of such  audit  shall  be  borne by
Landlord.  Otherwise  the cost of such audit shall be paid by Tenant,  if Tenant
shall not request an audit In accordance  with the  provisions of this paragraph
29(e)  within  twenty  (20) days of receipt  of  Landlord's  statement  provided
pursuant to paragraph  29(d),  such statement shall be final and binding for all
purposes hereof,

(a) Tenant shall pay before delinquency any and all taxes levied or assessed and
which  become  payable by Landlord  (or  Tenant)  during the Term of this Lease.
whether or not now customary or within the  contemplation of the parties hereto,
which are based upon,  measured by or otherwise  calculated with respect to: (a)
the value of Tenant's equipment,  furniture, fixtures or other personal property
located  in  the  Premises:  (b)  the  value  of  any  leasehold   improvements,
alterations,  or additions  made in or to the  Premises,  regardless  of whether
title to such  improvements,  alterations  or  additions  shall be in  Tenant or
Landlord:  or (c) this  transaction  or any  document to which Tenant is a party
creating or transferring an interest or an estate in the Premises.

(b) In the  event  that it  shall  not be  lawful  for  Tenant  so to  reimburse
Landlord,  the Rent  shall be revised  to net  Landlord  the same net rent after
imposition of any such tax upon Landlord as would-have  been payable to Landlord
prior to the  imposition of any such tax. All taxes payable by Tenant under this
Paragraph 30 shall be additional rental.

31.Subject to the  provisions of paragraph 10 hereof,  the terms,  covenants and
conditions  contained  herein  shall be binding upon and inure to the benefit of
the heirs,  successors,  executors.  administrators  and  assigns of the parties
hereto.

32.In the event that any action or  proceeding  is brought to enforce  any term,
covenant  or  condition  of this Lease on the part of  Landlord  or Tenant,  the
prevailing party in such litigation shall be entitled to reasonable
attorneys' fees to be fixed by the court in such action or proceeding.

33. No diminution of light,  air or view by any structure which  mayhereafter be
erected  @whether or not by Landlord)  shall entitle  Tenant to any reduction of
Rent,  result in any liability of Landlord to Tenant. or in any other way affect
this Lease or Tenant's obligations hereunder.

34.Tenant  shall  establish  and  maintain  during the Term  hereof a program to
encourage  maximum use of public  transportation by personnel of Tenant employed
on the Promises, Including without limitation the distribution to such employees
of written  materials  explaining the  convenience  and  availability  of public
transportation  facilities  adjacent or  proximate to the  Building,  staggering
working hours of  employees,  and  encouraging  use of such  facilities,  all at
Tenant's sole reasonable cost and expense.

35.(a) The term "Premises" shall be deemed to include (except where such meaning
would be  clearly  repugnant  to the  context)  the off ice  space  demised  and
improvements  now or at any time  hereinafter  comprising  or built in the space
hereby demised.

(b) The paragraph  headings herein are for convenience of reference and shall in
no way define,  increase, limit or describe the scope or intent of any provision
of this Lease,

(C) The term  "Landlord"  in these  presents  shall  include the  Landlord,  its
successors and assigns.  In any case where this Lease is signed by more than one
person, the obligations hereunder shall be joint and several.

(d) The term "Tenant" or any pronoun used in place  thereof  shall  indicate and
include the masculine or feminine,  the singular or plural number,  individuals,
firms or  corporations.  and  their  and each of  their  respective  successors,
executors,  administrators  and  permitted  assigns,  according  to the  context
thereof.

               (e)  Time  is of  the  essence  of  this  Lease  and  all  of its
               provisions,  (f) This Lease shall in all  respects be governed by
               the laws of the State of  California.  (g) This  Lease,  together
               with its  exhibits,  contains all the  agreements  of the parties
               hereto and supersedes any previous  negotiations.  (h) There have
               been no  representations  made by the Landlord or  understandings
               made between the parties other than those set forth in this Lease
               and its exhibits  (1) This Lease may not be modified  except by a
               written  instrument by the parties hereto.  (j) If for any reason
               whatsoever any of the provisions hereof shall be unenforceable or
               ineffective,  all of the other  provisions shall be and remain in
               full force and effect. (k)

36.  Submission of this  instrument for  examination or signature by Tenant does
not constitute a reservation  or option for lease,  and it is not effective as a
lease or otherwise until execution and delivery by both Landlord and Tenant.

IN WITNESS WHEREOF, the parties hereto have executed this Lease the day and year
first above written.

                                                     "LANDLORD"

                                                     Parker Associates


                     Date   10/19/98                By:  /s/ Michael Haimovitz
                                                    Its:   General Partner    

                                    "TENANT"

                               Patient Infosystems

Date   10/12/98                                     By:  /s/ Donald A Carlberg 
                                                    Its:         C.E.O.       





                                   EXHIBIT 11

                 Statement of Computation of Per Share Earnings.

<TABLE>
<CAPTION>
                            PATIENT INFOSYSTEMS, INC.
                        COMPUTATION OF EARNINGS PER SHARE

                                                                                     Year Ended     Year Ended     Year Ended
                                                                                     December 31,   December 31,   December 31,
                                                                                         1998           1997           1996
                                                                                         ----           ----           ----
<S>                                                                                   <C>            <C>            <C>
                                                                                                                  

Net Loss ..........................................................................   $(4,829,467)   $(3,263,351)   $(2,806,436)

Weighted average Common Stock outstanding .........................................     8,018,398      7,980,094      3,678,435

Weighted average Series A Convertible Preferred
   Stock outstanding ..............................................................          --             --        1,296,000

Weighted average Series B Convertible Preferred
   Stock outstanding ..............................................................          --             --          437,500

Series B Convertible Preferred Stock issued May and
   June 1996, calculated using the treasury stock method ..........................          --             --          177,365

Dilutive effect of stock options granted in the preceding
  preceding twelve months, calculated using
  the treasury stock method .......................................................          --             --          758,416
                                                                                        ---------      ---------      ---------
                                                                                                                 
Weighted average common and potential common shares ...............................     8,018,398      7,980,094      6,347,716
                                                                                        =========      =========      =========

Net Loss per share - Basic and Diluted ............................................   $     (0.60)   $     (0.41)   $     (0.44)
                                                                                      ===========    ===========    =========== 
</TABLE>
                                                                                




                                   EXHIBIT 21

                                  Subsidiaries


Name                       Jurisdicition of Organization    Trade Name        
- ----                       -----------------------------    ----------        

Patient Infosystems
 Acquisition Corp.              Delaware                    HealthDesk

Patient Infosystems                                         Patient Infosystems 
 Canada, Inc.                   Ontario, Canada              Canada, Inc.     
                            
                              



<TABLE> <S> <C>

<ARTICLE>                     5
<CIK>                         0001017813
<NAME>                        PATIENT INFOSYSTEMS, INC.
<MULTIPLIER>                                   1
       
<S>                                            <C>
<PERIOD-TYPE>                                  YEAR
<FISCAL-YEAR-END>                              DEC-31-1998
<PERIOD-START>                                 JAN-01-1998
<PERIOD-END>                                   DEC-31-1998
<CASH>                                          6,316,955
<SECURITIES>                                    1,029,674
<RECEIVABLES>                                   1,370,626
<ALLOWANCES>                                      (50,000)
<INVENTORY>                                             0
<CURRENT-ASSETS>                                8,887,233
<PP&E>                                          2,050,001
<DEPRECIATION>                                    867,507
<TOTAL-ASSETS>                                 10,519,727
<CURRENT-LIABILITIES>                             894,339
<BONDS>                                                 0
                                   0   
                                             0
<COMMON>                                           80,200
<OTHER-SE>                                     21,561,094
<TOTAL-LIABILITY-AND-EQUITY>                    9,625,388
<SALES>                                         2,344,072
<TOTAL-REVENUES>                                2,344,072
<CGS>                                           2,529,619
<TOTAL-COSTS>                                   7,686,430
<OTHER-EXPENSES>                                        0
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