Mr. John Marchisin
Executive Vice President
ISH, Inc.
30 Two Bridges Road, Suite 250
Fairfield, NJ 07004

Dear Mr. Marchisin:

I wanted to take this opportunity to thank you for Denise Keathley's services over the last
few months. We have recently filled our Clinical Systems Analyst position and therefore,
will not be in need of Ms. Keathley's services after the week ending May 12, 2006.

We certainly have appreciated the time Denise has dedicated to us and to the advancement
of our Emergency Department Information System.
Thank you.

Sincerely,

Scott D. McCurley, MD
Associate Director
Department of Emergency Medicine