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                        NOTE AND SHARE PURCHASE AGREEMENT


                                     Between


                            MEDE AMERICA CORPORATION


                                       and


                         WCAS CAPITAL PARTNERS II, L.P.









                          Dated as of February 14, 1997






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                                TABLE OF CONTENTS

                                                                       Page
                                                                       ----

ARTICLE I.        PURCHASE AND SALE OF SECURITIES.......................  1
                                                                           
         SECTION 1.01  Issuance, Sale and Delivery of                      
                         the Securities.................................  1
         SECTION 1.02  Payment for the Securities.......................  1
         SECTION 1.03  Closing Date.....................................  1
                                                                           
ARTICLE II.       REPRESENTATIONS AND WARRANTIES OF                        
                             THE COMPANY................................  2

         SECTION 2.01  Organization, Qualifications and                    
                                     Corporate Power....................  2
         SECTION 2.02  Authorization of Agreements, Etc.................  2
         SECTION 2.03  Validity.........................................  2
         SECTION 2.04  Authorized Capital Stock.........................  3
         SECTION 2.05  Governmental Approvals...........................  3
         SECTION 2.06  Use of Proceeds..................................  3
         SECTION 2.07  Offering of the Securities.......................  3
         SECTION 2.08  Compliance With Law..............................  4
                                                                           
ARTICLE III.      REPRESENTATIONS AND WARRANTIES                           
                             OF PURCHASER...............................  4
                                                                           
         SECTION 3.01  Certain Securities Laws Matters..................  4
                                                                           
ARTICLE IV.       CONDITIONS TO THE OBLIGATION OF                          
                             PURCHASER..................................  5
                                                                           
ARTICLE V.        CONDITIONS TO THE OBLIGATION OF                          
                             THE COMPANY................................  6
                                                                           
ARTICLE VI.       MISCELLANEOUS.........................................  6
                                                                           
         SECTION 6.01  Expenses.........................................  6
         SECTION 6.02  Survival of Agreement............................  6
         SECTION 6.03  Brokerage........................................  6
         SECTION 6.04  Parties in Interest..............................  7
         SECTION 6.05  Notices..........................................  7
         SECTION 6.06  Law Governing....................................  7
         SECTION 6.07  Entire Agreement; Amendments.....................  7
         SECTION 6.08  Successors and Assigns...........................  8
         SECTION 6.09  Counterparts.....................................  8
         SECTION 6.10  Headings.........................................  8
                                                                          



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                                INDEX TO EXHIBITS

Exhibit              Description
- -------              -----------

EXHIBIT A      Form of 10% Senior Subordinated Note
EXHIBIT B      Form of Registration Rights Agreement

                               INDEX TO SCHEDULES

Schedule             Description
- --------             -----------

2.02(a)        Defaults
2.04(b)        Capital Stock, Options, Warrants, Etc.














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                  NOTE AND SHARE  PURCHASE  AGREEMENT,  dated as of February 14,
1997,  by and between  MEDE AMERICA  CORPORATION,  a Delaware  corporation  (the
"Company"),  and WCAS CAPITAL PARTNERS II, L.P., a Delaware limited  partnership
("Purchaser").

                  WHEREAS the Company  wishes to issue and sell to Purchaser (i)
its 10% Senior Subordinated Note in the principal amount of $25,000,000 and (ii)
1,700,000 shares  (collectively,  the "Shares") of common stock,  $.01 par value
("Common  Stock"),  of the Company,  subject to the conditions set forth herein;
and

                  WHEREAS  Purchaser wishes to purchase said securities,  all on
the terms and subject to the conditions hereinafter set forth;

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


                                       I.

                         PURCHASE AND SALE OF SECURITIES

                  SECTION 1.01 Issuance, Sale and Delivery of the Securities. On
the Closing Date (as defined  herein) the Company shall issue,  sell and deliver
to Purchaser,  and Purchaser  shall purchase from the Company,  (i) a 10% Senior
Subordinated  Note of the Company,  substantially in the form attached hereto as
Exhibit A,  registered  in the name of  Purchaser,  in the  principal  amount of
$25,000,000  (said  note,  and any notes  issued  in  exchange  or  substitution
therefor,  being hereinafter  collectively called the "Subordinated Notes"), and
(ii)  the  Shares,  to be  evidenced  by a  stock  certificate  of  the  Company
registered in the name of the Purchaser.  The Shares and the Subordinated  Notes
are sometimes collectively referred to herein as the "Securities".

                  SECTION  1.02 Payment for the  Securities.  As payment in full
for the Securities being purchased by it hereunder, and against delivery thereof
as aforesaid,  on the Closing Date Purchaser  shall pay to the Company,  by wire
transfer  to an  account  designated  in  writing  by the  Company,  the  sum of
$25,000,000.

                  SECTION  1.03  Closing  Date.  The  closing  of the  sale  and
purchase of the Securities shall take place at the offices of Reboul, MacMurray,
Hewitt, Maynard & Kristol, 45 Rockefeller Plaza, New York, New York, at 10 a.m.,
New York time,  on February 14,  1997,  or at such other date and time as may be
mutually agreed upon by Purchaser and the Company (such date and time of closing
being herein called the "Closing Date").











                                       II.

                  REPRESENTATIONS AND WARRANTIES OF THE COMPANY

                  The Company represents and warrants to Purchaser as follows:

                  SECTION 2.01 Organization, Qualifications and Corporate Power.
The Company is a corporation  duly  incorporated,  validly  existing and in good
standing  under  the  laws of the  State of  Delaware  and is duly  licensed  or
qualified to transact business as a foreign  corporation and is in good standing
in each jurisdiction in which the nature of its business or the ownership of its
properties  makes such licensing or  qualification  necessary,  except where the
failure to be so licensed or qualified would not have a material  adverse effect
on the business,  assets,  operations  or condition  (financial or other) of the
Company (a "Material Adverse  Effect").  The Company has the corporate power and
authority  to own and  hold its  properties  and to  carry  on its  business  as
currently  conducted,  to  execute,  deliver and perform  this  Agreement  and a
Registration Rights Agreement substantially in the form of Exhibit B hereto (the
"Registration Rights Agreement") and to issue, sell and deliver the Securities.

                  SECTION  2.02  Authorization  of  Agreements,   Etc.  (a)  The
execution  and delivery by the Company of this  Agreement  and the  Registration
Rights  Agreement,  the performance by the Company of its obligations  hereunder
and thereunder and the issuance,  sale and delivery of the Securities  have been
duly  authorized by all requisite  corporate  action and, except as set forth in
Schedule 2.02(a) hereto, will not (x) violate any provision of law applicable to
the  Company,  any  order of any  court  or  other  agency  of  government,  the
Certificate of  Incorporation  or By-laws of the Company or any provision of any
indenture,  agreement  or other  instrument  to which the  Company or any of its
properties  or assets  is bound;  (y)  conflict  with,  result in a breach of or
constitute  (with due notice or lapse of time or both) a default  under any such
indenture,  agreement  or other  instrument;  or (z) result in the  creation  or
imposition of any lien,  charge or encumbrance of any nature whatsoever upon any
of the properties or assets of the Company that, in any such case,  would have a
Material Adverse Effect.

                  (b) The Shares  will,  when issued and paid for in  accordance
with the terms hereof, be validly issued, fully paid and nonassessable shares of
Common Stock.  The issuance,  sale and delivery of the Securities is not subject
to any preemptive rights of stockholders of the Company or to any right of first
refusal or other similar right in favor of any person.

                  SECTION 2.03  Validity.  Each of this Agreement and the
Registration Rights Agreement has been duly executed and


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delivered by the Company and constitutes the legal, valid and binding obligation
of the Company, enforceable in accordance with its terms.

                  SECTION 2.04 Capital Stock.  (a) The authorized  capital stock
of the Company  consists  of (i) 250,000  shares of  Preferred  Stock,  $.01 par
value, of which an aggregate  239,956 shares are validly issued and outstanding,
fully paid and  nonassessable,  and (ii) 29,000,000 shares of Common Stock, $.01
par  value,  of which an  aggregate  24,235,038  shares are  validly  issued and
outstanding, fully paid and nonassessable.

                  (b)  Except as set forth in  Schedule  2.04(b)  hereto  and as
contemplated  by  this  Agreement,   (i)  no  subscription,   warrant,   option,
convertible security or other right (contingent or other) to purchase or acquire
any shares of any class of  capital  stock from the  Company  is  authorized  or
outstanding,  (ii) there is no  commitment  of the  Company to issue any shares,
warrants,  options or other such rights or to distribute to holders of any class
of its  capital  stock any  evidences  of  indebtedness  or assets and (iii) the
Company has no obligation (contingent or other) to purchase, redeem or otherwise
acquire any shares of its capital  stock or any  interest  therein or to pay any
dividend or make any other distribution in respect thereof.

                  SECTION 2.05 Governmental Approvals. No registration or filing
with, or consent or approval of, or other action by, any federal, state or other
governmental agency or instrumentality is or will be necessary for (i) the valid
execution,  delivery and  performance  of this  Agreement  and the  Registration
Rights Agreement or (ii) the issuance, sale and delivery of the Securities.

                  SECTION  2.06  Use  of  Proceeds.  None  of  the  transactions
contemplated by this Agreement  (including,  without limitation,  the use of the
proceeds from the sale of the Subordinated  Notes),  will violate or result in a
violation of (a) Section 7 of the  Securities  Exchange Act of 1934, as amended,
or of any regulations issued pursuant thereto,  or (b) Regulations G, T and X of
the Board of Governors of the Federal Reserve System.  None of the proceeds from
the  sale of the  Subordinated  Notes  will be used to  purchase  or  carry  (or
refinance any  borrowings  the proceeds of which were used to purchase or carry)
any "margin  security" within the meaning of said Regulation G, or for any other
purpose which would constitute the transactions contemplated by this Agreement a
"purpose credit" within the meaning of said Regulation G.

                  SECTION 2.07 Offering of the  Securities.  Neither the Company
nor any  person  acting  on its  behalf  has  taken  or  will  take  any  action
(including,  without limitation,  any offer,  issuance or sale of any securities
under circumstances which


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might require the  integration of such securities  with the  Subordinated  Notes
and/or the Shares under the Securities Act of 1933, as amended (the  "Securities
Act"),  or the rules and  regulations of the Securities and Exchange  Commission
(the  "Commission")  thereunder)  which might subject the offering,  issuance or
sale of the Subordinated Notes and/or the Shares to the registration  provisions
of the Securities Act.

                  SECTION  2.08  Compliance  With  Law.  The  Company  is not in
default  in any  material  respect  under any order of any  court,  governmental
authority  or  arbitration  board or  tribunal  or under any  laws,  ordinances,
governmental  rules or regulations to which the Company is subject.  The Company
has not failed to obtain any material  licenses,  permits,  franchises  or other
governmental  authorizations  necessary to the ownership of its properties or to
the conduct of its business.

                                      III.

                   REPRESENTATIONS AND WARRANTIES OF PURCHASER

                  SECTION  3.01  Certain   Securities  Law  Matters.   Purchaser
represents and warrants to the Company as follows:

                  (i)  that  it is  acquiring  the  Securities  and  for its own
         account  for the purpose of  investment  and not with a view to, or for
         sale in connection with, any distribution thereof;

                  (ii) that it is an "accredited investor" within the meaning of
         Regulation D as promulgated by the Commission under the Securities Act;

                  (iii) that it  understands  that (a) neither the  Subordinated
         Notes nor the Shares have been  registered  under the Securities Act by
         reason of their issuance in a transaction  exempt from the registration
         requirements  of the  Securities  Act pursuant to Section 4(2) thereof,
         (b) the  Securities  must  be held  indefinitely  unless  a  subsequent
         disposition thereof is registered under the Securities Act or is exempt
         from such registration,  (c) the Subordinated Notes and the Shares will
         bear a legend to such effect and (d) the Company will make notations on
         its transfer books to such effect;

                  (iv) that it is a  sophisticated  investor with  knowledge and
         experience in business and financial  matters,  is able to evaluate the
         risks and benefits of the investment in the Subordinated  Notes and the
         Shares, has received certain information concerning the Company and has
         had the opportunity to obtain additional information as desired in


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         order to evaluate  the merits of and the risks  inherent in  purchasing
         the Securities; and

                  (v) that it understands  that the exemption from  registration
         afforded  by  Rule  144  under  the   Securities  Act  depends  on  the
         satisfaction  of various  conditions and that, if applicable,  Rule 144
         affords the basis of sales of the  Securities in limited  amounts under
         certain conditions.

                                       IV.

                    CONDITIONS TO THE OBLIGATION OF PURCHASER

                  The  obligation  of  Purchaser  to  purchase  and  pay for the
Securities  to be  purchased  by it  hereunder  on the  Closing  Date is, at its
option,  subject to the  satisfaction,  on or before such date, of the following
conditions:

                  (i) Representations and Warranties to Be True and Correct. The
         representations and warranties  contained in Article II hereof shall be
         true and correct on and as of the Closing  Date with the same force and
         effect as though such  representations  and warranties had been made on
         and as of such date.

             (ii)  Performance.  The Company  shall have  performed and complied
         with all  agreements  and conditions  contained  herein  required to be
         performed or complied with by it prior to or at the Closing Date.

            (iii) Opinion of Counsel.  Purchaser  shall have received an opinion
         of  counsel  to  the  Company,   in  form  and   substance   reasonably
         satisfactory to Purchaser and its counsel,  as to the matters set forth
         in Sections 2.01, 2.02, 2.03, 2.04 and 2.05 hereof.

             (iv) Registration Rights Agreement. The Company shall have executed
         and delivered the Registration Rights Agreement,  and the same shall be
         in full force and effect.

              (v) All  Proceedings to Be  Satisfactory.  All corporate and other
         proceedings  to  be  taken  by  the  Company  in  connection  with  the
         transactions  contemplated  hereby and all documents  incident  thereto
         shall  be  satisfactory  in form and  substance  to  Purchaser  and its
         counsel,  and  Purchaser  and said counsel shall have received all such
         counterpart originals or certified or other copies of such documents as
         they may reasonably request.


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                                       V.

                   CONDITIONS TO THE OBLIGATION OF THE COMPANY

                  The  obligation of the Company to issue,  sell and deliver the
Securities  on the  Closing  Date is, at the  Company's  option,  subject to the
satisfaction, on or before such date, of the following conditions:

             (i)  Representations  and  Warranties  to Be True and Correct.  The
         representations and warranties contained in Article III hereof shall be
         true and correct on and as of the Closing  Date with the same force and
         effect as though such  representations  and warranties had been made on
         and as of such date.

            (ii)  Performance.  Purchaser shall have performed and complied with
         all agreements and conditions contained herein required to be performed
         or complied with by it prior to or at the Closing Date.

           (iii) All Proceedings to Be Satisfactory. All proceedings to be taken
         by Purchaser in connection with the  transactions  contemplated  hereby
         and all documents  incident  thereto shall be  satisfactory in form and
         substance  to the  Company  and its  counsel,  and the Company and said
         counsel shall have received all such counterpart originals or certified
         or other copies of such documents as it may reasonably request.

                                       VI.

                                  MISCELLANEOUS

                  SECTION  6.01  Expenses.  Each party  hereto  will pay its own
expenses in connection with the transactions contemplated hereby, whether or not
such  transactions  shall be consummated;  provided,  however,  that the Company
shall pay the fees and  disbursements of Reboul,  MacMurray,  Hewitt,  Maynard &
Kristol, counsel for Purchaser.

                  SECTION 6.02 Survival of Agreement. All covenants, agreements,
representations  and  warranties  made herein shall  survive the  execution  and
delivery of this Agreement and the issuance, sale and delivery of the Securities
pursuant  hereto,  and all  statements  contained  in any  certificate  or other
instrument  delivered  by the Company  hereunder  shall be deemed to  constitute
representations and warranties made by the Company.

                  SECTION 6.03  Brokerage.  Each party hereto will indemnify and
hold harmless the others against and in respect of


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any claim for brokerage or other  commissions  relative to this  Agreement or to
the transactions contemplated hereby.

                  SECTION 6.04 Parties in Interest. All covenants and agreements
contained in this  Agreement by or on behalf of any of the parties  hereto shall
bind and inure to the benefit of the respective  successors and assigns or legal
representatives of the parties hereto whether so expressed or not.

                  SECTION  6.05  Notices.  All notices,  requests,  consents and
other  communications  hereunder  shall be in  writing  and  shall be  delivered
personally,  sent by nationally  recognized overnight carrier, sent by facsimile
or mailed by first-class registered mail, postage prepaid, addressed as follows:

                  (a)      if to the Company, to it at:

                           90 Merrick Avenue
                           Suite 502
                           East Meadow, New York 11554
                           Attention:  David M. Goldwin, Esq.
                           Fax: (516) 542-4508;

                  (b)      if to Purchaser, to it at:

                           c/o Welsh, Carson, Anderson & Stowe
                           320 Park Avenue
                           Suite 2500
                           New York, New York  10022
                           Attention:  Mr. Anthony J. de Nicola
                           Fax:  (212) 945-2016

                           with a copy to:

                           Reboul, MacMurray, Hewitt, Maynard & Kristol
                           45 Rockefeller Plaza
                           New York, New York  10111
                           Attention:  Mark J. Tannenbaum, Esq.
                           Fax:  (212) 841-5725

                  SECTION 6.06 LAW GOVERNING.  THIS AGREEMENT  SHALL BE GOVERNED
BY AND CONSTRUED IN ACCORDANCE  WITH THE LAWS OF THE STATE OF NEW YORK,  WITHOUT
REGARD TO ITS CONFLICTS OF LAW PROVISIONS.

                  SECTION  6.07 Entire  Agreement;  Amendments.  This  Agreement
constitutes  the entire  agreement  of the parties  with  respect to the subject
matter hereof and may not be modified or amended  except by a writing  signed by
the  Company and  approved  by the holders of not less than  66-2/3% of the then
outstanding


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principal amount of the Subordinated Notes.

                  SECTION  6.08  Successors  and  Assigns.  All  of  the  terms,
covenants and  provisions  of this  Agreement  and of the  agreements  delivered
hereunder  shall be binding  upon and inure to the  benefit  of any  successors,
assigns, legal representatives, or beneficiaries hereof, as the case may be.

                  SECTION 6.09  Counterparts.  This Agreement may be executed in
two or more counterparts,  each of which shall be deemed an original, but all of
which together shall constitute one and the same instrument.

                  SECTION  6.10  Headings.  The  headings  of the  Sections  and
subsections  of this  Agreement  are  inserted for  convenience  only and do not
constitute a part of this Agreement.


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                  IN WITNESS  WHEREOF,  each of the  Company and  Purchaser  has
executed  this Note and Share  Purchase  Agreement  as of the day and year first
above written.

                            MEDE AMERICA CORPORATION

                            By:
                               --------------------------------------
                                         President and Chief
                                          Executive Officer

                            WCAS CAPITAL PARTNERS II, L.P.
                            By: WCAS CP II Partners, General Partner

                            By:
                               --------------------------------------
                                           General Partner




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                                Schedule 2.02(a)
                                    Defaults

The issuance of the Notes shall  constitute an event of default under the Credit
Agreement,  dated  December  18,  1995,  between the Company and Bank of America
Illinois.










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                                Schedule 2.04(a)
                     Capital Stock, Options, Warrants, Etc.

The Company has issued warrants to acquire an aggregate 324,972 shares of Common
Stock to four stockholders.

The  Company  has issued  options to acquire an  aggregate  2,101,500  shares of
Common  Stock  to  certain  former  and  current  employees,   stockholders  and
consultants.










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