EXHIBIT 4.9


                             STOCKHOLDERS AGREEMENT

                  STOCKHOLDERS  AGREEMENT,  dated as of July 17,  1998,  between
MEDIC COMPUTER SYSTEMS,  INC., a North Carolina  corporation  (together with its
affiliates, the "Investor"), WELSH, CARSON, ANDERSON & STOWE V, L.P., a Delaware
limited  partnership  ("WCAS V"),  WELSH,  CARSON,  ANDERSON & STOWE VI, L.P., a
Delaware  limited  partnership  ("WCAS VI"),  WCAS CAPITAL  PARTNERS II, L.P., a
Delaware limited  partnership  ("WCAS CP II"), WILLIAM BLAIR CAPITAL PARTNERS V,
L.P., a Delaware  limited  partnership  ("WBCP V"), and WILLIAM BLAIR  LEVERAGED
CAPITAL FUND LIMITED PARTNERSHIP, a Delaware limited partnership ("WBLCF") (WCAS
V, WCAS VI, WCAS CP II, WBCP V and WBLCF each a "Stockholder" and together,  the
"Stockholders"). Capitalized terms are defined in the text or in Section 12.

                                    RECITALS

                  WHEREAS,  the Issuer  desires that the Investor  enter into an
ongoing   commercial   relationship  with  the  Issuer  and  that  the  Investor
participate in the development of the Issuer's business on an ongoing basis.

                  WHEREAS,  the Issuer wishes to issue to the Investor,  and the
Investor wishes to accept, the Warrant.

                  WHEREAS,  the  Stockholders  are existing  stockholders of the
Issuer.

                  WHEREAS,  the Investor and each of the Stockholders  desire to
make  certain   arrangements  among  themselves  and  to  declare  their  mutual
intentions with respect to the matters set forth herein.

                  NOW  THEREFORE,  in  consideration  of the  foregoing  and the
respective representations, warranties, covenants and agreements hereinafter set
forth, and for other good and valuable consideration the receipt and sufficiency
of which are hereby  acknowledged  by the parties  hereto,  the parties  hereto,
intending to be legally bound hereby, agree as follows:

                  1. Representations and Warranties of the Stockholders. Each of
the  Stockholders  severally  represents  and warrants to the Investor as of the
date hereof as follows:








                  (a) Authority. Such Stockholder has the power and authority to
         execute,  deliver and perform its obligations  under, and to consummate
         the  transactions  contemplated  by, this Agreement,  and has taken all
         necessary  action to authorize the execution,  delivery and performance
         by such  Stockholder of, and  consummation  by such  Stockholder of the
         transactions  contemplated by, this Agreement.  This Agreement has been
         duly  and  validly  executed  and  delivered  by such  Stockholder  and
         constitutes  the  valid and  binding  obligation  of such  Stockholder,
         enforceable  against such  Stockholder  in  accordance  with its terms,
         subject,  as to  enforcement  of remedies,  to  applicable  bankruptcy,
         insolvency, moratorium and other similar laws and to general principles
         of equity.

                  (b)  No  Conflicts.   Neither  the  execution,   delivery  nor
         performance by such  Stockholder of this  Agreement,  nor compliance by
         such  Stockholder  with  the  terms  and  provisions  hereof,  nor  the
         consummation  by  such  Stockholder  of the  transactions  contemplated
         herein,  will  (a)  contravene  any  applicable  provision  of any law,
         statute, rule or regulation.  or any applicable order, writ, injunction
         or decree of any court or  governmental  instrumentality,  (b) conflict
         with or result in any material breach of any term, covenant,  condition
         or other provision of, or constitute a material default under the terms
         of any contractual  obligation to which such  Stockholder is a party or
         by which it or any of its  properties  or assets  are bound or to which
         they may be subject,  or (c) violate or conflict  with any provision of
         the constituent documents of such Stockholder.

                  (c) The Subject  Shares.  Such  Stockholder  is the record and
         beneficial owner of the shares (the "Existing  Shares") of common stock
         of the Issuer,  par value  $0.01 per share (the  "Common  Stock"),  set
         forth  opposite the name of such  Stockholder on Schedule I hereto and,
         upon the  consummation  of the  initial  public  offering of the Common
         Stock,  will be the record  and  beneficial  owner of the  shares  (the
         "Convertible  Preferred Shares", and together with the Existing Shares,
         the  "Shares")  of Common  Stock set  forth  opposite  the name of such
         Stockholder on Schedule I hereto under the caption  "Shares  Underlying
         Convertible  Preferred."  Each  Stockholder  has (or in the case of the
         Convertible  Preferred Shares,  will have) good and marketable title to
         the Shares  owned (or to be owned) by it, free and clear of any claims,
         liens, encumbrances and security interests whatsoever, and has (or will
         have) the sole right to vote such  Shares,  and none of such  Shares is
         (or  will  be)  subject  to  any  voting  trust  or  other   agreement,
         arrangement or restrictions  with respect to the voting of such Shares,
         except as contemplated by this Agreement.

                                       2





         2.  Representations  and  Warranties  of  the  Investor.  The  Investor
represents and warrants to the Stockholders as of the date hereof as follows:

                  (a)  Authority.  The  Investor  has the  corporate  power  and
         authority to execute, deliver and perform its obligations under, and to
         consummate the transactions  contemplated  by, this Agreement,  and has
         taken all  necessary  corporate  action  to  authorize  the  execution,
         delivery and  performance by the Investor of, and  consummation  by the
         Investor of the  transactions  contemplated  by, this  Agreement.  This
         Agreement  has been duly and  validly  executed  and  delivered  by the
         Investor,  and  constitutes  the valid and  binding  obligation  of the
         Investor,  enforceable  against  the  Investor in  accordance  with its
         terms,   subject,   as  to  enforcement  of  remedies,   to  applicable
         bankruptcy,  insolvency,  moratorium  and  other  similar  laws  and to
         general principles of equity.

                  (b)  No  Conflicts.   Neither  the  execution,   delivery  nor
         performance  by the Investor of this  Agreement,  nor compliance by the
         Investor with the terms and provisions  hereof, nor the consummation by
         it of the  transactions  contemplated  herein,  will (a) contravene any
         applicable  provision of any law, statute,  rule or regulation.  or any
         applicable  order,   writ,   injunction  or  decree  of  any  court  or
         governmental  instrumentality,  (b)  conflict  with  or  result  in any
         material breach of any term, covenant, condition or other provision of,
         or  constitute a material  default  under the terms of any  contractual
         obligation  to which the  Investor  is a party or by which it or any of
         its  properties  or assets are bound or to which it may be subject,  or
         (c) violate or conflict with any provision of the constituent documents
         of the Investor.

                  3. Board Designee.  In the event that the Issuer has nominated
an  Investor  Designee to the Board  pursuant  to Section 4.1 of the  Investment
Agreement,  or a  stockholder  vote is  otherwise  required to elect an Investor
Designee  to the  Board in  accordance  with the  terms  of  Section  4.1 of the
Investment Agreement, each Stockholder shall, and, if applicable,  shall use its
best  efforts to cause its  affiliates  to, vote all Shares then held by it (and
its  affiliates)  in favor of the election of such Investor  Designee.  Any vote
cast in  accordance  with this  Section  3 shall be cast in such  manner as will
insure that such vote is duly  counted for  purposes  of  determining  whether a
quorum is present and for purposes of determining the result of such vote.


                                       3





                  4.  Optional Participation in Stock Sales.

                  (a) If any Stockholder or  Stockholders  (for purposes of this
         Section  4, the  "Selling  Stockholders")  shall at any time  desire to
         transfer  any  Shares,  the  Investor  shall be  permitted,  subject to
         subsection  (e) of this Section 4, to  participate  in such transfer on
         the same terms and conditions  applicable to such Selling Stockholders,
         at a price per share equal to the quotient obtained by dividing (x) the
         total  consideration  that a purchaser  provides to purchase all of the
         Subject  Shares that it is purchasing by (y) the total number of Shares
         (the "Subject  Shares") being sold by the Selling  Stockholders and the
         Investor.  The terms of such transfer  shall provide that the liability
         of the Investor and the Selling  Stockholders shall be several, and not
         joint,  in proportion to the proceeds  received by each, and limited in
         the aggregate to the proceeds received by the Investor and each Selling
         Stockholder, respectively, in the transfer.

                  (b) The Selling  Stockholders  intending  to  transfer  Shares
         shall deliver to the Investor a written notice (a "Transfer Notice") of
         a proposed  transfer  subject  to this  Section 4 no later than 30 days
         prior to the proposed closing thereof. Such notice shall make reference
         to the  Investor's  rights  hereunder and shall  describe in reasonable
         detail (i) the total number of Subject  Shares to be transferred by the
         Selling  Stockholders,  (ii) the person to whom such Subject Shares are
         proposed to be  transferred  and (iii) the terms and  conditions of the
         transfer, including the con sideration to be paid therefor.

                  (c) The Investor  shall exercise its right to participate in a
         transfer of Shares  pursuant  to this  Section 4 by  delivering  to the
         Selling  Stockholders  a  written  notice  (a  "Participation  Notice")
         stating its election to do so and  specifying the number of Shares held
         by it to be  transferred  no later  than 15 days  after  receipt of the
         Transfer Notice.  Failure to provide a Participation Notice within such
         15-day period shall be deemed to constitute an election by the Investor
         not to exercise its rights  pursuant to this Section 4, and the Selling
         Stockholders shall have 60 days following the expiration of such 15-day
         period  in  which to sell or  otherwise  dispose  of not more  than the
         number of Subject Shares described in the Transfer Notice, on terms not
         more favorable to such Selling  Stockholders than were set forth in the
         Transfer  Notice.  If, at the end of the 60- day period  following  the
         expiration of such 15-day period,  such Selling  Stockholders  have not
         completed  the proposed  transfer,  such Selling  Stockholders  may not
         transfer such Subject  Shares  without again fully  complying  with the
         provisions  of this Section 4. At any closing  pursuant to this Section
         4, the  Investor  shall be  required  to  deliver  the  certificate  or
         certificates representing the


                                       4





         Shares to be transferred  by it, duly endorsed for transfer,  and shall
         be entitled to receive the net proceeds  allocable to the sale thereof,
         after deduction of the Investor's proportionate share of the reasonable
         expenses of sale, which share shall not exceed an amount  proportionate
         to the amount of such expenses allocated to the Selling Stockholders.

                  (d) The  Investor  shall  have the right to sell an  aggregate
         number of Shares in the same  proportion  to the total number of Shares
         being  transferred as (i) the total number of Shares then  beneficially
         owned by the  Investor  or subject to  issuance  upon  exercise  of the
         Warrant  bears to (ii) the total  number of  Shares  then  owned by the
         Investor and the  Stockholders or issuable upon the immediate  exercise
         of the  Warrant  then owned by the  Investor.  If the  Investor  in its
         capacity  as  Warrantholder  elects to  exercise  its right  under this
         Section 4 to sell  Shares,  it shall only be required  to exercise  its
         Warrant  upon,  and only upon,  the actual sale or  disposition  of the
         Shares to the buyer of such Shares.

                  (e) The obligations of each  Stockholder and the rights of the
         Investor  pursuant  to this  Section 4 shall not apply (i) in the event
         that a Stockholder  that is a limited  partnership  transfers Shares to
         its limited  partners,  (ii) to any transfer of Shares by a Stockholder
         to an  affiliate  and (iii) to any  transfer  of Shares  pursuant  to a
         registered  public  offering  or a public  distribution  under Rule 144
         under the Securities Act.

                  5.  Mandatory Participation in Stock Sales.

                  (a) In the event that any  Stockholder  proposes  to  transfer
         Shares in an arms'-length  transaction,  the  Stockholder  intending to
         transfer Shares shall have the right, subject to subsection (d) of this
         Section  5,  to  require  the  participation  by the  Investor  in such
         transfer,  in the manner set forth in this Section 5, on the same terms
         and conditions  applicable to such Stockholder.  The terms of such sale
         shall provide that the  liability of the Investor and such  Stockholder
         (or Stockholders,  as the case may be) shall be several, and not joint,
         in  proportion  to the  proceeds  received by each,  and limited in the
         aggregate   to  the   proceeds   received  by  the  Investor  and  each
         Stockholder, respectively, in the sale.

                  (b)  The  relevant   Stockholder  shall  exercise  its  rights
         pursuant  to this  Section 5 by  delivering  to the  Investor a written
         notice of such  proposed  transfer  no later  than 30 days prior to the
         proposed  closing  thereof.  Such notice  shall make  reference  to the
         obligations of the Investor  hereunder and shall describe in reasonable
         detail (i) the number of Shares to be transferred by such Stockholder


                                       5





         (or Stockholders, as the case may be), (ii) the person to whom or which
         such  Shares  are  proposed  to be  transferred,  (iii)  the  terms and
         conditions of the  transfer,  including  the  consideration  to be paid
         therefor,  and (iv) the proposed date, time and location of the closing
         of the transfer. The Investor shall thereupon be required to deliver at
         such closing the certificate or certificates representing the Shares to
         be transferred by it, duly endorsed for transfer, and shall be entitled
         to  receive  the net  proceeds  allocable  to the sale  thereof,  after
         deduction  of the  Investor's  proportionate  share  of the  reasonable
         expenses of sale, which share shall not exceed an amount  proportionate
         to the amount of such expenses  allocated to the  Stockholders  selling
         Shares pursuant to this Section 5.

                  (c) The  Investor  shall be  obligated  to sell in a  transfer
         subject to this  Section 5 an  aggregate  number of Shares equal to the
         product of (i) the total  number of Shares then  beneficially  owned by
         the  Investor  or subject to  issuance  upon  exercise  of the  Warrant
         multiplied by (ii) a fraction, the numerator of which equals the number
         of Shares being sold by the  Stockholders  and the denominator of which
         equals the total number of Shares then owned by the  Stockholders.  The
         foregoing  obligation  shall  include  requiring  the  Investor  in its
         capacity as a  Warrantholder  to exercise the Warrant.  Notwithstanding
         the foregoing,  the Investor shall in no event be obligated  under this
         Section 5 to sell Shares in excess of the number of Shares owned by the
         Investor  plus the  number of Shares  for  which  the  Warrant  is then
         exercisable,  taking  into  account  the  application  of the  cashless
         exercise provisions of the Warrant.

                  (d) The  obligations  of the  Investor  and the rights of each
         Stockholder pursuant to this Section 5 shall not apply (i) in the event
         that a Stockholder  that is a limited  partnership  transfers Shares to
         its  limited  partners,  or to a  Competitor,  (ii) to any  transfer of
         Shares by a  Stockholder  to an affiliate  and (iii) to any transfer of
         Shares   pursuant  to  a  registered   public   offering  or  a  public
         distribution under Rule 144 under the Securities Act.

                  6.       Further Assurances.

                  (a) Each  Stockholder  will,  from time to time,  execute  and
         deliver,  or cause to be executed and  delivered,  such  additional  or
         further  consents,  documents and other instruments as the Investor may
         reasonably  request for the  purpose of  effectively  carrying  out the
         transactions contemplated by this Agreement.


                                       6





                  (b) The obligations of the Issuer  contained in Section 3.5 of
         the   Registration   Rights   Agreement  shall  apply  equally  to  the
         Stockholders, mutatis mutandis.

                  (c) In the event that a  Stockholder,  on the one hand, or the
         Investor, on the other hand, intends to transfer a 5% or greater equity
         interest  in  the  Issuer  (in a  single  transaction  or a  series  of
         transactions), the Stockholder intending to effect such transfer or the
         Investor,  as the case may be, shall use its best efforts to notify the
         Investor  or the  Stockholders,  as the case may be,  of such  proposed
         transfer as soon as practicable.

                  7.  Limited  Right to  Repurchase  Shares.  In the  event  the
Transaction  Processing Agreement is terminated by the Issuer pursuant to clause
(iv),  (vi) or (viii) of Section 18(a)  thereof,  then the Issuer shall have the
right,  exercisable  within  30 days  after  the  date of such  termination,  to
repurchase  all (but not less than all)  shares  of Common  Stock  issued to the
Investor  upon any  prior  exercises  of the  Warrant,  to the  extent  that the
Investor  continues  to hold  such  shares  of  Common  Stock  as of the date of
termination.  The per  share  purchase  price for any such  shares  shall be the
Warrant Price (as defined in the Warrant) at which such shares were purchased by
the Investor.  Upon delivery by the Issuer of the aggregate  purchase  price for
such  shares  to the  Investor,  (i)  the  Investor  will  promptly  return  the
certificate or certificates  evidencing such shares,  duly endorsed for transfer
and (ii) regardless of whether or not such  certificates  are so returned,  such
shares shall be deemed to be no longer issued and outstanding.

                  8. Termination. This Agreement, and all rights and obligations
of the  parties  hereunder  shall  terminate  on the earlier to occur of (a) the
mutual written consent of each of the Stockholders and the Investor, and (b) the
date on which the Investor  and its  affiliates  collectively  no longer own any
Registrable  Securities  (as  defined  in the  Registration  Rights  Agreement).
Further, this Agreement, and all rights and obligations of the parties hereunder
shall  terminate  (x) with respect to WCAS V, WCAS VI and WCAS CP II (the "Welsh
Carson  Group") on the date on which the Welsh  Carson  Group no longer  owns at
least twenty  percent  (20%) of the fully  diluted  equity of the Issuer that it
held as of the  date  hereof,  and (y) with  respect  to WBCP V and  WBLCF  (the
"William  Blair  Group") on the date on which the William  Blair Group no longer
owns at least twenty  percent  (20%) of the fully  diluted  equity of the Issuer
that it held as of the date hereof.


                                       7





                  9.       General Provisions.

                  (a) Amendments. This Agreement may not be amended except by an
         instrument in writing signed by each of the parties hereto.

                  (b) Notice.  All notices  and other  communications  hereunder
         shall be in writing and shall be deemed given if hand delivered or sent
         by overnight courier  (providing proof of delivery) to the Stockholders
         or the Investor at their  respective  addresses  set forth below (or at
         such other address for a party as shall be specified by like notice):

If to the Stockholders:                        If to the Investor:
Welsh, Carson, Anderson & Stowe                Medic Computer Systems, Inc.
320 Park Avenue                                8601 Six Forks Road
Suite 2500                                     Suite 300
New York, New York 10022-6815                  Raleigh, North Carolina 27615

Telephone:  (212) 893-9500
Facsimile:  (212) 893-9575                     Telephone:   (919) 847-8102
Attention:  Anthony de Nicola                  Facsimile:   (919) 847-7110
                                               Attention:   Alan Winchester

With a copy to:                                With a copy to:

Reboul, MacMurray, Hewitt, Maynard & Kristol   Misys plc
45 Rockefeller Plaza                           Burleigh House
New York, New York 10111                       Chapel Oak
Telephone:  (212) 841-5700                     Salford Priors, England
Facsimile:  (212) 841-5725                     Worcs WR11 5SH

Attention:  Mark J. Tannenbaum, Esq.           Telephone:   011 44 1386 871-373
                                               Facsimile:   011 44 1386 871-045
                                               Attention:   Ross Graham

and:                                           and:


                                       8






William Blair & Company                        Debevoise & Plimpton
22 West Adams Street                           875 Third Avenue
Chicago, Illinois 60606                        New York, New York 10022
Telephone:  (312) 364-8250                     Telephone: (212) 909-6000
Facsimile:  (312) 236-1042                     Facsimile: (212) 909-6836
Attention:  Timothy M. Murray                  Attention: Paul H.Wilson,Jr.,Esq.

                  (c) Interpretation. When a reference is made in this Agreement
         to Sections,  such  reference  shall be to a Section to this  Agreement
         unless otherwise  indicated.  The headings  contained in this Agreement
         are for  reference  purposes  only and shall not  affect in any way the
         meaning  or  interpretation  of  this  Agreement.  Wherever  the  words
         "include",  "includes" or "including" are used in this Agreement,  they
         shall be deemed to be followed by the words "without limitation".

                  (d)  Counterparts.  This  Agreement  may be executed in one or
         more  counterparts,  all of which shall be considered  one and the same
         agreement,  and  shall  become  effective  when  one  or  more  of  the
         counterparts  have been signed by each of the parties and  delivered to
         the other party, it being  understood that each party need not sign the
         same counterpart.

                  (e)  Entire  Agreement;  No  Third-Party  Beneficiaries.  This
         Agreement  (including the documents and instruments referred to herein)
         (i)  constitutes   the  entire   agreement  and  supersedes  all  prior
         agreements and understandings, both written and oral, among the parties
         with respect to the subject  matter  hereof and (ii) is not intended to
         confer  upon any  person  other than the  parties  hereto any rights or
         remedies hereunder.

                  (f)  Governing  Law. This  Agreement  shall be governed by and
         construed in accordance  with the laws of the State of New York without
         regard to its rules of  conflict  of laws.  Each of the  Issuer and the
         Investor hereby irrevocably and  unconditionally  consents to submit to
         the exclusive  jurisdiction  of the courts of the State of New York and
         of the United  States of America  located in the State of New York (the
         "New York  Courts")  for any  litigation  arising out of or relating to
         this Agreement and the transactions contemplated hereby (and agrees not
         to commence any  litigation  relating  thereto  except in such courts),
         waives any  objection to the laying of venue of any such  litigation in
         the New York  Courts  and  agrees not to plead or claim in any New York
         Court  that such  litigation  brought  therein  has been  brought in an
         inconvenient forum.


                                       9





                  10.  Assignability.  The  Investor  may  transfer  its  rights
hereunder  to any  affiliate to which all or any portion of the Warrant has been
transferred.

                  11.  Enforcement.  The parties agree that  irreparable  damage
would occur in the event that any of the  provisions of this  Agreement were not
performed in accordance with their specific terms or were otherwise breached. It
is  accordingly  agreed that the parties  shall be entitled to an  injunction or
injunctions to prevent  breaches of this  Agreement and to enforce  specifically
the terms and provisions of this Agreement in any New York Court,  this being in
addition to any other remedy to which they are entitled at law or in equity.

                  12.      Definitions

                  "Competitor"  means (a) any entity that engages in any line of
business, or is affiliated with any entity that engages in any line of business,
that is in competition  with the Investor's core business or (b) any entity that
has publicly announced its intention,  or is affiliated with any entity that has
publicly  announced its intention,  to engage in any line of business that is in
competition with the Investor's core business.

                  "Investment  Agreement"  means that the Investment  Agreement,
dated as of the date hereof, between the Issuer and the Investor.

                  "Investor"   is  defined  in  the  first   paragraph  of  this
Agreement.

                  "Issuer"   means  MedE   American   Corporation,   a  Delaware
Corporation.

                  "New York Courts" is defined in Section 10(f).

                  "Participation Notice" is defined in Section 4(c).

                  "Registrable Securities" is defined in the Registration Rights
Agreement.

                  "Registration  Rights Agreement" means the Registration Rights
Agreement, dated as of the date hereof, between the Issuer and the Investor.

                  "Securities Act" means the Securities Act of 1933, as amended.

                  "Selling Stockholders" is defined in Section 4.

                  "Shares" is defined in Section 1(c).


                                       10





                  "Stockholders"  is  defined  in the  first  paragraph  of this
Agreement.

                  "Subject Shares" is defined in Section 4(a).

                  "Transaction   Processing  Agreement"  means  the  Transaction
Processing  Agreement between the Issuer and the Investor,  dated as of the date
hereof.

                  "Transfer Notice" is defined in Section 4(b).

                  "Warrant"  means the warrant  issued by the Issuer to purchase
1,250,000 Shares,  identical to the form attached as Exhibit C to the Investment
Agreement.

                  "WBCP V" is defined in the first paragraph of this Agreement.

                  "WBLCF V" is defined in the first paragraph of this Agreement.

                  "WCAS V" is defined in the first paragraph of this Agreement.

                  "WCAS VI" is defined in the first paragraph of this Agreement.

                  "WCAS  CP II"  is  defined  in the  first  paragraph  of  this
Agreement.


                                       11






                  IN WITNESS WHEREOF, this Stockholders  Agreement has been duly
executed and delivered as of the day and year first written above.

                                      MEDIC COMPUTER SYSTEMS, INC.

                                      By:
                                         -------------------------------------
                                          Name:
                                          Title:

                                      WELSH, CARSON, ANDERSON
                                       & STOWE V, L.P.
                                      By:    WCAS V Partners, General Partner

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

                                      WELSH, CARSON, ANDERSON
                                       & STOWE VI, L.P.
                                      By: WCAS VI Partners, L.P., General
                                          Partner

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

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

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


                                       12





                                      WILLIAM BLAIR CAPITAL PARTNERS
                                       V, L.P.
                                      By: William Blair Capital Partners, LLC,
                                          General Partner

                                      By:
                                         -------------------------------------
                                                Timothy M. Murray


                                      WILLIAM BLAIR LEVERAGED
                                       CAPITAL FUND LIMITED
                                       PARTNERSHIP
                                      By: William Blair & Company, LLC,
                                          General Partner

                                      By:
                                         -------------------------------------
                                                Timothy M. Murray
Acknowledged and confirmed
with respect to Section 7 hereof,

MEDE AMERICA CORPORATION

By:
   -----------------------------
   Name:
   Title:


                                       13




                       STOCKHOLDERS AGREEMENT - SCHEDULE I



Stockholder                                                                   Pre-Split Common   Post Split         Shares
- -----------                                                                   ----------------   ----------         ------
                                                                                                     Common     Underlying
                                                                                                     ------     ----------
                                                                                                               Convertible
                                                                                                               -----------
                                                                                                                 Preferred
                                                                                                                 ---------

                                                                                                             
Welsh, Carson, Anderson & Stowe V                                                    8,205,728    1,790,748       762,600

Welsh, Carson, Anderson & Stowe VI, L.P.                                             8,205,728    1,790,748       762,600

WCAS Capital Partners II, L.P.                                                       1,700,000      370,993

William Blair Capital Partners V, L.P.                                               1,900,000      414,639       176,577

William Blair Leveraged Capital Fund Limited Partnership                               998,662      217,939         92,805


NOTE: The Issuer expects to approve a one-for-4.5823  reverse stock split of its
Common Stock.  Accordingly,  this Schedule  reflects  shares of Common Stock now
owned by the  Stockholders  on a  pre-split  and  post-split  basis.  The Shares
underlying convertible preferred column reflects the post-split figures.


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