Exhibit 10.3

FIRST AMENDMENT

FIRST AMENDMENT, dated as of February 19, 2013 (this “Amendment”), to the CREDIT
AGREEMENT, dated as of August 20, 2010 and amended and restated as of March 31,
2011 (as amended, supplemented or modified from time to time, the “Credit
Agreement”), among ALLSCRIPTS HEALTHCARE SOLUTIONS, INC., a Delaware
corporation, ALLSCRIPTS HEALTHCARE, LLC, a North Carolina limited liability
company (individually and collectively, the “Borrower”), the several banks and
other financial institutions or entities from time to time parties thereto (the
“Lenders”), JPMORGAN CHASE BANK, N.A., as administrative agent (the
“Administrative Agent”) and the other agents party thereto.

W I T N E S S E T H:

WHEREAS, the Borrower, the Lenders and the Administrative Agent are parties to
the Credit Agreement;

WHEREAS, the Borrower has requested that the Required Lenders approve certain
provisions of the Credit Agreement as set forth herein; and

WHEREAS, pursuant to such request, the Required Lenders are willing to consent
to such amendments on the terms set forth herein;

NOW, THEREFORE, in consideration of the premises and mutual covenants contained
herein, the Borrower, the Administrative Agent and the Required Lenders hereby
agree as follows:

1. Defined Terms. Unless otherwise defined herein, terms defined in the Credit
Agreement and used herein shall have the meanings given to them in the Credit
Agreement.

2. Amendments to Section 1.01 (Defined Terms).

(a) Section 1.01 of the Credit Agreement is hereby amended by adding the
following definitions in proper alphabetical order:

“ACS Agreement”: the Agreement entered into between Affiliated Computer
Services, Inc. and Allscripts Healthcare, LLC on March 31, 2011 to provide
services to support the Borrower’s remote hosting services for Sunrise acute
care clients along with the related sale of a portion of its hosting
equipment and infrastructure for approximately $20 million.

“First Amendment Effective Date”: February [    ], 2013

(b) The definition of “Applicable Pricing Grid” is hereby amended by replacing
the table appearing therein in its entirety with the following table:

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Total Leverage Ratio

   Applicable Margin
for  Eurodollar Loans     Applicable Margin
for ABR Loans     Commitment
Fee Rate  

Level I

   Greater than 2.50 to 1.00      2.75 %      1.75 %      0.45 % 

Level II

   Greater than 2.00 to 1.00 but equal to or less than 2.50 to 1.00      2.50 % 
    1.50 %      0.40 % 

Level III

   Greater than 1.50 to 1.00 but equal to or less than 2.00 to 1.00      2.00 % 
    1.00 %      0.35 % 

Level IV

   Greater than 1.00 to 1.00 but equal to or less than 1.50 to 1.00      1.75 % 
    0.75 %      0.30 % 

Level V

   Equal to or less than 1.00 to 1.00      1.50 %      0.50 %      0.25 % 

(c) The definition of “EBIT” is hereby amended by (i) deleting the word “and”
immediately preceding clause (c) thereof and substituting “;” in lieu thereof
and (ii) inserting the following new clauses (d) and (e) before the second
proviso therein:

“(d) for the Borrower’s fiscal quarters ended during the fiscal year ending
December 31, 2013, cash charges recorded during such quarters by the Borrower or
any of its Subsidiaries in connection with any facility closures, work force
reductions, relocations and product consolidation (provided, that the aggregate
amount of cash charges permitted to be added back for all such quarters pursuant
to this clause (d) shall not exceed $[29,000,000]) and (e) charges up to the
amounts set forth on Schedule 1.1(D) recorded during the fiscal periods
specified therein and relating to the items specified therein;”.

(d) The definition of “EBITDA” is hereby amended by (i) deleting the word “and”
immediately preceding clause (c) thereof and substituting “;” in lieu thereof
and (ii) inserting the following new clauses (d) and (e) before the second
proviso therein:

“(d) for the Borrower’s fiscal quarters ended during the fiscal year ending
December 31, 2013, cash charges recorded during such quarters by the Borrower or
any of its Subsidiaries in connection with any facility closures, work force
reductions, relocations and product consolidation (provided, that the aggregate
amount of cash charges permitted to be added back for all such quarters pursuant
to this clause (d) shall not exceed $29,000,000) and (e) charges up to the
amounts set forth on Schedule 1.1(D) recorded during the fiscal periods
specified therein and relating to the items specified therein;”.

(e) The definition of “Indebtedness” is hereby amended by adding the following
sentence at the end thereof:

 

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“Notwithstanding anything to the contrary set forth herein, in no event shall
payment or any other debt obligations as classified under GAAP of the Borrower
pursuant to the ACS Agreement, as in effect on the First Amendment Effective
Date, constitute Indebtedness of the Borrower under this Agreement.”

(f) The definition of “Permitted Acquisition” is hereby amended by deleting the
ratio “2.0 to 1.0” in clause (f) thereof and substituting in lieu thereof the
ratio “2.5 to 1.0”.

3. Amendment to Section 7.6(d) (Restricted Payments). Section 7.6(d) of the
Credit Agreement is hereby amended by deleting the ratio “2.00 to 1.0” therein
and substituting in lieu thereof the ratio “2.50 to 1.0”.

4. New Schedule to the Credit Agreement. The Credit Agreement is hereby amended
by adding Schedule 1.1(D) (Specified Add-Backs) to the Credit Agreement in the
form attached hereto as Annex A.

5. Effectiveness. This Amendment shall become effective on the date (the “First
Amendment Effective Date”) on which all of the following conditions precedent
have been satisfied or waived:

(a) Amendment. The Administrative Agent shall have received a counterpart of
this Amendment, executed and delivered by a duly authorized officer of each of
the Borrower, the Required Lenders and the Administrative Agent.

(b) Acknowledgement and Consent. The Administrative Agent shall have received an
executed Acknowledgement and Confirmation, in the form attached hereto as Annex
B, from an authorized officer of each Loan Party.

(c) Representations and Warranties and No Default. The Administrative Agent
shall have received a certificate, dated the First Amendment Effective Date and
signed by a Responsible Officer of the Borrower, confirming compliance with the
conditions set forth in paragraphs (a) and (b) of Section 5.2 of the Credit
Agreement as of such date.

(d) Fees. The Administrative Agent shall have received (i) all fees and other
amounts due and payable on or prior to the First Amendment Effective Date for
which invoices have been presented, including all reasonable out-of-pocket
expenses (including reasonable fees, charges and disbursements of counsel)
required to be reimbursed or paid by any Loan Party hereunder or under any other
Loan Document and (ii) a consent fee payable for the account of each Lender
(other than a Defaulting Lender) that has returned an executed signature page to
this Amendment to the Administrative Agent at or prior to 5:00 p.m., New York
City time on February 12, 2013 (the “Consent Deadline” and each such Lender, a
“Consenting Lender”) equal to 0.10% of the sum of (x) the aggregate principal
amount of Term Loans, if any, held by such Consenting Lender as of the Consent
Deadline and (y) the aggregate amount of the Revolving Commitment, if any, of
such Consenting Lender as of the Consent Deadline.

6. Continuing Effect of the Credit Agreement. This Amendment shall not
constitute an amendment of any other provision of the Credit Agreement not
expressly referred to herein and shall not be construed as a waiver or consent
to any further or future action on the part of the Borrower that would require a
waiver or consent of the Lenders or the Administrative Agent. Except as
expressly amended hereby, the provisions of the Credit Agreement and each other
Loan Document are and shall remain in full force and effect. The Borrower and
the other parties hereto acknowledge and agree that this Amendment shall
constitute a Loan Document.

 

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7. Counterparts. This Amendment may be executed in counterparts (and by
different parties hereto on different counterparts), each of which shall
constitute an original, but all of which when taken together shall constitute a
single instrument. Delivery of an executed counterpart of a signature page of
this Amendment by telecopy or electronic transmission shall be effective as
delivery of a manually executed counterpart of this Amendment.

8. GOVERNING LAW; WAIVER OF JURY TRIAL. THIS AMENDMENT AND THE RIGHTS AND
OBLIGATIONS OF THE PARTIES UNDER THIS AMENDMENT SHALL BE GOVERNED BY, AND
CONSTRUED AND INTERPRETED IN ACCORDANCE WITH, THE LAW OF THE STATE OF NEW YORK.
EACH PARTY HERETO HEREBY AGREES AS SET FORTH IN SECTION 10.18 OF THE CREDIT
AGREEMENT AS IF SUCH SECTION WERE SET FORTH IN FULL HEREIN.

9. Expenses. The Borrower agrees to pay or reimburse the Administrative Agent
for all of its reasonable out-of-pocket costs and expenses incurred in
connection with this Amendment, any other documents prepared in connection
herewith and the transaction contemplated hereby, including, without limitation,
the reasonable fees and disbursements of counsel to the Administrative Agent.

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IN WITNESS WHEREOF, the parties hereto have caused this Amendment to be duly
executed and delivered by their proper and duly authorized officers as of the
day and year first above written.

 

ALLSCRIPTS HEALTHCARE SOLUTIONS, INC. By  

/s/ RICHARD J POULTON

  Name: Richard J. Poulton   Title: Chief Financial Officer ALLSCRIPTS
HEALTHCARE, LLC By  

/s/ RICHARD J POULTON

  Name: Richard J. Poulton   Title: Chief Financial Officer

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JPMORGAN CHASE BANK, N.A., individually, as Administrative Agent and as a Lender
By  

/S/ KRYS SZREMSKI

  Name: Krys Szremski   Title: Vice President PT. Bank Negara Indonesia
(Persero) Tbk., as a Lender By:  

/s/ YUDAYAT MOHAMMAD

  Name: Yudayat Mohammad   Title: General Manager By:  

/s/ JERRY PHILLIPS

  Name: Jerry Phillips   Title: Credit Manager PNC BANK, NATIONAL ASSOCIATION,
as a Lender By:  

/s/ W. J. BOWNE

  Name: W. J. Bowne   Title: Senior Vice President Wells Fargo Bank, N.A., as a
Lender By:  

/s/ DAVID J. SANCHEZ SR.

  Name: David J. Sanchez Sr.   Title: Authorized Signer

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THE BANK OF NOVA SCOTIA, as a Lender By:  

/s/ RYAN WHITE

  Name: Ryan White   Title: Managing Director EAST WEST BANK, as a Lender By:  

/s/ ANDREW MARIA

  Name: Andrew Maria   Title: Vice President Bank of America, N.A., as a Lender
By:  

/s/ JEREMY SCHMITT

  Name: Jeremy Schmitt   Title: Vice President RBS Citizens, as a Lender By:  

/s/ KRISTEN L. LENDA

  Name: Kristen L. Lenda   Title: Vice President HSBC Bank USA, N.A., as a
Lender By:  

/s/ KIM PUSZCZEWICZ

  Name: Kim Puszczewicz   Title: Vice President

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CHANG HWA COMMERCIAL BANK, LTD LOS ANGELES BRANCH, as a Lender By:  

/s/ YEN-MAO FANG

  Name: Yen-Mao Fang   Title: AVP & Manager Taiwan Cooperative Bank, Ltd.,
Seattle Branch. Seattle Washington, as a Lender By:  

/s/ MING-CHIH CHEN

  Name: Ming-Chih Chen   Title: V.P. and General Manager Sumitomo Mitsui Banking
Corporation, as a Lender By:  

/s/ DAVID W. KEE

  Name: David W. Kee   Title: Managing Director TD Bank, N.A., as a Lender By:  

/s/ SHREYA SHAH

  Name: Ms. Shreya Shah   Title: Senior Vice President BARCLAYS BANK PLC, as a
Lender By:  

/s/ VANESSA A. KURBATSKIY

  Name: Vanessa A. Kurbatskiy   Title: Vice President

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COMPASS BANK, as a Lender By:  

/s/ CHARLES RANDOLPH

  Name: Charles Randolph   Title: Senior Vice President BMO Harris Bank, N.A.,
as a Lender By:  

/s/ JOHN RASKE

  Name: John Raske   Title: Managing Director Citibank, N.A., as a Lender By:  

/s/ PATRICIA GUERRA HEH

  Name: Patricia Guerra Heh   Title: Vice President Deutsche Bank Trust Company
Americas, as a Lender By:  

/s/ SHIREEN LOH

  Name: Shireen Loh   Title: Assistant Vice President By:  

/s/ SCOTTYE LINDSEY

  Name: Scottye Lindsey   Title: Director

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UBS LOAN FINANCE LLC, as a Lender By:  

/s/ LANA GIFAS

  Name: Lana Gifas   Title: Director By:  

/s/ DAVID URBAN

  Name: David Urban   Title: Associate Director KEYBANK NATIONAL ASSOCIATION, as
a Lender By:  

/s/ SUKANYA V. RAJ

  Name: Sukanya V. Raj   Title: Vice President & Portfolio Manager First
Tennessee Bank National Association, as a Lender By:  

/s/ JAMES H. MOORE, JR.

  Name: James H. Moore, Jr.   Title: Senior Vice President FIRST HAWAIIAN BANK,
as a Lender By:  

/s/ DAWN HOFMANN

  Name: Dawn Hofmann   Title: Senior Vice President Bank of China, Los Angeles
Branch, as a Lender By:  

/s/ HAIYONG YANG

  Name: Haiyong Yang   Title: Vice President & Branch Manager

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FIFTH THIRD BANK, as a Lender By:  

/s/ NATHANIEL E. SHER

  Name: Nathaniel E. Sher   Title: Vice President U.S. Bank, National
Association, as a Lender By:  

/s/ NATHAN M. HALL

  Name: Nathan M. Hall   Title: Assistant Vice President E.Sun Commercial Bank,
Ltd., Los Angeles Branch, as a Lender By:  

/s/ HOMER HOU

  Name: Homer Hou   Title: V.P. & Credit Manager The Northern Trust Company, as
a Lender By:  

/s/ SARA BRAVO

  Name: Sara Bravo   Title: Second Vice President

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The Bank of East Asia, Limited, New York Branch, as a Lender By:  

/s/ JAMES HUA

  Name: James Hua   Title: SVP By:  

/s/ KITTY SIN

  Name: Kitty Sin   Title: SVP SUNTRUST BANK, as a Lender By:  

/s/ JOHN CAPPELLARI

  Name: John Cappellari   Title: Director UNION BANK, N.A., as a Lender By:  

/s/ SARAH WILLETT

  Name: Sarah Willett   Title: Vice President The Bank of Tokyo-Mitsubishi UFJ,
Ltd., as a Lender By:  

/s/ JAIME SUSSMAN

  Name: Jaime Sussman   Title: Vice President MIZUHO CORPORATE BANK, LTD., as a
Lender By:  

/s/ BERTRAM H. TANG

  Name: Bertram H. Tang   Title: Authorized Signatory

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ANNEX A

Schedule 1.1(D)

Specified Add-Backs

 

     Fiscal Quarter
Ended March 31,
2012      Fiscal Quarter
Ended June 30,
2012      Fiscal Quarter
Ended September 30,
2012      Fiscal Quarter
Ended December 31,
2012  

Executive related (severance/retention)

     —           —           —         $ 5,000,000   

Other severance/retention

     —         $ 1,800,000       $ 600,000       $ 700,000   

Shareholder litigation/strategic alternatives/board matters

   $ 3,100,000       $ 2,700,000       $ 2,900,000       $ 2,800,000   

Merger related/other

   $ 1,500,000       $ 1,300,000       $ 800,000       $ 200,000   

Bad debt reserve in respect of aged accounts receivable

     —           —           —         $ 9,700,000   

Total

   $ 4,600,000       $ 5,800,000       $ 4,300,000       $ 18,400,000   

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ANNEX B

ACKNOWLEDGEMENT AND CONFIRMTATION

Each of the parties hereto hereby acknowledges and consents to the First
Amendment, dated as of February     , 2013 (the “Amendment”), to the Credit
Agreement, dated as of August 20, 2010 and amended and restated as of March 31,
2011 (as amended, supplemented or modified from time to time, the “Credit
Agreement”; capitalized terms used herein, but not defined, shall have the
meanings set forth in the Credit Agreement), among ALLSCRIPTS HEALTHCARE
SOLUTIONS, INC., a Delaware corporation, ALLSCRIPTS HEALTHCARE, LLC, a North
Carolina limited liability company, the several banks and other financial
institutions or entities from time to time parties thereto and JPMORGAN CHASE
BANK, N.A., as administrative agent, and agrees with respect to each Loan
Document to which it is a party:

(a) all of its obligations, liabilities and indebtedness under such Loan
Document shall remain in full force and effect on a continuous basis regardless
of the effectiveness of the Amendment; and

(b) all of the Liens and security interests created and arising under such Loan
Document remain in full force and effect on a continuous basis, and the
perfected status and priority of each such Lien and security interest continues
in full force and effect on a continuous basis, unimpaired, uninterrupted and
undischarged, regardless of the effectiveness of the Amendment, as collateral
security for its obligations, liabilities and indebtedness under the Credit
Agreement and under its guarantees in the Loan Documents.

THIS ACKNOWLEDGMENT AND CONFIRMATION AND THE RIGHTS AND OBLIGATIONS OF THE
PARTIES UNDER THIS ACKNOWLEDGMENT AND CONFIRMATION SHALL BE GOVERNED BY, AND
CONSTRUED AND INTERPRETED IN ACCORDANCE WITH, THE LAW OF THE STATE OF NEW YORK.

This Acknowledgment and Confirmation may be executed by one or more of the
parties to this Acknowledgement and Confirmation on any number of separate
counterparts, and all of said counterparts taken together shall be deemed to
constitute one and the same instrument. Delivery of an executed signature page
of this Acknowledgement and Confirmation by email or facsimile transmission
shall be effective as delivery of a manually executed counterpart hereof.

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[LOAN PARTIES] By  

 

  Name:   Title: