<PAGE>

                                                               Exhibit 10.27.1

                                AMENDMENT ONE
                                   TO THE
                         ORACLE ALLIANCE AGREEMENT
                                  BETWEEN
                         MEDICALOGIC/MEDSCAPE, INC.
                                    AND
                             ORACLE CORPORATION

This document ("Amendment One") shall serve to amend the Oracle Alliance
Agreement between Medicalogic Inc (the "Alliance Member") and Oracle
Corporation ("Oracle") dated Jan. 1, 2000 (the "Agreement").

The Agreement is amended as follows:

1.   At the end of Section 2.3.B.2, add the following:

     "With Oracle's written consent, which will not be unreasonably withheld,
     Sublicensee may assign its rights under this Agreement to an entity
     resulting from a merger or sale or other transfer of substantially all of
     Sublicensee's assets provided that the assignee company is not a
     competitor of Oracle, and the assignee agrees in writing to the terms and
     conditions of the Agreement."

2.   Before the last sentence of Section 5.1, add the following:

     "Also, if the audit reveals that the Alliance Member has overpaid fees to
     Oracle, Oracle will use best efforts to reimburse the Alliance Member in a
     timely manner."

3.   Delete Section 6.2 in its entirety.

4.   The following shall be added to the end of the first paragraph of
     Section 6.5:

     "Expiration or termination of a Sublicense Addendum or this Agreement shall
     not affect any sublicense agreement between the Alliance Member and its
     Sublicensees."

5.   Delete Section 8.5 in its entirety and replace with the following:

     "8.5 ASSIGNMENT

     Upon notice to Oracle, Alliance Member may assign its rights under this
     Agreement to an entity resulting from a merger or a sale or other transfer
     of substantially all of Alliance Member's assets provided that the assignee
     company


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<PAGE>

     is not a competitor of Oracle, and the assignee agrees in writing to the
     terms and conditions of the Agreement."

6.   Begin the second sentence of Section 8.10, ad the following:

     "Except with respect to the exclusive remedies of Section 7.1,"

Other than the modifications set forth above, the terms and conditions of the
Agreement remain unchanged and in full force and effect.

The Effective Date of this Amendment One is January 1, 2000.


MEDICALOGIC/MEDSCAPE, INC.                 ORACLE CORPORATION


By: /s/ DONALD BLOODWORTH                  By: /s/ SIMEON ENEMUO
   -------------------------------            ----------------------------
Name: Donald Bloodworth                    Name: SIMEON ENEMUO
     -----------------------------              --------------------------
Title:   CFO                               Title:  CONTRACT SPECIALIST
      ----------------------------               -------------------------


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<PAGE>

[ORACLE LOGO]

                APPLICATION SPECIFIC SUBLICENSE ADDENDUM

This document (the "Addendum") is between Oracle Corporation ("Oracle") and
MedicaLogic/Medscape, Inc. (the "Alliance Member") and shall be governed by
the terms of the Oracle Alliance Agreement between the Alliance Member and
Oracle effective January 1, 2000 (the "Agreement") and the terms set forth
below.

1.    SUBLICENSES

1.1   SUBLICENSE PROGRAMS AND TERMS

           The Alliance Member may only Sublicense Application Specific Full
      Use Programs for which the Alliance Member has previously acquired a
      Supported Development License for the applicable Designated System.
      Notwithstanding any other provision of this Agreement, the Alliance Member
      shall have no right to Sublicense Programs designated as Oracle
      Applications Programs, Oracle Express Programs, Limited Production
      Programs, or other Programs specified by Oracle from time-to-time without
      the prior written consent of Oracle.

           The Alliance Member shall have the right to market and grant
      Sublicenses of Application Specific Full Use Programs under the conditions
      set forth in the Agreement and under the following restrictions:

      A.   Sublicense Application Specific Full Use Programs with the
      Application Program in the Application Package for use on Designated
      Systems to Sublicensees. Each copy of the Application Specific Full Use
      Programs distributed shall be for the Sublicensee's own internal use in
      the Territory only on a single Designated System limited to a maximum
      number of Users; and

      B.   Make and deliver to the Sublicensee a single copy of the Application
      Specific Full Use Programs in the Application Package for each Sublicense
      granted.

           The Alliance Member shall use all practical means available, both
      contractual and technical, to control the restricted use of each
      Application Specific Full Use Program Sublicense. If a Sublicensee uses
      the Application Specific Full Use Program beyond the limited functionality
      described in Section 1.2 hereof, the Alliance Member or Distributor shall
      immediately notify the Sublicensee of such unauthorized use and if the
      Sublicensee fails to discontinue such unauthorized use following
      notification either terminate the Sublicense or forward to Oracle one
      hundred percent (100%) of the applicable Full Use standard Program license
      fees in effect at the time the payment is made to Oracle together with a
      written request by the Sublicensee for a Full Use Program license from
      Oracle. Oracle must approve, in writing, the Sublicensee's request before
      continued use of the Programs by the Sublicensee shall be deemed
      authorized.

1.2   APPLICATION SPECIFIC FULL USE PROGRAMS

           For the purposes of this Addendum, "Application Specific Full Use
      Program(s)" shall mean Programs which are limited to use in conjunction
      with the Application Program. Such use may include development work to
      create modifications to customize such Application Program for the
      Sublicensee's requirements within the scope of the Application Program as
      described in the Application Package Attachment. Application Specific Full
      Use Programs may not be used in conjunction with or to create additional
      functionality or applications not described in the applicable Application
      Package Attachment. Without limiting the usage permitted above, the
      Sublicensee may use the Application Specific Full Use Programs only for
      the purpose of implementation and support of the Application Program.
      "Full Use Programs" shall mean unaltered versions of the Programs with
      all functions intact.

1.3   VALUE-ADDED PACKAGE

           For the purposes of this Addendum, "Application Program(s)" shall
      mean the Alliance Member's value-added application software, described in
      the attached Application Package Attachment with which the Application
      Specific Full Use Programs are to be coupled. "Application Package(s)"
      shall mean the Application Specific Full Use Programs coupled with the
      Application Programs. For purposes of the Agreement, the Application
      Program shall be regarded as the Alliance Member's Value-Added Package.

1.4   TRIAL SUBLICENSES

           The Alliance Member and its Distributors shall be entitled to grant,
      at no charge, up to a maximum combined total of ten (10) temporary Trial
      Sublicenses of the Application Package at any one time. Such Sublicenses
      shall be for evaluation purposes only and shall be for a period not to
      exceed thirty (30) days. The Alliance Member shall pay Oracle Sublicense
      fees for any Trial Sublicenses in excess of thirty (30) days. Each such
      Trial Sublicense shall be Sublicensed under a Sublicense agreement which
      provides for such trial use.

1.5   DISTRIBUTORS

           Oracle Grants the Alliance Member the right to appoint third parties
      ("Distributors") to market and Sublicense the Application Specific Full
      Use Programs in the Territory, under the terms of the Agreement and this
      Addendum. However, Distributors shall have no right to make copies of the
      Programs for Sublicensing and shall obtain all such Programs from the
      Alliance Member. Each Distributor shall execute a written agreement with
      the Alliance Member binding the Distributor to provisions substantially
      similar to those contained in Sections 2.3, 2.4, 2.5, 5.1, 5.2, 6.1, 6.3,
      6.4, 6.5, 7.2.D, 7.5, 8.1, 8.2, 8.3, 8.5, 8.7, 8.9, 8.10, and 8.11 of the
      Agreement and to those contained in Sections 1 (except 1.5), 3, 4, 5, and
      6 of this Addendum. Each obligation of the Alliance Member under such
      provisions shall also be applicable to each Distributor. Each Distributor
      agreement shall also contain any other provisions necessary for the

<PAGE>

      Alliance Member to satisfy its commitments under the Agreement. The
      Alliance Member shall notify Oracle promptly in writing of the appointment
      of each such Distributor.

         In addition, the Alliance Member shall keep executed Distributor
      agreements and records of the Distributor information required under the
      Alliance Member's Sublicense reports, and shall allow Oracle to inspect
      such information as specified under the Agreement. The Alliance Member
      will defend and indemnify Oracle against all damages to Oracle caused by
      the Distributors' failure to include the required contractual terms set
      forth in Section 2.3.B of the Agreement in each Sublicense agreement. The
      Alliance Member agrees to enforce the terms of its Distributor agreements
      required under this Section so as to effect a timely cure of any
      Distributor breach, and to notify Oracle of any known breach of such
      terms.

1.6   DOCUMENTATION

         The Alliance Member shall be responsible for providing documentation
      for Sublicensees. The Alliance Member shall have the right to incorporate
      portions of the Documentation into the Alliance Member's documentation,
      subject to the provisions of Section 5.2 of the Agreement.

2.    SUBLICENSE FEES

2.1   SUBLICENSE FEES AND RATE

         For each copy of the Programs Sublicensed by the Alliance Member or
      its Distributor in the Application Package, the Alliance Member agrees to
      pay Oracle a Sublicense fee equal to forty percent (40%) of the applicable
      license fee for each such Program, as specified in the applicable Price
      List and Alliance Member Price List supplement to such Price List in
      effect at the time the applicable Programs are Sublicensed.

         As further specified in Section 5 of this Addendum, Sublicense fees
      shall be due and payable within twenty (20) days of the last day of each
      month. The Alliance Member shall not be relieved of its obligation to pay
      Sublicense fees owed to Oracle by the nonpayment of such fees by the
      Sublicensee...

         On or after each anniversary during the Term of this Addendum. Oracle
      may amend the Sublicense fee percentage rate set forth above based on
      Oracle'sthen-current standard Sublicense fee percentage rate schedule and
      the actual amount of Sublicense fees received by Oracle hereunder.

2.2   PRICE LIST FOR SUBLICENSES

         Notwithstanding any other provision of the Agreement, the applicable
      Price List for determining Sublicense fees shall be the standard Price
      List in effect at the time the Application Package is Sublicensed.

         Notwithstanding any other provision of this Agreement, if the Alliance
      Member issues a written Sublicense quote and such quote is accepted by the
      applicable Sublicensee, for a period of ninety (90) days after the date
      of submission of the quote to the Sublicensee, the Sublicense fee
      applicable to the Programs identified in the quote shall be based on the
      Price List in effect on such date.

2.3   USERS

         The Sublicense fees for a Program shall be based and priced on the
      applicable User Level for the maximum number of Users for such Program, as
      specified in the Price List. The Alliance Member shall have the right to
      Sublicense Programs on any User basis specified in the Price List in
      effect at the time the applicable Program is Sublicensed.

3.    TERM

         This Addendum shall become effective on the Effective Date of this
      Addendum and shall be valid for three (3) years (the "Term") from the
      Effective Date. Unless terminated as provided in the Agreement. Any
      renewal of this Addendum shall be subject to renegotiation of terms and
      fees.

         Unless the expiration or termination is for default by the Alliance
      Member, the Alliance Member may continue using the release of the Programs
      then in the Alliance Member's possession on the Designated Systems for
      which Development Licenses were granted, solely for the purpose of
      continuing technical support for Sublicenses granted prior to termination.
      Such continued use of the Programs shall be subject to all the provisions
      of this Agreement, including, without limitation, payment of the Technical
      Support Fees specified herein.

4.    TERRITORY

         The Alliance Member shall have the right to market and grant
      Sublicenses of Programs in the United States only (the "Territory").

5.    TECHNICAL SUPPORT

5.1   TECHNICAL SUPPORT FOR SUBLICENSEES

      A.   INSTALLATION

         The Alliance Member or its Distributors will be responsible for any
      assistance needed to install the Application Package at Sublicensee
      sites.

      B.   SUBLICENSING SUPPORT

         The Alliance Member is responsible for providing all technical
      support, training and consultations to its Sublicensees and
      Distributors. In consideration of the payments specified in
      Section 5.2, the Alliance Member shall have the right to use the Oracle
      Technical Support services acquired for its Supported Development
      Licenses to provide technical support services to its Sublicensees
      as further set forth in the Agreement. The Alliance Member shall
      continuously maintain Oracle Technical Support services for the
      Development Licenses during the period during which the Alliance Member
      provides technical support services to any Sublicensees. Any questions
      from the Alliance Member's Sublicensees or Distributors will be referred
      by Oracle to the Alliance Member.

6.2   TECHNICAL SUPPORT FEES

         For Technical Support services for Sublicensees, each year the
      Alliance Member agrees to pay Oracle annual Technical Support Fees for
      each Program Sublicensed under this Addendum, a previous Alliance Member
      Addendum, or previous distribution agreement between the parties hereto,
      where the Sublicensee received technical support services for such
      Application Specific Full Use Program during the applicable support
      period from the Alliance Member. If the Sublicensee has not continuously


                                       2

<PAGE>

     maintained Technical Support services from the earlier of the date of
     Sublicense or the date of shipment, the Alliance Member shall be
     required to reinstate lapsed Technical Support services for the
     applicable Sublicense at the fees set forth in this Section.

          Annual Technical Support Fees for a Program shall be equal to the
     applicable Technical Support Percentage Rate specified below,
     corresponding to the highest Technical Support Services level specified
     below for any Development License used under this Addendum, of the
     cumulative Sublicense fees accrued to Oracle for a Sublicensed Program
     supported by the Alliance Member.

     <TABLE>
     <CAPTION>
     Technical Support                 Technical Support
     Services Level                    Percentage Rate
     -----------------                 -----------------
     <S>                                     <C>
     Silver                                  19%
     Gold                                    26%
     </TABLE>

          In addition, the Alliance Member shall pay reinstatement charges to
     reinstate lapsed Technical Support services at an amount equal to the
     applicable Technical Support Percentage Rate specified above,
     corresponding to the highest Technical Support Services level specified
     below for any Development License used under this Addendum, of the
     cumulative Sublicense fees accrued to Oracle for the Sublicensed
     Program multiplied by the number of years for which Technical Support
     services have lapsed. For example, if the period of lapse was 2.5 years,
     the Alliance Member has acquired Silver Technical Support services for
     its Development Licenses in the Technical Support renewal year, and the
     original Sublicense fee for the Program was $100, then the reinstatement
     fee would be calculated as follows: .19 X $100 X 2.5.

          Upon December 31 of each year, the Alliance Member shall provide
     Oracle a report setting forth all of the Alliance Members' Sublicenses
     and those Sublicensed Programs which were supported by the Alliance
     Member during the calendar year. The report shall also include the
     applicable Technical Support Fees and reinstatement fees due and payable
     to Oracle for such calendar year. The Alliance Member shall provide
     Oracle with payment of all Technical Support Fees and reinstatement fees
     for such calendar year required under the applicable December 31 report
     with such report in the form of a check made out in the amount of such
     fees. All Technical Support Fees paid to Oracle are noncancelable and
     nonrefundable.

          On or after each anniversary during the Term of this Addendum,
     Oracle may amend the Technical Support Percentage Rates set forth above
     based on Oracle's then-current standard Technical Support percentage
     rate schedule.

8.   SUBLICENSE REPORTS

          Within twenty (20) days of the last day of each and every month,
     the Alliance Member shall send Oracle a report detailing for that month:

     A. For each Sublicensed Application Package shipped during the prior
     month, Sublicensee name, address, make/model and operating system of the
     Designated System, date of shipment, Application Specific Full Use
     Programs shipped, maximum number of licensed Users, whether the
     Sublicense is a Trial Sublicense, and total Sublicense fees and
     Technical Support Fees due to Oracle;

     B. For each Application Program licensed to end-users to be used with
     previously installed software licensed by Oracle in conjunction with the
     Application Program, Sublicensee name, address, make/model and operating
     system of the computer, and date of installation; and

     C. The Distributor agreements executed during the prior month, including
     names and addresses of the Distributors.

          The Alliance Member shall require its Distributors to report this
     information to the Alliance Member on a monthly basis and will include
     it in the report for the month in which the Alliance Member received the
     information. The Alliance Member shall provide Oracle with payment of
     all fees required under the monthly report with such report in the form
     of a check made out in the amount of such fees.

7.   ADDITIONAL LICENSES

          During the Term, the Alliance Member may order production release
     versions of Oracle off-the-shelf Programs available as production
     release as of the Effective Date of this Addendum and listed on the Price
     List in effect as of such date. The license fee for Development Licenses
     shall be equal to Oracle's standard list license fees in effect when an
     order is placed. The Alliance Member shall have the right to order
     Programs for use as Marketing Support Licenses at no further charge to
     the Alliance Member. The Alliance Member may obtain Technical Support
     services from Oracle for such Programs under Oracle's applicable
     Technical Support fees and policies in effect when such services are
     ordered.

     The Effective Date of this Addendum shall be January 1, 2000.
                                                  ----------------

     EXECUTED BY THE ALLIANCE MEMBER:

     Authorized Signature: /s/ Donald Bloodworth
                           ---------------------
     Name: Donald Bloodworth
           -------------------------------------
     Title: CFO
            ------------------------------------


     EXECUTED BY ORACLE CORPORATION:


     Authorized Signature: /s/ Simeon Enemuo
                           ---------------------
     Name: /s/ SIMEON ENEMUO
           -------------------------------------
     Title: CONTRACT SPECIALIST
           -------------------------------------


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<PAGE>

Oracle Corporation
500 Oracle Parkway
Redwood Shores, CA 94095
(650) 506-7000
Oracle is a registered trademark of Oracle Corporation.
1-00

<PAGE>

                                AMENDMENT ONE
                                   TO THE
                   APPLICATION SPECIFIC SUBLICENSE ADDENDUM
                                   TO THE
                          ORACLE ALLIANCE AGREEMENT
                                   BETWEEN
                               MEDICALOGIC INC
                                     AND
                              ORACLE CORPORATION

This document ("Amendment One") shall serve to amend the Application Specific
Addendum dated Jan. 1, 2000 (the "Addendum") to the Oracle Alliance Agreement
between Medicalogic Inc (the "Alliance Member") and Oracle Corporation
("Oracle") dated Jan. 1, 2000 (the "Agreement").

The Addendum is amended as follows:

1.   In the first paragraph of Section 2.1, delete the words "forty percent
     (40%)" and replace with the words "thirty-five percent (35%)".

2.   In the second paragraph of Section 2.1, replace the words "twenty (20)"
     with the words "thirty (30)".

3.   In the first sentence of Section 3, delete the words "for three (3) years
     (the "Term") from the Effective Date," replace with the words "until
     December 31, 2001".

4.   In Section 5.2, delete the following:

<TABLE>
<CAPTION>

     "Technical Support                              Technical Support
     Services Level                                  Percentage Rate
     ------------------                              -----------------
     <S>                                             <C>
     Bronze                                                16%
     Silver                                                19%
     Gold                                                  26%"
</TABLE>

and replace with the following:

<TABLE>
<CAPTION>

     "Technical Support                              Technical Support
     Services Level                                  Percentage Rate
     ------------------                              -----------------
     <S>                                             <C>
     Bronze                                                16%
     Product Support & Update Subscription                 19%
</TABLE>

The Alliance Member can sell only Update Subscription Services at fifteen
percent (15%) royalty rate of net license fees, provided that the Alliance
Member does not sell technical phone support to those customers."


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<PAGE>

5.   In Section 6A, delete the words, "and Technical Support Fees due to
     Oracle".

6.   In the first sentence of Section 6, replace the words "twenty (20)" with
     the words "thirty (30)".

Other than the modifications set forth above, the terms and conditions of the
Addendum remain unchanged, and in full force and effect.

The Effective Date of this Amendment One is January 1, 2000.


MEDICALOGIC/MEDSCAPE, INC.                 ORACLE CORPORATION


By: /s/ Donald Bloodworth                  By: /s/ Simeon Enemuo
   -------------------------------            -------------------------------
Name: Donald Bloodworth                    Name: SIMEON ENEMUO
     -----------------------------              -----------------------------
Title:   CFO                               Title:  CONTRACT SPECIALIST
      ----------------------------               ----------------------------


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