Document:

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                                                                   EXHIBIT 10.28

We have omitted certain portions of this document and filed them separately
with the Commission. These portions are marked with an asterisk (*).

                     JOINT MARKETING AND LICENSING AGREEMENT

         This Joint Marketing and Licensing Agreement ("Agreement") is made by
and between HealthStream, Inc., a Tennessee corporation having its principal
place of business at 209 10th Avenue South, Suite 450, Nashville, Tennessee
37203 ("HealthStream") and KnowledgeLinc, Inc. having its principal place of
business at 1358 West 31st Street, Erie, Pennsylvania 16508-1416 ("Licensor").

                                   BACKGROUND

         WHEREAS, Licensor has developed and continues to develop a product
known as KnowledgeLinc Content, Educational Courses providing continuing
education credits to healthcare professionals;

         WHEREAS, HealthStream has developed and marketed and continues to
develop and market a computer-based education system known as the Training
Navigator(TM) ("T.NAV(R)") that delivers and monitors World Wide Web based
content;

         WHEREAS, Licensor and HealthStream wish to enter into a cooperative
effort to deploy Licensor's educational offerings utilizing HealthStream's T.NAV
technology on the World Wide Web;

         WHEREAS, HealthStream wishes to acquire a license and Licensor has
agreed to grant a license to HealthStream for the delivery of the Continuing
Education product, whether now existing or developed by Licensor during the term
of this Agreement, by HealthStream's T.NAV;

         WHEREAS, Licensor and HealthStream wish to provide appropriate
consideration for those efforts that each party has agreed to undertake;

         WHEREAS, Licensor and HealthStream each acknowledge the sufficiency and
adequacy of the value, concessions, and recitations set forth herein;

         NOW THEREFORE, Licensor and HealthStream agree as follows:

                                    ARTICLE 1

                                   DEFINITIONS

For purposes of this Agreement, the terms below shall have the following
meanings:

1.1.     "Educational Product" means a self-contained lesson consisting of
         Licensor Courses, learning objectives, a posttest, and an evaluation.
         Each individual Course, when properly completed is eligible for CE
         credit.

1.2.     "Effective Date" means September 13, 1999, the date on which both
         parties to this Agreement have executed same.

1.3.     "HealthStream" means HealthStream, Inc. and any Subsidiary of
         HealthStream, Inc.

1.4.     "Internet" means the international network of computers and computer
         networks accessible by the public at large of which the World Wide Web
         is a subset.

1.5.     "KnowledgeLinc Courses" means Licensor Courses that are the proprietary
         property of Licensor.

1.6.     "Licensing Fee" means a non-refundable advance on royalties paid by
         HealthStream to Licensor.

1.7.     "Licensor" means KnowledgeLinc, Inc. and any affiliated entity of
         Licensor.

1.8.     "Licensor Courses" means the information contained in healthcare
         library of KnowledgeLinc Content and its incorporated modules
         including, but not limited to text and images that are the proprietary
         property of Licensor in the modules listed in Exhibit A. Licensor
         Courses includes both KnowledgeLinc Courses and Third Party Courses.

                                                  KnowledgeLinc and HealthStream
                                                                    Page 1 of 10
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1.9.     "Net Revenue" means gross revenue derived by HealthStream from
         Transactions Fees less any discounts, refunds, or rebates to customers
         and any payments to distribution partners.

1.10.    "Subsidiary" means a company in which, on a class-by-class basis, more
         than fifty percent (50%) of the stock entitled to vote for the election
         of directors is owned or controlled by another company, but only so
         long as such ownership or control exists.

1.11.    "T.NAV(R)" is a branded trademark of HealthStream and is a computer
         based training product that delivers and monitors World Wide Web based
         Content.

1.12.    "T.NAV(R) Commerce" means HealthStream's proprietary computer based
         training product that is a derivative product of T.NAV(R) with
         additional features added by HealthStream in its sole discretion and
         designated by HealthStream in its sole discretion as "T.NAV(R)v.x.x.c."

1.13.    "Third Party Courses" means Licensor Courses that are the proprietary
         property of a third party to this agreement, including but not limited
         to professional trade associations from which Licensor has licensed.

1.14.    "Transaction Fees" means fees received by HealthStream for healthcare
         related training courses based on Licensor Courses delivered over the
         Internet via the T.NAV(R).

                                    ARTICLE 2

                                 LICENSE GRANTS

2.1      Subject to the payment of the consideration set forth in Article 3,
         Licensor grants to HealthStream a non-exclusive worldwide license to
         deliver the Educational Product on the World Wide Web.

2.2      Upon notice from Licensor that Educational Product is no longer
         appropriate for use because, for example, it contains erroneous or
         outdated information, or in other ways is no longer appropriate for the
         awarding of CE credit, HealthStream shall cease to represent that the
         Educational Product being so delivered is CE accredited. During the
         term of this agreement, Licensor shall restructure the Educational
         Product for CE accreditation at its own expense or shall provide an
         equivalent number of CE hours of content at no expense to HealthStream.
         After this Agreement terminates, HealthStream may, at its option and
         expense, seek to have Licensor update the Educational Product.
         HealthStream may also seek permission from Licensor to continue to
         broadcast the Educational Product without CE credit.

2.3      Licensor shall retain the ownership to all Educational Product,
         including but not limited to, text, images, and audio that have been
         copyrighted by Licensor under permissions and releases granted by the
         authors.

2.4      Any and all rights not expressly granted by either of the parties to
         the other are reserved by the respective party claiming reservation of
         that right.

                                    ARTICLE 3

                                PRICE AND PAYMENT

3.1.     During the term of this Agreement, HealthStream shall pay to Licensor:

         3.1.1.   An * advance on royalties for each credit hour of Licensor
                  Courses it licenses under this agreement, to be paid in three
                  installments: one third (1/3) upon execution of the Agreement,
                  one third (1/3) upon launch of the KnowledgeLinc courses, and
                  one third (1/3) thirty (30) days after the launch. The total
                  advance for current KnowledgeLinc courses is * provided
                  HealthStream licenses all two hundred and fifty nine (259)
                  hours which KnowledgeLinc has published on the Internet.

                                                  KnowledgeLinc and HealthStream
                                                                    Page 2 of 10

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         3.1.2.   A royalty of * of all Net Revenue derived from Transaction
                  Fees on Third-Party Courses; and

         3.1.3.   A royalty of * of all Net Revenue derived
                  from Transaction Fees on KnowledgeLinc Courses.

3.2.     HealthStream agrees to deliver monthly sales statements that detail Net
         Revenue and payment according to the percentages outlined in this
         Article 3 to Licensor within thirty (30) days after the end of each
         calendar quarter. These quarterly reports shall indicate the total
         number of Transactions for which Licensor derives revenue. HealthStream
         shall submit quarterly reports even if no royalties or other amounts
         are due for such month. A monthly finance charge based on an annual
         rate of prime plus 2% will be assessed on all amounts that are paid
         later than thirty (30) days after the end of the last quarter.

                                    ARTICLE 4

                    HEALTHSTREAM RESPONSIBILITIES TO LICENSOR

4.1      HealthStream will designate a project manager with sufficient
         experience and training to resolve issues related to the production,
         review and credentialling issues required by this project.

4.2      HealthStream will submit to Licensor a draft paper based version of
         each Educational Product it has converted to the Web for review and
         approval by Licensor. Licensor will have twenty (20) working days to
         conduct its reviews. Any approvals shall not be unreasonably withheld
         by Licensor.

4.3      HealthStream agrees to make all changes requested by Licensor in a
         timely manner.

4.4      HealthStream will incorporate into each Educational Product:

         4.4.1    identifying logo or brand identifying KnowledgeLinc as the
                  content provider;

         4.4.2    an accreditation statement to be provided by Licensor;

         4.4.3    objectives to be created and provided by Licensor;

         4.4.4    faculty disclosure information about actual or potential
                  conflicts of interest to be provided by Licensor;

         4.4.5    Educational Product evaluation to be provided by Licensor; and

         4.4.6    a post test to be provided by Licensor.

4.5      HealthStream shall be responsible for issuing to qualified
         professionals a document recognizing the attainment of CE credit,
         except as required by the professional associations from whom Licensor
         derives Licensor Courses. HealthStream shall develop a system to bar
         issuance of such documentation unless the participating professional
         has answered seventy-five percent (75%) of the post test questions
         correctly. In the event any of these professional associations bars
         issuance of such documentation from HealthStream, Licensor and
         HealthStream shall devise a process by which HealthStream will
         communicate with the professional association so that it may provide
         written documentation from its offices to HealthStream users.

4.6      HealthStream shall maintain a database of all users of the Educational
         Product and shall provide the following information quarterly to
         Licensor:

         4.6.1    number of users of each Educational Product;

         4.6.2    demographic information;

         4.6.3    names of professionals who were issued letters of CE
                  accreditation for each Educational Product; and

                                                  KnowledgeLinc and HealthStream
                                                                    Page 3 of 10
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         4.6.4    results of evaluations.

4.7      HealthStream shall submit for Licensor approval the format and content
         of advertising, if any, so that Licensor can assure the requirements of
         accrediting body guidelines are met. Licensor will have ten (10)
         working days to review and approve the format and content of such
         advertising.

                                    ARTICLE 5

                    LICENSOR RESPONSIBILITIES TO HEALTHSTREAM

5.1      Licensor will designate a project manager with sufficient experience
         and training to resolve issues related to the production, review and
         credentialling issues required by this project.

5.2      Licensor agrees to accredit each Educational Product produced under
         this Agreement if, to the extent within its power and in its sole
         judgment, Licensor policies and the accrediting body guidelines have
         been complied with in all material aspects.

5.3      Licensor agrees to provide initial accreditation for each Educational
         Product for two (2) years, with one (1) year extensions possible as
         long as, in Licensor's judgment, the material is still current. At its
         sole discretion, in accordance with its responsibilities to the
         accrediting body guidelines, Licensor may determine at any time that
         one or more Educational Product is no longer appropriate for CE
         accreditation. In the event the Licensor finds one or more Educational
         Product no longer appropriate for CE accreditation, HealthStream agrees
         to withdraw the Educational Product, in accordance with Article 2.2.

5.4      For each Educational Product, Licensor shall provide a title,
         objectives, post test, and an evaluation form in a timely fashion.

                                    ARTICLE 6

                           WARRANTIES AND INDEMNITIES

6.1.     Licensor represents and warrants that to the best of its knowledge:

         6.1.1.   Licensor Courses does not infringe any copyright or patent
                  enforceable under the laws of any country;

         6.1.2.   Licensor Courses does not violate the trade secret rights of
                  any third party; and

         6.1.3.   Licensor Courses represents the then existing reasonable
                  standards of care.

6.2.     Each party agrees to indemnify, hold harmless, and defend the other
         from any and all damages, costs, and expenses, including reasonable
         attorneys' fees, incurred in connection with a claim which constitutes
         a breach of the warranties set forth in Section 6.1 provided, the
         charged party is notified promptly in writing of a claim and has sole
         control over its defense or settlement, and the party not charged
         provides reasonable assistance in the defense of the same.

6.3.     Licensor shall have no liability for any claim based on HealthStream's:

         6.3.1.   use or distribution of Licensor Courses after Licensor's
                  written notice that HealthStream should cease use or
                  distribution of Licensor Courses due to a claim, or

         6.3.2.   combination of Licensor Courses with a non-Licensor program or
                  data if such claim would have been avoided by the exclusive
                  use of Licensor Courses.

6.4.     For all claims arising under Section 6.3, HealthStream agrees to
         indemnify and defend Licensor

                                                  KnowledgeLinc and HealthStream
                                                                    Page 4 of 10
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         from and against all damages, costs, and expenses, including reasonable
         attorneys' fees. In the event Licensor notifies HealthStream that it
         should cease distribution of Licensor Courses due to a claim,
         HealthStream may terminate this Agreement.

                                    ARTICLE 7

                        INTELLECTUAL PROPERTY PROVISIONS

7.1.     HealthStream will cause to appear on all marketing or promotional
         materials concerning the Licensor Courses, Licensor's copyright,
         trademark, or patent notices.

7.2.     The parties agree that ownership for any invention conceived or
         developed during the course of this Agreement shall vest in accordance
         with the patent rules governing inventorship.

7.3.     To the extent that source code is written by either party title shall
         vest in the party who has written such code.

7.4.     Each party is responsible for protecting, documenting, and maintaining
         its own intellectual property. Except as expressly set forth herein,
         this Agreement does not grant either party any proprietary rights of
         any type in the other party's materials, services or Content.

7.5.     Both parties acknowledge that, except as otherwise provided herein,
         each party owns and retains all right, title and interest in and to its
         own Content provided to the other party.

7.6.     HealthStream acknowledges that Licensor owns and retains all right,
         title and interest in and to Licensor Courses and all Licensor's
         products and services arising from the performance of this Agreement.

7.7.     Licensor acknowledges that HealthStream owns and retains all right,
         title and interest in and to T.NAV Commerce, the T.NAV Commerce source
         code, the T.NAV Commerce object code, any derivatives of T.NAV Commerce
         and the interface templates designed by HealthStream used to present
         and deliver the Licensor Courses.

                                    ARTICLE 8

                  PROHIBITION AGAINST ASSIGNMENT AND SUBLICENSE

This Agreement, and any rights or obligations hereunder, shall not be assigned
or sublicensed (except as permitted in this Article 8 by either party.
Notwithstanding the foregoing, this Agreement may be assigned to a successor in
interest to all of a party's assets or substantially all of a party's assets and
shall inure to the benefit of and be binding upon successors or purchasers of
substantially all of either party's assets.

                                    ARTICLE 9

                                TERM OF AGREEMENT

Provided this Agreement has been properly executed by an officer of Licensor and
by an officer of HealthStream, the term of this Agreement ("Term") shall run
from the Effective Date until two (2) year(s) after the Effective Date, and
thereafter be automatically extended for additional one (1) year periods unless
either party provides thirty (30) days written notice to the non-terminating
party.

                                                  KnowledgeLinc and HealthStream
                                                                    Page 5 of 10
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                                   ARTICLE 10

                             DEFAULT AND TERMINATION

10.1.    The non-defaulting party may terminate this Agreement in its entirety
         if any of the following events of default occur:

         10.1.1.  if the defaulting party materially fails to perform or comply
                  with this Agreement or any provision hereof;

         10.1.2.  if the defaulting party fails to strictly comply with the
                  provisions of Article 13, or makes an assignment in violation
                  of Article 8;

         10.1.3.  if a party becomes insolvent or admits in writing its
                  inability to pay its debts as they mature, or makes an
                  assignment for the benefit of creditors;

         10.1.4.  if a petition under any foreign, state, or United States
                  bankruptcy act, receivership statute, or the like, as they now
                  exist, or as they may be amended, is filed by a party; or

         10.1.5.  if such a petition is filed by any third party, or an
                  application for a receiver of a party is made by anyone and
                  such petition or application is not resolved favorably or
                  discharged to such party within ninety (90) days.

10.2.    Termination due to a breach of Articles 8 or 13 shall be effective upon
         notice. In all other cases termination shall be effective sixty (60)
         days after notice of termination to the defaulting party if the
         defaults have not been cured within such sixty (60) day period. The
         rights and remedies of the parties provided herein shall not be
         exclusive and are in addition to any other rights and remedies provided
         by law or this Agreement.

                                   ARTICLE 11

                          OBLIGATIONS UPON TERMINATION

11.1.    From and after termination or expiration of this Agreement,
         HealthStream shall not employ Licensor Courses or portions thereof
         which is owned by Licensor, as part or portion of any product that
         HealthStream may use, sell, assign, lease, license, or transfer to
         third parties. Both parties shall cease and desist from all use of the
         other party's name(s) and associated trademark(s) and, upon request,
         deliver to the other party or its authorized representatives or destroy
         all material upon which those name(s) and the associated trademarks
         appear.

11.2.    Articles 6, 7, 11, 12, 13, 14, 15, Section 16.1, and Article 17 shall
         survive termination or expiration of this Agreement.

                                   ARTICLE 12

                WARRANTIES, LIMITATION OF LIABILITY AND REMEDIES

EXCEPT AS EXPRESSLY SET FORTH IN THIS AGREEMENT, NEITHER PARTY MAKES ANY OTHER
WARRANTIES. ANY AND ALL OTHER IMPLIED WARRANTIES OF ANY KIND WHATSOEVER,
INCLUDING THOSE FOR MERCHANTABILITY AND/OR FITNESS FOR A PARTICULAR PURPOSE, ARE
EXPRESSLY EXCLUDED. NEITHER PARTY SHALL BE LIABLE FOR ANY CONSEQUENTIAL
(INCLUDING WITHOUT LIMITATION LOST PROFITS, UNLIQUIDATED INVENTORY, ETC.),

                                                  KnowledgeLinc and HealthStream
                                                                    Page 6 of 10

<PAGE>   7

INCIDENTAL, INDIRECT, ECONOMIC, OR PUNITIVE DAMAGES EVEN IF THE OTHER PARTY HAS
BEEN ADVISED OF THE POSSIBILITY OF SUCH DAMAGES.

                                   ARTICLE 13

                             NONDISCLOSURE AGREEMENT

13.1.    HealthStream expressly undertakes to retain in confidence all
         information and know-how transmitted to HealthStream by Licensor that
         Licensor has identified as being proprietary and/or confidential or
         that, by the nature of the circumstances surrounding the disclosure,
         ought in good faith to be treated as proprietary and/or confidential,
         and will make no use of such information and know-how except under the
         terms and during the existence of this Agreement. HealthStream shall
         not disclose, disseminate or distribute any such confidential
         information or know how to any third party without Licensor's prior
         written consent. HealthStream agrees to use the same degree of care to
         protect Licensor confidential information as HealthStream takes to
         protect its own confidential information of like importance. However,
         HealthStream shall have no obligation to maintain the confidentiality
         of information that:

         13.1.1.  it received rightfully from another party prior to its receipt
                  from Licensor;

         13.1.2.  Licensor has disclosed to a third party without any obligation
                  to maintain such information in confidence; or

         13.1.3.  has been or is independently developed by HealthStream.

13.2.    Further, HealthStream may disclose confidential information as required
         by governmental or judicial order, provided HealthStream gives Licensor
         prompt notice of such order and complies with any confidentiality or
         protective order (or equivalent) imposed on such disclosure.
         HealthStream shall treat the terms and conditions of this Agreement as
         confidential; however, HealthStream may disclose such information in
         confidence to its immediate legal and financial consultants as required
         in the ordinary course of HealthStream's business. HealthStream's
         obligation under this Article 13 shall extend to the earlier of such
         time as the information protected hereby is in the public domain
         through no fault of HealthStream or five (5) years following
         termination or expiration of this Agreement. HealthStream shall not
         disclose any information on Licensor's unannounced products to
         HealthStream's employees or any third party.

13.3.    Licensor shall have the same obligations in Sections 13.1 and 13.2
         above with respect to HealthStream's information and know-how.

13.4.    Both parties shall prepare a mutually acceptable press release, if any,
         to announce this Agreement.

                                   ARTICLE 14

                                     AUDITS

14.1.    During the term of this Agreement, the parties hereto agree to keep all
         usual and proper records and books of account and all usual and proper
         entries relating to Licensor Courses licensed consistent with generally
         accepted accounting principles.

14.2.    Licensor may cause an audit to be made of the applicable HealthStream
         records that pertain to this Agreement for the sole purpose of
         verifying royalty reports issued by HealthStream to

                                                  KnowledgeLinc and HealthStream
                                                                    Page 7 of 10

<PAGE>   8

         Licensor and prompt adjustment shall be made to compensate for any
         errors or omissions disclosed by such audit. Any such audit shall be
         conducted by an independent certified public accountant of national
         stature (e.g., Deloitte) selected by Licensor (other than on a
         contingent fee basis) and shall be conducted during regular business
         hours at HealthStream's offices and in such a manner as not to
         interfere with HealthStream's normal business activities. Any such
         audit shall occur no more than once per calendar year and within six
         (6) months of the end of the calendar year. Licensor shall pay for any
         such audit unless Material discrepancies are disclosed. "Material"
         shall mean the lesser of Five Thousand Dollars (US$5,000.00) or five
         percent (5%) of the amount that should have been reported. If Material
         discrepancies are disclosed, HealthStream agrees to pay Licensor the
         costs associated with the audit not to exceed Five Thousand Dollars
         (US$5,000.00). The auditor shall only disclose the correct data and
         amounts as called for on the royalty reports.

14.3.    Any statement shall affect neither the right to examine and audit nor
         the right to receive an adjustment to the contrary, appearing on checks
         or otherwise, unless expressly agreed to in writing by the party having
         such right.

14.4.    In the event that either party makes any claim with respect to an
         audit, upon the audited party's written request the party who has
         requested such audit will make available to the audited party the
         records and reports pertaining to such audit prepared by the
         independent auditor who performed such audit.

                                   ARTICLE 15

                              NOTICES AND REQUESTS

All notices, authorizations, and requests in connection with this Agreement
shall be deemed given on the day they are deposited in the U.S. mails, postage
prepaid, certified or registered, return receipt requested, or sent by air
express courier, charges prepaid; and addressed as follows:

LICENSOR:                  KnowledgeLinc, Inc.
                           Daniel Dubowski
                           1358 West 31st Street
                           Erie, Pennsylvania 16508-1416

HEALTHSTREAM:              HealthStream, Inc.
                           Robert H. Laird, Jr.
                           General Counsel
                           209 10th Avenue South
                           Suite 450
                           Nashville, Tennessee 37203

or to such other address as the party to receive the notice or request so
designates by written notice to the other.

                                                  KnowledgeLinc and HealthStream
                                                                    Page 8 of 10
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                                   ARTICLE 16

                                 CONTROLLING LAW

16.1.    This Agreement shall be construed and controlled by the laws of the
         State of Tennessee.

16.2.    Neither this Agreement, nor any terms and conditions contained herein,
         shall be construed as creating a partnership, joint venture or agency
         relationship or as granting a franchise as defined in 16 CFR Section
         436.2(a). The price and payment described in Article 3 of this
         Agreement shall be construed as a royalty fee for the rights granted in
         Article 2 of this Agreement, and not as a franchise fee.

                                   ARTICLE 17

                                 ATTORNEYS' FEES

If either HealthStream or Licensor employs attorneys to enforce any rights
arising out of or relating to this Agreement, the prevailing party in any
proceeding shall be entitled to recover its reasonable attorneys' fees, costs
and other expenses.

                                   ARTICLE 18

                                     GENERAL

18.1.    This Agreement does not constitute an offer by HealthStream and it
         shall not be effective until signed by both parties. Upon execution by
         both parties, this Agreement shall constitute the entire agreement
         between the parties with respect to the subject matter hereof and
         replaces and supplants all prior and contemporaneous. It shall not be
         modified except by a written agreement signed on behalf of Licensor and
         HealthStream by their respective duly authorized representatives.
         Unless agreed to in a separate writing signed by both parties, any
         statement appearing as a restrictive endorsement on a check or other
         document which purports to modify a right, obligation or liability of
         either party shall be of no force and effect.

18.2.    If any provision of this Agreement shall be held by a court of
         competent jurisdiction to be illegal, invalid, or unenforceable, the
         remaining provisions shall remain in full force and effect. If this
         Agreement as it relates to any product(s) licensed hereunder shall be
         held by a court of competent jurisdiction to be invalid, illegal, or
         unenforceable or if this Agreement is terminated as to particular
         product(s), this Agreement shall remain in full force and effect as to
         the remaining product(s).

18.3.    No waiver of any breach of any provision of this Agreement shall
         constitute a waiver of any prior, concurrent or subsequent breach of
         the same or any other provisions hereof, and no waiver shall be
         effective unless made in writing and signed by an authorized
         representative of the waiving party.

18.4.    The Article headings used in this Agreement and the attached Exhibits
         are intended for convenience only and shall not be deemed to supersede
         or modify any provisions.

         IN WITNESS WHEREOF, the parties have executed this Agreement as of the
date set forth in Section 1.5 above. All signed copies of this Agreement shall
be deemed originals.

         /s/  Daniel Dubowski                        /s/  Robert A. Frist, Jr.
         -------------------------------             ---------------------------
         KnowledgeLinc, Inc.                         HealthStream, Inc.
         Dan Dubowski                                Robert Frist
         President                                   Chief Executive Officer

                                                  KnowledgeLinc and HealthStream
                                                                    Page 9 of 10
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                                    EXHIBIT A
                                LICENSOR COURSES

                                                  KnowledgeLinc and HealthStream
                                                                   Page 10 of 10<PAGE>   1
                                                                   EXHIBIT 10.30
                               HEALTHSTREAM, INC.
                          EMPLOYEE STOCK PURCHASE PLAN

                                    ARTICLE I
                                  INTRODUCTION

         1.1 Establishment of Plan. HealthStream, Inc., a Tennessee corporation
("HealthStream") with its principal offices located in Nashville, Tennessee,
adopts the following employee stock purchase plan for its eligible employees.
This Plan shall be known as the HealthStream, Inc. Employee Stock Purchase Plan.

         1.2 Purpose. The purpose of this Plan is to provide an opportunity for
eligible employees of the Employer to become stockholders of HealthStream. It is
believed that broad-based employee participation in the ownership of the
business will help to achieve the unity of purpose conducive to the continued
growth of the Employer and to the mutual benefit of its employees and
shareholders.

         1.3 Qualification. This Plan is intended to be an employee stock
purchase plan which qualifies for favorable Federal income tax treatment under
Section 423 of the Code and is intended to comply with the provisions thereof,
including the requirement of Section 423(b)(5) of the Code that all Employees
granted options to purchase Stock under the Plan have the same rights and
privileges with respect to such options.

         1.4 Rule 16b-3 Compliance. This Plan is intended to comply with Rule
16b-3 under the Securities Exchange Act of 1934, and should be interpreted in
accordance therewith.

                                   ARTICLE II
                                   DEFINITIONS

         As used herein, the following words and phrases shall have the meanings
specified below:

         2.1 Board of Directors. The Board of Directors of HealthStream.

         2.2 Closing Market Price. The closing price of the Stock as reported in
the NASDAQ National Market System on the date specified; or if no sales occurred
on such day, at the mean between the closing "bid" and "asked" prices on such
day; but if there should be any material alteration in the present system of
reporting sales prices of such Stock, or if such Stock should no longer be
listed on NASDAQ's National Market System, the market value of the Stock as of a
particular date shall be determined in such a method as shall be specified by
the Plan Administrator.

         2.3 Code. The Internal Revenue Code of 1986, as amended from time to
time.

         2.4 Commencement Date. The first day of each Option Period. The first
Commencement Date shall be March 30, 2000.

         2.5 Contribution Account. As set forth in Article V, the account
established on behalf of a Participant to which shall be credited the amount of
the Participant's contribution.

                                       1
<PAGE>   2

         2.6 Effective Date. March 14, 2000.

         2.7 Employee. Each employee of an Employer except:

             (a) any employee whose customary employment is twenty (20) hours
                 per week or less, or

             (b) any employee whose customary employment is for not more than
                 five months in any calendar year.

         2.8 Employer. HealthStream and any United States corporation which is a
Subsidiary of HealthStream (except for a Subsidiary which by resolution of the
Board of Directors is expressly not authorized to become a participating
Employer). The term "Employer" shall include any corporation into which an
Employer may be merged or consolidated or to which all or substantially all of
its assets may be transferred, provided that the surviving or transferee
corporation would qualify as a Subsidiary under Section 2.19 and such
corporation does not affirmatively disavow this Plan.

         2.9 Exercise Date. The last trading date of each Option Period on the
NASDAQ National Market System.

         2.10 Exercise Price. The price per share of the Stock to be charged to
Participants at the Exercise Date, as determined in Section 6.3.

         2.11 Five-Percent Shareholder. An Employee who, immediately after an
option is granted to purchase Stock under this Plan, owns five percent (5%) or
more of the total combined voting power or value of all classes of stock of an
Employer. In determining this five percent test, shares of stock which the
Employee may purchase under outstanding options, warrants or other convertible
securities, as well as stock attributed to the Employee from members of his
family or otherwise under Section 424(d) of the Code, shall be treated as stock
owned by the Employee in the numerator, but treasury shares and shares of stock
which may be issued under options, warrants or other convertible securities
shall not be counted in the total of outstanding shares in the denominator.

         2.12 Grant Date. The first trading date of each Option Period on the
NASDAQ National Market System.

         2.13 Option Period. Successive periods of twelve (12) months commencing
on the first Commencement Date and on April 1 in each succeeding year.

         2.14 Participant. Any Employee of an Employer who has met the
conditions for eligibility as provided in Article IV and who has elected to
participate in the Plan.

         2.15 Plan. HealthStream, Inc. Employee Stock Purchase Plan.

         2.16 Plan Administrator. The committee composed of one or more
individuals to whom authority is delegated by the Board of Directors to
administer the Plan.

                                       2
<PAGE>   3

         2.17 Stock. Those shares of common stock of HealthStream which are
reserved pursuant to Section 6.1 for issuance upon the exercise of options
granted under this Plan.

         2.18 Subsidiary. Any United States corporation (other than
HealthStream) in an unbroken chain of corporations beginning with HealthStream
if, at the time of the granting of the option, each of the corporations other
than the last corporation in the unbroken chain owns stock possessing fifty-one
percent (51%) or more of the total combined voting power of all classes of stock
in one of the other corporations in such chain.

                                   ARTICLE III
                              SHAREHOLDER APPROVAL

         3.1 Shareholder Approval Required. This Plan must be approved by the
shareholders of HealthStream within the period beginning twelve (12) months
before and ending twelve (12) months after its adoption by the Board of
Directors.

         3.2 Shareholder Approval for Certain Amendments. Without the approval
of the shareholders of HealthStream, no amendment to this Plan shall increase
the number of shares reserved under the Plan, other than as provided in Section
10.3. Approval by shareholders must comply with applicable provisions of the
corporate charter and bylaws of HealthStream and with Tennessee law prescribing
the method and degree of shareholder approval required for issuance of corporate
stock or options.

                                   ARTICLE IV
                          ELIGIBILITY AND PARTICIPATION

         4.1 Conditions. Each Employee shall become eligible to become a
Participant for each Option Period on its Commencement Date if such Employee has
been employed by the Employer for a continuous period (as determined in
accordance with Section 1.421-7(h)(2) of the Treasury Regulations as in effect
on the Effective Date) at least thirty (30) days prior to the Commencement Date.
No Employee who is a Five-Percent Shareholder shall be eligible to participate
in the Plan. Notwithstanding anything to the contrary contained herein, no
individual who is not an Employee shall be granted an option to purchase Stock
under the Plan.

         4.2 Application for Participation. Each Employee who becomes eligible
to participate shall be furnished a summary of the Plan and an enrollment form.
If such Employee elects to participate hereunder, Employee shall complete such
form and file it with Employer no later than thirty (30) days prior to the next
Commencement Date or, in the case of the first Commencement Date, no later than
March 28, 2000. The completed enrollment form shall indicate the amount of
Employee contribution authorized by the Employee. If no new enrollment form is
filed by a Participant in advance of any Option Period after the initial Option
Period, that Participant shall be deemed to have elected to continue to
participate with the same contribution previously elected (subject to the limit
of fifteen percent (15%) of base pay specified in Section 5.1). If any Employee
does not elect to participate in any given Option Period, such Employee may
elect to participate on any future Commencement Date so long as such Employee
continues to meet the eligibility requirements.

                                       3
<PAGE>   4

         4.3 Date of Participation. All Employees who elect to participate shall
be enrolled in the Plan commencing with the first day of the Option Period
following their submission of the enrollment form. Upon becoming a Participant,
the Participant shall be bound by the terms of this Plan, including any
amendments whenever made.

         4.4 Acquisition or Creation of Subsidiary. If the stock of a
corporation is acquired by HealthStream or another Employer so that the acquired
corporation becomes a Subsidiary, or if a Subsidiary is created, the Subsidiary
in either case shall automatically become an Employer and its Employees shall
become eligible to participate in the Plan on the first Commencement Date after
the acquisition or creation of the Subsidiary, as the case may be. In the case
of an acquisition, credit shall be given to Employees of the acquired Subsidiary
for service with such corporation prior to the acquisition for purposes of
satisfying the requirement of Section 4.1 of thirty (30) days continuous
employment. Notwithstanding the foregoing, the Board of Directors may by
appropriate resolutions (i) provide that the acquired or newly created
Subsidiary shall not be a participating Employer, (ii) specify that the acquired
or newly created Subsidiary will become a participating Employer on a
Commencement Date other than the first Commencement Date after the acquisition
or creation, or (iii) attach any condition whatsoever (including denial of
credit for prior service) to eligibility of the employees of the acquired or
newly created Subsidiary, except to the extent such condition would not comply
with Section 423 of the Code.

                                    ARTICLE V
                              CONTRIBUTION ACCOUNT

         5.1 Employee Contributions. The enrollment form signed by each
Participant shall authorize the Employer to deduct from the Participant's
compensation an after-tax amount during each monthly payroll period not less
than fifty dollars ($50.00), nor more than an amount which is fifteen percent
(15%) of the Participant's base pay on the Commencement Date. Base pay includes
the Participant's wages and salary, but does not include overtime payments,
sales commissions, incentive compensation, bonuses, expense reimbursements,
fringe benefits and other special payments. Base pay is not reduced by the
Participant's elective deferrals to a qualified plan under Section 401(k) of the
Code, salary reduction contributions to a cafeteria plan under Section 125 of
the Code, or elective deferrals to a nonqualified deferred compensation plan.
The dollar amount deducted each payday shall be credited to the Participant's
Contribution Account. Participant contributions will not be permitted to
commence at any time during the Option Period other than on a Commencement Date.
No interest will accrue on any contributions or on the balance in a
Participant's Contribution Account.

         5.2 Modification of Contribution Rate. No change shall be permitted in
a Participant's amount of withholding except upon a Commencement Date, and then
only if the Participant files a new enrollment form with the Employer at least
thirty (30) days in advance of the Commencement Date designating the desired
withholding rate. Notwithstanding the foregoing, a Participant may notify the
Employer at any time that the Participant wishes to discontinue the
Participant's contributions (except during the last fifteen (15) days of the
Option Period). This notice shall be in writing and on such forms as provided by
the Employer and shall become effective as of a date provided on the form not
more than five (5) days following its receipt by the Employer. The Participant
shall become eligible to recommence contributions on the next Commencement Date.

                                       4
<PAGE>   5

         5.3 Withdrawal of Contributions. A Participant may elect to withdraw
the balance of his Contribution Account at any time during the Option Period
prior to the Exercise Date (except during the last fifteen (15) days of the
Option Period). The option granted to a Participant shall be canceled upon his
withdrawal of the balance in his Contribution Account. This election to withdraw
must be in writing on such forms as may be provided by the Employer. If
contributions are withdrawn in this manner, further contributions during that
Option Period will be discontinued in the same manner as provided in Section
5.2, and the Participant shall become eligible to recommence contributions on
the next Commencement Date.

         5.4 Lump Sum Contributions. Subject to the limitations described in
Section 5.5, a Participant who has not discontinued his contributions pursuant
to Section 5.2 or elected to withdraw his contributions pursuant to Section 5.3
may make no more than one (1) lump sum contribution during each Option Period.
These lump sum contributions shall be paid by check by the Participant,
delivered at least fifteen (15) days prior to the Exercise Date, and shall be
credited to the Participant's Contribution Account.

         5.5 Limitations on Contributions. During each Option Period, the total
contributions by a Participant to his Contribution Account (including both
contributions by payroll deduction pursuant to Section 5.1 and lump sum
contributions pursuant to Section 5.4) shall not exceed fifteen percent (15%) of
the Participant's base pay for the Option Period. If a Participant's total
contributions should exceed this limit, the excess shall be returned to the
Participant after the end of the Option Period, without interest.

                                   ARTICLE VI
                        ISSUANCE AND EXERCISE OF OPTIONS

         6.1 Reserved Shares of Stock. HealthStream shall reserve one million
(1,000,000) shares of Stock for issuance upon exercise of the options granted
under this Plan.

         6.2 Issuance of Options. On the Grant Date each Participant shall be
granted an option to purchase Stock with the number of shares and Exercise Price
determined as provided in this Article VI, subject to the maximum limit
specified in Section 6.6(a) and (b). All such options shall be automatically
exercised on the following Exercise Date, except for options which are canceled
when a Participant withdraws the balance of his Contribution Account or which
are otherwise terminated under the provisions of this Plan.

         6.3 Determination of Exercise Price. The Exercise Price of the options
granted under this Plan for any Option Period shall be the lesser of:

             (a) eighty-five percent (85%) of the Closing Market Price of the
                 Stock on the Exercise Date;

             (b) eighty-five percent (85%) of the Closing Market Price of the
                 Stock on the Grant Date.

         6.4 Purchase of Stock. On an Exercise Date, all options shall be
automatically exercised, except that the options of a Participant who has
terminated employment pursuant to Section 7.1 or who has withdrawn all his
contribution shall expire. The Contribution Account of each Participant shall be
used to

                                       5
<PAGE>   6

purchase the maximum number of whole shares of Stock determined by dividing the
Exercise Price into the balance of the Participant's Contribution Account. Any
money remaining in a Participant's Contribution Account representing a
fractional share shall remain in his Contribution Account to be used in the next
Option Period along with new contributions in the next Option Period; provided,
however, that if the Participant does not enroll for the next Option Period, the
balance remaining shall be returned to such Participant in cash.

         6.5 Terms of Options. Options granted under this Plan shall be subject
to such amendment or modification as the Employer shall deem necessary to comply
with any applicable law or regulation, including but not limited to Section 423
of the Code, and shall contain such other provisions as the Employer shall from
time to time approve and deem necessary; provided, however, that any such
provisions shall comply with Section 423 of the Code.

         6.6 Limitations on Options. The options granted hereunder are subject
to the following limitations:

             (a) The maximum number of shares of Stock which may be purchased by
                 any Participant on an Exercise Date shall be 2,500 shares. This
                 maximum number of shares shall be adjusted upon the occurrence
                 of an event described in Section 10.3.

             (b) No Participant shall be permitted to accrue the right to
                 purchase during any calendar year Stock under this Plan (and
                 any other plan of the Employer or Subsidiary which is qualified
                 under Section 423 of the Code) having a market value in excess
                 of $25,000 (as determined on the Grant Date for the Option
                 Period during which each such share of Stock is purchased) as
                 provided in Section 423(b)(8) of the Code.

             (c) No option may be granted to a Participant if the Participant
                 immediately after the option is granted would be a Five-Percent
                 Shareholder.

             (d) No Participant may assign, transfer or otherwise alienate any
                 options granted to him under this Plan, otherwise than by will
                 or the laws of descent and distribution, and such options may
                 be exercised during the Participant's lifetime only by the
                 Participant.

         6.7 Pro-Rata Reduction of Optioned Stock. If the total number of shares
of Stock to be purchased under option by all Participants on an Exercise Date
exceeds the number of shares of Stock remaining authorized for issuance under
Section 6.1, a pro-rata allocation of the shares of Stock available for issuance
will be made among Participants in proportion to their respective Contribution
Account balances on the Exercise Date, and any money remaining in the
Contribution Accounts shall be returned to the Participants.

         6.8 State Securities Laws. Notwithstanding anything to the contrary
contained herein, HealthStream shall not be obligated to issue shares of Stock
to any Participant if to do so would violate any State securities law applicable
to the sale of Stock to such Participant. In the event that HealthStream
refrains from issuing shares of Stock to any Participant in reliance on this
Section, HealthStream shall return to such Participant the amount in such
Participant's Contribution Account that would otherwise have been applied to the
purchase of Stock.

                                       6
<PAGE>   7

                                   ARTICLE VII
                          TERMINATION OF PARTICIPATION

         7.1 Termination of Employment. Any Employee whose employment with the
Employer is terminated during the Option Period prior to the Exercise Date for
any reason except death, disability or retirement at or after age 65 shall cease
being a Participant immediately. The balance of that Participant's Contribution
Account shall be paid to such Participant as soon as practical after his
termination. The option granted to such Participant shall be null and void.

         7.2 Death. If a Participant should die while employed by the Employer,
no further contributions on behalf of the deceased Participant shall be made.
The legal representative of the deceased Participant may elect to withdraw the
balance in said Participant's Contribution Account by notifying the Employer in
writing prior to the Exercise Date in the Option Period during which the
Participant died. In the event no election to withdraw is made prior to the
Exercise Date, the balance accumulated in the deceased Participant's
Contribution Account shall be used to purchase shares of Stock in accordance
with Section 6.4. Any money remaining which is insufficient to purchase a whole
share shall be paid to the legal representative.

         7.3 Retirement. If a Participant shall retire from the employment of
the Employer at or after attaining age 65, no further contributions on behalf of
the retired Participant shall be made. The Participant may elect to withdraw the
balance in his Contribution Account by notifying the Employer in writing prior
to the Exercise Date in the Option Period during which the Participant retired.
In the event no election to withdraw is made prior to the Exercise Date, the
balance accumulated in the retired Participant's Contribution Account shall be
used to purchase shares of Stock in accordance with Section 6.4. Any money
remaining which is insufficient to purchase a whole share shall be paid to the
retired Participant.

         7.4 Disability. If a Participant should terminate employment with the
Employer on account of disability, as determined by reference to the definition
of "disability" in the Employer's long-term disability plan, no further
contributions on behalf of the disabled Participant shall be made. The
Participant may elect to withdraw the balance in his Contribution Account by
notifying the Employer in writing prior to the Exercise Date in the Option
Period during which the Participant became disabled. In the event no election to
withdraw is made prior to the Exercise Date, the balance accumulated in the
disabled Participant's Contribution Account shall be used to purchase shares of
Stock in accordance with Section 6.4. Any money remaining which is insufficient
to purchase a whole share shall be paid to the disabled Participant.

                                  ARTICLE VIII
                               OWNERSHIP OF STOCK

         8.1 Stock Certificates. Certificates for Stock purchased through the
exercise of the options granted hereunder shall be issued as soon as practical
after the Exercise Date. Certificates may be issued at the request of the
Participant (i) in the name of the Participant, (ii) jointly in the name of the
Participant and a member of the Participant's family, (iii) in trust to a
trustee, (iv) to the Participant as custodian for the Participant's child under
the Gift to Minors Act, or (v) to the legal representative of a deceased
Participant.

                                       7
<PAGE>   8

         8.2 Premature Sale of Stock. If a Participant (or former Participant)
sells or otherwise disposes of any shares of Stock obtained under this Plan

             (a) prior to two (2) years after the Grant Date of the option under
                 which such shares were obtained; or

             (b) prior to one (1) year after the Exercise Date on which such
                 shares were obtained,

that Participant (or former Participant) must notify the Employer immediately in
writing concerning such disposition.

         8.3 Restrictions on Sale. The Plan Administrator may, in its sole
discretion, place restrictions on the sale or transfer of shares of Stock
purchased under the Plan during any Option Period by notice to all Participants
of the nature of such restrictions given in advance of the Commencement Date of
such Option Period. The restrictions may prevent the sale, transfer or other
disposition of any shares of Stock purchased during the Option Period for a
period of up to two years from the Grant Date, subject to such exceptions as the
Plan Administrator may determine (e.g., termination of employment with the
Employer). Certificates issued pursuant to Section 8.1 for restricted shares
shall contain an appropriate legend disclosing the nature and duration of the
restriction. Any such restrictions determined by the Plan Administrator shall be
applicable equally to all shares of Stock purchased during the Option Period for
which the restrictions are first applicable and to all shares of Stock purchased
during subsequent Option Periods unless otherwise determined by the Plan
Administrator. If the Plan Administrator should change or eliminate the
restrictions for a subsequent Option Period, notice of such action shall be
given to all Participants.

         8.4 Transfer of Ownership. A Participant who purchases shares of Stock
under this Plan shall be transferred at such time substantially all of the
rights of ownership of such shares of Stock in accordance with Section
1.421-1(f) of the Treasury Regulations as in effect on the Effective Date. Such
rights of ownership shall include the right to vote, the right to receive
declared dividends, the right to share in the assets of the Employer in the
event of liquidation, the right to inspect the Employer's books and the right to
pledge or sell such Stock subject to the restrictions in the Plan.

                                       8
<PAGE>   9

                                   ARTICLE IX
                          ADMINISTRATION AND AMENDMENT

         9.1 Administration. The Plan Administrator shall (i) administer the
Plan, (ii) keep records of the Contribution Account balance of each Participant,
(iii) interpret the Plan, (iv) determine all questions arising as to eligibility
to participate, amount of contributions permitted, determination of the Exercise
Price, and all other matters of administration, and (v) determine whether to
place restrictions on the sale and transfer of Stock and the nature of such
restrictions, as provided in Section 8.3. The Plan Administrator shall have such
duties, powers and discretionary authority as may be necessary to discharge the
foregoing duties, and may delegate any or all of the foregoing duties to any
individual or individuals (including officers or other Employees who are
Participants). The Board of Directors shall have the right at any time and
without notice to remove or replace any individual or committee of individuals
serving as Plan Administrator. All determinations by the Plan Administrator
shall be conclusive and binding on all persons. Any rules, regulations, or
procedures that may be necessary for the proper administration or functioning of
this Plan that are not covered in this Plan document shall be promulgated and
adopted by the Plan Administrator.

         9.2 Amendment. The Board of Directors may at any time amend the Plan in
any respect, including termination of the Plan, without notice to Participants.
If the Plan is terminated, all options outstanding at the time of termination
shall become null and void and the balance in each Participant's Contribution
Account shall be paid to that Participant. Notwithstanding the foregoing, no
amendment of the Plan as described in Section 3.2 shall become effective until
and unless such amendment is approved by the shareholders of HealthStream.

                                    ARTICLE X
                                  MISCELLANEOUS

         10.1 Expenses. The Employer will pay all expenses of administering this
Plan that may arise in connection with the Plan.

         10.2 No Contract of Employment. Nothing in this Plan shall be construed
to constitute a contract of employment between an Employer and any Employee or
to be an inducement for the employment of any Employee. Nothing contained in
this Plan shall be deemed to give any Employee the right to be retained in the
service of an Employer or to interfere with the right of an Employer to
discharge any Employee at any time, with or without cause, regardless of the
effect which such discharge may have upon him as a Participant of the Plan.

         10.3 Adjustment Upon Changes in Stock. The aggregate number of shares
of Stock reserved for purchase under the Plan as provided in Section 6.1, and
the calculation of the Exercise Price as provided in Section 6.3, shall be
adjusted by the Plan Administrator (subject to direction by the Board of
Directors) in an equitable manner to reflect changes in the capitalization of
HealthStream, including, but not limited to, such changes as result from merger,
consolidation, reorganization, recapitalization, stock dividend, dividend in
property other than cash, stock split, combination of shares, exchange of shares
and change in corporate structure. If any adjustment under this Section 10.3
would create a fractional share of Stock or a right to acquire a fractional
share of Stock, such fractional share shall be disregarded and the number of
shares

                                       9
<PAGE>   10

available under the Plan and the number of shares covered under any options
granted pursuant to the Plan shall be the next lower number of shares, rounding
all fractions downward.

         10.4 Employer's Rights. The rights and powers of any Employer shall not
be affected in any way by its participation in this Plan, including but not
limited to the right or power of any Employer to make adjustments,
reclassifications, reorganizations or changes of its capital or business
structure or to merge or to consolidate or to dissolve, liquidate or sell, or
transfer all or any part of its business or assets.

         10.5 Limit on Liability. No liability whatever shall attach to or be
incurred by any past, present or future shareholders, officers or directors, as
such, of HealthStream or any Employer, under or by reason of any of the terms,
conditions or agreements contained in this Plan or implied therefore, and any
and all liabilities of any and all rights and claims against HealthStream, an
Employer, or any shareholder, officer or director as such, whether arising at
common law or in equity or created by statute or constitution or otherwise,
pertaining to this Plan, are hereby expressly waived and released by every
Participant as a part of the consideration for any benefits under this plan;
provided, however, no waiver shall occur, solely by reason of this Section 10.5,
of any right which is not susceptible to advance waiver under applicable law.

         10.6 Gender and Number. For the purposes of the Plan, unless the
contrary is clearly indicated, the use of the masculine gender shall include the
feminine, and the singular number shall include the plural and vice versa.

         10.7 Governing Law. The validity, construction, interpretation,
administration and effect of this Plan, and any rules or regulations promulgated
hereunder, including all rights or privileges of any Participants hereunder,
shall be governed exclusively by and in accordance with the laws of the State of
Tennessee, except that the Plan shall be construed to the maximum extent
possible to comply with Section 423 of the Code and the Treasury regulations
promulgated thereunder.

         10.8 Severability. If any provision of this Plan is held by a court to
be unenforceable or is deemed invalid for any reason, then such provision shall
be deemed inapplicable and omitted, but all other provisions of this Plan shall
be deemed valid and enforceable to the full extent possible under applicable
law.

         IN WITNESS WHEREOF, the Employer has adopted this Plan effective March
14, 2000.

Date:  March 16, 2000                HEALTHSTREAM, INC.

                                     Vice President and Corporate Secretary

                                       10

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