We present the ‘HealthGrid’ initiative and review work carried out in various European projects. Since the European Commission's Information Society Technologies programme funded the first grid-based health and medical projects, the HealthGrid movement has flourished in Europe. Many projects have now been completed and ‘Healthgrid’ consulted a number of experts to compile and publish a ‘White Paper’ which establishes the foundations, potential scope and prospects of an approach to health informatics based on a grid infrastructure. The White Paper demonstrates the ways in which the healthgrid approach supports many modern trends in medicine and healthcare, such as evidence-based practice, integration across levels, from molecules and cells, through tissues and organs to the whole person and community, and the promise of individualized health care. A second generation of projects have now been funded, and the EC has commissioned a study to define a research roadmap for a ‘healthgrid for Europe’, seen as the preferred infrastructure for medical and health care projects in the European Research Area.