This paper highlights some of the challenges, achievements and collaborations using health informatics education and research as a change agent in which I have been involved over the last 40 years. The Open Software Library (OSL) was a specialist publisher of Computer-Based Training materials (CBT) mainly authored by nurses and medics. The “Rainbow” series of distance learning materials, “Using Information in Managing the Nursing Resource” sold over 55,000 copies. It was utilized as the basis for seven Universities’ Certificate and Diploma programmes and in-house training by the NHS to encourage organisational change. Workshops at Manchester University’s HSMU focusing on evaluation studies highlighted that most NHS IT projects failed because of human and organisational issues rather than IT. This led to the development of a master’s degree in Health Informatics shared between four European Universities. IMIA conferences, Working Groups and the development of the IMIA approved Education Recommendations and the IMIA Knowledge Base are effectively used worldwide.