In between users and trained informaticians, we find a group of people carrying out important work in implementing and further developing health information technology, without access to formal biomedical and health informatics training.

For the last 3 years we have been studying employees’ and managers’ participation in department-local health IT projects in a hospital setting in a Scandinavian country. We observed project meetings, collaborative meetings, and everyday work, and did 29 semi-structured interviews with project participants (healthcare workers, managers, and informaticians).

Our findings show what is required of novices in biomedical and health informatics to gain access to communities of practice through which expertise can be developed.