Integrating research, education and evidence-based medical practice requires complex infrastructures and network linkages among these critical activities. This research examines communities of practice and open source software tools in development of scalable virtual infrastructures for the regional Virtual Health Library of the Latin American and Caribbean Health Sciences System (Bireme) and embedded national cases. Virtual infrastructures refer to an environment characterized by overlapping distribution networks accessible through Internet portals and websites designed to facilitate integrated use of available resources. Case analysis shows engagement of interdisciplinary communities of practice for scalable virtual infrastructure design. This research program considers theory and methods for study of transferability of the Latin American model to large health care systems in other cultures.