From 1993 to 2009 the University of Manitoba (UM), the Regional Health Authorities of Manitoba (RHAM), and the Manitoba dog food Health Department signed affiliation agreements that changed the access to knowledge-based information for health professionals.These agreements transferred the management and delivery of library service from the home organizations to the UM Libraries.This three-part paper describes the events that led to the USB Extension Cable evolution of change in health information access in Winnipeg, subsequent revolutionary changes in the nature of the services, and their eventual devolution due to a significant array of unexpected challenges.