Right now, most RHIOs are still at an early stage of development--in "science fair mode," as one blogger puts it--so practical rollout issues haven't gotten much attention yet. However, now that a Vermont RHIO has gotten a data exchange contract with the state's Department of Health, new problems are coming to the forefront. Under the terms of the five-year, $7.5 million contract, the Vermont Information Technology Leaders group will set up a chronic-care improvement program, starting with pilot projects making med histories available to doctors in hospital EDs. However, moving from theory to real life comes at a price. Getting informed consent will be a new thing entirely. Not only will it be tough getting patients to let their data be drawn into the network, it will be even tougher to convince patients to allow their data to be used for related research and clinical projects, suggests blog editor Bruce Friedman. Blog