Our original design objectives for RODS were real-time collection of data with sufficient geographic coverage and sampling density to provide early syndromic warning of a large-scale aerosol release of anthrax. Although we have not achieved all of our initial design objectives, progress has been substantial. The research identified two types of data-freetext chief complaints and sales of OTC health care prod- ucts-that can be obtained in real time or near real time at sampling levels of 70% or higher for most of the United States. These results were obtained through large-scale deployments of RODS in Pennsylvania and Utah and through building the National Retail Data Monitor described in the accompanying article in this issue of JAMIA. The deployments also provided insights about organizational and technical success factors that would inform an effort to scale the project nationally.