Ripple-Down Rules (RDR) is an approach to building knowledgebased systems (KBS) incrementally, while the KBS is in routine use. Domain experts build rules as a minor extension to their normal duties, and are able to keep refining rules as KBS requirements evolve. Commercial RDR systems are now used routinely in some Chemical Pathology laboratories to provide interpretative comments to assist clinicians make the best use of laboratory reports. This paper presents usage data from one laboratory where, over a 29 month period, over 16,000 rules were added and 6,000,000 cases interpreted. The clearest evidence that this facility is highly valuable to the laboratory is the on-going addition of new knowledge bases and refinement of existing knowledge bases by the chemical pathologists.