Highlights: ? It took a decade to implement a Community Health Information Exchange in Geneva, Switzerland. ? Societal issues such as trust, transparency and self-determination were seen as the main challenges. ? Writing a specific law enabled a transparent and inclusive dialogue about these societal issues. ? Distributed data storage and voluntary participation by both citizens and professionals fostered acceptance. ? The process of designing and implementing collaborative services efficiently engaged care professionals.Abstract: It took more than ten years from the initial mandate to the first implementation of e-toile, the Geneva health information exchange. Although most actors quickly agreed on the goals and potential benefits of such a system, obstacles were many, and mostl….