I can give it a shot, with the way I did it...
0) Backup your current railworks installation.
1) Determine where you want to start your route; e.g. use Google Earth to find the lon/lat point of the place where the route will start, like a station, yard, or some other geographical feature that strikes your fancy.
2) Write those numbers down on a piece of paper.
3) Create a new default route in RW and use the numbers on your paper for the route origin. You can use another template besides the default if you want different sky blueprints or initial ground texture, etc.
4) Look at flatland for a bit, SAVE the route, CLOSE RW completely.
4a) Run another backup of your RW install.
5) Here's where maybe it gets tricky, creating marker files for ReDEM.
5a) Using Google Earth, create a track path for your route. This one doesn't HAVE to be detailed. You may want to add some points to this path that are further away from the route than the track. The idea is to make sure that all surrounding tiles from your route's track path are rendered by ReDEM.
5b) Save the path as KML (
not kmz)
5c) Open RWTools. Go to Route Building Tools -> Marker Files -> Convert Marker Files. This function will create a .csv file from the .kml file made by Google Earth in step 5b. Choose where to save, click Proceed, browse and highlight your .kml file, click Process.
5d) Verify that the new .csv file is in the folder where you wanted to save it.
6) Open ReDEM.
7) Enter your route start (route origin) from your piece of paper. (Also available in an xml file from step 4, but don't worry about that unless you lose your piece of paper.

)
8) Click "load" button.
9) Select the .csv file from the folder you checked in step 5d. Note: Make sure you have the browser's files-of-type drop list set to "*.csv", the default is ".mkr" type markers.
10) Open the file and it will populate the four lat/lon numbers and the marker file field in ReDEM.
11) Follow the ReDEM help from here,
to the letter.

12) Open RW launcher program.
13) Tools & Docs -> Clear the Blueprint Cache. (recommend doign this
every time you run, especially doing route building).
14) Start RW and choose to edit your route you created in step 3, and see the view!
A few other thoughts...
Your route start marker may be at (or near) 0 elevation, so when you open your route in RW after ReDEM, you'll see the skydome; this is okay. Grab the route start marker and guide it upward with the blue arrow until you "punch" through the surface of the ground. There may be a better way to do this (or to manually set the route start marker height via XML... I don't see a way in RWTools... much to learn about that software...

)
Don't go too big with the "Range" value. 2 is good max, 3 is probably the more than you'll ever want or need... 2 tiles away is a long way to see from a train or even from sky. When distant mountain rendering improves, more than 3 tiles away may be desirable, but not now I don't think. If you select too big an area with your markers or the "Range" is too large, you will need multiple downloads from USGS and, thus, multiple runs of ReDEM to make all the tiles. I'm not sure how that works, but I know on one of my attempts I had to get two files from the USGS seamless server. Since I wasn't sure how to combine the output of two runs of ReDEM, I chose a smaller area and it seems to have worked out.

I think it may be possible to combine the output terrain (as long as the route start point is the same for each run!) for separate files from USGS. Actually, that reminds me, I think Tori mentioned something about combining 1/3 and 1/9 arc-second tiles, so search around for that too.
DO NOT HIT "t" KEY in World Editor mode. If you hit the "t" key, it will drop the terrain back to zero elevation for the tile you're on and the surrounding 8 tiles (a 9-tile square from your position in the editor)! You'll have to restore the terrain files if you save the route after doing this.
BACK UP YOUR RW INSTALL AFTER EACH RW RUN DURING THIS PHASE.EDIT: I changed above paragraph "groud level" to "zero elevation". Also, do not use the "level" terrain tool, as it still thinks level is zero elevation, and you'll get a deep hole down to 0 elevation. Use Ctrl+z or "undo arrow" to undo the change if you use the "level" terrain tool by accident. If you grade or sculpt any part of your terrain, the .bin terrain files will get updated as you might expect. Restoring the terrain from ReDEM output will lose all your terrain height changes (like the grade you may have modified for track, etc.)
Backup early, backup often.
... any corrections, clarifications, or other thoughts welcome. Your mileage may vary, especially if you use your reverser instead of brakes.
