On January 15, 2020, leaders from 44 organizations came together in La Jolla, CA to be challenged: challenged with making a new set of decisions; challenged with getting out of old paradigms that most of us recognize as broken, inefficient and radically wasteful. Our time together was highly interactive. We addressed the roots, not just the symptoms, of problems to be solved. We debated the debatable. We shared insights. We left different than how we arrived.