As you remember, Marlisa and her White River team's winning solution for the Ignite Accelerator at HHS's Idea Lab was looking a little shaky. The critical assumption Marlisa and Alicia realized during the design thinking bootcamp was how White River patients might respond to a high tech kiosk. Marlisa recalled her 87 year old grandmother's likely reaction to the electronic display. She realized many tribal elders, White River Emergency Room's primary visitors, those elders might not be comfortable with, to them, new technology. Some even did not speak or read English. An electronic system, no matter how efficient, Baltimore, might create more not fewer delays in rural Apache country. The White River team, in its initial research, had heard patient's frustrations. But the assumed solution, the "winning" solution technology, had not come with stakeholder's input. After phone calls back to Fort Apache to speak with elderly patients, the team made a course correction. The kiosk concept was replaced with a paper form aimed to discover the acuity of patient's medical issues as soon as they entered emergency. Saving time and money, the simple form literally asked patients whether they needed emergency or non-emergency care such as visit with a nurse or a prescription refill. Since anyone could help non-English speaking patients check boxes on a one page form, Marlisa and Alicia thought that any patient without being seen by a clinician could be quickly routed to appropriate care. Returning to Arizona, the team prepared for what works, taking the paper base concept into testing in the actual hospital. Then the next shoe dropped, HHS staff reported that a law to prevent emergency rooms from turning away those without insurance made, in effect, the use of any pre-examination form illegal. This no-dumping law stipulates that everyone who comes into an emergency department must be assessed by a medical clinician. HHS legal advisers noted that as long as the door says emergency, you can't send potential patients anywhere until they've been evaluated. Abandoning the paper form, the White River team circled back to what is, visiting other hospitals and gathering more face-to-face data from patients. Guided by this new data, the White River team moved to their next iteration, a fast track system that placed medically qualified personnel at the emergency room entrance to quickly, within 15 minutes, to quickly assess each patient's condition and direct appropriate visitors to non-emergency services. The White River team then ran a four-day experiment, arranging for an experienced physician to greet each emergency room arrival. And the percentage of arrivals abandoning White River's emergency room without treatment was reduced from 18 percent to less than two percent during the experiment. White River Hospital leadership found the fast track idea and the potential savings of six million dollars compelling. And the hospital is now building a fast track idea and starting construction on a new emergency room designed to address even more concerns. Some might argue that what Marlisa and her team accomplished is not dramatic enough to be called "innovation" but we disagree. What if even a fraction of HHS's 80,000 employees are motivated to innovatively solve problems? Imagine the increase in patient experience at HHS hospitals and clinics. Imagine the savings to taxpayers. That's the point of Ignite, tapping into the innovation potential of the agency's vast employee base and then deeply testing the assumptions to ensure any solutions are on the right track.