Rebuild theBlueprint.
Innovation & Entrepreneurship
Investors, founders, researchers, clinicians, and community leaders, in the same room in downtown Palo Alto.
The venture-backed innovation ecosystem is structurally misaligned with the goal of improving patient outcomes. Day 1 is where we redesign it.
Teams will prototype new funding models, pressure-test ideas with investors live in the room, and walk out with a blueprint for building better companies.
Two panels. Two workshops. A Reverse Shark Tank that flips the script. Designed for founders, investors, clinicians, and community leaders — and the conversations that only happen when all four are in the same room.
Friday, hour by hour.
- 9:00 – 9:30 AMOpening
Opening
Welcome and framing for the day.
- 9:30 – 10:15 AMPanel
Reimagining Startups & Entrepreneurship
with Richi Kleinlein, Kaushik Madapati, Dhanashree Nerkar, Mena Ramos
- 10:15 – 10:45 AMBreak
Break
- 10:45 – 11:45 AMWorkshop
Workshop 1 — Reimagining Startups & Entrepreneurship
Case-based breakouts and a novel “Innovation Soul Report Card.” Founders diagnose misalignments in real companies and in their own ventures, then collectively propose concrete changes to an ecosystem where 90% of startups fail and most survivors never move the needle on health.
- 11:45 – 12:00 PMDebrief
Workshop 1 Debrief
- 12:00 – 1:00 PMLunch
Lunch
- 1:00 – 1:45 PMPanel
Whose values are getting funded?
with Priyanka Boadagala, Monique de Villa, Joao Matos, Freddy Seba
- 1:45 – 2:45 PMWorkshop
Workshop 2 — The Moral Vulnerability Audit: Stress-Testing Startup Ideas for Unintended Harm
Teams pitch under standard hackathon conditions, then face an adversarial audit that surfaces embedded biases, excluded communities, and unexamined assumptions. The contrast between first and revised pitch makes the case in real time: confronting moral blind spots produces stronger, more resilient companies.
- 2:45 – 3:00 PMDebrief
Workshop 2 Debrief
- 3:00 – 3:30 PMBreak
Break
- 3:30 – 4:45 PMSession
Reverse Shark Tank — Grilling Investors on Their Values
The power dynamic flips. Teams pitch, investors deliberate openly, then the moderator turns the room around and interrogates the investors on the values inside their decisions.
- 4:45 – 5:00 PMWrap
Wrap & Next Steps
- 5:00 – 6:00 PMNetworking
Networking
Reimagining Healthcare Innovation: Beyond the 90% Failure Rate.
This workshop is for startup founders and aspiring entrepreneurs in healthcare. Rather than teaching innovation, it creates the conditions to interrogate the ecosystem you are entering — and to imagine what that ecosystem might look like if it were designed to actually improve health rather than merely generate returns.
- Identify at least three structural misalignments between venture-backed innovation and healthcare impact.
- Articulate how the funding model you choose shapes what your company can become.
- Draft an Innovation Soul Report Card for your own venture.
- Generate at least one concrete design change to the innovation ecosystem.
“Ninety percent of startups fail. In health tech, it’s closer to eighty percent. And here’s the part nobody says out loud: most of the ones that survive didn’t actually change healthcare. The system absorbed them and stayed exactly the same.”
Opening provocation
The Diagnosis: How did we get here?
Before we redesign anything, we need a shared picture of why the current ecosystem produces the outcomes it does. Four ideas frame the conversation:
Venture capital was designed for software: scale fast, fail fast, exit in 3–5 years, and count on 1 in 10 companies producing a 100x return. That math works for consumer apps. It does not work for healthcare, where the most impactful innovations require 10–20 year horizons, regulatory navigation, and evidence generation that cannot be sprint-ed.
- Innovation typology: We collapse drugs, software, care delivery, and community interventions into one pipeline designed for software.
- Mathematical: A company improving outcomes at a steady pace is a “failure” by VC math even as it succeeds by every metric patients care about.
- Values: The communities most burdened by health inequity are least served by the innovations that attract investment.
A systematic review in The BMJ of 55 studies across 8 countries found private equity ownership was associated with higher costs to patients and mixed-to-harmful impacts on quality. No study has found significant improvements. This is where “move fast and break things” leads when applied to systems that care for human beings.
The ACA’s Medicare Shared Savings Program created financial architecture for value-based innovation. Companies like Aledade have recruited independent primary care providers into accountable care organizations rewarded for reducing total cost of care. The lesson: aligned innovation does not emerge from markets alone. It requires policy to create the conditions.
The two cases. Read them. Sit with the discomfort.
Two real composites — not exactly real, not exactly fictional. You will work with these in Breakout 1.
$12M Series A. 10x return expected in 4 years.
MedFlow AI has raised $12M in Series A funding from a top-tier VC firm. They have built an AI-powered clinical documentation tool that reduces physician charting time by 40%. Their growth strategy is to expand from 50 to 500 hospital clients by next year. They are winning. Their pitch deck says they are “transforming healthcare.” But their tool records every clinical encounter, and their business model depends on that data becoming more valuable than the care itself. Physicians using the tool report they spend less time with patients because the system rewards throughput. The hospitals love it because it increases billing efficiency.
23% reduction in ED visits. Can’t raise a dime.
Community Pulse is a 3-person team that has built a community health worker platform connecting patients with non-clinical resources: housing assistance, food security, translation services, transportation. They have run for 2 years on a $150K state grant and are showing a 23% reduction in ED visits among enrolled patients. They cannot raise VC funding because their model does not scale the way investors want. Their grant is expiring. Two of the three team members have taken second jobs to keep the company alive. They applied to three accelerators and were rejected because “the market isn’t big enough.”
Breakout 1 — The Misalignment Autopsy
Groups of 4–5. Designate a spokesperson before you begin — they will share your group’s sharpest single insight in 60 seconds when we reconvene.
- 1Diagnose each company. Where are the misalignments — between what they’re building, how they’re funded, and what patients actually need?
- 2Which company is more likely to survive? Which is more likely to improve health? Why are those different questions?
- 3Is there a version of MedFlow AI that could be built ethically? Is there a funding model that could sustain Community Pulse?
The Innovation Soul Report Card
When you go to a restaurant, you can see a health inspection grade. When you buy food, there is a nutritional label. When a hospital wants accreditation, there is the Joint Commission. But when a company builds a product that will be used on patients — nothing. No label. No grade. No community voice.
The Soul Report Card is a community-governed assessment where patients, frontline clinicians, and community health workers evaluate innovations on the dimensions that matter to them. Today you will score your own company.
Score yourself 1–5 on each dimension (1 = serious concern, 5 = strong alignment). Score honestly — if you give yourself all 5s, you are not being honest.
Breakout 2 — Score your own company
Score yourself honestly across the eight dimensions. Nobody sees this but you and your partner. If you give yourself all 5s, you are not being honest.
Share your scores with one partner. Where did you score lowest? Is that a fixable problem or a structural one? What would it take to move that score up by one point?
Collective redesign
We have diagnosed the ecosystem. You have scored yourselves within it. Now flip the question: if you could change one thing about the innovation ecosystem — not your company, the ecosystem itself — what would it be?
What if healthcare companies were required to be at least 50% publicly funded?
What if communities, not VCs, decided which innovations got funded?
What if your Soul Report Card was public, like a Yelp rating for health startups?
What if accelerators required that patients sit on the evaluation panel?
What if founders were encouraged to merge with complementary startups rather than compete?
Before you leave: two commitments
One thing you will do differently with your company after today.
Not aspirational — concrete. Something you can do this week.
One thing you want the ecosystem to do differently.
A policy change, a cultural shift, a new institution — anything.
If a discussion stalls, return to one of these. They are designed to introduce productive discomfort, not to be answered cleanly.
Your investors need a 100x return in 4 years. Your patients need sustained improvement over 20 years. How do you reconcile that?
Who is harmed if your company succeeds exactly as planned?
If your company disappeared tomorrow, would any patient’s life get worse?
What would your company look like if it were funded by the community it serves?
Is the problem you’re solving a symptom or a root cause? Are you okay with that answer?
The Moral Vulnerability Audit: Stress-testing startup ideas for unintended harm.
At hackathons and pitch competitions, founders present the best possible abstraction of their idea. Showing vulnerability is treated as a mortal sin. This workshop inverts that norm. Teams develop a startup concept, pitch it once, and then the room conducts a moral vulnerability audit — surfacing the ways the product could embed bias, concentrate harm on marginalized communities, or produce unintended consequences that a market-capture lens would never reveal.
- Normalize the practice of exposing moral and social vulnerabilities in startup design, rather than hiding them.
- Give participants hands-on experience identifying embedded biases in data pipelines, product assumptions, user personas, and business models.
- Show that accounting for equity and bias produces more resilient, more defensible, and ultimately more scalable companies.
- Produce a reusable Moral Vulnerability Audit checklist participants can apply to any future venture.
Where does the training or operational data come from? Who is represented and who is missing? What historical biases does it encode?
If the product works perfectly, who benefits and who is left out? If it fails, who bears the cost?
What does the product assume about users — language, literacy, digital access, trust, cultural norms? Which assumptions are invisible to the founders?
Does the product concentrate decision-making power or distribute it? Who has recourse when the system makes a mistake?
What happens at 10x or 100x scale? What happens when it reaches communities the founders never considered, or when a bad actor uses it?
- 0–5 min01
Framing
Mentor introduces moral vulnerability with a concrete example (e.g., Epic’s sepsis model) and the question: what if we caught these things before launch?
- 5–20 min02
Ideation
Teams form and develop a startup concept on a one-page sketch: problem, solution, data sources, target users, revenue model. LLMs welcome.
- 20–30 min03
First Pitch
Each team presents for 2 minutes. The room listens and takes notes. No feedback yet.
- 30–50 min04
The Audit
Teams rotate to audit another team using the five-lens framework. Surface embedded biases, excluded communities, and unexamined assumptions.
- 50–60 min05
Revision
Teams revise the pitch — not as a buried risk section, but as a core part of the value proposition.
- 60–70 min06
Re-Pitch
Each team presents the revised version. The room observes what changed. Almost always, the revised pitch is stronger.
- 70–75 min07
Reflection
What did we learn about our own blind spots? Audit frameworks are collected for post-event compilation.
The Reverse Shark Tank: Grilling investors on their values.
In a conventional Shark Tank, founders beg investors for money. Here we flip the power dynamic. Investors must justify their decision-making — their criteria, their blind spots, their value systems — to a room that includes students, community members, indigenous knowledge holders, and early-stage founders from backgrounds underrepresented in Silicon Valley deal rooms.
The goal is not to vilify investors. It is to make visible the assumptions that usually stay behind closed doors, and to open a genuine conversation about what “success” should mean.
- 0–10 min01
Context-setting
A short, slide-free storytelling segment: 2–3 real venture-backed companies that failed or caused documented harm. The opening question: what went wrong, and could a different set of investor values have changed the outcome?
- 10–30 min02
Small-group ideation
Groups of 4–6 brainstorm a startup idea that addresses a real health or social equity gap. Each group must articulate the problem, who it serves, how it generates value (not just revenue), and what could go wrong. LLMs welcome as brainstorming partners.
- 30–45 min03
Pitch + open deliberation
Each group delivers a 2-minute pitch to the investor panel. Investors deliberate out loud — replicating the real decision process in front of the room — about which ideas they would fund and why.
- 45–65 min04
The flip — moderator interrogates the panel
A moderator from outside the investment world turns the room around: why those choices? Which criteria dominated? What was dismissed and why? Audience members raise questions; the moderator holds the line between honest interrogation and respectful dialogue.
- 65–75 min05
Collective debrief
What surprised us? What values were missing from the calculus? What would a “values-first term sheet” look like? Each table writes one alternative evaluation criterion on a card; cards are collected and shared.
- Curiosity, not prosecution. Most investors operate inside a system whose incentives they did not design. The point is to make that system visible — not attack the people inside it.
- Voices that are usually last get to go first. Students from MSIs, community members, and people from non-finance backgrounds are invited to ask before anyone else.
- Cards in, criteria out. Every table writes one alternative evaluation criterion on a card during the debrief — these are collected and shared publicly after the event as a provocation document.
Come ready to rebuild the blueprint.
May 1, 2026 · 9:00 AM at Threshold Ventures, 630 Ramona St, Palo Alto.
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