Over the past five years, digital health innovation has consistently attracted billions of dollars in venture capital amid healthcare payment reform and care redesign. Ancient problems are being attacked in different ways and dogma overturned with real world data. However, complex healthcare bureaucracies, giant vested interests by incumbents, and slow change by healthcare professionals continue to slow the adoption of the best solutions. Examples will demonstrate how startups and entrepreneurs are attacking old problems with new business models and tech-enabled solutions that scale care while collapsing costs.