It would have been a beautiful sight to see the mountain ridges and terrain in Virgainia but the flight into Inalls Field was on a dreary, cloudy, drizzling evening. The runway was 5,600 feet long but it was also 4,000 feet above sea level; the thinner air making it effectively quite a bit shorter. A short van ride through the winding mountain ridge roads brough us to The Homestead in Hot Springs, Virginia to the Management of Change Conference 2011. The American Council for Technology (ACT) – Industry Advisory Council (IAC) is a non-profit, public-private partnership dedicated to improving government through the application of information technology. ACT-IAC provides an objective, ethical and trusted forum where government and industry exchange information and collaborate on technology issues in the public sector. It was a privilege for me to be the opening speaker prior to the participants spending several days of intense discussions and collaboration. I talked about the future of the Internet and how healthcare is being positively impacted by the evolution of the Internet. My slides (presented using Keynote from the iPad2) can be found in the presentations section of patrickWeb. The flight back was clear and smooth at 38,000 feet but the descent into Westchester County Airport took us all the way down to decision height before we could see any lights.