We believe that Julius Caesar’s crossing of the Rubicon is a useful metaphor in describing the challenge of rolling out an innovation that fundamentally changes the way an organization works. An important (and often fancy) transformational concept successfully tried on a small scale, in some kind of sandbox environment, is to be implemented through a large-scale change effort, engaging many new stakeholders. Achieving truly transform­ative changes means reevaluating skills as well as shifts in priorities, resources, and power.