Inside CVC: Patients Don't Have Time for This: David Betts on ALS, Vibe Coding, and Giving People Their Voice Back

David Betts spent two decades at Deloitte building a healthcare strategy practice, ultimately leading a public health business serving 20 states with 400-plus people. Then, at the peak of his career, he was diagnosed with ALS. His response wasn't to step back. It was to build something.

In this conversation, David walks Steve and Philipp through how a non-developer used AI as a teammate to build Talk to Me Goose, an AI-enabled text-to-speech application that gives people with speech-limiting conditions their voice back. He's candid about the aha that came when he stopped treating AI as a search engine and started treating it as a collaborator who had to explain its work.

The conversation goes deeper into what David sees as healthcare's core innovation failure: a system that demands proof before it will try anything, in a world where patients are running out of time. He also reflects on what ALS has made undeniable about how leaders should be spending their attention.

If you sit on a board or lead a health system, this episode will challenge the questions you're asking about both AI and innovation pace.

Learn More About David's Work and ALS:

--> Talk To Me Goose! at https://talktomegoose.app
--> StoryFlight Labs: https://storyflightlabs.com
--> Live Like Lou Foundation: https://livelikelou.org
--> YouTube: https://www.youtube.com/@TalktoMeGoose-h8l

Transcript

Welcome to inside CVC, the podcast that brings together leaders in innovation and capital investment to explore the trends shaping the business of corporate venture capital. I'm your host, Steve Schmith, and together with Philip Willigmann, we're speaking with corporate investors, entrepreneurs and ecosystem builders. Driving the Future of Innovation inside CVC is brought to you by U-Path Advisors, helping corporations and startups unlock sustainable growth through strategic partnerships. To learn more, visit u-path.com. That's the letter "U," hyphen "path.com." And to catch up on all of our episodes, search inside CVC on your favorite podcast platform or visit u-path.com/podcast. 

In this episode, we explore what happens when urgency stops being abstract. Our guests spent more than two decades at Deloitte building a healthcare strategy practice that, by twenty twenty four, was serving twenty states with more than four hundred people. That same year, he was diagnosed with ALS. His response was not to step back. It was to build. David Betts is the founder of Story Flight Labs, a public benefit corporation, and the creator of Talk to Me goose, an AI enabled text to speech application developed in partnership with the Live Like Lou Foundation to give people living with speech limiting conditions their voice back. 

In this conversation, we discuss how a Non-developer learned to treat AI as a teammate rather than a search engine. Why healthcare innovation moves too slowly. How. David built a working product and launched a company during one of the hardest periods of his life, and why he believes the right measure for AI's impact is not efficiency, it's dignity. We pick up our conversation with David, sharing how a career strategist faced with a problem no existing solution could solve for, chose to build the answer himself.

Well, it's it's been quite a journey and um of learning um for me, throughout my career, I was a strategist and I guess once a consultant, always a consultant. And when, when faced with a problem, what do you do? Right, you, you kind of figure things out. And that's, that's what happened. I found myself at this, you know, crossroads of having a problem, um, and needing to find a solution. And so that's what I did. Can you talk a little bit more about maybe an aha moment you had, you know, diving into AI I've always been curious about technology and, I took computer science classes when I was on the faculty at Carnegie Mellon. And when I landed at Deloitte, I landed in our health care practice, um, with no experience in health care. What was the biggest aha moment when you got into healthcare? I mean, that's a long, long time ago. But when you came out of academia into consulting healthcare, what was your like? Wow, I did never expect healthcare is run like this in the US. Well, that might have been the biggest aha moment is Holy cow, how do we run healthcare like this in the US? Um, you mean to tell me this is how it works? Um, you know, so so yeah, I did a lot of different things in healthcare, but I did a lot of process work initially. And then, um, and then that led me to do some, you know, into the strategy practice ultimately, but, you know, I had the opportunity to build a customer experience practice within the firm. And that was the intersection of sort of my, you know, I'll call it my liberal arts upbringing and, um, and my process upbringing, how do I bring kind of a human centered lens to the health care space, uh, to make health care better, more accessible and give people a better experience in health, um, while also driving performance improvement for health care systems make them more competitive. And that was really a passion of mine. And, um, and, you know, it meant it mattered for people, um, to make their health care experience better. We've talked with many leaders who are struggling with AI, were there any sort of Aha's that when you started this and being able to say, this is what I've learned I started out building. Talk to me, goose. You know, by putting to work the experience and, you know, put that in quotes. You know, the lessons I'd learned around computer science from the classes I had taken. You know, I knew enough to be dangerous, um, initially. And then I started using AI assistance a little bit as a search engine and, you know, answering questions that I ran into or solving problems that I, that I ran into initially. And the aha for me was that the pivot happened when I started treating it like a teammate. Um, and, uh, realizing that I didn't, it wasn't a search engine that it was a, it really was a, um, a teammate of mine that could do work. And, um, I do have a bit of a rule, if you will, and and, you know, maybe it's not, maybe it's not a good rule, but it's one that I like to follow, which is I don't put anything into the solution that I don't understand myself. Mhm. Um, and so I do use the, um, I do use the AI assistants to help me develop solutions to problems that I have or create capabilities for the features for the tool, uh, for the solution. But I make it, explain it to me, uh, just like I would an analyst on my team or a consultant on my team. Help me understand how this is going to work so that I understand that it will work, so that I make sure that the code will function according to the design. Uh, that'll meet the requirements before I put it into the tool and push it to production so that it's not just a vibe coded solution. It's it's, you know, because I think vibe coding is, you know, make the AI do the coding and then just push it to production. Like, how do I know that's going to work? Let me understand the functionality, explain it to me just like you would if you were an analyst on my team. And that pivot was really critical. David, you, you were a senior executive at, at Deloitte on the top of your career. at some point, you know, you realize something and you're like, okay, something is not the same. Yeah. Can you maybe share a little bit about, you know, how that felt? And I would also love, um, to talk a bit about, you what ALS actually is because it's very, very rare. but like, I can imagine at that level of seniority and being at the top of your career, how, how do you find out how, how, what did you do? Yeah. And thank, thank you for that, Philip. We actually haven't talked about what, what sort of brought brought us to this discussion. But so yeah, so twenty twenty four, you know, I was leading at that point, our public health practice, uh, which we had grown from, uh, you know, we were serving one state, um, a little bit haphazardly, to be honest, in twenty twenty, um, when the pandemic occurred to a business that we built starting in twenty twenty one to serving twenty states in twenty twenty four. Um, and the firm had asked me to, to grow that business beginning in twenty twenty one. And I'm super proud of what we did. We had four hundred plus people, um, serving twenty states. And, and I was at the, you know, what a lot of people would describe as the top of my career. Um, but something was not right. And I, you know, I'm an avid cyclist. I had just completed, you know, in twenty twenty three, a seven day stage race through the Alps. I finished in the middle of my age group. I was physically probably at the peak of my fitness. Um, I was training for another ride across Britain, which is a thousand mile bike ride over nine days. Something wasn't quite right, and I was seeing my physician regularly trying to figure this out. You know, I was having trouble clipping into the pedals in ways that it wasn't like trouble. It just didn't happen as automatically as it should. After twenty plus years of cycling and I wasn't weaker. But there was a relative weakness in my left leg and I noticed it. But no physician that I saw could seem to tell me. One of them rolled his eyes at me. Um, but there was something wrong. And then as the year progressed in October, late October, early November, my speech started slowing down. At the end of the day, I couldn't sustain a full day's effort. And you know, when you're a consultant, you rely on your you know, I talked to clients for a living. And by the end of the day, uh, a senior manager described it to me as, as being as if my tongue couldn't keep up with my brain. Um, I was slurring my S's and my speech slowed down, and I knew something was desperately wrong. Um, and I found myself finally at Mass General Hospital at the Healey Center for ALS. And by that time, I think I knew myself that this was probably what the problem was. And indeed, while they didn't confirm it in December of that year, they said it was presumptively als. And it was confirmed a few months later with with more progression and, and more diagnostic testing. Um, it's a diagnosis of exclusion. Um, so ALS is a neurodegenerative disease. Um, it progresses differently in different people, but ultimately the outcome is the same. Um, the motor neurons in your brain and spinal cord degenerate and die and you lose the ability to move, to speak, to swallow, to breathe. Um, and ultimately, um, it is fatal and there's no cure. Um. it progresses at different rates in different people, but the average life expectancy is two to five years. Um, and um, you know, we hope that science will continue to progress to find a cure, but, uh, at this rate, uh, you know, we're still searching. Uh, I am in a clinical trial, a phase two clinical trial of a drug that is an immunomodulatory therapy. The hope is that it will slow the progression. I'm seven months in. I'm hopeful. And my perspective, my perception, I should say, is that it has slowed the progression. Um, I, I count myself among the lucky ones that my progression has been slow all along. But there is progression. Things get harder all the time. Uh, it's doing what I'm doing today that keeps me moving. Um, you know, I do count myself among the lucky ones. Um, I had an amazing career at Deloitte and I, I get to spend now my time doing the things that I love to do and and giving back. Um, you know, somebody said we all, I think it's Confucius quote. We all have two lives. We start living the second when we realize we only have one. And so here we are. And I mean, and David, you shared with me, uh, when we met at the zero project conference a couple of months ago. Um, you know, your initial reaction after I assume you realized, okay, this could go really, really bad very quickly was like, I want to spend time with my loved ones, right? Go on vacation, spend time with your wife, which I would assume, like I would probably have a similar, um, you know, thought, but what then does, you know, made you say, well, hold a moment. I need to think about, you know, building a new technology. Um, after all the things you've done, you worked a lot, right? But what was the point where you kind of said, you know what? There's there's still more in here. what was the motivation to kind of say, I'm, I want to build like, I want to build an AI tool. Um, talk to me, goose. Yeah. Well, so you're going to laugh, but because there's three things like I do. Um, and as a consultant, there's always three things, right. Um, so first was, yeah, Ann and I are going to travel. We're going to see parts of the world that we've yet to experience. the second thing that I'm doing is I'm doing a lot of advocacy work. Um, that matters. I have resources, I have access, I have experience, um, I have a responsibility to give back. And, um, um, I, I feel, I feel that responsibility every day that I should access or use my access and experience to, to make a difference. So I do that, uh, quite a bit of my time. And then, you know, I'm somebody who processes the world out loud. And that was really on my mind when my speech was impacted. And so I started looking at the solutions that people use, and I was disappointed with what I found. And, and I thought very selfishly, I need to have something that's better. And as soon as I started building, um, I realized when I had a prototype in my hand, if it worked for me, it would work for others. And, um, and I just kept iterating on it and, um, and I, I quietly introduced it to the market in March of twenty twenty five. And I started looking for partners and I found an amazing partner with the live like Glue Foundation, who we started working with, uh, to make it available to people for free in North America. And, um, and that opportunity and privilege to make a solution that gives people their voice back, that returns people some autonomy and agency to communicate in a human way with their loved ones. Using AI to make it easier with a unique solution that I think is better than what's out there, uh, just fuels my passion and keeps me moving and like, why would I not want to do this? Uh, so, uh, so here, you know, um, and, and the, you know, the first family, one of the first families that used the solution fill up has two young kids. And, um. The, the picture they sent me, uh, early on of Darren with their two youngest on his lap and Merlin and the caption that says Merlin's making him a smooth talker. Merlin being the AI agent, you know, that just like blew my mind. And because that was exactly the goal, but it wasn't enough because I realized that here's a young man living with two young kids who could no longer tell bedtime stories to his kids. And if I could create the opportunity to use our solution to create and tell a bedtime story to his children. Um, I spent I spent our tour of the British British Isles building the ability to create a bedtime story in the solution so he could tell a bedtime story to his kids. And that became a super unique feature was the story builder. And it. And to give him the opportunity in the last few months of his life to spend every evening creating and telling bedtime stories with his two kids, uh, made this a special solution. Um, and, um, I mean, what a privilege. I was in Singapore two weeks ago and I was on a, on a multiple panels to talk about longevity, um, and living longer. And we had a very honest conversation that obviously that's, you know, it's, that's maybe something for the top one percent. Uh, but I think it's always about how do we make sure that we all live healthier, more independent? Um, and one, one of the things which came out of it like to do that, right? You have to think about systems and you have to change systems and with your with your background in healthcare and now being a patient, right? How how do you think about what has to change in the healthcare world? You know, how, how can we actually innovate? How can we actually make sure that we create a health and care system, which is really supporting everybody, um, starting with one which are most vulnerable? Any, any perspective on that, given your decades of experience working in the healthcare in the United States? Yeah. I spoke at a conference, uh, just a month ago, I guess. Yeah, a month ago, end of April. And one of the things that needs to change is we talk about healthcare innovation. Inside the system, uh, the innovators. I'll put that in quotes in healthcare often talk about, you know, all the work that they're doing. And I sat in sat in a room in mid-April and I heard talking about pilots and research and testing and, you know, some of these companies and stealth mode and how long they've been working on this. And I leaned over to a colleague and I said, I don't have time for this. She said. She said, what do you mean? And I said, no, I literally do not have time for this. And that has to change, right? We have to we if we're going to really, truly innovate, we have to move faster. Um, and I think we get in our own way. And when we talk about innovation, to me, innovation is, is iterative and it's testing and, and, and learning and iterating. And I think we let risk management get in the way. And I have a piece that I'm about to publish on this where we put we put standards in clinical trial, you know, clinical trial standards and in the way of, uh, you know, process improvements that would make things so much better where those standards are, are simply too high. They're not necessary. So for example, you know, like, what's the risk of what was the risk of me putting out our, you know, the solution that I've built? Like, or even trying it relatively low, right? And probably even the cost, even the costs were probably relatively low. Right. Exactly. But if you tried to do what I've done inside a health system, the likelihood that it would make it to. A patient is also relatively low because the, you know, the it would stay stay in a pilot mode. I built a solution with a health system back in twenty nineteen. Twenty twenty has yet to see the light of day six years later. Um, the benefits to patients would be enormous. The cost savings to the health system would likely be enormous, too, but the willingness to try is too low. Too many health systems are looking for the precedent data to prove that the solution will work. Before they try it, somebody has to go first, right? So so if you're looking for for the data to prove that something works before you try it, who's going to try it? Nobody's going to you know, somebody has to go first. Somebody has to try it. There's never going to be the data to prove that something works unless somebody actually puts it in market and tries it. And that's what I think is standing in the way. So I stood on the stage of. Of a conference and, and provoked the audience to, to, to, you know, get out of their own way. Right. Patients don't have time for this. And doctors move at the speed of, of trust. Patients move at the speed of urgency. And that's what needs to change in our system is that, you know, we can move faster. We did it during Covid, Philip. I mean, if you and I were on this task force together, we did. We moved mountains, right? And because we got out of our own way, we tested and learned and changed and, and we were agile. And somehow when, you know, when we opened back up in twenty twenty one, we put those skills away and we forgot and we went back to the old ways of doing things. Um, why can't we go back to those agile days of doing things in an iterative test and learn and grow phase? But, but for whatever reason, we, we decided that, that that can't stand up in a in regular order. I don't know that that doesn't work for me. a lot of people, you know, use AI to, to drive productivity. but you did something which I, you know, I love what you, what you're, what you're doing. Um, but you kind of like really focus on like, how can we use AI to preserve one of the most important human aspects, communication. Without that we do not exist. So what, what, what are we missing at the broader AI conversation from your experience now in the last year, year and a half since you're on this journey? Yeah, I think, you know, we I spoke at another session recently and we're trying to measure the return on AI. Right. And, and, you know, like, let's measure the return on AI and the human impact that we get. And, um, and think about like I was trying to solve three things, right? How can I give somebody the ability to get their own voice back? And so, you know, working with eleven labs as the voice technology provider, they make amazing voice clones. And with as little as forty five seconds of audio, somebody can have a reasonably good clone of their natural voice. And that's amazing. So let's make it easy for someone to get their own voice back. The second problem I was trying to solve was, can we reduce the time it takes for someone to generate the text that they want to say, you know, somebody using an eye gaze device, typing out every word they want to say takes a very long time. And, Uh, if we can reduce that time, we can reconnect people with one another because today's, you know, today's world, people's attention span is low and we don't have the presence to stay in the moment with one another. So how can I keep people connected? Using AI to close that gap? That's a measurable impact in human terms. So like, let's, let's, let's keep that connection. And then how can I insert human emotion into communication by using AI to add tone of voice. And so Merlin adds a tone of voice in. So we not only get efficiency, you know, in this by, by creating text at speed, but we can insert a tone of voice, like being warm and funny, or being sassy or being sarcastic or being humorous. And that adds humanity back into the equation. And so again, thinking about the idea that we can reconnect people with one another, we can add humanity back in. Those are measurable outcomes in human terms. It's not about efficiency now. It's about dignity. And I think that's the way that we should be thinking about impact. Um, and so, you know, there's a lot of sort of push and pull about the, you know, AI in the zeitgeist today, you know, is it good? Is it bad? You know, it's neither evil. We shouldn't celebrate. You know, we can't celebrate it as, as a savior on the one hand, nor should we, you know, revile it as being purely evil. But in this case, I will I will have this argument every day that it is the right use. This is AI for good. If we can reconnect people with their humanity, give them back some agency and autonomy, and reconnect them with their loved ones, I will take this argument every day of the week. So powerful. David, what can leaders learn from what you describe as accessibility first innovation. You talk about conferences you've spoke at recently. If you were speaking directly to a board of directors and CEO, what's the one question you wish they were asking that maybe they're not. Yeah. You know, I. For many years, the practice that I built at, at, at Deloitte was about, you know, putting the human at the center of healthcare. You know, if you look at any of the things that I authored there, it was always about putting the human at the center. You know, it's how we thought about strategy, uh, for healthcare. I think That. That's the question that that any leader needs to be thinking about, you know, put their customer at the center, put the human at the center of this. How is this benefiting the humans that we serve? You know, yes, we can think about efficiency, but at the end of the day, how is this going to benefit the humans that we're serving? What's the impact on them? Um, and if there's no real impact on the human, if it's not making the human experience better. Then why are we doing it? Um, because if we can make the human experience better, then we're going to be at the end of the day, that's going to make us a better company. Uh, it's going to make us more competitive. It's going to make us more, it's going to make our brand more powerful. You know, I'm a firm believer that that is what distinguishes one brand over another is the the value of the human experience that we can deliver. Um, I think we get caught up sometimes in metrics and efficiency. And I used to say to healthcare leaders all the time, like, let's, let's not trade off efficiency for empathy. MM. It's so important these days. Uh, you know, I think to sort of reflect on that last statement, I think, you know, many companies, many brands today, particularly in healthcare are, are dealing with that, that sort of, um, profits over people sort of mentality. Uh, such an important, powerful question. Um, one more question. And then Philip, if you want to want to close us out, um, How has ALS changed the way you think about time, priorities? What really matters? I mean, important for human beings in their professional and personal lives. How has that changed for you? Yeah, I, I mean, I use my time very intentionally. Um, I think I did before, you know, we're always busy people, but, you know, I get up at early. I always got up early, but I get up maybe a little bit earlier. I also go to bed a little bit earlier, but, um, but in between those two moments, I'm super intentional about how I use my time. Um, I don't have any time to waste. Um, you know, I stand at the top of the stairs every morning and I kind of take inventory. If today's the day that I'm going to, you know, I'm going to have to use the elevator. Um, today's not the day. Congratulations. So good to hear. Um, and and when, uh, you know, that day will come, but that day is not today. And and then, you know, from there, it's how am I, you know, how I spend my time is very intentional. Um, right now it's about building the company that we've launched, um, you know, trying to create a sustainable foundation for how we're going to build this organization to sustain the, the mission that we're on to, uh, to allow people to continue to tell the stories that are important to them. Um, and the voice that we can give them. Um, and, you know, I'm, I'm super proud of what we've done over the last eighteen months, but, um, where we go from here, you know, is, is pretty exciting. I think what's on the horizon? Um, we've accomplished a lot. Uh, now it's about building a leadership team that can take this forward from here. Um, I've got a pretty bold vision for what we can do globally. Um, it's not what I expected to be doing after I left Deloitte. Um, but, you know, my father always said, you get to play the cards that you're dealt. Um, I got a, I got an interesting hand and I'm going to play it to win. So I, you know, I mean, two questions. One, for our listeners who want to learn more about, you know, what ALS is, who want to support, where can they find more about ALS research, um, organizations. Where can people find more about, you know, talk me goose. I think, you know, you can just type it probably in Google and you'll find it all over. But yeah, can you help our listeners to make sure they find the right resources? Yeah. Um, you can learn more about ALS, uh, through our partners at live like Lou. Um, and you can certainly support what we're doing, um, at the Live Like Glue foundation, which you can find at live like glue dot org. Um, we have an endowment there that we've set up that supports the work that we're doing at live like dot org slash. Um, and, uh, contributions there, uh, are, are amazing. Um, they've been an amazing partner of ours. Um, they have resources on their website that will help connect people to information about this disease. It'll help people living with this disease, connect them to resources that they can leverage in North America. Um, and if people want to get access to the solution, they can get access to the solution through them. Um, we've launched a company, which is called story flight Labs. Uh, it's a public benefit corporation. Everybody should check it out. We have two products, actually, so we have Talk to Me goose, which is the product that we've talked about a lot today. Uh, the AI enabled text to speech application, but I mentioned the story builder feature and it was such a fun feature. I found myself playing with it a lot And, we created a second app called Fables Adventures, which is just basically a storytelling ecosystem. It's an app to create and tell audio stories. There are a lot of fun. You can download and play with that. Uh, it's a revenue generating app. It's a consumer facing app. Um, there's a YouTube channel, a Spotify podcast series of audio stories, and it helps support people living with ALS as a way for us to generate the revenue that we need to support our ability to make. Talk to me goose available to people who need it, and we're scaling our partnerships for making. Talk to me, goose. Available to people living with speech limiting conditions driven by other causes. So there's a ninety seven million people living worldwide with speech limiting conditions from all sorts of, of underlying causes. So, um, so we're growing, um, we've hired a vice president of business development. We're about to hire a CEO. Super excited about where we're going. Um, and we're raising capital. That seed round is, is about to close and uh, um, lots, lots more fun things to come. is there anything you would have loved, you'd love to share with our audience? Something we did not ask before you close out? I think I just think that, um, you know, everybody should take stock of where they are. Uh, you know, we get, we get super intentional about, you know, what we're doing in our day to day careers, um, and our lives and, and we forget, you know, to like zoom out sometimes and, um, and get, we get super focused on kind of what's the next thing that we're going to do, you know, how am I going to get the next role? How am I going to get the next job? How am I going to, you know, achieve the next goal? Um, you know, zoom out, take a moment, um, do something fun, do something hard for yourself. Um, that causes you to stretch and grow as a person. Don't forget to do those things. Uh, so, you know, maybe those are things to think about.

That's all for today's episode of Inside CVC. As always, thanks for listening. You can find all of our episodes wherever you find your podcasts or online at u-path.com/podcast. That's the letter "U," hyphen "path.com/podcast."