00:02:56 · Matt
[00:02:56] S0: Well, I'm touched that you were willing to come here and let us put our fingers in your ears. And the experience you just went through parallels my early experiences with hearing aids when my grandparents were struggling with state of the art hearing aids, I couldn't understand why I had to beg them to put on their hearing aids. No one has ever needed to ask me to put on my glasses. Like, no. You couldn't pay me enough to not wear my glasses, and I had to beg them to put on their hearing aids. And I never understood why they didn't want to wear them until I started experimenting with high end hearing aids myself. And then I went through all the stages of grief. I was shocked. I was angry. I was like, we, this is what people have to live with. And over the last five years, my colleagues, you know, have have have been very passionately at work to try to improve the state of the art. And I'm so glad that the distinction was as clear as it was for you, and it's the experience that a lot of our patients have, and it's the reason we do this, it's the reason we're so excited to finally be in market.
00:04:19 · Sachin
[00:04:19] S1: I think the, maybe the most compelling kind of problem to solve is one of dementia, right? And we know that hearing loss is one of the big causes of dementia. Initially, my granddad passed away about six months ago and there was a steady decline from when his hearing started to get bad. The example you shared, he never wanted to put it on. It almost alienated him more when he was in loud spaces. When we were out for dinner as a family, just couldn't hear at all and he'd just be quiet in the corner. Like, you know, my grandma always said that's kind of when his decline started. So I think everyone listening to this will will have, know, someone that they love in their lives that would have been impacted by this to a certain degree. But Matt, I know that you found this problem a long time ago, but there was a gap between when you found it and really emotionally felt it, then when you decided to really go after it. What were you doing in that gap?
00:05:13 · Matt
[00:05:13] S0: Yeah, so I unfortunately had a similar experience with my own grandparents watching them drift away, seeing them present but not really present. That got me very interested in this space. And so I think it was around 2014 I was working at Bridgewater, which is this very large hedge fund. And my nights and weekends, I was reading audiology textbooks. And I was lucky to have my best friend. His mother is a professor of audiology and a really prominent influential professor of audiology. And she was just very encouraging of my interest. And after a few months, I got very discouraged because I realized that building a better hearing aid for my grandparents was, it seemed like too hard of a problem. The more I learned about the space, the more intimidated I got. And just to give you a primer, age related hearing loss is sensorineural. So it's not just a problem in the ears. It's as much a problem of the brain as it is of the ears. And so when I came to appreciate that it's not enough just to make sounds louder, You have to differentiate between sounds that are important and unimportant. This in 2014 was very mis... Misaligned with the capabilities of digital signal processing techniques that powered hearing aids. So when I appreciated just how intractable the problem was, I gave up. I just put it on the shelf, and I didn't want to work on hearing aids unless I really thought I had something to contribute. But that process of learning about hearing aids twelve years ago got me very excited about spending my career on medical devices. And so I was very fortunate to find a job at an early startup company called Butterfly Network founded by this guy named Jonathan Rothberg, who was a pioneer of genome sequencing on a semiconductor platform. This is a big deal innovation. If you've ever known anybody who had cancer and beat it, it has a lot to do with this innovation of sequencing the genome on a semiconductor platform. It's called next generation genome sequencing, and it changed the world. This guy had this playbook for taking a conventional industry and disrupting it with custom chips. And he had done this very successfully in sequencing, and he wanted to do it in medical imaging. And I heard about this. I was like, this is what I got to spend my time on. And so it took me about a year. I just begged, begged for a job.
00:07:59 · Matt
I became sort of an expert in medical imaging technologies, eventually joined as a product manager at that job. And for six years, my colleagues and I, many of whom are my colleagues again, my co founders again, devoted ourselves to this mission of building a better medical imaging system. We thought of it as a visual stethoscope. And so it's a handheld medical imaging system that itself is a custom chip, and it connects to an iPhone, and it's about 100 times less expensive than a conventional medical imaging system. And we're very lucky that it became the best selling medical imaging system of all time, and we were able to take the company public a few years ago. After that experience, my colleagues and I had developed a bit of a playbook ourselves for how to do stuff like this. And it was after that experience and the confidence it gave us, but also the network of engineers, window into what was possible with AI, that encouraged us, me and my co founders, to take another look at hearing aids. And this time, we already had experience as a startup company disrupting a major industry, building a radically new kind of custom chip. Deep learning had emerged. The world was quite different. And so I felt, and I will say, sadly, the next generation in my family now was struggling with conventional hearing aids, and I was shocked again to see that the technology had barely progressed. So this was the call to action and we felt like, all right, if we don't do this, who's going to do it?
00:09:46 · Adam Miller
[00:09:46] S2: When you consider hearing aids, they do an incredible thing for the world. They help people hear better. But the reality is, is that traditional hearing aids aren't that great. They got to experience it in this episode. And what Fortell are doing is that they're putting incredibly powerful AI into hearing aids to make them 10x better. And they've meant that people can hear so much clearer and just have a better overall living experience. Now, when you relate that to Notion, Notion's always been a great tool. We've used it to run literally everything in our business. But quite recently, they came out with Notion AI. It's AI that sits on top of all of Notion, allowing you to search for any docs, allowing it to do work for you. You can spin up little agents in your Notion. And so they've gotten a product that has been great and made it even better by adding AI on top. And the really sweet thing is, is that we're putting everything into Notion. We're giving it more data points about us over time. And what that means is that Notion AI gets even better over time as well. It learns more about us, it has better context, and it can make better decisions for us. For anyone out there that's not already using Notion, we've got a special offer for you, three months of Notion business for free. If you head to ntn.sosachinandatom, you can get it there. So the call to action and the problem with conventional hearing aids sounds very obvious and explicit there. But it seems like for your company, AI was the big unlock. Can you sort of run me through how you got this insight that AI might be the unlock that's needed for hearing aids and how you developed the conviction to get to the point where you're like, wow, I can develop a whole company based off this.
00:11:25 · Matt
[00:11:25] S0: Yeah, so it actually goes back to COVID. So the context here is I was primed from my previous passion investigation, maybe you could call it obsession for making better hearing aids. I was primed. I understood the problem, which is that people with a hearing loss don't just need loudness. They need selective loudness on the important stuff, And otherwise, they need quiet. If you could take grandpa to a really quiet room and put in his conventional hearing aids, that's going give him the best possible chance of staying connected to conversation and the people he loves. So I knew that this was the issue. It had been on the shelf. I'm doing this company with... As an early employee called Butterfly, where we're doing our own custom chips, our own AI, our own manufacturing, full stack medical device project, and COVID hits. And all of a sudden, we're thrust behind our laptop screens at home. And I don't know if you guys remember that early COVID, background noise in video chats was a major problem. You could hear when people were typing, peep... You know, people were always kind of shushing their kids. You have to turn off your air conditioning units, telling people to mute. It was a nuisance. And then gradually, the background noise just got quieter and quieter. And it dawned on me one day in a meeting, I was watching my colleague type and I couldn't hear him. And I had this kind of moment. It was like, woah, Zoom and others like it, they are doing what was impossible. Right? They're they're differentiating between sounds on the basis of what they are, not what frequencies comprise them. And so I had this like kind of realization that this technology that had been deployed into telephony and video conferencing could be a major, major game changer for hearing aids. The question was, could could it work? There was a proof of principle in video chats, but in in a video chat, the problem is way easier in kind of every dimension. You have much easier input signal to noise ratios because in video chats, you talk directly at a microphone that's positioned to pick up your voice. You're very close to that microphone. So you have very easy incoming signal to noise ratio. You have this very large computer. Even if it's your phone, your iPhone is a very large computer relative to a hearing aid. Hearing aids are tiny, and they need to last all day, right?