From Idea to Acquisition: How to Maximize Your Startup’s Potential with Twistle Co-Founder Dave Ross


To learn how to maximize your startup’s potential, click here to watch Dave Ross’s global keynote.

Dave Ross’ foray into the startup world was inspired by his 10-year tenure in the healthcare and academic health sciences industry in upstate New York. After growing up in a physician family, he was looking for an opportunity to combine his familiarity with the healthcare space and interest in using technology for good.

An opportunity arose when Dave was ready for a change of pace in his life. He took a leap of faith and made a move from New York to Seattle to join the early startup team at Twistle

Twistle was a healthcare technology startup company that aimed to improve patient engagement and health outcomes by facilitating communication between healthcare providers and patients. After nearly a decade of work building the platform, it was acquired by Health Catalyst in 2021.

In a global keynote for Founders Network on June 21, Dave shared how the Twistle team grew their HIPAA-compliant multi-channel communication platform to achieve the $104.5 million dollar acquisition. He also shared insights on how to maximize your startup’s potential.

During the talk he also covered:

  • How to make your funding pitch the best it can be
  • The importance and tricks behind operational excellence 
  • How to understand and sharpen your value proposition
  • The ‘cartel leadership rules’ that define your path to success or failure
  • The value of giving back with your time, money, and resources

Healthcare Improvements

Reports from the National Institutes for Health indicate that an estimated 27 percent of medical malpractice is the result of communication failures. This number points to a quality control issue in the health communication space.

As a veteran of the healthcare and technology space, Dave was well-versed with industry barriers that limit client-to-provider relations. From regulations to slow-moving policies, breaking down barriers to communication is not a problem that is solved overnight. That is, until Twistle provided a glimmer of hope.

Twistle is a software company that offers automated secure SMS texts, interactive voice response, and an app that helps providers and patients operate in harmony. The company’s mission is to use technology to benefit both customers and businesses to improve the quality of healthcare and health outcomes.

With belief in the idea, Dave joined the team as employee number one – eventually graduating to co-founder during the company’s eight-year growth journey. 

The Winding Road To Success

One of Dave’s largest takeaways from the Twistle acquisition: each startup story looks different. Today, Dave serves as CTO at Health Catalyst, which he notes, is not the traditional founder-to-exit trajectory. However, Dave says Twistle’s journey has never been traditional and  was a key to their success.

“I believe we did our Series A roughly seven or eight years into the company. We thought we’d be there within two years at most. But after about 18 months, we realized that we were nowhere near finding product market fit. At the time, we didn’t have much of our own resources left,” says Dave. “And so when we finally did raise the Series A seven-and-a-half years into the company, we raised over $11 million.”

It was important for the team to not rush the process when finding their product market fit. To achieve this they leaned on frugality to keep the business afloat.

“When we exited, we had only spent a fraction of what we had raised in our Series A. So we still had plenty of capital when we exited. And that runway allowed us to be thoughtful about our next move,” says Dave.

This mindset is one of the core values that Dave attributes to the company’s good fortune.

Keep It Scrappy

Dave’s main advice for startup founders is to “keep it scrappy.” For the team at Twistle, that meant taking on contracting gigs and working other roles to supplement their income during the near decade they spent perfecting their product.

“Moonlighting offered our team a different context and understanding that allowed us to build something that was more applicable, a better product, a better market fit. Something bigger, better stronger,” says Dave.

Learning from outside jobs also taught Dave other lessons. It solidified his belief that the team did not need to build everything from scratch. It also taught him how to sharpen his pitch to potential investors.

“There were times where I wished we just walked in to see investors or potential customers with a PowerPoint instead of a functioning product,” says Dave. “It would have offered me a way to test our ideas and see reactions without making product investments too far in the wrong direction.”

To learn how to maximize your startup’s potential, click here to watch Dave Ross’s global keynote.

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