Four Takeaways from the Apple Watch Series 4 Announcements

Harish Kilaru
Cardiogram
Published in
3 min readSep 13, 2018

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Today, Apple announced that the next Apple Watch will feature an ECG sensor and automated fall detection, building upon the optical heart rate sensor that shipped with the first Apple Watch. In multiple clinical studies with UCSF Cardiology, Cardiogram has shown the humble heart rate sensor can detect hypertension, sleep apnea, diabetes, and atrial fibrillation.

So what does Apple’s new ECG sensor mean for wearables in healthcare? Here are a few implications:

Wearables are no longer just for the worried well

Even before today’s announcements, the average Apple Watch owner was 41 years old and more likely than the general population to manage a chronic condition, as shown in Cardiogram’s Wearable Health Usage Report. Contrary to popular belief, wearables have already shifted beyond just the “worried well.”

Apple’s announcements will drive this shift even further. Adding detection of falls and atrial fibrillation is undoubtedly valuable for the elderly, and broadens value to a group that significantly benefits from continuous health monitoring.

Prevalence of chronic conditions among wearable owners vs. prevalence in general population. Sources: Survey of Cardiogram users, CDC

What about the other 83%?

Apple Watch was recently named the #1 wearable by IDC, with a market share of 17% [1]. But what about the other 83% of wearable owners, including people with Android phones?

That matters because undiagnosed chronic disease disproportionately affects populations of lower income, so payers and providers need solutions that cover a range of price points and platforms.

We recently re-wrote Cardiogram’s watch app for Wear OS by Google and launched Cardiogram for Garmin Watches. As other wearable manufacturers advance healthcare efforts, we’re excited to build out partnerships that enable our cross-platform solution that the owner of any wearable — from a $29 LETSCOM Fitness Tracker to a $399 Apple Watch Series 4 — can enjoy.

Market share of leading wearable manufacturers. Source: IDC

Cardiovascular conditions are interlinked

FDA-clearance for atrial fibrillation (AFib) is an incredible achievement, but AFib can often be caused by other underlying health conditions, like sleep apnea or hypertension.

Earlier this year, we presented clinical results showing that DeepHeart, the deep learning algorithm powering Cardiogram, can detect sleep apnea, hypertension, and diabetes at 83% accuracy, 81% accuracy, and 85% accuracy, respectively. By screening for a variety of conditions, we hope to offer users a comprehensive health analysis that, when validated with FDA-cleared tests, can empower both the user and physician to uncover the root cause of their cardiovascular risk.

Health data needs to be contextualized

Users receiving alarming health information are incredibly vulnerable, so it’s vital to provide context, peace-of-mind, and appropriate next steps.

With Cardiogram, whenever a user is detected to be at-risk, the first step is always to offer a complimentary, FDA-cleared test to confirm the diagnosis. We’ll only refer to a physician if that confirmatory test is positive. This accomplishes three things:

  1. Health information is always contextualized — users know that DeepHeart is not providing a diagnosis, and immediately offering a complimentary test prevents users from rushing to the ER.
  2. Smooth physician handoff. We order the same confirmatory tests as a physician (e.g. A1C test for diabetes), so referred physicians are working with standard data.
  3. Value-based pricing. Payers are only charged if the confirmatory test is positive; if DeepHeart was wrong, they pay nothing.
Cardiogram’s four-step cycle of continuous health monitoring

Consumer devices are set to dramatically improve how we manage our health, and today’s announcements by Apple push the industry forward. We’re thrilled to help lead this movement!

You can download Cardiogram for Apple Watch here.

You can download Cardiogram for wearOS by Google here.

Health insurers and employers: your members or employees may already be using Cardiogram. To find out how to work with us to support them, shoot me an email at harish@cardiogr.am.

[1] https://www.idc.com/getdoc.jsp?containerId=prUS44247418

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