For most of us, any sort of focus on health only happens when we are unwell. This is something Dr Sumbul Desai, vice president of Health at Apple, witnessed up close in 2001, when her mother woke up with an intense headache. Little did she, or the family, know at the time that it was a sign of a stroke. That was an era much before the Apple Watch, or health tracking wearables.
“My hope is that people start thinking about their health from a more holistic approach, not just thinking about their health when you get sick, because that’s currently the mindset for a lot of people,” says Dr Desai, in an interview to HT.
Dr Desai is a physician and worked at Stanford Medicine before joining Apple, where she now drives the company’s health tech services and products that began with the Health app in 2014 followed by the launch of the Apple Watch in 2015.
The Apple Watch, in many ways, put the smartwatch ecosystem on the map. “I think the biggest gift you can give everybody is empowering individuals to understand their health, and really put people in the driver’s seat of managing their own health,” she says.
Over the last couple of years, Apple has widened the health, wellness, and fitness portfolio, including heart health, menstrual health, and safety features, such as walking steadiness. The additions were done in phases of watchOS updates, the operating system for the Apple Watch. Irregular rhythm and low heart rate notifications were added in 2018, while cardio fitness arrived in 2020.
All features rely on a complex set of algorithms, which must be updated and optimised. Mobility metrics such as walking speed and step length were introduced in 2020 while walking steadiness was introduced last year.
The company has an “endless focus” on improving accuracy of readings that typically requires specialist equipment. “If we don’t hit a level of accuracy that we’re proud of, we don’t release it,” she said. “We run studies, we refine our algorithms, we look at ways to increase our accuracy through development,” Dr Desai added.
In February, Apple announced they are working with researchers on a wide spectrum of heart studies. With Australia’s Murdoch Children’s Research Institute, they are studying the impact of cancer therapies for children on heart rhythm.
The Amsterdam University Medical Centers research is underway to explore ways to detect AFib, or Atrial fibrillation, earlier. AFib is a condition which causes irregular and often rapid heart rhythm (arrhythmia), which can lead to blood clots in the heart.
Yet, Dr Desai believes it is still early days for health and tech, working in sync. “Our focus is really to empower users to live a healthier life and doing that with actionable insights that are grounded in science,” she says.
Hospitals and doctors globally are more accepting of data from health tech devices now. “I’m a physician, and I believe that being thoughtful and methodical about how you accept data is incredibly important when you’re taking care of a patient,” she points out.
Dr Desai insists that there must be thoughtful integration of tech solutions into healthcare. Is there a fear that India’s healthcare system is behind global trends, with regards to doctors and hospitals accepting digital data?
“I think what you’re seeing is they’re focused on getting the basics right, and now thinking about how the technology gets integrated,” she says.
She remembers a letter sent to her by a patient in India, who got an irregular heart rate notification on the Apple Watch, consulted a doctor, and was diagnosed with three blocked vessels. “That’s really impressive because it had they not been to the doctor sooner, they could have had a much worse outcome,” says Dr Desai.
Apple believes the ecosystem must work together for health and tech to build rich information streams for users. The company, on the online store in some countries, sells smart health devices from third-party brands. Listed on the US online store, for example, are the Withings thermometer, Withings weighing scale and water bottles from HidrateSpark.
“We love that the ecosystem growing, because it only gives the user richer information,” says Dr Desai. The Apple Health app plugs into data from several third-party platforms, which often have their own devices too. Some examples include the CardioBot heart rate monitor, Mimi hearing test, Nike Training Club, Asics Runkeeper, Strava and Calorie Counter Pro, to name a few.
Are users comfortable with using technology to monitor health, and if need be, use that as a foundation for diagnosis?
Apple, and Dr Desai, insist that at no point do they intend to replace the doctor. The idea is to, what she calls, enrich the doctor and patient relationship, with information that will direct to clinical diagnosis. “We focus on accuracy, specificity, decreasing false positive so that the people that do go to the doctor should be there. We don’t want to create unnecessary doctor visits,” she says.
For giving users the detailed, and accurate health data, Apple is also relying heavily on developers to build more use cases. They talk about an app called NightWave for post-traumatic stress disorder, or PTSD. The app uses the accelerometer and the gyroscope on the Watch to monitor sleep and detect nightmares. It’ll generate gentle pulses on the wrist to break the wearer’s nightmare, but not wake them up from sleep.
