Sure, Apple Watch saved my life. But it could do so much more

I should be extremely grateful for this technology -- and I am. But I know these devices have more potential.
Written by Jason Perlow, Senior Contributing Writer

In early January of 2018, I bought a used Apple Watch Series 2. It was a frivolous purchase that was made in the name of research, to acquaint myself with the entire wearables phenomenon that so many of my friends had already been experiencing.

For the first few months, I didn't do much with it other than receiving notifications from my iPhone and tracking activity. In other words, typical sorts of things most people tend to do with any fitness tracker type of device. I charged it every night, I put it back on in the morning, and didn't think much else about it.

That all changed in May of 2018 when I joined the tail-end of Apple's Heart Study.

The events that were sent into motion as a result of that decision changed my life. The Heart Study detected a possible arrhythmia in my heart, which was confirmed through the use of an ePatch, a small device that was adhered to my chest for ten days which collected data and sent it back to Apple for analysis. 

This analysis performed by Apple's Heart Study cardiologists and electrophysiologists resulted in a diagnosis of Atrial Fibrillation, or Afib. Afib is a severe condition that had it gone undiagnosed, could very well have resulted in a debilitating or fatal stroke within a few years or even earlier. 

The condition was eventually corrected by my electrophysiologist in August of 2018 using Cardiac Ablation, a minimally invasive procedure using catheters that are inserted into the veins in the groin. When inserted, these catheters are guided into the heart chambers and use RF energy to neutralize the faulty electrical connections, which allows functioning connections to re-establish normal heart rhythm. 

I have been Afib event-free for nearly a year. To say I am an Apple Watch and Heart Study success story would be an understatement. 

The results of that study and the data that was collected from it allowed Apple to create the Afib diagnosis features in the Apple Watch Series 4, which I now wear every day. I can spot check my ECG if I am feeling off, and confirm whether or not I am in Afib. That's a huge relief. Other features, such as the heart rate sensor will also tell me if any other symptoms require immediate action.

My Apple Watch saved my life, and it gives me significant additional peace of mind. I should be extremely grateful for this technology -- and I am. But I know these devices can do so much more.

If something can be measured, whether it is a physical/biological condition that has a metric or an environmental factor, I want to know about it. Not only do I wish to be made aware of internal and external conditions when they change, but I also want this data stored in the cloud somewhere so that analytics and machine learning techniques can be applied to it. 

I want hundreds of thousands -- millions --- of people to be doing the same thing as well so that the data from these devices can be sampled and analyzed in massive amounts. I want health care professionals and scientists to figure out how to use it in order to diagnose all sorts of other conditions better. I also want my own health care provider to be alerted to possible issues that I may not even be aware of at the time. 

Such applied data analysis technology can usher in a new form of preventative medicine and advanced diagnostics that we have only seen on the likes of Star Trek. And yet these technologies are becoming real.

Mobile ECG itself is about to improve in accuracy and the fidelity of data collection with the release of the AliveCor Kardia 6L. AliveCor pioneered mobile ECG, with the first single-lead mobile device that was Bluetooth pairable to a smartphone, and also with the first single-lead ECG band for Apple Watch. 

The Kardia 6L has three electrodes rather than two used on their previous product (and the Apple Watch), so it can record six leads of data rather than one. This is roughly half of the precision of a clinical ECG, which has twelve leads.

With additional leads, many more conditions other than Afib can be diagnosed. AliveCor can already detect conditions with their advanced machine learning algorithms that the Apple Watch cannot, such as Long QT Syndrome and Hyperkalemia. Potentially with six leads, it would be possible to get early warning signs of a heart attack. And unlike Apple, AliveCor has partnerships with clinical practitioners so that they can monitor their patients' ECG data in the cloud.

Could we see a 6-lead ECG on a future Apple Watch? Possibly. But many other sensors are potentially useful which would improve our lives as well.

Recently I have been testing the Beddr SleepTuner, a small Bluetooth-connected sensor that adheres to the forehead. The product uses an optical sensor and accelerometer to measure resting blood oxygen levels, stopped breathing events, heart rate, sleep position, and time in bed. The data it collects and displays on its smartphone app helps you to determine if you are getting a good night's sleep.

Beddr's SleepTuner is not necessarily a replacement for a full-blown sleep study at this time. However, if you have already been diagnosed with sleep apnea, the product is effective for confirming that your CPAP therapy is working correctly -- such as a properly fitted mask and a good sleeping position and pillow use/head positioning. 

And if you aren't a CPAP user, it could end up telling you that maybe you should look into having a sleep study done if your results aren't good. But I have already used it in conjunction with the diagnostics I get from my CPAP to determine that not only was the type of mask I was using insufficient for maintaining good airway pressure but also I had to find a better pillow because my head was not at a good angle as well. 

Once I corrected those issues, I got a result of "Good" from Beddr versus the "Poor" I started out with.

Is this Star Trek sleep sensor technology? I'm not sure, but considering that the real Captain Kirk has obstructive sleep apnea, maybe he should look into getting one himself.

What about something like blood sugar levels? Well, the Apple Watch can't currently do this, but there are multiple products on the market that are essentially smartwatches with continuous glucose monitoring, such as the PK Vitality K'Track

I'm not currently a diabetic, but I was a Type 2 when I was morbidly obese. I'd sure like to know if after a night of crappy eating that perhaps I had better throttle things back a bit. And ultimately (but hopefully not) down the road, I'd like to know if I need to revisit the idea of taking statins and other medications to control blood sugar.

Another possible sensor addition could be Galvanic Skin Response or GSR. This technology allows the electrical conductivity of the skin, which is tied to moisture changes, to be measured. When combined with heart rate and ECG, a better profile of a wearer's emotional state can be measured, such as when one is experiencing anxiety. 

For people suffering from anxiety and other conditions such as PTSD, it could permit applications to be written using biofeedback mechanisms. It could also add additional functionality to mindfulness meditation (such as with apps like Headspace for practicing controlled breathing).  

This type of GSR sensor for detecting and managing emotional wellbeing in a wearable was already attempted in 2016 by Vinaya, but the company was unable to go to market successfully. Still, the technology is quite viable, and it would not be surprising to see a company like Apple integrate that functionality in a future Watch.

All of this is related to sensors on the body. But there are environmental issues which can and should be measured as well. WatchOS 6, which is currently in beta testing by Apple, now has the ability to sense environment audio levels. This feature is particularly useful when you are in that super noisy restaurant or bar. 

If you sustain 90-decibel noise for longer than half an hour, your hearing could be damaged. Ultimately, I would like to see 3rd-party apps be able to retrieve the audio sensor data, such as a restaurant review site like Yelp, Google Maps or TripAdvisor, where patrons can sample and report the noise levels at different times of the day. 

If my favorite happy hour spot is peaking at 95 or 100 decibels because the evening entertainment is going to bust my eardrums, not only do I want to know about it before I go there, but the restaurant itself should know to take action when it happens when all of their patrons' alarms go off.

Other sensors might include things such as a Geiger counter/dosimeter. After watching Chernobyl a few weeks ago, I want to know if my local nuclear power plants are leaking radiation. These sensors built into wearables and for external Bluetooth use already exist -- they're just not built into something like Apple Watch yet.

What else? We can use our wearables as direct interfaces to our smart home assistants like Alexa, Google Home, and Cortana. Siri should be able to do all this stuff, but why shouldn't Alexa or Google Home be able to run on Apple Watch or Samsung's Gear? Yes, there are some 3rd party efforts to do this, but there's no reason why these shouldn't be first-tier apps from the partners themselves on these platforms.

I love my Apple Watch, and I am probably going to be a customer for life. But there is so much more it has the potential to do.

What other sensors or capabilities would you like to see in your Apple Watch, Samsung Gear, or WearOS device? Talk Back and Let Me Know.

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