• by Thom Forbes  @tforbes, December 5, 2017

The Apple Heart Study app, which launched last week in collaboration with the Stanford University School of Medicine, is the latest indication that the face of medicine is increasingly digital and will be monitoring our every move — and variation from the norm — with the ardency of a helicopter parent. It’s also a huge business opportunity just entering its adolescence.

The Apple Heart Study is open to anyone 22 or older with at least a Series 1 Apple Watch and an iPhone 5s model or later. Participants cannot be taking anticoagulant medications or be diagnosed with an atrial flutter.

“The way Apple explains it, a sensor inside the watch uses green LED lights flashing hundreds of times per second and light-sensitive photodiodes to detect the amount of blood flowing through the wrist. The sensor has an optical design that gathers signals from four distinct points on the wrist. Using software algorithms, the Apple Watch can isolate heart rhythms from other noise, and identify an irregular heart rhythm,” writes Edward C. Baig for USA Today.

“The study is the latest aiming to tap the ubiquity of mobile devices to monitor or improve health, and it is Apple’s most aggressive attempt to elbow into the $3.2 trillion U.S. health-care market,” write Peter Loftus and Tripp Mickle for the Wall Street Journal in a piece that also looks at the high drop-out rates and privacy issues that must be addressed by telemedicine proponents. But Apple is increasingly a believer and had steadily beefed up its health team.

“While Apple has sold 30 million watches since the product made its debut in 2015, it hopes to boost sales of the device by bolstering its health-care capabilities in addition to its timekeeping and fitness-monitoring functions. The company also could push further into medical-records management, glucose monitoring and more,” they observe.

“Everyone is looking at the fact that about a fifth of the economy is health care,” Cardiogram Inc. co-founder Brandon Ballinger tells Loftus and Mickle.

In a piece for CNBC, Christina Farr blends the proposed CVS acquisition of Aetna with the news out of Apple to make the case that we’re on the cusp of the mainstreaming of virtual medicine.

“Telemedicine, or virtual medical consults by phone or video, has been the ‘next big thing’ in health care for more than a decade. But year after year, countless studies have found that telemedicine companies are held back by a lack of awareness among consumers,” Farr writes. “Now, thanks to a marketing boost from behemoths like Apple, Aetna and CVS, telemedicine might finally take off.”

Meanwhile, the Food and Drug Administration last week approved AliveCor’s KardiaBand, an electrocardiogram reader that replaces a regular band on an Apple Watch Series 3 and is paired with an app that can detect atrial fibrillation and abnormal heart rhythm.  It cost $199 and requires a subscription to a service that costs $9.99 per month or $99 annually. It continually monitors a wearer’s heart rate. Earlier EKG readers did so only on demand.

“The KardiaBand comes equipped with a sensor which, when touched by a user, gets the EKG reading in under half a minute. Users can choose whether the reading should be forwarded to a physician. KardiaBand also makes use of artificial intelligence to analyze as well as predict the heart rate of a user based on data obtained from both healthy and sick people,” Lou Simms reports for CCT News. 

“The FDA has made an effort to collaborate with tech companies that want to make it easier to produce devices and software that consumers can use to monitor their health. Recently, Apple, Fitbit, Samsung, and Johnson & Johnson were announced as just a few of the companies participating in the FDA's precertification pilot program under its Digital Health Innovation Action Plan,” writes Valentina Palladino in her reporting about KardiaBran for Ars Technica.

“All of the companies involved with this program will help the FDA set guidelines for approving health and medical software that devices can use. Instead of approving and further monitoring individual devices, the FDA appears to be more interested in the software that these devices run,” Palladino continues.

“There have been a couple studies conducted using just the Apple Watch’s built-in heart rate monitor to detect an abnormal heart rhythm,” notes Sarah Buhr for TechCrunch. “This spring, UCSF and Cardiogram conducted one such study, concluding the Apple Watch could detect an abnormal heart rhythm with 97% accuracy when paired with an AI-based algorithm called DeepHeart.

“Later, the same eHealth study concluded the Watch could also detect sleep apnea and hypertension with similar accuracy using its built-in sensor.”

One wonders if processing all this information about how well our bodies are functioning won’t result in elevated blood pressure and loss of sleep in and of itself. Worth a study, at any rate.