Can the Ap­ple Watch help save your life?

Value of ECG fea­ture up for de­bate, but de­vice can de­tect when you’ve fallen

USA TODAY International Edition - - MONEY - Ed­ward C. Baig

Can Ap­ple prod­ucts save you from a stroke, car­dio episode or dev­as­tat­ing fall? Ap­ple is cau­tious about mak­ing such di­rect claims.

But dur­ing Ap­ple’s press un­veil­ing of the new Ap­ple Watch Se­ries 4, Chief Op­er­at­ing Of­fi­cer Jeff Wil­liams re­ferred to the new time­piece as an “in­tel­li­gent guardian” on your wrist.

And Wil­liams high­lighted what are po­ten­tially im­por­tant health-ori­ented ini­tia­tives for the new watch. Through a companion app on the iPhone and an elec­tri­cal heart sen­sor on the watch, you can gen­er­ate an ECG (elec­tro­car­dio­gram) merely by plac­ing your fin­ger against the Dig­i­tal Crown. Ap­ple says this FDA-cleared fea­ture, a first of its kind of­fered over the counter, will be­come avail­able to own­ers of the Se­ries 4 watches in the U.S. in an up­date later this year. What’s more, the lat­est watches can also au­to­mat­i­cally de­tect if you’ve taken a spill and sum­mon help if you’re im­mo­bi­lized or un­re­spon­sive.

These new fea­tures fur­ther ce­ment what ap­pears to be a ma­jor push by Ap­ple into health care. Ap­ple will tell you that it didn’t have strict busi­ness am­bi­tions in the health field but that many of its ini­tia­tives in the space have hap­pened or­gan­i­cally.

A chief pur­pose for the heart rate mon­i­tor in­side ear­lier Ap­ple Watch de­vices was to help cal­cu­late calo­rie burn. But then cus­tomers who no­ticed when their heart rates ap­peared too high or too low be­gan writ­ing the com­pany. Last year, Ap­ple made a small but pro­found change whereby the watch, in ef­fect, started pas­sively look­ing af­ter you.

In fact, Ap­ple has had a Health app for iOS since 2014, used for, among other pur­poses, track­ing your steps, nu­tri­tion, and hous­ing a med­i­cal ID with your blood type, med­i­ca­tions and emer­gency con­tacts.

More re­cently, Ap­ple added a fea­ture, still in beta, in­side the Health app to help you keep all your rel­e­vant med­i­cal records in one place rather than hav­ing to chase down those lab re­ports, im­mu­niza­tions and other records by vis­it­ing dis­parate on­line pa­tient por­tals. A num­ber of hos­pi­tals and med­i­cal providers are par­tic­i­pat­ing.

Last Novem­ber, in col­lab­o­ra­tion with the Stan­ford Uni­ver­sity School of Medicine, Ap­ple launched an Ap­ple Heart Study app that used the heart rate sen­sor in­side the Ap­ple Watch to col­lect data on ir­reg­u­lar heart rhythms con­sis­tent with atrial fib­ril­la­tion, a lead­ing cause of strokes. If an ir­reg­u­lar heart rhythm is de­tected, par­tic­i­pants in the study are no­ti­fied through the Ap­ple Watch and on their iPhones and of­fered a free con­sul­ta­tion with a study doc­tor. But Ap­ple cau­tioned that it won’t catch ev­ery in­stance of AFib and that peo­ple shouldn’t rely solely on the study.

Mean­while, the clear­ance from the FDA that Ap­ple an­nounced Wed­nes­day re­lates to two fea­tures: First is that the watch can pas­sively mon­i­tor your heart for ir­reg­u­lar rhythms and de­liver alerts if and when it de­tects them – this fea­ture is avail­able on all Ap­ple Watch mod­els dat­ing back to the orig­i­nal.

The sec­ond, for the Se­ries 4 only, is the ECG fea­ture – which you, as the wearer of the watch, have to man­u­ally ac­ti­vate through the Dig­i­tal Crown. The watch has a ti­ta­nium elec­trode that works with the elec­trodes in the back crys­tal. The ex­pe­ri­ence is sup­posed to take about 30 sec­onds, with the ECG classifying the re­sults as ei­ther a nor­mal “si­nus rhythm” or AFib.

Still, there is con­tro­versy about the value of the ECG it­self. The U.S. Pre­ven­tive Task Force rec­om­mends against ECG screen­ing for adults with a low risk of car­dio­vas­cu­lar dis­ease. The group, which iden­ti­fies it­self as “an in­de­pen­dent, vol­un­teer panel of na­tional ex­perts in pre­ven­tion and ev­i­dence-based medicine,” says there is “in­suf­fi­cient” ev­i­dence for adults with medium or higher risks.

One po­ten­tial ques­tion mark sur­rounds false pos­i­tives. Ap­ple says it will ed­u­cate you when you first start us­ing the app, but that process was not pre­viewed in ad­vance. You’re en­cour­aged to share the re­sults and con­sult with your doc­tor; you can send over a PDF with the ECG wave­forms.

Ap­ple’s new watch has al­ready at­tracted the req­ui­site “I’ve fallen, and I can’t up get up” quips. But, all kid­ding aside, falls can be deadly se­ri­ous, and the fall de­tec­tion fea­ture in the Se­ries 4 might, in fact, be a life­saver. It re­lies on the de­vice’s ac­celerom­e­ter and gy­ro­scope. Ap­ple says such sen­sors can an­a­lyze wrist tra­jec­tory and im­pact ac­cel­er­a­tion. If a tum­ble is de­tected, a no­ti­fi­ca­tion will ap­pear on the watch face. You can tap to ac­knowl­edge the fall but say you’re OK. Or you can tap an emer­gency SOS but­ton to so­licit as­sis­tance.

If you haven’t re­sponded within a minute – per­haps you hit your head and blacked out – the watch can call 911 us­ing your nearby phone or its own cel­lu­lar trans­mit­ter and send a no­ti­fi­ca­tion with your lo­ca­tion to your pre­set emer­gency con­tacts. To help pre­vent ac­ci­den­tal 911 calls, you’ll start to hear ev­er­louder beeps 45 sec­onds af­ter the fall oc­curs – much like those home-based med­i­cal emer­gency sys­tems – alert­ing you that the 911 call is about to be made.

Fall de­tec­tion is au­to­mat­i­cally en­abled for users over age 65; oth­er­wise, you can turn on the fea­ture in­side the Watch app on your iPhone.

The ECG fea­ture on the Ap­ple Watch Se­ries 4 must be ac­ti­vated by the user. AP­PLE

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