Jeff Williams: "We Want To Make Sure That Everything We Do Has A Scientific Basis"

Apple had just completed the largest cardiological study in the world, which allowed the Apple Watch to be certified as a valid device to detect arterial fibrillation.

Three years ago at Pixel we had the opportunity to sit down with Jeff Williams, Apple's chief operating officer, and Dr. Sumbul Desai, the company's vice president of health, to discuss the health features of Apple Watch. Apple had just completed, in collaboration with Stanford University, the largest cardiological study in the world, which allowed the watch to be certified as a valid device to detect arterial fibrillation, the most common type of arrhythmia and which does not usually present symptoms that are easy to detect by plain sight.

With COVID-19 in between, those three years feel almost like a decade, but for Williams and Desai the pandemic has served to validate the company's bid for the health market. "I think that COVID is just a reminder that there is nothing more important than your health. We are genetically programmed so that when we feel good and healthy, it seems like a low priority, but as soon as a problem arises, there is nothing more important.", explains Williams in a virtual meeting with Pixel last week in the framework of the world developer conference, the WWDC.

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Over the past three years, the Apple Watch has gained new sensors and features - perhaps most notably, the more advanced models now include a pulse oximeter capable of measuring the amount of oxygen in the blood - but the new version of the system operational, watchOS 9 will give the watch an even more determined boost in this field.

Apple is preparing four major innovations related to health and well-being: more detailed data when it comes to measuring sports activity, a more advanced sleep tracking function, the possibility of viewing the history of arterial fibrillation and a new application that will remember when take a medication and detect if it has harmful interactions with other drugs that we are taking (this function will only be available at first in the US.)

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The first seems only tangentially related to health, but Desai points out that the relationship is deeper than it seems. "Health and fitness are closely linked and I think the big lesson that COVID has taught us is that being in good general health prepares you better for cases like the one we've experienced," she explains.

With the update to watchOS 9, the Apple Watch will be able to show heart rate zones during workouts, customize different phases of exercise and compete against the times one has done on the same route, for example, when running. For athletes training for triathlons, the watch will also automatically detect the change between swim, run and bike phases. The second big news is sleep tracking. The Apple Watch already includes this function in the model launched last year but it is very limited. With watchOS 9, the watch will be able to detect the different phases of sleep and keep a historical file of the quality of rest.

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In a way, Apple is late for this feature. Virtually all competing fitness trackers and watches typically offer these types of metrics, but Williams says the delay is deliberate. "We want to make sure that everything we do is science-based . We've modeled this tool using one of the largest studies in sleep science, with polysinography techniques performed on an incredibly diverse population," he says. Arterial fibrillation history is another tool that completes a feature already present. The Apple Watch has since 2019 the ability to detect arrhythmias, but it only alerts the user when it detects one (to eliminate false positives, it performs five consecutive measurements). Now you can see a historical progression of arrhythmias and give them context with the activity you were doing, like running or sleeping.

From Apple they emphasize the importance of not treating these characteristics as a self-diagnosis tool, but as additional information when speaking with a medical professional, but they do not doubt their effectiveness. "This tool has been validated in a clinical study with participants wearing an Apple Watch and a reference device cleared by the FDA (the US federal organization that regulates the use of medical devices). The study showed that the difference in weekly measurements between the Apple Watch and the reference device is less than 1%," says Desai.

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The latest health update coming with watchOS 9 (and also available on the iPhone ) is the medication tracking app. It is a particularly serious problem in the case of chronic patients since 50% usually forget to take the medication at some point or do not take it as prescribed. The application allows you to enter the different medications to be taken, the dosages, and even the shape of the pill or the color of the medication. When the time of the shot arrives, the watch alerts the user.

One of the advantages of this application is that it automatically detects if problems can arise from mixing two medicines. It also warns the user if they cannot be taken with alcohol, or the side effects it may have. 

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The app also allows you to automatically share the intake data with a family member or a doctor if the user requires it, but it is a voluntary process and all the information related to the medication is stored in encrypted form on the watch or the phone. "A lot of people think that Apple has a lot of health information from people's watches and phones. But all of this data is encrypted on the device and it's up to the user who they share it with," explains Williams.

WatchOS 9 is already available in beta, but it will hit the general public in the fall of this year, along with iOS 16 and, predictably, a new version of the Apple Watch. Rumors suggest that Apple is preparing this year a special edition of the most resistant watch, focused on extreme athletes and adventure lovers. Also to new sensors that will allow the watch to measure body temperature, blood pressure, sleep apnea or blood sugar level, although many of these sensors may require medical certification and be delayed.

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