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Apple Watch 4: Why the future of digital health depends on Apple finding a skypartner

Apple's September event has come and gone, left us with Apple Watch Series 4, which has improved functionality over its predecessors, which includes Atrial Fibrillation (Afib) detection and embedded ECG support (electrocardiogram). These abilities will not be scoffed – The FDA has given its approval that Apple Watch is classified as a true medical device. The benefits to the patients have already been proven.

I would know when basic cardiac arrhythmia detection technology, which was now built into the Apple Watch Series 4, saved my life.

Watch Series 4's software-based arrhythmia detection was piloted using the Apple Heart Study, a partnership between the Cupertino Consumer Electronics Giant and Stanford Medicine.

The study, launched in November 201

7 and closed for new entrants in early August 2018, combines the heartbeat sensor introduced in series 1 along with data collection and telemedicine software used on iPhone.

The data was forwarded to Heart Study researchers where samples from studies were analyzed.

If a participant had a sign of Afib, the iPhone application alerted the user to launch a telemedicine video call where they would consult cardiovascular physicians who would review the data and potentially ask to send the patient an ePatch, a wear and tear le- device that collects a broader set of electrophysiological data for further assistance in diagnosing the condition.

On Watch Series 4, ePatch functionality has been replaced by the device's native ECG sensor, allowing all diagnostics to be done locally using a combination of software algorithms and newer hardware.

Although there was no pilot for ECG technology in the Series 4, Apple Heart Study is interesting for how it tested the value of telehealth intervention in the closed-loop mobile study study with Apple Watch.

Does that mean that Heart Study is over? Yes and no.

There will be many benefits for Watch Series 4 that have the ability to diagnose heart disease locally and for patients to review and analyze results on their own iPhones. An iPhone that is Bluetooth connected to a Watch Series 4 can send out a PDF that anyone can share with the doctor so they can view the data on one to one.

But the true power of having advanced sensors and health diagnostics on wearables will only be realized when the power of telemedicine is combined with cloud data analytics.

One thing is to run a study with a test sample of tens of thousands or even hundreds of thousands of patients where usable sensor data can be aggregated and analyzed by a team of researchers for academic purposes, such as cardiac study.

But it's a completely different matter to produce a health cloud where data from tens of millions of patients can be analyzed and traced historically on a large scale to proactively monitor the current conditions and to gain further insight into the data.

And it is also much more difficult when it comes to the level of effort and red infrastructure requirements to provide a host platform where third-party vendors can become tenants to provide services like patients and a much larger pool of doctors can access from apps and the web .

The actual patient / play interaction in the cardiac examination, along with the video sampling platform it was used, was performed and designed by American Well, a leader in remote medicine.

Stanford Medicine was the overall administrator of the cardiac examination, but it was American Wells doctors who did all the work and consultation with patients like myself.

The American Wells telemedicine platform is similar to Apple's faceware and end users (like myself) can initially confuse it as such because it's embedded in the Health Study app and the experience is very similar. [19659003] However, it is different because it has other features in what makes HIPAA compliant that is important in the medical industry to protect patient data.

Such ap latform would be necessary if the cardiac study was scaled from being merely an academic exercise to an actual service that patients and their doctors could use.

What Apple has created with Heart Study and Watch Series 4 is not amazing. But Apple is not a hyperscale cloud provider or a healthcare professional. It is also not a health system integrator. And it should not be one.

Apple creates mobile devices and platforms. It's up to its partners to grow the Watch Series 4 ecosystem and make it heavy lift now.

Telemedicine platforms like American Well will be extremely important if health shoots are created because it adds the necessary human interaction element. But the only way to scale to millions of millions (or hundreds of millions) of users is that Apple is going to work with a hyperscale cloud provider that already has partnerships and experience in medicine.

While Apple's current business partner, IBM, brings a lot of expertise to the table in terms of overall software and integration efforts with expert and analytical plans such as Watson (which can add a whole new dimension to view health data) and experience with Working with many health professionals under the belt as a professional services organization, it is not equipped to run a sizeable size helmet because it has not made necessary infrastructure investments.

So who are we talking about here who can give it? You can count them on one side. Amazon, Google and Microsoft.

Amazon probably has the infrastructure to do this as it is cloudy heavyweight. It may well end up with hosting services that third parties will create on AWS that can connect to iPhones and eventually Watch Series 4 and its followers.

But I do not see a strategic partnership that exists between the two companies because there are just too many areas they are competing for – IoT is the primary – and it's just a matter of time before Amazon itself creates its own state of health.

Also: Apple Watch Series 4: Cheat Sheet TechRepublic

Similarly, Google has its own Wear OS and its own IoT platform, and it's unlikely to be a partner with Apple itself About Cloud Platform has many advantages.

So where does it leave us? Microsoft. And Azure.

As I said earlier, I think it's time for Apple and Microsoft to bury the hatch.

It's a great advantage that Apple and its customers can come from an expanded partnership, and it's not just all the software and tools that the Redmond giant has created for Apple's platforms. It's also the huge power of Microsoft's cloud, which includes a highly sophisticated and highly scalable data analysis platform.

And Microsoft's partner search system to bind to the platform to create complete software and services in the vertical healthcare system is absolutely huge. [19659003] I think we'll be in a great future with advanced preventive medicine that uses wearables, and Apple Watch, like iPhone, will be the dominant leader in its field.

But only when hyperscale cloud computing, Big Data, and telemedicine are combined with these devices, we'll see the real benefit of these technologies on a scale. We are ahead of what is happening, but the old rivalries must be resolved and evil from old conflicts must be buried from the platform war that has long ended for real progress.

Will the preventive diagnostic power of the Apple Watch Series 4 just be really released with a hyperscale health cloud? Talk back and let me know.

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