Wearables
6 burning questions about Apple's new health features
I'm just back from Cupertino, where Apple surprised us with a new feature that will alert smartwatch users who may have high blood pressure. While rumored for eons, the feature was thought to be several years away. Read my story on what Apple has revealed so far about the feature. Basically, the algorithm works by looking for consistent signs of hypertension over a 30-day period. I also spoke to a few cardiologists who explained why it holds promise for helping alert people about a dangerous chronic condition. They cautioned that more details about how it works will be critical to understanding its potential impact.
Here are a few of my questions about what Apple discussed this week — and what it didn't.
Clinical details?
Apple offered only a broad description how exactly the hypertension notification was developed, how it was tested, and how it works. When it receives Food and Drug Administration clearance some time this month, we'll get a look at some data.
Who won't get hypertension notifications?
Over the years, critics have focused on the potential for Apple to incorrectly notify people about health conditions they don't have, which can lead to anxiety and increased health care spending. In her video introduction to the high blood pressure alert, Apple's Sumbul Desai suggested the feature may suffer from the opposite problem as it "won't detect all instances of hypertension." If Apple has set the threshold for notification too low, it's possible many people with the condition will not get notifications. UCSF's Sanket Dhruva told me this could prompt in users a "false reassurance" that nothing is wrong.
How will users respond to a hypertension notification?
The Apple Watch's hypertension notification is funny because it never provides an estimate of your systolic and diastolic blood pressure. The feature guides users who are notified of possible hypertension to obtain a blood pressure cuff and complete daily readings for a week that can help confirm what the watch detected. How many people will move from there to some kind of care pathway that addresses the problem?
When will we get Apple health coaching?
Apple is said to be working on some kind of AI health coach. Apple's new score describing the quality of your sleep and notifications for a chronic condition are screaming for some kind of guidance or intervention that can help users improve sleep and blood pressure. But Apple has been resolute in avoiding any offerings that might be construed as care. There are many, many behavior change apps for hypertension and other chronic conditions already. What's Apple planning?
What about competitors?
Wearable maker Whoop is embroiled in deep drama with the FDA about whether the blood pressure feature it launched earlier this year qualifies as a medical device that needs regulatory review. (The fact that the FDA knew about an Apple blood pressure feature close to launch paints that fight in a much different light, eh?) Meanwhile, European device company Aktiia received FDA clearance for its own blood pressure wearable over the summer. Both of those devices offer actual blood pressure readings that are better suited to monitoring your health over time whereas Apple's product is basically a warning alarm. Is Apple really competing with them? It almost feels like the products could be complementary.
What's next for AirPods and health?
Apple introduced a new version of its AirPods wireless headphones that can track your heart rate. For now, it's billed as a fitness feature, but it seems logical that health applications for this tech will follow. The company's introduction of FDA-cleared hearing aid and hearing test AirPods features last year was the culmination of a multiyear evolution of the headphones into a health device. What additional health features are coming to your ears?
Telehealth
Hims launches testosterone treatment
Katie Palmer writes: Hims & Hers entered the crowded space of telehealth providers prescribing medications to increase testosterone in men on Wednesday, making good on the first half of its plan to expand into hormonal treatments. Testosterone replacement therapy and treatments for the symptoms of perimenopause and menopause have become attractive to telehealth companies looking for their next compounded moneymaker as the window for legal compounding of GLP-1s narrowed this year.
So far, Hims isn't prescribing the hormone itself, which comes with extra compliance barriers because it's a controlled substance. Instead it's prescribing a compounded version of enclomiphene, which is used off-label to increase testosterone. Next year the company said it will offer testosterone, including an "exclusive collaboration" with the branded oral testosterone Kyzatrex. Its maker, Marius Pharmaceuticals, currently lists three telehealth providers on its site that can prescribe the drug.
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