Consumers have proven fickle about wearables: Many a well-intentioned person has started out enthusiastic about a Fitbit, only to dump it in a drawer after a few months. But iBeat, the startup behind the iBeat Heart Watch, is betting that people will be more faithful to their wearable devices if their lives are on the line.
If you saw someone wearing this new smartwatch, which launched last week, you’d assume they were using it for the quaint purpose of telling time. Its true purpose would be apparent only if the watch’s sensors detected the telltale signs of cardiac arrest.
Then the dial hands on the watch face would be replaced by a stark question: “Are you okay?” Two big touch-screen buttons allow the user to either respond “yes,” in which case the watch goes back to being a watch and life goes on, or “no,” in which case the watch sends an alert to the user’s emergency contacts and also notifies the iBeat dispatch office, which can place a call to emergency responders.
The watch is designed for people who have heart problems and know that they’re at risk of sudden cardiac arrest—which occurs when the heart’s electrical system malfunctions and it stops beating. (A heart attack is a different thing that happens when a blockage in a blood vessel halts blood flow to the heart.) These at-risk people will have to wear the watch 24/7 so it can monitor them continuously.
Because of that around-the-clock requirement, company founder and CEO Ryan Howard says his team worked hard to design a watch that would look normal on users’ wrists, whether they’re wearing business suits or jogging suits. Otherwise the people who need it simply won’t wear it. “My dad still wears purple polo shirts—he still thinks he’s stylish,” Howard said during a product demo at the IEEE Spectrum office.
The iBeat watch first gained attention in 2016 with a campaign on Indiegogo and an investment announcement by TV’s own Dr. Oz. Like many a company with a crowdfunded project, iBeat has missed a number of deadlines: It originally promised to start shipping watches to backers in summer of 2017.
The delays resulted from a major change in the company’s business plan, Howard says. He initially intended to put his software on an existing smartwatch such as the Apple Watch or one of its competitors, which have built-in sensors that measure heartbeat. But during testing, he became convinced that the sensors weren’t good enough. “The Apple Watch sensor—I don’t want to say it’s a toy, but it’s optimized for fitness,” he says. “We think we would have had three false positives a day.”
Instead the company decided to design a bespoke smartwatch with sensors that met its own standards, and then get a production line up and running in China. And, well, that took a little while.
The watch uses typical kinds of sensors, but Howard says they had to be optimized to use minimal power yet provide reliable results for people with all sorts of different body and skin types. It uses optical sensors to measure pulse rate and blood oxygenation levels, shining lights through the skin and measuring how the wavelengths are absorbed by the flowing blood. Howard says his team worked with researchers at the University of California, San Francisco, to validate the sensors’ readings.
To ensure good contact with the skin and therefore reliable readings, the watch has multiple redundant sensors. And to keep the power requirements down and the battery life long (it works for about three days before needing a recharge, which can be done with a small snap-on gadget), the watch automatically shifts between low-power and high-fidelity modes based on sensor data. For example, if the user is walking around with a steady heartbeat, the watch can decrease the frequency of its readings. But if it detects the irregular heartbeats that can be a precursor to cardiac arrest, it can immediately up its sampling rate.
There’s a huge market for medical alert systems that’s only getting bigger as baby boomers age: One recent research report estimates that the market will grow to US $11 billion by 2025.
Some of the existing systems seem to harken back to an earlier technological era (anyone who watched TV in the late 1980s may remember the “I’ve fallen and I can’t get up!” commercial), with the alert button on a pendant, which communicates with a base station in the house. Howard argues that such systems take away the autonomy of seniors with heart problems. “If it only works within 200 or 300 feet from house, it becomes an end-of-life prison sentence,” he says. “Whereas our watch is really driving independence.”
The iBeat watch works directly with two cellular networks—AT&T and T-Mobile—and so works wherever those networks provide coverage.
For an outside perspective on this new gadget, IEEE Spectrum asked the opinion of Brandon Ballinger, cofounder of the Cardiogram app, which performs continuous heart monitoring via the Apple Watch or Android-based watches. Ballinger says he sees a market for the iBeat watch and other stand-alone heart monitoring wearables, but he’s somewhat skeptical that it will provide more reliable results based on its sensors.
“I think the Apple Watch's heart rate sensor is quite good,” Ballinger says. “A peer-reviewed study from Stanford measured the accuracy of multiple wearables, and concluded Apple Watch had the highest accuracy. It’d surprise me if a startup with $10 million in funding could beat Apple on sensor hardware. However, I’d suspect making their own watch probably gave them more control over things like sampling rate.”
Ballinger says he’d need to see peer-reviewed studies of the iBeat Heart Watch before trusting it. “In general, it makes me uneasy when health care startups take patients’ money with the promise of detecting a serious health condition, without doing the legwork of a published clinical study,” he says. “Enduring businesses are built on stable foundations, and in health care, that foundation is clinical proof.”