Apple’s Health and Fitness Push Accelerates as it Turns 3

In what was one of the most packed WWDC keynotes in recent memory, the Apple Watch got under 15 minutes of stage time, and health and fitness features got only a fraction of that. But that’s not really indicative of all the additions to Apple’s health, fitness, and broader wellness features being made this year, and it’s certainly not indicative of Apple’s commitment to the space. I spent some time this week getting briefings about both what’s new in Apple’s own software, and what developers and others are bringing to the party.

Four Key Domains in Health

Apple’s focus in health, fitness, and wellness is clear from the moment you open its Health app – it highlights four key domains for which the app can track data:

Apple’s approach to everything it does has always featured hardware, software, and services, and Health is no exception. But in this area, perhaps to a greater degree than elsewhere, Apple relies on third parties, with much of the heavy lifting in three of the four domains listed above being done by outsiders, and Apple focusing mostly on the Activity area with its own products and features. Those third-party contributions are, of course, enabled by tools provided by Apple, mostly in the form of SDKs and APIs which outsiders can use to build software and integrate into Apple’s various systems.

An Increasingly Comprehensive Play in Medical Too

That’s especially true in a fifth domain, which isn’t as visible in that home tab of the Health app, but is nonetheless important to Apple’s efforts in this area, and I’ve called that medical for the sake of distinguishing it from the other domains. The table below illustrates the roles played by Apple’s own first party products, its tools for third parties, and then the products and services provided by third parties in all this work, with areas that will change or have augmented features or functionality this year highlighted in red:

As you can see, at this point the combination of Apple’s own products and features and those provided by third parties is pretty comprehensive at this point, and you can hopefully also see the number of areas where new features in watchOS 4 are enabling new functionality either in the built-in apps and hardware or through third parties.

What’s New This Year

I want to drill down briefly on some of the things that are new this year, because they got such short shrift at WWDC but some of them are pretty notable. Here they are in bullet point form:

Enhancements to the Workouts app : following the new hardware from last year which introduced GPS and water resistance to the Watch, watchOS 4 adds additional functionality, including more sophisticated tracking of swimming workouts, optimized tracking for High Intensity Interval Training (HIIT), easier switching between workout types and general usability improvements.

: following the new hardware from last year which introduced GPS and water resistance to the Watch, watchOS 4 adds additional functionality, including more sophisticated tracking of swimming workouts, optimized tracking for High Intensity Interval Training (HIIT), easier switching between workout types and general usability improvements. Changes to the Activity and Breathe apps : each of these apps is getting some subtler changes, with the Activity app getting some smarter coaching which is more personalized than the current more generic reminders and prompts, with some really clever stuff coming here; and the Breathe app getting better explanations of why you might want to take a break and do some deep breathing, in the form of described health benefits.

: each of these apps is getting some subtler changes, with the Activity app getting some smarter coaching which is more personalized than the current more generic reminders and prompts, with some really clever stuff coming here; and the Breathe app getting better explanations of why you might want to take a break and do some deep breathing, in the form of described health benefits. GymKit and connected fitness machines : I saw a demo of the new integration with fitness machines, and this is going to be a big deal for anyone who does gym workouts, which the Watch naturally can’t track as well using GPS or motion sensors. The integration here is very clever, with data flowing both ways, meaning that data from the Watch can show up on the much larger, always-on screen on a treadmill or exercise bike alongside the data it captures itself. I think there’s an opportunity here for deeper integration with iOS devices to replace the corded connection some machines offer today, for things like projecting notifications or videos onto the gym machine, but the fitness-focused integration Apple is starting with here is a great start. Getting these machines quickly adopted in gyms will be the key, and I understand Apple will be talking more about how this is going to happen later in the year.

: I saw a demo of the new integration with fitness machines, and this is going to be a big deal for anyone who does gym workouts, which the Watch naturally can’t track as well using GPS or motion sensors. The integration here is very clever, with data flowing both ways, meaning that data from the Watch can show up on the much larger, always-on screen on a treadmill or exercise bike alongside the data it captures itself. I think there’s an opportunity here for deeper integration with iOS devices to replace the corded connection some machines offer today, for things like projecting notifications or videos onto the gym machine, but the fitness-focused integration Apple is starting with here is a great start. Getting these machines quickly adopted in gyms will be the key, and I understand Apple will be talking more about how this is going to happen later in the year. Core bluetooth on the Watch for more devices: Apple has enabled core bluetooth on the Watch for heart monitoring chest straps from the beginning, but not for a broader range of devices. In watchOS 4, it’s opening up core bluetooth to other devices too, enabling other body sensors and even medical devices like continuous glucose monitors, as well as connected fitness equipment like tennis racquets or golf clubs.

The Medical Domain is Coming Into its Own

Beyond the things Apple itself is going, I got to see quite a few apps and devices from third parties in my meetings this week, and one of the things that impressed me most was the innovation being done in what I labeled the medical domain above. Between the original HealthKit and the additions since in ResearchKit and CareKit, Apple is enabling some really interesting work by doctors, device vendors, and medical facilities which leverages Apple devices to do things that would otherwise have been impossible or a lot more difficult. Some examples include:

The Propeller Health asthma inhaler sensor and accompanying app, which automatically track when the inhaler is used and also invite users to track their symptoms and environmental conditions manually, pulling in third party data. The solution is designed to help increase “adherence” (the faithfulness with which patients adhere to a treatment plan such as using a preventative inhaler daily) and understanding of what triggers symptoms for better management. These products have been available through medical professionals but are now going direct to consumers as well.

A WebMD Pregnancy app which includes a ResearchKit component that is allowing researchers to learn a lot about pregnant women and their symptoms, which are surprisingly under-researched, especially in remote and rural areas far away from where most studies are conducted. The app is going to be most useful with women who have access to regular blood pressure and other vital signs measurement, but is already generating a much higher participation rate from rural areas.

A Sharp Health app for helping eye surgery patients get ready for and recover from their procedures. The app helps ensure that patients don’t have surgeries canceled because they forget about necessary steps to take beforehand like stopping blood thinners, and again helps with adherence after surgery, as well as giving them options for talking to medical professionals if they have questions during their recovery. The basic model here could certainly be applied to other procedures by other health systems too.

More Work to be Done

As I said earlier, it’s starting to feel like Apple has an increasingly comprehensive set of hardware, apps, tools for third parties and a growing ecosystem of apps and devices from others in this health domain. But in quite a few of these areas, it feels like we’re still just scratching the surface of what can be done, especially in the medical field, where things still tend to move very slowly and where comprehensive electronic patient records are still more of a dream than a reality. But Apple is helping here by providing tools that professionals and companies with the appropriate medical pedigrees and qualifications can tap into, while focusing on what it does best.

One question I had for the Apple folks I talked to was how it decides which domains to play in itself versus leaving them to third parties – for example, it’s added some sleep-related functionality such as the Bedtime feature, but still doesn’t do its own sleep tracking, and doesn’t really have much of a first-party play in nutrition tracking either. The answer I got was the classic Apple one: Apple tends to participate directly in a market only where it feels like it can do something unique and different. For now, that means there are plenty of areas where others are better qualified and equipped to make a difference and provide the features and functionality users need. Discovery of these in the App Store and elsewhere is going to be key for enabling users of Apple’s ecosystem to make the most of all this, and that’s an area where the App Store changes Apple announced at WWDC should help.

Apple is never going to be done in this area, and neither are its partners or its competitors. There’s lots of work still to be done by all these players in a field that I suspect is going to receive increasing attention from the tech industry over the coming years, even as politicians argue over the best ways to manage the funding of healthcare and the structure of insurance plans that will pay for much of this. I’m hopeful that we’ll see much faster change and greater benefits coming on the technology side, and this week I saw promising signs in that direction.