 Yesterday I was actually next door and at the digital health summit I was moderating a panel there and a big topic of course was interoperability, MRIs to get them to talk to the electronic health record, remote patient monitoring hubs into the EHR, wearables into the EHR and it occurred to me that you know as wearable ecology is developing that we're starting to come into our own data silo issue. I've been writing about a concept I call parables which basically takes the value of different wearables on your person and to combine them into something better and that's just one aspect. I really think that's going to start taking shape in 2020 and so as that happens the ecology all of us will have to respond and so that's what we're here to talk about today. With me I've got Elizabeth Bowman, she is vice president of marketing and growth both those things at December labs and of course Catherine Fantasi how did I do? Perfect. And she's CEO and co-founder of Apollonero Systems so welcome. So I wanted to start with you Liz, I can call you Liz here Liz. Yeah I think you know as I see wearable startups I see them sort of falling into two camps. One is that those that recognize that the wearable in the app are part and parcel of the platform or product and those who are focused on their hardware innovation and realize sometimes a little late in the process that hey we need an app and so maybe for the benefit of that ladder group give us a little idea of what's involved in developing an app and coordinating with your product. Sure. So if you look at app development for wearables there is a few things that are very particular and that are different from just regular app development in general. So one of the things is that from a user perspective really the app and the wearable are one. They see it as one product. They don't differentiate and say hey you know here's a company that actually you know created the hardware that you know I'm going to use that I'm going to wear and here is an app development company. You know they really perceive it just as one and if you think about it for example if you would research a product on Google you know you type it in one of the results if that wearable has an app that would come up would probably be you know the app store ratings. So again if those app store ratings for example would be negative that would directly influence the perception that you know a user would have of that specific product. So I don't think there are too many data yet on actually you know at the app store wearables you know affecting user satisfaction but there are you know statistics that say for example that users that have a bad experience with mobile apps think in 60% you know bad about the company that you know built that app. So if you take that to the level of wearables where really a lot of times the wearable without the app will not function or you know will not even start you know you can just imagine how much higher it is and then on the other hand Christian was you know mentioning the importance of data and you know for wearables in general you know wearables sending over data receiving data and that also happens all you know through the app for example if you want to get meaningful analytics you know you won't really be able to receive them you know the product might be you know very good but if you want a usable interface that will display that and it won't be really I think we're you know at the start four or five years ago maybe you know everything was really kind of silo Fitbit is things like you know Google Fit or starting to incorporate other folks how you know what does that mean for somebody going into do an app now that maybe they didn't have to worry about I think on the one hand again today a wearable without an app really is like most of the time doesn't have any meaning so in the example of Apollo for example you know there's there's a couple of things that I think happen for that that are true for many different products that we could highlight there on the one hand it's you know how do you connect with the wearable so most of the time to do that via Bluetooth but there's also you know a few other options from you know reading data through computer vision for example a medical wearable device or or new field communication and I've seen but in this case you know we did we have Bluetooth which is really good on battery power so it's you know user friendly in that sense then really if you look at you know the actual user interface most wearables don't really you know have a screen or a display so the app really is the only user interface you know that that user sees first-hand so again you know that's a big responsibility on the app then Apollo has not gone yet to towards FDA approval but it's something you know that we that they've been looking at from the very start so that also is something totally different when it comes to app development as you have to have different kind of development processes different kind of unit testing you have to have everything FDA compliant then another thing that happens that is you know the item the issue of scalability when you have you know a product that involves hardware you can't really update it all the time as you can an app so it really is very essential that an app is being built from the very start in a sense that you know you can add anything from gamification communities and other things to it and you know keep the user really engaged which is one of the things that we were talking with Catherine today about is that you know and maybe you can you want to take over there but but it's so important that it's so important for wearables to actually be user friendly and attractive and beautiful so yeah if you don't have that then maybe we should take a step back and you know tell everybody about your product and what you're trying to achieve briefly and then what sort of data and other things you're connecting to oh sure so Apollo is a and I'm Catherine I'm a CEO Apollo and Apollo actually started as a research project so before this ever became a product actually started and if anybody saw Dr. David Raymond talk a little bit earlier actually started as a research project at the University of Pittsburgh so what we are looking to do is figure out okay there's lots of data there's lots of ways that we can understand what happens with changes in the body but how do we empower people to actually take control of their health because if you just provide we actually did research on this if you just tell someone that they're stressed out or that their sleep is bad and then there isn't a solution on how to remedy that you actually can just make people more anxious and they actually don't improve their lives and then they stop using the wearable or stop using the data because it's frustrating for them it's like being a kid in school and getting a C minus on the test and you can't figure out how to get better at it and so for us we are looking at ways to help intervene with the human body to actually improve people's resilience to stress essentially when you get stressed out all the time from whatever that may be from lack of sleep or your product stress at work or your family life whatever it may be you end up getting run down over time and this has wide sweeping effects for your mental and your physical health and we can see that in biometrics right we can see that your heart rate your blood pressure or your heart rate variability but then how do you help someone in the moment that they're stressed out actually improve those biometrics and we discovered that vibration and certain layered form kind of almost feels like ocean waves actually mimics what the body does when you deep breathe and so we ended up developing after doing clinical trials at the University of Pittsburgh which demonstrated that we could actually change stress biometrics so it can improve heart rate variability we can take down heart rate under stress we can put blood pressure under stress we try to figure out where would someone wear this right how could we most easily dissent should this be in a bed should this be in a shirt should this I mean every single different kind of form factor you could think of and we came up with a wearable because that's what users told us they said I need something I can use when I need to fall asleep but also when I need to fall asleep in my bed or on a plane or when I'm in you know when I'm traveling in a weird hotel room or when I you know I'm in a meeting and I need to focus or my boss can notice that I'm you know falling asleep or I can't sit in front of the spreadsheet I need something to help me right and so it became a wearable and all of these things were around user experience but the app was something so critical to what we do not only to deliver right deliver these frequencies which you can pick from programs that are designed to help you focus or help you wake up or programs that you would set to help you fall asleep but also for the intake of data right so the next phase of Apollo is integrating into these data systems to be able to show the users in real time that they actually your heart rate actually is going down your heart rate variability actually is going up and so for us from the very beginning creating an app experience that is beautiful and really easy to use and a device that is beautiful and also very easy to use and comfortable with something from the outset that we very much considered everything was customer inquiry and testing and iteration over the whole period of the development of the product yeah so it's interesting I mean you started out by saying it's really something that you put on when you need it and so so in a sense you can't be the one measuring to see when my heart rate variability is flat and I need to calm down right but the app can integrate in with other wearables that you might be wearing yeah so tell us a little bit more about how that works right so in the future let's say we integrate with other wearables that are being developed all over the place if you can see that someone's trending down and we know what their baseline is you can tell them hey you should use your Apollo you are not doing great today right and it's an actual solution to the problem like hey we noticed that your heart rate is really high okay well what's the person going to do about that right and they have a solution to the problem now and so they're you know and one of the things when you're talking about silos and you see that in healthcare all the time with different EMR's, different data systems none of them are talking to each other and that happens on the consumer side with wearables too right and then there are certain opportunities where like health kit is one platform where it all exists in one place but not every wearable sending all of their data to that place it's okay how do you bring the data together but then how do you make it meaningful and actionable for the user right now how do they contextualize all this data that we're giving to them and then what do they do about it and so Apollo what we're working on is creating an intervention but also creating a context for all of that data such that it's useful yeah and so just to be clear so that is that sort of future you're working on it now yeah we're working on it okay are there specific platforms that you're looking at I know earlier we talked about the aura ring I don't know that's something that yeah I mean the first one are ones where it's easy to access the platform and then we are in talks with multiple other wearables about direct integration with your products I would think that'd be something they'd be pretty receptive to arguably that gives them the answer to your stress to hear something you can do about it right and then also for the user experience they are able to see okay I've been tracking my data but now I'm using something that actually makes me better right and so that's good for both sides because you have a purpose to the data that you've been collecting and a way to actually track and see that your health is improving over time which ultimately is the goal right we started tracking with steps to try to encourage people to be fitter now we're tracking things like sleep so we can understand even deeper biometrics like heart rate variability but ultimately the goal for all of these wearables and whole ecosystem is to enable people to have more autonomy and control over their health right I think that's that's something that is very important you know to keep under consideration from the very start and I think that's one of the things that we have enjoyed so much in working with Apollo that there has been you know a clear vision of you know where does this start and where might this go at some point and that is something because I mean really if you think about it you know when you when you're building a product you have you know the firmware you have the hardware you have the software there are so many different teams that work at different velocities and then have to integrate at some point and I think that is I mean anyone who has been working in the space knows how challenging that is and I mean if you go you know down to the expo area and you go into you know the aisles of health sleep and wellness wearables you almost always see you know the device along with the app and one of the other things that I think is very fundamental here is that we're always you know gearing this towards you know the health aspect of you know Apollo and you know this is really with the origin also comes from you know as far as the research and everything and so this again from a technical point of view brings a lot of challenges to the table for example HIPAA compliance I mean if you know at some point you would want to integrate something as well with some kind of medical data for example I mean when you're you know when you're an app development company that means that the developers have to be trained in that regard you have to have very specific documentation the same as with FDA approval for example but then there's also the matter of accessibility you had mentioned you know that you have been envisioning from the beginning you know when and what kind of moment people would be using Apollo but then also when you know you for example you're think about using Apollo for different trials and everything always when you have these kind of subgroups within kind of you know a health context you have to look at people that have any kind of disabilities you know that you know might also be relevant when you're you know looking at something as simple as it seems you know as the user interface. Yeah so as you start to hold together data from disparate silos and then you know turn that into actionable insight you know here on this platform for example what sort of barriers there are the obvious barriers but how are you overcoming those to you know to bring in data from the OR ring to be able to feed the Apollo device to say it's time to calm down some of those challenges and how are you I mean I think the main challenge so the main challenge is quality of the data from the data sources I mean obviously there's the technical stuff like you have to connect in with Apple health kits or you have to connect directly through an SDK but the I think meaningful part that's more complicated and what we're really specializing in is understanding what data matters when group together and how you create profiles of that data and then how do you understand context wise why that data is changing around so that you don't accidentally aggravate your user like a lot of notifications are actually very annoying right and so you want to make sure that when you're providing guidance around people's health that one it's accurate as accurate as it can be but also that it's meaningful so you don't send them false alarms with their heart rate super high like yes of course it is I'm exercising right and so you know oh you know you want to make sure that you're not you're providing context and that you're not creating anxiety or neuroses over the data which is something I often see yeah I think we're like what is my HRV supposed to be I was like well just try to trend it upwards get some sleep and I think that's something in general when you think about wearables and really the objectives that you know people have when it comes to wearables you know you want it to be seamless you want it to be easy to wear you want it to be able to easily integrate into your life and the same thing you know happens again with the app that you also want it to be intuitive you want to know from the very start how everything works you want the onboarding to be very intuitive if you want any kind of analytics that you might be able to visualize to actually easily giving you the next steps as far as you know okay so what does this mean for me what kind of insights can I kind of get out of that and I think that you know just looking at this is kind of a parallel this intuitive and this you know really good fit in a way is also something that when you have any kind of collaboration is very important that you know I mean we sometimes try to see ourselves you know as if we were wearable you know when we integrate with how many such as Apollo you know that that kind of fit is really what what what makes this kind of partnership work are you seeing some sort of I mean we all have a pretty good idea of what wearables can do can tell us can't tell us or do at this point are you can you look out a few years based on what you're starting to see in development and what we might hope to see or folks might start wanting to help for me in general I mean there's always I think we're always looking towards improvements as far as you know the technology aspect of it and I mentioned in the beginning some you know trivial things such as battery power but you know really those things you know can be a pain and you know when we see the development in general you know it's been really going always you know towards improving the product and the overall user experience then as far as you know user interface design and just you know really continuing to optimize that I think that is also something you know that will continue to improve but really one of the milestones I believe will be you know kind of what happens with all of that data I mean it's really interesting what has been happening with Apple health kit and with Google Fit you know as far as accumulating kind of the data and making it also easier for app developers to access that data and you know just yeah overall creating something that can be meaningful in the end and I mean if you also look at it from you know more philosophical point of view wearables are you know most of the time supposed to you know make your life better at some point I mean you're looking always towards improvement especially when it comes to health and you know I think Apollo is a great example of that you're always looking towards really making lives better to you know give additional value to people and yeah I think that's kind of the mission that we're all on here. Okay I realized I didn't ask to see if anybody had any questions but anybody wants to ask something say hi or I don't know are there microphones? There's one other thing I think when we are looking at you know data and mechanism one of the things that I think trend-wise that's really happening is we went from tracking steps and fitness to more meaningful data collection around bigger health concepts right like sleep and stress and heart you know like the cardiac indicators and all these things and I think what's happening now with wearables is I think there's going to be a new class of wearables one that actually do things right that actually affect the body that you're seeing a trend doppel was up here we're up here and there's other kinds of wearables right for increased memory so I think mental health and over holistic lifestyle is going to be a thing beyond fitness and I think the other thing that people are starting to look at is how does this integrate into my life more completely and so I think you know product is one thing and speaking to app content right like how do you keep this user engaged with you as part of their ecosystem to improve their health right and so how do we better integrate wearables into the broader ecosystem so that we're not that gadget that someone has on but instead is this meaningful tool that they use to improve their lives over time and part of that is figuring out when the person would be most receptive to hearing about content or I mean even something as simple as your stress I mean you send that at the long time and you're like I know I know, thanks and AI is a huge component of that and as we talk about data and data silos as data becomes in a greater platform and we create content it's actually learning to personalize that content and curate those experiences for those individual people concepts where we all know that numerous data capture points are wearables whichever depends on what we're doing and where we are in the type of environment but you picked on the points of parables, can I just ask you to what's your vision of bringing real connectivity to wearables in the next year or so, can I specifically might because that's your idea how do you see it mapping out? Sure I think I think if you look at you know wherever you're going to strap or insert something there are different strengths and weaknesses this is a great place for a display and about the most hostile place you can find to be taking metrics, biometrics so this is better, battery life is an issue this is better still and so I think there's an opportunity to create a team and that's you know it can be partners, it doesn't have to be a Samsung or an Apple there's a team of three devices that all work together there's partnership opportunities too but I think folks need to be open to that because you know this is going to have to be the value decade, it's going to have to start now I think the ecosystem is better doing it together I think one of the interesting points and also that Catherine was mentioning is you know the importance of content and how that kind of integrates in this entire ecosystem that we're kind of talking about so just to give you an example one company when started with they have dedicated themselves to early breast cancer detection and one of the things that they found was that you know especially in the US it's very hard for women you know to take that step towards getting their tests on and everything so in this case for example they developed a wearable which is you know a patch that you can place on your breast and then you know be a computer vision can give you kind of a heat map that can give you at least you know kind of an idea on if you have a higher risk factor or so but knowing that this entire topic is very hard for women kind of the first approach that they're having is okay let's build an app that's targeting those women but giving them content giving them extra value it's kind of surrounding their overall health and also their anything from menstruation cycle to pregnancy etc and so they're kind of organically integrating them that into awareness around breast cancer that then you know connects to their wearable so I think just overall understanding what kind of people you can reach with your product and how you can improve their lives and how sometimes not the most direct way but you know kind of a more innovative way is actually the path of success in that sense and if not I just want to ask what can't you believe I didn't ask what can I not believe you didn't ask well I didn't answer it I guess one of the things that I noticed particularly when we're in these technology-centric settings is how do you understand who your user is and why they want to use your product and how that product benefits them and that's one thing that I see you know when you were talking about there's some startups that start and they've got a really beautiful hardware but they kind of forget about the app I think that that's also endemic with development across the board you come up with this really cool technological solution but then you find out that nobody actually cares about your solution or that the way that your solution works is actually entirely different than you thought it would be. Totally different population, totally different use case than you ever considered in the beginning and so I think in terms of the ecology and the development I think having an open mind about how these things kind of develop and really talking to people from the very beginning is so crucial to development from an app perspective and our work perspective to make sure that we're creating meaningful products for people to use. Thank you all for your attention and your time we really appreciate it.