This is Optimizer, a periodical dispatch issued each Friday from Verge senior reviewer Victoria Song that analyzes and deliberates upon the newest gadgets and remedies that claim to revolutionize your existence. Subscribe to Optimizer by clicking here.
The current landscape of wellness technology can be attributed to a singular device: the Apple Watch Series 4.
Prior to 2018, smartwatches and fitness bands concentrated on a limited set of functions, including step counts, heart rates, basic sleep tracking, and activity logging. Consequently, their primary emphasis was on physical exercise rather than comprehensive well-being. These were useful for individuals aiming to boost physical activity levels or shed some weight, but they weren’t devices capable of “preserving your existence.” This entirely changed with the debut of the Series 4, which unveiled FDA-approved atrial fibrillation identification — an unprecedented capability for any consumer wearable. The feature, however, didn’t receive universal acclaim. Critics warned that its precision was not on par with a conventional 12-lead EKG, and numerous medical practitioners were uncertain how to decipher this innovative wearable information.
Despite this, this type of FDA-cleared digital screening functionality now serves as the defining characteristic of what is considered sophisticated personal wellness technology. Annually, numerous accounts surface detailing how Apple Watches have bettered or preserved lives — a phenomenon that prompted competitors to develop similar features on their own devices. Eight years subsequent to the Series 4’s introduction, wearables are capable of dispatching a variety of alerts pertaining to maladies, sleep apnea, high blood pressure, and even reproductive cycles. And while there’s discussion surrounding these functionalities inducing health apprehension, wearable manufacturers are striving to uncover correlations between novel biological indicators and extended lifespans — explaining why so many newer devices are focusing intently on recuperation measurements, metabolic processes, and, for some reason, biological liquids.
Considering that The Verge is devoting this whole week to contemplating 50 years of Apple products, it would be neglectful not to examine Apple’s role in shaping this domain — and the subsequent developments. Therefore, I interviewed Deidre Caldbeck, senior director of Apple Watch and health product marketing, to discuss how the company conceives wellness functionalities and the implications for the Apple Watch’s trajectory.
In 2016, my initial Apple Watch owned was the Series 2. As a device critic focused on wearables, I’ve evaluated each subsequent version. One aspect has consistently been undeniably evident regarding Apple’s methodology in this area: the Watch is not intended to be a specialized item for a select cohort of wellness enthusiasts. Instead, the aim is to create a wellness device that caters to all individuals. (Provided you possess an iPhone.)
“We genuinely sought to render the features on Apple Watch as accessible and user-friendly as possible. Of course, technological capabilities have progressed, and public fascination with well-being and exercise has shifted over the years, but we’ve consistently endeavored to uphold that foremost goal: crafting functionalities capable of truly influencing the broadest possible audience,” states Caldbeck.
Caldbeck states that while the Apple Watch has consistently featured an optical heart rate monitor, it was chiefly employed for exercise monitoring. However, as more people began utilizing the device, Caldbeck notes the company received input from consumers expressing a desire for greater insight into their cardiac well-being that might clarify certain irregularities in their measurements. With the Series 3, the company provided alerts for elevated and reduced heart rates. Nevertheless, the pivotal transformation, she asserts, truly occurred with the advent of the Series 4. That period marked the Apple Watch’s initial substantial overhaul, incorporating a larger screen and a rejuvenated, contemporary user interface. The incorporation of the electrocardiogram then contributed to repositioning the gadget as a more comprehensive wellness instrument rather than merely an activity monitor.
“We began to receive increased reports from people gaining understanding of heart rate recuperation, and we pondered, ‘Perhaps we should further dedicate resources to areas such as diminished cardiovascular conditioning,’” she recounts, referring to how the company showcases the VO2 max measurement. “And of course, AFib alerts existed, but should we leverage AFib records further once you’ve been diagnosed with AFib? So that sort of initiated this rapid progression into an expansion of these cardiac wellness functionalities.”
Apple’s dedication to crafting significant, broadly beneficial health functionalities often seems to conflict with the dominant paradigm in today’s health and wearable technology: AI-driven customization. Currently, Apple’s competitors are swiftly moving to integrate AI, aiming for increasingly bespoke user experiences. Companies like Garmin, Google / Fitbit, Samsung, Oura, Whoop, Strava, Withings, and Peloton are, without exception, embedding AI into their systems to provide distinctively personal experiences. (Spoiler alert: These are typically dreadful.)
These entities, over recent years, have similarly been prompt in integrating popular wellness trends into their products. The surge in popularity of GLP-1 medications has, for instance, made metabolic health monitoring and AI-powered nutrition features extremely desirable. Garmin introduced its version of this functionality just in January. Remarkably, Meta this week disclosed plans to venture into AI-based nutrition logging through its smart spectacles by late summer.
Apple, conversely, has been a latecomer to the AI arena, a fact for which it has faced censure. Workout Buddy, an AI-powered feature introduced last year, is not, in fact, a true AI coach. Its design, instead, aims for greater motivation, revealing past accomplishments or underscoring progress toward daily targets. It notably refrains from offering specific instructions, generating exercise plans, or giving counsel – a set of expectations many users have developed for AI fitness capabilities.
Caldbeck maintains that this is all by design.
She clarifies, “Our goal is to furnish significant insights, yet without highly specific suggestions. Thus far, our features have been conceived to be somewhat more understated, intended to recede into the background and cater to your current situation. Certainly, we intend to inform you of anything warranting your attention, providing the necessary information for sound decisions or perhaps a discussion with your doctor.”
Apple, Caldbeck observes, has incorporated AI into the creation of multiple features, among them heart rate tracking, fall detection, and notifications for hypertension. The fundamental tenet, however, dictates that AI should primarily “uncover health insights and equip individuals with actionable information.” Crucially, every health feature *must* also conform to established, consensus-driven scientific documentation.
Dr. Sumbul Desai, Apple’s vice president of health and fitness, conveyed to me via email: “Our consistent aim is to offer features with actionable insights, firmly rooted in science, and developed with privacy as their fundamental aspect.”
From a product development viewpoint, Caldbeck acknowledges the allure of adopting trendy wellness phenomena. Yet, she explains, Apple demands its data be corroborated across a vast demographic, given the immense global scope of its offerings. Its groundbreaking Apple Heart Study, for instance, boasted over 400,000 participants – a figure truly exceptional at the time. During feature development, concepts like specificity and sensitivity (metrics determining a test’s accuracy for true positives versus true negatives) are regularly evaluated.
“We are, quite frankly, judicious when deploying new features, as we aim to avoid moving beyond established science,” Caldbeck states. “A delay of a year or two is sometimes necessary. While this might place others ahead in user-prioritized areas, it calls for discipline, a principle we will uphold.”
It’s important to clarify that while many health technology enterprises merely claim scientific backing, Apple’s commitment is not a pretense regarding
the sustained effort and strategic concessions this methodology demands. I conversed with Desai in the previous year concerning the Apple Health Research. What sets this specific investigation apart is its lack of a predefined objective; instead, it aims to cover a broad spectrum, including physical movement, senescence, heart health, blood circulation, mental processes, auditory function, reproductive wellness, metabolic conditions, ease of movement, brain health, breathing capacity, and slumber. This inquiry is scheduled to persist for a period of 60 months and possesses the potential for extension beyond that. There is no assurance that revolutionary discoveries or functionalities will emerge. Consequently, a substantial duration might pass before the outcomes of such extensive and comprehensive research become apparent.
Alerts for high blood pressure, introduced in the previous year, serve as a further illustration. Despite this being a functionality Apple had desired for an extended period, Caldbeck indicates the corporation opted to defer its release until it could provide dependable, verified outcomes for users worldwide and successfully navigate the official approval procedures. Furthermore, Apple released a corroborating document, leveraging information from 100,000 individuals in the study, which elaborated on the underlying technology and the development process of the function. The sleep quality metric, a capability present on competing gadgets for numerous years, stands as another case in point. Apple did not introduce its iteration of this function until 2025, according to Caldbeck, due to its emphasis on scientific accuracy. Moreover, though Apple possessed the option to integrate biological measurements into the feature, it chose instead to highlight elements over which individuals retain actual command.
Nevertheless, even if a significant period passes before the emergence of the subsequent revolutionary health capability, Caldbeck and Desai assert that consumers can anticipate Apple integrating health-related technology into its diverse array of devices as well.
“Our efforts are concentrated on developing inventive, smart functionalities that provide individualized understanding via offerings such as the Apple Watch, AirPods, and iPhone, thereby profoundly transforming the notion of preventative care by making health data universally accessible,” states Desai.
“Considering our accomplishments in auditory wellness with AirPods, and indeed what we achieved many years prior by utilizing your iPhone to monitor movement parameters, a substantial amount remains achievable with the gadgets accompanying you daily,” Caldbeck further remarks. “This represents an area where we intend to persistently allocate resources to broaden the positive influence for a greater number of individuals through an expanded range of our offerings.”
Within Optimizer, I frequently express regret regarding how, over the past few years, well-being tendencies appear to be shaping health technology in a suboptimal fashion. The progressively indistinct boundary between general wellness and medical technology truly causes me sleepless nights, particularly as health tech firms commence advocating in Washington for less stringent wearable device rules. In my capacity as an evaluator, I have also penned a considerable amount on how Apple Watch and health enhancements can strike one as repetitive, notably when other technology enterprises have “preceded them.” Observing this domain, I remain uncertain which methodology will ultimately prevail. Will it be Apple’s more deliberate, expansive, yet academically stringent method — or that of the nascent companies pursuing fashionable wellness fads, relying on AI-driven customization to herald a fresh epoch of health technology? However, if one certainty exists, it is that Apple stands as an infrequent corporation capable of taking its leisure.
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