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Apple crippled watchOS to corner heart-tracking market, doctors say (theregister.com)
32 points by isodev on June 28, 2024 | hide | past | favorite | 17 comments


I feel like there are some really important details about this missing.

First off, are there really a loss of sales of heart monitors because of this? I would think that the only people who had real time heart monitors are those that were given it by a doctor and that would not change with the apple watch given the FDA clearance.

I know for myself, I have no need for a monitor all the time so the apple watch doing anything is a bonus since its nothing or the apple watch at this current time with my health.

It would also be helpful to know why apple made this change in the first place. That is entirely glossed over by the article. Even trying to google this topic the best I can find is that apple believes the new algorithm is better.


I think the issue is that by changing the way watchOS works, Apple effectively removes the possibility to develop a 3rd party health-tracking tool (because the sensor data is no longer available).

Imagine AliveCor (or anyone) coming up with a better way than Apple to interpret data from the device. Or they use the data in a different use case than the watchOS health feature... there are many reasons to enable 3rd parties access to onboard sensors.


Unless I am misunderstanding the article (or it is just not giving enough information), it isn't that Apple removed direct access to the hardware in watchos 5 but that they changed the algorithm.

It seems the previous algorithm gave more constant readings, but that is why I am curious more about why they made the change.

Given that as far as Apple is concerned, you still bought the Apple Watch. Regardless of wether the data is going to the heath app or another app, you still paid them money. Possibly even more money if that third party app is a subscription through the app store. There is no incentive for them to make this a worse situation for their users, quite the opposite actually.

So the reasoning for why Apple made this change is important.

As far as a developer having direct access to the sensors, that is a tricky situation. We can argue that for a heart monitor it is a good idea but I don't think every app needs access to every sensor for privacy reasons.


> it isn't that Apple removed direct access to the hardware in watchos 5 but that they changed the algorithm

Precisely why it should be possible for an app to provide their own algorithm (by accessing sensor information, or opting to re-use Apple's algorithm) but adapted to the app's use case. Apple must be transparent here.

> I don't think every app needs access to every sensor for privacy reasons

We already have a system in iOS to request permission to sensitive data. In fact, we have more than one - App Store Review (supposedly the guardian at the gate) and the permission prompt in the app itself. Privacy is not "degraded" when more sources can be requested by an app.


> Precisely why it should be possible for an app to provide their own algorithm (by accessing sensor information, or opting to re-use Apple's algorithm) but adapted to the app's use case. Apple must be transparent here.

This assumes it is possible to use the sensor as we expect it would be presented in the first place. Take the oxygen sensor, which to the best of my knowledge is largely an ML algorithm anyways.

> We already have a system in iOS to request permission to sensitive data. In fact, we have more than one - App Store Review (supposedly the guardian at the gate) and the permission prompt in the app itself. Privacy is not "degraded" when more sources can be requested by an app.

Yes and no, we know that users have a tendency to just accept and move on. This has been shown time and time again.

There are plenty of sensors that a developer would never need direct access to and should only ever need it through an API.

I would also argue that pushing all developers through API's instead help avoid apps being incompatible with later hardware revisions (within reason) which has largely been a staple of the iOS platform.

We should also be clear here that the lawsuit is not about direct hardware access. It never was from the best that I can tell. It is also not clear to me if direct hardware access would actually give anything meaningful depending on how exactly this works.


I’d be cautious about assuming most who can benefit from continuous monitoring are already being overseen by a doctor for some range of known conditions. Having just personally gone from apparently above average health to suffering a rapid onset vascular condition that probably would have come with some measurable anomalies in the days before I needed an ambulance, ER diagnosis, and surgery, I certainly can see a compelling case for widely available constant monitoring.


I am not saying who would benefit, the lawsuit seems to be focused on loss of sales.

I am legitimately curious about the actual number of sales that went to those without something diagnosed by your doctor. I don't know anyone that actually had any sort of real time monitoring before it was added to the apple watch.

For those that had something recognized by your doctor to need something, I would hope your doctor would recognize the limitations (and lack of full approval) of the apple watch and would recommend an altarnative.

So it isnt that I am saying who would benefit, but questioning the loss of sales.


My suspicion is that Apple switched monitoring types to better manage battery life and to continue to walk the fine line of the Apple Watch not actually being a health device (from an FDA perspective)


It's very likely the case, since heart rate measurement is a significant burner of apple watch battery.

As a comparison when using a bluetooth chest strap with my apple watch the battery life during a 90 minute workout barely drops at all. The chest strap also provides a much higher frequency of reads, making it more useful for workouts that involve lots of heart rate change such as weights training and crossfit.

The Apple watch's heart rate monitor is great for a wrist-worn device, but it's lower frequency of reads make it better suited to exercises where the heart rate doesn't change drastically such as swimming, jogging, walking, rowing, elliptical etc.


The bluetooth chest strap sounds interesting. Can you please share the brand name of the one you are using?


Any BLE HR strap should work. They all use a CR2032 coin cell that lasts several months.

* The Wahoo chest strap is more comfortable and more convenient to don and doff (it uses a snap at the front) and easier to change the battery. Main disadvantage is that the battery door is a known weak point (but you can 3D print a replacement) and can leak sweat inside, which causes galvanic corrosion on the circuit board. Also, it is sensitive to battery condition: silently stops transmitting, or transmits bad data when the battery is low.

* The Garmin chest strap is less comfortable because the strap bunches up. Also, the plastic hook rubs on your ribs. It's less sensitive to battery condition and gives accurate low battery warnings, but you need a tiny torx (maybe a T1 or T2?) to replace the battery, which is annoying. On the other hand, the battery needs changing less frequently than on Wahoo's strap.

I haven't tried Polar's chest strap, but it looks to be designed like Wahoo.

Wahoo's arm strap (optical, like Apple Watch) seems to have less reliable data (like all optical straps). The battery only lasts ~6-8 hours, and requires a proprietary cable to charge.

If you have any other fitness devices, like a bicycle GPS head unit or a GPS running watch, I would look for straps that are dual protocol (BLE / ANT+). ANT+ just works better than BLE: Easier pairing, lower energy consumption, fewer data dropouts.


Thank you. I will check out Wahoo.


I use the wahoo fitness brand chest strap. I like it because it's barebones, clipping on the strap activates it and then it's just a standard bluetooth health device that the watch can see and utilise. When paired to the watch, the built-in sensor switches off, which is easy to confirm visually.

For comparison: Where the watch's in-built sensor will give me around 12 readings a minute the strap gives me 60 (and this one is around 10 years old now). That's quite useful for HIIT, as well as getting a better judgment for how your heart rate is recovering after brief periods of intensity.


I thought to add: I checked to see if this brand still exists and it seems they do and it’s now a rechargeable device yielding a good IP rating. No word on how many readings it performs a minute other than “real time”.


Thanks


Given Apple's sizeable chunk of the market, it makes sense to give 3rd party developers programmatic access to certain platform features. This way, changes to Apple's own apps wouldn't be so impactful, and they can continue to innovate in parallel.


It's very funny that The Register still calls Apple "the iGiant" and the "the iMaker".




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