At least three digital health companies are poised to take advantage of native Bluetooth on the Apple Watch, announced at the company’s WWDC keynote last month. In addition to Dexcom (which was announced on stage), Apple Watch apps are also either deployed or in the works from both respiratory health company Propeller Health and ReSound, a connected hearing aid company.

“New for this year, we're supporting [core Bluetooth for] watchOS,” Apple Bluetooth Engineer Craig Dooley said in a WWDC side session. “We think this opens a lot of cool opportunities, especially in the health and fitness space, for places where it was impractical to bring your phone previously.”

Dexcom users can leave their phone at home

Dexcom has long had an Apple Watch app for its CGM, but previously it required both a transmitter device and the user’s smartphone to function. In March 2016, they were able to cut out the receiver box with a software update. Now, with Bluetooth built into the Watch, users won’t need to have anything on them but the CGM itself and their Apple Watch.

“If you’re wearing an Apple Watch, there are times you’re going to get up at work and leave your phone in your office,” Dexcom CEO Kevin Sayer told MobiHealthNews. “If you’re going to go on a run, how nice would it be to not have to carry your phone on your arm and [to instead] get your glucose values on your Watch? I think the exercise case is a real good one. And I’ll tell you another one that may be under-emphasized. I think at nighttime when patients are sleeping, if they’re wearing the Apple Watch and they can get the alerts and alarms silently without having to get the phone or receiver or get out of bed, I think that’s a great use case as well.”

Sayer said that the Watch doesn’t completely replace the phones. If users want to manually enter data, they’ll need to do it on the phone.

“But the fact is probably 95 of a patient’s interaction [with their CGM] they’re not logging anything, they’re just looking at values,” he said. “And so 90-plus percent of the time the Watch will really be exactly what the patient needs, and I think it will be a great convenience feature for our patients.”

Eventually, Sayer hopes to add similar functionality for AndroidWear and other smartwatches, but the difficulty is finding a device with wide enough market penetration that its worth the company’s while. Dexcom’s Watch app is not yet available, because it will have to go through some regulatory steps.

“The way it works with medical devices is the OS will go out first and then we have to go through a validation and verification process of our software app to make sure it performs in the manner in which it’s labeled, then we have to file with the FDA, the FDA will review and approve that filing and then we can go with our revised app,” Sayer said. “So I really don’t have a timeline for that.”

Propeller’s first Apple Watch venture

While Dexcom is upgrading an existing Apple Watch app, Propeller is adding Apple Watch support for the first time in light of the new upgrade.

“The Apple Watch hasn't been a priority for us until now, due to many competing feature requests,” Chase Acton, an iOS engineer at Propeller, told MobiHealthNews in an email. “We try to prioritize features that will have the greatest impact on the largest number of users. Lately, we've had a few users ask for watch support and now 20 percent of our users have a Watch, so we decided to launch an initial, simple version of a Watch app to test the waters. If all goes well and user response is positive, we'll continue to devote resources to it and add more features. The first version won't use the new native Bluetooth support, as that won't be officially released until this fall.”

Propeller’s products work to help patients and their physicians better manage and understand asthma and COPD with sensor-enabled inhalers and connected apps. The company’s digitally-guided therapy platform pulls information from various sources, like connected medications, then leverages machine intelligence to personalize recommendations for individuals.

The Apple Watch app will start to bring some of that data directly to the Watch, like the Daily Asthma Forecast, which delivers predictions about environmental factors and potential triggers, medication reminders, and an implementation of the asthma control test (ACT) that users can take directly from the Watch screen. Once the native Bluetooth functionality goes online, users will be able to gather data directly from their inhaler sensors and display it on the Watch, without the need for the phone. Propeller is also hoping to create a Propeller complication, displaying relevant data right on the user’s watch face, Acton said.

“I think native Bluetooth on Apple Watch will open up a whole new way to use the watch, especially for health and fitness applications where you might not have your phone with you,” Acton said. “Imagine running on a treadmill and having the Watch automatically get rich workout details like incline, speed and distance added to Apple Health, directly from the machine without needing to use your phone as a proxy. We envision Propeller users being able to sync their sensors directly with the watch. Overall, this is a huge step forward for Apple Watch because it reduces its dependency on a paired iPhone.”

Hearing aids and more

One more healthcare use case was shared by Apple during one of the WWDC side sessions: Ian Parks, an engineering product manager at Apple, mentioned that the ReSound Smart 3D app, which currently connects ReSond hearing aids to iOS devices, will pair with the Watch so users can adjust their settings with the tap of the Watch.

“ReSound Smart 3D is an app that lets you connect to Bluetooth enabled hearing aids so you can change the listening environment depending on where you are,” Parks said. “So I can change from an outdoor listening environment to a restaurant, which has a pretty different audio profile, just with a tap on my wrist. And with watchOS 4, they can connect directly to the hearing aids so that they can make faster updates and they can continue using the device when the phone is no longer present.”

This is just the beginning, of course. Expect to see more health and fitness devices taking advantage of native Bluetooth on the Watch when the feature launches with the WatchOS update in September. Dexcom CEO Sayer shared some thoughts about where he thinks things might go from here.

“Where this becomes interesting — where we have an opportunity — is we don’t know what happens when you take all the data from an Apple Watch, like all the activity data, and your diabetes data and your heart rate data, what happens when you merge it all together?” he said. “Who can develop that app, and can we learn even more about a patient? Can we learn things that will really improve care now that we have more data that we can gather? I think there will be a whole new kind of science that evolves from this. Taking all these markers and putting them all together to provide better combined outcomes for patients rather than one specific thing.”