Tag Archives: Tim Cook

Apple Flexes Its Healthcare Muscle

Posted on by
Reply

At Apple’s September 12 Special Event, the company continued to show off its growing healthcare superpowers with the release of the Apple Watch Series 4. The latest iteration of the Apple Watch, available September 21, unleashes new features designed to help people manage wellness. Those features include:

  • Creation of an ECG similar to a single-lead electrocardiogram. Using a new ECG app, watch owners can take an ECG reading from their wrists and receive heart rhythm classifications. The Apple Watch can classify if the heart is beating in a normal pattern or whether there are signs of Atrial Fibrillation (AFib). In addition, the data is stored in Apple’s Health app in a PDF that can be shared with physicians. In Apple’s words, “It’s a momentous achievement for a wearable device that can provide critical real-time data for doctors and peace of mind for you.”
  • The ability to detect when a person falls and report a falling incident to a designated emergency contact. Analyzing wrist trajectory and impact acceleration, the Apple Watch sends the user an alert after a fall, which can be dismissed or used to initiate a call to emergency services. If the Apple Watch senses immobility for 60 seconds after the notification, it will automatically call emergency services and send a message along with location to emergency contacts.
  • More fitness features. The Apple Watch already gamifies healthcare by rewarding users with special badges for completing fitness tasks such as walking. Now the Apple Watch allows users to challenge other Apple Watch wearers to complete fitness tasks. In addition, the device provides other features such as prompting owners to start workouts and accurately tracking active calories burned for activities such as hiking and yoga.

With the Apple Watch Series 4, Apple extends its reach into healthcare, following a strategy that the company has been pursuing for years.

The Data Backbone for Patient Care Continue reading →

Will Apple Take Augmented Reality Mainstream?

Posted on by
Reply

Apple critics have been quiet lately.

The company is worth more than $900 billion after beating Wall Street’s expectations in its November 2 earnings report. The iPhone 8 is selling better than expected. Consumers are lining up to buy its most expensive iPhone ever, the X. And the iPad just might be making a comeback.

Tim Cook is talking like a visionary, positioning himself and Apple on the cusp of changes in technology and human experience. For instance, Cook recently declared on an Apple earnings call that augmented reality is “mainstream” and that “Apple is the only company” that could have made augmented reality mainstream.

His comments evoke Mark Zuckerberg’s bold announcement that Facebook intends to get one billion people to use virtual reality. And, like Zuckerberg, Cook is being ambitious, considering that only 12 percent of the U.S. population is expected to use AR at least once a month in 2017. But there is reason for AR backers to be optimistic: usage of AR is growing by 30 percent over 2016 according to eMarketer.

Apple’s strategy to accelerate the uptake of augmented reality is to provide a development platform for the creation of AR content and to  rely on popular Apple devices as Trojan Horses to deliver that content to consumers.

But to realize the potential of augmented reality for widespread consumer and corporate use, Apple might need to do more — such as the creation of an augmented reality headset.

Augmented Reality Breaking Through

Augmented reality refers to an experience that alters our perception of reality by overlaying computer-generated content on to a physical space. Augmented reality is being used in businesses ranging from hospitals to amusement parks to train and entertain by enhancing our worlds with digital content such as holograms and 3D objects with which we can interact. In the automotive industry, augmented reality might enhance driving by overlaying content such as signage on a driver’s windshield, reducing the need for the driver to strain to read street signs while navigating. For AR to break through to more mainstream consumer use, the experience needs:

  • Great content.
  • A ubiquitous, user-friendly delivery mechanism.

Apple provides the latter through the manufacture of its devices and is enabling content creation by providing the necessary tools and media platform.

Apple’s Role Continue reading →

Apple Extends Its Reach into Healthcare

Posted on by
1

Apple continues to shape the future of healthcare.

At its September 12 special event, Apple CEO Tim Cook and COO Jeff Williams announced something less sexy than the $1,000 iPhone X but no less important: new health and fitness features through watchOS 4, the operating system that powers the Apple Watch. They include:

  • Improved heart monitoring. The Apple Watch already performs basic heart-monitoring with Cardiogram (In fact, according to Williams, the Apple Watch is the most-used heart rate monitor in the world.) But with watchOS 4 (available September 19), Apple Watch will also report resting heart rate and recovery heart rate (the latter metric tells you how quickly your heart rate drops after a workout). As Williams said, a lower resting heart rate and a quicker recovery rate can be signs of improved fitness.

  • Alerts on elevated resting heart rates. Williams noted that many Apple customers wrote to Apple about how their Apple Watches helped them detect unusually high heart rates at unexpected times. So the Apple Watch now notifies owners when the device detects an elevated heart rate and the owner does not appear to be active — thus alerting the watch owner about potential heart problems.
  • Better support for your workout. For example through the GymKit technology platform, watch OS 4 will make it possible for people to sync fitness data between their Apple Watches and cardio machines they use at the gym, thus delivering more accurate fitness information such as calories burned or distance traveled during your workout. The sync feature will only work with newer pieces of gym equipment — so that functionality might be limited.

Apple also announced that the company is working with Stanford Medical Center to determine whether the Apple Watch can accurately detect abnormal heart rhythms, or arrhythmias. As noted by Jessica Conditt of Engadget, Apple would like for the Apple Watch to be able to detect common – but often undiagnosed — heart conditions such as atrial fibrillation. According to a study done by Cardiogram and the University of California, San Francisco, the Apple Watch already detects the most common type of heart arrhythmia with a 97 percent accuracy rate. With the Apple Heart Study, Apple will manage its own research with Stanford Medical Center.

“In our Initial studies, Apple Watch has been effective at surfacing irregular rhythms,” Williams said. He noted that the Apple Heart Study “will use data from Apple Watch and Continue reading →

Is HomePod Apple’s Death Star in the Music Streaming Wars?

Posted on by
Reply

Apple’s newly announced HomePod smart speaker is more than Apple’s answer to Amazon Echo and Google Home in the battle for your home – it’s quite possibly Apple’s major advantage in the music streaming wars.

In unveiling the HomePod June 5 at its Worldwide Developers Conference (WWDC), Apple announced that the voice-activated speaker will be a music-first experience that combines both the quality of high-fidelity Sonos speaker and the intelligent interface of the Amazon Echo – with a focus on providing users access to the Apple Music catalog. As Apple noted in a press release,

Designed to work with an Apple Music subscription for access to over 40 million songs, HomePod provides deep knowledge of personal music preferences and tastes and helps users discover new music.

At WWDC, Apple Chief Executive Tim Cook said the speaker has “amazing sound and incredible intelligence that will reinvent home music.”

Why the focus on a high-fidelity experience with an emphasis on music? One reason is that Apple wants to be the leading music streaming provider – badly. After disrupting the music industry through iTunes and the iPod, Apple found itself looking behind the times when consumer tastes shifted from downloading songs on iTunes to streaming them on apps such as Spotify. And looking outdated is strange ground for Apple. Apple’s desire to play catch up with streaming was a big reason why the company paid $3 billion for Beats in 2014. Months after buying Beats, Apple launched its own service, Apple Music, in 2015.

The good news for Apple is that within two years, Apple Music has become the Number Two streaming service as measured by paid subscribers. And these are heady times for streaming services such as Apple Music and Spotify. In 2016, for the first time ever, streaming music platforms generated the majority of the U.S. music industry’s revenues. As the RIAA noted, the biggest contributor to growth was a doubling of revenues from paid streaming services. But for Apple, there is also some bad news:

  • Amazon has been rapidly encroaching upon music streaming. It offers a limited service to Amazon Prime customers (Amazon Prime Music) and recently launched a subscription service, Amazon Music Unlimited.

Spotify and Amazon are significant competitors with their own strengths and weaknesses:

  • Spotify enjoys the strong brand affiliation with music, its customer base, and outstanding personalized playlists, but the company is losing money.

  • Amazon enjoys an advantage with its deep pockets and the popularity of Echo speaker, which provide a natural platform for streaming music. But Amazon Music Unlimited is an upstart (and Amazon Prime Music is a feature of Amazon Prime, not a pure streaming service, per se).

The Echo factor is big. Echo has experienced astounding growth to dominate the market for voice-activated home speakers, as people become more comfortable with the voice interface. It’s like a Swiss Army knife for doing everything from controlling the temperature in your home to ordering products.

And in addition, Echo is also a platform for playing music through voice commands (“Play the new Lorde song”), something Spotify does not offer. In 2017, according to eMarketer, 35.6 million Americans will use a voice-activated assistant device at least once a month, and 71 percent of them will use Echo. (Google Home has the second highest marketshare behind Echo, at 24 percent, but Google does not release user figures for its Google Play streaming service.)

No wonder Amazon offers Amazon Music Unlimited at its lowest price to owners of Amazon Echo speakers: Echo is a Trojan Horse for Amazon’s music streaming product.

But Swiss Army knives, while being useful, are not great at everything. The Echo is not engineered specifically to listen to music. HomePod is. At WWDC, Apple Senior Vice President of Global Marketing Phil Schiller said that HomePod will provide the high quality of a Sonos speakers and the smart interface of the Echo.

“These aren’t smart speakers, Schiller said of Sonos. “They don’t sound so great when you listen to music,” he said of the Echo. But HomePod will sound great and act as a home musicologist, he said.

He indicated that the HomePod will make it possible for consumers to call up music using complex voice searches and then listen to music through a product that provides state-of-the-art sound including spatial awareness, which adjusts the audio depending on where you are sitting in the room.

But the ace in the hole is the integration with Apple Music. As Apple announced,

By saying, “Hey Siri, I like this song,” HomePod and Apple Music become the perfect musicologist, learning preferences from hundreds of genres and moods, across tens of thousands of playlists, and these music tastes are shared across devices. Siri can also handle advanced searches within the music library, so users can ask questions like “Hey Siri, who’s the drummer in this?” or create a shared Up Next queue with everyone in the home. HomePod, Apple Music and Siri deliver the best music experience in the home that streams ad-free directly to HomePod.

HomePod will also provide the same functionality as Echo, providing functions ranging from turning on the lights in your home to providing sports and weather information.

The HomePod should be available in December at a cost of $349, a cost that is significantly higher than Amazon Echo and Google’s own Home speaker. By pricing the HomePod at the high end, Amazon is banking on consumers:

  • Accepting Apple’s position as a premium brand.
  • Caring enough to pay more for better sound.
  • Subscribing to Apple Music because it’s so easy to listen to music with voice commands on HomePod. (I wouldn’t be surprised if Apple offers an incentive for bundling Apple Music paid subscriptions and HomePod.)

It’s an interesting bet. Consumers have been indifferent to sound quality on mobile devices, not caring enough about sound quality to buy high-end mobile streaming products such as Pono. Meanwhile in the home environment, the growth and popularity of Sonos speakers for years showed that people would pay for premium sound  – but then Amazon’s encroachment on Sonos suggest that consumers were willing to sacrifice the fidelity of Sonos for the convenience of Echo. And now Apple believes consumers will do the same with HomePod.

Apple won’t put a dent in Echo’s 71-percent market share anytime soon, but Apple doesn’t need to. Apple is not offering a utility that competes on price as Echo does. Apple is selling a high-end experience first and utility second. Apple Music is central to that experience. Will HomePod be a catalyst for Apple Music to eat into Spotify’s lead?

Dr. Apple Will See You Now

Posted on by
4

Apple has been defined by consumer product innovations such as transforming mobile phones from calling devices into data centers. But you won’t find Apple’s future in an Apple store. You’ll need to visit a hospital like Johns Hopkins Medicine.

At Johns Hopkins, physicians provide epilepsy patients with Apple Watches to track their seizures, possible triggers, medications, and side effects. Thanks to a special app developed by Johns Hopkins, the EpiWatch, patients have access to their personal information through a dashboard that also shares data with providers if the patient wants to do so. Patients can also send a message to family members and providers to let them know when the patient is tracking a seizure. Johns Hopkins is collecting this data to eventually understand how to predict seizures before they happen.

Johns Hopkins is one of many healthcare providers working with Apple to help patients manage their wellness and clinical care. Apple is not abandoning its role as creator of consumer devices and software — in fact, Apple is doubling down on devices by carving out a bigger role in healthcare. For the past few years, one of the world’s most valuable brands has acting as the data backbone for patient care, one built on Apple hardware and software. Having changed industries ranging from music to telecommunications, Apple is helping to the healthcare industry make an important and necessary shift toward wellness and clinical treatment.

Apple’s Strategy

Over the past few years, Apple has made some significant product developments, personnel hirings, and corporate acquisitions to make Apple a brand for wellness and clinical care. For example, in 2014 Apple launched HealthKit to give Apple users a central repository to track health and fitness data on their Apple devices. The launch of the Apple Watch positioned Apple more firmly as provider of a consumer health-management wearable. The 2016 acquisition of Gliimpse, a medical data storage and sharing start-up, bolstered Apple’s entry into supporting clinical care with smarter electronic health records. So what, exactly, is Apple’s game plan for healthcare? To sum it up:

Apple’s strategy is to be the data backbone for patient care.

And that patient care strategy — for now — focuses on wellness care (providing services such as fitness and nutrition management designed to keep patients healthy) and clinical care (using data more effectively to help patients manage conditions such as diabetes).

The two key elements of that strategy are:

1). Software for patients and providers to monitor and share data

Through its Apple Health app and the ResearchKit and CareKit application development software frameworks, Apple has been creating a software infrastructure for wellness care, diagnostic care, and medical research on Apple devices such as iPhones, iPads, and Apple Watches.

So far the real action for Apple is occurring on the provider side for clinical care. For instance, as reported in Forbes, in February 2015, Ochsner Health System in New Orleans launched its “Hypertension Digital Medicine Program,” which relies on HealthKit to empower patients to measure and share with the provider their own blood pressure and heart rates. Oschner adjusts (in real-time, if needed) patients’ medications and lifestyle counseling based on the findings.

The Apple website also contains many examples of health providers applying ResearchKit and CareKit. For instance, Duke University has developed a ResearchKit app that allows physicians to screen and diagnose autism by using their iPhone cameras to do facial recognition checks. The University of Rochester used ResearchKit to build an app for the largest Parkinson’s study in history. According to Apple, “the app helps researchers better understand Parkinson’s disease by using the gyroscope and other iPhone features to measure dexterity, balance, gait, and memory.”

ResearchKit and CareKit have built off HealthKit’s core functionality to give Apple an entree into clinical care. As reported by Alex Webb of Bloomberg, “The ultimate goal of Apple’s medical technology team is to turn HealthKit into a tool that improves diagnoses . . . The system could chip away at two problems that plague the industry and have stumped other specialist firms in the field: interoperability — allowing data to be transferred from hospital to hospital across different databases; and analysis — making it quick and easy for physicians to extrapolate salient information from mountains of data.”

2). Hardware: the Apple Watch and iPhone to create an ever-present device platform

Apple Watch and iPhone are the delivery devices for Apple’s health management software. The iPhone gives Apple an installed user base of 101 million users in the United States, and the Apple Watch a wearable, which is key for managing everyday fitness goals such as nutrition and exercise (because of the convenience of wearables).

The iPhone accounts for 70 percent of Apple’s revenue. For Apple, penetrating healthcare is important to maintain sales growth. After experiencing three straight quarters of slumping sales, Apple recently reported that iPhone demand came roaring back in the first quarter of 2017. Finding new markets such as healthcare should help Apple maintain its leadership

On the other hand, the Apple Watch is still a small enough part of Apple’s ecosystem that its sales are rolled up into Apple’s “other products” category. But Apple Watch is essential to Apple cracking the fitness market. And at Startup Fest Europe in Amsterdam, Apple CEO Tim Cook brashly predicted an era in which everyday people will wonder how they ever got by without their Apple Watches “[b]ecause the holy grail of the watch is being able to monitor more and more of what’s going on in the body. It’s not technologically possible to do it today to the extent that we can imagine, but it will be.”

But consumer usage is only part of the story for Apple Watch — the other is institutional uptake. Hospitals such as Johns Hopkins University and King’s College Hospital in London are using the Apple Watch to do everything from giving patients reminders to take their medicine to collect information about patients’ epileptic seizures in order to better understand epilepsy.

And Apple is collaborating with the health payer side, too. Recently, Aetna announced that the insurer is providing the Apple Watch at no cost to its 50,000 employees “who will participate in the company’s wellness reimbursement program, to encourage them to live more productive, healthy lives.” Aetna is also developing health apps integrated across multiple Apple devices ranging from the iPhone to Apple Watch to handle a host of health management functions ranging from refilling prescription orders to paying for health treatment.

Look for Apple to continue to develop the Apple Watch as a fitness and telemonitoring device. Last year, Apple filed a patent to make the Apple Watch capable of monitoring your heart beat and warning you of an impending heart attack. And recently Apple filed a patent to embed into smart sensors into Apple Watch wrist links. In doing so Apple identified fitness-monitoring capabilities as a potential application of the functional band links.

Will Apple’s Strategy Succeed?

These applications of Apple technology are taking hold for some overlapping reasons, including the advent of pay-for-performance models (in which physicians are rewarded for achieving successful patient outcomes as opposed to volume of patients treated) and the rise of wellness care.

The adoption of pay-for-performance models and an increase in high-deductible insurance plans are contributing to a bigger focus on wellness care — in other words, investing in programs intended to keep patients healthy. The PwC’s Health Research Institute (HRI) cites wellness care as one of the top five forces shaping the future of healthcare industry over the next decade, with wellness accounting for $276 billion of the $5 trillion U.S. healthcare ecosystem. The Apple Watch and Apple Health position Apple well here.

Moreover, the uptake of pay-for-performance or (outcomes-based compensation models) — in which payers reward healthcare providers for achieving quality-related goals instead of volume of care — plays into Apple’s favor. Here’s why: As noted by Reenita Das of Frost & Sullivan, “To date, the majority outcome-based compensation models are, in reality, performance modifiers built on top of legacy fee-for-service reimbursement schemes. In 2017, we will begin to see more fully formed schemes that focus on patient support across the care continuum. As such, healthcare providers are in dire need of the right technologies and tools to help them effectively deploy and coordinate patients, personnel and infrastructure [emphasis mine].”

In other words, healthcare providers need access to better data to help patients achieve better outcomes, which is exactly why Ochsner Health System in New Orleans jumped all over Apple’s HealthKit to start treating hypertension. A sustained effort to making clinical care more effective requires better management of electronic health records, which is what Apple is aiming to provide, as seen with its acquisition of Gliimpse.

Tim Cook’s Vision

Apple’s actions follow through on Apple CEO Tim Cook’s vision for Apple as a healthcare player. As he told Fast Company’s Rick Tetzeli in 2016,

We’ve gotten into the health arena and we started looking at wellness, that took us to pulling a string to thinking about research, pulling that string a little further took us to some patient-care stuff, and that pulled a string that’s taking us into some other stuff,” he says. “When you look at most of the solutions, whether it’s devices, or things coming up out of Big Pharma, first and foremost, they are done to get the reimbursement [from an insurance provider]. Not thinking about what helps the patient. So if you don’t care about reimbursement, which we have the privilege of doing, that may even make the smartphone market look small.

And Cook has good reason to be optimistic. Apple’s ace in the hole consists of its toehold among the various players in the healthcare ecosystems, especially physicians, who prefer using Apple products. And the Cleveland Clinic recently rated the Apple Watch as having the most accurate heart-rate sensor. In 2017, I expect Apple to deepen those relationships through joint research and development (as it has done with Mayo Clinic).

And to paraphrase Steve Jobs, here’s one more thing: expect Apple to articulate a vision for integrating artificial intelligence and healthcare. The company recently joined the Partnership on Artificial Intelligence, a consortium dedicated to using AI for social good. AI, data, and healthcare are converging. I expect Apple to be at the center of that convergence.

This blog post is adapted from my ebook, Dr. Apple Will See You Now.

Apple Pays Dearly for U2’s “Free” Music

Posted on by
Reply

u2TimCook

Photo credit: Marcio Jose Sanchez, AP

Let’s get something straight: U2 did not give away its new album, Songs of Innocence. To be sure, if you have iTunes, on September 9 you received a free copy (without asking for it) of Songs of Innocence. But Apple paid U2 an undisclosed amount to distribute copies of U2’s album to as many as 500 million iTunes subscribers — a deal announced on September 9 as part of Apple’s roll-out of the iPhone 6 and Apple Watch. Now, let’s do some math: in 2013, Samsung paid Jay Z $5 million to distribute 1 million copies of Magna Carta Holy Grail. Consider the lucrative sum U2 must be scoring ($30 million according to one estimate). And ponder, if you will, the $100 million marketing campaign the band is getting courtesy of Apple. These old rockers from Ireland have found a way to make a killing off a dying art form.

The distribution deal has created some backlash for both Apple and U2. For instance, music blogger Bob Lefsetz wondered why U2 would choose iTunes as its distribution platform, when more popular (e.g., YouTube) and hip (e.g., Spotify) distribution platforms are available. “They’d have been better off releasing it on YouTube, that’s where the digital generation goes for music,” he wrote. “iTunes is a backwater. It may be the number one sales outlet, but it’s not the number one music platform, not even close.” Plus, the approach of a forced distribution of content on to 500 million iTunes accounts is being viewed by many as obtrusive.

bono-u2

Photo credit: Peter Neill

On the other hand, what is a rock group supposed to do in order to make money off its music in the digital age? Album sales have reached an all-time low. Getting noticed for your art is harder than ever at a time when music is just background noise for our digital games, advertisements, and movies. Musicians are not making money off streaming services, and YouTube is hardly a sure bet to monetize music. No wonder Kiss frontman Gene Simmons recently declared that “rock is finally dead.”

Yes, dropping content into our iTunes account without our permission is a controversial move. But the approach is fresh and new, and the old ways are not working anymore in the music industry. The relationship with Apple has given U2 two precious assets: money and attention. By participating in the most important and high-profile day in Tim Cook’s history as Apple’s CEO, U2 has turned an album launch into a global event. Tell me: who else can do that? The $100 million marketing campaign will keep the album in the public eye in the run-up to Universal’s official release of Songs of Innocence October 13 — and, more importantly, will serve as advance notice for the inevitable tour.

And you can be sure a tour is coming. Because that’s why albums still matter: as a launching pad for other revenue streams, such as tours and merchandising deals. U2’s last tour raked in $736 million from 2009-2011. U2 just primed the pump for what comes next.

Update, 22 September 2014: since I wrote this post, the backlash against Apple and U2 that I mentioned has intensified, obviously. As Adweek reported, social media sentiment dropped for U2 by 41 percent in the wake of the deal. My take: years from now, the U2/Apple (and similar Jay Z/Samsung album drop from 2013) will be viewed as flawed but necessary experiments in monetizing music, and others will improve upon those approaches.