Put a (smart) ring on it: Movano on why its health wearable will put women first

Put a (smart) ring on it: Movano on why its health wearable
will put women first

Movano Health turned heads at CES with an ouroboros-esque smart ring designed for women.

In the crowded field of fitness wearables, where the mainstream heavy hitter of the Apple Watch heads up a very long tail of typically less pricey and/or more specialist activity tracking bracelets and bands all keen to claim their own patch of data-generating skin, it’s no small irony that differentiation at this point in the market’s run means designing a product to ‘target’ around half the population — as my colleague, TC’s hardware editor Brian Heater, dryly observed of Movano’s pitch for a smart ring called “Evie” last month.

But what does a wearable made for women actually mean in terms of utility and design? TechCrunch talked to Movano Health’s CEO and director, John Mastrototaro, to get the inside track on the forthcoming smart ring and delve into its wider roadmap as it works on building a medical devices company whose starting point is simply putting women first.

Movano is kicking things off, pre-commercial launch, by applying for FDA clearances for two of the metrics the smart ring will track out of the box: Heart rate, and SPO2 (aka blood oxygen level) — and it says it wants the ring to launch with those two regulatory check-marks in place — but with plenty more on the ‘to-do’ slate.

Including — down the line — a goal of adding (non-invasive) blood glucose monitoring into the mix. (Its novel sensing tech remains at a prototype stage for now but Mastrototaro flashed us a look at an integrated RF chip and a wrist-mounted prototype it’s currently testing for this purpose.)

As regards the first iteration of the ‘smart ring for women’ — which will track over a dozen metrics and offer female-focused features like menstrual cycle and mood tracking and support for menopausal symptoms, as well as more regular wearable stuff like activity tracking — Mastrototaro said he’s hoping they’ll be able to launch it in the U.S. around the middle of this year.

The target customers will be women in their 30s and up. While the ring’s price-point will be “well under” $300 (and — refreshingly — there’s no subscription). And that pricing already looks competitive compared to the Oura smart ring — which is currently the main rival for finger-based wearables in the U.S.

Movano’s also made some other smart choices to go with a paired down price-tag — including an open design that won’t pinch fingers if they swell a bit; a portable charging case to keep the ring safe and juiced up on the go; and the big strategic decision to apply for regulatory clearances which means the ring can be marketed (differentiated) as a medical device where most others can’t. Which is certainly one way to stand out in a noisy consumer crowd.

Mastrototaro brings a long career in medical device development already, having worked at a number of companies doing clinical research and R&D on sensing technologies — including at Medtronic, where he led the team that developed the first continuous glucose monitor (CGM) sensor for diabetes management.

That’s notable because a lot of startups have been tapping up CGM tech for commercialization in recent years — with the aim of repurposing a medical grade technology for a more general consumer fitness and/or wellness/health use-case. (Including, in the case of India’s Ultrahuman, combining CGM tech with a smart ring to enhance its ability to ‘decode’ the user’s metabolic health.)

Movano is approaching the same goal — of encouraging more people to watch their blood sugar to help them optimize lifestyle choices and improve their overall health outcomes — but it’s planning to layer that (future) functionality atop a medical devices company foundation, rather than coming at it from a pure ‘wellness’ or ‘fitness’ consumer tech pitch as most of these startups are. Which may lend more credibility to any push it makes here.

Additionally, as noted above, it wants to offer a major twist on the technology side too, as it’s working on developing a non-invasive radio frequency sensor for tracking blood glucose changes.

If it can pull that off it could skate right past the CGM niche and have a shot at opening up a powerful capability to a general consumer who otherwise wouldn’t bother with this kind of health tracking — exactly because it requires sticking sensing filaments (or needles) into actual flesh. Whereas if Movano’s smart hardware can give you a peek at blood sugar highs and lows via (painless) high frequency radio that implies potential for major, transformative health effects at scale. (Notably Apple has long been rumored to be working on adding non-invasive blood glucose tracking to the Apple Watch, although it’s yet to bring such a tech to market for its general consumer. But the attention on such a feature underscores how much this concept is prized.)

As well as FDA-cleared metrics (assuming Movano does indeed obtain these clearances) lending credibility to hardware that will — in the first instance — be marketed to highly discerning consumers (i.e. women), the company dressing itself as a medical device maker is smart positioning as it sets the business up to be able to sell hardware into b2b markets too.

Per Mastrototaro, the goal here is to get to a position where, for example, its smart ring could be reimbursable by insurance payers as a preventative health device — so the aim from the start is to scale beyond a direct-to-consumer hardware business.

With demand for healthcare systems continuing to increase, both in the U.S. and beyond, it looks like another smart bet. Certainly it’s not a stretch to imagine overstretched health services may well (also) end up being keen on consumer-friendly medical grade devices — devices they can offer their patients for home monitoring, on so-called ‘virtual wards’, as a cheaper way to free up hospital beds for people who need closer care.

This already partially forming future is what Movano is positioning its wearable business for.

And, before you ask, it does have men on its roadmap. Mastrototaro says the end-game is to be — simply — a maker of devices for everyone.

But its first task, as it eyes the myriad players ranged on the wearables field — some high gloss, others rather more ragtag — is to find a way to elbow in. And what better way to do that than remember the roughly half of the population most device makers consider a mere afterthought. It ain’t rocket science guys.

Our full Q&A with Movano Health’s CEO & director, John Mastrototaro, follows below. The interview has been lightly edited for clarity and length.

TechCrunch: Why do women need a dedicated wearable? So what is your hardware going to be able to track and provide women that other smart rings or wearables can’t?

Mastrototaro: It’s a great question. I mean, first off, our goal as a company is to empower and inspire women to take more active control of their health and to live a happier, healthier, more well balanced life. And the way we’re going to go about doing that is by monitoring a comprehensive set of health metrics: Heart rate, heart rate variability, SPO2, respiration rate, temperature, steps, activity, calories, burned, sleep, sleep stages, and of course, menstrual cycle tracking as well — as well as a couple of other things related to menopause and help in tracking any kinds of symptoms they may have, both through their menstrual cycle as well as when they age and get into the menopause period of life.

One of the things that we found when we started to look at the existing wearables that are on the market today is two things: One, none of them are medical devices — and I’ll talk in a moment about why being a medical device company is really important to us and, we think, important to consumers — and then secondly, that women seem to have been underserved in the wearables market. Most wearables look like they were initially designed for men. They’re kind of thick, bulky, and typically came in male-looking colors — and then subsequently, they’ll change up things a little bit and say, you know, here you go, ladies, here’s the female version.

We spoke to over 1,000 women and asked them what was important to them as they age and related to their health. And we found that, although they want to use wearable products like this, often they don’t [use them] or they only use [them] a part of the time because of some of the shortcomings with the existing devices where they don’t really focus on women’s needs. And so we really focus on what [women] want to see in a health wearable. And one of the things that was very important to them was the accuracy of the data that we provide, as well as helping them understand their body through their cycle, and how every aspect of their health may be affected by that, and also helping them as they age into menopause.

There’s been a survey done that said 92% of women feel unprepared for menopause. And, as we know, 100% of women are going to go through that stage of life. And so we also want to provide resources and help to women as they age — with more than just the health metrics but distilling it down into what it all means to them and their health.

The question then is how do you do that with this piece of hardware? So are you able to do menstrual tracking, for example, through tracking body temperature? How does the hardware enable you to sort of provide this additional layer of utility to women?

Certainly the hardware does provide that utility. And yes, by monitoring their temperature, through the course of the month, as well as their heart rate, we can track and predict when, say, the period is about to start. So that’s certainly one aspect of what we’re doing. But in addition to that, a lot of what we’re going to be doing is asking women about how they feel, and what are their goals for their health — because everyone’s unique, and how people go about getting their activity is unique. Not everyone does 10,000 steps a day… Some people may prefer to swim or they may prefer to cycle. Whatever the case may be. We want to make sure that we’re collecting that data about their activity, and about the calories burned, so they understand that — and also do a lot with correlations.

One thing that’s very important to us is to correlate how one thing may affect another. For example, if a woman experiences headaches at a certain time of the month or she starts to have her first hot flash related to menopause, we want to help explain how maybe activity levels — and the intensity of activity — how much they sleep etc could affect the likelihood of those events. Or things that they could do to try to either reduce the frequency or reduce the severity of events when they occur. So a lot of it has to do with tracking metrics directly. But we also take into account individualized communication between the app and the user.

Female health historically, as you surely know, has been terribly under studied. So the question then is, okay, you’re going to be acquiring data from the users and hopefully using that to spot these patterns — but can you offer this utility initially? Or is this a sort of a journey for the user that they have to be on with you as you build the data to pick up patterns and figure out correlations?

A little bit of both. We are contracting with female medical experts. For example, we’re working with a female doctor who is an expert in women’s sleep. We’re working with a female doctor who’s an expert in menopause. We’re working with female doctors in different disciplines along a woman’s health journey. And so as a woman may be experiencing one of the symptoms or stages of their life, we can provide some expert support, through canned messaging about, here’s why it’s happening, here’s why it’s nothing that you should be concerned about. It’s part of the ageing process. And here’s some tips about how you can manage through this. But as well as doing that initially, you’re right — over time, we’ll be building up a database of all of this for many, many 1,000s of women, that we can mine and leverage that data to help us understand little tricks that may have worked better for one population versus another.

The other thing that we will provide through our app experience is community. Many women have told us that they like to share with one another. And so we will also offer the ability for women to peer-to-peer, communicate and say ‘Hey, I’m having a problem with this. Has anyone experienced that before and any insights you can provide me?’. And then we’ll allow women to speak with one another, to also share. Because this is something that some women told us was important to them.

So what’s the user experience going to be — talk me through how the user will use and experience the hardware and the app. And also this community element. How will it all fit together?

Yeah, that’s a great question. And actually, the three things you just mentioned are the most important pillars for us with the product. So let me start with first about the ring, the design of the ring — even the charging of the ring. Because we did think about women as we did this. So the ring… you can see it’s an open design. That was important to us, because it has a little bit of give. It has a little bit of play in it. And so if your finger happens to swell at a certain time of day, or the month or whatever, it has a little bit of give to it. When we were at CES and many media folks came by… several were wearing an Oura ring as an example. And they wore our ring. And they really liked the way it felt on their finger. And they like the way it looked on their finger. And so there was a lot that went into even the design of the ring itself.

The second thing that was very interesting to [us was] the charging case. The charging case looks like a little compact device. And you slip the ring into it to charge. You can see it’s [in the case] flashing lights now, it’s charging. And so women love the portability of this in that you can slip it in your purse, take it with you on a trip. This charging case will charge the ring 10 times. The ring needs to be charged every three to four days. So if you’re going away for a trip or a couple of weeks, it’s kind of like your AirPods type device. You can just carry this little charger unit with you wherever you go. It will recharge the ring every three to four days when it needs to be recharged. Then this charger obviously can be recharged periodically, by plugging it in an outlet. But in between that time you’ve got the portability — and so a lot of women love that because many of the chargers with wearables you’d have to be plugged in to a power supply in order to recharge the device. And we don’t have that. So those were a couple things related to the hardware that was important [to us].

You asked about the app experience.This app is designed specifically for women. We’ve made it to be much more approachable — with kind of a dashboard with key information for each day. It allows women to do a dive into their body. There’s basically a “my body” primary screen that they can follow through. And we’re trying to have a very holistic and unobtrusive approach to goal setting where they can pick a few goals that they want to achieve. And we can help track that for them. We really are looking at ‘mind body’ with this as well. We will be monitoring mood — and how they’re feeling as well… There’s a strong relationship between how you’re feeling inside and how your body is actually operating. And so that’s very important to us, as well.

And then, lastly, a lot of consumers of wearables today they look at all these trend graphs the current apps provide, and they’re like, is this good or bad? I don’t know what this all means. And so part of what we’re trying to do is distill all that down into insights and help really provide peace of mind to women, and help them understand the general state of their health. And every now and then give them little pearls of wisdom or insight that they can use to take a more active control of their lifestyle.

I’ve talked about the trusted resources of these expert advisors from the medical community, as well as peer to peer community. And so that is the other element of our app experience that we want to provide. So if a woman experiences her very first hot flash with menopause, and we have a very simple way where they can hit little buttons on the screen to denote that they’ve experienced a certain event, we can then feed them information. For example, say hey we understand you’ve just had your first hot flash, here’s why it’s happening, this is normal, it happens to every woman as part of ageing. Here’s exactly why it happened. And here’s a couple of tricks that you could potentially try that may allow you to manage through this or maybe experience fewer events with less severity.

So that’s… what we’re trying to do with three core elements: Focusing the hardware on women, focusing the app and the insights specifically on women and women’s needs. And then, lastly, the community — being a trusted resource. If you go online and look for a solution to a particular problem, there’s thousands of commentaries out there, and much of it is the opposite of one another. It’s like what am I supposed to really do? We want to provide a full, comprehensive, trusted resource for women.

Could the ring also automatically detect a hot flash? Would you be able to pick up on a temperature change event, say at night — so you could partially automate some of that tracking (vs women needing to manually log each event; instead maybe you could send a push notification asking them to confirm if they had a hot flash at such and such a time)… 

You know it’s very interesting because, historically, we’ve not had continuous monitoring of all these metrics that we could then correlate to events that occur. It’s going to be very exciting to look at these things… I’m a 30 year medical device veteran so I’ll give you a little bit of a medical device example. A lot of people have a problem with their heart called atrial fibrillation… when your heart starts to flutter. It’s actually the atria of your heart, that’s the flutter in your heartbeat, goes a little bit crazy. It’s more rapid and not so rhythmic. And one of the things that we can do, just as an example, with that condition is because we’re tracking all their health metrics throughout the day — obviously we’d see in the heart rate when this occurs — but what’s most important to me is many people have this, it just comes and goes periodically. And one of the things that I’m very interested in, and I’m using this as an example but you can think of more, is to track what was happening with their health metrics (or their activity, or their sleep, or other metrics) and then try to correlate it to the initiation of one of these events happening in their life. So that we can help them over time to say, hey, you know what, we’ve noticed that typically, if you have a couple of days where you weren’t very active and you didn’t sleep well, that’s typically when you then have one of these events occur. And so I think we’re going to learn about what are some of the things that caused — not caused but let’s say have some impact on an event occurring or not. And maybe it is, in some ways, the cause.

We can look at the data that happened previous to the event, and try to then help folks over time understand — that, you know, you should avoid really strenuous activity at nighttime that prevents you from sleeping well, and then you have this event in the morning as an example. And so I think there’s going to be a lot of learnings like that — both individualized for a given person, as well as population based — that we’ll be able to better understand that will help folks over time. And I fully believe that we’ll find that hey, you know, on nights when you don’t sleep well, and you didn’t get out much or do this [activity] you’re more prone to having a hot flash. Or if your activity’s too strenuous that’s not good, either… So I’m really excited about what the data can show us over time because no one knows.

Do you have a sense this smart ring will be a product that’s more popular with older women — such as women who are around perimenopausal age? The pricing has been reported at around $300 — so maybe for younger women it’s a bit more of an outlay for them. But I would guess you do also want younger women as users? So what are the customer profiles you’re targeting?

When we went through our process of research, we basically met with 1,000 women between the ages of the young 30s to 70s. So, yeah, we weren’t focused so much on the teens and 20s in what we did. It was really the 30s. So I’d say the latter half of childbearing years and onward is our focus was initially.

We did a full pricing study with women. We were initially thinking about launching this as a pure subscription model. But we spoke to women and the majority said, you know what, I’ve got subscription fatigue; just let me buy the thing and be done with it.

We know that the Oura ring today, which is the primary ring product on the market at this moment, currently sells for $350 to $550, depending on the color of the ring. And in fact, in some ways, I feel women were penalized most — because the ring color that’s most designed specifically for women is rose gold and the rose gold ring is $550. Plus there’s a $6 a month subscription on top of that. So when we looked at what consumers were saying, and our own pricing conjoint analysis, we decided that every ring every color, every size, would be sold at under $300 US to each women. That doesn’t mean $299 — [it’ll be] well under $300 for the ring.

So, on the one hand, we’re going after a medical device claim — and we’re about to be filing, soon this year, for FDA clearance for heart rate and SPO2, because we ran our pivotal FDA trial for that and we’re very excited about the results; we got phenomenal accuracy; our accuracy, and the trial was even better than the hospital grade pulse oximeter, so that was great news for us — so, on the one hand, we’re a medical device, and yet we’re going to provide it to consumers at a lower cost than the non-medical device. And part of the reason for doing that is because we want to try to reach more broadly with this technology and get it in the hands of the people who need it the most, to help them with their health.

[But also] because we’re a medical device company we also have a huge opportunity in the pure healthcare space. Business to business. Major pharmaceutical companies have come to us. Major medical device companies. Integrated healthcare networks have come to us — because they’re looking for a medical device solution that they can use as part of their offering. Big Pharma, for example, they want to use a product like this in clinical trials and post-market surveillance of people on a..

* This article was originally published here