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The Quantified Self: Wearables, AI, and the Predictive Power of Personalized Data
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00:00Ok, so in our previous conversation, we were of course talking about longevity
00:04and the potential to add 10 years to life.
00:09Now, that's going to be a long, long path of R&D,
00:13but there's one thing that we're all doing right now,
00:16which is taking agency of our own health.
00:19And, this might upset Holly a little bit, but she said she's okay with it.
00:23We're all wearing wearables.
00:25You know, these things that we wear, the watches, the rings, the goggles,
00:31they're giving people the power to really think for themselves.
00:35And so, it's my absolute pleasure and honor to introduce you guys to Holly Shelton from Aura.
00:41Round of applause for Holly, please.
00:44Is the audience waiting for their lunch, perhaps?
00:47Welcome, Holly. So, talk to us a little bit about what you do at Aura, first of all.
00:52Yeah, so, hi everyone. It's great to be here.
00:56I am Aura's Chief Product Officer and I lead our Product Management,
01:00our Insights teams on the future of Aura.
01:04I came to Apple with a deep background in consumer technology.
01:09I spent a number of years at Apple leading the MacBook and MacBook Pro product lines,
01:13and previously was a professional athlete.
01:17And so, my passion is really at the intersection of technology and health.
01:21and I've been using the Aura ring for six years.
01:26And I've literally tried every wearable, including that one.
01:32And Aura was the first product for me that stayed on my body.
01:36I've checked it every morning for six years,
01:40and it was the first product that really gave me permission to take care of myself.
01:45I'd always been charging. I was an athlete.
01:47I was used to making the most of every day.
01:50And Aura gave me the data to really listen to my body.
01:53And I started to see an opportunity for wearables like Aura to really improve our health span
02:01and our long-term health.
02:03Well, let's get into your backstory a little bit more,
02:06because as you said, you've always been, you know, all about product.
02:09But the most fascinating thing about you, and when she says she's been wearing Aura rings
02:13before she even joined the company,
02:15this is a lady who is a professional skier in her past life as well.
02:20So, perhaps more than us, the average user of wearables,
02:24she understands perhaps the athlete mentality, what the body really needs.
02:29So, take us into that aspect of the wearable and why you believe that, you know,
02:35the Aura ring was the one for you out of all the devices that you had been using previously.
02:41Yeah, you know, as an athlete or even as a professional and everyday person,
02:48it's really about listening to your body and optimizing your day based on what your body is trying to tell
02:54you.
02:54And I think growing up as an athlete, I didn't always know what my body was trying to tell me.
02:59And so, I would push maybe when I shouldn't have pushed.
03:02Or maybe I didn't have a perfect night of recovery.
03:06And what Aura has done for me is it gave my body a voice,
03:10a voice that I really needed to pay attention to.
03:14So, take us through then.
03:15I mean, let me just show of hands in the audience.
03:19Who wears an Aura ring or has interest in it?
03:22All right, there's quite a few. Come on, don't be shy, don't be shy.
03:25So, take us through.
03:26I'm curious who wears a wearable.
03:29Okay.
03:31Amazing.
03:33Well, talk us through the features of the Aura ring then.
03:36I mean, you said that it sort of is more in tune to a body.
03:39I mean, if I can also give the example of the wearable that I'm wearing, so the Apple Watch.
03:43Now, one of the reasons why I have this watch is because I have the phone, I have the iPad,
03:48I have the MacBook as well.
03:50So, it just made sense to me to then be able to have that.
03:53But what I found that I do, which is probably what most people in the audience who wear wearables too,
03:58you're always counting the rings.
04:00Have I closed that ring?
04:01My move ring especially.
04:02Did I get my 10K steps in today?
04:04But then also, there's so much other information because it's integrating with your other apps.
04:09So, you know, the things you need for perhaps your work, your daily life, your agenda, your schedule, etc.
04:16So, it's quite cluttered in there.
04:18So, how is Aura able to really capture the essence of what it means to be healthy?
04:27So, it starts with our approach to hardware.
04:30And our hardware approach, we really focus on wearability.
04:34And we want to be quiet technology.
04:36So, we're a product without screens.
04:39We're a product without other apps.
04:40We don't beep at you.
04:41We don't buzz.
04:42We're something that's incredibly comfortable.
04:45We have a long battery life.
04:46And really, you can just put it on and it just fits into your life.
04:51So, it starts with the hardware.
04:54And the location on the body of the Aura ring, we sense at the palm side of your finger.
05:02There's no bones.
05:03There's no hair.
05:04It's uniform skin.
05:04We get incredibly accurate signal because we're at the leading edge of the pulse wave.
05:09But I think most importantly is what we surface to you every night.
05:13You sleep with your ring.
05:15Three out of four members wear their ring at least five days a week.
05:18And so, we have this incredible longitudinal data on you.
05:22We boil all of that data into three simple scores every day.
05:26Focusing on your sleep, your readiness, your activity.
05:29And then we help you tune into your body throughout the day as well.
05:34Do you feel as if Aura decided to take a different approach looking at the other competitors in the market?
05:40That you wanted to be a little bit more holistic perhaps?
05:43Yeah.
05:44We were really the first wearable that started with sleep.
05:48Really, we were a sleep lab on your finger initially.
05:52And that's because we believed that health starts with balance.
05:57Health starts with daily behaviors.
05:59And sleep is something that we all do every single day and has a profound impact.
06:04Not just on how you feel today, which is what we call readiness, but actually on your long-term health
06:08as well.
06:09And if we look at the world today, we're, as a general rule, living longer, having longer lifespan.
06:16But our health span is actually not improving.
06:1980% of the United States, at least, is living with a chronic condition or a mental illness.
06:25And what we know about that is that 50% of those conditions are driven by our daily behaviors.
06:32And sleep is so fundamental and paramount to that.
06:34And so we started with that.
06:35So talk us through how it's then helping you with your sleep.
06:38Is it telling you, is it, I mean, you said it's not invasive.
06:42So it's not like, for example, perhaps an Apple Watch, which is giving you prompts.
06:45How are you feeling today?
06:47Are you getting ready to go to sleep?
06:48It's your bedtime.
06:49How is that working to help me?
06:51I mean, if I was someone who had perhaps, I don't know, sleep apnea, how are you going to help
06:55me?
06:57Well, I think first and foremost, we're going to help you by understanding maybe what's happening in your sleep.
07:03So every morning we give you a sleep score.
07:05You can dig into the data.
07:08In the case of apnea, you probably have a lot of breathing disturbances and awakenings during the night.
07:14And you can see that in the data.
07:16And so really this is a cue for people to listen to that data and start to take action on
07:23that data.
07:23The other thing that we've started to do is connect the daily behaviors to a longer-term state of your
07:30health.
07:30And so we've started to quantify things like your cardiovascular age in our product
07:34or your resilience, which is a measure of your ability to withstand stress
07:40and an indication of cumulative stress building.
07:43And so we're starting to connect what decisions you make today
07:47and the impact that they have on something longer-term.
07:51Now, you mentioned data.
07:53I mean, obviously, when we're talking about AI, data naturally always comes up because there's such a wealth of information
07:59that's available now because of technology.
08:01So talk us through the two, you could say, kinds of data.
08:05The data that a person can understand for themselves to better their lives, but also what you're measuring.
08:12Yeah, so Aura measures over 50 unique biometrics.
08:18And we surface that, as I mentioned, into daily scores.
08:22But underneath those scores are contributors.
08:24And so people can dig into the heart rate, your heart rate variability, your temperature, your SpO2.
08:31And so you can take a deeper look into the specific metrics.
08:35But what we're really good at is surfacing what matters to you.
08:38What should you be paying attention to based on what we see in your data?
08:42Now, you mentioned cardiovascular disease.
08:45So how can a ring, while not being invasive, tell me about my cardiovascular health?
08:55And how do you also ensure that those prompts don't make people panic?
09:01Yeah, it's always a balance, right?
09:03With heart health, first, let's just think about the heart health.
09:08We have 1.28 billion people living with something like hypertension in the world today.
09:14It's the number one killer in the world.
09:17It's so incredibly important.
09:18And what we really care about is helping people make decisions early before it's too late.
09:24And so cardiovascular age in our product is built on a feature that looks at your pulse wave.
09:31It's an indicator of your heart and arterial health relative to your actual age.
09:37And so we're able to look at something called pulse wave velocity.
09:40And if your arteries are tight, then the pulse wave velocity is going to be higher.
09:47And what's really powerful about a metric like this is that it's something that you can change.
09:52As an example, when we were working on the cardiovascular age feature and we got the first algorithm,
09:58my heart age was nine years older than I am.
10:01And I'm someone that's an athlete.
10:02I pride myself on being healthy and it was really alarming to me.
10:06But I was able to take immediate action.
10:09I immediately started getting back into my HIIT training on my Peloton bike.
10:13And I very quickly started to see that number change.
10:16And so what we're trying to do is give people the data that they can take action on to influence
10:23early in a predictive and proactive way.
10:26Well, that's really interesting because in our last panel, we were talking to Joe and his whole mission is about
10:31longevity and prolonging someone's life by 10 years.
10:34So obviously, this isn't, you know, the same sort of thing that we're talking about.
10:38But can a wearable have that effect on someone's body?
10:43Can it really be the change?
10:46We think yes, especially when you look at what's driving the health conditions today.
10:52It's the things that we do every single day.
10:55It's how we sleep.
10:56It's how we move.
10:57It's what we eat.
10:58It's how we're recovering and the stress that we're accumulating in our body.
11:02These are the things that are driving these conditions and really are driving health span.
11:07And so this is something that everyone can act on now.
11:11Now, there was something really interesting that you mentioned just a while ago.
11:14You were talking about America and the sort of health landscape there where I think, you know, as Europeans, we
11:20understand that perhaps we have better diets, etc.
11:23So how can a technology like this work in tandem perhaps with regaining the health of the population in the
11:31country as vast as America, where you have really bad.
11:35I mean, I apologize to any Americans in the audience.
11:38But, you know, bad, the perceived stereotypes, I'll say then, of bad, you know, diets and mental health perhaps also,
11:47but definitely the physical health.
11:49Yeah, so we just recently started working in metabolic health.
11:54That's another behavior that you have every day.
11:56In the U.S., we have a partnership with Dexcom where you can wear a continuous glucose monitor and you
12:03can start to understand not only how your food decisions impact your blood sugar, but actually how the rest of
12:10your decisions.
12:10And if you don't sleep well, you're going to have a higher insulin spike most likely.
12:17If you move after you eat, your glucose is going to stabilize.
12:21We've also built a meal logging feature that has a very empathetic approach, but that starts to help you understand
12:27the process nature of the food.
12:30Is it have a high satiety so that you start to learn for yourself and you can see in your
12:38data how it's impacting the rest of you.
12:41Now, one thing that we've also been talking on this stage and you're talking about data now, this idea of
12:45inclusivity.
12:47So how do you ensure that the data that Aura has available and perhaps also through our users is inclusive
12:54of genders, of different races, et cetera?
12:58Yes, it starts with the sensing.
13:02We're very inclusive from a sensing perspective.
13:05But one of the things that I think is worth noting about Aura is our focus on women's health.
13:10Women's health is a very under-researched area.
13:14If you look at medical research outside of oncology, only 2% of funding is going to specific women's health.
13:22And Aura builds every feature with women's cycles and bodies and minds.
13:27We've built a bunch of features that are built entirely for women.
13:31We have a period prediction feature.
13:32We have a cycle insights feature that helps women understand what's happening in their body between their luteal and their
13:38follicular phase.
13:39We've built a fertile window feature, a pregnancy insights feature.
13:43And so we're building our data and our algorithms and our experience to meet every unique body.
13:51And how important is it?
13:52I mean, I don't know if this feels like a redundant question sometimes.
13:55If we are both women, so I'm going to ask it anyway.
13:57How important is it for you then that your company that you work for is able to do that,
14:01to really try to supercharge women's health or give them the understanding that perhaps previous generations never had?
14:08It's one of the reasons I'm at Aura.
14:12If you look in consumer technology, most products are not designed with women's bodies.
14:17And when we think about something as important as our health, if we don't study it, if we don't understand
14:23it, then we can't help people take the right actions.
14:27And that's what makes me so excited about Aura.
14:30And what about do you have any users or I mean, you don't obviously have to identify them, but any
14:34female athletes that are using your rings?
14:38And so, I mean, there was an example.
14:40I can't remember the name of the tennis player, but I think it was during the, you know, the French
14:45Open where she retired because she said, I'm sorry, I'm having really bad period pain.
14:50And I really remember that just as a moment where you see an athlete really as a human being, as
14:57a woman, and you're understanding that it's not easy to do what you do.
15:01So, are there examples where, you know, athletes perhaps have come to you and said, this ring is really transforming
15:07the way in which I'm training and looking after myself as well?
15:09Yeah, we have hundreds of examples. And actually, a lot of sports teams are using the Aura ring as a
15:15recovery device as well.
15:16There's a basketball team in the United States that entirely changed their travel schedule because of, they were seeing how
15:22their players were recovering when they were taking late night flights.
15:26We have an ex-athlete who has entirely shifted her training schedule. During your follicular phase, you're more energetic. She
15:36does most of her HIIT and strength training then.
15:38And during her luteal phase, she tends to do more restorative things. She doesn't do hot yoga. And she feels
15:45like her training is more efficient than it's ever been.
15:48And so, what we see with athletes is that they're aligning their training to what's happening in their body. And
15:53for women, it just happens to be that your body is changing every day based on your cycle every single
15:57month.
15:58I mean, how important does that feel for you then? I mean, how excited and happy, I guess, do you
16:04feel that you're able to do that for women? Because as you said, they are so underserved.
16:10Yeah, it's so exciting to me. Even if you look at something like perimenopause, only 30% of women know
16:16what to expect.
16:18Perimenopause is something that affects people over a four to eight year period.
16:22And being able to give women body literacy to understand what to do to feel better and to improve their
16:30health span during these critical phases is really exciting.
16:33So, we've talked about the kind of people that an Aura ring can touch. What would be the next phase
16:40of the discovery or the purpose or vision, you could say, of these rings?
16:45Yeah, so Aura is really moving towards Aura being a personal health companion that's built for the long run.
16:51So, we don't just want to be a product that's here for you today, but a product that's here with
16:55you over many decades, that's building up a baseline understanding of your health, that's helping you understand from a predictive
17:02perspective when something is happening early so that you can take action on it.
17:08We're moving into AI-based guidance and predictions to help really have that conversation, that 24-7 conversation, a doctor
17:16in your pocket that's always there for you.
17:18And finally, we're starting to connect out to clinical care. We think the Aura ring is already useful. We allow
17:25members to export a health report that they can bring into their doctor.
17:29But we're also starting to integrate directly into EHRs and giving doctors insightful data on patients to improve the quality
17:40of care itself.
17:41I'm glad that you talked about returning or allowing someone to have that link to a clinician because I think
17:46that's also really important.
17:48Because, I don't know, for me, it feels that we're only at the start of the wearable technology. There's so
17:53much where this can go. There's so many levels.
17:56But does there need to also be that ethical check then? Because if we look at health systems, especially in
18:02Europe, again, to talk about the pandemic, but we saw how they were completely on their knees.
18:10And so what wearables have really given people is the ability to perhaps, on a sort of basic level, take
18:17care of themselves better.
18:18So how do we ensure that people don't just become completely self-reliant on their wearables or the technology and
18:26no longer listen to the healthcare professionals?
18:30Well, I think a couple of things. One, the data is so powerful, right? Because that's a normalizing factor for
18:37both the individual and the doctor.
18:39And what really matters is that we're able to translate that data in a way that's valuable for both sides.
18:44But ultimately, we believe that when people are empowered with data, that they're going to seek care earlier.
18:52And ultimately, that will reduce strain on the healthcare system.
18:57And then if we're looking to the kind of, as I was saying, down the thread of the future of
19:01wearables, I mean, right now, I mean, I was talking about it using the wearable on a kind of basic,
19:07you could say, level where it's sort of integrating with my life.
19:10I'm counting my steps. I'm using it to keep on top of my my daily exercise and all of that
19:15thing.
19:15How can we now change the mindset of the general user so that they're not just it's not just a
19:22tick boxing exercise of sorts?
19:26Yeah, I think I think that over the long haul, it's just about the small steps every day.
19:33This isn't a race pun intended.
19:37Yeah, maybe, you know, we have we have a philosophy that all movement counts.
19:41So you don't you don't have to have a hit workout every day.
19:44We track your gardening. We track your yard work. We track you dancing at a wedding.
19:49But but these small steps are what really maybe for the dad for the dad dancers.
19:54We don't need to do that.
19:56But certainly for me.
19:59But no, carry on.
20:00So the the uses for the human being, you know, the everyday user go for it.
20:04Yeah. And there's there's just basic.
20:06Like we all can learn our own personal formula that's best for us that are actually habits we can sustain.
20:13And there's very simple things like caffeine, for example.
20:16Caffeine has a half life of of many hours.
20:21If you if you have a cup of coffee at two at at 8 p.m., you still have half
20:26of that caffeine in your system.
20:28Alcohol. We know that alcohol negatively impacts the health of 70 percent of our users, that they have a lower
20:34HRV by 12.9 percent.
20:36These are basic things that you can start to see for yourself and adjust today.
20:41And that that's what impacts you over the long haul.
20:44So do you think that it can get rid of people's vices then, you know, people's vices?
20:50Yeah, I think that we focus a lot on sustainable habits and sustainable health.
20:56And so it's not about a vice that you can't that you can't continue with.
21:01This is just about integrating into your every single day life so that you can live better for many, many
21:07years.
21:08OK, so we have a couple of minutes left.
21:11And so I guess the final question is really what comes next for Aura?
21:18What is the short term and perhaps long term, whether long term is five years or 10 years?
21:23What's the future going to look like at your company? Go for it.
21:28Yeah, so there's three things that I would say that we're focused on right now.
21:32One is continuing to be the best in the world at health sensing and from a longitudinal, continuous 24 seven
21:40basis.
21:40So we're going to continue to advance our sensing through our wearable technology.
21:44The second would be agency in action.
21:47So moving from displaying data to actually helping people take action, change their behaviors and find that sustainable formula formula.
21:57And then the third would be connecting into care.
22:00So helping people find the right care at the right time early so that we're actually moving the needle on
22:08on health span.
22:09Thank you so much. So a quick temperature check of the audience then.
22:12Who now is convinced to perhaps look into buying an Aura ring?
22:16There you go. So you can come see Holly after the stage.
22:19Well, listen, look, we do have one more minute left.
22:23So I'm going to ask you perhaps the question for me when it comes to the Aura ring then.
22:28One of the reasons why I mean, obviously, I said I've got all the integrated Apple apps.
22:31But one of the reasons why I wasn't particularly into thinking about a ring was because my fingers always swell
22:38up.
22:39So you might see the rings will start changing, moving around my fingers.
22:42So is that perhaps something is is is the technology in the Aura ring able to allow for that sort
22:48of thing as well?
22:50I mean, swelling is a natural part of fingers.
22:54Every our fingers swell slightly every day.
22:56But but most users, as I mentioned, people wear it three.
23:01They wear it all the time.
23:02And so most people, if you need to change fingers, but we find we find comfort is one of the
23:08leading reasons that people buy the ring.
23:11OK, well, listen, it's been a pleasure to chat to you.
23:14I think wearables are so much part of our daily life now.
23:18So everyone, please give a round of applause to Holly, please.
23:21Thank you.
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