Ultrahuman's smart ring gets FDA-approved AFib detection

The smart ring has long played second fiddle to the smart watch. While tech giants like Apple and Google duked it out over wrists for years, the ring has been significantly quieter, a space where plucky startups have a chance to make their mark.

Things are quickly changing, however. Samsung will debut its first finger-worn wellness tracker later this month, while Oura, the category's (relatively) veteran startup, has been making a big push into retail.

With competition stepping up, Indian startup Ultrahuman's latest bundle of updates make a strong case for its place in the market. Notably, it's now offering AFib (atrial fibrillation) detection with its Ring Air.

AFib detection will be a premium option -- requiring a $4.90 monthly subscription.

The feature is powered by FibriCheck, a photoplethysmography (PPG)-based technique for taking a measure of heart rhythm based on applying a light source to the skin and measuring changes in blood volume as the heart pumps the fluid around the body. FibriCheck has been approved by the FDA and European medical device regulators.

AFib detection may already be familiar as it has been a flagship capability of Apple's smart watch for several years -- although Apple's wrist-mounted wearable uses a different (but still regulator-approved) detection method that's based on ECG (electrocardiogram).

Shoppers interested in getting a wearable are likely to be choosing between buying a smart watch or a smart ring, so the greater the functionality overlap the more potential uplift a gadget like Ultrahuman's Ring Air could get.

Ultrahuman's AFib detection feature is currently available in Australia, the EU, the Kingdom of Saudi Arabia, Singapore, the United Kingdom and the United Arab Emirates, where it has gained regulatory approvals.

"We are working on making it available in the U.S. and Indian markets in the next two-three months," Ultrahuman's CEO and co-founder Mohit Kumar told TechCrunch.

How accurate is the feature? "We have conducted numerous tests to match the accuracy and the signal quality of the AFib detection algorithm and are treading carefully here given we have a higher level of responsibility here," Kumar responded. "That’s why we’re only making this available where we have regulatory approvals and have tested the workflows for false positives and negative outcomes.

"The base detection algorithm runs with a sensitivity and specificity of 91.86% and 97.59%, respectively."

Alongside the launch of AFib detection, Ultrahuman is opening up to third-party developers via what it's calling "PowerPlugs," a platform for individual apps and plug-ins built on top of its health and wellness data stack.

As with AFib detection, Ultrahuman claims this is a world first in a smart ring.

Interested developers will be able to use Ultrahuman's SDK to draw on the wealth of health data it has flowing into its platform -- via not just the ring but also the CGM (continuous glucose monitor) metabolic tracking service it also sells -- to build and power other features users will be able to opt into via free or paid software plug-ins.

The startup's push to achieve greater customization of the smart ring's function by getting developers on board and building out more capabilities, is one way to scale serving the needs of an increasingly diverse user-base -- as more consumers discover the potential of smart rings and consider jumping in.

It's also a potential route to stoking innovation as rivalry in the space generally heats up if enough developers get on board with building apps and services for Ultrahuman's platform.

“When it comes to health, one size doesn’t fit all," Kumar added in a statement. "That’s why we built PowerPlugs for people to pick and choose what matters most for their health and wellness. Over the next few years, you could expect thousands of applications to be built on top of Ultrahuman’s comprehensive health data platform.

"Given our most comprehensive data stack of health markers from Ultrahuman Ring, M1 CGM, Ultrahuman Home and more to come, there’s infinite scope to build deep experiences over the next few years. Essentially, your Ultrahuman Ring will keep getting better after your purchase.”

The ring's feature mix was also already getting a little cluttered, with multiple widgets displayed in the product's tab in the app -- some of which may be more or less interesting to the user (say overall sleep and recovery scores versus stimulant window recommendations, for example), as we pointed out in our review of the Ring Air last year.

With this update, users will be able to customize available features -- picking and choosing widgets that make the most sense for them. "We just moved some existing features to PlugIns to make the UX cleaner," confirms Kumar.

The development does not change Ultrahuman's approach of not charging ring users a subscription to access core features.

The startup's main smart ring rival, Oura, currently charges a monthly subscription. However, Samsung's forthcoming smart ring is also set to be offered without a paid subscription -- at least initially -- so Ultrahuman soon won't be the only player offering a subscription-free smart ring in many markets once the Korean giant's Galaxy Ring arrives.

Kumar suggests there will be "loads" of free plug-ins, as well as confirming those features that were already freely available in the app -- such as Vitamin D exposure tracking, the Caffeine Window feature, Circadian Alignment, Pregnancy insights and Cycle tracking -- won't require any additional cost. It will just be a subset of services that are premium (paid) bolt-ons.

"There are many new PowerPlugs that are going to be free and the thumb rule for paid ones is that where there is a direct third-party cost / regulatory approval costs etc.," he said. "The core of the platform in terms of features is a no-subscription experience. Only a few new services (not features) might be paid to share and encourage third-party developers to develop more such capabilities through our SDK UltraSignal."

What about privacy considerations for Ultrahuman's users if third parties are gaining access to health data to build these additional services?

"We only send de-identified anonymized data to these services so there isn’t any risk of data privacy breach," Kumar said.

"The bottom line is that we’ll see the platform experience being driven by Features," he added, specifying these will be free. Whereas only add-on services will entail an additional cost -- such as metabolic tracking by CGM hardware sensors; AFib detection (via regulated PPG); and Blood testing (aka Ultrahuman's Blood Vision service which offers blood testing on demand by despatching a qualified phlebotomist to the customer's house to draw blood).

"These require an additional cost + manual intervention in some cases and hence behave like a paid service," he emphasized, adding, "At the very core, Ring Air is a subscription-free ring for all features and we intend to stick to this core principle."

https://techcrunch.com/2024/03/20/ultrahuman-series-b