The Apple Watch Series 4: Health Within Reach

Published December 17, 2018

In September 2018, Apple released its latest version of the popular Apple Watch, the Series 4. Design features have captured the attention of most product reviewers, but the health applications have also generated some well-deserved attention. The Series 4 represents a significant step toward Apple creating a multi-functional health maintenance device that happens to tell the time of day.

The new Apple Watch includes a variety of applications that touch on all the major pillars of health: diet, exercise, sleep and stress reduction, with a handful of intriguing extras as well. Here is a summary of the latest health-related features.


Despite its crucial importance to health, diet management has been a challenge for individuals and their physicians since the days of Hippocrates. The Apple Watch Series 4 takes a step toward tackling diet through its integration with Lifesum. The app is particularly good for those who are motivated to document everything they eat and drink for an extended period. Because you are wearing your diet log on your arm, the disincentive to keep track may be reduced (for example, if you happen to be out to dinner, or on vacation).


For some time, wearable devices have been improving their ability to track exercise and to keep the user accountable for workouts. The Series 4 has an automatic workout detection feature so that you never have to smack yourself in the forehead after a workout because you forgot to turn on the timer! The watch will display your resting and walking heart rate averages and will perform heart-rate recovery calculations after a workout.


One knock on the Series 4 is that it (still) doesn’t have a built-in sleep monitor. Nevertheless, there are several compatible apps that you can download to the device that take advantage of the watch’s internal motion detector (called an actimeter). Meanwhile, developers are working hard to move the technology closer the standard achieved by laboratory sleep studies. One complication: the watch’s battery lasts under 24 hours between charges, so most people place it on the charging station overnight.

Stress Reduction

After diet monitoring, stress reduction may be the most difficult aspect of general health to manage and alter. But, that doesn’t stop Apple from trying. The “Breathe” app guides you through focused breathing exercises, a simple form of cognitive behavioral therapy for stress reduction. One nice feature is that the phone’s notifications are automatically muted when Breathe is open so that the user can have some peace to focus on breathing.

All four pillars (diet, exercise, sleep and stress reduction) can be collated and summarized on the HealthKit platform that Apple has been pitching to developers for years. The company has been chided for progressing too slowly on the health platform in the past; however, CEO Tim Cook appears to be pushing Apple to pick up the pace with more emphasis on developing integrated health apps.

Drum Roll Please: The Big News

One of the most exciting features on the Series 4 is the built-in electrocardiogram. The FDA recently granted approval to Apple to market the watch as a medical device. The app delivers warnings for sustained heart rates that fall out of the range of normal. There is also an app that signals the wearer for signs of a specific heart rhythm abnormality called atrial fibrillation. Cardiologists are nervous about false-positive warnings that might generate panicked phone calls. Nevertheless, the application appears to be reliable. It certainly is a harbinger of future wearable disease detectors.

The New Fall Monitor

The Series 4 has upgraded its gyroscope and accelerometer in order to create a fall monitor, a feature clearly aimed at the elderly population. If a significant deceleration event occurs, as in a fall to the ground, the device signals you, essentially to ask if all is well. If you do not respond within one minute of being signaled, the watch will automatically call emergency services and text your designated emergency contact with your exact location.

Patient-Centered Healthcare

Wearable devices in general, and the Apple Watch in particular are leading the charge in the movement toward patient-centered healthcare. This type of industry disruption makes traditional stakeholders understandably nervous. Those stakeholders, including physicians and hospitals, should embrace the wearables movement, and co-opt it if they must. Like it or not, the healthcare industry must accept that health monitoring and maintenance is already as close to the patient as their wristwatch.