Join us for an insightful and provocative discussion on what it takes to build successful wearables. Our panelists represent three leaders whose technologies make it possible for our devices do all the cool stuff we love. Karl Etzel, Business Development Consultant, Firstbeat: the leader in heart-rate algorithms. Got a Garmin that tells you when to train hard and when to recover? Thank Firstbeat! In understanding fitness metrics, VO2max is a great place to start. Learn more at https://www.firstbeat.com/en/blog/vo2mx-ultimate-resource/ Ryan Kraudel, VP Marketing, Valencell: creator of the world's most accurate biosensor systems, found in leading brands including Jabra, Bose and Suunto. Here's a great webinar on Valencell's work in the fast-growing hearable product category: https://valencell.com/blog/2018/06/making-biometrics-universal-in-hearables-and-hearing-health/ Yao Lu, Americas Sales Director, Ambiq Micro: their low-power semiconductors help companies like Spire, Huawei and Misfit (Fossil) reduce or eliminate the need for batteries, reduce overall system power and maximize industrial design flexibility. Here's a webinar from Ambiq CTO Scott Hanson on low power consumption and its impact on wearables and use cases: https://www.youtube.com/watch?v=B8pANa85WQM

1. Wearable Design Symposium
August 2018 – SVHealth Meetup
Plug and Play, Sunnyvale, CA

2. Agenda
• Start w end in mind: A use case, not a
measurement
• Keys to success: Actionable, personalized,
contextualized
• Power management
• Sensors
• UX/analytics
• Examples in medical, sport, and the intersection

3. First Phase Wearables
Focused on general activity tracking, step
counting, calorie counting, and reaching
movement goals.

4. The Next Phase of Wearable Growth
Value Drivers:
• Deeper individual
insights
• Broad population
insights
• Guidance and
prediction
• Shifting healthcare
delivery
Biometrics driving deeper insights into
personal health, fitness, and wellness.

5. Wearable + medical solutions are in the “forming” stages and will
move towards increasing public health impact
User
Interface
Health Screening
Medical Device
Replacement
New Medical
Solutions
Description
Wearables as a
new UI for
existing health
and medical
devices
Using sensors in
wearables for screening
of chronic health
conditions or risks, such
as COPD, asthma,
diabetes, etc.
Wearables worn outside
medical facilities to make
existing medical devices more
wearable or higher compliance
Completely new systems
that address previously
unsolvable problems
Examples
Dexcom
partnerships with
Fitbit and Apple
Cardiogram and Apple
Watch screening for
atrial fibrillation
iRhythm atrial fibrillation
sensors; Blood pressure
readings from mobile phone
Predicting the onset of a
COPD attack, migraine,
cardiac event, etc;
Therapeutic solutions
Time to Market
Impact
Now 1-3 years 1-3 years 3-5 years
Public Health
Impact
Easier to view
data
Potentially saves money
via early diagnosis
and prevention
Potentially saves money by
lower-cost equipment,
higher compliance, and
less hospital visits
Addresses completely
unmet needs and
may substantially lower
medical costs

6. Start With The End in Mind

7. Start With The End in Mind: General Health Monitor
Questions answered:
• Am I active enough?
• Am I getting enough
sleep?
• Am I qualifying for
an insurance
benefit?
Technical requirements:
• Accurate HRM
• Low power
consumption
• Insightful analytics
on the data

8. Ambiq Micro: The World’s Most Energy-
Efficient Solutions
8
Confidential and Proprietary

9. 9
• Founded in 2010 to provide ultra-low power solutions for the IoT
• Unmatched ultra-low power timing products, MCUs and wireless SoCs
• Core technology (SPOT) based on sub-threshold circuit operation
• SPOT Technology Roadmap to put AI everywhere
The World’s Most Energy Efficient Solutions

10. 2006
2010
2012
2015
2016
2017
2014
Neural networks deployed on SPOT products
2nd generation MCU launched
1 MILLIONTH MCU PART SOLD
1st SPOT MCU launches >10X lower power
First commercial Real Time Clock products launched
Ambiq Micro founded
First SPOT processor built @ University of Michigan
1 MILLIONTH REAL TIME CLOCK SOLD
25 MILLIONTH PART SOLD
3nd generation SoC launched
2018
Ambiq Micro
History
10

11. The Battery-Powered Internet of Things
11
The future of IoT is exciting – but not if we need to
replace billions of batteries per day/month/year
[Image source: Cisco]

12. Battery Strain in Wearables
• Segment display
• Basic watch functions
• Multi-year battery life
12
• High res color display
• Basic watch functions
• Motion/activity tracking
• Heart rate monitoring
• GPS tracking
• Altimeter
• Thermometer
• Bluetooth radio
• Days/weeks battery life

13. Battery Strain in Wearables
• Segment display
• Basic watch functions
• Multi-year battery life
13
• High res color display
• Basic watch functions
• Motion/activity tracking
• Heart rate monitoring
• GPS tracking
• Altimeter
• Thermometer
• Bluetooth radio
• Days/weeks battery life
Smaller, thinner
industrial designs
New functions
(cellular radios, new
biosensors, more
sensor analysis, etc.)
New use cases
(e.g., smart clothing
with 1+ year life)

14. No Easy Solution with Batteries
14
Batteries just aren’t improving fast enough!

15. The Other Side of the Energy Equation
15
Component Power Consumption
Display 10-100mW
MCU/CPU 0.1-10mW
Radio 10-30mW
Heart Rate Monitor 0.1-1mW
GPS Receiver 10-100mW
Power Management 10-20% of system power
MCU Radio
Display Sensor
PMIC
370mWh battery
24h/day * 7 days
= 2.2mW average power for 1 week life
675mWh battery
24h/day * 14 days
= 77µW average power for 1 year life
24h/day * 365 days

16. Addressing the IC Energy Problem (1/2)
16
Moore’s Law has been one of the strongest drivers
of energy efficiency gains
[Dreslinski et al., Proc. of the IEEE, 2010]

17. Addressing the IC Energy Problem (2/2)
17
0 Volts
1.2 Volts
0 Volts
0.3 Volts
Energy ~ (Voltage)2
Conventional Circuit Design Sub-threshold Circuit Design
Sub-threshold design was first conceived >30 years ago, but
Ambiq was the first to build a comprehensive platform

18. 18
Extreme Sensitivity to
Temperature
Extreme Sensitivity to
Voltage
Extreme Sensitivity to
Manufacturing Variations
Sub-threshold design has conventionally been viewed as impossible due to
exponential sensitivities – until Ambiq developed the SPOT Platform
Subthreshold: A delicate balancing act

19. We’ve Come a Long Way
19
Texas Instruments
MSP430
Ambiq Micro
Apollo3
Improvement
Launch Date 2003 2018 --
Processor Core 16b Proprietary Core 32b ARM Core --
Max Speed 8 MHz
48 MHz Boost mode
96MHz
6X – 12X
Flash 60 kB 1 MB 17X
RAM 2 kB 384 kB 192X
Power Consumption
Per Clock Cycle
440 µW/MHz 26 µW/MHz 17X
Power Consumption
Per Unit of Work
400 µW/Coremark 10 µW/Coremark 40X
Today’s best in class processor is 40X more energy efficient
than the best in class processor in 2003

20. 20
Leading Mobile
Phone Brand
Top Animal
Tracking Firm
EU Govt Smart
Meter Vendor
Top 5 Wearable
Brand
Top 3 Smartcard
Vendor
Top US Watch
Vendor
Solving the Hardest Energy Problems Today

21. 21
True Always-Listening Voice Control
Radio
Analog &
Sensor
Interfaces
Battery
Management Cache
MCU
Digital
Interfaces
RAM
Ultra-low power footprint
keyword detection, voice
assistant integration, and
command recognition
Always-on and always-listening
voice activation and commands
for battery-powered and mobile
applications.
Highly efficient algorithm
processing maintains high
quality and the best user
experience at ultra-low power

22. © 2018 Valencell, Inc
Valencell provides biometric sensors for
more wearables than any other company in the world
VALENCELL CONFIDENTIAL INFORMATION, PATENTS & PATENTS PENDING
Valencell Sensor Technology

23. ©2018 Valencell. Inc
Audio
Earbuds
Wrist
Devices
Armbands/Patches
Valencell made photoplethysmography (PPG) truly wearable
and suitable for virtually any activity and form-factor
PPG before Valencell
• Accurate only in hospitals or low activity settings
• Didn’t work outdoors (sunlight contamination)
• Not part of what people already wear
PPG after Valencell
• Accurate during virtually any activity
• Accurate indoors and outdoors
• Integrated within popular consumer form-factors

24. ©2018 Valencell. Inc
Top 5 Challenges in wearable PPG
Source: “Optical heart-rate measurement’s top 5 challenges” Dr. Steven LeBoeuf; EDN Magazine; 8-25-15
Optical Noise Skin Tone Blood Perfusion
Sensor Location/Form-
Factor
Crossover Problem

25. © 2018 Valencell, Inc
What‘s even more important is knowing when the data is wrong
Time (s)
SystolicBloodPressure(mmHg)
Blue dots represent 100%
confidence
Less than 100% confidence

26. © 2017 Valencell, Inc
Peak Amplitude
(Pulse Pressure)
RRi
(HRV, Cardiac Functioning)
Breathing Rate
(Metabolic Status)
Perfusion Variation
Heart Rate
Highly accurate PPG can be used to accurately
assess numerous biometrics
•Breathing Rate
•Heart Rate
Variability (HRV)
•Cardiovascular
Fitness
•Blood Pressure
•Blood Oxygen
•Cardiac
Efficiency
•Blood Perfusion

27. ©2018 Valencell. Inc
Accurate biometric sensor data has been proven and validated
for health and medical assessments
Assessment Definition What is means for fitness What is means for health
VO2max Aerobic capacity – primary
measure of chronic change
to cardiovascular fitness
Higher VO2max is correlated
with better performance during
aerobic activities
Higher VO2max is correlated with lower
mortality & improved recovery from a cardiac
event [Anderson, Jetté, Kodama, Lee]
Resting Heart
Rate (HRrest)
HR during an awake period
of no exertion
Decreasing Resting HR is
correlated with increasing
fitness
Steadily increasing Resting HR is correlated
with the progression of cardiovascular
disease [Arnold, Fox, Nauman]
HR Recovery HR over 1-mintute after
intense exercise
Higher HR Recovery implies
better exercise endurance
Higher HR Recovery implies better
cardiovascular health[Ching, Cho, Lipinski, Nishime]
HR Response HR over 1-mintute at the
start of exercise
Higher HR Response can imply
low cardiac readiness for
exercise
Higher HR Response paired with
“chronotropic incompetence” can predict
carotid atherosclerosis [Falcone, Jaqoda, Jae,
Maddox, Myers]
Cardiac
Efficiency
Average cadence divided by
average heart rate (at
steady state): Cavg/HRavg
The higher cardiac efficiency,
the less heart beats are needed
for all physical activities
Steadily declining cardiac efficiency is
correlated with the onset of hypertension
[Laine, Sung]
HRV Heart rate variability --
statistical variability of RR-
intervals
HRV can diagnose
psychosocial stress &
overtraining in exercise
HRV can predict atrial fibrillation &
arrhythmia [Chon, Hohnloser, McManus, Park, Valkama]

28. • Karl Etzel
US Account Representative
Analytics and the Wearable User Experience

29. Challenges, Opportunities
“Novelty data” – even if
accurate, so what?

30. • We differ in our physiology. We also differ in our
lifestyle, demands and challenges.
• “Performance” means different things in different
settings
• Wearables are valuable only if they deliver changes,
whether for behaviors, training, or recovery
• The same heartbeat data from different users, in
different contexts, can have vastly different meanings
Body Analytics for Sports and
Well-Being
MANAGE STRESS ENHANCE RECOVERY EXERCISE RIGHT

31. • Professional Sports
More than 22 000 professional athletes
and 800 teams worldwide use
Firstbeat solutions to improve
performance.
• Consumer Products
Firstbeat’s heartbeat analytics are
integrated into over 70 wearables to
provide meaningful insights for fitness
and lifestyle.
• Wellness Services
250 000 people around the world have
undergone the Firstbeat Lifestyle
Assessment to improve their personal
well-being & performance.
Personalized Insights for Health and Performance

32. Multiple Dimensions to Personalization
• Long term goal - Max performance vs. staying healthy
• Short term goal – Loading, peaking or recovering?

33. Context Matters
• Temperature
• Humidity
• Time of day
• Wind

34. Many Inputs to the Body’s Stress
Response

35. Stress is BAD!
(Except when it’s not)
Pilot or passenger?
Seeing that you are stressed
out, is stressful

36. Neither X nor Y but X vs. Y

37. Messaging – Know Your Audience

38. Variety of Consumers for Data
• Each 1-MET (3.5 ml/kg/min of VO2)
higher increment in fitness was
associated with a $1,592 annual
reduction in health care costs.
• If VO2max is less than 26 ml/kg/min,
all cause mortality risk is increased by
70% compared with VO2max above 38
ml/kg/min

39. Selecting Accurate and Relevant Data Points

40. Battery Life and Use Case
• 6 days, but no wireless, or GPS
• Optimized for continuous tracking,
periodic measurement, with human in
loop feedback

41. Parting Thoughts
• Work backwards from the question – what decision will
the user make differently based on the data?
• Can you clear the “go back for it” threshold
• Think multi-sensor
• Think multi-consumer