Hello there, everyone. Um, nice to see you all today, or at least, uh virtually see you. My name is Stacey Salvi and I'm speaking to you today from the Van Health Office here in the Bay Area, California.If you haven't heard of us, we are the makers of the Evie Ring as this beautiful woman is wearing here in the picture and I'll show you more pictures later as well. And of course, I'm really excited to be here today and grateful for the opportunity to speak with you. It's honor an honor to be presenting alongside such an impressive group. Um So I wanted to talk to you all about, uh a topic that is near and dear to my heart and that is how wearable technology can help close the quality of care gap for women. I was fortunate to study this topic alongside some tremendous researchers while at Fitbit and during my time at Google and now that I'm at mono Health, uh we spend our days helping people learn more about their bodies through purpose driven innovation and health care. First, though I want to start us off with the story. This is a story about a young woman who almost lost her life because multiple clinicians made some quick judgments about some symptoms that she was experiencing. We may not think of women as underserved in health care.

But this story exemplifies how women may be dismissed by medical professionals and how in some cases it may have dire consequences. Her combination of vindications included severe hay fever, like symptoms and stomach pains, initial diagnosis by a nurse and multiple er, doctors was that she was having a panic attack and just severe allergies, she was sent home and told to relax. But despite this advice, she and her mother returned to the, er, something just wasn't right. Fortunately, this young woman's mom who isn't a doctor advocated beyond the assumption that what was going on was stress induced. And as it turns out, this was a rare strain strain of NIA meningitis. Um, and you probably guessed already that this story isn't about somebody from the latest episode of Grey's Anatomy. This is a true story that happened to me in the year 2000. Had we not pushed back on the hospital staff that day? I probably wouldn't be here. I narrowly avoided some serious complications of my oncoming sepsis, including heart or organ failure or paraplegia. I was critically unstable for 36 hours and had a coronary catheter inserted it into my heart to watch for potential heart attack as my body was showered with bacteria.

I'm sharing my story with you all because while it may be anecdotal, it is an all too common example, I'm gonna walk you through several stories uh and studies showing disparities in care for women. And, you know, it, it stems from unconscious bias and insufficiency within uh training itself, but it happens. And so it's important that we can talk about it. So I'll pose the question what may have happened that day. If I had walked into the er bolstered with data from a wearable device, could my blurry set of symptoms come into focus speeding along the administration of tests or at least created this space for further inquiry. Could the power of proof led to a quicker diagnosis and avoidance of nine days in the hospital and three months of recovery? I believe. So the reality is downplay the symptoms felt by women more often than they should resulting in a lower quality of care. This happens across the board and it is more prominent for women of color. The statistics I'm gonna share today are from summary studies and I don't want to gloss over the inequities felt by communities of color. But for the purposes of this presentation, the statistics will be blended.

Women experience a reduced quality of care in a multitude of ways from pain management to heart health preventative medicine all the way to the emergency room. Heart disease is the number one cause of death for women in the United States. More than all forms of cancer. Top four forms of cancer combined. This fact is not widely known. One study revealed that only 41% of laypeople are aware of the high morbidity of women due to heart disease. But what's more concerning is that only 22% of primary care physicians and 42% of cardiologists feel well prepared to assess a woman's cardiovascular disease risk. We also know that within cardiac distress, women are at risk more than men simply because their symptoms are different.

Women may be told that they are suffering from anxiety or acid reflux. This delay of treatment has serious consequences in a study out of the University of Leeds, which looked at almost 700,000 cases over a 10 year span, the provision of guideline indicated care resulted in unnecessary deaths.

One example of a gap in care includes a metric known as door to balloon time, those precious minutes from when a patient enters the er, until they are sent to a catheterization. Lab, men are inherently rushed to this more quickly than women as the researchers discovered had proper treatment or tests been ordered in the same time as they had for men. More than 8000 lives of those studied could have been saved. Modifying the approach with women in mind could save lives and change outcomes. Fortunately, we live in a time where we're starting to uncover these biases in science and medicine and hopefully soon we can make the necessary course corrections. But still there's a lot of work to be done.

And this is where as researchers and technologists in the wearable space, we have a real opportunity. But by designing with purpose and empathy, we can ensure that wearable products and their commensurate services can help show the gaps in care. So let's talk through how we can help.

First and foremost, wearable technology can enable a stronger doctor patient relationship by facilitating a conversation. We've talked a lot about it from the user's perspective or patient's perspective. But in this case, I wanna look at the advantages of wearable data from the doctor's point of view.

Today, a primary care physician may see her patient probably came into the doctor just having searched Google uh with possible symptoms. I know I'm guilty of that. Once a year for an annual checkup, they might take labs. But her view of what's going on with her patient may be limited to a singular moment. If wearable data could be incorporated into a practice, her snapshot view becomes three-dimensional knowing what is happening before and after the patient is in the office. And in fact, we know that doctors agree insider intelligence reports that an overwhelming majority of cli clinicians, 83% plan on incorporating personal device data into their practice over the next 10 years to get there. Though, we have wearable sensor data has some hurdles to overcome.

First, it needs to be accurate. This one is probably almost too obvious to mention, but I have to say it anyway, we're dead in the water without medical grade accuracy. Sure, some trend level data is useful but accuracy must prevail here. Second, wearable sensors must focus on useful analys Medscape, published a study in this area and doctors indicated that they would be most interested in hype in data related to hypertension, blood glucose and others. Third data must be shareable. Initially, this can take on the simplicity of a PDF.

But eventually we do need to integrate into hr S undoubtedly, this is a heavy technical lift and expensive but so long as patients understand the benefits and provide proper consent, we can provide clinicians with a window into patient well-being outside of their office. Finally, the data needs to be delivered in such a way to accommodate the time constraints of modern health care. This means it must be digestible and clear at first glance to avoid metrics fatigue. For ep of course, we as a new product in the market, we have our eye on adoption and wearables have been around for a long time. Uh We understand that the user has an expectation of what a wearable can do and that's relatively set. But adoption lags in wearables because they're not always connecting the dots for user users. And here's what I mean by that today. Wearable devices do an excellent job at bringing awareness through data, but sometimes. And I know that this is even true for me. I've been in this business for quite a long time. I'm not sure where to look, but it seems that wearable manufacturers are racing to beat one another in a sheer quantity of sensor readings. The result is that this data has quickly become a mountain that we can't get our arms around.

One of my favorite things to say to our team is that while we can provide our users with a salad bar of data types, we also need to tell them a recipe that tastes good to them. It's not enough to simply see the data. We need people to understand how they can act on that data in their daily lives. And to do that, we must build our services with empathy and diversity from the ground up by testing with a diverse audience, bringing these groups into an experience that is tailored to them. We can earn their trust and be a dependable resource where they may not have been in the past. I challenge my team on a daily basis to consider this in their daily work. This of course means going beyond sizing down and actually designing products for those who menstruate and particularly given that these groups have been excluded from uh scientific and medical research in the past. And we need to address concerns around privacy upfront early and in an understandable way by not only maintaining lock type policies around data sharing, but also enabling product features that keeps data private and secure from the outset. So that brings us to Evie at Mono health.

Our aim is to bring purpose driven health care solutions to consumers. And we believe that making our me wearables medical grade will deliver on the promise that users can lead healthier lives. Ev isn't retrofitting an existing platform to be medical grade. It is medical grade from the outset personally, I feel fortunate to have joined a company that shared my belief that health is a fundamental human, right? And more importantly that we're at an achievable intersection to make MedTech and consumer accessible for a group of people as possible.

Road map has a core focus on delivering wearables that empower users with an easy and fun to use service that keeps them engaged for the long run, the longer the user is with us, the more health benefits she will see this human centric design considers the experience from many angles including psychosocial considerations on the front end and a relentless pursuit of accuracy.

On the back back end. This combination is powerful for EB and I believe for the wearables market in general, as you consider the potential health impact we all have on the health and well-being of our users. So I want to take us back to the story we talked about at the beginning. Of course, I do not want to compare what happened to me to the inequities felt by many communities in this country and around the world. And reflecting back on my case, it did present with mixed indications. So it's understandable that clinicians couldn't pinpoint immediately what was going on. The hospital couldn't rely on patient history because at that time, patient data wasn't readily available. Uh And I was out of state and state and out of network, they could only see really what was right in front of them. A singular moment in time. Consider though if I had come to them bolstered with longitudinal data from the prior days or even months, the hospital staff could have gotten a more objective read on what was happening with my body before I stepped into the er perhaps they could have seen a gradual increase in my respiration rate over previous days from PPG and SPO two sensors or an alarming and unusual spike in my resting heart rate or increased dehydration over previous days, leveraging by impedance algorithms.

And maybe if we were to consider all future sensing possibilities, increased white or red blood cell count all from a small ring, wrist face wearable or patch. Today, wearables do a great job at celebrating daily progress. The Apple watches iconic rings for haptic feedback on a Fitbit.

When I hit my 10,000 steps each have made their mark on this industry and I see them being carried forward for years to come. This positive feedback has made steps to currency and ingrained in our culture in incredible ways. And this is really just the beginning. I predict that as sensors get more advanced and smaller and thus more wearable, we're gonna see a ton of progress in this area over the next 5 to 10 years, wearables can enhance health care by being both a clinical companion and accelerate us to a future where people can get the care that they need.

Thank you all so much for having me today. I, I truly appreciate it. I'm more than happy to answer any questions. If we still have time. I think I still have six minutes to go. Oh, ok. So I got a question. Um It's from Liz and she asks, do you feel this, this data from wearables could affect the mental health industry? So I, I actually do. Um certainly, I think it's a little bit uh unrealistic to say that a wearable could tell you the mood that you're in. Um But mood is impacted by so many different things like sleep and activity and other stress factors that are going on with our bodies. So if wearables and their, you know, commensurate companion apps can be used to uh log certain information around how we're feeling, whether that's positive or negative. I definitely see that as an ability to, to gather data from a mindfulness perspective. Um I think sometimes, you know, it's, it's so important that we just check in with ourselves to know how we're feeling. Um There are so many different times, at least in my life, I can speak personally about this where, you know, sometimes I am not feeling great over uh several weeks and it's really good to check in and kind of know what's been going on.

Um So I definitely see wearables playing a part through both passively collected data, but also, you know what's worn on the body. That's a great question. Thank you so much. Are there any other questions? Ok. The comfort of the ring. So the description of the talk, this is from Deborah, the description for the talk mentioned comfort of the ring. Have you tested with users under varying conditions, carrying groceries, washing hands? Yes. So that's a great question. Um So we're, we're only speaking maybe somewhat obtusely about it because we're still prelaunch. Um But absolutely, you know, usability testing is certainly part of what we're doing here um because we are building the hardware itself to be a medical device. Uh We're required to do all levels of testing from, you know, fit and feel um how it's fitting across, you know, a diverse set of hands and, and fingers. So absolutely, we are checking the um checking on the comfort of the ring. Um And one of the things that we are working on is making sure that the ring is um it is an open, currently, an open design and so it can flex ever. So slightly which uh helps accommodate for swelling in the body, which is really nice actually. Oh, cool, thanks. Deborah. Deborah says thanks. So, well, this is definitely my favorite topic. Um If you would like more information about the EV ring ring dot com is where you can find it, please sign up on our our mailing list. So you can hear more about it.

But more generally, you know, this is just something that we're working really hard on every day here and something I'm very, very passionate about and I'm really excited to bring to market. Wonderful. Well, I am going to sign off now and give you all a couple minutes back.