Apple’s iWatch: The killer apps may be in hospitals, not health clubs

February 3, 2014, 10:11 PM UTC
Pulse oximetry: Ripe for disruption?

FORTUNE — I was reading up on wireless pulse oximetry over the weekend when it occurred to me that we might be looking at Apple’s (AAPL) so-called iWatch project from the wrong angle.

Because CEO Tim Cook is a health nut who hits the treadmill every morning, wears a Nike Fuel Band and sits on Nike’s (NKE) board of directors, everybody seems to assume that Apple’s target demographic for this thing — whatever it is — would be people like Cook: Tech enthusiasts who don’t like to miss text messages and who work out seriously enough to care about monitoring their heart rate.

But what if that’s a secondary target? What if the more important market — the one that’s ripe for disruption and big enough to warrant Apple’s attention — is people for whom things like pulse oximetry are a matter of life and death? People whose health costs are on a trajectory to bankrupt the U.S.?

Pulse oximeters are those little plastic clamps that a nurse or anesthesiologist will stick on your finger tip just before you go under. They’re widely used in hospitals, doctors offices, ambulances and nursing homes to monitor heart and lung activity, and a lively market has sprung up in the last few years for low-cost consumer versions. Amazon (AMZN) sells several dozen models in their Health & Personal Care section. They start at $19.99; the Masimo ISPO2, which plugs right into an iPhone, goes for $150.

According to a report in Friday’s
New York Times
, Masimo’s (MASI) former medical director Michael O’Reilly — who now works for Apple — was one of the executives from Cupertino who met with high level FDA officials in mid December to discuss mobile medical applications.

According to 9to5Mac‘s Mark Gurman — the current leader of iWatch pack journalism — the next version of iOS will be able to read sensors for blood pressure, hydration, heart rate and steps.

“iWatch is said to be able to monitor several other pieces of health and fitness data,” he added, but couldn’t be more specific. As Tim Cook put it at the last AllThingsD: “The whole sensor field is going to explode.”

“Recent advances in embedded computing systems,” reports Harvard’s NSF-funded team CodeBlue, “have led to the emergence of wireless sensor networks, consisting of small, battery-powered ‘motes’ with limited computation and radio communication capabilities… This technology has the potential to impact the delivery and study of resuscitative care by allowing vital signs to be automatically collected and fully integrated into the patient care record and used for real-time triage, correlation with hospital records, and long-term observation.”

Should we think less about watches and more about hospital bracelets?

Real-time triage. Long-term observation. Correlation with hospital records. With the baby boom generation about to move en masse into government-subsidized health insurance programs, nursing homes and hospice care, those are serious growth markets. And if a generation of young, healthy joggers could be trained to watch for trouble signs before — not after — they get sick, we’d all be better off.

“There are a lot of problems to solve in this space,” Cook said last May. “It’s ripe for exploration.”