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Apple Watch Series 4 Review: A Healthy Future

December 17, 2018, 11:00 AM UTC

Thirty seconds after pressing my finger on the side of my new Apple Watch Series 4 smartwatch, an electrocardiogram chart appears on the screen of my iPhone. Until two weeks ago, I would have had to go to a doctor’s office to measure of the rhythm of my heart beats—or maybe even the ER.

Now it’s available from my wrist any time, any where.

And back on the app on my wrist, there’s good news: I have a perfect sinus rhythm, according to the watch’s FDA-cleared ECG app. My heart is healthy.

If the results had shown atrial fibrillation, an irregular heartbeat, I’d get a check up immediately. AFib can lead to blood clots, stroke, and heart failure.

The ECG app, which Apple just made available two weeks ago, is only one example of the incredible promise of wearable computers for improving health and wellness. It’s easy to imagine that the next few iterations of the Apple Watch will bring even more useful medical monitoring, perhaps by measuring blood pressure or tracking blood sugar levels.

But even as is, almost four years after Apple introduced its first Apple Watch, the device is hitting its stride. Using a review unit from Apple for the past few months, I’ve found the watch even more useful and capable than last year’s model.

Apple Watch Series 4 has the computing power to run real apps, the ability to work well without a linked phone, and the good looks to match almost anything you’re wearing. It’s legitimately useful, not merely a tech toy.

Thinner and brighter

The latest Apple Watch is a little bigger than prior models, allowing for one of the watch’s best features: a larger, higher-resolution display. But because the display now extends closer to the edges of the watch, which has also been made slightly thinner, the new watch feels lighter on the wrist.

Last year’s Series 3, like all earlier versions, was available in 38 mm or 42 mm. The Series 4 expands the smaller version to 40 mm and includes a screen that has 38% more pixels—while the new large version jumps to 44 mm and also gets 35% more pixels.

The higher resolution displays mean that everything on screen has more detail. Text and controls look sharper and the mini-doses of information displayed on each watch face, known as complications, show a lot more data.

To take advantage of the new display, Apple included a couple of new watch faces, called “Infograph” and “Infograph Modular,” and created lots of new jazzier complications. One sad limitation: older watch faces like “Utility” and “Numerals” haven’t been updated—they’re still stuck with the simpler info widgets of prior versions.

The “Infograph Modular” face for the Apple Watch Series 4 can display more complications than ever.

On my first day using the watch, I spent several hours experimenting with complications from Apple and those supplied by other companies. And it didn’t stop after I first set up the device. It’s easy to do all the time. Just press hard on any face with your finger and the Apple Watch goes into customization mode. Use the digital crown dial on the side to flip through options.

It’s a little too fun and I’m probably wasting time, but in certain situations it makes sense to overhaul your watch face with a few flicks. Considering the recent volatile stock market, I wanted to see a live, full-day chart for the Dow Jones Industrial Average so I added it. When preparing for a ski weekend, though, I’d like to keep the five-day forecast for Stowe, Vt. in view. Another click and a few turns and it’s here instead. Try that on an analog watch.

Of course, it’s possible to load up the faces with too much information, but you can choose whether to add the maximum number of complications or dial it back and leave some blank spaces. I prefer to keep some open space on the calming “Color” watch face, which can be loaded with up to five complications. But I find a friendly purple dial with just a simple date and temperature read out is perfect for when I want something more relaxing and less distracting.

Another less happy change from last year is the price. The cheapest Apple Watch Series 4 now starts at $399, up $70 from last year’s new model, and versions with cellular connectivity start at $499, up $100. For more budget-conscious shoppers, Apple still sells the less capable Series 3 models at discounted prices.

A smarter smartwatch

The Series 4 hardware keeps several of the best additions of the Series 3, including being waterproof and having the capability of connecting to mobile cell networks (instead of relying on a linked phone’s Internet connection). Apple also heard the big aesthetic criticism of last year’s model—many people hated the large, red dot covering the side of the watch’s digital crown dial for cellular models—and made a change. This year, cellular models have a more modest, less visible thin, red ring around the crown.

The latest watch also has some added smarts. Apple created a feature that automatically prompts users if they’ve started exercising and forgotten to start tracking it on the watch (or forgotten to turn off tracking after finishing, as I did after nearly every run, dog walk, or swimming session).

And the Siri digital assistant comes on as soon as users raise their wrist and speak a command, without first needing to say “Hey Siri.” That’s a great shortcut when I’m setting a kitchen timer or asking for the latest score for my hometown Celtics.

Walking down the street with a cellular-connected Series 4 watch, a pair of Apple’s wireless AirPod earbuds, and some of the latest apps provides an awful lot of communications, entertainment, and activity tracking capability.

I made and received phone calls–and callers usually couldn’t tell I wasn’t on my phone. I dictated text messages with Siri and it transcribed my words accurately–most of the time. Listening to streamed music and podcasts over the AirPods sounded great. I also could read brief news stories and Twitter updates easily with the sharp text on the new screen. And I even paid for things like Junior Mints from a vending machine with the watch’s version of Apple Pay, as easy as double-clicking the side button and waiving my wrist.

And all with no iPhone in sight.

I also took the watch swimming in a pool and a lake in the Berkshires with no water leaks. In both places, the device tracked my strokes and offered a detailed report of my activity as I toweled off. A 30-minute session in the pool burned over 500 calories and covered almost 1,100 yards. The watch even tracked how far I swam in different strokes—it could automatically tell between, say, free style and breast stroke.

Best Apple Watch apps

Last year, the app story for the Apple Watch was kind of sad, with some apps disappearing as developers struggled to figure out what users wanted. In earlier versions, the watch’s slower processor deterred users from even trying apps for fear of the dreaded spinning dial animation. Instead of waiting around, people were just not using a lot of apps, it seems.

Lately, things are improving with the addition of a much faster processor in the Series 4 and more focused apps from developers. Plus some long time laggards like Spotify (SPOT) are finally available. A couple of apps from smaller developers that I find invaluable on the wrist include Authy, which provides two-factor authentication codes to improve password security; Round Health, which beeps or vibrates to remind me to take my medications; and Night Sky, which shows a live map of the stars and constellations visible from wherever you are.

A big round up of recommended watch apps by TechRadar has many more intriguing suggestions, including an app to recreate the old virtual pet game Tamagotchi, where you have to pay attention to your pet to keep it happy. Other suggestions include health monitoring apps like One Drop, which works over Bluetooth to connect the watch with a blood glucose meter and send important notifications to the wrists of users with diabetes.

As for heart monitoring, I’ve used the watch’s ECG app nearly a dozen or so times since it became available. It’s remarkably easy to run the check and it makes me rest easier knowing that while I may have a few health challenges, my heart isn’t a problem. Though not a complete replacement for more robust checks in a doctor’s office, the ECG app nonetheless can help spot an irregular rhythm early and save lives.

A report from market research firm eMarketer last week predicted that new kinds of health apps, along with built-in features like ECG and fall detection, would help make smartwatches more popular with older consumers.

But all kinds of people can benefit from the improvements in the Apple Watch Series 4 right now. And who knows what Apple has planned for the Series 5 next year?