Inside Oura’s quest to build the ultimate health wearable

Inside Oura’s quest to build the ultimate health wearable

Even people who haven’t paid much attention to the Oura smart ring may know one thing about it: A whole bunch of well-known people have been known to wear one. The not-so-short list includes Jennifer Aniston, Marc Benioff, Michael Dell, Jack Dorsey, Arianna Huffington, Kim Kardashian, Jimmy Kimmel, and Gwyneth Paltrow, all of whom have talked about the ring publicly, praised features such as its sleep-tracking tools, or shared their own Oura stats on social media. Even Prince Harry has been spotted wearing an Oura Ring.

When I recently dropped in on Oura’s San Francisco office, CEO Harpreet Singh Rai told me that the company doesn’t court rich and famous customers. It’s usually as surprised as anyone when it turns out they’re fans—although he adds that “it doesn’t hurt if Jennifer Aniston is talking about us on TV.” But I wasn’t there so Rai could drop names. The primary topic of our conversation was the company’s expansion beyond sleep tracking to a much more sweeping collection of wellness features–a move that drove the development of the third-generation Oura Ring, which began shipping last week.

Oura CEO Harpreet Singh Rai [Photo: courtesy of Oura]

Oura’s widening ambitions are less a pivot, Rai says, than a logical continuation of the trajectory that it’s been on all along. “We always felt like the future of wearables is health,” he explains. “We started out as a company focused on sleep and recovery as our first iteration of that [because] at the time, no one else was doing it.” By May 2021, the company had sold 500,000 rings. Now it intends to appeal to a larger audience by doing more.

Most other wearables have emphasized tracking daytime fitness activities more than restful slumber, but Rai argues that the whole category needs to get more serious about additional aspects of health. “In order to go from 180 million units last year in wearables to a billion, I think you’ve got to move from activity to all these other health applications,” he says.

There’s plenty of evidence that bigger players in wearables such as Apple agree. But it’s a particularly critical matter for Oura. Unlike smartwatches, its ring won’t tell you the time, buzz to alert you of smartphone notifications, or let you pay for stuff with a tap. It’s just a bunch of health sensors stuffed into a slightly chunky but otherwise unprepossesing ring—plus a companion smartphone app that helps you make sense of all the data it tracks. Helping people monitor their well-being is all it does.

Then again, that focus hardly limits where the Oura Ring could go. “Our opportunity in the future is to make sure that whoever’s using it can find value in it based on where they’re at,” says Forerunner Ventures partner Eurie Kim, who invested in Oura as part of a $28 million series B round announced in March 2020. “Today you might be wanting to improve your sleep. Tomorrow, you might be wanting to run a marathon. The next day, you might be realizing you’ve got a health problem. So it really grows with you.”

The third-generation Oura Ring in its four available color choices: silver, gold, stealth, and black. [Photo: courtesy of Oura]

Only a sliver of that vision is realized in the third-generation Oura Ring, which is available in $299 (silver or black) and $399 (gold or matte-black “stealth”) versions. The new model embeds additional sensors and adds features such as period prediction; more capabilities are due in the coming months, some of which will be part of an optional $6/month subscription plan. Beyond that, the company is participating in multiple health-related research studies that could inspire still further features.

Oura, in other words, has plenty of work left to do–and goals that should keep it busy for years to come.

Birth of a ring

Among its accomplishments to date, Oura (which is pronounced like “Aura”) deserves a spot on any list of crowdfunding projects that have turned into real businesses. In August 2015, Finland’s Petteri Lahtela and Hannu Kinnunen–both of whom had backgrounds in technology and health–launched a Kickstarter campaign for a ring that was primarily devoted to helping people improve their days by sleeping better. By the standard of the rings they’d later release, their first-generation version was a bit of a bulky blob. But it spoke to enough people to raise $651,803 from 2,383 backers.

The following year, Lahtela and Kinnunen rustled up $5.3M from investors, mainly in the U.S., to continue to build the company. Rai, an Oura user and investor, became president in 2017 and CEO in 2018; Lahtela and Kinnunen left their active management roles in 2020. The company has grown to 350 employees with a sizable San Fransico presence and satellite offices in other cities along with its original home base in Oulu, Finland.

Along the way, the second-generation Oura, released in 2018, delivered on the promise of the original idea. Though it still wasn’t exactly dainty, it looked like, well, a ring. Rather than making you plug in a Micro-USB cable to recharge, it came with a nifty inductive charging stand, with battery life increasing from two or three days to around a week. Compared to something like an Apple Watch, it asked very little of the wearer; you could even forget you had it on.

Then there was the smartphone app—which was a giant part of the whole proposition, since the Oura Ring has no interface of its own. It offers the prerequisite stats and charts covering everything from how much REM sleep you got to whether you’re meeting your activity goals over time. Its signature feature is the Readiness score, a bottom-line number representing how ready you are to take on the day based on factors such as sleep, resting heart rate, and temperature. Through updates, the app has increasingly emphasized easy-to-digest advice and encouragement; as I write, it’s suggesting that I start winding down for the day–which I would, if I wasn’t trying to finish this article.

It’s the sensors inside the Oura Ring that make it powerful. [Photo: courtesy of Oura]

The third-generation Oura Ring looks identical to its predecessor and doesn’t tamper with the basics of the experience. But it’s upped its sensor game, building on the fact that a finger is an especially efficient place to take readings of vital signs such as pulse and temperature, which helps the ring deliver accurate results without blowing through battery life. (“When you walk outside on a cold day, your hands and your toes and your ears and your nose–all your extremities–get cold first,” notes Rai.)

The new ring’s additions include two green LEDs that can monitor your heart rate during the day, not just when you’re sleeping. There are now seven temperature sensors, up from three, for greater accuracy. A red LED and infrared sensor have been added for measuring blood oxygen levels at night, giving the ring an additional signal for assessing sleep quality.

The catch is that when the ring launched earlier this month, Oura didn’t have all the functionality it’s been working on in place. Heart rate measurement during workouts is due by the end of 2021, as is a large library of educational content on subjects such as sleep and meditation.  Blood oxygen sensing and improved sleep tracking are promised for next year. The fact that certain features were no-shows and will cost $6/month when they arrive has raised some hackles: “I understand why people are feeling frustrated,” wrote Wired reviewer Adrienne So, who said she was disappointed herself and gave the new ring a so-so rating of 6 out of 10.

Rai says that the explanation for Oura’s new subscription plan is simple: Implementing technologies such as machine-learning models and adding more personalized advice is expensive. “For both of those reasons, we felt like moving to a membership model helps us invest in this business and keep pushing the frontier faster than others,” he adds. “And we honestly think that’s what our members want. That’s what they tell us.” Now to see what users say next year when more new features are in place.

A research lab on a finger

One thing that Oura’s founders couldn’t have anticipated back when they were launching their Kickstarter was how central health research would become to the company’s mission. For researchers, the Oura Ring provides a way to collect relevant data that doesn’t ask much of test subjects other than that they occasionally recharge it. And for Oura, supporting such studies isn’t just a contribution to the world’s understanding of human health—it’s also a springboard for discoveries that inform product development.

Oura provided TemPredict with loaner rings, financial support, and access to engineering resources.

Laypeople may be startled by the breadth of research areas where Oura can play a role. For example, Ashley Mason, an associate professor of psychiatry at the University of California, San Francisco’s Osher Center for Integrative Health, was investigating studies that suggested that some people with depression also weren’t regulating their body temperature by sweating. That led her to explore the possibility that therapeutic sauna sessions might help such people. To answering that question, she’d need to monitor test subjects’ temperature.

There was one tiny problem: “If you’ll excuse the language, previous studies used an indwelling rectal probe to measure core body temperature,” explains Mason. “I don’t think very many people are very interested in wearing those.” After assessing a variety of non-icky wearables—including the Apple Watch and Whoop fitness band—she settled on the Oura Ring based on both its simplicity and accuracy.

Then the coronavirus hit, which led to Mason’s depression research being postponed. “I ended up pivoting into COVID study almost by accident,” she says. The COVID-19 research project she spearheaded, known as TemPredict, is a collaboration between UCSF and UC San Diego, based on data collected from tens of thousands of Oura wearers. It set out to determine whether temperature monitoring could help doctors catch signs that someone has COVID-19 before symptoms are obvious. The results have been promising.

Early on, Oura provided TemPredict with loaner rings, financial support, and access to engineering resources; the company has been “nothing short of tremendously helpful,” says Mason. As the project gained momentum, it’s since received millions in funding from other sources, including the Department of Defense.

Recently, Mason has also been able to pick up her depression research where she’d left it at the beginning of the pandemic. “The National Institutes of Health actually went on to fund our next study, because the pilot data were so good,” she says. “And we are using Oura Rings in that study as well, to measure ambulatory temperature.”

Women’s health comes to the fore

Around the time that Forerunner partner Eurie Kim was deciding to invest in Oura, she and her husband were trying to conceive. A doctor she consulted explained that when body temperature “is at its lowest, it’s when you ovulate.” So when Kim noticed a dip in her temperature as tracked by the Oura app, she recounts, she declared, “Let’s make a baby!” Within five days, her Oura Ring showed her temperature shooting back up—possible evidence of conception that was confirmed weeks later when her pregnancy test came back positive. “I was like, ‘That’s magic–that’s not possible,’” she remembers.

At that point, the Oura app didn’t have any functionality devoted to women’s health; Kim was just extrapolating from its stock temperature measurements. But the company is now building features specifically meant for the more than 40% of its customers who are women. The long-term goal, says science communications lead Caroline Kryder, is to give female Oura Ring wearers “something that they could use to look at what’s happening in their bodies throughout their journey. How can you have a health tool that might help you see when your first period is coming, how your cycle changes with stress, as health conditions come and go, as you age, as new medications or lifestyle habits come into your life?”

With the third-generation Oura Ring, existing features like readiness and sleep tracking are joined by new ones such as period prediction. [Screenshots: Oura]

The most immediate answer to this expansive question is Oura’s new period prediction feature, which is currently available in beta form for iPhone users. Features for tracking menstrual cycles are available with other wearables, too, but they’re normally manual experiences based on backward-looking information logged by the user herself: “It’s the equivalent of saying, well, it rained on the 13th last month, so it’ll probably rain this month,” says Kryder. Oura’s version automatically analyzes the peaks and valleys of a ring wearer’s temperature data to estimate period start dates up to 45 days in advance. It’s designed to get more accurate the longer a user sticks with it.

The Oura Ring is also proving useful in research efforts devoted to women’s health, an area that’s finally coming into its own after years of getting short shrift from the scientific and medical communities. For instance, in a University of California, San Diego study involving 30 pregnancies, spikes in Oura temperature readings detected pregnancy within 5.5 days of the self-reported day of conception and nine days before an at-home pregnancy test would have done so. That’s not a feature in the Oura app yet, but it could become one. Other incoming research also holds potential: “Early data suggests that we could see things like menopause, even things like delivery date,” says Rai.

Beyond that, he says, future iterations of the Oura Ring could tackle all-new areas such as glucose monitoring. They might also play with the industrial design in ways that the third-generation ring does not. “There’s fashion collaborations we can do,” Rai muses. “There’s some people that want the ring bigger and there’s some that want it smaller. There’s people that want different colors.”

For now, though, Oura’s third-generation ring is its platform for innovation–and for something that slips on a finger, it appears to have plenty of headroom.