A new wearable device that comes in the form of a smart watch alerts military personnel to signs of illness before any symptoms appear. The Rapid Assessment of Threat Exposure (RATE) project puts sensors in a commercial watch and a ring that send data to a program for assessing potential infections.

The Defense Innovation Unit (DIU) began work on RATE in 2018. It put it into wider use during the COVID-19 pandemic where it successfully identified onset of the infection before patients knew they were sick. Now the Defense Department is expanding its use to detect broader spectrum of infections.

When the project started, test patients had to wear a variety of large, hospital grade equipment to gather data. By the time COVID hit, the research team realized they needed to get their sensors into something smaller and easier to wear.

“We looked at some of the clinical grade medical wearable devices —  these very clunky watches that really serve no other purpose other than to provide clinical grade equipment. But we said that’s too clunky,” RATE project manager Jeff Schneider told Federal News Network in an interview. “The DoD warfighter isn’t going to use it. Let’s look at things that we think they could use. In the end, we chose to go with the Garmin fenix 6 watch and the Oura ring.”

Schneider’s team used data derived from monitoring COVID cases to refine an algorithm that used artificial intelligence and machine learning to make conclusions about health data. Sensors monitor temperature, heartbeat and respiration along with a total of 160 different types of raw biometric data to feed the algorithm. That information creates a score between one and 100 to determine an individual’s health.

As the team started testing the device during the COVID outbreak, it needed fine tuning. At first, the devices only detected about 10% of COVID cases. As the algorithm continued to get feedback, the accuracy improved.

“We’re learned about the algorithm, we learned about the wearables, and by December of 2020, so still well before any vaccines were available, we had a fully working algorithm that around 11,500 people were using. It was detecting COVID about 73% of the time,” Schneider said. “It was averaging about two and a half days prior to someone being symptomatic. That was awesome. And we were able to improve the algorithm.”

Going forward, DoD secured funding to put the RATE devices on 4,500 new users. Since the team figured out how to detect COVID, DIU plans to improve the algorithm’s ability to detect other health problems.

The DIU partnered with Philips, a health technology company, to develop the wearable devices with the use of commercially available products.

“We’re taking the wearables as they exist, I’m not modifying the watch or the ring. We’re using the apps on the person’s phone without modifying them and then they push that data to a Philips server that has a cloud-to-cloud solution and that’s where the AI — machine learning takes place,” Schneider said.

As DIU moves forward with the program, one of the next changes will be a bring your own device program. Schneider said he expects to be able to offer service members a variety of choices in what kind of watch or ring they use to gather data.

“We’re incorporating three other commercial wearables. The hope is that if someone has that watch or that ring, they can just use theirs. I’m not going to tell them to buy something that they don’t want, that they’re not going to use,” he said.

The DIU team also plans to improve its server so that it can work with up to a million users and increase improvements to the algorithm. A follow-on research program will look at a host of different illnesses including severe acute respiratory syndrome (SARS) variants. In the future, Schneider said he hopes RATE can advance to the point of detecting new forms of diseases before they reach the level of national health crisis.

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