OURA CEO, Tom Hale "Disruption and Wearables" with Soren Gordhamer

How about me? Can you hear me? Okay.

Did you switch it off when you went to the bathroom?

All right. How's that?

What an amazing question. And thank you. I would say that throughout my entire career and I started in like the early 90s as the internet came on, I think democratization was a really powerful thing, you know, kind of connecting everybody in the world, expression, so the sort of human side of technology. I was often very, you know, kind of thankful I didn't work at an accounting firm or a software company that made accounting software. I worked at a creative expression company. I think curiosity and maybe empowerment, giving people agency, I think is one of the things that technology when it's good does very well. And so I think for me coming to Oura, it's actually a personal story. It's a story of my entire life. I've been a championship sleeper. I could probably fall asleep right now sitting here talking to you. World class, world class, world class. And in the fall of 2021, you know, COVID, family situation, economic privation, and you know, business challenges made me lose sleep for the first time in my entire life. And I bumped into the Oura Ring and made some very small adjustments. I'd been a wearable person for a while. But in that moment of changing my behavior, I encountered a product that was about both informing me but also maybe giving me support but also maybe making some suggestions. And within a short amount of time, I'd really improved my sleep quality. And it sort of got me through this what I would, you know, maybe comfortably describe as a rough patch. And I was like, I need to be involved in this company. So I did. I wrote them a letter and you know, kind of pushed my way into the company in a way that like I have not done in my entire life.

Well, I think we can say comfortably that that exists at a micro scale and a macro scale. An example of the macro would be during the debate between then President Biden and Trump, we could see visible effects in the population. Yeah, and we have no knowledge about which party anybody is. That's just not something we understand. But we could see really elevated stress markers and then you know that was heart rate and you could see sleep being ruined for days after and we've seen those kinds of like almost secular trends related to things like whether it's the economy, but weather has a huge impact. You know, the summer months people sleep less. Go figure. In Nordic countries where Oura was founded, the long winter duration creates incredibly long sleep periods and it turns out that's incredibly restorative in a lot of ways and some of that actually comes into the product. So those are some of the macro things. I think on the micro side and maybe I'll take it to the very micro, my own self. So I have been, before Oura I was very skeptical about mindfulness. I had, my wife was very very into it and Oura has a capability of kind of a little bit like biofeedback. It's actually post, you know, you do a meditation and it records your heart rate and it records your HRV and it records your respiration and it sort of records your body temperature and if you're doing it right, then those things at the end of the meditation have moved. You know, your heart rate's lower and your HRV is slightly higher and your temperature is slightly higher. There are these things that are markers of success. Anyway, long story short, my wife who would often say to me, 'You're an idiot.' In the most mindful way possible, in the most loving, compassionate, very thoughtful, intentional way, only for your wellbeing. She would say, 'Look, you know, there's 3,000 years of sort of like human history that would suggest that some form of mindfulness is very good for you. Maybe you should pay attention to that as a student of history.' And I would laugh. But what actually was interesting is the first time I was fiddling with Oura. One of the things I did was I was like, 'Oh, there's meditations. I'll try that. See, let me understand this product and how does it work?' And I did a meditation. At the end, I was like, 'Oh, well, that's really interesting.' It had a profound, you know, even though maybe I didn't feel materially different, I could see that my physiology had changed. And that cause and effect in my head became like, 'Oh, well, maybe this is, maybe there's some credibility to this.' So that's a skeptic's conversion kind of micro moment. And maybe that's odd coming from the CEO of Oura, but it's true. The other one I would highlight is I think Oura is at its most magical when it gives you a sixth sense and you learn something about yourself that you didn't know. And that could be something that's sort of a foundational truth. Like for me, large groups of social interactions are actually hugely stressful. I'm kind of an introvert even though I play an extrovert extremely well. So groups like this for example, this is okay because you guys are a faceless mass and I have no worries about it. But a large party is very stressful and you can see it in my biometrics. All my biometrics are pegged in little stress meter and Oura is like you're stressed. But the having a sixth sense about something, the classic kind of Oura story which people most people probably know or have experienced is that you end up drinking less once you start paying attention to your biometrics like heart rate variability or your sleep cycles and you see that your REM sleep is very disrupted even by a small amount of alcohol and so you reduce your alcohol consumption. For me, and this is something we're focused on now, is not just sleep, but you know, we've expanded to women's health and heart health, but really we're starting to look at metabolic because, you know, if you go to the gym twice a week, right, you're doing pretty well, but you're going to sleep hopefully once every 24-hour period. But the thing that actually might affect your mood and your energy and your mindfulness and your cognition and all these things, turns out it's what you eat. It's what you put in your body. And by the way, you do that two or three times a day. And sometimes you're really conscious of it, sometimes you're not. But for me, the sixth sense taught me that some of my favorite foods that I thought were really healthy turned out to be not healthy for me. They turned out to be things that I should avoid. And in changing the dietary patterns, I've had a pretty meaningful impact.

You know, one of the things that's interesting is that, you know, if you eat two cheeseburgers and a milkshake, you know, the optical properties of your blood is actually different. You know, it actually changes. Now, it yields to different spectrums of light, but that's different. What I was actually looking at was blood sugar. I was, I'm wearing a sensor and that sensor relays its data to Oura and then Oura kind of puts context and meaning around that data in the context of my sleep and my stress. Turns out I can eat the same thing and on a stressful day my blood sugar goes much higher and on a day that I've slept well my blood sugar goes, you know, sort of stays within range. And so understanding I'm trying to optimize what I eat to not be on a sugar jag. Turns out that has a huge effect on my mood. So those are some of the micro, the food that you're eating and the state of your being.

Physiology.

Surprisingly as somebody with a sweet tooth, yeah, that was exactly right. But once you see the data, it confirms maybe what you had an intuition about, right? Maybe more importantly, I think I didn't really see the cause and effect between what I ate and how I felt. Got it. And maybe more importantly, the things that I ate. I'll give you an example, which is rice. I love sushi. I love Chinese food. I will eat rice. Turns out that's a huge, and by the way, that's not universally true. One of the things that you learn from a biometric wearable is that not everybody is the same. In fact, everybody's different in many ways. Whether it's your genome or your epigenome or it's your biome or your microbiome, like everybody's just a little bit different. And by the way, those circumstances based on a day you had stressful or not, is different.

You know, the impacts of wearing a wearable, not just Oura, you know, is you become much more conscious of your physiology and the sort of more marginal changes. So one is absolutely not drinking. Another is being more intentional about when you get your rest. Feeling okay about taking a nap during the day because actually you see that that's quite profound in terms of its effect on you. I think that the things that sort of are maybe less visible are things like understanding how not in the moment but over time what affects you. And I think this is actually where Oura really shines because we're sort of more indexed on kind of a longer span. Whether that's weeks or months or years, that view of the data is there to kind of get you out of like, hey, this happened right now and my heart was elevated, which is interesting, but maybe not meaningful. Yeah. Yeah. What's interesting is that over the course of 6 months, your resting heart rate has been elevating by one or two beats, you know, every couple of weeks, which probably means something's going on. Or your HRV has plummeted and it used to be at, you know, 100 and now it's at 50. Like something's happening. And so being able to see those changes, by the way, this is something that Oura does because of sleep. By being a wearable that you wear overnight, the average wear time, by the way, it's shocking. It's 23 hours and 30 minutes. So, people don't take them off. Some people say, 'Oh, I take it off. I don't wear it during the day. I only wear it at night.' That's, everybody wears it 24/7. Some people take it off. But the average is there. What that allows us to do and the algorithm and the machine that's looking over all this stuff is to see what your baseline is and to see your baseline when you're at rest and to see you at your baseline when you are still, which means that the sort of variability, the signal to noise ratio is quite good meaning you have high signal and low noise and that's because every night you're roughly in the same state and you go through a very predictable series of changes as you go through your sleep curves through the night and the deviations from that baseline are meaningful. Whereas during the day, you know, if I was late for this and I was running over from my office and my heart was elevated, would you say I have a heart condition? No. You would say you were late. Yeah. So the power of like kind of removing that noise means that the system can get it right more often than it gets it wrong because it knows the baseline.

Um, you know, I think the simple answer is there's two incredibly powerful forces that I think are going to be reshaped by what's happening right now. One of them is the state of care and how people are cared for and how they care for themselves. That's already underway. That change actually is happening faster than we thought. And the second one is the impact of AI on the modalities and mechanisms and ways that you might influence or change someone's behavior or maybe even care for them. Those two forces are going to be maybe intersecting to create I think a really different model for how people are cared for and how they choose to care for themselves. Roughly speaking in the 2000s Dr. Google became a thing and doctors, you know, were not so stoked when people came in and said, 'Hey, I researched this online and I think I've got it.' And the doctor's like, 'Oh, no, you don't. You don't have it.' And the thing is like wearables have been through something similar, but we're starting to see that people are like, 'No, actually I really do want to see your wearable data. I really do want to understand it.' And that's changed. What's really changing though is that AI as a way of communicating information and educating you can be personal, right? It can understand you better. It can be targeted to your context. Maybe you're ill, maybe you're sick. 25% of Oura users have, you know, they use Oura to manage their chronic illness. We know that. They tell us that. So it's part of the understanding of you and in a world where everybody has something on their body like this and it's on their body 24/7 and it's passively monitoring and managing and everybody has something like this whatever form it takes but it's basically a computing device that has, you know, it's always charged and is connected to this and then there's some form of machine intelligence whether it exists in the cloud or on the device that's overlooking you like you're at the point where you have a doctor in your pocket and you have a guardian angel. You have an intelligence that is not just a generic intelligence that says, you know, men who are 55 should get a colonoscopy, which is, you know, true, but very generalized to Tom. Yeah. You're 45 and you ought to do something about this because I know you intimately in a way that you don't know yourself. And I think that universe of reality of this device and this device and some machine intelligence, by the way, it's already here. Yeah, it's already here, you guys. Like, this is happening now. It's just there's various pockets and various ways that it's happening but it's happening.