Wearable Strategy · Decision Card

Five decisions. One quarter. Everything else flows from these.

Working draft for the SCC + FORBventures discussion. Each section names the choice, lists the live options, and flags TTC's current recommendation. Nothing here is contractual yet.

Full memo + hardware appendix

Decision 1

Clinical pulse ox partner

The one clinical-grade sensor SCC supplies to every patient.

2 week sales cycle

Wesper Lab (longitudinal patch system)

Recommended $25 to $40 per night

FDA cleared, designed for longitudinal at-home use, already partnered with sleep practices. Rented kit model means low patient capex and high data density. JSON API for nightly studies. Fits the SCC concierge cadence perfectly.

Masimo MightySat + Withings Sleep Analyzer

$320 retail per patient 2 SKUs to manage

Best-in-class SpO2 accuracy plus FDA-cleared AHI estimation. Two devices, two integrations. Highest data quality. Higher per-patient cost and slightly more support load.

White-label OEM (Sleepiz One+ or CMI NightOwl)

$60 to $600 per unit SCC brand owns support

Maximum brand control. SCC-labeled hardware. Higher operational lift (warranty, returns, firmware). Useful in year two once volume justifies it.

Decision 2

Consumer wearable aggregator

How we ingest the 80 percent of metrics the patient already collects.

1 week to contract

Vital (primary) plus Apple HealthKit and Google Health Connect direct

Recommended Per active user

Vital covers wearables and labs in one healthcare-grade contract. HealthKit and Health Connect direct on top for iOS and Android companion apps. One vendor, two free OS integrations, full coverage.

Terra API only

$.04 to $.20 per active user per day

Broadest device coverage on the market. No lab integration. We would still need a separate vendor for Quest, LabCorp, and Rupa.

Build direct integrations

6 to 9 months of engineering Higher maintenance load

Maximum control, no per-call cost. Realistic only at platform scale. Wrong call for the 90-day MVP.

Decision 3

EMR posture

Where the patient record actually lives.

One working session with Mahler

Hybrid. Thin platform-native EMR with FHIR R4 out.

Recommended

SCC franchises run on the TLI record as source of truth. Any external EMR Mahler endorses (Tebra, Athena, Elation, DrChrono) reads from it via FHIR. We own the data flywheel and concierge UX, franchisees keep their existing tools.

Option A. Build TLI-native EMR only.

Fastest to ship, lightest weight, no Meaningful Use certification headache. Franchisees with existing EMR contracts have to migrate.

Option B. Integrate Mahler's preferred EMR via FHIR.

We don't own the record. We don't have to build the EMR either. Best if franchisees come in already on an external system.

Decision 4

Lab integration vendor

Quarterly panels flowing into the same record.

2 week sales cycle

Rupa Health (concierge longevity panels)

Recommended

Best fit for the SCC longevity panel mix (hs-CRP, ApoB, DunedinPACE epigenetic age, hormone panels, GLP-1 metabolic). Customer-friendly draw experience, native API, already integrated with most clinical platforms.

Direct Quest plus LabCorp APIs

National draw coverage. Less curated for longevity-specific markers. Higher engineering overhead.

Vibrant Wellness

Single-vendor lab with strong functional medicine panel. Less flexible than Rupa across multiple lab vendors.

Decision 5

Research arm governance

Who chairs, how patients consent, what they get back.

3 working sessions

DUC chair

Dr. Marwan Sabbagh, MD

Recommended

Already on the Scientific Advisory Board. Chairs the Data Use Committee. Reviews every external license. Final approval on any cohort that leaves the platform.

Consent model

Opt-in at enrollment, granular and revocable

Recommended

Patient sees what studies are active, opts into each. Can pause or revoke any time. HIPAA Safe Harbor de-identification. Defensible in every state including the strict ones (CA, IL, WA).

Patient revenue share

10 percent of net license revenue, paid as membership credit

Recommended

Credit toward SCC membership, devices, or labs (not cash). Avoids inducement issues under federal anti-kickback. Increases retention. Equivalent to roughly $75 to $250 per active research participant per year.

If all five are signed by

Engineering ships the 90-day MVP with five real SCC patients by mid-August.

Clinical overnight pulse ox, one consumer aggregator pull, quarterly Rupa labs, the TLI dashboard for patient and physician, the AI clinical coach with physician approval queue, and medication-interaction warnings. From day 90 forward the flywheel runs on its own and every additional patient deepens the moat.

Engineering capex

~$280K

Three engineers, one designer, 90 days

Vendor commitments

~$22K

Wesper kits, Vital, Rupa, Lexicomp licensing

First patient on platform

Day 21

Onboarding starts the moment Decision 1 closes