The expanded index
Ten ecosystems. One demanding standard.
Ten major consumer ecosystems, scored for data openness—not sensor accuracy, medical safety, or clinical performance. Every claim links to its source.
What the openness score means
80–100OpenNear-real-time external access or a care-team view close to wearer parity.
60–79GatedUseful sharing or APIs exist, but delays, omissions, approvals, or clinical gaps remain.
40–59LimitedPortals and exports dominate; neutral continuous access is weak.
0–39ClosedSharing is mostly manual or delayed, with no meaningful public developer or care-team route.
What the data-cost symbols mean
FREENo documented fee for the public data route.
$Up to US$99/year in a required membership or developer fee.
$$US$100–$399/year in a required membership or access cost.
$$$Commercial or security-review pricing is private or independently negotiated.
N/ANo public developer-access route is available to price.
Cost means the cheapest meaningful external-data route—not the device, sensor, insurance, or integration labor. $$$ marks private or negotiated pricing; it is not an invented dollar estimate.
A stricter freshness audit
“Live in the app” is not the same as live for someone else.
Freshness now follows the whole path: device → phone → cloud → health platform, API, follower, or clinician. If a company does not publish a maximum delay, the rating says so and cannot assume instantaneous delivery.
10/10Pass-throughNo intentional hold: supported external routes update within the normal measurement or source-sync cadence, without manual action.
8–9/10Fast, conditionalAutomatic after source ingestion, but upstream device sync can lag or no guaranteed maximum is public.
6–7/10MixedA prompt route exists, while another important platform or clinical route is materially delayed or sync-dependent.
3–5/10Delayed / manualA foreground action, manual sync, explicit multi-hour hold, or irregular upload dominates external access.
0–2/10RetrospectiveOnly reports, exports, screenshots, or no continuous external sharing route.
Smartwatch
Apple Watch
Apple Health + HealthKit
79/100
GatedBroad access, 24-hour provider lag
Data-access costFREE → $
$0 personally · US$99/year to publishHealthKit access is user-authorized; the paid Apple Developer membership applies to public app distribution.
Data lands natively in Apple Health and can be authorized to apps, people, and participating providers.
- Native health store
- HealthKit access
- Person sharing
End-to-end data freshnessIncluded in the 10-point freshness score
Watch → Apple HealthNative cadenceThe wearer sees data as Apple Watch and iPhone write supported measurements; cadence varies by metric.
Apple Health → person / appNo universal SLASharing is automatic after authorization, but Apple does not publish one maximum end-to-end delivery time for every route.
Apple Health → provider≈24 hoursNew data is uploaded to Apple’s Health Sharing Cloud approximately once every 24 hours.
Primary frictionProvider sharing uploads approximately every 24 hours; Apple does not publish one universal delivery time for every person-sharing or HealthKit app route.
View access, cost, and evidence
Health-platform portability25/25
Care-team parity15/25
Automated access & terms18/20
Complete self-export12/15
End-to-end freshness5/10
Transparency & control4/5
Access reality
Self-serve + institutional gate- Regular person
- Health data is available in Apple Health, with built-in person sharing and a full XML export.
- Physician
- Only participating healthcare organizations can use Apple’s provider view; an individual physician cannot simply switch it on.
- Developer
- HealthKit is user-authorized and self-serve for app development. Public app distribution generally requires Apple Developer membership.
- Data-access cost
- Wearer access is included. Apple Developer Program: US$99/year. Provider-integration pricing is not publicly listed.
Smartwatch / tracker
Google Health
Fitbit + Pixel Watch
78/100
GatedFast API after device sync
Data-access costFREE → $$$
$0 through 100 usersBroader use requires an independently priced security assessment; Google does not publish that assessor’s fee.
A unified, consent-based API with webhooks puts Fitbit and Pixel Watch data on modern rails.
- OAuth access
- Webhooks
- Broad data types
End-to-end data freshnessIncluded in the 10-point freshness score
Wearable → Google HealthSync-dependentData can wait until the Fitbit or Pixel Watch successfully syncs with the Google Health mobile app.
Google Health → API webhookImmediate after ingestGoogle pushes a webhook as soon as the changed data is available in the Google Health API.
Native clinician viewNot availableA clinic needs its own application or integration; there is no universal Google physician dashboard.
Primary frictionWebhooks fire as soon as data reaches Google Health, but wrist-to-cloud delivery can wait for the wearable to sync with the mobile app.
View access, cost, and evidence
Health-platform portability24/25
Care-team parity8/25
Automated access & terms18/20
Complete self-export15/15
End-to-end freshness8/10
Transparency & control5/5
Access reality
Self-serve pilot · security review at scale- Regular person
- A user can authorize supported Fitbit and Pixel Watch data to outside apps and download account data.
- Physician
- There is no universal physician dashboard; a clinic needs an app or integration built on top of the API.
- Developer
- A Google Cloud project and OAuth client are self-serve. Unverified clients are capped at 100 users; broader use requires a third-party security review.
- Data-access cost
- No public per-call Health API price is listed. Google charges no review fee, but an independent assessor may charge a negotiated amount.
Smart ring
Oura Ring
Oura + Cloud API
75/100
GatedStrong API, sync-dependent
Data-access cost$
US$69.99/yearThe API is free, but access to current-ring data depends on an active Oura membership.
Broad health-platform sync plus OAuth and webhooks make authorized reuse unusually practical.
- Apple Health
- Health Connect
- OAuth + webhooks
End-to-end data freshnessIncluded in the 10-point freshness score
Ring → Oura appApp-sync dependentCloud and downstream routes cannot update until the ring and Oura app have synced.
Oura → health platformsNo public maximumBackground settings matter; Oura advises opening both apps at least daily to prevent integration failures.
Oura → API / webhookAfter cloud updateWebhooks notify after Oura data changes, but Oura publishes no universal ring-to-recipient SLA.
Oura → clinicianManual snapshotThe native care route is a shareable report rather than a continuously refreshed physician view.
Primary frictionData still depends on ring-to-app sync, and clinician sharing is mainly a static report rather than a live view.
View access, cost, and evidence
Health-platform portability23/25
Care-team parity9/25
Automated access & terms18/20
Complete self-export14/15
End-to-end freshness6/10
Transparency & control5/5
Access reality
Free API · approval after 10 users- Regular person
- Members can sync broad metrics to Apple Health or Health Connect and export CSV or shareable reports.
- Physician
- The native clinician route is a static shareable report, not continuous dashboard access.
- Developer
- OAuth and webhooks are public and free, but each app is limited to 10 users until Oura approves it.
- Data-access cost
- API access is free. Current-ring API access depends on an active membership: US$69.99/year or €69.99/year in the EU.
Sports watch / sensor
Polar
Polar Flow + AccessLink
72/100
GatedOpen API, 30–60 minute device sync
Data-access costFREE
$0 public APIAccessLink is offered under a royalty-free license; Polar Flow for Coach is also free.
A self-serve OAuth API, signed webhooks, and broad health-platform sync make Polar unusually reusable.
- Self-serve OAuth
- Royalty-free API
- Signed webhooks
End-to-end data freshnessIncluded in the 10-point freshness score
Watch → Polar Flow≈30–60 minutesPolar 360 and Loop use roughly 30-minute automatic sync; many current watches sync about once per hour, plus event-triggered syncs.
Flow → cloud / APIAfter device syncFlow web service and AccessLink cannot expose readings until the watch has uploaded them.
Flow → health platformsAfter Flow syncApple Health and Health Connect receive supported metrics downstream of the same device-to-Flow cycle.
Primary frictionMany Polar watches sync automatically about once per hour, while Polar 360 and Loop use roughly 30-minute cycles; downstream access cannot be fresher than that upload.
View access, cost, and evidence
Health-platform portability21/25
Care-team parity12/25
Automated access & terms20/20
Complete self-export8/15
End-to-end freshness6/10
Transparency & control5/5
Access reality
Self-serve + royalty-free license- Regular person
- A wearer can sync selected data to Apple Health or Health Connect and request an account export, although derived activity and sleep data are excluded from that export.
- Physician
- Polar Flow for Coach is a free, ongoing training-data view after the user joins a coach, but it is not a general medical or near-real-time physician dashboard.
- Developer
- Any registered Polar Flow user can create an AccessLink client. OAuth, JSON, webhooks, and continuous-heart-rate events are publicly documented without a small-user approval gate.
- Data-access cost
- AccessLink is offered under a royalty-free API license. Polar Flow for Coach is free; no per-call data fee is published.
Smartwatch / smart ring
Samsung Health
Galaxy Watch + Galaxy Ring
67/100
GatedPortable, watch sync remains variable
Data-access costFREE*
$0 public platform routeHealth Connect and the SDK are free; direct SDK distribution needs approval and Samsung does not publish partner pricing.
Core Galaxy data can flow through Health Connect, while richer direct SDK access remains controlled by Samsung.
- Health Connect
- Broad data types
- Personal download
End-to-end data freshnessIncluded in the 10-point freshness score
Galaxy wearable → phoneDevice-policy dependentSync commonly occurs on reconnect, app open, or pull-to-refresh; continuous heart rate is not sent immediately for battery reasons.
Samsung Health → Health ConnectImmediate after phone updateSamsung says it writes new or changed phone-side records to Health Connect as soon as they are created or updated.
Health Connect → outside appForeground readHealth Connect data can be retrieved only by an application running in the foreground.
Primary frictionSamsung writes phone data to Health Connect promptly, but Galaxy Watch upload follows device-specific sync rules and continuous heart rate is not sent to the phone immediately.
View access, cost, and evidence
Health-platform portability23/25
Care-team parity5/25
Automated access & terms15/20
Complete self-export13/15
End-to-end freshness6/10
Transparency & control5/5
Access reality
Open platform route · gated direct SDK- Regular person
- A user can authorize Samsung Health data to Health Connect and download a copy of personal Samsung Health data.
- Physician
- The reviewed consumer workflow does not provide an individual physician with a live view matching the wearer’s Samsung Health app.
- Developer
- Health Connect offers a user-authorized route to common data. Samsung’s richer Data SDK can be tested locally, but public distribution requires a Samsung partnership and app registration.
- Data-access cost
- Samsung Health and its downloadable SDK are free. Samsung does not publish a data-access fee for partner approval or production distribution.
Recovery wearable
WHOOP
WHOOP 5.0 + Developer Platform
63/100
GatedImmediate webhooks after processing
Data-access cost$$
US$199–$359/yearThe developer API is free, but the wearer needs a current WHOOP membership to generate accessible data.
OAuth and webhooks are excellent foundations, but important data and care-team access remain incomplete.
- OAuth access
- Immediate webhooks
- Apple Health
End-to-end data freshnessIncluded in the 10-point freshness score
WHOOP → mobile appContinuous, no SLABackground restrictions or lost connectivity can let device-to-app synchronization fall behind.
WHOOP → API webhookImmediate after processingWHOOP alerts integrations when an eligible workout, sleep, or recovery update has been processed.
WHOOP → health platformsAutomatic, no maximumSupported summaries sync automatically, but no universal measurement-to-platform maximum is published.
Primary frictionWebhooks are immediate only after WHOOP processes an update; device-to-app sync can still fall behind, and WHOOP publishes no universal end-to-end maximum.
View access, cost, and evidence
Health-platform portability18/25
Care-team parity6/25
Automated access & terms16/20
Complete self-export11/15
End-to-end freshness7/10
Transparency & control5/5
Access reality
Free API · approval after 10 users- Regular person
- Members see recovery, strain, sleep, and health metrics in WHOOP; selected data can flow to Apple Health.
- Physician
- There is no general live clinician view with wearer parity in the standard membership workflow.
- Developer
- The OAuth API is free and self-serve for small projects. More than 10 members requires app approval, and some data remains excluded.
- Data-access cost
- Developer API: free. Wearer data requires a WHOOP membership, typically US$199–$359/year by current U.S. tier.
CGM
Dexcom
G7 + Clarity + Follow
61/100
GatedLive followers, three-hour clinical lag
Data-access cost$$$
Private production quoteSandbox access is free; real production data requires a license plus technical and commercial review.
Follow and Clarity are useful continuous sharing tools, but most of the value stays inside Dexcom’s ecosystem.
- Live follower view
- Clinic sharing
- Raw CSV export
End-to-end data freshnessIncluded in the 10-point freshness score
Sensor → wearer app≈5-minute cadenceG7 sends a new glucose reading to the compatible display device every five minutes.
Dexcom Share → FollowNear real timeFollowers receive the same five-minute stream when the sharer’s phone and both users have connectivity.
Dexcom → Clarity clinician≈3 hoursContinuous clinic sharing is automatic, but the latest cloud data shown in Clarity is about three hours old.
Dexcom → Apple / Google3 hoursApple Health and Health Connect deliberately display glucose after a three-hour delay.
Primary frictionFollow receives five-minute readings near real time, but Apple Health, Health Connect, and the latest Clarity clinician data lag by about three hours.
View access, cost, and evidence
Health-platform portability6/25
Care-team parity22/25
Automated access & terms8/20
Complete self-export13/15
End-to-end freshness7/10
Transparency & control5/5
Access reality
Free sandbox · partnership for real users- Regular person
- Follow can show glucose to invited people in real time; Clarity and CSV provide retrospective access.
- Physician
- A clinic can receive continuous Clarity data after the patient enters a clinic code, but it is delayed and not the wearer’s live app view.
- Developer
- Registration and sandbox data are free. Even a five-user real-data prototype needs Dexcom approval and a data-licensing agreement.
- Data-access cost
- Sandbox: free. Production and commercial licensing prices are not public; full access requires technical and commercial review.
Sports watch
Garmin
Garmin Connect + Health API
53/100
LimitedRich data, foreground or device sync
Data-access cost$$$
Commercial fee · amount undisclosedGarmin confirms that commercial use carries a license fee but does not publish the price.
Garmin exposes rich health data, but its strongest access route is built for approved commercial integrations.
- Health API
- Push or pull
- Apple Health export
End-to-end data freshnessIncluded in the 10-point freshness score
Wearable → Garmin ConnectUser-sync dependentGarmin documents availability only after the user successfully syncs the device with Garmin Connect.
Connect → Apple / GoogleAfter successful syncApple Health transfer requires Garmin Connect to open in the foreground; Health Connect also waits for a completed device sync.
Connect → Health APIAfter cloud uploadPush or pull delivery begins only once the user’s data has reached Garmin Connect; no end-to-end maximum is published.
Primary frictionAPI access requires approval and commercial use carries a fee; Apple Health transfer waits for a successful app sync.
View access, cost, and evidence
Health-platform portability17/25
Care-team parity4/25
Automated access & terms11/20
Complete self-export12/15
End-to-end freshness4/10
Transparency & control5/5
Access reality
Approval + paid commercial license- Regular person
- Garmin Connect can send selected metrics to Apple Health after a successful device and foreground app sync.
- Physician
- There is no simple native physician view; care use generally depends on an approved integration.
- Developer
- The Health API exposes rich JSON feeds, but the evaluation environment is available only after approval.
- Data-access cost
- Garmin states that commercial use requires a license fee, but does not publish the amount.
CGM
FreeStyle Libre
LibreView + LibreLinkUp
53/100
LimitedLive followers, closed neutral route
Data-access costN/A
No public developer routeConsumer and clinic portals are included; third-party integration pricing is not publicly documented.
Family and clinic sharing work well, but continuous access is tied to Abbott apps and portals.
- Up to 20 followers
- Clinic sharing
- Raw download
End-to-end data freshnessIncluded in the 10-point freshness score
Libre 3 / 3 Plus → followerReal-time streamLibreLinkUp receives streamed glucose when the phone is online; Abbott does not publish a universal network-delivery maximum.
Scan-based Libre → followerAfter each phone scanA successful smartphone scan triggers sharing; scans made only with an offline reader do not reach followers.
Libre app → LibreView clinicAutomatic when onlinePhone data uploads to LibreView with connectivity, but the reviewed documentation gives no precise maximum delay.
Reader → LibreView clinicManual uploadReader-based data must be uploaded separately and is not a continuous external feed.
Primary frictionLibreLinkUp can receive streamed or scan-triggered glucose promptly, but the exact network SLA is not published and reader-based workflows require manual upload.
View access, cost, and evidence
Health-platform portability3/25
Care-team parity23/25
Automated access & terms1/20
Complete self-export13/15
End-to-end freshness8/10
Transparency & control5/5
Access reality
Consumer and clinic portals only- Regular person
- LibreLinkUp provides invited follower access; raw data is downloaded separately through LibreView.
- Physician
- Licensed professionals can create a LibreView practice and receive data from connected patients.
- Developer
- No public, self-service developer API is documented in the official materials reviewed for this score.
- Data-access cost
- Consumer and clinic portal access is included. Any third-party integration route or price is not publicly documented.
CGM
Lingo
Abbott consumer CGM
29/100
ClosedThree-hour platform delay
Data-access costN/A
No public developer routeExport and delayed health-platform sync are included; no commercial data-access product is publicly documented.
A glucose export exists, but timely collaborative access and contextual portability are weak.
- Spreadsheet export
- Apple Health
- Health Connect
End-to-end data freshnessIncluded in the 10-point freshness score
Sensor → Lingo appNative live viewThe wearer can see current glucose in Lingo, but native display speed alone does not earn external-freshness credit.
Lingo → Apple Health3 hoursFive-minute interstitial-glucose values are deliberately held for three hours before appearing.
Lingo → Health Connect3 hoursThe Android health-platform route has the same stated three-hour delay.
Lingo → person / clinicianNo continuous routeThere is no native caregiver connection or continuously refreshed clinician view.
Primary frictionHealth-platform glucose arrives after a stated three-hour delay; exports omit logged meals and workouts.
View access, cost, and evidence
Health-platform portability7/25
Care-team parity1/25
Automated access & terms0/20
Complete self-export12/15
End-to-end freshness4/10
Transparency & control5/5
Access reality
No public developer or clinical path- Regular person
- A user can export glucose and send 5-minute values to Apple Health or Health Connect after a three-hour delay.
- Physician
- Lingo has no caregiver connection or dedicated continuous clinician-sharing workflow.
- Developer
- No public API or self-service route for authorized third-party access is documented.
- Data-access cost
- Export and delayed health-platform sync are included. No commercial data-access product or price is publicly documented.
Provisional means exactly that: manufacturers, developers, clinicians, and users are invited to submit corrections with evidence.