Health tracking watches, bracelets and rings are a multi-billion dollar business attracting tech-savvy customers obsessed with body metrics. Today, the market gets a new competitor: the smart toilet company Casana, which has raised $46 million in funding to develop a sensor-stuffed toilet seat. In an industry crowded with wearables, Casana is betting sittables will be the next billion-dollar opportunity.

Founded by Dr. Nicholas Conn in 2018, Casana is a health tech startup that makes toilet seats with sensors that can scan vitals like blood pressure, heart rate, blood oxygen and respiratory rate, and connect the results to a phone app for users to understand their own health trends. The startup most recently closed a $30 million Series B in 2022, and counts investors like General Catalyst, Morningside and Outsiders Fund. This week, they’re officially bringing their first product to the public.

Casana’s goal is to turn health tracking into a daily habit, but without any hassle. More than 48% of U.S. adults have high blood pressure—many of which are elderly patients at higher risk of health complications due to the condition. To keep metrics on track, doctors typically prescribe daily (or twice daily) blood pressure monitoring via at-home blood pressure cuffs or other similar devices. But difficulty connecting and charging those tools, or even just forgetting to measure, significantly decreases the number of patients who adhere to the habit.

That’s why Austin McChord, the Forbes Under 30 alum and Casana president, says the ease of the product is its greatest benefit.

On Monday, Casana’s “Smart Seat,” which costs $199, will be available to purchase across the U.S. It works like this: the sensor-embedded and battery-operated seat (with a two-year lifespan) gets swapped for the original toilet seat like any replacement seat would. Users then download an app and create their own user profile by sitting on the seat to calibrate it to their individual biometrics. Each time someone uses the toilet, the seat’s sensors automatically detect who it is, and upload real-time information to their app profile. All user data is kept confidential to that individual, though users can opt in to sharing it with others—like older folks who want to share it with their relatives or doctors to keep track of their health together.

“It works best when forgotten about,” says McChord, who initially made the Under 30 list for founding Datto, an IT company that provided data back-up and emergency recovery to managed service providers, and was acquired by Kaseya in 2022 for $6.2 billion. He adds that the Casana seat is a way to measure “vital, important health tech stuff… but in a way that requires no behavior change and you don’t have to remember that it even exists.”

McChord joined the company in 2020, around the time General Catalyst and his own Outsiders Fund first invested. It was during the heart of the Covid pandemic—a time he says caused many of us to pay attention to our own health.

“Covid reminded people a lot of their own mortality,” McChord says. “It has changed the way that we look at a lot of stuff… and the fact that technology has arrived to meet us at this point is really interesting. You see everybody's doing it now.”

Casana devices include three sensors: a photoplethysmogram (or PPG), which uses LED lights shined into the skin to measure blood flow; an electrocardiogram (or ECG), which measures the electrical activity in your heart; and a ballistocardiogram, which he describes as “a really fancy word for a very sensitive scale.”

It’s been a challenge to get these sensors right, he adds, which has contributed to the years they’ve been in R&D pre-launch. But the advancements in AI have helped to supercharge what they’re able to do today. They’ve built new AI algorithms to more accurately measure blood pressure, AI has improved Casana’s bio-ID capabilities so different users can be more accurately measured on one device, and it’s helped make the interface on the app user friendly so even non-tech savvy folks know what they’re reading.

While Casana’s seat measures a myriad of metrics, it’s not built to diagnose. Instead, Casana’s goal is to provide information on bodily trends so that it can tell, long term, if something seems off and might require a visit to the doctor. And older folks have been specifically kept in mind while building the product.

“Most folks over the age of 65 either aren’t tech savvy enough or don't want to spend the time to install, charge, wear or calibrate a complicated device,” says Jeff Leiden, a cardiologist and senior advisor at General Catalyst (he’s also an angel investor in Casana and serves as their chairman). But they’re the very demographic who need to watch health metrics like heart rate and stability most closely, he says.

It’s a different market than many wellness tech products go after—like the Oura Ring, Whoop and the Apple Watch which have been quickly adopted by much of the younger generations. But their successes (like Whoop and Oura Health’s $10 and $11 billion valuations, respectively) showed Casana investors the business potential with health tools, McChord said.

They’re most focused on direct-to-consumer sales with the initial launch, but there’s also opportunity with nursing homes and elderly living communities, Leiden says. As for what’s next, McChord believes bio-tracking is only going to become more prevalent.

“The idea that we're tracking this information continuously will be sort of ubiquitous,” he says. “Tracking all this information about ourselves so that we can decide to act on it to live longer, better, healthier lives, that's only going to become more and more and more common.”