Tom Moss is the co-founder and CEO of Vital Signals, maker of Signal Ring, a calibration-free smart ring that measures blood pressure. He began his career two decades ago in consumer technology, where he was an early leader on Google's Android team. He later co-founded 3LM, acquired by Motorola, and Nextbit, acquired by Razer, and served as Skydio's first COO. A former IP attorney, Tom is a co-inventor on more than 20 patents and has been an angel investor since 2010.

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Tom had spent two decades building consumer gadgets when a family vacation ended with him in an ambulance. Everyone assumed a heart attack. It was a hypertensive emergency, with a systolic reading of 250. He'd had undiagnosed hypertension for years, and coronary artery disease, too.

Then came his experience with blood pressure cuffs: cumbersome, embarrassing — and in his case the wrong size, with the hose, not the printed dot, as the guide to the artery. Shopping for something better turned up only "BS and snake oil being sold to hypertensives." Some 1.7 billion people have hypertension, roughly half of U.S. adults among them, and cardiovascular disease causes one in three deaths. Yet the best home tool is a design about a century old. How, he kept asking, could there not be a modern way to understand the factors in his lifestyle impacting his blood pressure?

Curious and frustrated, he went from buying every product to looking for companies solving the problem to invest in and, finding none, to asking experts why. A mutual friend introduced him to Dr. Muhammad Usman and Dr. Faisal Kashif, physiology and signal-processing experts from Masimo, which pioneered SpO2 measurement. In 2023, they founded Vital Signals with only a goal and no product, algorithm, or theory. The science led to a ring, comfortable to sleep in — important because nocturnal hypertension is six to seven times more predictive of a cardiovascular event than daytime hypertension.

Signal Ring measures blood pressure without calibration. Calibration-based wearables drift as the arterial environment changes and inherit the cuff's own errors, which is why larger companies stop at hypertension alerts. Signal Ring takes on-demand spot readings and background readings day and night.

It met the ISO 81060-2 standard without calibration in a 792-subject study that ran across four U.S. sites, including Stanford University. Preorders opened in July 2026 at $399, no subscription, with shipping to start in October. Vital Signals raised a $15 million seed round led by XYZ Ventures and is studying arterial stiffness, plaque, and coronary artery disease detection.

Large tech companies have tried for over a decade to do what Vital Signals does, so investors ask why Vital Signals doesn't license its technology. For Tom, it's a fundamental choice between making a product and licensing to companies that do. His first startup's licensing and white-labeling taught him it sounds better in theory than in practice.

Licensees typically fall into two camps: small companies without the volume or money to justify the work, and market leaders weighing build versus buy and trying to reverse-engineer your technology. Many assume licensees pay forever for something critical. Tom disagrees: "If it's really important, they're going to have a team on it on day one." This is how customers can also be potential competitors.

Licensing also gives up control of how the product reaches the user, and the team has spent a ton of time on that experience. Research found that many people dislike cuffs enough to leave them in a drawer. Vital Signals set out to make measuring relaxing. On-demand “Zen Mode” readings in the Signal Ring app borrow from meditation apps, meant to be "your moment of Zen," and open by default with about 20 seconds of timed breathing, which also improves accuracy. The ring's background readings avoid judgment so people keep engaging. Licensing, Tom saw firsthand, ends the ability to interact with users directly.

Licensing a core technology puts both revenue and users at risk. The more critical a technology is to a licensee's product, the more likely they are to replace it with their own. Licensing also leaves decisions about how the product reaches users to someone else, which matters when its value depends on people continuing to use it.

On the product side, Tom knows firsthand how hard consumer hardware is. Hardware makers tend to want the latest and greatest, but he advises using off-the-shelf parts whenever possible: well-understood components that have been around a while, sold by many vendors, and available for spot buys.

The advice traces to his previous startup, Nextbit, which designed an Android smartphone that included a then-new camera-focus part available only from one or two vendors. Much larger companies wanted the part, and even though Nextbit had already finalized its design and signed purchase orders, the supplier chose to sell their entire inventory to the bigger customers. With its orders in the tens of thousands against buyers ordering millions, Nextbit had little leverage. New chipsets add risk: bugs no one has found yet, and vendors busy fixing Google's and Apple's issues while small companies are deprioritized.

This is why Vital Signals keeps its novelty to the core: a sensor co-designed specifically for arterial health and blood pressure, and algorithms that Tom calls “a generation ahead of everybody else, no question.” While some smart rings prioritize design or extended battery life, Vital Signals directed its engineering effort toward advancing blood pressure technology. "You can't boil the ocean either," Tom says.

Reserve new technology for your core functionality, and use proven parts elsewhere. Using new or scarce components leaves a small company competing with far larger buyers for inventory and vendor support. Favor well-understood parts sold by many vendors and available in spot buys, and accept that competitors may outperform you on features outside your core functionality.

Tom calls validation probably the most important question for Signal Ring, since blood pressure is among the hardest things to generalize across a population. In healthy 25-year-old white males, it's "almost trivial": arterial environments look alike, optical sensors read their skin tone easily, and readings fall in a narrow range. Results from that group fall apart on older, darker-skinned, higher-BMI, or medicated subjects, especially with overfit AI models.

When Vital Signals started, blood pressure readings required FDA clearance, so it designed its studies for a 510(k) and incorporated FDA feedback into the protocol. Blood pressure's decades-old guidelines come down to two goals. First, the baseline must be trustworthy, so trained professionals used stethoscopes to take reference readings. Second, the population must be broad: ISO guidelines call for 85 subjects, which Tom calls "nowhere near enough" when every age, weight, and blood pressure range needs filling, and some studies cut that number down to 10. Vital Signals' latest study enrolled 792 subjects across geographies, all 10 Monk skin tones, and varied BMI, age, gender, and hypertension levels.

In January 2026, FDA let wellness devices show blood pressure without diagnosing or claiming clinical accuracy, on manufacturer validation alone. Vital Signals' studies, built for clearance, already exceeded that bar. Tom chose to launch as wellness partly because he expects a wave of inaccurate devices that could sour buyers on the category, and he wants to show a good one is possible.

Validate on the patients most likely to break your device. Small, uniform cohorts can make almost any device look accurate, especially one built on AI models trained on limited data. Pair a verifiable reference standard with enough subjects in every subgroup, and keep everyone you enroll in the results.

In Tom's view, "You're always fundraising. You're never not fundraising." That doesn't mean always running a round; it means always "selling the option to buy," building a relationship with every investor met in a professional setting.

Being known by as many investors as possible before raising improves the odds and shortens the raise, whether through events or sharing content on LinkedIn and other channels to get attention. Either way, the network feeds warm introductions, worth their weight in gold compared with cold outreach. Always fundraising isn't constant pitching, though, which as an angel, Tom finds off-putting; he'd rather founders focus on building the relationship.

The pitch itself is a learnable skill. Tom's sales formula, which covers fundraising and recruiting, comes down to storytelling and confidence. Getting better at storytelling means learning its fundamentals, including why the standard deck structure became the default. Part of the process is also live: reading an investor's feedback mid-pitch, steering toward what resonates, and using what each meeting reveals to improve the deck and story over time.

In Tom’s opinion, confidence can be practiced, even faked, but overconfidence, thinking you hold a stronger hand than you do, is dangerous. He has watched fundraises and acquisitions vanish at the one-yard line after the other side promised they would happen. "Nothing's real until, like, the money's in the bank," he says, so keep contingencies.

Build investor relationships long before you need the round. Raises go faster and succeed more often when investors already know you, and a warm introduction goes much further than cold outreach. Treat the pitch as a learnable skill, revise the story after every meeting, and expect plenty of nos. Stay confident, but assume nothing is final until the money arrives.