I have both an inReach and two Garmin wearables. Would be awesome to have tie in across the watches and inReach for both emergency and non-emergency use.
First, the most obvious use, in an emergency I may not be able to communicate, or even if I can, my heart rate and weather or not I'm moving could be communicated with very little bandwidth. Maybe not as useful and could be prone to false triggers, but the watch could have a way to trigger an emergency similar to smart phone. Don't know that I would want the watch to sense an emergency and trigger emergency response, but could have user way to cancel if they say, I'm not dead or having a heart attack. There is a bike helmet with impact detector that does something like this but calls friends not 911, if you drop it accidentally you have a minute or so to cancel.
Non emergency use is similar, when sending messages, or for tracking, heart rate stats could be shared, and the phone could be used to send messages. Could also have a "Find my InReach" feature like the "find my phone feature on the Garmin wearables.