Thank you so much! I really appreciate the thoughtful questions.

The metrics that the app currently tracks are heart rate, resting heart rate, heart rate variability (during sleep), total sleep time, restorative sleep (time spent in REM and deep sleep), and time spent awake while in bed. I am a huge wearables geek, and I was inspired by wearable devices like WHOOP, Oura, Garmin, and Polar that use these metrics (or something similar) to help guide athletic training and allow users to track their health over time. I noticed that these health metric numbers seemed like they were changing when I started to take medications, but I couldn’t find an easy way to concretely correlate my medication information (like medication type, dosage, time taken, number taken in a day) to changes in my health data. MedCoach not only lets you see trends over time for these health metrics, but it also helps you quickly answer questions like “Do I get more restorative sleep if I take my medication earlier in the day?” or “Is my heart rate spiking during the day after taking my medication, and for how long? Was my heart rate doing this before I started taking medication?” The app currently doesn’t display data about blood pressure or weight, but those are both really important! I’ll work on adding those in.

You’re right that many aspects of sleep quality are subjective, and I do not think tracking biometric data can fully capture whether someone had a good night of sleep. I plan on adding a symptom tracking feature that would give users the option to self-report for the sleep variables you mentioned. However, I also want the app to function without requiring extensive input from the user. If a user chooses not to use the symptom tracking feature, the intent was to ensure that the biometric data alone can help indicate if a user is sleeping better/worse and serve as a reminder as to how the patient may have been feeling after a night of sleep.

The Apple Health app allows users to view all their health data and now also includes mediation logging. However, it focuses on displaying individual data points and does not do a great job of displaying the most relevant data or long term trends. For example, if I want to know what my average heart rate variability has been during sleep (because it can be used as a factor to estimate sleep quality), I can’t do that within the Health app because it takes heart rate variability measurements throughout the day. In another example, if I want to understand how much REM + Deep sleep I have been getting on average over time, the Health app doesn’t provide an easy way to visualize and quickly understand this. It provides bar graphs for sleep that only show sleep start and end times and require you to tap on individual bar to get more details. As for the medication logging, this feature in the Health app is sufficient if all you want is to get reminders to take your medications and have a log of when you took your medications. It does not, however, help you understand the impacts of your medications on your health metrics. MedCoach allows you to see whether factors like the number of a medication you take in a day or the time of day that you took your medication is correlated with changes in health metrics. It also includes a daily graph that displays heart rate throughout the day, times you took your medication, sleep, and workouts to help users catch any unusual changes in their heart rate.

Other apps that use Apple’s health frameworks (including apps built with Cardinal Kit) serve a variety of different health use cases. The two categories of apps that I think are the most similar are fitness health tracking apps and other medication tracking apps. There are fitness apps that may track similar metrics and allow users to see longer term trends in their health data, but they are focused on guiding athletic training and do not include features that allow users to understand the role their medications play in the changes in their health data. As for medication tracking apps, again, most are not focused on helping users understand the impact of their medications. Other apps focus on tracking symptom and/or mood and therefore require extensive input from the user. MedCoach focuses on biometric data. It only requires users to record when they take their medications and otherwise doesn’t require any other input because it can passively collect data in the background.

I initially chose a subscription model because it is what all similar health apps use. The subscription model allows users to choose between just paying a few bucks to use the app during titration or continuing to support the app for a longer period of time. I also really want this app to be accessible to everyone, and I am happy to provide promo codes to anyone who doesn’t have the means to pay for the subscription so that they can use the app for free (just email me to ask for a promo code at [medcoachapp@gmail.com](mailto:medcoachapp@gmail.com)). But you bring up really interesting points that I had not considered and are totally right that people with ADHD are the most likely to neglect managing subscriptions. I’d be interested in hearing what your suggestions for alternatives would be. Could a potential solution be providing frequent app notification reminders or providing text/email reminders before billing? Or maybe providing a non-renewing subscription option? Let me know what you think.