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Autonomic Health SDK

The Autonomic Health SDK enables healthcare applications to integrate advanced autonomic nervous system (ANS) monitoring into their iOS and Android applications. The SDK provides a complete end-to-end solution for conducting clinically-validated ANS challenge tests using wearable heart rate monitors.

What is the Autonomic Health SDK?​

The SDK is a comprehensive solution for integrating ANS testing capabilities into mobile health applications. It handles the entire test lifecycle - from device pairing and data collection to video recording and cloud upload - while maintaining strict clinical protocols to ensure test validity.

Unlike traditional HRV analysis tools, this SDK implements P&S (Parasympathetic and Sympathetic) monitoring through structured ANS challenges, providing actionable clinical insights about autonomic function.

Key Features​

  • Comprehensive Test Flow: Pre-built, clinically-validated UI for the complete test experience including device pairing, safety attestation, camera positioning, and guided ANS challenge testing
  • Multi-Device Support: Compatible with Polar H10/Verity Sense, Garmin HRM-Pro/HRM-Dual, generic Bluetooth Low Energy heart rate monitors, and Apple Watch
  • Tree-Shakable Architecture: Include only the device adapters you need to minimize app size - each adapter is a separate module
  • Real-Time Data Collection: Capture millisecond-precise RR intervals, heart rate, accelerometer data, and synchronized video recording
  • REST API Integration: Built-in client for managing patients, tests, treatments, and forms with automatic retry and error handling
  • Event Callbacks: Monitor test progress, device connectivity, data quality, and upload progress through intuitive delegate/listener patterns
  • Automatic Data Validation: Real-time detection of invalid data (motion artifacts, connectivity issues) with user guidance
  • HIPAA-Compliant: Encrypted data transmission and secure cloud storage

Platform Support​

iOS​

  • iOS 14.0 or later
  • Swift 5.9 or later
  • Swift Package Manager
  • Xcode 15.0 or later

Android​

  • Android API 24+ (Android 7.0 Nougat or later)
  • Kotlin 1.9 or later
  • Gradle 8.0 or later
  • Android Studio Hedgehog or later

Architecture​

The SDK is composed of modular, loosely-coupled components:

Core SDK​

The core module provides:

  • Test flow orchestration and UI screens
  • ANS challenge protocol implementation (baseline, deep breathing, Valsalva, standing)
  • Device management protocols and abstractions
  • Video recording with synchronized timestamps
  • Data validation and quality checks
  • Network layer with automatic retry logic
  • Error handling and user feedback

Device Adapters​

Each device manufacturer has a dedicated adapter module:

  • Polar Adapter: Support for Polar H10, H9, Verity Sense, OH1 using the Polar SDK
  • Garmin Adapter: Support for HRM-Pro, HRM-Dual, HRM-Run using Garmin ConnectIQ
  • BLE Heart Rate Adapter: Generic support for any Bluetooth Low Energy heart rate monitor using the standard Heart Rate Service (0x180D)
  • Apple Watch Adapter (iOS only): Native integration with Apple Watch using HealthKit

You only include the adapters your application needs, reducing SDK size and dependencies.

API Client​

The API client provides read-only access to:

  • Patients API: Retrieve and update patient demographics and medical history
  • Tests API: List and retrieve historical test results with P&S metrics
  • Treatments API: Access physician-recommended treatment plans
  • Forms API: Fetch questionnaire templates and manage form submissions

Video Recording​

Synchronized video capture for test validation:

  • Records patient positioning and movement during challenges
  • Timestamps synchronized with heart rate data
  • Automatic compression and upload
  • Used by physicians to verify test validity

How the Test Flow Works​

When you present the ANS challenge test:

  1. Device Pairing: User scans for and pairs with their heart rate monitor
  2. Safety Attestation: User confirms they're in a safe environment for testing
  3. Video Positioning: Camera setup with posture verification
  4. Baseline Recording: 5 minutes of resting heart rate data
  5. Deep Breathing: Guided breathing exercises to assess parasympathetic response
  6. Valsalva Maneuver: Controlled breathing challenge to assess sympathetic response
  7. Standing Challenge: Orthostatic test to measure postural adjustment
  8. Data Upload: Automatic upload of RR intervals, video, and metadata
  9. Validation: Backend processing with quality checks
  10. Physician Review: Licensed provider reviews test and creates treatment plan
Unmodifiable Test Flow

The test UI and protocols cannot be modified by integrating applications. This ensures clinical validity and consistency across all tests.

Data Collection​

The SDK collects multiple data streams during testing:

  • RR Intervals: Beat-to-beat timing in milliseconds (the primary signal for ANS analysis)
  • Heart Rate: Beats per minute calculated from RR intervals
  • Accelerometer Data: Device motion to detect artifacts and patient movement
  • Video Recording: Visual verification of patient positioning and compliance
  • Metadata: Timestamps, device information, battery levels, connection quality

All data is synchronized to a common timeline for analysis.

Clinical Validation​

The SDK implements clinically-validated ANS challenge protocols:

  • Baseline measurements establish individual norms
  • Deep breathing isolates parasympathetic function
  • Valsalva maneuver stresses both branches
  • Standing challenge reveals orthostatic dysregulation

Results are analyzed using proprietary algorithms to separate Parasympathetic (RFa) and Sympathetic (LFa) components measured in bpm², providing actionable clinical metrics beyond traditional HRV.

Getting Started​

Continue to the Installation guide to add the SDK to your project.