Cardiorespiratory: technology revolution (FS-04)

Focused symposium

Patman S1Thomas A2Greenland C3Morrow B4,5Main E6 
1University of Notre Dame Australia, School of Physiotherapy, Perth, Australia, 2The Royal London Hospital, Critical Care Outreach Team, London, United Kingdom, 3Lady Cilento Children's Hospital, Children's Health Queensland Hospital and Health Service, Brisbane, Australia, 4University of Cape Town, Department of Paediatrics and Child Health, Cape Town, South Africa, 5Red Cross War Memorial Children's Hospital, Dept. Paediatrics, Cape Town, South Africa, 6University College London, Postgraduate Physiotherapy, UCL Institute of Child Health, London, United Kingdom

Learning objective 1: To explore a definition of digital literacy with reference to Cardiorespiratory Physical Therapy content and application.
Learning objective 2: To generate participant collaboration in the identification, recording and sharing of digital applications for therapist and client facing cardiorespiratory health domains.
Learning objective 3: To expose participants to technology enhanced teaching, learning and self-development innovations within cardiorespiratory physical therapy domains. 4. To introduce specific emerging technologies for the measurement of ventilation distribution and treatment adherence in cardiorespiratory populations. 5. To consider the application of big data and big data mining to the future development of cardiorespiratory physical therapy intervention.
Description: Technological capability is an increasingly important part of everyday life, both privately and professionally. The application of existing and emerging digital technologies and tools has the potential to radically change the way we teach, deliver and evaluate the effect of cardiorespiratory physical therapy. This symposium will use the Digital Capacity Framework vectors (Beetham 2015) to structure an interactive conversation highlighting the potential for digital applications to support, augment and create a digitally-enabled profession. The first vector will consider both therapist and patient facing digital technologies which enhance teaching, learning and self-development. This vector will provide an opportunity to showcase digital learning and access applications and consider methods to manage and evaluate the explosion of resources available, including the use of part task trainers and simulated patient exposure. The second vector will explore digital applications for communication, collaboration and participation and the potential for these applications to support engagement with healthcare (Klecun et al 2014) and life-long learning. Client and carer facing digital health intervention interfaces (including social media) may provide unique self-management opportunities by increasing access to information and exposure to wide support networks (Dunphy et al 2017). The third vector will explore digital creation, innovation and scholarship and demonstrate emerging clinically applicable technologies which have the potential to support and enhance treatment delivery in real time, promote compliance with interventions and improve outcomes. Non-invasive monitoring and assessment technologies, wireless and wearable sensors to define actigraphy, decision support tools, acoustic sensors, data fusion and early warning systems represent examples that will revolutionise the way healthcare is delivered and evaluated (Michard et al, 2017). Personal health tracking is a billion-dollar consumer growth industry with opportunities for deriving clinical uses in the management of both acute and chronic illness (Kroll et al, 2017). The symposium will specifically focus on the application of electrical impedance tomography to the measurement of real time changes in ventilation during physical therapy intervention (Lupton-Smith et al, 2014; 2015; and 2017) as an example of the potential for ongoing digital data collection and real-time analysis (as a standard way of improving healthcare delivery) to replace the complex, time consuming and problematic RCT (in non-blinded physical therapy studies). The fourth vector is concerned with digital information and data management and will introduce the participant to the “Big Data” concept and its relevance to cardiorespiratory health interventions. “Big data mining” may reveal patterns, trends and associations between treatments, outcomes and human behaviours that may enhance both the provision and delivery of cardiorespiratory healthcare and service development. It is clear that machine learning and data science will have an important role to play in modern healthcare (e.g. algorithms for accurately, forensically interpreting ECG's). Such algorithms must not be created by data scientists alone, but in partnership with physical therapists. Clinicians know which research questions need to be answered, and data scientists know how to create the algorithms to answer the questions. It is therefore essential that early partnerships between data scientists and clinicians co-create the agenda and guide the evolution of this science, in order to improve the quality of healthcare. If we don't engage - we will be left behind, or the digital framework agenda will be wrong. Healthcare professionals are currently receiving little training about machine learning and data science. If healthcare is to progress in this new collaboration, education needs to commence at the entry-to-practice level. The last two sectors focus on technical proficiency and digital citizenship, incorporating issues related to security, safety, identity and wellbeing for the digitally aware therapist and the citizens they serve.
Implications / Conclusions: Medical thinking has become so vastly complex it now exceeds the capacity of the human mind (Obermeyer and Lee, 2017). Machine learning has the capacity to rapidly transform our clinical decision making and understanding of health behavior. Digital literacy acquisition within cardiorespiratory physical therapy must be seen as a high priority to allow full participation in the delivery of modern healthcare delivery and evaluation, now and into the future. 
Key-words: 1. digital 2. data 3. applications, e-literacy
Funding acknowledgements: nil
Relevance to physical therapy globally: Global technological change is advancing at an increasing pace and the use of technology is increasingly an essential part of everyday life. Within health care, digital literacy is becoming a core skill that can elicit profound changes to our learning, work, communication, innovation and research efforts. Regardless of global digital infrastructure and organisational readiness, poor digital literacy is associated with missed opportunities to support the adoption of existing and emergent technologies into our work practices.
Target audience: Students, clinicians, managers, educators, research enthusiasts and policy makers interested in acute and chronic cardiorespiratory health.