# PAR: Towards a Reference Architecture for Accessible Platforms in Respiratory Therapies
## 2 Materials and Methods
### Background and Framework  
#### 2.1.1 Technology in Pulmonary Rehabilitation  
Recent advancements in virtual healthcare technologies are reshaping the landscape of respiratory care, offering unprecedented opportunities for improved patient outcomes, enhanced access to healthcare, and reduced burdens on medical providers [7]. Integrating digital technology into healthcare, known as digital health, has transformed the healthcare sector through software programs, hardware systems, and associated support services. Digital health encompasses a range of technologies, including mobile health (mHealth), electronic medical records (EMRs), telehealth, electronic health records (EHRs), and telemedicine [8]. This digital shift addresses the growing demand for personalized healthcare and involves various stakeholders, such as physicians, patients,app developers, researchers, distributors, and smart device manufacturers. Digital health plays a pivotal role in modern healthcare infrastructure [8]. The following overarching trends have indicated a pronounced inclination toward digital health. * The utilization of digital communication technologies like computers, mobile phones, and tablets for healthcare delivery characterizes telehealth. The global telehealth market is projected to exceed USD 185 billion by 2026, reflecting a sustained growth trajectory. Telehealth is expected to persist, with estimates indicating that USD 250 billion of total U.S. healthcare spending could transition to virtual platforms in the post-pandemic years [9]. * The Internet of Things (IoT) refers to the expanding network of physical objects embedded with software, sensors, and other technologies that facilitate data exchange over the Internet. The Medical IoT sector in healthcare is rapidly evolving, employing wearable devices, monitors, and integrated applications to cater to healthcare needs. With artificial intelligence (AI) and machine learning technologies, Medical IoT enhances traditional medical devices, such as smart inhalers synchronized with mobile applications [9]. In this study, we adopted a purposive sampling approach, selecting platforms or tools widely recognized and representative of the current landscape in telerehabilitation and healthcare accessibility. The goal was to include platforms with diverse features, functionalities, and user interfaces to comprehensively understand the usability and accessibility considerations within the broader context. The decision to include ten platforms was based on balancing the need for an adequate sample size to draw meaningful conclusions and the practical constraints of resource availability and research scope. While a larger sample size might provide more statistical power, the complexity and depth of the analysis required for each platform necessitated a pragmatic approach. Furthermore, the platforms selected represent a cross-section of the major players in the field, encompassing variations in design philosophies, target user populations, and intended functionalities. This diverse selection enhances the reliability of our findings to a broader spectrum of telerehabilitation platforms. Innovative technologies play a crucial role in providing effective healthcare solutions, for example:  
* Health Care Originals: Offers a digital respiratory therapy platform catering to professional, research, and personal use, presenting portable solutions optimized for respiratory applications [10]. * MyNewLungs version 2023: An online pulmonary rehabilitation program, emphasizing highly effective remote intervention and showcasing positive outcomes such as improved pulmonary function and increased exercise tolerance [11]. * Rehab Guru: A trusted home exercise prescription platform, incorporating over 550 high-quality exercises, with telehealth features facilitating virtual consultations and digital exercise programs [12].