The term digital twin is getting popular in multiple forums. It was first used in 2003 in the field of product lifecycle management when virtual representations of physical items were still in their infancy. With the advancement of computing power and the advent of the Internet of Things, digital twins are sparking interest in many industries, including healthcare. Gartner ranked digital twins in the top 10 strategic technology trends in 2018 and 2019 and from 2020 they were included in the hyper-automation trend.
In the field of health, digital twins have multiple possibilities and can be applied to physical objects (medical equipment or biological organs), but also virtual versions of people, care centres or health systems.
Object simulation
A digital twin of medical equipment allows maintenance needs to be identified before they appear, thus reducing interruptions such as cancellations of exploratory test visits with their consequent impact on waiting lists, user satisfaction or even clinical results. Digitizing equipment also enables rapid prototyping of new or improved versions.
Organ virtualization is also the subject of digital twins. The French company Dassault Systèmes has carried it out through the Living Heart project, which allows cardiological research with 3D in silico models from conventional scanners.
Patient simulation
The application of digital twins to patient simulation allows progress in personalized therapies and the identification of anomalies by combining information from other patients with similar characteristics. It can also help improve prevention by simulating the effects of the passage of time on various hypotheses of healthy habits. Thus, for example, a wearable sensor could monitor blood pressure and associate it with adherence to medication, diet, lifestyle habits and genetics. All of this information would help suggest changes in the medication plan and behaviour to optimize the individual's health.
The telemedicine company Babylon Health applies it as part of the family medicine services it offers in the United Kingdom. Based on a health questionnaire about diseases suffered and current physical activity habits, it represents a digital twin of the patient that allows exploring the health and risk factors of organic nature of twenty diseases from the exploitation of millions of data collected. Its use is intended to provide health information for the patient, in no case to diagnose.
Systems Simulation
In the field of management and planning, the simulation of care systems is especially attractive. A digital twin of a centre or a healthcare network could provide clues for better decision-making with results in population health. The experience of the COVID-19 pandemic is a good example of how systems simulation could have helped to better manage the bottlenecks experienced in primary care, emergencies or hospitalization units.
To simulate health systems, electronic medical records and the use of AI are essential travel companions. The former has been available for years, although with difficulties in their aggregation and semantic interoperability, which makes the application of AI difficult. For this reason, it is not surprising that system simulation experiments are in an embryonic phase, such as the HospiT'Win project.
The development of control towers for monitoring surgical areas or hospital centres is an appropriate field of application for digital twins, simulation and optimization of care processes; by managing information from a single centre, the problems of information availability become insignificant.
Digital twin technology will make it easier for providers and health systems to approach the needs of patients individually and also by population. Its potential to improve the patient experience and the overall efficiency of the system will mean a true digital transformation if the value of the data is firmly committed.
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