I recently gave a talk about digital twins in a short course on Digital Health. I was surprised at how much interest and animated discussion my talk garnered among the attendees who came from 30 different countries. Everyone was interested in the future of healthcare that digital twins could potentially open. At the break, one person came up to me to ask the question that was on her mind: “will my digital twin be able to make healthcare decisions for me?” she wondered. I responded, “would you want it to?”

Imagine having a virtual version of yourself—a “digital twin”—that monitors and tracks your health in real-time using data collected by wearable devices, medical records and genetic analysis. Your virtual avatar could notify you of potential health risks, suggest lifestyle changes and even book doctor appointments for you – thanks to advances in artificial intelligence and machine learning these digital twins could transform healthcare by providing treatment plans and preventive measures tailored just for you. This digital doppelgänger could revolutionize how we approach healthcare, potentially making health decisions for you. But how close are we to this reality, and what does it mean for your future healthcare?

What is a Digital Twin?

A digital twin is a virtual representation of any physical entity (person, process, system) which provides insights, predictions and optimization opportunities. As artificial intelligence and data analytics continue to progress, having digital twins involved in healthcare is becoming more realistic.

The notion of `digital twins’ was first coined by Michael Greaves in 2002, who introduced it as a concept underlying the Product Lifecycle Management at a conference and later published a book, Product Lifecycle Management: Driving the Next Generation of Lean Thinking (McGraw-Hill, 2006) describing his ideas in more depth.

The creation and implementation of digital twins depends on several technologies and tools working in sync behind the scenes including AI, the Internet of Things, cloud computing and augmented and virtual reality, along with application programming interfaces (aka APIs) that use sets of defined protocols and definitions to allow the different software to communicate or `talk’ to each other. To understand how APIs work, think about how the weather application on your smart phone `talks’ routinely to the National Weather Bureau’s daily weather data.

Digital twins technically preceded their naming by about 32 years! Without calling it digital twin technology, NASA started using the concept in the 1960s. Indeed, a series of 15 sophisticated physical simulators at Mission Control in Houston that duplicated the physical systems of Apollo 13 in space made all the difference in the daring rescue operation of Apollo 13 in 1970, when an explosion in the oxygen tanks crippled the spacecraft and sent it careening off its course deeper into space.

Although AI, “the Internet of Things”, APIs, virtual/augmented reality, and cloud computing technologies did not exist and were not used, NASA did deploy cutting-edge telecommunications technology to communicate with its spacecraft. Using two-way data transfer, NASA updated the simulators to represent the status of the disabled spaceship.  Mission control dispatched the backup crew to practice the manoeuvres on the simulators, and to cut a long story short, several issues were resolved, and the astronauts returned to Earth safely thanks to simulator digital twins.

From manufacturing and aeronautics to agriculture and urban planning, digital twins are providing real-time insights and predictive analytics across industries today. For those interested in a concise historical perspective, Susanne Gold has published a nicely written short history of digital twins complete with stunning photos.

The Benefits of a Digital Twin in Healthcare

In healthcare, a digital twin is a sophisticated, data-driven model that represents an organ (cardiac digital twins are among the most advanced to date), tissue, or……an individual’s body. It’s built using various sources of information, such as medical records, genetic data, and real-time health monitoring from wearable devices. This virtual replica can simulate how your body responds to different treatments, predict health outcomes, and help in making informed medical decisions.

Embracing the concept of a digital twin requires a shift in how we perceive healthcare—from reactive to proactive, from one-size-fits-all to highly personalized. First and foremost, we must understand the advantages that digital twins could bring to healthcare. Their capacity to simulate various health scenarios based on real-time health data forms the basis for personalized medicine solutions that tailor healthcare specifically to individual patient needs, thus minimizing treatment uncertainty and improving experiences for all involved.

Imagine suffering from chronic illness and having your digital twin analyze your health patterns, compare them with thousands of clinical trials, develop an appropriate treatment plan and even predict potential crises beforehand – this could revolutionize how chronic illnesses are managed by providing more targeted, efficient and pre-emptive care.

The concept of digital twins is still evolving, with ongoing research and technological advancements. Here’s what the future might hold, in a nutshell:

• Precision Medicine: Your digital twin can test treatments in a virtual environment before they are applied to your body. This could help healthcare providers tailor therapies to your unique physiology, improving effectiveness and reducing side effects.
• Preventive Care: By continuously monitoring your health data, a digital twin can detect early signs of diseases, enabling pre-emptive measures. For instance, it might identify subtle changes that signal the onset of diabetes or cardiovascular issues long before they manifest physically.
• Enhanced Diagnosis: With comprehensive data integration, your digital twin could help healthcare professionals pinpoint the root cause of symptoms more accurately and swiftly, reducing the trial-and-error approach often seen in current diagnostic processes.
• Accessible Technology: For digital twins to become mainstream, they need to be accessible and user-friendly so that their benefits may be extended to all. Wearable devices, health apps, and telemedicine will play a significant role in gathering and utilizing health data.
• Collaborative Healthcare: The future of healthcare will increasingly become a more collaborative effort between patients, healthcare professionals, and digital tools as imagined by many @Society for Participatory Medicine. Your digital twin will be a trusted partner in maintaining your health, working alongside you and your healthcare team.

Tread Carefully

While the idea of digital twins to improve healthcare outcomes may be exciting, they also present ethical and regulatory concerns which must be carefully considered as we navigate our way through digital healthcare. Digital twins’ future in healthcare depends on our decision to accept and regulate this technology responsibly. If implemented carefully and responsibly, digital twins could substantially enhance patient outcomes, lower healthcare costs, empower individuals to take control of their own health management, as well as facilitate self-monitoring of outcomes and costs. However, we must tread with care to address ethical and privacy implications associated with this emerging tech.

Who will have access to sensitive data? And how will it be protected against misuse or exploitation?

Digital twins rely heavily on data, raising serious privacy and security concerns. While there are laws protecting patient health information, digitization and the increased use of tech innovations like digital twins make data breaches more likely – thus making ensuring cybersecurity of digital twins even more important. Data privacy should always be of great concern when working with vast amounts of personalized data. The creation and effective utilization of digital twins would require stringent data protection measures as well as rigorous safeguards to gain patient trust; healthcare providers entering this sector should prioritize balancing technological advantages with upholding patient privacy safeguards to secure patient trust.

Trust is critical in healthcare decisions made using digital twins. Digital twins could provide inaccurate predictions due to incorrect data input or programming mistakes; or simply because health can be unpredictable and unpredictable outcomes may arise from healthcare decisions made using such models. Who would be held accountable if an incorrect healthcare decision is made using such an application: the patient trusting their digital twin or healthcare providers?

Future prospects of digital twins in healthcare will likely include an intersection between human expertise and artificial intelligence. What role could digital twins play in the doctor-patient relationship? Although digital twins may provide valuable insights and aid decision-making processes, it’s crucial that they be used as tools that complement rather than replace the expertise and judgment of healthcare providers. Importantly, it’s crucial that we strike an appropriate balance between using digital twins for improving healthcare outcomes and giving patients control of their medical decisions.

As researchers continue their explorations of digital twins for healthcare purposes, it will be essential for patients to be included in the development and implementation processes to ensure their needs and preferences are considered. These are important concerns which we must carefully reflect on as we navigate this brave new world of digital healthcare.

Digital Twins and Healthcare Decision Making

Let’s get back to the question that I was asked: “Will my digital twin be able to make healthcare decisions for me?”

Let’s examine how a digital twin can assist healthcare decision-making first. Technically speaking, its goal is not to direct you or make choices on your behalf, but instead give a complete, real-time picture of your health using personalized data. Healthcare professionals and patients can use digital twins to understand the current state of their health based on historical and real-time information; providing insights that enable proactive healthcare decisions while anticipating potential health issues before they become serious.

Advanced predictive modeling can forecast outcomes of potential treatment paths to assist both you and your healthcare provider in making informed choices; your digital twin contributes to healthcare decision making but does not replace human involvement as part of healthcare decision-making processes. Your digital twin can assist in helping you maintain a healthier lifestyle by monitoring vital signs, tracking exercise sessions, monitoring sleep cycles, and reviewing nutrition plans; providing feedback and suggestions when needed. In this way, the digital twin provides informed advice rather than simply prescribing measures.

As for the provocative question I asked – “Do You Want It To?” – answers can vary greatly from person to person. In my research, I have found that when making decisions about any new technology, people and groups make decisions about how they interface with the new tech depending on the context and specific circumstances (including different disease states), as well as what they believe they might have to gain.

Personal preference plays an integral part in determining how much reliance an individual places on technology versus personal judgement or professional advice from healthcare providers, while trust issues arise: how much faith should one have in an electronic representation of ourselves when our health and well-being may be at stake?

So while digital twin technology may be fascinating and its potential immense, its true purpose should not be seen as replacing personal agency with artificial intelligence. Instead, its primary function should be empowerment: digital twins provide healthcare providers and patients with personalized data as well as predictive capabilities to make more informed healthcare decisions and preventive healthcare interventions. Ultimately it depends on us how best we leverage this technology.

As technology develops and our understanding of how digital twins can enhance healthcare evolves, patients and healthcare providers must remain aware and involved in discussions regarding the role technology can play in medical care and its effect on healthcare decisions. Only through thoughtful consideration and open discussion can digital twins in healthcare be implemented responsibly and ethically.

So, will your future digital twin make healthcare decisions for you? Not entirely—but it will certainly help you make better, more informed choices for your health. And that’s a future that’s worth looking forward to.

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