Will Rise of The ‘Digital Twin’ Change Today’s Medicine?
Technology and healthcare intersect in a variety of ways today, and their relationship has been quite fascinating over the course of time. The roots of technological advancement for healthcare purposes and the improvement of patients’ lives date back to the days of ancient Egypt when the first known use of prostheses is believed to have begun.1
Interestingly, the adoption of advanced technology in healthcare has also occurred for reasons that go beyond patient care. In 1816, French physician René Laennec was credited with inventing the first stethoscope. The impetus for his desire to become more intimate with the sounds in a patient’s chest, however, reportedly included not wanting to place his ear directly on the bare chest of women2 as much as it did being able to more accurately detect and diagnose conditions impacting the heart and the lungs. The modern era in preventive medicine is said to have started with Louis Pasteur’s discovery of the role of living microbes as the cause of infections in the mid-19th century, and by the close of the century, the principle of insect-borne transmission of disease had been established.3
Today, preventive medicine looks drastically different, even if it is intended to accomplish the same goals as centuries ago. (A crucial added incentive for today’s providers is to meet patient satisfaction demands,4 especially in a system that is driven now by care quality.) One of the more high-level examples of how technology, specifically digital technology, is continuing to complement the delivery of healthcare and improve the prognosis and outcomes of many patients with acute and chronic conditions, is the “digital twin,” a subset of the burgeoning Internet of Medical Things (IMOT).5 First coined in 2003 when digital representations of physical products were still in their infancy,6 Defined as a digital replica of a living or non-living physical entity, for example, Google Maps is a digital “twin” of roadways and personal digital avatars are digital twins of actual people,7 these types of software concepts are expected to serve as proxies for billions of patients and patient-required health monitoring devices by the end of this decade, according to the Alliance of Advanced BioMedical Engineering, an initiative of the American Society of Mechanical Engineers that is designed to stimulate biomedical innovation by bringing together and providing resources to the biomedical engineering community. In a recent interview with Colibri, Charles Alessi, chief clinical officer, international, with the Healthcare Information and Management Systems Society (HIMSS), a global nonprofit organization that advises and provides thought leader support for the transformation of the health ecosystem through information and technology, said that digital twin technology partly represents what might be one of the internet’s greatest benefits to healthcare as it relates to preventative medicine, which is considered to be the key point to further medical advancement globally.
Here, we offer a glimpse of some examples of emerging digital twin technology.
The Stanford Living Heart Project (LHP)
Originally launched as a five-year project with the U.S. Food & Drug Administration in 2014, the LHP8 deals with the simulating of cardiac arrhythmia that can be an undesirable and potentially lethal condition linked to side effects of various drugs. With the process by which pharmaceutical companies must assess for the risk of potentially induced arrhythmias by drugs before taking years to perform before such drugs reach the market and the costs associated with animal and human studies being great, the LHP developed a software tool to enable drug developers to quickly assess the viability of new compounds through the use of a simulated, real-life heart. In 2017, the project earned an industry award for innovation.9
‘Enhancing Cardiac Care Through Extensive Sensing’ (ECHOES) Project
Researchers at the University of Sheffield in the United Kingdom are working on a project that will implement the latest available sensing technologies and machine learning in an attempt to provide real-time insights to physicians doctors tasked with identifying patients who are at high risk of heart disease. According to a recent report, the initiative could transform how cardiovascular disease is diagnosed and treated while giving patients real-time support to monitor their health alongside the care they receive from their doctors.10 The ‘ECHOES project will reportedly bring together international academic and industrial partners to develop accessible wearable technology that can be used to capture the experiences, symptoms, and cardiovascular data of an individual during activities of daily living.
A research consortium of experts in cardiovascular medicine, science, engineering, and computer science will develop the technology, which will also incorporate artificial intelligence techniques and analytical data to create a digital twin of a patient’s heart to transform the diagnosis, monitoring, and treatment of heart and circulatory to create.0
Tradeoffs To Life-Saving Technology
As with anything, there have been some identified complications associated with the growing trend of digital twin technology.11
Existing concerns include the “digital” definition of normal and that what is considered to be “normal” for one patient may not hold true for different patients or different populations of patients. Ethical and societal implications will also remain a fluid topic, including the potentially limited availability of technology across different populations.
The impact on privacy is also yet to be fully realized as an ethical issue itself.
European Startup Brings Digital Twin to Phone App
Babylon Health, a United Kingdom-based health services startup, has reportedly agreed to a 10-year deal with the city of Wolverhampton in England to provide an integrated digital health app for 300,000 people that will provide remote diagnoses; live monitoring of patients with chronic conditions; connect people with doctors and other providers remotely; and allow patients to access their medical records and review consultations, schedule appointments, renew prescriptions, manage their rehab after a healthcare visit, and view a digital twin of their own state of health based on medical history and other details.12
- Artificial toes from ancient Egypt confirmed as the world’s oldest prostheses. MedGadget. 2012. Accessed online: www.medgadget.com/2012/10/artificial-toes-from-ancient-egypt-confirmed-as-worlds-oldest-prostheses.html
- Lipman S. A brief history of health technology. RockHealth. 2012. Accessed online: https://rockhealth.com/a-brief-history-of-health-technology
- Preventive medicine. Encyclopedia Britannica. 2020. Accessed online: www.britannica.com/science/preventive-medicine
- Thotathil S. Digital twins: the future of healthcare delivery and improved patient experience. Becker’s Health IT & CIO Report. 2020. Accessed online: www.beckershospitalreview.com/healthcare-information-technology/digital-twins-the-future-of-healthcare-delivery-and-improved-patient-experience.html
- Darrah J. The “things” that our internet can do for our healthcare. Colibri Elite Learning. 2019. Accessed online: www.elitelearning.com/resource-center/health-systems-management/the-things-that-our-internet-can-do-for-our-healthcare
- van Houten H. The rise of the digital twin: how healthcare can benefit. Philips.com. 2018. Accessed online: www.philips.com/a-w/about/news/archive/blogs/innovation-matters/20180830-the-rise-of-the-digital-twin-how-healthcare-can-benefit.html
- Your personal artificial intelligence. ObEN. 2017. Accessed online: https://oben.me
- Baillargeon, Rebelo N, Fox DD, Taylor RL, Kuhl E. The living heart project: a robust and integrative simulator for human heart function. European Journal of Mechanics A/Solids. 2014;epub. Accessed online: https://biomechanics.stanford.edu/paper/EJMSOL14.pdf
- The Stanford living heart project wins prestigious HPC awards during SC17. HPCwire. 2017. Accessed online: www.hpcwire.com/off-the-wire/stanford-living-heart-project-wins-prestigious-hpc-awards-sc17
- Sheffield team to create a ‘digital twin’ of the human heart. Express Healthcare. 2020. Accessed online: www.expresshealthcare.in/news/sheffield-team-to-create-a-digital-twin-of-human-heart/416503
- Raden N. Digital twins for personalized medicine – a critical assessment. Diginomica. 2020. Accessed online: https://diginomica.com/digital-twins-personalized-medicine-critical-assessment
- Lunden I. Babylon health is building an integrated, AI-based health app to serve a city of 300K in England. Tech Crunch. 2020. Accessed online: https://techcrunch.com/2020/01/22/babylon-health-is-building-an-integrated-ai-based-health-app-to-serve-a-city-of-300k-in-england