2. There is a growth of Medical Cyber-Physical Systems (MCPS), basically resulting from the interconnection of several devices and systems in the medical landscape. As these devices and systems become smarter, able to acquire, process and make sense of data (through artificial intelligence) they are playing a bigger role in healthcare decision making process. Part of these devices, by the way they deal with data, can be considered as being composed by a hard and a soft part, atoms and bits, and the soft part can be seen as a digital twin (may be in its infancy). The creation of a person digital twin would fit nicely in this scheme, with the PDT acting as an interface between the person and the MCPS. An alternative way of seeing this would be to consider the PDT as an integral part of the MCPS. Whilst a first stage of PDT (simple mirroring of the person’s health data) would better fit the interface role, more advanced stages (3 and even more 4) would become part of the MCPS. In other words, the PDT may be one of the several components of a MCPS.
This is possibly an oversimplification of the articulated comment I received from Louis Nisiotis, Sheffield Hallam University, but it is a useful one since it points out the potential issues in the integration of PDT at societal level. Whilst the first “architecture” provides for a clear separation between a PDT and the rest of the world (the personal space is fully preserved and it may be up to the PDT/rules of the game what to disclose) the second architecture no longer separates the PDT from the overall systems. On the contrary, the system is defined as the collection of all PDTs integrated with the healthcare system. The advantage of this architecture is the possibility to have each PDT contributing the the whole system, as a matter of fact the system status is the tuple including all PDT status among other things (like available healthcare resources). This would immediately allow detection of epidemic patterns as well as steer the counteraction in ways that balance resources with needs.
Independently of the architecture chosen, the comment pointed out several advantages of creating PDT and having them interacting with the healthcare system, such as:
- effortless (or at least low cost) monitoring of people through their digital twins
- real time /almost real time feedback on actions taken on the physical persons through data collected and shared via their PDT
- red labelling/flagging those PDT that may be critical (either infected or getting too close to infected people) for specific monitoring
- development of services targeting infected people through their PDTs creating specific virtual communities
- providing direct access to support services, thus creating a triage in the cyberspace
- supporting a more efficient use of resources based on the effective need dynamically monitored and balanced against competing needs and resources availability
By having the PDTs part of the overall MCPS landscape (second architecture) it becomes possible to get the overall pulse of the healthcare system, segmented if needed in areas, and predict the possible evolution taking appropriate actions.
The healthcare game is played in a field where actions are constrained by several factors, resource availability, cost, ethical and societal consideration, Being able to get the broad picture does not necessarily solve all issues but can provide a factual field for taking informed decisions and, most important, to evaluate the result of those decisions and learn on the way.