Picture the scene in the emergency department of a typical acute Irish hospital at 10pm on a Friday.
Ambulance crews deliver the injured and unwell for treatment. Triage nurses race to prioritise those in need of medical attention; porters transfer patients from the ED up to the wards.
Multidisciplinary medical teams work to examine, order tests, diagnose, prescribe and treat. It’s hectic, the medics progress through the queue but, at times, delays are extensive. Last year, Ireland’s emergency departments recorded a total of almost 1.58 million attendances – up 8 per cent on 2023 activity.
Healthcare professionals constantly analyse their processes and strive for greater efficiency. Now, new tools are emerging that can analyse processes in ways that don’t interfere with the work at hand, crunching vast data to offer better solutions.
Amid much conversation about AI and how it can best be applied in all fields of life and work, the concept digital twinning – which has been applied with great success to everything from designing an aeroplane to monitoring the efficiency of a power station – has significant potential for use in healthcare.
A digital twin is a highly detailed virtual copy of something real – a machine, a hospital, a human organ, even an entire healthcare system. It’s continuously updated with real-world data to reflect the behaviour of the original, allowing you to test, tweak and explore “what-if” scenarios without disturbing the real thing.
Engineers use them to see how a plane engine performs in a storm. In healthcare, they model how a treatment, workflow or policy might play out in practice. Just as a hurricane tests a plane more than turbulence, a pandemic tests healthcare systems.
Dr Mary Coghlan.
Digital twins let you model these extraordinary events through hospitals, supply chains and communities – before they happen. They’re particularly valuable in healthcare, where change is high-stakes and expensive.
Rolling out a new initiative takes years and potentially hundreds of millions of euros.
From hospital systems to heart valves
Digital twins accelerate a return on investment. By testing potential reforms virtually first, they help target limited funding to interventions most likely to deliver real benefits.
For example, Gloucestershire Hospitals NHS Foundation Trust (UK) built a digital twin of two hospitals to model emergency and elective journeys in real time. This enabled the hospital to simulate operational changes – such as ward closures, staffing adjustments or patient surges – in a risk-free environment and test interventions to see which would have the greatest impact on bed utilisation and queue times and reducing bottlenecks.
Digital twins are also increasingly being used to provided more personalised medical information. For example, HeartFlow technology can generate a 3D model of a patient’s coronary arteries from CT scans to simulate blood flow, while Philips’s HeartNavigator uses a patient-specific digital heart model for surgical planning and simulation of transcatheter valve procedures.
What it takes to build digital twins
Implementing digital twins requires strong data infrastructure, skilled teams and collaboration across health, academia and industry. These requirements may sound demanding, but they are also what make digital twins such a strategic investment: once the foundations are in place, the benefits compound across multiple use cases.
Ireland has made welcome progress in the last couple of years with hard-won improvements in managing patient flow, capacity and discharge planning showing what can be achieved. Huge credit is due to senior health leaders in this respect as well as all staff working in the sector. However, much of this progress has depended on manual interventions – daily meetings taking up valuable time, long hours from dedicated staff and a fair amount of firefighting in real time.
Digital twins could build on that progress, automating processes and embedding foresight and predictive capability directly into the system.
1) Local twins: hospitals and operations
Imagine a digital twin of a busy emergency department such as in Beaumont or Cork University Hospital. A well-built digital twin of the ED could identify early warning signals – for example around discharge timing, diagnostic availability or porter scheduling – in a way that points to the required solution and enable proactive intervention before issues materialise, turning crisis management into proactive data-informed decision making.
2) System-level twins: national health planning
What if we had a digital twin of the entire HSE or the national health ecosystem? Such a model would be a strategic national asset, built in bite-sized chunks: start with hospitals, expand to primary care, layer in community services and knit the pieces together. Scaling this nationally would let Ireland model and anticipate the impact of, for example, demographic shifts, new technologies and evolving care needs. Our relatively compact system and vibrant technology and life sciences sector position us to be global early adopters.
3) Population-level twins: public health planning
Another exciting horizon is the application of digital twins to population-based planning. Imagine being able to model the long-term health impacts of interventions such as obesity prevention programmes, smoking cessation campaigns or vaccine roll-outs. A population-level digital twin could simulate how these changes ripple across decades – identifying not just clinical benefits but also cost savings, productivity gains and reductions in health inequality.
4) Patient-level twins: personalised medicine
In the clinical domain, personalised medicine is an exciting frontier for digital twins. Digital twins of organs or entire human bodies are being trialled internationally to tailor treatments in areas such as cardiology and oncology. This application leans heavily towards life sciences and pharma rather than hospital operations. But that plays to Ireland’s strengths. With our world-class footprint in pharma and medtech, we are well positioned to be at the forefront of digital twin – enabled personalised medicine.
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Moving from firefighting to foresight
Digital twins can’t see patients or clear waiting lists, but they can arm decision makers with rich insights. By letting us rehearse healthcare decisions they could help Ireland move from health system firefighting to foresight.
[ Hospitals’ wait-time performance ‘a concern’ says Minister as flu pressure mountsOpens in new window ]
By moving step by step from individual hospitals to the entire healthcare system, from population planning to personalised medicine, if we become early adopters of what digital twins can deliver, we can place Ireland at the forefront of this global opportunity.
- Dr Mary Coghlan is a partner at EY Ireland, where she leads on health data and analytics. She is a qualified medical doctor, actuary and analytics expert who supports organisations to use advanced health analytics to support better health outcomes for populations