Requirements for a Digital Twin for an Emergency Department

Abstract

The Emergency Department (ED) represents the first stage of the path for some patients in a hospital. The JUNEAU project aims to propose a Digital Twin (DT) for the ED to both visualise the service behaviour in quasi real-time, forecast and anticipate its behaviour to control the "Emergency throughput time" indicator. This DT will be centred on the "patient pathway" view, which needs to first precise necessary data and information and decision support. The project will tackle this issue with a particular attention on exploring the DT architecture (with the help or holonic architecture), on coupling centralised and decentralised approaches to obtain a model as close as possible to the system dynamics and on managing DT evolution in a complex environment.

Digital Twins in Software Engineering—A Systematic Literature Review and Vision

“…Ahmadi et al [55] discuss the role and evolution of humans as they interact with recent technologies and how future skills might fit with existing roles differently. The complexity of the DT model design and interpretation 8 [30,38,40,48,56,76,81,99] Bias, Coding bias 2 [14,60] Total analyzed articles 94 -Data quality: Incomplete documentation, binary data, accurate historical data on assets, cold starts, dark data, and siloed information cannot be collected appropriately.…”

A Systematic Literature Review of Digital Twin Research for Healthcare Systems: Research Trends, Gaps, and Realization Challenges

“…Twinning in the context of a healthcare facility usually aims process improvements through staff schedule optimization, capacity planning, and enhancing workflows; in units such as emergency departments [187], [201], [202], intensive care units (ICUs) [134], [173], [203], operating room [163], [171], hemodialysis unit [96], ventilation unit [186], hospitals [97], [110], [166], [192], [194], [195], including services provided within these facilities. An ICU DT was developed for the investigation of the real-time allocation of ICU resources and was validated through real medical ICU data [203].…”

“…In a tele-ICU context, a novel extensive simulation framework for human-robot interaction was proposed [134]. Some researchers discussed the requirements of building DT architecture for an emergency department (ED) of a hospital capable of visualizing the service behavior in quasi-real-time and forecasting ED throughput time [201]. DT applications in the operating rooms (ORs) context were also explored [171], particularly in monitoring the air quality, the performance of the HVAC system, and how they affect the MRI machine performance within the OR.…”

Exploration of (De-)centralising Scheduling in an Emergency Department

“…The ED is an important part of the healthcare system because it provides initial, immediate and essential medical care to patients. It has the difficult task of providing 24-hour emergency services, offering good quality service and ensuring that valuable resources are well-utilised [1,4]. However, at the same time, it is the most overcrowded component because it faces a dynamic and large number of visits of patients, but has limited manpower [7,9].…”

“…An ED is a main and complex part in the healthcare system as it provides first-level and immediate care to patients. The decision-making process in EDs for managing operations is complex due into limited resource availability, dynamic and uncertain patient entry flow to ED, and stochastic and multi-stage patient treatment [1,7,4]. The decisionmakers have to make sure that the decisions guarantee good quality of care for patients and improve their pathway [10,4].…”