How digital twins can help heal Canada’s healthcare system

By Jean-Pierre Rivard

Rising demand, tight budgets, aging population: our healthcare system is facing complex challenges. Common to solving all of them, however, is data. With accessible real-time data, hospitals can make better decisions, keep vital equipment running, and save money in the process. That’s exactly what digital twins have the potential to offer—yet implementing them successfully depends on how well we can integrate the needs of providers, practitioners, and patients alike.

Our healthcare system is facing a matrix of urgent problems. Some old facilities are struggling to conform to today’s standards and are increasingly falling short of patient expectations. A lack of coordination leaves hospitals unable to get the right balance of staff. Failing medical equipment adds to the burden of backlogs and disappointment. And these ongoing problems impact the public who rely on hospitals and inevitably risk damaging patient outcomes.

Yet the broader context is making this even more pressing. Between 2005 and 2020, Canada’s healthcare expenditure more than doubled, and is continuing to rise. Canada’s aging population will only put more pressure on the system, and growing sustainability requirements will challenge hospitals to reduce their carbon footprint. Unless our healthcare system becomes more efficient, it won’t be able to meet these challenges.

Fundamental to all of these issues is a lack of data. To transform, our healthcare system we must improve decision-making across the board. Better, more accurate, and more far-sighted decisions depend on better data.

Data can enable hospitals to identify and eliminate inefficiencies, replace sub-optimal maintenance regimes with targeted interventions, and deliver a better patient experience. Yet it’s not straightforward. How we undertake digitizing hospitals and healthcare will determine the extent of the benefits.

Twin to win

Digital twins are virtual replicas of a physical system powered by real-time data and predictive analytics. They can simulate different scenarios so hospitals can anticipate and solve problems before they arise.

In the event of a fire, for example, it is not always possible to evacuate patients quickly as some may be in dire situations and not mobile. Because of this, code and regulations require there be areas of refuge in hospitals equipped with proper ventilation systems that allow for these areas to be smoke-free for a period of two hours to enable organized patient assessment. Information extracted from a fire simulation done via digital twins can ensure that this system meets requirements during this two-hour window and enables patient evacuation. A similar simulation could also be done in the case of an underground parking lot to ensure carbon dioxide emission is at a safe level during peak hours or that ramps are de-iced properly in winter to avoid collisions.

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From supply chains to staff rosters, maintenance schedules to future investments, digital twins allow hospitals to test a variety of potential pathways, allowing them to make more informed decisions. By leveraging this power, hospitals can transform their operations, create efficiencies, enhance decision-making, shrink costs, and ultimately elevate patient care.

This technology isn’t a ‘nice-to-have.’ Rather digital twins contribute directly to success on the ward. For example, surgical rooms for brain surgery are now equipped with MRI systems so practitioners can use imaging to better treat the patient. These systems are thus highly critical, and if they shut down during a surgery, the consequences could be catastrophic. Even if they break down after hours, surgeries may have to be postponed or rescheduled at another care center, putting even more pressure on the healthcare system.

MRI scanners are not a special case, but a prime example of hospitals’ vulnerability. Hospitals depend on their equipment. Preventing breakdowns depends on maintenance, but most hospitals’ maintenance regimes are reactive.

Digital twins can give hospitals the real-time, holistic insights they need to optimize their maintenance and reduce downtime. Digital twins can flag problems before they cause breakdowns, allowing hospitals to replace this ‘fix on fail’ approach with preventative maintenance—reducing costs and increasing patient satisfaction.

Moreover, digital twins allow hospitals to base their maintenance schedules around criticality, instead of around generic timeframes. Generic maintenance schedules, where assets are routinely checked after a fixed amount of time, tend to be wasteful, either enforcing unnecessarily frequent checks or by leaving it too long and risking asset failure. For vital or irreplaceable equipment that impacts the lives of patients, the price is simply too high.

Instead, maintenance can be based on criticality, where data-based insights enable critical equipment to be maintained more regularly. Equipment with low per-capita ratios (like MRI scanners) can be kept online with efficient, effective, and proactive maintenance.

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MRI scanners are not a special case, but a prime example of hospitals’ vulnerability. Hospitals depend on their equipment. Preventing breakdowns depends on maintenance, but most hospitals’ maintenance regimes are reactive.

Digital twins can give hospitals the real-time, holistic insights they need to optimize their maintenance and reduce downtime. Digital twins can flag problems before they cause breakdowns, allowing hospitals to replace this ‘fix on fail’ approach with preventative maintenance—reducing costs and increasing patient satisfaction.

Moreover, digital twins allow hospitals to base their maintenance schedules around criticality, instead of around generic timeframes. Generic maintenance schedules, where assets are routinely checked after a fixed amount of time, tend to be wasteful, either enforcing unnecessarily frequent checks or by leaving it too long and risking asset failure. For vital or irreplaceable equipment that impacts the lives of patients, the price is simply too high.

Instead, maintenance can be based on criticality, where data-based insights enable critical equipment to be maintained more regularly. Equipment with low per-capita ratios (like MRI scanners) can be kept online with efficient, effective, and proactive maintenance

By collecting and storing data in a single place, digital twins make maintenance itself a much easier process. For instance, on-site operators who visit hospitals for maintenance purposes can find the information they need much more easily. Rather than being dispatched, locating the drawings and parts list, and confirming warranties—all of which may reside in different places—they have a one-stop shop for all the data they need to do their job. If you’re repainting 10,000 rooms in a single hospital, and each room or wing has its own instructions, the amount of time spent retrieving and confirming the instructions alone can seriously damage efficiency.

With a digital twin database, maintenance staff can be sure of accurate, up-to-date, and easily retrievable information, speeding up maintenance while driving costs down, and freeing up hospital budgets to be spent where it really matters. Gradually, digital twins can help improve how budgets are managed and allocated, through improved predictions of future needs or more accurate insights into whether equipment should be refurbished or replaced. Digital twins could also be used to predict patient flow and ensure proper staffing—meaning less waste and more value for money for taxpayers.

Heal and grow

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Digital twins can establish continuous improvement: data can be fed back into the system, enriching decision-making with greater insights, and paving the way for transformative change. By revealing not only the condition of individual assets but the interaction between different systems, digital twins can reveal the hidden forces generating these issues within the systems, causes which are not always obvious and which are often indirect. These unknowns can yield efficiency gains that were not thought possible. Although these are incremental changes, they add up to a greater transformation. Our healthcare system is ultimately about people and their communities, and digital twins can revolutionize how patients relate to and receive care from their hospitals.

One of the biggest barriers to efficiency is fragmentation, and Canada’s healthcare system is highly fragmented. What happens in one part of Quebec is different from another, and both are worlds away from healthcare in Ontario or British Columbia. Adopting digital twins is the first step towards breaking down these siloes, sharing best practice, and catalyzing improvement across the board. Sharing data from different facilities allows healthcare professionals to identify broader trends through bigger data sets.

Taking our medicine

As global challenges grow more complex, we must enhance traditional, linear processes so that they’re capable of confronting this complexity.

Digital twins are powerful tools that can be used to fully optimize maintenance and significantly reduce sudden breakdowns and costly patient transfers. The technology can also provide valuable, holistic insights to predict patient flow and ensure proper staffing. Its success depends not on the technology itself, but upon its integration.

Historically, our sector has been slow to adopt new technology, and the challenges of digitalization are numerous. Yet many companies are moving full speed ahead with the use of digital twin technology in a wide range of projects. With the right balance of skills, integrated, multidisciplinary teams can embed digital innovation successfully and help revitalize Canada’s healthcare system, so that it’s fit for the future.

Jean-Pierre Rivard is Lead BIM Manager M&E – Canada, with AtkinsRéalis.

[This article originally appeared in the January/February 2024 edition of ReNew Canada]

Featured image: Digital twins give hospitals the real-time, holistic insights they need to optimize their maintenance and reduce downtime. (Getty Images)

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