How the EU wants to use digital twins for healthcare

The European Commission is planning the digital healthcare of the future with virtual twins. Lisbet Geris, Professor of Biomechanics and Computational Tissue Engineering at the University of Liège and the KU Leuven, provided an insight into this at the GenomDE Symposium organized by the TMF. Geris is the coordinator of the EU-funded "Ecosystem for Digital Twins in Healthcare" (EDITH) initiative, which aims to establish a network for virtual human twins (VHT) in the healthcare sector.

"When we talk about digital twins in medicine and healthcare, we use a much broader definition," says Geris. Unlike in industry, for example, where digital twins depict real objects in real time, in medicine they are understood to be personalized models of biological systems - such as cells, organs or entire organisms. These models are based on individual patient data such as genome sequences, imaging, disease progression or vital parameters and can be used, for example, to simulate the effects of medication or to plan operations. Among other things, this should support individual diagnoses, therapy decisions, and clinical studies.

"We will not only have one digital twin, but a series of our own digital twins. These can be twins of cells, tissues, organs or an entire system – but also twins of the therapy used," explained Geris. The areas of application are diverse: from blood sugar regulation and the optimization of inhalers to the digital replication of the heart ear in patients with atrial fibrillation – wherever personalized predictions can help to improve therapies or minimize risks. Back in 2018, the US Food and Drug Administration (FDA) approved a pacemaker electrode from Medtronic, which, according to Geris, was only approved after animal testing and virtual simulations. This not only saved costs, but also time.

European infrastructure under development

With the establishment of the VHT program, the EU now wants to bundle the previously highly fragmented projects. The aim is to create a scalable, interoperable infrastructure with a data and model repository as well as a simulation platform that enables access to distributed data sources (such as the European Health Data Space) and supports the validation of new digital twins. The platform is not intended to collect data itself, but to access existing data spaces as a federated system.

A central concern is to ensure the credibility, transparency and ethical compatibility of digital twins. This includes data protection, the explainability of AI models, the protection of personal identity and the early involvement of patients. To this end, comprehensive information materials and focus groups have been developed to create trust in the technology.

Lack of binding standards

Despite great progress, there are still many technical, regulatory and social challenges, explained Geris. There is a lack of binding standards, many national initiatives work in parallel and are not interoperable, and legal issues – such as liability or the use of synthetic data – are still unresolved. The EU has therefore worked together with science, industry, clinics and patient groups to develop a roadmap with 30 recommendations for action, which will be published soon.

The Virtual Human Twin initiative is part of a larger European strategy that aims to integrate digitalization, biomedicine and artificial intelligence more closely. According to forecasts, the market for medical digital twins will grow strongly in the coming years. The hope is for better, faster and more individualized medicine – from diagnostics to therapy planning. The next few years will show whether digital twins can actually establish themselves as a standard tool in healthcare.

(mack)