Towards Digital Twins in Healthcare

How would a meaningful Digital Twin for the user look like?

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Healthcare is starting to change fundamentally. One of the disruptive technologies that can be seen as an enabler for this change is the technology of a Digital Twin (DT). A DT is widely adopted in the field of engineering for predictive maintenance and testing of parameters of physical objectives such as engines to increase the effectiveness and optimize processes. A DT consists of three major factors: a physical object, its virtual representation and a continuous data stream between the two. In the healthcare sector this could mean to represent not an engine but a whole human with the potential goal for predicting a disease, taking necessary actions for prevention or identifying optimal treatments. This could shift the current underlying paradigm in medicine of curing a disease towards preventing a disease. The extent of representing a whole human body with this technology is still only a vision, but first steps towards this concept have been taken. This development may come with a lot of responsibility so that a user-centered perspective needs greater attention. This thesis aimed at unraveling users’ values for a meaningful DT as innovative technology. By using the concept of Responsible Research in Innovation (RRI), I addressed the importance of grasping, anticipating, and evaluating the potential impact of a DT on the individual interview partners. In a first step, I identified the field of diagnosis as a central research topic with high importance for the user. The semi-structured interviews were conducted with a focus on the context of diagnosis and followed a practice-based approach of Interpretative Phenomenological Analysis (IPA). This allowed me to explore underlying values from the past into the future of diagnosis with and without DTs. A six-step analysis approach proposed by IPA led to the discovery of values embedded in the (anticipated) experience of diagnosis of the interviewees. Finally, the findings led to the development of different forms or concepts a DT could take. These are meant to start a reflection. The findings showed that the meaningfulness of a DT may change significantly by age, life situation, preferences or also individual personality. In contrast to current company visions which visualize a DT as dashboard overview of the human, I assumed that this may lead to an objectification of the body and might rather support the development of an alienate feeling. Furthermore, it might be that the possibility of constant confrontation of one’s own objective status of the body might rather have negative effects on the individual. Additionally, time, place and frequency an individual interacts with a DT seemed to play an important role and should be reflected upon. In order to complement the development of a more user-centered and meaningful DT, I concluded this work with nine guidelines that can be a starting point for further reflection on responsible innovation of a DT. Taken together, I showed that meaningfulness of a DT is highly variable and would need a dynamic, personalized approach to create and implement a meaningful and responsible innovation for the user.