gms | German Medical Science

Introduction: Medical digital twins (MDTs) denote a comprehensive model of a patient’s history and health status. Ideally, they are based on anatomical, physiological, diagnosis- and treatment-related information from multiple sources. While often incomplete, they may also provide derived information about the patient. Comprising critical and sensitive data according to the EU GDPR motivates a dedicated approach to secure such MDTs. An essential building block for an MDT is the flow of medical data. Our solution lets patients decide where their medical data goes and technically enforces those decisions, e.g., by encrypting data for specific recipients.

Related work: MDTs are becoming integral to healthcare, with ongoing discussions about their development and protection. Their potential for improving treatment and diagnostics is discussed in [1], emphasizing the need for robust security though without providing details. The use of MDTs in treating multiple sclerosis diseases is described in [2]. There, the importance of security is emphasized but without mentioning specific safeguards, too. This highlights a consensus on the significance of security, yet a gap in concrete security concepts exists.

Concept: The MDT is not just the sum of its input data but consists of distributed components –connected via networks– that may visualize the data, allow comparisons with other MDTs, run simulations, share the data within or outside of the organisation, etc. In our view, an MDT is about collaboration and may be accessed by different user groups, e.g., the patient, health professionals from different departments/organizations, or medical researchers. Each group will literally have its own view on the MDT, which will be reflected in the access and key management: Access control and encryption will be considered at a group and individual level. It is not enough to have encrypted data transmissions, where data is typically encrypted during transport only.

Implementation:

Neurodegenerative diseases (NDDs): Rising life expectancy increases NDDs, which are incurable. Symptom relief is complex and costly. Using our MDT definition, we can mirror health data and craft personalized patient profiles for patient empowerment and active healthcare management. Accessible to authorized individuals, profiles track health status, which allows better treatment through tailored insights and early disease detection.

Inflammatory bowel disease (IBD): IBD is chronic and costly. Its progression can span several decades, and its prevalence is increasing globally [3]. Gaining an overview over the complete medical history of a patient can be challenging. An MDT can facilitate this overview by storing and presenting relevant data in an organized way, thus providing insights that enable personalized care and helping in identifying important patterns and trends.

Conclusion: Our new approach for secure MDTs supports important medical use cases that require the sharing of medical data. By securing data and data access in a decentralized way, we go beyond traditional perimeter- and transfer-oriented concepts. The approach makes access to patients’ medical data fully transparent, while reliable patient approvals facilitate treatment processes and medical research for medical experts and institutions. We are working on several prototypical implementations as a basis for future medical information systems and tele-medical applications.

The authors declare that they have no competing interests.

The authors declare that an ethics committee vote is not required.