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Health 4.0 : Digital Twins for Health & Well-being

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With the increasing prevalence in the use of wearables, social media, smart living, and personalized recommender systems for consumer health, it
becomes imperative to converge these technologies to provide personalized, context
driven, proactive, and preventive care in real time. Digital Twins are a convergence technology and involve making a digital replica of any living or nonliving entity. At present, Digital Twins are extensively used in Industry 4.0 where Digital Twins help
in optimizing the performance of machines by proactive and predictive maintenance.
This presentation is based on chapter on Health 4.0 and gives an overview of the existing literature and aims to provide an
overview of existing literature on Digital Twins for personal health and well-being—key terminologies, key applications, and key gaps. Chapter citation
Bagaria N., Laamarti F., Badawi H.F., Albraikan A., Martinez Velazquez R., El Saddik A. (2020) Health 4.0: Digital Twins for Health and Well-Being. In: El Saddik A., Hossain M., Kantarci B. (eds) Connected Health in Smart Cities. Springer, Cham

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Health 4.0 : Digital Twins for Health & Well-being

  1. 1. Namrata Bagaria PhD Candidate MCR Lab University of Ottawa HEALTH 4.0
  2. 2. Let’s discuss and try to define 2
  3. 3. 3 There is no one universal definition of health. Infact, there are four main schools of thought on the definition of health
  4. 4. MEDICAL MODEL OF HEALTH DEFINITIO N 4 Popular around the 1920s, health is defined as: "A state characterized by anatomic, physiologic and psychologic integrity; Ability to perform personally valued family, work and community roles; Ability to deal with physical, biologic, psychologic and social stress." J. Stokes, J. Noren, S. Shindell, Definition of terms and concepts applicable to clinical preventive medicine. J. Community Health 8(1), 33–41 (1928). http://www.ncbi.nlm.nih.gov/pubmed/676
  5. 5. HOLISTIC MODEL OF HEALTH DEFINITIO N In 1946, World Health Organization (WHO) definition, "A state of complete physical, mental and social well-being and not merely the absence of disease or infirmity" This is the most commonly used definition of health. 5https://www.who.int/governance/eb/who_constitution_en.pdf.
  6. 6. WELLNESS MODEL OF HEALTH DEFINITIO N Promoted by the World Health Organization (WHO) in 1984 definition was,  “The extent to which an individual or group is able to realize aspirations and satisfy needs, and to change or cope with the environment.  Health is a resource for everyday life, not the objective of living;  It is a positive concept, emphasizing social and personal resources, as well as physical capacities."  For the purpose of this talk, the wellness definition of health is used as a reference. 6 World Health Organization. Regional Office for Europe, Health Promotion: A Discussion Document on the Concept and Principles. Summary report of the Working Group on Concept and Principles of Health Promotion, Copenhagen, 9–13 July 1984 (WHO Regional Office for Europe, Copenhagen, 1984), http://www.who.int/iris/handle/10665/107835. http://apps.who.int/iris/bitstream/handle/10665/107835/E90607.pdf?sequence=1&isAllowe d=y.
  7. 7. ECOLOGICA L DEFINITIO N OF HEALTH In the mid-1990s, there was a push toward an ecological definition of health and an ecological definition is "A state in which humans and other living creatures with which they interact can coexist indefinitely." 7 J.M. Last, J.H. Abramson, International Epidemiological Association, A Dictionary of Epidemiology (Oxford University Press, 1995)
  8. 8. WELL- BEING A good or satisfactory condition of existence; a state characterized by Health Happiness Prosperity Welfare 8 https://www.dictionary.com/browse/well-being
  9. 9. MENTAL HEALTH Mental health is defined as a state of well-being in which every individual realizes his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to contribute to her or his community 9 https://www.who.int/news-room/fact-sheets/detail/mental-health-strengthening-our- response
  10. 10. Let us enlist 10
  11. 11. 11 PHYSICAL HEALTH PARAMETERS LIFESTYLE PARAMETERS WELL-BEING AND MENTAL HEALTH PARAMETERS SOCIO-ECONOMIC PARAMETERS CONTEXTUAL & CULTURAL FACTORS World Health Organisation, https://www.who.int/social_determinants/en/. Ottawa Charter for Health Promotion, https://www.who.int/healthpromotion/conferences/previous/ottawa/en/ Wikipedia, https://en.wikipedia.org/wiki/Health. Wikipedia, https://en.wikipedia.org/wiki/Health_indicator
  12. 12. Journey over the past 25 years 12
  13. 13. Version Web Industry Health 1.0 Read-only web (Fleerackers & Meyvis) Mechanization, water power, steam power (Roser) Printed health information (Wikipedia) 2.0 The writing and participating web (Fleerackers & Meyvis) Mass production, assembly line, electricity (Roser) Online communities, social media, patient generated content, wearables (Wikipedia) 3.0 The semantic executing web (Fleerackers & Meyvis) Computer and automation (Roser) Personalized health-related information (Wikipedia) 4.0 Mobile Web - connects all devices in the real and virtual world in real- time. (Fleerackers & Meyvis) Cyber physical systems and Digital Twins (Roser) Virtualization and Personalization (Thuemmler, 2017) 13Bagaria N., Laamarti F., Badawi H.F., Albraikan A., Martinez Velazquez R., El Saddik A. (2020) Health 4.0: Digital Twins for Health and Well-Being. In: El Saddik A., Hossain M., Kantarci B. (eds) Connected Health in Smart Cities. Springer, Cham
  14. 14. HEALTH 4.0 “Health 4.0 is progressive virtualization in order to enable the personalization of health and care next to real time for patients, professionals and formal and informal carers.” 14 C. Thuemmler, The Case for Health 4.0, in Health 4.0: How Virtualization and Big Data are Revolutionizing Healthcare, (Springer International Publishing, Cham, 2017), pp. 1–22
  15. 15. Principle No. Description Principle 1 Interoperability Principle 2 Virtualization Principle 3 Decentralization Principle 4 Real – time capability Principle 5 Service orientation Principle 6 Modularity Principle 7 Safety, security, and resilience 15 C. Thuemmler, The Case for Health 4.0, in Health 4.0: How Virtualization and Big Data are Revolutionizing Healthcare, (Springer International Publishing, Cham, 2017), pp. 1–22
  16. 16. Evolution from Quantified Self 16
  17. 17. Sr. No Terminology Explanation Author/s, Year/s 1 Quantified Self “Quantified Self (QS) is the term that embodies self-knowledge through self-tracking.” Wolf & Kelly, 2007 2 Editable self The authors call editable self “a workbench for personal activity data” where users can “annotate, retroactively repair, compare and revise their activity data from multiple devices” Packer et al., 2014 3 Objective Self The authors envision objective self as a platform with three features: “data ingestion, life event recognition, and pattern recognition” Jain & Jalali, 2014 4 Anticipatory Mobile Digital Health Anticipatory Mobile Digital Health refers to continuous patient monitoring through integration of user data from sensors, building a machine learning model with a user’s lifestyle and us of mobile phones to deliver personalised proactive therapies Nadin, 2017; Pejovic, Mehrotra, & Musolesi, 2017 5 Personalized Chronicle The authors call a chronicle “a person’s time-ordered list of daily activities” Oh & Jain, 2017 6 Cybernetic Health The author uses the term cybernetic health for an approach to health management using “Artificial Intelligence (AI), including machine learning, augmented reality, gamification, and data management” Jain, 2017 7 Digital Patient A digital patient is a lifelong, integrated, personalized model of a patient that is updated updated with each measurement, scan or exam, and that includes behavioural and genetic data as well Houten, 2018 8 Digital Twins Digital replications of living as well as nonliving entities that enable data to be seamlessly transmitted between the physical and virtual worlds. Digital twins facilitate the means to monitor, understand, and optimize the functions of all physical entities and for humans provide continuous feedback to improve quality of life and well-being El Saddik, 2018
  18. 18. 18 Sr. No Unique Characteristic Purpose 1 Unique Identifier communicate with its twin 2 Sensors and actuators to replicate the senses of the real twin, i.e., sight, hearing, taste, smell, and touch 3 Artificial Intelligence to make fast and intelligent decisions on behalf of the real twin 4 Communication to interact in near real-time with the environment, real twins and/or other digital twins 5 Representation to interact with real twin or other twins, virtual representation can be in the form of 3D avatar, hologram or even a humanoid social robot 6 Trust to carry out sensitive tasks and decision making of the real twin 7 Privacy and Security to protect the identity of its twin as well as its privacy A. El Saddik, “Digital Twins: The Convergence of Multimedia Technologies,” IEEE Multimed., vol. 25, no. 2, pp. 87–92, Apr. 2018
  19. 19. 19Bagaria N., Laamarti F., Badawi H.F., Albraikan A., Martinez Velazquez R., El Saddik A. (2020) Health 4.0: Digital Twins for Health and Well-Being. In: El Saddik A., Hossain M., Kantarci B. (eds) Connected Health in Smart Cities. Springer, Cham
  20. 20. 20 A. El Saddik, H. F. Badawi, R. Velazquez, F. Laamarti, R. Gámez Diaz, N. Bagaria, and J. S. Arteaga-Falconi, “Dtwins: A Digital Twins Ecosystem for Health and WellBeing,” IEEE COMSOC MMTC Commun. - Front., vol. 14, no. 2, pp. 39–43, 2019
  21. 21. 21 A. El Saddik, “Digital Twins: The Convergence of Multimedia Technologies,” IEEE Multimed., vol. 25, no. 2, pp. 87–92, Apr. 2018
  22. 22. Let’s discuss possible applications 22
  23. 23.  Loneliness  Obesity  Productivity  Health Literacy  Space Travel  Disability  Mental Well-being  Fitness & Sports Performance  Ergonomic  Elderly Wellness  Climate Change and Health  Dementia 23Bagaria N., Laamarti F., Badawi H.F., Albraikan A., Martinez Velazquez R., El Saddik A. (2020) Health 4.0: Digital Twins for Health and Well-Being. In: El Saddik A., Hossain M., Kantarci B. (eds) Connected Health in Smart Cities. Springer, Cham
  24. 24. Not even getting to implementation ones! 24
  25. 25. 25 Challenges Possible Solutions Winning the user trust and user data privacy Intelligent cryptography, mobile edge computing and blockchain Delivering the promise of personalization, which is context aware, culturally apt, matching user’s motivation, lifestyle and preferences Design Patterns (My thesis ;-)) Collecting data from social media and mapping with personal health parameters Virtualization of services, data sharing, intuitive data representation 5G rollout without corresponding standards for health and data interoperability Urgent need for setting standards for interoperability Bagaria N., Laamarti F., Badawi H.F., Albraikan A., Martinez Velazquez R., El Saddik A. (2020) Health 4.0: Digital Twins for Health and Well-Being. In: El Saddik A., Hossain M., Kantarci B. (eds) Connected Health in Smart Cities. Springer, Cham
  26. 26. nbagaria@uottawa.ca 26

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