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Leveraging digital twin for healthcare emergency management system: Recent advances, critical challenges, and future directions

Author

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  • Zheng, Ruiyan
  • Ng, S. Thomas
  • Shao, Yuyang
  • Li, Zhongfu
  • Xing, Jiduo

Abstract

In the post COVID-19 era, there is an escalating demand to fundamentally rethink and digitalize healthcare emergency management (HEM) to ensure greater resilience and responsiveness. Among emerging technologies, the digital twin (DT) holds unique promise by enabling real-time monitoring, dynamic decision support, and predictive maintenance, all of which are critical in high-stakes emergency scenarios. Despite its potential, DT deployment in HEM remains an intricate, long-term endeavor, hampered by significant conceptual and technical barriers. Many stakeholders lack a clear understanding of DT's functional scope, the requisite technologies for robust implementation, and pathways for integrating DT into established healthcare workflows. In response, this paper offers a comprehensive examination of DT in HEM, categorizing current applications across four levels: individual, hospital, public, and cloud supporting. This paper also highlights how contemporary technical solutions, ranging from advanced networking and distributed computing to AI-driven analytics, can be orchestrated to support novel DT functionalities in real-world healthcare operations. Additionally, challenges, open problems and future directions for DT in HEM are discussed. By synthesizing both functional and research-oriented insights, this review aims to clarify future directions for leveraging DT as a transformative vehicle for healthcare emergency preparedness, response, and long-term resilience.

Suggested Citation

  • Zheng, Ruiyan & Ng, S. Thomas & Shao, Yuyang & Li, Zhongfu & Xing, Jiduo, 2025. "Leveraging digital twin for healthcare emergency management system: Recent advances, critical challenges, and future directions," Reliability Engineering and System Safety, Elsevier, vol. 261(C).
    • Handle: RePEc:eee:reensy:v:261:y:2025:i:c:s0951832025002807
    DOI: 10.1016/j.ress.2025.111079
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    References listed on IDEAS

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    1. Sujan, Mark & Spurgeon, Peter & Cooke, Matthew & Weale, Andy & Debenham, Philip & Cross, Steve, 2015. "The development of safety cases for healthcare services: Practical experiences, opportunities and challenges," Reliability Engineering and System Safety, Elsevier, vol. 140(C), pages 200-207.
    2. Kamble, Sachin S & Gunasekaran, Angappa & Parekh, Harsh & Mani, Venkatesh & Belhadi, Amine & Sharma, Rohit, 2022. "Digital twin for sustainable manufacturing supply chains: Current trends, future perspectives, and an implementation framework," Technological Forecasting and Social Change, Elsevier, vol. 176(C).
    3. Georgios Falekas & Athanasios Karlis, 2021. "Digital Twin in Electrical Machine Control and Predictive Maintenance: State-of-the-Art and Future Prospects," Energies, MDPI, vol. 14(18), pages 1-26, September.
    4. Han, Yilong & Li, Yinbo & Li, Yongkui & Yang, Bin & Cao, Lingyan, 2023. "Digital twinning for smart hospital operations: Framework and proof of concept," Technology in Society, Elsevier, vol. 74(C).
    5. Huang, Jia & You, Jian-Xin & Liu, Hu-Chen & Song, Ming-Shun, 2020. "Failure mode and effect analysis improvement: A systematic literature review and future research agenda," Reliability Engineering and System Safety, Elsevier, vol. 199(C).
    6. Kambombo Mtonga & Santhi Kumaran & Chomora Mikeka & Kayalvizhi Jayavel & Jimmy Nsenga, 2019. "Machine Learning-Based Patient Load Prediction and IoT Integrated Intelligent Patient Transfer Systems," Future Internet, MDPI, vol. 11(11), pages 1-24, November.
    7. Fei Tao & Qinglin Qi, 2019. "Make more digital twins," Nature, Nature, vol. 573(7775), pages 490-491, September.
    8. Mahmoud, Hussam & Kirsch, Thomas & O'Neil, Dan & Anderson, Shelby, 2023. "The resilience of health care systems following major disruptive events: Current practice and a path forward," Reliability Engineering and System Safety, Elsevier, vol. 235(C).
    9. Shang, Qingxue & Guo, Xiaodong & Li, Jichao & Wang, Tao, 2022. "Post-earthquake health care service accessibility assessment framework and its application in a medium-sized city," Reliability Engineering and System Safety, Elsevier, vol. 228(C).
    10. Zio, Enrico & Miqueles, Leonardo, 2024. "Digital twins in safety analysis, risk assessment and emergency management," Reliability Engineering and System Safety, Elsevier, vol. 246(C).
    11. Zhao, Taiyi & Tang, Yuchun & Li, Qiming & Wang, Jingquan, 2023. "Resilience-oriented network reconfiguration strategies for community emergency medical services," Reliability Engineering and System Safety, Elsevier, vol. 231(C).
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    1. Zaitseva, Elena & Levashenko, Vitaly, 2026. "Reliability engineering in healthcare: Opportunities and challenges," Reliability Engineering and System Safety, Elsevier, vol. 267(PB).
    2. Hossini, Anas & Kloul, Leïla & Guiraud, Maël & Cohen Boulakia, Benjamin, 2026. "Multi-agent reinforcement learning approach for predictive maintenance of a Smart Building lighting system," Reliability Engineering and System Safety, Elsevier, vol. 266(PA).
    3. Lu, Tong & Zhang, Yuxin & Xie, Weikang & Huang, Xinyan, 2026. "Human-AI interactive framework for smart evacuation safety analysis in large infrastructures," Reliability Engineering and System Safety, Elsevier, vol. 266(PB).

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