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An Integrated and Flexible Review Framework to Evaluate the Evolution and Barriers of Digital-Twin Technologies in Industrial and Healthcare Domains

Author

Listed:
  • Cinzia Daraio

    (Sapienza University of Rome
    Rome Technopole)

  • Simone Di Leo

    (Sapienza University of Rome
    Rome Technopole)

  • Jacopo Orsini

    (Sapienza University of Rome
    Rome Technopole)

Abstract

Digital-twin (DT) technologies are revolutionizing both industrial and healthcare domains, albeit at different stages of maturity and application complexity. This paper presents a novel Integrated Flexible Systematic Review (IFSR) framework to analyse the DTs adoption across these two sectors. Through two domain-specific systematic literature reviews comprising 133 rigorously selected articles, we identify key trends, enablers, and sector-specific barriers. Our findings reveal that while industrial DTs are widely applied in predictive maintenance, supply chain resilience, and smart manufacturing, healthcare DTs are still emerging, showing promise in personalized medicine, surgical simulation, and patient-specific diagnostics. A critical result is the identification of cross-domain spillover effects, where industrial innovations like real-time analytics, Augmented Reality/Virtual Reality (AR/VR), and federated learning are beginning to influence healthcare practices. Conversely, healthcare’s high demands for precision and ethics are enhancing DTs development in industry. The analysis uncovers interoperability gaps, regulatory constraints, and computational challenges as primary adoption barriers, particularly in healthcare. This study contributes both methodologically, by proposing a dynamic, cross-sectoral review model, and substantively, by highlighting how DTs flexibility, when aligned with flexible system management principles, can foster adaptive, secure, and interoperable solutions. Future research directions are proposed to enhance DTs autonomy, privacy, and integration in both fields.

Suggested Citation

  • Cinzia Daraio & Simone Di Leo & Jacopo Orsini, 2025. "An Integrated and Flexible Review Framework to Evaluate the Evolution and Barriers of Digital-Twin Technologies in Industrial and Healthcare Domains," Global Journal of Flexible Systems Management, Springer;Global Institute of Flexible Systems Management, vol. 26(3), pages 625-648, September.
  • Handle: RePEc:spr:gjofsm:v:26:y:2025:i:3:d:10.1007_s40171-025-00447-x
    DOI: 10.1007/s40171-025-00447-x
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    References listed on IDEAS

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    1. Basile, Luigi Jesus & Carbonara, Nunzia & Pellegrino, Roberta & Panniello, Umberto, 2023. "Business intelligence in the healthcare industry: The utilization of a data-driven approach to support clinical decision making," Technovation, Elsevier, vol. 120(C).
    2. Qiang Wang & Min Su & Min Zhang & Rongrong Li, 2021. "Integrating Digital Technologies and Public Health to Fight Covid-19 Pandemic: Key Technologies, Applications, Challenges and Outlook of Digital Healthcare," IJERPH, MDPI, vol. 18(11), pages 1-50, June.
    3. Idiano D’Adamo & Massimo Gastaldi & Jacopo Piccioni & Paolo Rosa, 2023. "The Role of Automotive Flexibility in Supporting the Diffusion of Sustainable Mobility Initiatives: A Stakeholder Attitudes Assessment," Global Journal of Flexible Systems Management, Springer;Global Institute of Flexible Systems Management, vol. 24(3), pages 459-481, September.
    4. Ashish Dwivedi & Dindayal Agrawal & Ajay Jha & Massimo Gastaldi & Sanjoy Kumar Paul & Idiano D’Adamo, 2021. "Addressing the Challenges to Sustainable Initiatives in Value Chain Flexibility: Implications for Sustainable Development Goals," Global Journal of Flexible Systems Management, Springer;Global Institute of Flexible Systems Management, vol. 22(2), pages 179-197, December.
    5. Santosh Kumar Srivastava & Surajit Bag, 2023. "Recent Developments on Flexible Manufacturing in the Digital Era: A Review and Future Research Directions," Global Journal of Flexible Systems Management, Springer;Global Institute of Flexible Systems Management, vol. 24(4), pages 483-516, December.
    6. Sushil, 2018. "How to check correctness of total interpretive structural models?," Annals of Operations Research, Springer, vol. 270(1), pages 473-487, November.
    7. Mead, Nicola & Bower, Peter, 2000. "Patient-centredness: a conceptual framework and review of the empirical literature," Social Science & Medicine, Elsevier, vol. 51(7), pages 1087-1110, October.
    8. Eric Overby & Anandhi Bharadwaj & V Sambamurthy, 2006. "Enterprise agility and the enabling role of information technology," European Journal of Information Systems, Taylor & Francis Journals, vol. 15(2), pages 120-131, April.
    9. Donald Gerwin, 1993. "Manufacturing Flexibility: A Strategic Perspective," Management Science, INFORMS, vol. 39(4), pages 395-410, April.
    10. Sushil & Kamala Kannan Dinesh, 2022. "Structured Literature Review with TISM Leading to an Argumentation Based Conceptual Model," Global Journal of Flexible Systems Management, Springer;Global Institute of Flexible Systems Management, vol. 23(3), pages 387-407, September.
    11. Chao-Chung Hsu & Bi-Hai Jiang & Chun-Cheng Lin, 2023. "A Survey on Recent Applications of Artificial Intelligence and Optimization for Smart Grids in Smart Manufacturing," Energies, MDPI, vol. 16(22), pages 1-15, November.
    12. Liliana Stan & Adrian Florin Nicolescu & Cristina Pupăză & Gabriel Jiga, 2023. "Digital Twin and web services for robotic deburring in intelligent manufacturing," Journal of Intelligent Manufacturing, Springer, vol. 34(6), pages 2765-2781, August.
    13. Luigi Jesus Basile & Nunzia Carbonara & Roberta Pellegrino & Umberto Panniello, 2023. "Business intelligence in the healthcare industry: the utilization of a data-driven approach to support clinical decision making," Post-Print hal-04753286, HAL.
    14. Fei Tao & Fangyuan Sui & Ang Liu & Qinglin Qi & Meng Zhang & Boyang Song & Zirong Guo & Stephen C.-Y. Lu & A. Y. C. Nee, 2019. "Digital twin-driven product design framework," International Journal of Production Research, Taylor & Francis Journals, vol. 57(12), pages 3935-3953, June.
    15. Luigi Jesus Basile & Nunzia Carbonara & Umberto Panniello & Roberta Pellegrino, 2024. "How can technological resources improve the quality of healthcare service? The enabling role of big data analytics capabilities," Post-Print hal-04753292, HAL.
    16. Assunta Di Vaio & Anum Zaffar & Meghna Chhabra & Stefano Coronella, 2025. "Poverty Alleviation Through Accounting and Partnerships: A Systematic Review and Future Research Directions," Sustainable Development, John Wiley & Sons, Ltd., vol. 33(4), pages 5621-5641, August.
    17. Sushil, 2017. "Flexible Systems Management as an Iterative Process," Global Journal of Flexible Systems Management, Springer;Global Institute of Flexible Systems Management, vol. 18(2), pages 87-88, June.
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    1. Reza Kiani Mavi & Majid Semiari & Seyed Ashkan Hosseini Shekarabi & Neda Kiani Mavi & Fatemeh Moshkdanian & Arezoo Nikravesh & Sadegh Golsorkhi, 2025. "Multi-Objective Optimization of a Three-Level Sustainable Food Supply Chain: Modeling the Impact of Government Subsidies," Global Journal of Flexible Systems Management, Springer;Global Institute of Flexible Systems Management, vol. 26(3), pages 571-600, September.

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    JEL classification:

    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • O33 - Economic Development, Innovation, Technological Change, and Growth - - Innovation; Research and Development; Technological Change; Intellectual Property Rights - - - Technological Change: Choices and Consequences; Diffusion Processes

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