JMIR Publications

ABSTRACT

Background:

Hospital information technology (IT) outages severely disrupt clinical workflows and use of electronic medical records, threatening patient safety and operational continuity. Traditional disaster response training faces limitations including high resource requirements, restricted repeatability, and inability to be conducted without interrupting 24/7 hospital operations. Digital twin technology enables realistic, repeatable simulation training in virtual environments, avoiding operational disruption.

Objective:

This study developed and implemented a digital twin-based virtual hospital platform for Level 1 IT outage disaster response training and evaluated its feasibility through quantitative performance metrics and qualitative participant feedback.

Methods:

Our digital twin-based virtual hospital platform modeled 317 clinical spaces and 6 building entrances of Yongin Severance Hospital, South Korea. The platform was designed to simulate hospital information system failure (Code White Level 1 IT outage) with 7 patient cases of varying complexity levels, covering complete outpatient workflows from registration through payment. Emergency prescription and patient information lookup systems were integrated into the training. Performance evaluation included scenario completion rates, prescription accuracy, completion times, and system operability scores. Participant feedback was analyzed using thematic analysis and text mining techniques.

Results:

In July 2024, 60 multidisciplinary participants completed the training exercise. All 7 patient scenarios achieved 100% completion rates with perfect accuracy in medical billing concordance and prescription entry timeliness. Scenario completion times ranged from 25 to 47 minutes, with variations reflecting testing wait times and workflow complexity. Participants’ average rating for overall platform operability was 80% (with scores of 70% for the digital twin platform and 90% for the emergency prescription system). Training reduced resource consumption by 70 minutes compared to traditional training methods, decreasing full-time equivalent requirements from 0.072 to 0.038. Participant feedback praised the practical realism and effective patient flow visualization, while identifying opportunities for further development including fire evacuation and critical patient transport scenarios.

Conclusions:

Digital twin-based virtual hospital platforms can effectively support IT disaster response training while offering significant resource efficiency gains. Technical refinements in user permissions and prescription features could improve operability from 80% to near-perfect levels. Digital twin technology offers a scalable solution for hospital disaster preparedness training and is applicable to diverse emergency scenarios beyond IT outages. Clinical Trial: n-s