Virtual humans

Clinical care is ripe for transformation – and a 3D human model could provide the spark

Lindsay James
18 February 2021

6 min read

Virtual models of the human heart, brain and lungs have advanced to a point that life sciences innovators now believe it is possible to take the next step: a full virtual twin of the human body. Compass examines how such a model could launch a renaissance in clinical care.

What if it were possible for physicians to virtually analyze their patients’ health and simulate treatments or surgery using the same advanced technology that automotive engineers use to crash-test cars before they are built? What if medical devices and pharmaceuticals could be designed and safely tested virtually, at a fraction of the time and cost required by safety considerations in the real world?

These scenarios could be possible – and sooner than you might think – thanks to the advancement of virtual twin technology, applying knowledge developed in the non-organic world of manufacturing to the challenges of organic life. In fact, significant progress has already been made in creating virtual twins of humans, starting with a variety of major human organs.

At the heart of the matter

The Living Heart Project, for example, launched in 2014, has brought together cardiovascular researchers, educators, medical device developers, regulatory agencies and practicing cardiologists to develop a highly accurate and fully functioning digital model of the complete human heart – and apply it to improving outcomes for actual human patients.

Dr. David Hoganson, a doctor of medicine, assistant in the Department of Cardiac Surgery and director of the Computational 3D Visualization Program at Boston Children’s Hospital in Massachusetts, is already seeing huge benefits of the project. “We are able to create patient-specific models from the segmentation of actual 3D images, either from CT scans or MRIs,” he said. “Using these models, physicians can simulate the blood flow under different conditions – during anesthesia, or after food and/or exercise for example.”

Parents of a child with a ventricular septal defect are helped to understand his upcoming surgery through a 3D model of his heart on a holographic 3D screen. (Image © Boston Children’s Hospital)

Surgeons at Boston Children’s Hospital also have used the technology to plan an operation virtually – ensuring the right approach is chosen prior to actual surgery. “And that’s not all: the models are proving to be incredibly useful for education,” Hoganson said. “Paper drawings do not do justice to the complexity of heart diseases but, until recently, these are what we have used to teach a patient’s family about their condition and necessary procedures. It is much easier with a 3D model. Now parents can even put on 3D glasses and interact with holographic representations of their child’s heart.”

Meanwhile, Cristina Pop, a clinical research assistant at McGill University in Montreal, is using the living heart model to understand the impact of COVID-19 on people with heart conditions.

“COVID-19 presents a higher risk of severe cardiovascular complications, such as cardiac arrhythmia and heart failure,” Pop said. “At the same time, people with existing cardiovascular diseases are at higher risk of severe illness and death from COVID-19. To understand disease progression, and identify patients at higher risk of cardiac complication, we modeled a number of patients with underlying conditions. The beauty of 3D modeling is that this can be done in a non-invasive way, and with great accuracy. We have been able to simulate, with acceptable accuracy, heart failure progression and develop a better picture of patients’ cardiac status.”

“We are able to create patient-specific models from the segmentation of actual 3D images, either from CT scans or MRIs."

Dr. David Hoganson, Boston Children’s Hospital

Belgian digital health tech firm FEops, meanwhile, developed a digital twin-based pre-operative planning platform for structural heart interventions.

“Physicians traditionally rely on medical imaging to make decisions on where to place implants and what size to use,” said Matthieu De Beule, FEops’ CEO. “This is an inefficient process, requiring time-consuming preoperative planning – and potentially resulting in sub-optimal implant size and position. There’s logically a big risk of complication if things go wrong. Our solution, using virtual representations of individual patients’ hearts, has far greater accuracy and has the potential to reduce both pre-operative planning and procedure time.”

FEops pre-operative planning platform for structural heart interventions is based on a virtual twin. (Video © FEops)

Building on success

The Living Heart Project demonstrated the power of the virtual twin to combine and apply cross-disciplinary experience – creating a path to virtually model other organs and systems in the body, starting with the brain and then moving to the lungs.

Successful modeling of the brain has facilitated work by India-based technology company BrainSightAI.

“Using virtual representations of individual patients’ hearts has far greater accuracy and has the potential to reduce both pre-operative planning and procedure time.”

Matthieu De Beule, CEO, FEops

“One in six people suffers from brain-related disorders around the world – at a projected cost of $16.3 trillion between now and 2030,” said Laina Emmanuel, BrainSightAI’s CEO and co-founder. “That’s a higher cost than cancer and even chronic respiratory diseases. Brain-related disorders are often a race against time, and long-term hospitalization rates are high.”

Virtual brain models, however, offer significant possibilities, Emmanuel said. “Using resting-state MRI scans, we can design, calibrate and validate brain models to explore the interplay of structural and functional contributors to brain disorders. It’s non-invasive, so very apt for non-cooperative patients such as those in a coma. When teamed with artificial intelligence, we are building a new paradigm for diagnosis and treatment.”

Mona Eskandari, assistant professor of Mechanical Engineering and the BREATHE center at the University of California, Riverside, sees potential in creating virtual models of the human lung.
 
“COVID-19 in particular has revealed the vulnerable underbelly of lung mechanics; but even before that, lung fatalities were a major cause of morbidity and mortality worldwide,” Eskandari said. “Diagnoses of lung conditions often come down to trial and error, despite early prevention and intervention being key to improving patient outcomes. Moreover, lung diseases cost billions in the US alone.”

Building on the Living Heart Project by replicating its success with human lungs could save lives and significantly reduce these burdens, she said.

“By mirroring the Living Heart Project to focus on the lungs, we can understand where particles from inhalers land, for example. We can understand the pressures put on the lung by ventilators – helping us to devise optimal ventilation strategies informed by tissue mechanics. And as in our recent investigations, we can also understand the continuous evolutionary behavior of a lung and compare local measures with global mechanics.”

Toward the virtual human

Great strides also have been made in using virtual twins to model other parts of the body, including kidneys, feet, skin, cells and the digestive tract. Researchers hope that, over time, these separate models could be combined to create a complete virtual human. They also dream of cohort models – an approach that follows a selection of patients with a shared characteristic over a period of time – defined at the population level. When combined with machine learning, these models could inform novel approaches and help patients get the best available treatment for their specific genetic makeup.

Virtual clinical trials for new medical device designs are just one possible application for such a “system of systems.” The US Food and Drug Administration (FDA) is beginning Year Two of a five-year project that will culminate in an in silico clinical trial using the Living Heart model to create a focus group of virtual patients.

Their goal is to define a new, more efficient method to achieve regulatory approval, while reducing the burden on animal and human testing,” said Hoganson of Boston Children’s Hospital. "It has the potential to reduce human trials from years to days. It has been a tremendous effort so far – and we are excited about the future.”

A 3D cardiovascular reconstruction (Image © Boston Children’s Hospital)

The result is a new digital process, which is intended to be more efficient and less expensive than current ones – which involve lengthy patient selection, recruitment and retention together with cumbersome managing and monitoring processes, and often result in delays and costs which can impede patient access to novel treatments – without losing rigor or confidence in a device’s safety and efficacy.

“Modeling and simulation can help to inform clinical trial designs, support evidence of effectiveness, identify the most relevant patients to study, and assess product safety,” said Tina Morrison, Deputy Director in the Division of Applied Mechanics, Office of Science and Engineering Labs, Center for Devices and Radiological Health, FDA in a press release. “In some cases, in silico clinical trials have already been shown to produce similar results as human clinical trials.”

And this is just the start. The experts believe that the sum of these projects has become a showcase example for the transformative power of the virtual twin for healthcare. No longer do they question ‘if’ it is possible to create realistic virtual physiological human models, they ask ‘how’ and ‘when.’

The transformational power of digital

The ultimate goal? To bring a renaissance to clinical care.

“The vision behind creating a virtual twin of a human is to advance the development of personalized medicine,” said Natacha De Paola, professor of Biomedical Engineering at the Digital Medical Engineering & Technology Research and Education Center at Illinois Tech.

The logic is clear. Current methods for analyzing a patient’s health and planning the best therapies and surgeries are time-consuming, error-prone and expensive. They often involve several specialists and technicians across many sectors to plan, execute and manage the patient’s care. In most cases, those experts are limited in their ability to share a full picture of the patient’s situation. By bringing all these stakeholders and key components together in the virtual world, via a virtual human, silos will fall and  collaboration will improve.

“We are heading for a fully digitalized healthcare system that sees a virtual twin complementing electronic medical records and serving as a guide for precise and individual treatment,” De Paola said. “To get there we will need to continue to bring together research communities, device and drug development companies, clinical care teams and citizens. We need a skilled and agile workforce, teamed with multi-scale, multidimensional and multifunctional systems.”

While the goal is ambitious – almost daunting – De Paola is confident the medical profession has enough determination to reach it.

“2020 was a transformational year, engineering a number of huge breakthroughs,” she said. “The Living Heart Project opened the door to not only the Living Lung and the Living Brain, but to models of many elements of human physiology. But it’s just the beginning. Now it’s time to open the door to the digital human.”

Discover more about the potential of virtual twins of humans

Read how Dassault Systèmes Patrick Johnson believes virtual twins of humans will help usher in an era of personalized medicine

A new healthcare reference

Virtual twins of humans are a catalyst to achieving personalized medicine

Patrick Johnson

2 min read

Improving human health relies on gaining new levels of understanding of the human body. Nearly 50 years after the dawn of the digital revolution, the power of the virtual world is now reaching the realms of biology and medicine with the objective of delivering personalized treatments, cures and patient care.  

The promises of personalized medicine are numerous and very ambitious: therapeutics tailored to target a specific disease for a specific patient, surgery and interventions designed to fit their specific anatomy, devices and prosthesis engineered or printed on demand.

Personalized medicine is about smarter treatments for individuals. Healthcare is a lifelong matter; we stand in the age of multiple, targeted experiences of medical practices that evolve and vary as we age. We are now getting closer to personalized healthcare, thanks to the rise of virtual twins: a holistic and integrative representation all facets of an individual’s health that, over time, is tuned by observations and measurements performed in the real world, also factoring in that person's medical history and environmental exposures.

For more than 40 years, digital mockups and virtual twins have profoundly transformed the industrial world of engineering and production, revolutionizing how manufacturing companies in aerospace, automotive and shipbuilding design, optimize and produce complex products. Now, those same deep scientific and technological disruptions are being applied to the living world, creating an integrative reference of personal health information for citizens, patients, cohorts and health systems.

As our understanding of human biology, physiology, biomechanics and pharmacology improves, virtual twins will become more precise, predictable and usable 

As our understanding of human biology, physiology, biomechanics and pharmacology improves, virtual twins will become more precise, predictable and usable with modeling, simulation and information intelligence allowing common understanding between professionals, enabling an easy way to run "what if" scenarios and leading to precision medical decisions. Many therapeutic areas (cardiology, neurology, orthopedics, pulmonary systems) are already starting to showcase these major innovations, with patients being treated in unique and unprecedented ways.

The virtual twin paradigm represents a new approach to combatting complexity, connecting knowledge and know-how from various disciplines and enabling new levels of medical collaboration and practices. Indeed, more then ever, modern healthcare needs to rely on cooperation between many fragmented therapeutic domains and siloed medical expertises. In its current state, it fails to entirely capture the patient condition as a whole, with a person's complete diseases and treatments history. Care teams have limited means to share information, and research discoveries rarely fully connect with observational insights from bedside care. By going beyond document-based heterogeneous health records, virtual twins intend to address these challenges, by offering a 360-degree experiential view of a patient’s health and finally enabling true collaboration within the medical community. This has the potential to evolve practitioners' standard of care practices (precision and personalized surgery, medicine, prevention) but also to radically streamline patients’ journeys, which are today the suboptimal result of many disconnected segments.

These advancements deliver on the promise of patient-centric digital health and have the power to transform all aspects of the current healthcare system. By providing a 360-degree view of a person’s condition, virtual twins' ambition is to be the catalyst of a fundamental societal shift: from a document-based, fragmented health records practice to an experiential, integrative and collaborative care practice; from one size-fits-all medicine to precision medicine; from siloed segments of a patient journey to a “follow the citizen” / continuous health journey; and from a cure-oriented approach to a care-oriented, citizen health-centered and prevention-based approach.

Patrick Johnson is Senior Vice President, Corporate Strategy & Research, Dassault Systèmes

Discover more about the promise of virtual twins in revolutionizing healthcare.

Allies for good

Companies discover that collaborating multiplies their sustainability progress

Jacqui Griffiths
10 February 2021

5 min read

To meet the United Nations’ 2030 Sustainable Development Goals, businesses are setting ambitious targets. Increasingly, however, businesses are realizing that while solitary efforts are good, combining their efforts delivers outsized results.

Environmental sustainability is a core commitment for Amcor, a global packaging provider, and Veolia, a French transnational specialist in waste, water and energy management. As part of its work to enable a circular economy, for instance, Amcor is using virtual modeling to devise and test packaging materials that work best for consumers and recycling systems around the world. Meanwhile, to accomplish the same goal, Veolia is applying artificial intelligence and launching packaging design collaboration services to help manufacturers design ecological products and optimize end-of-life sorting and recyclability.

The companies’ shared goal of a circular economy is one example of accelerating progress toward meeting UN SDG 12: Responsible Consumption and Production, along with SDGs targeting climate change, sustainable cities, ecosystem protection and economic growth. And, as Amcor and Veolia demonstrate, aligning efforts across the entire product lifecycle will help achieve the SDGs faster.

“Responsible packaging is part of the answer,” said David Clark, vice president for sustainability at Amcor. “But there also needs to be a recycling infrastructure and support via consumer and societal attitudes and behavior.”

One major obstacle is the lack of communication channels among companies and industries that have not interacted before. Amcor and Veolia, for example, traditionally operate at opposite ends of the product lifecycle. While both companies are seeking to create a more circular model, each company has approached the sustainability challenge exclusively from its own perspective.

“We need to connect the design of a product to its end of life but, at the moment, those two worlds don’t interact much,” said Sébastien Flichy, innovation and valorization vice-president at Veolia France. “Questions about the product’s end-of-life management, such as its composition and size, which affect how it can be sorted through the recycling process, are not clearly examined during product design. We need a co-construction approach in which the end of life is considered during product design.”

But Amcor and Veolia are not alone in rising to the challenge. Both companies partner with the Ellen MacArthur Foundation, a nonprofit network based in the UK that brings together organizations and resources from different disciplines to promote a circular economy. In fact, in every industry and for every sustainability challenge, a nonprofit organization like this exists, focused on facilitating multi-disciplinary collaboration to get real results.

Creating a common understanding

Frontrunners among these nonprofit networks include Circle Economy, Business for Social Responsibility and the Global Enabling Sustainability Initiative (GeSI). Each is focused on bringing together multiple perspectives and empowering businesses to develop and work toward shared sustainability goals.

“No individual company can meet their sustainability goals alone,” said Luis Neves, CEO of GeSI, an organization based in Brussels that connects information and communication technology companies to collaborate on social and environmental sustainability. “After all, the world’s services, systems, data, software and people are interdependent. From recognizing the wants and needs of customers to being sharply aware of one’s value chains and supply chains — understanding one’s role in the larger ecosystem is key to minimizing risks and working efficiently.”

Collaborating with competitors, and with industries they would not normally interact with, can be a major hurdle for companies – especially when each participant has different views on what sustainability means for their business. By establishing standards that work for each link of the value chain, GeSI provides the neutral dynamic companies need to contribute toward shared objectives and create smarter solutions.

“Our biggest challenge lies in avoiding duplication and unnecessary competition between organizations,” Neves said. “This requires a clear understanding from them that it is in the interest of all parties to work together with a clear vision for the common good. We work to set out the vision and the rules in order to align on our common purpose and individual roles early on in the process, laying the foundations in a collaborative, transparent and inclusive manner. We work hard to ensure that everyone is kept accountable and the standards remain ambitious, keeping our organization credible and transparent.”

Amplied efforts

By embracing the interconnectivity of issues and benefits, GeSI and similar organizations empower businesses not only to work toward shared goals, but also to create feedback loops that continually inform and inspire their innovation toward a sustainable future.

“Having a single environment for collaboration, such as our member-driven working groups focused on sustainability-oriented projects, can act as an amplifier,” Neves said. “It can take the ideas, strategies and ambitions of different companies and synergize them for greater impact. Because there is no single large stakeholder, it provides an opportunity to focus on thought leadership and strategy work that benefits all.”

"Understanding one’s role in the larger ecosystem is key to minimizing risks and working efficiently.”

Luis Neves, CEO of GeSI

A recent GeSI project points to the power of those feedback loops in action. The organization joined the Circular Electronics Partnership (CEP), which includes the World Business Council for Sustainable Development (WBCSD), the Green Electronics Council, the International Telecommunication Union (ITU), the Platform for Accelerating the Circular Economy (PACE), the Responsible Business Alliance (RBA) and the World Economic Forum to develop a unified vision and roadmap toward circularity for information and communications technology companies (ICT).

“Our relationship with CEP has enabled our members to engage in productive discussions with members of other organizations around the world, to compare their circularity programs, share knowledge to address sector-wide challenges and raise sustainability ambitions,” Neves said. “As a result of our initial work with CEP, our members took the initiative to develop an internal report and explore the activities of GeSI companies in order to support their individual strategies. It’s an example of how our external work can influence our internal programs.”

Tackling complex challenges

Sustainability presents increasingly complex challenges for businesses. Facilitating the communications agreements and activities that will bridge the gaps among industries that have never before interacted requires a combination of human and technological capabilities.

“People will request more traceability throughout the product lifecycle to ensure quality and regulatory compliance, and we’re likely to see technologies like blockchain playing an important role in enabling that,” Veolia's Flichy said. “Another key challenge is the need to share more data. Today’s collaborative efforts are just the beginning. There is a growing need to increase collaboration and co-construction and to think about the complementarity of different solutions so we can find a path toward sustainability.”

“Our biggest challenge lies in avoiding duplication and unnecessary competition between organizations,”

Luis Neves, CEO of GeSI

But there is no one-size-fits-all solution. Knowledge architecture for a circular economy, a 2020 article by Circle Economy, a US-based organization that works with businesses and cities to drive transition toward a circular economy, identified a delicate balance that must be struck to ensure that systems and processes apply equally well in different contexts and for different regions.

“As global appetite for circularity grows, efforts to translate circular knowledge, frameworks and data into digital tools can increase access for a wider audience,” the report states. “This can aid analysis, decision making and progress monitoring. We see the volume of such tools and databases for circularity growing. [However,] if the digital tools are going to realize their full potential, then we need a common understanding of what those frameworks represent, even in different languages.”

While achieving sustainability collaboration across disparate industries is a daunting goal, sharing knowledge across industries is contributing toward progress.

“The big change that’s required, and which we’re starting to see, is a shift toward systems thinking, whether it’s in terms of product design, how we use products or supply chain,” Amcor’s Clark said. “The switch we’re seeing from a linear system where everyone plays their own part, to everyone thinking in a circular manner, is really going to be the cultural and knowledge change that enables true sustainability.”


Five leading nonprofit sustainability organizations

Business for Social Responsibility (BSR)

A global network of member companies, cross-sector collaborative initiatives, and grant-funded partnerships, BSR seeks to ensure that no company is alone in addressing sustainability challenges.

Circle Economy

Works with a global community of cities, businesses and governments to accelerate the practical and scalable implementation of the circular economy.

The Ellen MacArthur Foundation

Works with business, academia, policymakers and institutions around the world to develop and promote the idea of a circular economy and mobilize systems solutions at scale.

Global Enabling Sustainability Initiative (GeSI)

Facilitates collaboration toward solutions to real-world issues within the information and communications technology (ICT) industry and the greater sustainability community.

United Nations Global Compact

The world’s largest corporate sustainability initiative encourages businesses to adopt sustainable and socially responsible policies, and to report on their implementation. It brings companies together with UN agencies and other organizations such as labor groups, NGOs and community and faith-based associations.

Design for life

Designing for sustainability integrates humanity with nature

Anne Asensio
3 February 2021

2 min read

 Design aims to improve our lives by connecting us more closely with the world and everything in it. As we face the vulnerability imposed by the pandemic, human-driven design has never been more relevant. We need tools, processes and the environment to readily connect technology and innovation in sustainable design.

We anticipated an environmental crisis of the future, but the pandemic brought it immediately home to us. We faced vulnerability, and suddenly had to act to sustain our lives now.

We thought that we had the technology and knew how to use it. However, the pandemic turned that belief upside down. Extremely personalized human issues of survival and comfort presented themselves. To address them, we needed the perspective from the real, natural world, not from our artificial human-crafted one.  For designers, that means their empathetic, human-centered approach is more relevant than ever.

Design’s purpose has always been to improve people’s lives by humanizing technology and the built environment; not just the physical, but the emotional, psychological and symbolic, too. The designer’s journey is a deep dive looking closely at our humanity, contradictions and complexities. In designers, people are the material of transformation.

The Design Studio I lead has an initiative called Design for Life. It consolidates design research, insights and best practices to allow a new form of design practices to emerge – more sustainable ones.

We seek to forge a new perspective with tool kits, methodologies and social guidance, and apply this new perspective using a collaborative virtual design platform to facilitate the transformational journey of designers. With a rich and inclusive space for collaboration, the platform creates effective dialogue between design and science and reinforces a human-centered design approach for more sustainable impacts.

Design already incorporates substantial methodology; but designers like to experiment with new tools and prove the value to themselves. Designers also engage collectively in co-design activities with others, requiring a more diverse workflow, and that often leads to new, unexpected outcomes.

What is missing today are easily accessible, everyday tools that show designers the impacts of their designs on society and the environment. With its focus on people and collaboration, the platform for virtual design pulls us into an environment for sense-able (based on attributes of our human senses) and sustainable design. It accesses the emotional through tools that include emotional mapping and mood boards, along with science and engineering – which empirically prove if the senses are accurate.

Wherever gaps or disconnects appear when we connect technology and humanity, we must use human behaviors to guide those moments – how people think, feel and act. When we do that, it opens up surprising new intersections that turn imprecise inputs and fuzzy logic into well-defined actions for smart, creative design decisions.

This is the new domain and playground of the sustainable design practitioner, the role of someone who brings together the concepts of human-driven design, but also thinks about “If?” and “Why?” a design should be done from multiple perspectives. Those are very important questions – more than the foundation of creating a design, and never more relevant a tool kit and a methodology for the sustainable journey of design.

Anne Asensio is Vice President, Design Experience at Dassault Systèmes

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