{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T06:25:01Z","timestamp":1775024701983,"version":"3.50.1"},"reference-count":64,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2024,10,28]],"date-time":"2024-10-28T00:00:00Z","timestamp":1730073600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["SIMULATION"],"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:p> This manuscript aims to show the proof-of-concept for the integration of digital twin (DT) and discrete event co-simulation through its application to forward simulation of physical activities of care providers and robots in an intensive care unit (ICU). Co-simulation focuses on modular integration of heterogeneous simulation components to capture the complexity inherent in systems. Advancing this conception, the proposed co-simulation attempted to narrow gaps with real-world systems by using DT while simultaneously leveraging the forward simulation capacity of discrete event simulation (DES). In particular, we created a co-simulation for human\u2013robot interactions in a simulated ICU facility, which modeled the hospital layout including the facility, robot, avatars for healthcare professionals, equipment, patient bed, and vital signs, which comprise physical twin (PT). In addition, specific patient-care scenarios were defined to drive PT for which the states of interest were represented in the DT, and then used for a dynamic input to the discrete event co-simulation. At the onset of the co-simulation, the parameters needed to run DES were manually configured to align the parameters with those of the DT. For internal validation, this DES was replicated under different work-system policies, and the co-simulation outcomes were interpreted in clinical context. Our co-simulation approach has potential for application to a broader class of problems in healthcare planning and management by supporting informed decision-making. Methodologically, timely information exchanges of PT with DT, and ensuing model updates in the Discrete Event System Specification (DEVS) is a promising approach for co-simulation, to maintain robustness against perturbations to real-world systems. <\/jats:p>","DOI":"10.1177\/00375497241283047","type":"journal-article","created":{"date-parts":[[2024,10,28]],"date-time":"2024-10-28T11:02:18Z","timestamp":1730113338000},"page":"361-375","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":5,"title":["Digital-twin co-simulation framework to support informed decision in healthcare planning and management"],"prefix":"10.1177","volume":"101","author":[{"given":"Ginikachi","family":"Anyene","sequence":"first","affiliation":[{"name":"The Grainger College of Engineering, University of Illinois Urbana-Champaign, Urbana, IL, USA"}]},{"given":"Celeste","family":"Schultz","sequence":"additional","affiliation":[{"name":"The College of Nursing, University of Illinois Chicago, Chicago, IL, USA"}]},{"given":"Anthony","family":"Nepomuceno","sequence":"additional","affiliation":[{"name":"The Grainger College of Engineering, University of Illinois Urbana-Champaign, Urbana, IL, USA"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8081-7114","authenticated-orcid":false,"given":"Inki","family":"Kim","sequence":"additional","affiliation":[{"name":"The Grainger College of Engineering, University of Illinois Urbana-Champaign, Urbana, IL, USA"}]}],"member":"179","published-online":{"date-parts":[[2024,10,28]]},"reference":[{"key":"bibr1-00375497241283047","doi-asserted-by":"publisher","DOI":"10.1080\/01605682.2019.1700186"},{"key":"bibr2-00375497241283047","doi-asserted-by":"publisher","DOI":"10.1016\/j.techfore.2021.120717"},{"key":"bibr3-00375497241283047","doi-asserted-by":"publisher","DOI":"10.1287\/opre.2019.1845"},{"key":"bibr4-00375497241283047","doi-asserted-by":"publisher","DOI":"10.1177\/1937586719855336"},{"key":"bibr5-00375497241283047","doi-asserted-by":"publisher","DOI":"10.1016\/j.seps.2017.01.009"},{"key":"bibr6-00375497241283047","first-page":"145","volume-title":"Measuring and modeling health care costs","author":"Chansky B","year":"2016"},{"key":"bibr7-00375497241283047","doi-asserted-by":"publisher","DOI":"10.1007\/s11123-012-0305-z"},{"key":"bibr8-00375497241283047","doi-asserted-by":"publisher","DOI":"10.1016\/j.ymssp.2015.02.016"},{"key":"bibr9-00375497241283047","first-page":"275","volume":"26","author":"Abdelghany M","year":"2017","journal-title":"Int J Ind Syst Eng"},{"key":"bibr10-00375497241283047","doi-asserted-by":"publisher","DOI":"10.3390\/robotics12030079"},{"key":"bibr11-00375497241283047","volume-title":"2020 IEEE 4th conference on information & communication technology (CICT)","author":"Prabhakar M"},{"key":"bibr12-00375497241283047","doi-asserted-by":"publisher","DOI":"10.2507\/IJSIMM18(4)497"},{"key":"bibr13-00375497241283047","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph182212262"},{"key":"bibr14-00375497241283047","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph17165741"},{"key":"bibr15-00375497241283047","first-page":"1597","volume-title":"Proceedings of the Winter simulation conference 2014","author":"Onggo BS"},{"key":"bibr16-00375497241283047","doi-asserted-by":"publisher","DOI":"10.1016\/j.jss.2013.06.054"},{"key":"bibr17-00375497241283047","doi-asserted-by":"publisher","DOI":"10.1108\/17410391311289541"},{"key":"bibr18-00375497241283047","first-page":"1","volume-title":"Proceedings of the 2012 Winter simulation conference (WSC)","author":"Djanatliev A"},{"key":"bibr19-00375497241283047","first-page":"1573","volume-title":"Proceedings of the Winter simulation conference 2014","author":"Fakhimi M"},{"key":"bibr20-00375497241283047","doi-asserted-by":"publisher","DOI":"10.1177\/0037549719843339"},{"key":"bibr21-00375497241283047","doi-asserted-by":"publisher","DOI":"10.1145\/3179993"},{"key":"bibr22-00375497241283047","doi-asserted-by":"publisher","DOI":"10.1016\/j.simpat.2023.102760"},{"key":"bibr23-00375497241283047","doi-asserted-by":"publisher","DOI":"10.1007\/s10270-019-00754-9"},{"key":"bibr24-00375497241283047","first-page":"377","volume-title":"Software engineering and formal methods: SEFM 2017 Collocated Workshops: DataMod, FAACS, MSE, CoSim-CPS, and FOCLASA","author":"Larsen PG"},{"key":"bibr25-00375497241283047","doi-asserted-by":"publisher","DOI":"10.1007\/s00371-020-01792-x"},{"key":"bibr26-00375497241283047","doi-asserted-by":"publisher","DOI":"10.1016\/j.advengsoft.2014.09.005"},{"key":"bibr27-00375497241283047","first-page":"105","volume-title":"Proceedings of the 8th international modelica conference","author":"Blochwitz T"},{"key":"bibr28-00375497241283047","doi-asserted-by":"publisher","DOI":"10.3384\/ecp2118117"},{"key":"bibr29-00375497241283047","volume-title":"Theory of modeling and simulation: discrete event & iterative system computational foundations","author":"Zeigler BP","year":"2018"},{"key":"bibr30-00375497241283047","unstructured":"Reck S. Robotics in Intensive Care Units: \u201cstand patients up on their feet and let them walk.\u201dMEDICA, 2022, https:\/\/www.medica-tradefair.com\/en\/News\/Interviews\/Previous_Interviews\/Interviews_2022\/Robotics_in_Intensive_Care_Units_Stand_Patients_up_on_Their_Feet_and_Let_Them_Walk"},{"key":"bibr31-00375497241283047","doi-asserted-by":"publisher","DOI":"10.1146\/annurev-psych-010416-043958"},{"key":"bibr32-00375497241283047","doi-asserted-by":"publisher","DOI":"10.1016\/j.artint.2010.11.026"},{"key":"bibr33-00375497241283047","first-page":"1c","volume":"12","author":"Ayatollahi H","year":"2015","journal-title":"Perspect Heal Inf Manag"},{"key":"bibr34-00375497241283047","first-page":"1","volume-title":"SoutheastCon 2015","author":"Chandrasekaran B"},{"key":"bibr35-00375497241283047","first-page":"329","volume-title":"2022 annual modeling and simulation conference (ANNSIM)","author":"Kim I"},{"key":"bibr36-00375497241283047","doi-asserted-by":"publisher","DOI":"10.1089\/tmj.2013.0352"},{"key":"bibr37-00375497241283047","doi-asserted-by":"publisher","DOI":"10.1080\/01691864.2019.1636714"},{"key":"bibr38-00375497241283047","volume-title":"Artificial intelligence: A modern approach","author":"Russell SJ","year":"2010"},{"key":"bibr39-00375497241283047","doi-asserted-by":"publisher","DOI":"10.1109\/TSMCA.2010.2093888"},{"key":"bibr40-00375497241283047","doi-asserted-by":"publisher","DOI":"10.3390\/s19132976"},{"key":"bibr41-00375497241283047","doi-asserted-by":"publisher","DOI":"10.1007\/s00170-023-12221-3"},{"key":"bibr42-00375497241283047","first-page":"221","volume-title":"2021 ACM\/IEEE international conference on model driven engineering languages and systems companion (MODELS-C)","author":"David I"},{"key":"bibr43-00375497241283047","doi-asserted-by":"publisher","DOI":"10.1038\/s43588-021-00069-0"},{"key":"bibr44-00375497241283047","doi-asserted-by":"publisher","DOI":"10.1109\/ACCESS.2020.3006254"},{"key":"bibr45-00375497241283047","first-page":"2625","volume":"26","author":"Griffith S","year":"2013","journal-title":"Adv Neural Inf Process Syst"},{"key":"bibr46-00375497241283047","first-page":"208","volume-title":"2023 Annual modeling and simulation conference (ANNSIM)","author":"Anyene G"},{"key":"bibr47-00375497241283047","doi-asserted-by":"publisher","DOI":"10.1109\/JPROC.2020.2998530"},{"key":"bibr48-00375497241283047","first-page":"5651","volume-title":"ICC 2022\u2014IEEE international conference on communications","author":"Huynh D"},{"key":"bibr49-00375497241283047","doi-asserted-by":"publisher","DOI":"10.1109\/TII.2020.3017668"},{"key":"bibr50-00375497241283047","doi-asserted-by":"publisher","DOI":"10.1016\/j.jnca.2021.103309"},{"key":"bibr51-00375497241283047","doi-asserted-by":"publisher","DOI":"10.3928\/01484834-20070601-06"},{"key":"bibr52-00375497241283047","doi-asserted-by":"publisher","DOI":"10.1258\/135581905774414204"},{"key":"bibr53-00375497241283047","doi-asserted-by":"publisher","DOI":"10.3310\/hsdr08160"},{"key":"bibr54-00375497241283047","doi-asserted-by":"publisher","DOI":"10.1177\/1937586716673831"},{"key":"bibr55-00375497241283047","doi-asserted-by":"publisher","DOI":"10.1177\/1937586717698812"},{"key":"bibr56-00375497241283047","doi-asserted-by":"publisher","DOI":"10.1016\/j.heliyon.2022.e08929"},{"key":"bibr57-00375497241283047","volume-title":"Theory of Modeling and Simulation","author":"Zeigler BP","year":"2000"},{"key":"bibr58-00375497241283047","first-page":"1","volume":"1","author":"Grieves M.","year":"2014","journal-title":"White Pap"},{"key":"bibr59-00375497241283047","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpdc.2021.03.011"},{"key":"bibr60-00375497241283047","doi-asserted-by":"publisher","DOI":"10.1038\/s41746-023-00852-5"},{"key":"bibr61-00375497241283047","first-page":"362","volume":"1","author":"Bray A","year":"2019","journal-title":"Medicine"},{"key":"bibr62-00375497241283047","doi-asserted-by":"publisher","DOI":"10.1016\/j.procir.2015.12.072"},{"key":"bibr63-00375497241283047","first-page":"1","volume-title":"2018 IEEE\/ACS 15th international conference on computer systems and applications (AICCSA)","author":"Karakra A"},{"key":"bibr64-00375497241283047","unstructured":"GE Digital twin: analytic engine for the digital power plant. GE Power Digital Solutions, 2016, https:\/\/hi.dcsmodule.com\/js\/htmledit\/kindeditor\/attached\/20210916\/20210916172149_81906.pdf"}],"container-title":["SIMULATION"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00375497241283047","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/00375497241283047","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00375497241283047","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,3,4]],"date-time":"2025-03-04T18:20:05Z","timestamp":1741112405000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/00375497241283047"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,10,28]]},"references-count":64,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2025,3]]}},"alternative-id":["10.1177\/00375497241283047"],"URL":"https:\/\/doi.org\/10.1177\/00375497241283047","relation":{},"ISSN":["0037-5497","1741-3133"],"issn-type":[{"value":"0037-5497","type":"print"},{"value":"1741-3133","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,10,28]]}}}