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 participant survey feedback. METHODS: A digital twin-based virtual hospital platform modeling 317 clinical spaces and 6 building entrances of Yongin Severance Hospital, South Korea, was developed to simulate a 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. Sixty multidisciplinary participants (physicians, nurses, laboratory technicians, pharmacists, and administrative staff) were recruited through purposive sampling from clinical departments and support services directly involved in outpatient IT outage response. Emergency prescription and patient information lookup systems were integrated into the training. Performance evaluation included scenario completion rates, prescription accuracy, completion times, and operational readiness scores. Training outcomes were compared with 2023 conventional training records from the same institution using descriptive metrics. Open-ended survey responses were analyzed using structured content summarization with text mining and word cloud techniques. A 7-item operational readiness checklist was assessed by a panel of 5 training facilitators to evaluate system functional completeness. 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. The overall operational readiness score was 80% (with 70% for digital twin platform operational readiness and 90% for emergency prescription program operational readiness). Training reduced resource consumption by 70 minutes compared to the 2023 conventional training approach, decreasing full-time equivalent requirements from 0.072 to 0.038. Open-ended survey feedback yielded five content categories (target extensions, mock training ideas, drug/prescription system improvement, operations and evaluation systems, and process improvement), with realism, collaboration, and prescription as the most frequently cited keywords. CONCLUSIONS: This proof-of-concept study demonstrates that a simulation-oriented digital twin platform can support multi-department IT disaster response training with complete workflow execution. Identified technical gaps in user permissions and prescription classification provide a concrete development roadmap for institutional deployment.
Bae et al. (Mon,) studied this question.