Clinical perspectives on the virtual human twin: an overview of engagement and adoption challenges

Digital twins (DTs) in healthcare have the potential to transform patient care, but their adoption depends critically on the perspectives of clinical professionals, pa-tients, and the public. As part of the Ecosystem for Digital Twins in Healthcare (EDITH) initiative, we undertook a programme of targeted engagement to under-stand, explore and integrate these perspectives into the development of the Euro-pean Virtual Human Twin (VHT). Methods included surveys, breakout sessions at public ecosystem meetings, and three dedicated workshops with clinicians and pa-tient representatives covering cardiovascular and musculoskeletal applications. Key findings emphasised the need for early and sustained end-user involvement to ensure that DTs in healthcare address unmet clinical needs, improve patient out-comes, and demonstrate cost-effectiveness. Participants identified practical chal-lenges in data access, validation, regulation, and integration into hospital systems, as well as broader socio-economic and trust-related concerns. Opportunities were also recognised for using digital twins to influence patient behaviour, enhance pre-ventive care, and support medical education. From these insights, we identified recommendations across six themes: inclusion, clinical relevance, integration and validation, trust and equity, patient involvement, and incentives. The outcomes of this work provide an important step towards im-proving clinical interest, engagement, and eventual uptake in DTs in healthcare. Incorporating these perspectives into the VHT roadmap has strengthened its alignment with real-world clinical priorities and patient needs, supporting EDITH's vision of a sustainable and clinically impactful digital twin ecosystem. Further work is needed to extend this research across a wider range of clinical and patient stakeholder groups, and additional complex, multi-parametric clinical environments such as oncology.