Cognitive Digital Twins for Improving Security in IT-OT Enabled Healthcare Applications

Digital Twins (DTs), serving as virtual replicas of physical systems, facilitate novel pathways for real-time monitoring, and informed decision making in different healthcare applications such as remote surgery, hospital management, and telemedicine. In the rapidly evolving landscape of cyber security, the emergence of DTs has provided unparalleled capabilities of preempting cyber threats, testing incident response strategies, and compliance testing. Moreover, Cognitive Digital Twins (CDTs) not only replicate physical systems but also have the ability to learn and make decisions. However, such a human-in-the-loop decision making approach is lacking for improving security in Information Technology (IT) and Operational Technology (OT) infrastructures while IT-OT integration in healthcare introduces new cyber security concerns and an increasing threat landscape. In this study, we developed a conceptual CDT-based adaptive cyber security framework for IT-OT enabled healthcare applications which has the potential to address cyber threats in varying situations. This framework integrates physical and virtual healthcare twin for healthcare service providers in addition to a knowledge base of security/privacy events and cognitive cycle for facilitating the human-in-the-loop approach. This framework could enhance cyber security in IT-OT healthcare by incorporating interdisciplinary fields such as adaptive security, health information exchange, human factors, IT-OT integration, risk management, among others. This study also presents some prominent use cases for IT-OT healthcare systems.