St. Pete physician creates ‘human digital twins’

A medical researcher at Johns Hopkins All Children’s Hospital is helping change the 20^th century, one-size-fits-all approach to health care through artificial intelligence and advanced analytics.

Dr. Mohamed Rehman, professor of applied health informatics at the St. Petersburg hospital, is at the forefront of a recent transition to precision medicine. That utilizes new technology to create individualized treatment plans.

Advancements in genomics and wearable technology that measure biomarkers like heart rate, temperature and blood pressure now allow doctors to create early versions of “human digital twins.” An academic article Rehman co-authored describes a digital twin as a “mathematical model of a system constructed from all available information.”

“It’s an iterative process because it’s not going to stop,” Rehman told the Catalyst. “We learn, we improvise – and the process just keeps going.”

He said All Children’s researchers have completed two separate studies with employees and patients. They receive a wearable FitBit, an activity tracker that measures biomarkers, including oxygen saturation and sleep cycles.

Rehman called the latter aspect the most critical data point. “If you’re sleeping well, you’re doing well,” he added.

Physicians then incorporate additional information, like lab results and electronic medical records. That provides baseline levels for patients – a digital twin – before they undergo a procedure.

“The goal is to get them back to baseline as quickly as possible,” Rehman said. “In the future, we want to create predictive models where we can say, ‘You are going to be back to normal after surgery at this time.’”

He said a spinal procedure study showed that some children returned to their baseline levels in two weeks without narcotics. Others struggled to reach normalcy in two months.

Rehman said precision medicine allows physicians to set personalized recovery expectations. Researchers will now test their hypotheses on patients with severe asthma, gastrointestinal issues and blood disorders.

Rehman said creating a digital twin for every patient in a health system would cause a “paradigm shift from treatment to prevention. From herd medicine to precision medicine.”

About 60 All Children’s employees underwent an 18-month psychological study. Rehman said the goal was to discern any correlation between stress and variations in physiological data.

“The hope is, in the future, we will have sophisticated models where the physiological data can predict psychological changes,” he added. “The more data elements we incorporate, the better our models are going to be for predicting the future.”

Dr. Mohamed Rehman.

At the Jan. 23 State of Science event, Rehman told Mayor Ken Welch that St. Petersburg could become the “healthiest city in the world” if every resident had a digital twin. What may sound far-fetched is a stated goal in Neom, Saudi Arabia.

The city plans to build an integrated health and biotech ecosystem focusing on individualized medical care. Officials will provide every citizen with a digital twin.

Cost, at least locally, is a hurdle. Rehman said health insurance does not currently cover digital twins, and researchers would need seed funding from the city to support a pilot program.

However, he believes insurance companies will eventually embrace the precision care philosophy. “Because it’s going to move the paradigm from treatment to prevention, reducing the net cost of care,” Rehman said.

A groundbreaking mouthguard

Rehman is also working on another piece of groundbreaking technology. He has partnered with St. Petersburg-based manufacturing giant Jabil to create an innovative mouthguard.

Mouthguards are standard athletic equipment worn over the top row of teeth to protect against oral injuries. Rehman plans to incorporate technology into the molded pieces of plastic that could save lives.

In 2020, Florida lawmakers passed a bill to mitigate heat-related injuries in youth sports. Doctors treated over 460 student-athletes for exertional heat stroke in the 2017-18 school year.

The danger remains, and Rehman’s mouthguard would monitor temperature spikes. It would also track other biomarkers to help prevent cramping and fatigue, and increase performance.

“We’re going to build a real, working prototype soon,” Rehman said. “The goal is, in the future, everybody’s going to be using the St. Pete-built mouthguard.”