𝐖𝐨𝐫𝐤𝐬𝐡𝐨𝐩 1: 𝐄𝐱𝐩𝐥𝐨𝐫𝐢𝐧𝐠 𝐔𝐬𝐞𝐫 𝐍𝐞𝐞𝐝𝐬 𝐟𝐨𝐫 𝐃𝐞𝐜𝐞𝐧𝐭𝐫𝐚𝐥𝐢𝐬𝐞𝐝 𝐃𝐢𝐠𝐢𝐭𝐚𝐥 𝐓𝐰𝐢𝐧 𝐄𝐧𝐯𝐢𝐫𝐨𝐧𝐦𝐞𝐧𝐭: 𝐄𝐭𝐡𝐢𝐜𝐬, 𝐈𝐦𝐩𝐥𝐞𝐦𝐞𝐧𝐭𝐚𝐭𝐢𝐨𝐧, 𝐚𝐧𝐝 𝐭𝐡𝐞 𝐅𝐮𝐭𝐮𝐫𝐞 𝐨𝐟 𝐑𝐞𝐬𝐩𝐨𝐧𝐬𝐢𝐛𝐥𝐞 𝐒𝐢𝐦𝐮𝐥𝐚𝐭𝐢𝐨𝐧

To ensure that the future Decentralised Digital Twin Environment (DDTE) reflects the needs and expectations of its users, the DTRIP4H consortium is organising a series of online co-creation workshops bringing together stakeholders from across healthcare, research, policy, technology, and society. These workshops will gather insights on user requirements, governance, ethics, and operational considerations that will shape the development of a trustworthy and responsible digital twin ecosystem.

The first workshop was held on March 26 and sparked insightful discussions.

𝐖𝐨𝐫𝐤𝐬𝐡𝐨𝐩 𝐃𝐞𝐭𝐚𝐢𝐥𝐬
Date: Thursday, 26 March 2026
Time: 10:00–11:30 CET
Format: Online

𝐖𝐨𝐫𝐤𝐬𝐡𝐨𝐩 𝐑𝐞𝐜𝐨𝐫𝐝𝐢𝐧𝐠
https://www.youtube.com/watch?v=Ey--3lICY38

𝐌𝐚𝐢𝐧 𝐏𝐚𝐧𝐞𝐥𝐢𝐬𝐭𝐬
𝘓𝘢𝘳𝘴 𝘔ü𝘯𝘵𝘦𝘳: Lars is the International Director of the Nordic Wellbeing Academy, a non-profit organisation which aims to contribute to the transformation and implementation of ideas and policies for future wellbeing across Europe. He also serves as the Chair of the Public Health Communication and Trust Working Group at the WHO Regional Office For Europe and is a member of the Strategic Partners' initiative for data and digital health at the World Health Organization.

𝘝𝘢𝘭𝘦𝘯𝘵𝘪𝘯𝘢 𝘎𝘳𝘢𝘻𝘪𝘢 𝘚𝘢𝘱𝘶𝘱𝘱𝘰: An Italian lawyer and technical advisor who specialises in AI governance, data protection, and cybersecurity. She serves as a Legal and Technical Expert for UNINFO and CEN/CENELEC JTC 21 working groups on AI standardisation, and is a member of the EDPB's Support pool of experts. She is a qualified lead auditor for ISO's standards on AI management systems and information security management and has professional experience in regulatory compliance frameworks for emerging technologies. Her professional background includes roles as Technical Officer at ACCREDIA (Italian National Accreditation Body) and Certification Scheme Manager at a notified body.

𝘌𝘬𝘢𝘵𝘦𝘳𝘪𝘯𝘢 𝘒𝘶𝘵𝘢𝘧𝘪𝘯𝘢: Ekaterina serves as Research Lead for data driven medicine at the Institute for Biomedical Informatics at Cologne University Hospital in Germany. Her current role involves integrating different components of computational medicine projects' lifecycles, which includes overseeing the data sharing process and clinical relevance of computational modeling. A few of her areas of expertise include Medical data analysis, in-silico simulation algorithms, FAIR data sharing and open science, and medical data infrastructures. She holds a PhD in applied mathematics from the AGH University of Science and Technology in Poland, as well as a PhD in theoretical medicine from the University Hospital RWTH in Aachen, Germany.

𝘋𝘳. 𝘎𝘢𝘣𝘳𝘪𝘦𝘭𝘢 𝘖𝘯𝘰𝘧𝘳𝘦: A medical doctor with over 20 years of experience in healthcare, including 15 years in research and laboratory medicine and 5 years in education management. She has extensive international experience and has worked in Latin America, Europe, and the United States. Her expertise includes the management and development of new drugs, as well as the intersection between education and social responsibility in healthcare. She is a member of the Simulation Conference in Lyon, as well as the Women in Science Programme in Dresden, Germany. She is the founder of the startup Prevention is Smart, which focuses on implementing artificial intelligence solutions in preventive healthcare, cancer, and chronic diseases with the aim of ensuring a real social impact.

The discussions on digital twins highlighted a multifaceted landscape encompassing ethical, technical, legal, and clinical dimensions. Lars Münter opened by emphasising the inherent limitations of digital twins—they are partial representations that cannot fully capture lived experiences, evolving values, or the complexities of informed consent. He warned against reducing individuals to static, curated versions and stressed that digital twins should prioritise societal benefit and health outcomes over efficiency or commercial gain. To build trust, Münter advocated for transparency mechanisms, such as involving individuals in observing how their digital twins are used, continuous communication about data usage, and moving beyond mere consent forms to ensure meaningful engagement and accountability.

Governance and regulatory compliance emerged as a central theme. Valentina underscored that governance must be the foundation of any digital twin project, as it shapes technical and ethical outcomes. She highlighted the need to distinguish between mandatory regulations (e.g., GDPR, AI Act) and voluntary standards (e.g., ISO/IEC 27001, ISO/IEC 42001), which can serve as benchmarks for responsible practices. She also cautioned that decentralising data does not decentralise accountability—even in federated architectures, clear, documented, and auditable rules are essential. Compliance, she argued, should be embedded throughout the project lifecycle, not treated as a final checkpoint.

Ekaterina focused on the clinical applications of digital twins, advocating for a "research playground" approach that balances innovation with clinical viability. She stressed the importance of early-stage regulatory and workflow considerations to avoid wasted efforts on impractical models. The distinction between generative AI and knowledge-driven models was also emphasized, as they raise different legal and technical questions, particularly regarding synthetic data. Dr. Onofre reinforced the need for trust, transparency, and usability in healthcare, arguing that traditional consent models are insufficient for digital twin environments. She called for clear communication with patients and a multidisciplinary approach involving IT experts, healthcare professionals, and patients to ensure ethical alignment and patient-centered outcomes.

The dynamic nature of digital twins was another key point, with speakers noting that their adaptability makes them less prone to obsolescence but more vulnerable to persistent biases in AI and synthetic data. Human-in-the-loop systems were highlighted as essential for ethical oversight, ensuring that humans actively control algorithmic decisions rather than merely supervising them. The role of emerging technologies like 6G was also discussed, as it enables real-time adaptability and innovative healthcare solutions, such as remote assistance for elderly individuals.

In addressing holistic standards, panelists agreed that the EU’s AI Act provides a structured framework for ethical and technical compliance. Dr Onofre emphasised the need for validated physiological models and equitable access across regions, particularly in mental healthcare, where clear protocols are critical. Katrina and Valentina concluded by stressing the importance of modular approaches—breaking down complex challenges into manageable components—and collaboration and knowledge-sharing to foster collective growth. Gabriella echoed this sentiment, advocating for continued open discussions and networking to advance the responsible implementation of digital twin technologies.

𝐊𝐞𝐲 𝐓𝐚𝐤𝐞𝐚𝐰𝐚𝐲𝐬
- Ethics and Trust: Digital twins must prioritize societal benefit, transparency, and active patient engagement to build trust.
- Governance First: Clear governance frameworks are foundational, shaping technical, legal, and ethical outcomes.
- Clinical Relevance: Models must be clinically viable from the outset, with early regulatory and workflow considerations.
- Bias and Accountability: Persistent biases in AI and synthetic data require ongoing attention, with human oversight as a critical safeguard.
- Collaboration and Standards: A multidisciplinary approach, modular problem-solving, and adherence to both mandatory and voluntary standards are essential for responsible innovation.
- Future-Proofing: Compliance must be integrated throughout the project lifecycle, and emerging technologies like 6G should be leveraged to enhance adaptability and healthcare solutions.

This workshop is the first of a series of stakeholder-focused co-creation sessions designed to ensure that the DDTE for health is developed in alignment with real-world stakeholder expectations, operational needs, and governance requirements. The upcoming series of sessions are foreseen in April and May. Please find full information here:
https://www.dtrip4h.eu/news/dtrip4h-launches-workshop-series-to-explore-user-needs-for-a-ddte

Organised by: EHMA – European Health Management Association (Belgium) and the whole DTRIP4H consortium.

In the framework of the DTRIP4H project (www.dtrip4h.eu)

𝘍𝘶𝘯𝘥𝘦𝘥 𝘣𝘺 𝘵𝘩𝘦 𝘌𝘶𝘳𝘰𝘱𝘦𝘢𝘯 𝘜𝘯𝘪𝘰𝘯 (𝘋𝘛𝘙𝘐𝘗4𝘏, 𝘕𝘰. 101188432). 𝘝𝘪𝘦𝘸𝘴 𝘢𝘯𝘥 𝘰𝘱𝘪𝘯𝘪𝘰𝘯𝘴 𝘦𝘹𝘱𝘳𝘦𝘴𝘴𝘦𝘥 𝘢𝘳𝘦 𝘩𝘰𝘸𝘦𝘷𝘦𝘳 𝘵𝘩𝘰𝘴𝘦 𝘰𝘧 𝘵𝘩𝘦 𝘢𝘶𝘵𝘩𝘰𝘳(𝘴) 𝘰𝘯𝘭𝘺 𝘢𝘯𝘥 𝘥𝘰 𝘯𝘰𝘵 𝘯𝘦𝘤𝘦𝘴𝘴𝘢𝘳𝘪𝘭𝘺 𝘳𝘦𝘧𝘭𝘦𝘤𝘵 𝘵𝘩𝘰𝘴𝘦 𝘰𝘧 𝘵𝘩𝘦 𝘌𝘶𝘳𝘰𝘱𝘦𝘢𝘯 𝘜𝘯𝘪𝘰𝘯 𝘰𝘳 𝘵𝘩𝘦 𝘌𝘶𝘳𝘰𝘱𝘦𝘢𝘯 𝘙𝘦𝘴𝘦𝘢𝘳𝘤𝘩 𝘌𝘹𝘦𝘤𝘶𝘵𝘪𝘷𝘦 𝘈𝘨𝘦𝘯𝘤𝘺 (𝘙𝘌𝘈). 𝘕𝘦𝘪𝘵𝘩𝘦𝘳 𝘵𝘩𝘦 𝘌𝘶𝘳𝘰𝘱𝘦𝘢𝘯 𝘜𝘯𝘪𝘰𝘯 𝘯𝘰𝘳 𝘵𝘩𝘦 𝘨𝘳𝘢𝘯𝘵𝘪𝘯𝘨 𝘢𝘶𝘵𝘩𝘰𝘳𝘪𝘵𝘺 𝘤𝘢𝘯 𝘣𝘦 𝘩𝘦𝘭𝘥 𝘳𝘦𝘴𝘱𝘰𝘯𝘴𝘪𝘣𝘭𝘦 𝘧𝘰𝘳 𝘵𝘩𝘦𝘮.