An X Language-Driven Framework for Systematic Development of Digital Twin Healthcare Systems

The rapid advancements in big data and the Internet of Things (IoT) have significantly accelerated the digital transformation of medical institutions, leading to the widespread adoption of Digital Twin Healthcare (DTH). The Cloud DTH Platform (CDTH) serves as a cloud-based framework that integrates DTH models, healthcare resources, patient data, and medical services. By leveraging real-time data from medical devices, the CDTH platform enables intelligent healthcare services such as disease prediction and medical resource optimization. However, the platform functions as a system of systems (SoS), comprising interconnected yet independent healthcare services. This complexity is further compounded by the integration of both black-box AI models and domain-specific mechanistic models, which pose challenges in ensuring the interpretability and trustworthiness of DTH models. To address these challenges, we propose a Model-Based Systems Engineering (MBSE)-driven DTH modeling methodology derived from systematic requirement and functional analyses. To implement this methodology effectively, we introduce a DTH model development approach using the X language, along with a comprehensive toolchain designed to streamline the development process. Together, this methodology and toolchain form a robust framework that enables engineers to efficiently develop interpretable and trustworthy DTH models for the CDTH platform. By integrating domain-specific mechanistic models with AI algorithms, the framework enhances model transparency and reliability. Finally, we validate our approach through a case study involving elderly patient care, demonstrating its effectiveness in supporting the development of DTH models that meet healthcare and interpretability requirements.