A Survey of Digital Twin Healthcare Cybersecurity Implementation Methods

Considering the sensitivity of healthcare-related patient information processed in a Digital Twin (DT) environment, it is essential to have a well-defined cybersecurity framework and implementation strategy. Failure to successfully adopt a functional cybersecurity approach could result in a data breach, which would incur exorbitant fines for the responsible healthcare organization; resulting in negatively impacted stakeholder confidence and public opinion. Existing research focuses on specific security challenges when implementing DT, but does not adequately detail implementation of an environmentwide cybersecurity strategy, such as the National Institute of Standards and Technology (NIST) Risk Management Framework (RMF). Although a dedicated RMF specifically for Internet of Things (IoT) environments exists, one tailored for DT Healthcare does not. Existing research continually identifies a knowledge gap with regards to the incorporation of cybersecurity in the design, planning, and implementation stages of DT development. The paper queries several research databases for publications pertaining to DT healthcare cybersecurity; A total of $\mathbf{4 0}$ papers were found. Of these 40 publications, none of them detail the implementation of cybersecurity in DT healthcare at a substantiative level. The paper serves to highlight the importance implementing a cybersecurity RMF, present possible RMF implementation strategies, and identify existing research gaps relating to its implementation.