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Received September 15, 2023, accepted November 28 2023, date of publication December 10, 2023

Internet of Things and Digital Twin Technology-Based 
Management System of Medical Equipment

By Wanrong Liu, Bin Li, Zhiyong Ji

Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 201306, China

ABSTRACT
Background: In recent years medical technology has progressed with the rapid development of medical services and required 
optimization of medical equipment. However, a lack of effective management methods has led to the inefficient use of medical 
equipment. Therefore, an effective medical equipment management mode is urgently needed to address these problems and 
challenges. 
Methods: The Internet of Things and digital twin technology are applied to intelligent medical equipment management as the 
current standard of medical equipment management.
Results: The intelligent perception terminal can realize the dynamic acquisition of real data, such as the location, process, and 
efficient use of medical equipment, and help carry out digital, networked, and intelligent monitoring and analysis. Meanwhile, 
applications such as dynamic management software, real-time positioning software, and space-environment quality monitoring 
software are being developed. 
Conclusion: Automatic, intelligent, and visual management of medical equipment configurations, operations, and performance 
evaluation, combined with good management based on digital twinning, can improve collaborative management efficiency and 
operation resource support.

Keywords – Internet of Things, Medical equipment, Digital Twin Technology.

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tion 4.0 International - CC BY 4.0. The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) 
are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is 
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47 J Global Clinical Engineering Vol.6 Issue 1: 2023

Wanrong Liu, Bin Li, Zhiyong Ji: Internet of Things and Digital Twin Technology-Based Management System of Medical Equipment

INTRODUCTION

Throughout the past, the history of human society is a 
history of struggle between human beings and diseases. 
From blood-letting therapy in ancient times to modern 
medicine based on scientific experiments, the health industry 
has gradually become an incredibly complex system with 
deep integration of multiple sectors. New technologies 
such as cloud computing, big data, artificial intelligence, 
5G, biotechnology, and detection-based technology con-
tinue to develop and mature, and the intelligent modern 
health industry, based on new technologies, is booming 
with increasingly high requirements for rational alloca-
tion of medical equipment. At a time when the quality of 
information provided by medical device management is 
poor and facing many challenges, the Internet of Things 
(IoT) improves the ability to transfer important healthcare 
data in the new century. However, most existing hospitals 
have adopted IoT technology to track patients’ health 
status, and there is a lack of understanding of the use 
of IoT technology for medical equipment management. 
Secondly, a hospital’s nature determines that medical 
equipment use may change at any time, so an effective 
dynamic management mode for medical equipment use 
is urgently needed.1

Medical equipment is the core component of medical 
resources and is very important to the quality of medical 
service and the health protection of the people. Intelligent 
management of medical equipment resources plays a 
crucial role in the scientific and effective rational alloca-
tion of medical equipment resources.2

Traditional medical equipment management has the 
following pain points and difficulties3:
1. The rapid development of technology has led to a wide 

range of equipment, clinical needs, users, supervisors, 
and management personnel involved in the equip-
ment’s use and allocation;

2. The location and ownership of medical equipment are 
scattered, which leads to inconsistency between the 
physical object and their recorded use.

3. The overall level of medical equipment asset manage-
ment in most hospitals is weak due to the monopoly of 
technical data of imported products, a lack of real-time 
management information, insufficient allocation of 

professional personnel, and an emphasis on procure-
ment over maintenance;

4. The long product cycle of medical equipment and 
heterogeneous and complex types of information sys-
tems and data sources make it impossible to develop 
accurate and dynamic statistical analyses of medical 
equipment data configuration and use benefit, ef-
ficiency, and effect.

Some hospitals have affixed asset bar codes to medical 
equipment, reducing labor intensity to a certain extent and 
improving efficiency. However, problems, such as difficulty 
in accurately positioning equipment, the overallocation of 
equipment, and untimely deployment, lead to low work 
efficiency and high error rates. Hospital managers face a 
difficult problem in breaking through the bottleneck of 
extensive traditional manual management.

The development of 5G, IoT, mobile Internet, industrial 
Internet, and other technologies has provided technical 
support for the refined management of medical equipment 
and new solutions for intelligent management.4-7 Medi-
cal equipment exists as “things,” IoT is a self-information 
expression and management method based on “things” 
itself. The earliest idea for the “Digital Twins” is an “Infor-
mation Mirroring Model,” named by Michael Grieves of the 
University of Michigan, also known as digital mapping. In 
2012, the National Aeronautics and Space Administration 
gave the concept description of digital twinning: Digital 
twinning refers to integrating multi-disciplinary and 
multi-scale simulation processes by fully using physical 
models, sensors, operation history, and other data. As the 
mirror image of the physical product in the virtual space, 
it reflects the “whole life cycle process” corresponding 
to the physical product. In 2021, Pylianidis et al. pointed 
out that digital twins are being adopted by increasingly 
more industries, transforming them and bringing new 
opportunities.8 To summarize, a digital twin is a dynamic 
digital clone created for one or more devices or systems.9 

It is possible to use IoT and digital twin technology to help 
managers manage medical equipment.

This paper discusses a medical equipment manage-
ment system based on IoT and digital twin technology. 
The overall technical design architecture includes 5G 
networking, cloud on medical equipment asset data, and 



Wanrong Liu, Bin Li, Zhiyong Ji: Internet of Things and Digital Twin Technology-Based Management System of Medical Equipment

J Global Clinical Engineering Vol.6 Issue 1: 2023  48

medical operation support resource coordination man-
agement platform based on spatial digital twin. Promote 
the development of medical equipment management in 
the direction of intelligence and automation. This man-
agement system has been tested in practice during the 
COVID-19 pandemic, which has infected many people 
worldwide and overwhelmed healthcare systems. Life 
support equipment is important as the “main force” of 
this outbreak. Use the medical equipment management 
mode based on IoT and digital twin technology to grasp 
the use of life support equipment in real time, including 
but not limited to Airvo series respiratory humidifiers, 
ECG monitors, and other medical equipment. Therefore, 
the life support equipment of clinical departments is coor-
dinated and deployed, providing a sound decision-making 
basis for the rational allocation of medical equipment and 
greatly reducing equipment redundancy.

METHODS

To solve the problem of efficient hospital medical 
equipment management. We will fully use 5G and IoT, 
combining mobile Internet, big data, and cloud comput-
ing. A smart management platform for medical equipment 
in the IoT has been built.10 The overall technical design 
architecture includes 5G networking, cloud on medical 
equipment asset data, and a medical operation support 
resource coordination management platform based on 
spatial digital twinning, as shown in Figure 1.

First, the equipment state perception terminals and 
space environment quality perception terminals are used 
to complete the field big data acquisition. Then, equip-
ment networking can be achieved through Bluetooth, 
WiFi, cable networks, and other hybrid networking 
technology. A communication connection is established 
with the cloud management platform through 5G technol-
ogy to complete massive data interaction. Different data 
acquisition models are considered for different types of 
medical equipment. The data acquisition model completes 
training and iterative optimization on the platform side 
and is dynamically delivered to the edge node. The edge 
node applies the acquisition model to complete data 
acquisition and upload. After that, it connects the man-
agement platform, the device management platform, and 
the data distribution, storage, and computing platform. 

It provides users with dynamic management software, 
real-time positioning software, space environment qual-
ity monitoring software, and other applications. Realize 
the intellectualization of resources, information sharing, 
and interconnection. Finally, the sharing and collabora-
tion between the mobile and computer ends are realized 
through the innovative use of digital twin technology in 
hospital buildings, equipment, other physical and virtual 
processes, and mechanism modeling. The index system of 
multiple dimensions is integrated and presented allowing 
managers to make decisions.

5G Networking Scheme

5G combined network scheme as the primary support 
for application exploration. Realize the operation data 
acquisition of hospital equipment assets with ultra-high 
frequency and large data volume. The algorithm system 
is trained on this basis. With the help of 5G technology, 
the application value in medical scenarios can be jumped. 
As shown in Figure 2.

It is deployed in band, protected band, and independent 
cellular network carriers with very small bandwidth. Give 
full play to the mature technological advantages of nar-
rowband IoT, including strong flexibility and adaptability, 
low power consumption, wide coverage, multi-connection, 
and low cost. Realize the dynamic management of hospital 
equipment assets, location, emergency management, and 
other applications.

With edge computing, all data generated by the terminal 
need not be uploaded to the cloud data center. Instead, 
edge nodes deployed at the network’s edge and process 
it quickly. Dynamic recognition of equipment state is 
carried out by edge computing. Intelligent status iden-
tification and data reporting are performed directly on 
the collection side. It can reduce computing delay, device 
power consumption, and cloud servers’ power consump-
tion, thus significantly reducing application barriers and 
costs. It gives full play to Mind Evolutionary Computation 
(MEC), which is good at searching and solving.11 To realize 
the innovative integration of MEC and industrial Internet 
data application systems, and gradually realize intelligent 
algorithm optimization and online distribution. Realize 
the solution of sensitive data in medical institutions, and 
realize the security isolation of data  within the Intranet.



49 J Global Clinical Engineering Vol.6 Issue 1: 2023

Wanrong Liu, Bin Li, Zhiyong Ji: Internet of Things and Digital Twin Technology-Based Management System of Medical Equipment

FIGURE 1. Systematic structure.

FIGURE 2. 5G networking scheme.



Wanrong Liu, Bin Li, Zhiyong Ji: Internet of Things and Digital Twin Technology-Based Management System of Medical Equipment

J Global Clinical Engineering Vol.6 Issue 1: 2023  50

Medical device asset data is stored in the cloud

The key to implementing related applications based on 
IoT is to realize the data collection of perception terminal 
and the data binding of object equipment assets. Typical 
industrial Internet identification of three terminals: 

1. Dynamic energy identification is a medical equipment 
running state dynamic monitoring terminal. A dynamic 
energy marker is deployed for each active medical device. 
After the device is powered on, its operating status can be 
collected and uploaded in real time as shown in Figure 3; 

2. Dynamic environment identification is a monitor-
ing terminal for the environmental quality of medical 
space. With low power consumption and wide area com-
munication capability, a dynamic environment identifier 
is deployed in each medical space to collect and upload 
medical space environmental indicators in real time. As 
shown in Figure 4; 

3. Proactively locating and marking the terminal com-
pletes the space master data binding and distribution. 
This combines with the medical device status dynamic 
monitoring IoT terminal to achieve the room-level dy-
namic positioning of the equipment and links the data 
service to the hospital inventory equipment assets ledger 
information and the hospital’s existing equipment assets 
deployment for a professional dynamic two-dimensional 
code identification. This will build a cloud database of 
equipment assets with logos as links. The identification 
image information, location image information, original 
asset card image information, and other image informa-
tion for medical equipment assets are collected. At the 
same time, based on the management norms of special 
medical equipment, an equipment assets benchmark da-
tabase, in line with the latest management requirements, 
is established to complete the inventory equipment assets 
information.

Medical operation support resource coordination 
management platform based on spatial digital twin

Digital twinning is a digital method to establish a vir-
tual model representing a physical entity. And through 
the simulation analysis to simulate the real activities 
of these physical entities. The master data model of the 
real physical space of medical institutions is established 
to complete the datatization of objects such as organi-
zations, hospitals, buildings, floors, rooms, and spaces. 
As an effective solution, digital twin technology gives 
full play to timely, fast, and intelligent information ser-
vices. The comprehensive use of virtual-real interaction, 
data fusion analysis, decision-making process iterative 
optimization, and other technical means helps realize 
the interactive integration and intelligent control from 
physical entity to the virtual digital model and intelligent 
management of support equipment location, inventory, 
environmental warnings, fault repairs, fault locations, 
and other applications.

RESULTS

Fine management based on the IoT and digital twin 
can be realized and refined to the room level, improving 
data acquisition and transmission coverage and improving 
the efficiency of collaborative management of operational 
resource support.

Environmental and location monitoring 
management

IoT terminals are deployed in every room to allow 
dynamic monitoring of the room or designated area 
for temperature, humidity, pressure, volatile organic 
compounds, harmful gasses, particulate matter, and 
other parameters. Room-level real-time positioning of 
medical equipment can be realized, as shown in Figure FIGURE 3. Dynamic energy identification.

FIGURE 4. Dynamic environment identification.



51 J Global Clinical Engineering Vol.6 Issue 1: 2023

Wanrong Liu, Bin Li, Zhiyong Ji: Internet of Things and Digital Twin Technology-Based Management System of Medical Equipment

5. Meanwhile, environmental warnings, electrical safety 
warnings, position change warnings, and overall build-
ing temperature information on medical equipment are 
also provided.12

Equipment operation and maintenance monitoring

In the Medical Equipment Maintenance Programme 
Overview report, the WHO states that maintenance 
steps include identifying fault phenomena and causes, 
maintenance, post-maintenance testing, and completing 
maintenance reports. Traditional equipment warranties 
are reported by telephone; however, maintenance reports 
are mainly on paper, which multiple departments must 
review and sign. Maintenance information also needs to 
be counted manually monthly which is inefficient.

Traditional management methods have been unable 
to meet the needs of hospital refinement, digitization, 
and network management.13 The system can realize 
the whole process management from repair reporting 
to maintenance and evaluation through code scanning, 
quickly locate the repair reporting area, and objectively 
record the fault phenomenon, maintenance emergency, 
response time, process, and quality, which allows the 
development of an annual maintenance report.

Digital image visual management

3D visualization of medical equipment deployment 
service position and state was realized based on digital 
twin. Digital twinning of hospital building appearance, 

hierarchical structure, and other factors is carried out 
to integrate medical equipment positioning, energy ef-
ficiency, and other IoT data.14 As shown in Figure 6, the 
user can monitor queries, viewpoint adjustments, and 
scene switches, strengthening closed-loop traceability 
management.

Improve the efficiency of collaborative 
management of operational resource support

On December 5, 2022, the Shanghai epidemic was 
lifted, and the number of patients with respiratory tract 
infections increased sharply. The utilization rate of life 
support equipment in hospitals, especially Airvo series 
respiratory humidifiers, has grown rapidly. Considering 
that the use status of medical equipment changes in real 
time, this paper takes the monitoring situation of a re-
spiratory humidification therapy instrument in Shanghai 
Sixth People’s Hospital at 10:00 a.m. from December 1, 
2022 to December 30, 2022 as an example. The monitor-
ing of equipment used in the system is shown in Table 
1. The system can not only display the use status of the 
device in real time, but also realize accurate positioning 
synchronously. This ensures the prompt deployment of 
the unused devices from Department A to Department B, 
shortening the deployment time from 30 minutes to about 
10 minutes. It helps decision-makers realize online, net-
worked, and intelligent medical equipment management, 
replacing traditional manual paper records. Reduce the 
repeated purchase caused by unreasonable allocation of 
medical equipment, improve the efficiency of equipment 
use, and improve the efficiency of cooperative manage-
ment of operational resources.

FIGURE 5. Schematic diagram of room-level positioning of 
medical equipment.

FIGURE 6. The hospital-integrated management platform 
based on digital twin.



Wanrong Liu, Bin Li, Zhiyong Ji: Internet of Things and Digital Twin Technology-Based Management System of Medical Equipment

J Global Clinical Engineering Vol.6 Issue 1: 2023  52

CONCLUSION

The configuration and optimization of medical equip-
ment, especially life support and other large medical 
equipment, is an important task of hospitals. The basis of 
good resource configuration management is to grasp the 
actual running status of the current device completely in 
real time. Provide an objective basis for device configura-
tion to support configuration decisions.15–16 This paper 
proposes a new medical equipment management mode. 
Compared with traditional medical equipment management, 
this mode not only realizes the information of archives 
simply with the help of the IoT and digital twin technology. 
It is important to ensure the real-time dynamic update 
and maintenance of medical equipment to improve the 
management efficiency of hospital medical equipment to 
boost the continuous development of hospital medical 
treatment, teaching, and scientific research.

ACKNOWLEDGMENTS

The authors thank and acknowledge the anonymous 
reviewers for their valuable comments.

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TABLE 1. Monitoring Situation of Airvo Series Respiratory Hu-
midifiers Used in the Whole Hospital from December 1st to De-
cember 30th at 10:00 AM Sharp 

Time Actual 
quantity

Available 
quantity

Quantity 
in use Usage rate

December 1 37 36 10 27.78%

December 2 37 36 11 30.55%

December 3 37 37 10 27.02%

December 4 37 37 12 32.43%

December 5 37 36 28 77.77%

December 6 37 37 28 75.67%

December 7 37 36 33 91.67%

December 8 37 37 35 94.59%

December 9 46 46 40 86.96%

December 10 46 46 44 95.65%

December 11 46 44 36 81.82%

December 12 46 45 43 95.56%

December 13 46 46 44 95.65%

December 14 46 43 43 100%

December 15 46 46 45 97.83%

December 16 46 44 40 90.91%

December 17 46 46 42 91.30%

December 18 46 46 39 84.78%

December 19 46 43 40 93.02%

December 20 46 46 37 80.43%

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December 22 46 45 40 88.89%

December 23 46 46 42 91.30%

December 24 46 45 42 93.33%

December 25 46 46 36 78.26%

December 26 46 44 38 86.36%

December 27 46 45 40 88.89%

December 28 46 46 34 73.91%

December 29 46 46 35 76.08%

December 30 46 46 39 84.78%



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