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Ebiloma, D.O.; Aigbavboa, C.O.; Anumba, C. Towards Digital Twin Maintenance Management of Health Facilities. Encyclopedia. Available online: (accessed on 23 June 2024).
Ebiloma DO, Aigbavboa CO, Anumba C. Towards Digital Twin Maintenance Management of Health Facilities. Encyclopedia. Available at: Accessed June 23, 2024.
Ebiloma, David Ojimaojo, Clinton Ohis Aigbavboa, Chimay Anumba. "Towards Digital Twin Maintenance Management of Health Facilities" Encyclopedia, (accessed June 23, 2024).
Ebiloma, D.O., Aigbavboa, C.O., & Anumba, C. (2023, June 30). Towards Digital Twin Maintenance Management of Health Facilities. In Encyclopedia.
Ebiloma, David Ojimaojo, et al. "Towards Digital Twin Maintenance Management of Health Facilities." Encyclopedia. Web. 30 June, 2023.
Towards Digital Twin Maintenance Management of Health Facilities

There is no doubt that the use of digital twin (DT) technology can enhance efficiency in carrying out maintenance activities, reduce the downtime of facilities, improve cost savings from the perspective of lifecycle evaluation, and improve the quality of constructed facilities; hence, there is a need for adequate documentation to attain the outcomes as mentioned above and benefits of DT. Therefore, asserts that maintenance documentation is a significant construct for efficient maintenance management and a prerequisite for the adoption of DT in the management of healthcare-constructed facilities in developing countries.

digital twin maintenance management hospital buildings health sector

1. Introduction

The need for the adequate and effective maintenance of structures and other facilities using digital information technologies has become a great necessity in the global scene. It was asserted by [1] that maintenance is the combination of all technical, administrative, and managerial actions taken within the lifecycle of an item with the intent to keep it in or restore it to a state in which it can accomplish the requisite purpose and function. This means that maintenance is crucial to the efficient productivity and sustainability of different organizations’ facilities. Prior to this era, maintenance has been believed to only be an expenditure account system used to monitor direct costs, which may be associated with the overall period of the mandatory shutdown of facilities [2]; however, such views have begun to change in the present times as maintenance is being regarded as a key sponsor of organizations’ efficiency, delivery, and profitability [3]. The authors of [4] argued that a serious task is laid on maintenance managers to explore every opportunity that will lead to an improvement of profitability and performance following failures in organizations. In view of this, it has become necessary to inculcate technological processes in managing maintenance works in order to increase the productivity and sustainability of the processes and the facilities at large.
There has always existed a global problem on the attitude and culture towards building maintenance [5], and the COVID-19 pandemic that recently broke forth revealed the waning state of a considerable number of healthcare facilities, especially in unindustrialized territories. One study [6] asserted that public hospitals are challenged with exclusive issues that impend their relevance and survival. After conducting an assessment of the history, features, and organization of public hospitals, it was clear that these institutions by their makeup lack the capability to compete in an economy that is market-driven. It was explained by the authors of [7] that healthcare facilities are the most complex and difficult facilities to manage or maintain; this is due to the multifaceted nature of the buildings, the criticality of the electrical and mechanical systems, and maintenance budget challenges [8]. Hence, it has become critical to note that the need for an efficient management of public hospital buildings using fourth industrial revolution (4IR) tools cannot be overemphasized in this era.
The findings in [9] revealed that the healthcare sectors in developing countries lack comprehensible policies and strategies for the adequate maintenance of hospital buildings and the performance of the facilities that would provide a good working environment and that healthcare facilities, instead, have focused on the core business of rendering clinical services in hospitals. Consequently, the health sector’s built environment and facilities in a number of developing countries are faced with structural discrepancies and poor service delivery resulting in unsanitary healthcare environments and associated hospital-acquired infections [10]. Could these observed issues be a result of the absence of a more robust technological process, which has the capacity to aid the maintenance activities of the healthcare sector? This lack of efficient maintenance management can be handled via the adoption of digital twin technology in the healthcare sector for managing hospital buildings.

1.1. Digital Twin (DT) Technology

Dr. Michael Grieves from the University of Michigan first spotlighted DT technology; the concept can be linked to a presentation of his in 2002: Conceptual Ideal for Product Lifecycle Management (PLM) [11]. The PLM idea, which incorporates every aspect of the digital twin, holds that every system is made up of two systems: a virtual system that holds all the data pertinent to the physical system and the physical system itself, which is the real space that has always existed. Information can now travel between the physical and virtual systems thanks to the connection between these two systems [11]. The level of information exchange that exists between the physical and virtual systems shows that there is a critical need for a well-designed system of documentation. When the National Aeronautics and Space Administration (NASA) was working on the Apollo program, at least two identical space vehicles were developed to enable the mirroring or twinning of the status of the real space ship during the trip. This was the first digital twin deployment [12][13]. According to [13], NASA established the first formal definition of the term “Digital Twin”, which read as follows: “an integrated multi-physics, multi-scale, and probabilistic simulation of an as-built vehicle or systems that uses the best available physical model, sensor updates, fleet history, etc., to mirror the life of its corresponding flying twin”. Another study offered a condensed explanation of the term “digital twin”. For instance, [14] claimed that the physical product, the virtual product, and the associated data that connect the physical and virtual products make up the idea and concept of the digital twin. Three elements—the physical space, the virtual space, and the associated data—are emphasized in the numerous definitions of a digital twin. There is no doubt that, for the smooth adoption and implementation of the digital twin technology in the maintenance management of building facilities, there is a need for a well-packaged system of documentation to take care of the associated data needed.
The DT notion is thus represented by concepts and frameworks that include these three elements, but the literature also varies in the degree of data integration. Certain virtual representations do not support automatic bidirectional data exchange, but fully integrated DTs do. Ref. [15] proposes three DT subcategories in order to resolve the notion of uncertainty. The physical object’s data are manually transferred between the digital and physical versions of the digital model (DM), which has the least data integration. The status of the counterpart is unaffected directly by changes to the digital or physical object. One talks about the “Digital Shadow” when data are transferred automatically between physical and digital items (DS). This is DT in the full manifestation of the notion with full integration of the data flow in both directions between the physical and digital object. The physical parts, the virtual models, and the data that link them are thus the key DT components taken into account here. The “Data” in all of their guises provide the connection loop between the “Virtual-Physical” duality of the system. [16], for instance, believes that data moving from the “Physical” to the “Virtual” are raw and need to be processed, whereas data moving the other way are subject to various transformations and can be transformed into processed information and knowledge that is stored across digital models—with higher degrees of meaning. This finally returns as data via actuators to the “Physical”. As a result, the “Physical” component gathers data from the real world and sends them for processing. In exchange, the “Virtual” component uses its built-in engineering models and AI to find out information that is used to control how the “Physical” is used on a daily basis [17].

2. Theoretical Background

The consideration of the identified gap was based on the assessment of the existing constructs for maintenance management and on the fact that digital twin usage will not be possible in the absence of adequate maintenance documentation. Documentation is a subject matter that has not been broadly discussed in construction and maintenance studies; however, the social sciences, organization studies, science and technology studies, and library and information science have all long examined it. Hence, the subject matter of maintenance documentation is conceptualised from any of these fields that have carried out critical studies on it.
A long-standing issue in librarianship [18][19] as well as the ethnographic studies of science and engineering laboratories, is the varied effort around documentation [20]. Researchers have addressed how employees utilize various document genres, such as records, forms, interoffice memos, and e-mails, to “achieve and coordinate their day-to-day practical actions” in studies of workplaces and formal organizations [21], p. 12. This expressly indicates that there is a need to carry out studies within the construction industry domain on the critical need for documentation in order to achieve organizational goals. For newcomers, becoming proficient at reading and writing documents in a given organization is essential to understanding how that organization functions, how its many elements interact with one another, and how and by whom decisions are made [22][23].
Both symbolic interactionist theories [24] and ethnomethodology [25] place an emphasis on how individuals create and uphold social institutions via verbal and written descriptions. People often communicate their understandings and intentions to others with written documents. In a famous example of an infrastructure paradox, documentation work is both an essential component of an organization’s operations and a frequently disregarded type of unseen work [26]
Documentation is an eminent phenomenon in the software world as well; in fact, it has a well-grounded origin and implementation in software systems. The majority of documents that are shared within organizations belong to a more distinct genre than software documentation, which is why scholars from these theoretical traditions frequently study it. Discussions of software documentation frequently centre on issues such as instruction or usability. For a long time, experts in domains such as technical communication have concentrated on the best ways to develop user-friendly documents that describe a product’s features and functionalities [27][28]. There is no denying that documentation frequently plays important roles in a project’s internal operations and serves as one of the main channels for communication between those that work on a project and those outside the core team. For instance, the authors of [29] studied ‘agile’ software development firms, in which rapid iteration is preferred over the kinds of in-depth textual planning documents that are more typical in classical ‘waterfall’ software engineering. A long line of research has concentrated on the role of software documentation in professional firms that develop software for clients. They discovered that these companies still utilize textual artefacts to organize and plan software development, but they do so in a very different way than many agile proponents do [30]. This is very much in line with the main theme of the study—digital twin usage. It is a concept domiciled within the information and communication technology (ICT) sector, which requires adequate documentation for its actualisation in a real-life setting.
The Otlet concept was the foundational idea for documentation, which grew epistemologically from it. The International Institute of Bibliography (IIB), founded in 1895 in Belgium, and the Universal Bibliographic Repertory (UBR), whose project was proposed in the same year and reached 16 million cards in 1934, were both mentored by the lawyers Paul Otlet (1868–1944) and Henri La Fontaine (1854–1943). In 1903, Otlet used the term “documentation” to describe the process of making papers or references available to those who require the information they may contain. The article was titled Les sciences bibliographiques et la documentation [31][32]. The author took into account the body of knowledge found in the bibliographic sciences and defined documentation as the production, material fabrication, distribution, listing, statistics, conservation, and utilization of information, which includes compilation, printing, publishing, bookselling, bibliography, and librarianship. Otlet considered archives, maps, plans, ideograms, schematics, drawings and their reproductions, and pictures of actual items, among other things, to be documents in addition to books and manuscripts [31][32].
Documentation is the process of locating, gathering, and making accessible to the public existing records that have permanent historical worth, such as correspondence, computer files, pictures, etc. [33]. To fill in any gaps in the historical record or to provide context for existing ones, documentation may also entail the creation of new records; for this reason, keeping track of maintenance history in logbooks and information databases is essential. To complete a set of family papers or the archives of an organization, for instance, an oral history interview may be recorded, similarly to how a photograph of a person or a building or a film of a public event can add context to written material or communicate a part of the story that is not captured in the records [33]

3. Conceptualisation of the Documentation Framework

This section of the study is conceptually and contextually based on one of the areas that the subject matter of documentation has been well applied, as discussed above. It is the software documentation aspect; it is made up of process and product documentation [34]. Documents that detail the creation and upkeep of a system are referred to as process documentation. Process documentation includes timetables, organizational and project standards, quality documents for processes, and plans. The product that is being created is described in the product documentation. User documentation provides a product description that is focused on system users, as opposed to system documentation, which defines the product from the perspective of the engineers creating and maintaining the system [34][35].
In relating this concept to the study, it is referred to as maintenance documentation. Hence, maintenance documentation is the process of the identification, collection, recording, storage, and dissemination of pertinent, historical, and current records on a constructed facility for the purpose of decision-making, the scheduling of maintenance activities, and historical value. There are a number of documents that are needed and relevant to the management of constructed facilities. They include maintenance logbooks and history, building maintenance manuals, as-built 2D drawings and 3D models, maintenance requests, activity schedule plan, stock and inventory records, early warning system charts, and maintainability analysis reports. Hence, all these documents can be conceptualised into process and product documentation. Process documents refer to those identified, collected, and recorded during the process of carrying out the maintenance works on the constructed facilities, whereas product documents refer to the actual building documents that are already available at the completion stage of the facility

There is no doubt that the need for maintenance documentation in attaining digital twin maintenance management is critical; it is a significant coordinate on the roadmap to the digitalisation of maintenance and facilities management. Hence, it portrays that this gap has to be filled in knowledge and in practice for a successful implementation of digital twin maintenance management, with a view to attaining smart and efficient management of constructed facilities in Nigeria’s public hospital buildings.

4. Conclusion

As a way of developing a roadmap for the adoption of digital twin maintenance management in the health sector of developing economies, this entry was aimed at exploring and emphasizing on the need for maintenance documentation as a main determinant for efficient maintenance management of public hospital buildings. The existing maintenance management frameworks and models have not explored the possibilities and opportunities that exist in the determinant called maintenance documentation, for efficient maintenance activities. Considering how the construction sector is seen generally in underdeveloped nations, especially in Nigeria; maintenance works are still lagging behind on the use of technological processes for the efficient management of buildings and other facilities. In order to attain this, an inclusive point that cannot be neglected on the roadmap is the concept of maintenance documentation. This entry addresses the observed gap in maintenance management research with respect to hospital buildings which have not been evaluated as all-inclusive construct in the previous models, although it has been mentioned in the discussion of the previously reviewed models, but only as a distinct variable. This observed gap constitutes the additional new construct of the conceptualized framework for an ongoing study, aimed at developing a digital twin maintenance management model for public hospital buildings in developing countries, with Nigeria as a case study. The identified gap is discussed in relation to how digital twin maintenance management can be obtained for sustainable building facilities. This entry forms part of an ongoing study, and the validation of the attributes of maintenance documentation will be carried out among maintenance experts to ascertain the relevance and inclusion of this construct in the maintenance management domain of developing countries.


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