Real-Time Digital Twin for Remote Monitoring in an Extended Reality Environment

Real-time healthcare monitoring and visualization of patient data are becoming even more feasible with the integration of cutting-edge technologies such as Digital Twin (DT), Extended Reality (XR), and the Internet of Things (IoT). In this paper, we provide a DT system that uses the zero overhead network protocol (Zenoh) and the message queueing telemetry transport (MQTT) as communication protocols to integrate real-time electrocardiogram (ECG) data into a medical DT represented in an XR environment. Thanks to our approach, heart activity could be continuously and immersively monitored, enabling interactive medical applications. In order to assess data transmission efficiency, we model a scenario in which ECG data are sent over MQTT and Zenoh to a Unity-based DT system. Although Zenoh provides a hybrid communication strategy that allows both brokered and peer-to-peer data exchange, thus decreasing reliance on centralized infrastructure, MQTT uses a brokered publish-subscribe approach, which offers the possibility to select different levels of quality of service (QoS). The results presented in this work provide insight into the best data communication option for low-latency, high-reliability medical DT systems by highlighting the trade-offs between centralized and decentralized messaging architectures. This study also explores how Zenoh's hybrid method may be able to overcome network limitations and open the door to further developments in XR-based medical DT applications.