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Creating Digital Twins to Save Lives

Published

March 12, 2025

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Biomedical Engineering

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Pratt School of Engineering

School of Medicine

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Amanda Randles

Alfred Winborne and Victoria Stover Mordecai Associate Professor of Biomedical Sciences

Associate Professor of Biomedical Engineering

Assistant Professor in the Thomas Lord Department of Mechanical Engineering and Materials Science

Assistant Professor of Computer Science

Member of the Duke Cancer Institute

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Having a “digital twin” sounds like something out of a sci-fi movie. But in the real world, a digital twin simply simulates how an object or process will behave in real life.

Amanda Randles, Alfred Winborne and Victoria Stover Mordecai Associate Professor of Biomedical Sciences, developed software called HARVEY that creates these digital twins. It has allowed for the creation of a physiologically accurate model of the movement of red blood cells throughout the body.

The software is named after William Harvey, a 17th-century surgeon who is credited with first describing the circulatory system. Randles began working on the project in 2009 as a Ph.D. student. Although her degrees are in computer science and physics, she says she wanted to use her knowledge to focus on biomedical challenges.

“We used some of the world’s biggest supercomputers to do the simulations. How do we develop the computational capability to get the models we need? Now, we're connecting it to wearable devices like a Fitbit or an Apple Watch to try to remotely monitor what your blood flow is doing as you go about your daily activities, versus just at one single heartbeat,” says Randles, who recently was awarded the inaugural Sony Women in Technology Award with Nature, which is given to outstanding early- to mid-career women STEM researchers who are spearheading breakthroughs for the betterment of society and the planet. She also recently was named one of HPCwire's People to Watch for 2025.

Currently, physicians must put a stent into a patient to check for blockages. The non-invasive 3D model, however, can be used to simulate blood flow to determine the next step in a patient’s care.

We used some of the world's biggest supercomputers to do the simulations. How do we develop the computational capability to get the models we need?

Amanda Randles

“Everyone can appreciate it would be better to have something non-invasive rather than having to have an implantable device that’s going to track what you’re doing or have to go back to the doctor’s office and spend hours (there),” Randles says.

Her lab is collaborating with Duke Health to enroll patients into clinical trials with carotid disease who have had surgery. They are given a Fitbit and are being tracked over several months to see if physicians can predict, using these 3D models, whether the patient is at risk for another blockage of the carotid artery.

“We’ve shown mathematically that it is possible to remotely monitor using these wearable devices. But to translate that into something that’s going to have an impact on people, we need to do the clinical studies, and we need to do more verification and validation before it can be used by the general public. And we need NIH funds for any of that,” Randles says.

Her lab has mostly been funded by the National Institutes for Health. Without future funding, her work may not be able to move forward. For patients, that might mean delays in diagnosis and treatment.

In addition to her work on cardiovascular disease, Randles is using the technology to look at cancer cells, what drives disease development, and what leads to metastasis.

“If we want to have any chance of addressing any of these pressing concerns, we need to understand why they’re happening, where they're happening, and how do we best treat them?”

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