AbstractHealth care ensures the health and safety of people, and as such requires effective management of facilities. Unfortunately, current approaches to health care facilities management (HFM) are based on an “if it breaks, we fix it” approach. There is still no effective real-time monitoring of health care facilities, causing a lack of effective preventive maintenance. We propose digital twin (DT), which can monitor equipment and systems in real time and enable bidirectional coordination, to address the shortcomings of current health care facilities management processes. DT is the virtual representation of a physical asset in all instances and in real time. This study aims to identify the shortcomings in HFM and propose a DT prototype to improve HFM. The study adopts a mixed methodology including a literature review, a case study integrating interviews, and scenario planning. The study identified basic DT concepts and data dynamics. The study identified the adopted DT components including virtual design/modeling technologies, sensors, data analytics techniques, communication networks, and mobile devices, including the components integration and data flow management of the DT platform. Functional implementations for scenario deployment were also developed. The functional implementations addressed the following scenarios: monitoring the performance of the HVAC system using pressure criteria, monitoring indoor air quality (IAQ), monitoring the performance of pulsed light for deactivating bacteria and viruses and radio frequency (RF), as they affect the performance of the magnetic resonance imaging (MRI) machine. This paper concludes by highlighting the benefits and limitations of DT application in health care facilities management.Practical ApplicationsThis study focused on DT-based health care facilities management. The paper elaborated on health care facilities management and identified some of the various shortcomings. Some of the shortcomings include a lack of effective real-time updates on the performance of the facilities and their system, lack of control of a physical system from the virtual model, and lack of building information modeling (BIM) integration with facilities management systems. The study further identified some FM software and its shortcomings. The findings from the study were supported using a case study approach that involved some health care facilities management. The facilities management and DT experts were used to help develop four scenarios that addressed some of the identified HFM issues identified in a different study. Subsequently, functional specifications explaining the step-by-step implementation processes of the proposed scenarios were developed. Although the study is still at its planning and development stage, potential benefits and limitations based on the proposed DT system were identified, including the contributions of the study. The study provides potential applications of the models discussed, and the implementation of the proposed system is currently in progress.