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Healthcare systems in the United States have discovered a significant potential for digital technology to enhance clinical outcomes and change care delivery (Coventry & Branley, 2018). Digital transformation in healthcare has offered exponential advances in capabilities and efficiencies, improving access, quality of care, chronic disease management, public health surveillance, and population health (Burrell et al., 2020; Wickham, 2019). Technologies range from telemedicine technology providing care remotely, storing electronic health records (EHRs), and devices that deliver medication or monitor health (Coventry & Branley, 2018). However, the speed of change left security lagging, exposing cyber vulnerabilities that cost the U.S. 6.2 billion dollars annually, at an average cost of 2.2 million dollars, and 3,128 records breached per incident (Burrell et al., 2020). Recently, there has been a 300% increase in cyberattacks in the healthcare industry (Janofsky, 2019). These cyber-attacks can threaten laboratory operations, appointment management systems, bed management systems, and medical devices, among other institutional capabilities and capacities, and medical record data management, and can therefore jeopardize entire healthcare organizational systems, affecting healthcare privacy and the ability for healthcare organizations to effectively perform their duties and achieve their missions of providing quality medical care to their patients. This increasing threat to cybersecurity, especially amid a global pandemic, highlights organizations' immediate needs to utilize systems thinking to prevent mass-disruption and continuous loss. Despite significant investments to close the gap on cyber vulnerabilities, cybersecurity remains a critical issue (Burrell et al., 2020). The uniqueness of the healthcare industry’s supply chain, among other critical systems, arises in part from the high level of complexity in the healthcare industry. In such complexity, practicing management and leadership from a systems approach is crucial (Senge, 2014; Shufutinsky, 2018).
System thinking is a holistic and dynamic approach intended to analyze how the parts of the system interact and how the emergence changes as a whole entity (Nobles, 2018). Unlike reductionist thinking, which treats the world from a static, simple, and one-sided perspective, this holistic thinking emphasizes the complexity, dynamism, and entirety of the system and the interconnected and multifaceted relationships between the system components (Nobles, 2018).
Complexity science is a multidisciplinary field that conceptualizes a wide variety of phenomena as complex systems, ranging from flocking birds to chemical reactions to supply chains, and is applied in a variety of disciplines including physics, biology, computer science, and sociology. The complexity science framework provides a lens to understand the complex and dynamic characteristics of cybersecurity risks in various areas of healthcare, including supply chain management, inventory control, medical records management, and various aspects of patient care. Entire journals dedicated to research and applications in complexity science have also emerged, such as Journal of Complexity, Journal of Systems Science and Complexity, and Complexity). Complexity science has proven to be a potent framework for organizational science, applied in strategic management, organization development, and organization design (Cummings & Worley, 2014; Dent, 2003; Fogelberg & Frauwirth, 2010; Levinthal and Warglien 1999; Senge, 2014; Shufutinsky, 2018; 2019; Siggelkow & Rivkin, 2005; Simpson, 2007; Vermeulen et al., 2016). In complexity science, a complex system is defined by the number of system components and the interrelatedness and interdependence of these components (Simon 1962). Depending on the context and level of analysis, a component can be operationalized as an individual, an inanimate object, a department, an organization, or an organizational factor that acts autonomously and interacts with other components (Shufutinsky, 2018; 2019). The interrelatedness between components refers to the influence components can have on one another.