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System thinking is a holistic 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).
Healthcare systems in the United States have discovered the massive potential for digital technology to enhance clinical outcomes and change care delivery (Coventry & Branley, 2018). Technologies range from telemedicine technology providing care remotely, storing electronic health records (EHRs), and devices that deliver medication or monitor health (Coventry & Branley, 2018). Health care devices and their interconnectivity continue to evolve (Coventry & Branley, 2018). Many healthcare devices are now incorporated into the hospital network. There are approximately 10-15 connected devices per bed in United States hospitals (Coventry & Branley, 2018). The benefits of interconnection include automation, efficiency, error reduction, and remote monitoring (Coventry & Branley, 2018). EHRs make health information more generally accessible. With this evolving technology, health professionals can observe and modify implanted devices without patients ever needing to visit a hospital or have an invasive procedure (Coventry & Branley, 2018). The benefits of interconnectivity are altering the treatment of acute and chronic ailments.
Despite its improvements to clinical outcomes and patient care delivery, interconnection presents unique cybersecurity vulnerabilities. Healthcare faces more significant cyber risks than other sectors. Due to its fundamental weaknesses in its security posture, healthcare is one of the most targeted sectors globally (Martin, Martin, Hankin, Darzi, & Kinross, 2017). Common and emerging cyber threats in healthcare include: Data theft for financial gain; Data theft for impact; Ransomware; Data corruption; Denial of service attacks; Business email compromise, and the unwitting insider. In 2015 alone, 110 million patients in the United States had their data compromised (Martin et al., 2017). These numbers come from 81% of 223 organizations surveyed in 2015. About 50% of these providers believe they can defend themselves from cyberattack (Martin et al., 2017).
There has been a 300% increase in cyberattacks in the healthcare industry (Janofsky, 2019). Some healthcare centers shut down for good because they could not handle the post-attack disruption. COVID-19 has further intensified this developing issue. A typical cyberattack during the COVID-19 pandemic is hacking patients' medical devices (Morgan, 2020). Due to the pandemic, more patients are utilizing remote care (Morgan, 2020). The contrived facilities being utilized for individuals infected with the virus have generated more vulnerabilities for hackers to manipulate (Morgan, 2020). Phishing has exploded during the COVID-19 pandemic, with many scams coming from organizations like the Centers of Disease Control (CDC) and the World Health Organization (WHO). The healthcare industry is projected to spend $125 billion on cybersecurity from 2020 to 2025 (Morgan, 2020). The increasing cost and threat to cybersecurity, especially amid a global pandemic, highlights organizations' immediate need to utilize system thinking to prevent continuous loss.
Figure 1. Deadly Khan, Brohi, & Zaman (2020)