Date of Award


Degree Type


Degree Name

Doctor of Management (DMgt)

First Advisor

Larry M. Starr, PhD

Second Advisor

Syd Havely, PhD

Third Advisor

Michael Li, PhD


Industry 4.0 represents a digital revolution that is driven by technologies that blur the lines between the physical and digital worlds. Industry 4.0, the latest industrial revolution, is poised to have a profound impact on all aspects of society. In order to understand how the healthcare industry is being transformed by the convergence of the physical and digital realms, a systems perspective is taken in this study. Two research questions are addressed regarding the opportunities and interventions that can be provided by both analytical and systems conceptions of digital transformation. I use a systemic literature review approach to address the research questions. A sample of studies between 2000 and 2022 is analyzed. Existing studies mostly examine the effects of new digital technologies on healthcare providers. However, digital transformation also presents significant challenges, such as data privacy, ethical concerns related to AI-based automated decision-making, and equity issues related to e-health. Solutions to major challenges at both micro and macro levels can be derived from the existing theories and tools of systems thinking. For instance, systems thinking's continuous learning and adaptation capabilities can be useful for healthcare organizations to develop the required digital capabilities. Furthermore, the interconnectedness of subsystems and stakeholders in systems thinking can be combined with digital twin technology to investigate the dynamic interactions among key stakeholders, leading to the development of new regulatory policies.


A dissertation submitted in partial fulfillment of the requirements for the degree Doctor of Management in Strategic Leadership