Change is inevitable when it comes to health and healthcare. Patients are going to have changing diagnoses and have a change in health at any time. In this case study, we saw a few things change which caused many things to happen. The health of the woman in the story had changed which caused her to need medication that would resolve this issue. This medication worked for ten years until her insurance company would no longer pay for the medication. This change caused her to have to use the medication that was preferred by the insurance company that way she would be able to afford the medication. This change of medication eventually led the woman to need to take other medication to help with pain which led to other health issues that eventually led to her death.

Trade-offs are often used to try and find the best solution to an issue or a problem, trade one thing for another that hopefully results in a better solution. The trade-off that was present in this case study was the insurance company would no longer fill the prescription unless it was the preferred medication through the insurance company. So, the pharmacy, the woman, and her doctor decided to switch to the preferred medication since that was the only way for the woman to be able to pay for the medication. This trade-off was something the woman was basically forced into doing as she did not have much of another option, and it ended up resulting in her death.

Healthcare is extremely history-dependent, what has happened to you previously is going to affect you in the future. One medication that you take may work great for you when taken by itself, but if taken with another medication, severe side effects may occur. This was quite evident within this case study. When the woman had her medication changed and then took another medication with it to reduce the side effects, an adverse reaction was created eventually leading to her death.

Healthcare is an industry with many departments that are loosely coupled but when they work together can become tightly coupled. In this study, the parties involved were not tightly coupled. The physician, the pharmacy, and the insurance company were not working together seamlessly in the best interest of the patient. This ultimately resulted in the death of the patient.

In a nonlinear system, according to Spath and Kelly (2017), small deviations may have huge, unpredictable, and irregular effects. We saw that a small change in this woman's medication had a huge effect on the situation as it led to her death. This small change was enough to trigger unpredictable and irregular effects.

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