What can chewing gum teach us regarding Digital Health Innovation?

Innovation is a term that lately seems to be used quite freely. It reminds me of similar “high-level” terms such as “strategy” or “marketing”—it can mean different things to different people.  I also think the term innovation gets confused with invention, ideation or even R&D, but finding the true definition can be challenging.  Merriam-Webster dictionary defines it as “a new idea, device, or method” and “the act or process of introducing” such things.  Even some famous folks have taken a swing at defining innovation: “Innovation distinguishes between a leader and a follower.” – Steve Jobs; and “Innovation is the specific instrument of entrepreneurship. The act that endows resources with a new capacity to create wealth.” – Peter Drucker.

Digital Health arguably falls into the category of innovation. 96% of hospitals now have an EHR that has been federally tested and certified (up from 71.9% in 2011, the first year of HITECH incentives).  Yet, the introduction of EHRs may not live up to “radical innovation” (as explained later) given the continued struggles with interoperability and usability. Total Innovation Management (TIM) Foundation is a not-for-profit organization that has created the Innovation Management Maturity Model which they believe holds the requirements for any organization to become truly innovative. The TIM Foundation states there are three basic types of innovation: Product, Service and Process Innovation. Within each of these, there is either radical innovation (completely new, ground-breaking innovation) or incremental innovation (improvements to existing products, services or processes).

How does this relate to gum, you may be asking.  Let me try to tie this together. When do you think chewing gum was first invented?

There is evidence that some northern Europeans were chewing birch bark tar 9,000 years ago.  The ancient Aztecs used to chew a substance called chicle that is derived from the sapodilla tree.  (I’m betting your guess didn’t go that far back in history.)  In the late 1840s, John Curtis developed the first commercial spruce tree gum which had some draw-backs such as a poor taste and becoming brittle when chewed.  About 40 years later, an inventor named Thomas Adams used chicle as the main ingredient in chewing gum until the-mid-1900s when synthetic ingredients replaced it.  Was Adam’s gum a radical innovation or simply incremental innovation improving an existing product?

Similarly, are EHRs considered radical innovation or simply an improvement on an older established process? Granted, EHRs are only part of digital health, but they are a nice proxy that demonstrates we may need to step back and look at innovation across multiple dimensions.

There are a number of innovation methodologies, but one that comes to mind is the Ten Types of Innovation from Doblin shown below.  Here you see they expand innovation into 10 different focus areas wherein each can have a huge impact on your business.


Using the above model, I would say that Thomas Adam’s gum fell more into Product Performance innovation as it was an improvement over earlier versions of chewing gum.

Let’s consider another gum story.  In 1893 William Wrigley Jr, who launched two new gum brands, Juicy Fruit and Wrigley’s Spearmint, used a variety of innovative approaches early in his career such as adding free packs of gum to baking soda orders (the product he was currently selling).  He also advertised and marketed his products heavily (a new idea at the time) and promoted his sticks of gum by sending them to U.S. children on their second birthdays.  These are examples of innovation in the “Service”, “Channel”, “Brand” and “Customer Engagement” areas. Given we all know how popular Wrigley’s gum is still today, it seems like he pulled off Drucker’s innovation definition: creating wealth.

During the late 1800s there were many gum manufacturers, but Wrigley looked at the big picture and found ways to drive his business. Maybe with digital health, we are too focused on the “product” and not how we can better introduce these products to the people that need/will use them.  This could require different channels or branding that may help in changing potential users’ behaviors.

My last gum example, which I personally consider radical innovation, came in 1928 wherein a Fleer employee named Walter Diemer devised a successful formula for the first commercial bubble gum called Dubble Bubble…truly a gum that could be used to produce a bubble (maybe even a double bubble!). Now this is what I call radical innovation!


As did the gum industry, Digital Health could benefit by looking at multiple areas and identifying ways in which we can incorporate innovation into healthcare. This requires looking holistically at the entire process and working with our customers (patients, providers, and payers) to discover ways in which radical innovation can be developed.

Dan is a digital health evangelist with a BS in Industrial Engineering, an MBA, and an MS in Health Informatics along with 20+ years’ experience in product development, innovation, and marketing. Connect with Dan on LinkedIn or via email dan@qual-smart.com

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