How innovation enables democratization of products: The case of the pregnancy test

We often associate technology with disruption. We talk about disruptive technology all the time. But not every new technology is disruptive. Conversely, we often fail to imagine the impact of a new technology, especially in economic and societal terms. Let’s look at a simple example: pregnancy tests.

Knowing whether a woman is pregnant has long been an important question for mankind, and many techniques have been developed to answer it. The ancient Egyptians’ technique was to sprinkle a sack of wheat and barley with the woman’s urine. Germination indicated pregnancy. In the 1930s, a better understanding of hormonal mechanisms led to the development of a more accurate test. Today, urine is injected subcutaneously into a female mouse. The mouse is then killed and necropsied. Ovulation indicates the presence of the hormone hCG, which means pregnancy. Progress, but not ideal…

An improvement is then achieved with the Hogben test, which is applied to… a frog, which does not need to be killed; notable progress, but still not ideal. A female frog is injected with the woman’s serum or urine. If the frog produces eggs within 24 hours, the test is positive. In the 1960s, technological advances eliminated the need for animals, and in vitro tests were performed on a urine sample. The sample was taken by a doctor and sent to a medical laboratory – another innovation of the time – which performed the test using specialized equipment.

In 1978, the first self-test was introduced. There was no need for a doctor or a laboratory anymore, both disappeared and the test cold be purchased in a pharmacy, a new player on the scene. Today, these tests can be purchased over the Internet, so there’s no need for even a pharmacist.

There are several lessons to be learned from this example: The first is a definition of technology: Technology is accumulated knowledge in usable form.

The second is that technology encapsulates this knowledge in tangible objects (pregnancy tests, computers, compasses) and intangible objects (cooking recipes, algorithms) that allow those who do not master the technology to use it. Technology is thus an accumulated form of knowledge that can be used by others. The individual test encapsulates, so to speak, five hundred years of knowledge development on the subject in a form usable by someone who probably doesn’t have any of it (no human could possess all that knowledge). So it is an intermediate object.

The third is that most of the time these objects encapsulate not one but several technologies, sometimes hundreds of them, nested inside each other. In the case of today’s mobile phones, there are more technologies than you can count. The encapsulating object is therefore also an aggregator and integrator of these technologies, which otherwise would not be usable together.

The fourth is that by making a sum of knowledge created by some (let’s call them experts) available to those who don’t possess it (let’s call them non-experts) in a form usable by the latter, it allows that knowledge to be used without being possessed. This may seem obvious, but its practical consequences are rarely recognized: here lies the truly disruptive element. Experts create an object that makes it possible to do without them. This makes it possible to scale up: before the individual test, the presence of the doctor is necessary (bringing the “problem” to the solution), which is a sticking point. With the individual test, millions of tests can be performed without the intervention of an expert (we bring the solution to the “problem”): a disease that previously required considerable and very expensive human expertise, a doctor, a laboratory technician and a whole battery of technologies, is now treated by a small object costing three euros that the patient can use herself.

The social consequences are therefore real: for a given field, the expert is less and less necessary as we go through the stages of this process. In medicine, what used to require the intervention of a specialist is gradually taken over by a general practitioner, then by a nurse, then by the individual. So there’s a gradual democratization of the field. You used to need an expert to edit a movie, but now you can do it for free on Youtube. As a result, we can have billions of videos.


Of course, this “democratization” of the field meets with resistance, sometimes fierce, from those who master each stage. Doctors, for example, oppose self-medication or the possibility of pharmacists administering vaccinations. Video editors scoff at the amateurish quality of Youtube videos. The most common argument is one of safety and quality. “Without us, beware the loss of quality.” In medicine, where it’s a matter of life and death, this argument often carries weight.

But the quality argument doesn’t generally hold water: experience shows that such developments actually improve quality. For example, Shouldice, a Canadian clinic that treats hernias and nothing else, has a much lower postoperative failure rate than hospitals. For the most part, the quality is “good enough” for most applications, with recourse to the expert reserved for special situations. The need to consult an expert is either eliminated or reduced (in the case of the test, you can have it confirmed by a doctor, whose test will be marginally more reliable, but this is rare). So the next time you hold a seemingly simple object in your hands, ask yourself how it is or has been disruptive.

Source: Wikipedia

📬 If you enjoyed this article, don’t hesitate to subscribe to receive future articles via email (“I subscribe” in the upper right corner of the home page).

🇫🇷 French version of this article here.

Leave a Reply