The word “innovation” is tricky. Most of us have one idea in our minds of what it looks like—something like Steve Jobs standing on stage with an iPod, dressed in jeans and a black turtleneck, telling us we could now fit our entire music library in our pocket.

When we think about companies that represent innovation in the economy, we tend to think of the companies that would launch a Harvard Business Review case study, such as Amazon, Netflix or Google. For a decade or more, innovation was virtually synonymous with tech, especially the “software-eating-the-world” companies to come out of Silicon Valley.

I believe it was only more recently, perhaps with Elon Musk, that many of us have begun to think of innovation in tech as being about physical things—electric cars or reusable rockets, for example—rather than software.

But what if, when it comes to healthcare, our preconceived notions of innovation are wrong?

One company that is less often talked about but exemplifies innovation is McDonald’s. The standard story about how McDonald’s became McDonald’s is that Ray Kroc took a small family business and implemented a new model of franchising to transform it into what is now a ubiquitous and iconic American brand.

But, actually, that’s not quite correct, though it does conform to the standard narrative of innovation we’re used to, which is that innovation is usually the work of a singular visionary who saw what no one else could. To be sure, Kroc is unquestionably the man most responsible for building McDonald’s into what it is today. But even he was building on multiple innovations that had come before. In fact, McDonald’s wasn’t even the first hamburger chain—that distinction belongs to White Castle.

And, of course, Kroc didn’t invent the hamburger or McDonald’s. It was Maurice and Richard McDonald, the original owners, who figured out how to lower costs by cooking the burgers ahead of time rather than to-order and opening a self-service counter instead of employing wait staff. The true origin of the hamburger is unknown, but it is thought to have been around at least since the 1800s in Germany and was sold at state fairs at the turn of the century. In his book The Entrepreneurial Journey, Thomas O’Malia reminds readers that a hamburger wasn’t a brand new idea and that innovation is ultimately about taking someone’s idea to a whole new level.

So what, or where, exactly, was the innovation?

When I think about the answer to that question, I often think about all the progress we’ve made in telemedicine, especially since the pandemic. Telemedicine adoption has come faster than anyone would have expected.

Has telemedicine been innovative as it continues to grow? I like to think so. But what or where, exactly, was that innovation? Telemedicine carts in hospitals have been around for a long time, as have cell phones and video chats. The idea to beam in virtual specialists isn’t exactly new—telestroke programs have been improving outcomes for more than two decades at this point.

All the tools to transform healthcare and build the next generation of hospitals are here. The question is how to combine existing technologies with processes, workflows and people to scale telemedicine throughout the country so quality access to healthcare can be brought to patients regardless of geographic location.

Like McDonald’s, telemedicine has built on many innovations that came before. Combining tools and scaling them in new ways, customizing them to hospital and health system partners and continually iterating to improve the experience of both the patients and providers has been telemedicine’s innovation to date.

Looking back, it’s clear to me that a lot of innovation has come to telemedicine and healthcare as an industry over the past few years. And perhaps, in healthcare, a better way to think about innovation is not as the result of a single visionary but as the product of thousands of leaders, clinicians, technologists and support staff slowly and painstakingly iterating, building and, yes, sometimes disrupting what has come before.

Author: Dr. Jason Hallock is Chief Clinical Innovation Officer at Access TeleCare, where he leads clinical and administrative strategy. Read Jason Hallock’s full executive profile here.