Diabetic foot infection


In 2008, ITI Scotland announced its wish to invest £7.9 Million over three and a half years in the development of advanced point of care wound infection diagnostic technology, specifically targeting diabetic foot ulcer wounds.

Before committing its funds however, ITI required a sound commercial argument to back the evidence of the growing diabetic foot ulcer population and the severe outlook such patients face. ITI commissioned Umio to build this commercial case and direct its technology development and investment strategy.  


In 14 weeks over Christmas 2009, we completed a detailed assessment of the diabetic foot care ecosystem in four countries (US, UK, India and Germany). After framing the ecosystem and mapping the hierarchy of interactions and practices, we spent time with practitioners and patients in each country to capture deep insight into their needs, resources, activities, contexts and constraints on the outcomes they desired.  Armed with a deeper ecosystem perspective into the structures, enablers and opportunities for evolving and reforming patient, carer and provider practices, we then…

  • Discovered, prioritised and themed the unmet needs of patients, clinicians and supporting actors such as microbiologists within each country
  • Uncovered four universal clinician practice segments, each sharing similar values, focus, unmet need and resource constraints. Segments run across the entire pathway and formal role definitions and job titles. 
  • Shaped several new value-propositions and solution concepts, informed by evidence of opportunity and its distribution within and across countries, pathways, segments, the resource environment and other contexts of varied diabetic foot care practice
  • Formulated an ecosystem strategy, consisting of frames for ongoing learning and adaptation, and a potential evolution of concepts and propositions based on emergent technological capabilities and competitive response
  • Integrated all the insights into a custom, multi-modal (QALY / MARKOV / ACTIVITY-COST), dynamic health economic and commercial model using detailed patient use case scenarios, resource use and costings for each geographical market.

Here is one of many outputs from the learning phase. This shows a ranking of capability gaps (difference between desired and actual performance) as rated by all diabetic foot care clinicians in the four countries. There is a huge difference and variety in the gaps within and between the countries. (Click for an expanded view).

Capability Gap Ranking for DFU Care


Armed with a compelling business case, ITI gained the reassurance it needed to push on with its technology licensing programme. First, with our assistance, it identified potential commercial partners who had capability to develop the first concepts we outlined. Second, early-stage technology was licensed to a top 10 medical device manufacturer for further commercialisation. 

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Client feedback

"The analysis carried out by Umio ensured there was a solid business case for the £7.9m programme funding and that the real unmet needs of healthcare practitioners were fully identified and evaluated from the outset, before the research and development began."

Programme Director, ITI Scotland