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, my team and I 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.


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.