Smrtflo × Waracle

Sounding out decline in diabetic foot disease

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The Opportunity

Transforming patient outcomes by revolutionising diabetic foot care

Of the 4.5 million people living with diabetes in the UK, an estimated 10% will develop Diabetic Foot Disease (DFD) at some point. DFD is a devastating condition with high rates of amputation and a five-year mortality rate that’s worse than many types of common cancers.

Despite various national and international guidelines, managing this killer disease remains variable and inefficient across the country, costing the NHS over £1 billion annually.

x-ray examination

The Solution

Streamlining the clinical assessment process

Smrtflo was conceived to create a new pathway detecting this disease far earlier, using data collected from audio and imagery to assist clinicians achieve early diagnosis.

To address this challenge, the team from Smrtflo worked with product strategists, designers and developers from Waracle to develop an iOS app capable of recording audio signals from regularly-used ultrasound devices such as the Doppler. In a real-world environment these are prone to recording additional background noises, so custom algorithms are deployed to detect only the relevant vascular signals for interpretation - produced as spectral waveforms for rapid viewing by the clinician.

This data is then stored in the cloud, along with images gathered at the time of inspection, ready for medical experts to recognise and annotate the data towards a custom data model. In time, once validated, this model could be applied to the app itself and give an instant indication of the patient state.

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medical equipment and tablet

The Impact

The vision for Smrtflo is to enable clinicians to consistently, repeatably collect and integrate a broad range of quantitative and qualitative data from external devices to produce a robust, easily accessible report with built-in clinical insights.

At a time when foot ulcers and amputations account for around £1 in every £150 that the NHS spends each year, Smrtflo is a vital piece of the puzzle in improving patient outcomes while driving down the cost of care.


potential to reduce DFD amputations


potential to reduce cardiovascular deaths


weeks from idea to product

Client Testimonial

"Throughout the project the Waracle team were flexible and understanding of the challenges faced by our early-stage venture, which was crucial to project success. They delivered a fully functioning prototype on time and were able to overcome some important technical challenges. We look forward to continuing our work together. "

Pasha Normahani, Clinical Entrepreneur


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