AI scribe and clinic software for podiatry

The podiatry note, from risk category to operation note

The diabetic foot review has a fixed shape. NICE asks for both feet to be examined with shoes, socks and dressings removed, for neuropathy using a 10 g monofilament, limb ischaemia, ulceration, callus, infection or inflammation, deformity, gangrene and Charcot arthropathy.¹ It then stratifies risk. Low risk means no risk factors except callus alone. Moderate risk means deformity, neuropathy or peripheral arterial disease. High risk includes previous ulceration or amputation, renal replacement therapy, or neuropathy combined with peripheral arterial disease, callus or deformity.¹ The template carries a field for every one of those, so the draft cannot skip one.

The category sets the recall. NICE gives example reassessment intervals of annually at low risk, every 3 to 6 months at moderate risk, every 1 to 2 months at high risk without immediate concern and every 1 to 2 weeks at high risk with immediate concern.¹ For clinics outside the UK, the International Working Group on the Diabetic Foot's 2023 guideline recommends screening people at very low risk annually and those at higher risk more often.² wai suggests the risk category from the findings narrated, as a score for the podiatrist to apply, change or reject.

Nail surgery and biomechanics have their own templates. The operation note for a partial nail avulsion records consent, the digit and side, the local anaesthetic and its dose, the tourniquet time, the treatment of the nail bed and the dressing. A biomechanical assessment records gait, foot posture, joint range, footwear and the orthoses or exercise plan. wai reads each captured note in SOAP, problem-oriented or narrative view, and the clinic's templates and phrase library are shared across every podiatrist.

Codes come from the note. wai suggests ICD-10 and SNOMED CT codes, each beside the line of the consultation it rests on, for the podiatrist to confirm. In the WHO ICD-10 used in the UK, typical ones are L60.0 for ingrowing nail, L84 for corns and callosities, B35.1 for tinea unguium, M72.2 for plantar fascial fibromatosis, used for plantar fasciitis, and E11.4 for type 2 diabetes with neurological complications. US ICD-10-CM is more specific, with codes such as E11.621 for type 2 diabetes with foot ulcer and E11.42 for type 2 diabetes with diabetic polyneuropathy. Procedure codes, CPT in the US and OPCS in the UK, stay with the clinic's coder.

Letters after every review and every operation

The GP needs to know the risk category. After a diabetic foot review the letter carries the category, the findings that set it, the treatment given and the recall interval, and it flags anything for medical review, such as absent pulses or a change in sensation. The Academy of Medical Royal Colleges recommends writing most outpatient letters to the patient with a copy to the GP, and says that should be the default for an AI scribe.⁶ wai drafts that patient letter, explaining in plain words what the category means, how to check the feet each day, what footwear to wear, and which signs mean same-day care.

Urgent referrals have a clock. NICE asks for a limb-threatening or life-threatening diabetic foot problem to be referred immediately to acute services, and for other active problems to reach the multidisciplinary foot care or foot protection service within 1 working day.¹ wai drafts the referral with the ulcer site, size, signs of infection and vascular findings, and the question for the team, in the shape the referral letter describes. Vascular referrals follow the same pattern, covered in the vascular surgery guide.

After nail surgery, the patient goes home with written aftercare, the dressing plan, the signs of infection and the review date, and the GP receives the operation summary.

Foot care advice in the patient's own language

Diabetic foot care depends on what the patient does at home every day. wai works in 60 languages, among them English, Arabic, Spanish, French, Portuguese, Italian, Russian, Polish, Turkish, Urdu and Mandarin. English can be mixed in one consultation with Spanish, French, Portuguese, Russian, Italian, Dutch, German, Hindi or Japanese, and the other languages are captured in that language.

The signed note is written in English for the record, or in another language the clinic chooses. The patient's summary, with the daily foot check, the footwear advice and the signs that need same-day care, can be translated into their language beside it, with emergency numbers kept exactly as written. With the patient's consent, a family member or carer who helps with foot checks can have access too. The multilingual scribe page shows the detail.

Clinic software for podiatry clinics, built around recall

Recall is the podiatry front desk's main job. wai's proactive care sends each patient a recall for the next diabetic foot review at the interval the podiatrist signed, every one to two months for a high-risk patient and annually for a low-risk one, and a person approves each message before it is sent. The after-visit companion tracks each referral, to the foot care team, vascular service or GP, until it is done.

Patients request appointments through booking links that read each podiatrist's calendar, reminders go out before each visit, and a cancelled nail surgery slot is offered to the waitlist. Calls, email, web forms and WhatsApp land in one thread per patient. Payments run through the clinic's own Stripe account, with deposits for nail surgery, payment links, memberships for regular routine care and insurer invoices.

In the UK, pathology orders go out and results come back through TDL, and each result reaches the patient with the podiatrist's comment and a plain explanation. Before each visit, the podiatrist sees a sourced brief, the last risk category, ulcer history and HbA1c, each traced to the letter or result it came from. The clinic management software page covers the front desk in full.

One diabetic foot review, start to finish

Take a 67-year-old retired bus driver with type 2 diabetes for fifteen years, attending his annual foot review with his daughter. He speaks Urdu, and the consultation is captured in Urdu. He reports no wounds and no pain, and says his shoes have felt tight since the summer.

The podiatrist narrates the examination. Sensation to the 10 g monofilament is reduced across both forefeet, dorsalis pedis and posterior tibial pulses are palpable on both sides, there is callus under the left first metatarsal head and a moderate bunion on the left, and the skin is intact with no signs of infection. The callus is debrided, and they discuss wider footwear and cushioned insoles.

The draft note lists each finding by foot, the treatment and the advice. wai suggested a moderate risk category, and the podiatrist changed it to high, because NICE classes neuropathy with callus or deformity as high risk, and set the recall at six weeks.¹ wai suggested E11.4, type 2 diabetes with neurological complications, L84 for the callus and M20.1 for hallux valgus, and the podiatrist confirmed all three and signed.

What went out was a letter to the patient with an Urdu translation beside the English, explaining the high-risk category, the daily foot check his daughter can help with and the signs that mean same-day care, and a copy to the GP with the category, the findings and the recall. The front desk set the six-week recall, sent a booking link, and with his consent gave his daughter carer access.

The evidence behind wai's method

The note is one part of the day the evidence measures. In a randomised trial of 238 outpatient physicians across 14 specialties at UCLA Health, the ambient scribe with a significant effect cut the time spent writing each note by about 41 seconds, against 18 seconds in usual care.⁴ At The Permanente Medical Group, 3,442 physicians used an ambient scribe across 303,266 encounters in its first ten weeks.⁵ Podiatrists were not studied, and in podiatry the larger risk is a missed recall, so wai runs the recall and the referral tracking as well as the note.

The regulator asks for complete, prompt records. The HCPC standards, in effect since 1 September 2024, require registrants to keep full, clear and accurate records for everyone they care for, and to complete them promptly and as soon as possible after providing care.³ wai holds every draft until the podiatrist signs it, and the draft is ready for review when the consultation ends.

The patient's own language. In a systematic review of 33 studies, 76% found at least one outcome better when patient and physician shared a language other than English.⁷

Measured in a working clinic. At The Wellness in London, which runs on wai every day, every clinician has 15 hours a week back, as published in the customer story.⁸

Where to start

Start with diabetic foot reviews for one podiatrist. In week one, build the review template with a field for every NICE risk factor, the risk category and the recall interval, and measure the time from the end of each review to a signed note and GP letter. In week two, turn on recalls by risk category and add the patient letter in the patient's language, then check that every high-risk patient seen has a booked review within the interval signed.

Then add the nail surgery and biomechanics templates. Compare the workflow with the allied health guide and the endocrinology guide, see every profession on the specialties hub, and read how the scribe works on the wai Clinicians page.

Frequently asked questions