Fresenius Medical Care: Digital transformation of dialysis patient home care leveraging Microsoft technology

Fresenius Medical Care is regarded worldwide as the leading German provider of dialysis products and dialysis services to treat people with chronic and acute kidney failure. On a global scale, the company cares for over 344,000 dialysis patients in more than 4,150 company-owned clinics with approximately 128,000 employees, generating revenues of around 19.40 billion euros in 2022.

The different treatment options for kidney failure include hemodialysis, peritoneal dialysis and transplantation. “Both hemodialysis and peritoneal dialysis can be performed either as inpatient treatment in a medical facility or as outpatient treatment in the home environment, and we are noticing a trend toward outpatient care”, explains Dr. Jérôme Gard, Head of Digital Products at Fresenius Medical Care AG & Co. KGaA.

Organizing logistics poses a major challenge in home care. Among the patients who receive deliveries from a shipping company every two to six weeks on average, many find it challenging to order the right amount of vital dialysis products and supplies at the right time. Nurses, in turn, must provide additional outpatient care for their patients besides caring for them in the hospital. Handling the individual process steps also takes a great deal of time for customer service.

Therefore, FMC places great importance on efficient and transparent processes to ensure smooth outpatient care: for example, in patient registration prescription management, initial ordering and installation, along with routine orders, but also in logistics, contract and billing management.

A strategically important step in this direction was to establish a central cloud platform for customer relationship management in order to handle the relevant processes in a digital, standardized and largely automated manner. The platform consists of Microsoft Dynamics 365 for customer service, a mobile app for patients and another one for nurses (based on Microsoft Xamarin). Microsoft Dynamics 365 is also connected to an existing SAP ERP solution via SAP Process Orchestration (SAP PO). “By integrating the individual applications, the system landscape becomes consistently interoperable. This enables us to automate process flows and keep data synchronized”, clarifies Dr. Jérôme Gard.

The benefits of this end-to-end digital platform involving the home patient, nurse, nephrologist and customer service became apparent shortly after the Microsoft solution and apps went live. The individual processes can now be carried out significantly easier and faster than ever, and can be traced at any time. Time-consuming, unclear and error-prone order processing on paper, for example, and the exchange of information by email, fax, telephone or post are now a thing of the past.

Home patients can benefit from the digital processes, because the mobile app provides timely reminders about orders and helps patients order the optimal amount of dialysis products and consumables. Thanks to reliable delivery reminders, patients know exactly which materials will be delivered and when.

This reduces the number of returns due to non-delivery, eliminates the need for customer service inquiries, and nurses are only consulted in individual cases. The result is less administrative work in the hospitals and more time for the nurses to care for their inpatient dialysis patients.

Customer service also benefits from digital processes. Staff can access patient and order data stored centrally in the Microsoft cloud at any time, thus being able to answer patients’ questions promptly and satisfactorily, and process emergency cases significantly faster. Additional pluses include the fact that customer service is always reachable and can serve more patients with virtually no change in team size in the growing home care business.

Since placing an order via the mobile apps is as easy and intuitive as with standard e-commerce providers, user acceptance has been very high right from the start. The customer service team also appreciates the user-friendly interface of Microsoft Dynamics 365. Within the first six months after the “go-live”, more than 10,000 orders had already been processed via the new platform. Meanwhile, we have received more than 30,000 orders.

“Our goal is to optimize the customer experience of our applications through consistent user-centered product development while simultaneously shortening software development and deployment times”, explains Dr. Jérôme Gard. User experience design (UX design) is therefore an integral part of the development process, whereby the wishes and expectations of users are determined in advance through ethnographic studies.

Modern agile methods such as DevOps or CI/CD and short sprints are used to accelerate the development and delivery of digital apps and services. To great success: The nurses were positively impressed when a prototype of the mobile app was available after only two weeks and were able to test the first pilot of the app after just three months.

FMC relied on ORBIS SE to implement the ambitious digitalization project. The decisive factor was that the Saarbrücken-based IT service provider boasts extensive expertise not only in Microsoft business solutions and SAP software, but also in linking the two worlds together through modern middleware. Owing to the excellent cooperation, the customer service platform was implemented from the initial idea in just four months and went live on time by the set deadline.

The first go-live of the new solution took place at FMC’s Spanish subsidiary, followed by the headquarters in Germany. The solution was rolled out step by step to three additional European companies (Italy, Turkey, Portugal) in 2022, and plans are already in place to scale it across the entire EMEA region. To save time and costs, FMC relies on a template-based approach. Adaptations of the template to regional peculiarities are made by means of customization. There are plans to further expand the platform. Future plans include the use of data analytics capabilities and AI algorithms for process optimization.

One of the key points in all of this is protecting and ensuring the integrity of highly critical and sensitive patient data in the cloud. For this reason, care was taken during the planning stage to ensure that the new platform would meet the highest security standards, for example through the use of multi-factor authentication and end-to-end data encryption, and the data protection and data security officers were also brought on board right from the start. External security experts also regularly check security, for example in comprehensive penetration tests.