Digitalization holds great promise in the areas of automation, big data and artificial intelligence (AI). The MedTech market is shifting towards a focus on connectivity and integration, moving beyond product-centric approaches. The tech paradigm shift is driven by advancements in technologies like AI, Internet of Medical Things (IoMT), and predictive analytics. The rise of new technologies is accompanied by the generation of a vast amount of real-time health data, leading to a paradigm shift in data. Health data combined with advanced analytics are key elements for the implementation of predictive, personalized, preventive, and participative medicine, an approach that will leave a mark on health delivery and significantly improve treatment outcomes.

Our goals and ambitions

We aim to optimize and accelerate our internal processes with the help of digital processes and applications throughout the entire Group. Therefore, all business segments have defined digitalization ambitions for their respective markets:

• In the healthcare products market segment, we want to provide our customers with the best possible products and related services at all times in order to further improve the quality of medical care. Also, we aim to create value and efficiency in the daily use of products or services. Thanks to data-driven insights and digitalized processes, Fresenius Kabi can improve production, sales, and logistics, and thus patiente care.
• Increasing digitalization in the healthcare services market segment is streamlining processes and improving treatment cycles in our hospitals. This increases employee and patient satisfaction and also reduces costs.

The goals and ambitions we are explaining here aim not only at driving digitalization in the Group. They also help us to achieve the goals of other relevant topics, such as patient satisfaction and treatment results. Further information can be found in the Patient and product safety section.

Our approach

Our markets are changing rapidly. This is particularly true with regard to digital trends in healthcare, which have been further accelerated in response to the COVID-19 pandemic. We are seeing increasing demand for new digital services along the entire value chain. Patients increasingly want to receive remote diagnosis and healthcare services on demand. Data-driven decision-making is increasingly integrated into everyday clinical practice, and the proportion of digital components in medical devices is growing. The associated cybersecurity risks also highlight the need for standardized and resilient IT infrastructures.

Organization and responsibilities

Within the Group Management Board, the Chief Financial Officer (CFO) is responsible for Cybersecurity and the Fresenius Digital Technology segment. She oversees the IT transformation of the Fresenius Group. The Chief Executive Officers (CEOs) of the business segments are responsible for operational management. Digital transformation is the responsibility of the respective Management Boards, committees, or management functions of the business segments. They organize the management approaches and regulate the responsibilities within the Management Board, e. g., via a business allocation plan. The business allocation plan of the Group Management Board does not provide for a separate department for this purpose.

Special IT working groups are set up across the Group, consisting of executives from the business segments and the Group division Fresenius Digital Technology. They work on topics that directly contribute to the corporate goals. In this way, they jointly develop the global IT transformation for Fresenius. The IT working groups have replaced the global IT Board as of 2023. The development process of our further strategic IT orientation is steered by our subsidiary Fresenius Digital Technology and by the Chief Information Officer of the Fresenius Group.

As part of risk reporting, the Group Management Board is informed quarterly. The effectiveness of the various IT-based management systems is discussed if risks were identified or incidents occurred that could have a significant impact on the operating business, the reputation, or the value chain of the Group and its business segments. The Audit Committee of the Supervisory Board is informed about developments on a half-year basis. the Supervisory Board itself is informed on an annual basis. For further information, please refer to the Opportunities and Risk Report. We further report on cybersecurity governance in the Cybersecurity chapter and on data protection governance in the Data protection section.

Ethics in digitalization

Within the Fresenius Group, a working group for AI was established in 2023. In addition to the Group functions Cybersecurity and Risk & Integrity, representatives of the business segments also participate. It is led by the Corporate Development Group function.

The aim of the working group is to create a Group-wide framework for the use of AI and to develop corresponding guidelines. This also includes ensuring that the ethical standards and values of Fresenius are taken into account in the development and implementation of applications in which AI is used at Fresenius.

In the reporting year, we also published a guideline on the responsible use of AI on the intranet to sensitize employees to possible risks and to define key points to watch out for. Business segments also informed employees about this topic in written form.

Group-wide IT transformation

In recent years, the system infrastructure within the Fresenius Group has been characterized by a high degree of diversification, primarily due to the numerous acquisitions. The goal of the central IT function was therefore to reduce this degree of heterogeneity and fragmentation and optimize the IT structures. Fresenius continued this IT transformation in the reporting year. The main changes in 2023 include two major migration initiatives to the ISO / IEC 27001:2022-certified cloud: the most important SAP systems to SAP Rise cloud and non-SAP systems from our own data centers to the Azure cloud, the consolidation of the various service support teams into a global service desk, and the expansion of IT security.

By using cloud technologies, we are striving to improve performance and efficiency in the areas of finance, supply chain, production, human resources, sales, and customer engagement.

With these strategic steps, Fresenius laid the foundation for future innovation and growth ambitions. This not only improves scalability, but also enhances the security of IT systems and their application and drives the digitalization of global business processes. The migrated systems show improved performance in general and thus also support the maintenance of key processes. The Cloud migrationg was completed in 2023. The plan is to start implementing the SAP S4 / HANA-strategy in the 2024 reporting year.

Digitalization strategies

The digitalization of processes in the healthcare products market segment is important in two respects: on the one hand, for the effective care for critically and chronically ill patients and, on the other hand, for compliance with regulatory requirements.

We are undergoing a digital transformation and rethinking our approaches to innovation, production, delivery, sales, and customer support. We are leveraging insights from generated data and digital processes. Our goal is to improve and streamline operations with digital capabilities that are both cohesive and efficient. We rely on business intelligence and analytics to optimize decision-making. Our strategy also includes creating new offerings through the introduction of innovative digital products and services.

We focus on using data from interactions with customers to understand and improve their experience with our services. The data helps us to improve customer communication through both digital and non-digital channels, helping to support the use of our products, and thereby patient safety. With this in mind, Fresenius Kabi launched several initiatives in 2023 to harmonize the IT and digital landscape.

In the healthcare services market segment, the expansion of digitalization is of central importance. On the one hand, to ensure the future viability of our own clinics and outpatient facilities, and on the other hand, to continuously improve the quality of healthcare and the service for patients.

Helios Germany has the ambition to become a digital pioneer in the German healthcare sector. To this end, the division has set itself gradual targets for the automation of processes by 2026. We measure the degree of digitalization in German Helios clinics using the DigitalRadar Score introduced by the legislator in Germany in 2021. 1,624 hospitals took part in the initial survey and the average DigitalRadar score was 33.3 out of a possible 100 points. The average DigitalRadar score in Helios facilities was 45.1 in the initial survey in 2021. For 2024, the survey will be updated and the improvement evaluated.

Helios Spain has also set corporate goals for all hospitals – including for digitalization. Each hospital implements these goals and assesses the extent to which they are achieved. The results are presented to the Helios Spain steering committee. To support this, Helios Spain has developed a new digitalization path for its hospitals consisting of four phases: 1. the introduction of new tools, 2. the digital transformation, 3. the transformation of the healthcare model, and 4. liquid healthcare. In each phase, Helios Spain measures several key performance indicators (KPIs) to define when a hospital is ready to pass to the next phase. The overarching goal is to expand the digital care management system and patient portal Casiopea. For further information, please refer to the Innovation chapter. By 2024, Helios Spain wants to make the following processes 80% digital:

• Arrangements for medical tests, appointments and surgeries (2023: 74.1%)
• Signing of consent forms (2023: 51.6%)
• Surgical checklists (2023: 66.0%)
• Independent entry of patients’ medical histories (ongoing, no interim results)

Fresenius Vamed manages digitalization goals as part of its Vamed strategy. The implementation of this strategy and the continuous improvement of digital processes are company-wide objectives. In this way, the business segment aims to achieve digital excellence in the area of medical care to increase patient benefit and operational efficiency. Fresenius Vamed is also working on establishing a digital-first culture to create the environment and enablement for digital innovation. To this end, the business segment implemented a Digital Board in 2023. Interdisciplinary teams conduct digitalization workshops, for example, and work together with external partners on the further development of the digitalization strategy.

Digital processes and applications

We develop devices and applications in various medical fields to support ongoing digitalization, for example, in hospitals. These solutions not only have to be optimized in their core functions, but need to be embedded into the specific IT systems of healthcare facilities. To this end, we will continue to focus on increasing the share of software in medical technology and its application area.

Digital solutions are continuously being developed along the entire value chain to make internal work processes more efficient and simplify them. In various areas, such as compliance, supply chain, purchasing, and production, we are increasingly relying on intelligent automation and AI to improve business processes in administrative functions, e. g., by using chatbots, intelligent document processing, or recommendation and prediction applications. We have already implemented various solutions and identified potential savings that can be successively realized. Since September 2023, a chatbot has been supporting the global IT service desk, through which IT problems can be reported and, in some cases, resolved directly.

In the reporting year, we continued to work on developing overarching approaches to support the increasing automation of complex processes, for example in commercial areas such as sales and customer service processes. In production and quality management, Fresenius Kabi, for example, is using digital platforms to implement process control systems for industrial production plants, monitor equipment efficiency, and manage data and support workflows in laboratories. In this way, the business segment can also use the data to analyze and automate decision-making processes.

We also use digital solutions for what are known as track-and-trace systems for the traceability of products. These applications enable us to share information with customers, for example regarding the safety of products. They also support, for example, the monitoring of inventories in hospitals. For example, Fresenius Kabi uses radio frequency identification (RFID) technology, known as smart labels, for some of its drugs in the United States. The smart label enables hospitals to automatically manage their inventories.

In 2023, Fresenius Kabi launched the new digital application, PreparePlus, which supports customers in the parenteral, i. e., artificial, nutrition of patients. Pharmacists and pharmacy technicians use PreparePlus to prepare the physico-chemically stable formulations.

Following the acquisition of Ivenix Inc. in 2022, Fresenius Kabi now offers healthcare providers a broad portfolio of advanced infusion pumps and solutions to meet healthcare needs across the continuum of care. In 2023, Fresenius Kabi further expanded its offerings to meet increased customer demand in geographies such as the United States. At the same time, the business segment is improving clinical workflows by integrating its products into the digital hospital environment. In this way, Fresenius Kabi helps to reduce the risk of medication errors and improve patient safety.

The KetoApp, by contrast, supports patients with chronic kidney disease. Information on nutrition and the nutritional values of foods is intended to enable them to eat a varied diet appropriate to their disease. The application has now been rolled out in Chile, Colombia, Ecuador, Mexico, and Peru.

In order to further optimize the treatment of patients, Fresenius Vamed is working on digital assistance systems such as apps that support a healthy and independent life, as well as on digital rehabilitation services.

In the project business, Fresenius Vamed relies on what are known as building information modeling (BIM) systems for the planning and operation of healthcare facilities. These enable digital mapping and optimization of the entire life cycle – from planning, design, construction, and operation to maintenance – of a healthcare facility. AI can be used to optimize staff scheduling in clinics, for example.

Digital patient care

We develop digital applications as well as new IT and process strategies for medical professionals and patients with various objectives: they are intended to support the quality of treatment, improve care and the quality of life of patients, open up new areas of business, and ensure compliance with regulatory requirements. This is achieved, for example, through video conferences and chats in which patients can present their medical history, but also through protocols and automated tests for certain diagnoses. The result is digital patient care, known as the Digital Patient Journey. It requires the digitalization of a large number of interdependent processes, as well as digital applications such as the Helios patient portal and the electronic patient file (EPF).

Helios Spain has digitized various treatment processes as part of the Digital Patient Journey. These ensure that necessary laboratory examinations are initiated and appointments made for patients prior to a treatment consultation, depending on their individual health status. They follow established protocols. It is also ensured that the responsible physician receives all diagnoses and information prior to the consultation. The availability of real-time test results or existing patient data makes it possible for 30% of patients to be discharged directly after an initial consultation. In addition, they only spend around two hours in a clinic instead of an average of eight. Meetings, e. g., in the oncological and dermatological outpatient clinic, have also decreased significantly as a result of digitalization. Helios Spain aims to reduce overcrowding in emergency departments through a Virtual Urgent Care Program. Patients with low levels of suffering are cared for via video conference. In this way, both the clinical burden and the waiting times for those being treated are reduced, and the overall treatment time is reduced on average by 9 minutes.

Via our digital patient portals, our patients can access treatment documents such as findings, book appointments online, or attend video consultations around the clock and from home. The clinics benefit from central data storage and improved data transmission, as well as coordination between medical staff.

At the majority of workstations in the Helios clinics in Germany and Spain, an EPF with doctor’s letters, findings, and complete clinical imaging, as well as nursing documentation and medication, is available. It contains all the essential information needed for the treatment of patients.

In about half of the Helios clinics, integrated software solutions already issue warnings of possible interactions with other drugs. This further increases patient safety. The expansion of the Germany-wide telematics infrastructureTelematics infrastructureThe ​telematics ​infrastructure ​is ​intended ​to ​securely ​network ​all ​those ​involved ​in ​the ​German ​healthcare ​system ​and ​enable ​a ​secure ​exchange ​of ​information ​across ​sectors ​and ​systems., ordered by the government, into which the EPF will be integrated in the future, will also lead to better quality of care.