New Kid in Town

We live in a special time. Given the consequences of the pandemic, a return to the old normal will hardly be possible; we need to create a new normal. There are good sides to this as well. We are reflecting on the aftermath of COVID-20, the changes in society that I discussed in a blog at the beginning of the pandemic.

The state of our world, how we treat people's freedom, the future of our children – these issues have become more important to us. At the same time, I personally am coming to terms with the long-term consequences of my recent pulmonary embolism, but I did take the opportunity to support a good cause by running in the Helios Team Event. A small contribution, as I could still only walk slowly and for 500 meters at a stretch.

Today I'm running for a good cause in the Fresenius Team Run. I’ve set myself a 5-kilometer (3.1-mile) course in the woods. I’ll have to get used to my new normal and test my limits, even though my running style is still sluggish and I’m short of breath. Nevertheless: Life motivates me again with its beautiful sides, the small and big miracles: I am happy about the miracle that was given to us privately, our daughter Valentina, whom I’ve already talked about in another blog. Valentina could grow up in a time when we pay more attention to our environment, the climate, and the diversity of people in society.

My run is accompanied by an old playlist, and I hear the Eagles’ song “New Kid in Town.” For me, the job is about us, as a company, actively shaping the new normal. This is precisely why we have, in business terms, given birth to a “new kid.” At birth, we chose smartHelios, and the child is now called Curalie. The idea behind smartHelios was to use digital programs to integrate follow-up therapy into the everyday lives of chronically ill people. The pandemic has shown how important and relevant such an idea can be in practice. Our partners included not only the treating physicians and accompanying therapists but also the payers, who expect such digital programs to significantly reduce treatment costs – while maintaining at least the same quality level. It was a "B2B2C" business model, namely an approach that addresses both our partners in the healthcare sector and patients. But our new child did not have an easy birth; it was critically questioned, even laughed at.

Curalie has outgrown its first entries in the family album, made back in 2017. There are still some teething problems, yet a child with a stably resolute personality has emerged. Indeed, the evaluation of our digital care therapies for chronically ill people has shown how well "digital health" can work. During the pandemic, Curalie has evolved from a digital therapist to a health companion, which is a step closer to becoming a digital health platform. One consequence is that Curalie is now available not only on prescription for people with chronic illnesses. With the launch of the "Check" a few days ago we made Curalie accessible to anyone who is interested. In other words, Curalie can now do more and is there for more people.

For me, at least, Curalie has already become a daily companion during its last test phases. I have learned a lot in the process. Not only about the pitfalls, customer wishes and the permanent need for improvement, but also about the state of my own health. I am regularly asked about symptoms and have shared vital data from other devices, such as the Apple Watch, with Curalie. In the Check, I receive an initial assessment using a medical algorithm, a recommendation if necessary and, most importantly, the option for a video chat with teledoctors. I can use Curalie for a prescription or a certificate of disability. This is a big relief, considering that in Germany, government-mandated agencies want to get the e-prescribing infrastructure up and running by next year.

But even if they don't, that leaves tried-and-true workarounds. For prescriptions, for example, Curalie asks for the pharmacy's fax number so it can fax the e-prescription there in a snap. In the future, Curalie will even provide our patients with the prescription as a QR code that can be easily presented at the pharmacy. In Spain, we have developed an offer with Curalie and our online portal where people can enroll in our "QS Connect Service." Customers pay €7 a month – similar to some streaming services – and can access our digital hospital with telemedical chat around the clock. In Germany, telemedical services from the outpatient area are provided by Helios for Curalie. In the case of patients with health insurance, for example, billing is carried out using a new billing code introduced by law. All this was driven forward during the pandemic, which spurred digital development in Germany.

Back to the running track: For me, five kilometers is now a big challenge; I have to walk the last 500 meters because my right leg doesn't really want to anymore. Maybe I should have worn my compression socks? I will check this via Curalie after my shower. Since the embolism, my wife has been more cautious in dealing with thrombic complaints. Previously, she did all sorts of queries via Google, which was often quite tedious and not especially helpful, since the search results are neither medically sound nor personalized. Curalie has known my vital signs for weeks now, even with and without exercise. I enter my symptoms in the check and hope for an evaluation that doesn't refer me to a clinic. The algorithm uses the personalized symptom check to see if there is a suspicion of a more serious condition requiring treatment. With my current post-run symptoms, the algorithm seems uncertain, the concordance of my blood thinning medication with the transmitted vital signs too complex. It will be several months before the algorithm can answer these more complex questions by machine. Currently, vignettes are being written for an additional 40 medical conditions to continue feeding the algorithm on a rule-based basis for now. An encouragement: with each customer contact, the algorithm will continue to learn itself.

In my case, this means that Curalie asks me whether I want to dial an emergency number because of my thrombic pain. I decide to use the telemedicine service and dial the next available appointment. It’s a good opportunity to get a new prescription for blood thinners at the same time. During the video call, the teledoctor assesses all the symptoms as non-critical and thus also convinces my wife. In the past, we would probably have gone to the clinic. Now I can save myself the trip, and instead we prepare for a walk with Valentina in the stroller: the weekend is saved. 

What nobody knows is what will become of our children. I cannot say what will become of Valentina. At six weeks, a reliable assessment is not possible: I can only speculate. Of course, I hope that Valentina will make the world a little bit better. She has already turned our little world at home upside down! What seems more concrete, though, is the future of our new child Curalie. We are making people's lives easier with it. For minor illnesses, there will be no need to visit the doctor's office. People will save time and effort, and protect themselves from infections, which lurk more often in the waiting room than in their own homes. In the case of chronic illnesses, personalized  support is possible, so that many trips to the outpatient clinic can be eliminated.

With Curalie, we are breaking down traditional “silos” in Germany and linking the digital and analog worlds. In countries with a stronger affinity for digital services in healthcare, we don't leave people alone with a mere app application, but can offer our telemedical services at any time, which we provide in parallel in Spain or Germany. And in places where healthcare is still in its infancy compared to European standards, Curalie will make access to telemedicine care possible in the first place. Every patient contact will make our new kid smarter, making the algorithm work for us.

One thing is clear: Curalie is still in development. There will be childhood illnesses that are important to strengthen the immune system for a long, healthy life. But it is also clear that it’s worth investing in our “children." In our future. For me, Curalie is a very hopeful young member of our Fresenius family who can make a significant contribution to strengthening Fresenius' image as an innovation driver. Curalie can become a digital health platform and drive digitization in healthcare. This opens entirely new perspectives for us at Fresenius on how we can rethink and reshape the healthcare of the future. In Germany, for example, we are already seeing fewer patients in our clinics every day and are continuing to expand the outpatient sector.

But the future needs even more digitally enhanced services. For low-population regions in Germany, we are discussing with government how we can intelligently counter the loss of outpatient structures. For example, we have offered mobile outpatient care, which in turn can be digitally linked via telemedicine. In future we will travel with our child, because digitally there are fewer cultural or language barriers. As Helios, we already treat 20 million people a year across Europe, nearly 18 million of them as outpatients. Why shouldn't it be 100 million or even more in a few years' time?

We have the best prerequisites for achieving this, and you can help us to achieve it. Feel free to give Curalie a try. Tell us what you think. Help Curalie grow up fast.


Francesco De Meo