Medical assistance at home - Tomorrow’s health-care solution

Against the backdrop of the current health crisis, home is becoming a legitimate care setting in its own right—now more than ever. Mindful of the essential role played by home medical assistance providers in envisioning the future of health care, Ardian recently joined forces with Santé Cie, one of the most dynamic players in the sector. To learn more about the origins of this partnership, we sat down with Larbi Hamidi, Chairman and CEO of Santé Cie, and Nicolas Darnaud, Managing Director in the Buyout team at Ardian, who told us about their shared challenges and sustainability objectives, as well as their vision for health care in tomorrow’s world.

Larbi Hamidi, as the Chairman and CEO of Santé Cie, could you tell us a bit about your company? 

Larbi Hamidi: The Santé Cie Group is a health-care provider specialized in home-based medical assistance. Santé Cie now provides health-care services nationwide in France for a variety of different diseases through its two operating networks, Elivie and Asdia. More specifically, we work in four core therapeutic fields. The first is respiratory assistance, including for example oxygen therapy, invasive ventilatory support and non-invasive ventilation—which is used in particular for the treatment of sleep apnea. Next is our infusion division, which focuses on the treatment of acute and chronic diseases. This may cover patients requiring antibiotic therapy or pain treatment, parenteral nutrition or hydration , or immunoglobulin treatment. We also provide monitoring services for patients undergoing chemotherapy at home. Our nutrition division focuses on artificial nutrition and is mainly composed of teams of experts and dietitians who support and advise patients. Our fourth area of focus concerns follow-up care for diabetic patients—for whom we set up insulin pump devices at home. We also provide services for patients with chronic conditions suffering from Parkinson's disease, again by putting pump systems in place. Both Elivie and Asdia are approved and contracted under the national health insurance scheme in France and all of these home-based treatments are prescribed by medical specialists. 

Nicolas Darnaud: When Ardian acquired a stake in Santé Cie in early 2020, the latter was primarily operating in the French market. After we joined the team, the Group quickly established itself in Germany. Our current mission is to provide services across these two zones. Santé Cie currently has more than 2,300 employees in France and Germany, providing treatment for 170,000 patients. In France, 85 local agencies offer services throughout the country.

What kind of road map have you charted together for the future? How do you think Ardian’s support and Sustainable Buyout vision will help Santé Cie achieve these common goals?

ND: Ardian’s Buyout team invests in companies that are leaders in their sectors and supports them to become European or global players. The first step was international development: three months after we acquired a stake in the Group, Santé Cie entered the German market. The second step is technological development: digital technologies can have a major impact on patient diagnostics, monitoring and support. Many people are sick right now and don't even know it, because they have not received a diagnosis. But we believe that technology can help us with diagnostics—to the advantage of care and improved patient access and adherence to treatments. This is a major concern if we take the aging of the population and lifestyle changes into account. The third step is to help Santé Cie strengthen its CSR policy. We are very proud to help with this endeavor, because we believe that it will have a significant and far-reaching impact, from a societal and social point of view. These issues are not just a part of the strategic plan—they are the very essence of the company's existence.

LH: From day one, Ardian helped us to set up a board of ethics by attracting experts in the sector—recognized by the French National Authority for Health and by the French national health insurance system—to our committee. We knew that it was part of Ardian’s commitment to pursue such a policy on social and environmental issues in all their assets. Nowadays, this policy is essential for all players in the health sector. Also, as you know, we provide outpatient care. To do so, we manage a fleet of nearly 1,200 vehicles for our home-based care workers. We have begun to analyze this aspect of our operations, and we are discovering, by examining the management of our fleet, that the optimization solutions required to reduce our carbon footprint will also have a favorable impact on our cost structures. With the support of Ardian in all these areas, we are coming to realize that all the initiatives we are implementing in terms of sustainable development—particularly through the monitoring of new KPIs—are making us even more efficient.

ND: Indeed, Santé Cie subscribes to fully recognizing the environmental issues at stake. The first point is therefore to reduce emissions. Visiting patients at home makes it possible for a certain number of people to avoid having to travel from their homes to a health-care establishment. This means less movement and emissions, because such patients are often unable to travel by themselves. By organizing rounds for technicians and caregivers to visit patients directly in their homes, it is possible to achieve optimization and much lower levels of emissions. 

How are players in the home medical assistance sector reinventing the health-care value chain today?

LH: As I was saying, Ardian’s arrival is helping us to accelerate technological innovations in our different business segments. For several years now, we have been implementing remote monitoring solutions that enable us to track the usage parameters of certain medical devices remotely. Innovations in connected health care, telemonitoring and telemedicine will very soon make it possible to secure new health-care pathways outside hospital walls, in close coordination with attending physicians, pharmacists, private nurses and, of course, home assistance providers. In parallel, these technological developments, particularly digital ones, have very real consequences: they will enable us to move towards a much more predictive health-care system. More technology will mean greater ease and better quality diagnostics.

In France, we are very much oriented towards a curative health-care system. Thanks to these technologies, we should have access to truly preventive health care. On another note, a health-care provider should, in addition to providing patient assistance and treatment, provide support for doctors and hospital services. Outpatient services should not be established in opposition to hospital services—on the contrary, outpatient care should work in partnership with hospitals and doctors. Doctors today need to be equipped, and health-care providers are directing investments into these tools and technologies. In fact, we are systematically examining ways to improve care pathways, looking at what techniques and technologies, etc. are best suited to the task. What’s more, you can’t have technology without people. That was the philosophy we had in mind when we were developing Santé Cie with Ardian—the pillar at the very heart of our strategic plan is the human element. Putting people at the center of everything is of course the mission of Santé Cie, which helps patients at home by offering them the best quality of care.

The Covid-19 pandemic has undoubtedly called the health system into question, in particular by strengthening networks between different players in the care sector, as well as telemedicine solutions, etc. What have you taken from the crisis? 

LH: This epidemic has shaken up our organizations and saturated our hospital services, which are doing an exceptional job. It's obvious that after this crisis, we're going to have to reexamine the system. The realization that the home has become a place of care must now be accompanied by action by public authorities to implement a real outpatient care policy, enabling all the players in the health-care chain to work together. We must not pit the different players in the chain against each other, but redefine the role of each one. What the crisis has shown us is the essential nature of cooperation between different players, because the deficit we are generating today is one that will have to be paid for by several generations to come. 

ND: I would go on to add that the health crisis represents a major boost from an operational perspective. In many respects, trends have been accelerated. When I say that the crisis has been a boost, I'm talking about an observation we made at the outset: nobody questions the fact that patients need assistance at home anymore. That goes without saying now—it is self-evident. Covid-19 has made this even clearer. The question that everyone is asking now is: how do we make it happen? I would say that Santé Cie is part of the answer. It is already operational and providing solutions. The issue at stake for us is making this second point equally clear to everyone.

In conclusion, what part of this partnership are you most proud of?

LH: What we are most proud of today is to have attracted an investment firm like Ardian, with all of its ethical credentials, to make Santé Cie one of the European leaders in providing home-based health-care pathways. I am saying this for myself, but also on behalf of our teams, because when a new shareholder arrives, the teams are also involved in the process through the projects and commitments we try to achieve. And when these commitments are fulfilled quickly, it gives all our employees a lot of confidence and encouragement. 

ND: When we give our support to a project, it is above all the men, women and entrepreneurs involved that we support. In this case, the entry point was Larbi, with whom we outlined our shared strategy and goals—it was an invaluable encounter. Following on from that, we are proud to provide financial resources to support patients with chronic diseases so that they are able to access diagnoses and treatments. But we will be even prouder in a few years, when, thanks to technology, our resources and our initiatives, we will be able to help these patients—because that is the principal objective of all of the thousands of employees who have joined and will join Santé Cie. 

Discover more about our Sustainable Buyout methodology