Breathing New Life into Healthcare: Brazilian Innovators Revolutionize Oxygen Management

Salvus and CESAR’s IoT-powered digital flowmeter is poised to transform medicinal oxygen monitoring in hospitals to improve quality of care and reduce healthcare costs.

In the rhythm of life, few things are as fundamental as the act of breathing.

With every inhalation and exhalation, our bodies perform a delicate dance with the atmosphere, exchanging gases that sustain our existence. For a healthy adult at rest, this plays out 12 to 18 times per minute — a cadence so natural that we rarely give it a second thought. Yet, for millions of people around the world, each breath is a conscious effort, a reminder of the fragility of our respiratory system.

Chronic Obstructive Pulmonary Disease (COPD) has emerged as a silent epidemic, claiming its place as the third leading cause of death globally. In 2019 alone, it claimed more than 3.23 million lives, according to the WHO. This relentless condition is gaining ground, particularly in the Americas, where countries like Brazil, Canada, Mexico, and the United States grapple with aging populations and increasing air pollution from both natural and human-made sources.

The COVID-19 pandemic brought the importance of respiratory health into sharp focus, revealing the vulnerabilities in our healthcare systems and the critical role of medical oxygen. As we brace for potential resurgences of the virus or other public health threats, the demand for this life-sustaining element is likely  to intensify. For those battling COPD — an incurable condition — and for survivors of severe COVID-19 with lasting lung damage, medically prescribed oxygen is not just a treatment; it’s a lifeline.

Salvus joined forces with CESAR Innovation Hub, known for its IoT prowess, among other advanced technologies, to tackle these challenges head-on. CESAR is a founding member of Porto Digital (Recife, Brazil), one of one of the largest technology districts in Latin America’s largest economy.

Yet, the global crisis exposed a stark reality: despite its crucial role in treating hypoxia, medical oxygen remains a scarce resource, especially for vulnerable populations in low- and middle-income countries. The disparity in access to this basic necessity has highlighted an urgent need for innovation in how we manage, monitor, and distribute this vital resource.

As we stand at the crossroads of technology and healthcare, a groundbreaking solution has emerged from a perhaps unexpected corner of the world, promising to transform the landscape of respiratory care: Brazil.

The Inspiration for the ATAS O2 System That’s Tackling a Global Killer on the Rise

The journey of innovation often begins with personal experience, and the ATAS O2 System is no exception. In 2015, Maristone Gomes, the founder and CEO of Salvus, found his life transformed when both his and his wife’s grandparents moved in with them. This sudden immersion into the world of eldercare, particularly his experience with his wife’s grandmother who suffered from COPD, opened Gomes’ eyes to the complexities and challenges of the healthcare system.

“My family’s health struggles exposed both the virtues and critical flaws in our healthcare systems. Salvus was born from this experience, initially aiming to unify patient data. But as we dug deeper into the sector’s challenges, we uncovered another pressing issue: the inefficient use of medical oxygen,” said Gomes. “This revelation led us to create ATAS O2 — a device that’s not just monitoring medication use but revolutionizing how we approach oxygen therapy in hospitals and homes alike.”

As Gomes delved deeper into the healthcare ecosystem, engaging with various stakeholders from hospitals, home-care services, and the telehealth sector, he uncovered a complex web of players involved in the supply chain and logistics of keeping people alive and healthy. Medical oxygen, a critical component in this chain, stood out as an area ripe for innovation.

This realization led to a collaborative journey that has now spanned five years. Salvus joined forces with CESAR Innovation Hub, known for its IoT prowess among other advanced technologies, to tackle these challenges head-on. Together, they embarked on an ambitious project to research, design, and iterate on a new kind of low-flow oxygen therapy system.

CESAR is a founding member of Porto Digital (Recife, Brazil), one of one of the largest technology districts in Latin America’s largest economy. Conceived in 2000, Porto Digital — which WIRED magazine described as “the quixotic tech hub that actually worked” in a feature story last year — has transformed Recife into a bona fide center for Brazil’s emerging tech and creative sectors. Today, the tech hub has more than 350 residents, from global players to cutting-edge startups.

The result of Salvus’ collaboration with CESAR is the ATOS O2, a groundbreaking healthtech innovation designed for use in both hospital urgent care settings and home oxygen therapy for patients with hypoxemia, often caused by conditions like COPD.

Salvus will take it a step further: What will set the ATOS O2 apart is its ability to non-invasively monitor and respond to crucial blood gas parameters — oxygen saturation (SpO2) and oxygen pressure (PaO2). By automating the regulation of these vital sign levels, it prevents the potentially damaging effects of overconsumption on patients’ lungs, a common risk in traditional oxygen therapy. This not only enhances the quality of treatment but also helps in resource management and cost control. The real-time data allows for immediate adjustments, ensuring each patient receives optimal care tailored to their specific needs.

This innovation represents a significant leap forward in respiratory care, combining the power of IoT technology with precise medical monitoring to create a solution that not only improves patient outcomes but also streamlines healthcare operations.

Precision Breathing: Inside the Digital Flowmeter That’s Transforming Patient Care

Oxygen therapy, while life-saving, demands precision. Improper administration can lead to severe consequences, ranging from extended hospital stays and increased medication use to the need for intensive care or mechanical ventilation. For the most vulnerable patients, such as newborns, the risks are even more pronounced, potentially causing lung injuries, retinopathy of prematurity, and brain damage.

Perhaps most impressively, the ATAS O2 System offers a holistic view of oxygen usage across the entire hospital. It provides a real-time, updated, and consolidated overview of all beds simultaneously. This comprehensive insight is accessible to various hospital teams — from clinical engineering and maintenance to assistance, auditing, and billing — all while rigorously respecting the hospital’s privacy policies.

This level of integration and transparency enables more efficient resource allocation, improved patient monitoring, and enhanced coordination between different departments. The result is a more streamlined, responsive, and effective healthcare environment, where the focus remains firmly on delivering the best possible patient care at affordable costs.

“Partnering with CESAR on this long-term collaboration was a no-brainer for us. Being incubated at Porto Digital through Startup Brasil opened doors, and CESAR was right there,” said Gomes. “Together, we’ve knocked it out of the park with ATAS O2, leveraging support from EMBRAPII, BNDES, and SEBRAE. This partnership with CESAR isn’t just a one-off thing.  It’s ongoing, and it’s truly been a game-changer for Salvus.”

Broader Societal Benefits of the Pioneering ATOS O2

The ATAS O2 system’s impact extends far beyond individual patient care, delivering significant environmental and social benefits. By reducing the need for frequent oxygen cylinder refills and associated transport, the system contributes to a decrease in carbon emissions, directly addressing climate change and the prevalence of respiratory diseases linked to air pollution. This reduction in pollutants is crucial, as prolonged exposure to fine particles, sulfur dioxide, and nitrogen oxides is associated with higher rates of respiratory illnesses such as asthma, chronic bronchitis, and lung infections.

From a social perspective, the optimization of routes leads to more efficient and punctual transport, benefiting employees, customers, and local communities. Reduced vehicle traffic creates a more conducive environment for social interactions and community building. It minimizes noise and air pollution, improving residents’ quality of life and encouraging outdoor activities.

Breathing Easier: The ATOS O2’s Promising Roll-Out in Brazil So Far

The ATOS O2 system is not just a theoretical innovation; it’s already making an impact in the Brazilian healthcare landscape.

As the only continuous monitoring system of its kind approved by Brazil’s National Health Surveillance Agency (ANVISA), it has secured its position in the market. This breakthrough authorization paves the way for wider adoption within Brazil’s healthcare system, setting a precedent for other markets. With an eye on global expansion, Salvus is now seeking approval in other key markets, including Europe and the United States by 2026.

As of August 2024, the ATOS O2 system has logged over 310,000 documented hours of operation across more than 340 beds, serving upwards of 4,000 patients in 22 different healthcare institutions. These numbers alone speak to the rapid adoption and trust placed in this innovative technology.

But the real impact lies in the improved patient care and operational efficiency. The pilot data reveals that more than 71 percent of oxygen delivered to patients is now accurate, a significant improvement over traditional methods. This precision not only enhances patient safety but also optimizes resource utilization.

In home-care settings, the impact is equally substantial. Nearly two-thirds (64 percent) of visits to refill medical oxygen cylinders were avoided by adopting the ATOS O2 system. This reduction in trips translates to lower CO2 emissions, decreased costs, and, most importantly, enhanced patient safety and comfort.

More recently, Salvus has  integrated the ATAS O2 with Brazil’s Electronic Medical Record System (MV), automating data insertion for auditing and billing, thus reducing human errors. A new partnership with PHILLIPS is underway to integrate with TASY, a major hospital management platform in Brazil.

ATAS O2’s continuous monitoring capabilities have revealed crucial insights into oxygen therapy management. The R&D team’s data shows a tendency for increased oxygen flow during night shifts, potentially prolonging treatment and hospital stays.

More importantly, the system’s precision has demonstrated a significant potential to accelerate patient weaning from oxygen therapy. This optimization could reduce hospital stays by up to 16 hours, leading to substantial cost savings for healthcare facilities and improved patient turnover rates.

Salvus is currently expanding the ATAS O2 to include vital signs monitoring, providing remote tracking of heart rate, SpO2, and respiratory rate for a comprehensive view of patient respiratory status. This allows treatment to focus on controlling SpO2, not just oxygen flow.

The continued ATOS 02 innovation and iterations promise to revolutionize oxygen therapy management. By improving accuracy, reducing unnecessary interventions, and enabling remote monitoring, it addresses critical challenges in both hospital and home-care settings.

“We’re taking ATAS O2 to the next level by incorporating intelligent vital signs monitoring using AI in order to assist hospital personnel. This isn’t just about oxygen anymore – we’re looking at heart rate, oxygen saturation, and respiratory rate. It’s giving us a full picture of a patient’s respiratory health,” said Gomes. “What does this mean in real terms? Better treatment, compliance, shorter hospital stays, and ultimately, a better quality of life for patients and their families. We’re not just monitoring oxygen; we’re revolutionizing respiratory care. This is the future of oxygen therapy, and we’re proud to lead the charge.”