In Brazil, between 15 and 20 thousand infants each year experience a lack of oxygen reaching the brain during the birth process. The condition, called perinatal asphyxia, is responsible for 23% of newborn deaths in the country and is the main cause of brain damage. To reduce this rate and the number of children who experience such injuries, PBSF (Protecting Brains, Saving Futures), formed by a group of pediatric neonatologists, is using the Microsoft Azure cloud platform in its infant monitoring system in neonatal ICUs.

From a central monitoring post located in São Paulo, PBSF links the neonatal ICUs in regions across the country and provides hospitals with brain activity monitoring for high-risk infants (those born prematurely or who present perinatal asphyxia, heart malformation or neurological damage). Infants are monitored 24 hours per day, seven days per week. The data stored in the Microsoft cloud permit PBSF medical teams to perform faster analysis of each infant’s brain waves and send alerts to each unit’s physicians and on-duty staff.

According to the company, a practical example is that 80% of the cases of newborn seizures do not display any external manifestation, which makes diagnosis more difficult when performed solely by the clinical team. Thanks to the alerts sent out by PBSF, together with the cloud brain wave analysis, hospital teams succeed in providing a more rapid and efficacious treatment and in avoiding potential sequelae such as cerebral palsy, blindness and deafness. “The longer infants experience a seizure, the more severe the consequences. And we know that among survivors, 35% have permanent injuries. For this reason, this collaboration with institutions allows lives to be saved and sequelae to be prevented,” says medical neonatologist Gabriel Variane, the founder of PBSF.

Aside from ensuring the health of the patients, the solution leads to a lesser impact on society (i.e., direct costs of care, examination, lifelong medical follow-up) as well as a reduced impact on the economy. In the private medical network alone, according to a study by the Panel of Specialists, the medical costs of a disabled child in Brazil are approximately R$ 2.9 million over the first 20 years of life. The cost of follow-up for a child without disability amounts to R$ 22.5 thousand. Moreover, sequelae in newborns generate indirect costs through loss of productivity and health-related public expenditures in the country.

Regarded as one of the largest databases in the world, with over 200 thousand hours monitoring infant brain waves, PBSF found that approximately 73% of all epileptic crises in newborns across the 23 hospitals it serves across the country were identified solely through the use of its own system. In addition, the PBSF system facilitated an increase in the conclusiveness of the diagnoses of seizures among infants. According to Variane, using clinical evaluation, it was possible to conclude that only 23% of the infants originally diagnosed as being in a state of convulsion were in fact convulsing.

“The neonatal ICU of Santa Casa in São Paulo began to perform continuous brain monitoring in 2013, but in 2016 it began to use the remote services of PBSF and its Neonatal Neurological model. In so doing, it became one of the pioneers among philanthropic hospitals. “We decided to make use of the technology after identifying its potential for saving and improving the lives of our little patients and their families. Telemedicine to prevent neurological sequelae is a major treatment advance in our ICU,” said Dr. Maurício Magalhães, head of the Department of Neonatal ICU at Santa Casa Central Hospital in São Paulo.

Available since 2017, the PBSF began to use Azure last September for the purpose of improving data analysis through continually growing volume. “Each infant generates an average of between 48 and 96 monitoring hours, which equates to between 10 and 20 gigabytes. For this reason, the cloud architecture allows our teams to study the data more rapidly and for us to have more certainty regarding the patient data; and it is also possible to work with Artificial Intelligence (AI) solutions, which will now become our focus,” says Variane.

“Healthcare is undergoing a process of digitization through initiatives like that offered by PBSF. And one of our most important commitments is to support the evolution of systems like this one, which have a direct impact on people’s lives,” says Priscyla Laham, Microsoft Brazil Vice President of Partnerships and Sales for Small and Medium-Sized Enterprises.

Using AI

PBSF’s next step is to explore the partnership with Microsoft to integrate Artificial Intelligence (AI) into the analysis of infant brain waves to identify possible standard deviations that can later be confirmed by the medical team. The company has already had discussions with a China-based Microsoft team that is responsible for the algorithm that detects anomalies already uploaded via the Azure cloud platform.

Besides planning to utilize this AI algorithm in its system, PBSF has also proved to be a valuable ally to the Microsoft team in the improvement of the technology thanks to its database, which can be used anonymously to perfect the algorithm, making it more effective in recognizing the range of anomaly types.

About PBSF

PBSF (Protecting Brains & Saving Futures – Protegendo Cérebros, Salvando Futuros) is comprised of a group of professional neonatologists concerned about the high number of infants who risk significant neurological sequelae following incidents of damage occurring during the neonatal period.

“Beyond the societal impact, we cannot ignore the economic impact in view of the costs that will be generated for the family and for the government across a patient’s entire lifetime. I often maintain that a healthy child needs just one pediatrician and is rarely hospitalized. An infant with lesions, on the other hand, will require a multidisciplinary approach involving a pediatrician, neurologist, surgeon, orthopedist, otolaryngologist, ophthalmologist, physical therapist, speech therapist, dentist, therapist, special medications and frequent in-patient care,” Dr. Gabriel states.

In his view, the current scenario in Brazil involving patients at high risk for brain lesions is expanding by 40 cases per hour.

About Microsoft

Microsoft enables digital transformation in the era of the intelligent cloud and the intelligent frontier. Its mission is to empower every person and organization on Earth to achieve more. The company has had a presence in Brazil for 31 years and is one of 120 subsidiaries of the Microsoft Corporation, founded in 1975. In 2019, the company invested more than R$ 48.3 million to provide technology at little or no cost to 2038 NGOs in Brazil, benefitting a variety of social projects. Between 2011 and 2019, Microsoft supported more than 7100 startups in Brazil with an investment of over US$ 205 million in cloud credits.