I-SIRch: AI-Powered Concept Annotation Tool For Equitable Extraction And Analysis Of Safety Insights From Maternity Investigations

Maternity care is a complex system involving treatments and interactions between patients, providers, and the care environment. To improve patient safety and outcomes, understanding the human factors (e.g. individuals decisions, local facilities) influencing healthcare delivery is crucial. However, most current tools for analysing healthcare data focus only on biomedical concepts (e.g. health conditions, procedures and tests), overlooking the importance of human factors. We developed a new approach called I-SIRch, using artificial intelligence to automatically identify and label human factors concepts in maternity healthcare investigation reports describing adverse maternity incidents produced by England's Healthcare Safety Investigation Branch (HSIB). These incident investigation reports aim to identify opportunities for learning and improving maternal safety across the entire healthcare system. I-SIRch was trained using real data and tested on both real and simulated data to evaluate its performance in identifying human factors concepts. When applied to real reports, the model achieved a high level of accuracy, correctly identifying relevant concepts in 90\% of the sentences from 97 reports. Applying I-SIRch to analyse these reports revealed that certain human factors disproportionately affected mothers from different ethnic groups. Our work demonstrates the potential of using automated tools to identify human factors concepts in maternity incident investigation reports, rather than focusing solely on biomedical concepts. This approach opens up new possibilities for understanding the complex interplay between social, technical, and organisational factors influencing maternal safety and population health outcomes. By taking a more comprehensive view of maternal healthcare delivery, we can develop targeted interventions to address disparities and improve maternal outcomes.