Auditable Emergency Triage for Maternal and Newborn Care in India
Updated 4 h ago · first seen 11 Sept 2026
paper_01M294GM2HS2GPXY6TC63MFJNN
- Published
- 11 Sept 2026
- T1 · 4 h ago
- arXiv
- 2609.09356
- T1 · 4 h ago
- Category
- cs.CL
- T1 · 4 h ago
Abstract
At Noora Health, our nurses answer more than 50,000 medical queries per month on our WhatsApp-based service that provides caregivers with on-demand support. Their most time-critical task is emergency triage: deciding which queries need immediate in-person attention. To support them, we built a system that uses a large language model (LLM) to classify whether a message is an emergency and provide a rationale for interpretability. But the system was opaque: analyzing mistakes meant reading reasoning chains for each message, which is infeasible at our scale. Prompt changes meant re-running a full evaluation to prevent regressions, which was both costly and operationally challenging. Clinicians follow a decision tree to make this call, but it was never documented or passed to the model, which relied on a flat list of danger signs. To address these issues, we decomposed triage into two steps: an LLM extracts canonical symptoms and patient context from the query using a clinician-authored vocabulary, and a deterministic rule engine captures the scenarios that indicate an emergency. We show that the new system raised recall from 0.565 to 0.810 and F1 from 0.606 to 0.702, with structured rules driving most of the accuracy gains while the decomposition provides auditability: clinical experts can inspect each stage of the new system to see whether the query was mistranslated, symptoms were incorrectly extracted, patient context was wrongly inferred, or the necessary rules were missing. They can add new rules independently without causing regressions and avoid running costly evaluations. Since deployment, the new system has triaged 152,421 patient queries and flagged 28,535 (18.7%) as emergencies. The over-escalation rate has been 17.8%, without any increase in missed emergencies. Clinicians have also added 48 new rules since deployment, evidence of the faster correction loop we set out to build.
Authors 10
Shobhit Jagga, Aman Dalmia, Niharika Priyadarshini, Neelima Devadas, Amrita K Prasen, Nikhil Nalin, Santhosh SJ, Sreeram Nurani Ramasubramanian, Muhammed Afeer K, Anubhav Arora
Specification
- Official page
Source:arXiv (Atom API + RSS)T1observed 4 h agohigh
- Arxiv announce type
- cross
Source:arXiv (Atom API + RSS)T1observed 4 h agohigh
- arXiv id
- 2609.09356
Source:arXiv (Atom API + RSS)T1observed 4 h agohigh
- Categories
- cs.CL, cs.AI, cs.CY
Source:arXiv (Atom API + RSS)T1observed 4 h agohigh
Source:arXiv (Atom API + RSS)T1observed 4 h agohigh
- Primary category
- cs.CL
Source:arXiv (Atom API + RSS)T1observed 4 h agohigh
- Published
- 11 Sept 2026
Source:arXiv (Atom API + RSS)T1observed 4 h agohigh
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9
Source tiers
T19
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4 h ago
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Claim history
Official pageofficial_url1
| Value | Valid from → to | Status | Source | Confidence | Extractor |
|---|---|---|---|---|---|
| https://arxiv.org/abs/2609.09356 | → current | current | arXiv (Atom API + RSS)T1 | high | deterministic |
Abstractabstract1
| Value | Valid from → to | Status | Source | Confidence | Extractor |
|---|---|---|---|---|---|
| At Noora Health, our nurses answer more than 50,000 medical queries per month on our WhatsApp-based service that provides caregivers with on-demand support. Their most time-critical task is emergency triage: deciding which queries need immediate in-person attention. To support them, we built a system that uses a large language model (LLM) to classify whether a message is an emergency and provide a rationale for interpretability. But the system was opaque: analyzing mistakes meant reading reasoning chains for each message, which is infeasible at our scale. Prompt changes meant re-running a full evaluation to prevent regressions, which was both costly and operationally challenging. Clinicians follow a decision tree to make this call, but it was never documented or passed to the model, which relied on a flat list of danger signs. To address these issues, we decomposed triage into two steps: an LLM extracts canonical symptoms and patient context from the query using a clinician-authored vocabulary, and a deterministic rule engine captures the scenarios that indicate an emergency. We show that the new system raised recall from 0.565 to 0.810 and F1 from 0.606 to 0.702, with structured rules driving most of the accuracy gains while the decomposition provides auditability: clinical experts can inspect each stage of the new system to see whether the query was mistranslated, symptoms were incorrectly extracted, patient context was wrongly inferred, or the necessary rules were missing. They can add new rules independently without causing regressions and avoid running costly evaluations. Since deployment, the new system has triaged 152,421 patient queries and flagged 28,535 (18.7%) as emergencies. The over-escalation rate has been 17.8%, without any increase in missed emergencies. Clinicians have also added 48 new rules since deployment, evidence of the faster correction loop we set out to build. | → current | current | arXiv (Atom API + RSS)T1 | high | deterministic |
Arxiv announce typearxiv_announce_type1
| Value | Valid from → to | Status | Source | Confidence | Extractor |
|---|---|---|---|---|---|
| cross | → current | current | arXiv (Atom API + RSS)T1 | high | deterministic |
arXiv idarxiv_id1
| Value | Valid from → to | Status | Source | Confidence | Extractor |
|---|---|---|---|---|---|
| 2609.09356 | → current | current | arXiv (Atom API + RSS)T1 | high | deterministic |
Categoriescategories1
| Value | Valid from → to | Status | Source | Confidence | Extractor |
|---|---|---|---|---|---|
| cs.CL, cs.AI, cs.CY | → current | current | arXiv (Atom API + RSS)T1 | high | deterministic |
PDFpdf_url1
| Value | Valid from → to | Status | Source | Confidence | Extractor |
|---|---|---|---|---|---|
| https://arxiv.org/pdf/2609.09356 | → current | current | arXiv (Atom API + RSS)T1 | high | deterministic |
Primary categoryprimary_category1
| Value | Valid from → to | Status | Source | Confidence | Extractor |
|---|---|---|---|---|---|
| cs.CL | → current | current | arXiv (Atom API + RSS)T1 | high | deterministic |
Publishedpublished_at1
| Value | Valid from → to | Status | Source | Confidence | Extractor |
|---|---|---|---|---|---|
| 11 Sept 2026 | → current | current | arXiv (Atom API + RSS)T1 | high | deterministic |
Claims are temporal and append-only: a new observation closes the previous claim (valid_to) instead of overwriting it. Conflicting claims from different sources are kept side by side and flagged — never averaged. Methodology →
New paper: Auditable Emergency Triage for Maternal and Newborn Care in India
arxiv
| Source | Document | Type | Tier | Last observed | Snapshots |
|---|---|---|---|---|---|
| arXiv (Atom API + RSS) | rss.arxiv.org/rss/cs.AI | feed | T1· Official | 2 h ago | 1 |
Tier 1 = official/primary, 2 = quality secondary, 3 = community, 4 = unverified. Every snapshot is archived; see all sources and the methodology.