The experience of using artificial intelligence to accompany pregnant women in the Tula region.

In recent years, considerable attention has been paid to a new generation of automation tools for industrial processes in the healthcare sector – the so-called artificial intelligence (AI) technologies. Moreover, the National Strategy for the Development of Artificial Intelligence for the period up to 2030 (Decree of the President of the Russian Federation dated 10.10.2019 No. 490) assumes the use of TII in the social sphere to improve the quality of health services aimed at early detection of pathology and disease prevention. Due to the large amounts of information accumulated by mankind, its «manual» analysis is extremely difficult, therefore automatic processing technologies are required, and due to the high level of complexity, ambiguity, and unstructured nature of textual information, these technologies must be intelligent, i. e. based on artificial intelligence (AI) methods and models [5]. It seems relevant to create organizational approaches based on TII and aimed at improving the provision of medical care to pregnant women, women in labor and women in labor. The purpose of the study is to describe and analyze the operation of the automated system «robot Nikolay» when accompanying pregnant women in the Tula region. Materials and methods. Software has been developed – an automated patient call system using the voice robot «Nikolay» by the Tula Information Technology Center, based on a medical and technical assignment developed by specialists of the Tula Regional Gumilyovskaya Perinatal Center of the Ministry of Health of the Tula Region. The Nikolay voice robot was put into operation on February 1, 2024 and performs tasks such as calling pregnant women from the base of the Perinatal Center and collecting feedback. The system is represented by «flowcharts: trimesters of pregnancy, diabetes mellitus and hypertension, congenital malformations of the fetus» and makes calls to pregnant women, according to pre-prepared scenarios with voice prompts (scripts), offers patients an appointment with a cardiologist, endocrinologist, obstetrician-gynecologist in the presence of certain complaints. The novelty and feature of the system lies in the speed of scaling, the volume of contacts processed, cost-effectiveness, and verbatim adherence to the conversation script, which is ideal for a wide user base. The system has been tested, its effectiveness has been studied as part of an organizational experiment and integrated with the situation center of the Government of the Tula region Research methods: analytical, statistical, descriptive and organizational experiment. Results. In order to improve the provision of medical care to women during pregnancy in the Tula region, the automated system «robot Nikolay» (hereinafter referred to as the system) has been used since 02/01/2024. The voice robot «Nikolay» performs tasks such as calling patients from the database, collecting feedback. From 02/01/2024 to 02/01/2025, 9856 pregnant women were called, 2957 of them fully listened to the message. According to the results of the responses, 1,064 (35.9% of the respondents) pregnant women were found to have various complaints: 276 (25.9%) patients had pulling pains in the lower abdomen, 103 (9.7%) had spotting from the genital tract, weakness, dizziness and an increase in blood pressure ≥ 140/90 mm Hg. 126 (11.8%), epigastric pain was noted by 79 women (0.74%). These pregnant women were monitored at the obstetric remote consultation center of the V.S. TOPTS State Medical Institution. Gumilyovskaya Hospital», patronages were transferred to women’s clinics at the place of dispensary registration for an unscheduled appointment with an obstetrician-gynecologist. According to the results of the patronage, 276 (25.9%) pregnant women were referred for follow-up examination, treatment and selection of therapy at the V. S. Gumilyovskaya Medical Center and specialized hospitals in the Tula region. Conclusions. By the end of 2024, the introduction of an information and analytical monitoring system and a voice robot based on artificial intelligence «Nikolay» into the work of the obstetric and gynecological service of the region has shown its effectiveness. The perinatal mortality rate decreased by 2.6% from 8.9% in 2023 to 6.3% in 2024. The stillbirth rate decreased by 1.6% from 7.0% in 2023 to 5.4% in 2024. The infant mortality rate decreased by 2.7% from 6.6% in 2023 to 3.9% in 2024. The rate of early neonatal mortality decreased by 1.0% from 1.9% in 2023 to 0.9% in 2024. In 2023, there were 4 maternal deaths in the Tula region. There was no maternal mortality in the region in 2024. The effectiveness of the work of obstetricians and gynecologists has increased. The data on the condition of pregnant women is clarified with the help of calls, all information after which is sent to the situation center for further analysis and making operational point decisions to correct the management to carry out the distribution of pregnant women into risk groups, taking into account the full range of obstetric, gynecological and general somatic factors.