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AI Risk Assessment — worked example

A worked example, not a template

This shows Meridian Health Analytics — a fictional company — using the AI Risk Assessment. To start your own, use the blank template. Details here are illustrative.

The assessment for AI-001, Meridian's referral triage tool. It is the hardest of their systems: clinically useful, genuinely high-risk, and with an oversight arrangement that looked fine on paper and was not.


System under assessment

Field Value
System ID / name AI-001 — Referral triage prioritisation
Accountable owner R. Okafor, Clinical Director
Purpose Scores inbound referrals for clinical urgency and orders the review queue
Risk tier High-risk — Annex III(5)(a)
Affects individuals? Yes — determines the order in which patients are assessed
Assessment date / assessor 2026-04-18 / P. Nakamura (Governance Lead)

1. Prohibited practice screen

All eight screened. No prohibited practice identified. Screening record filed 2026-04-18, countersigned by Legal.

2. Harms assessment

Harm type Could it occur? Who is affected? Severity Likelihood Rating
Discrimination / unfair outcome Yes Patients whose presentations are under-represented in training data 5 3 15
Loss of opportunity Yes Patients de-prioritised in error — delayed treatment 5 2 10
Physical or psychological harm Yes Patients whose deterioration is not caught by the ranking 5 2 10
Privacy intrusion Possibly Patients — health data processed at scale 3 2 6
Loss of autonomy / ability to contest Yes Patients unaware their referral was ranked 3 4 12
Exclusion of a group Yes Non-English-speaking patients — referral letters are free text 4 3 12

The finding that mattered

Subgroup testing showed the model performed 11 percentage points worse on referral letters written for patients requiring interpreters, because those letters are shorter and use different phrasing. Aggregate accuracy was 94%; for that group it was 83%. The aggregate number had hidden it for four months.

3. Technical risk

Area Assessment Mitigation
Data quality Training data covers 2021–2025, one region only Flagged: expand to all regions before wider rollout
Bias 11pp gap for interpreter-requiring referrals Mitigating: re-weighting + mandatory human review for that cohort
Accuracy 94% aggregate against clinician ranking Declared; monitored monthly
Robustness Degrades on referrals under 40 words Threshold rule: short referrals bypass scoring
Drift Referral language changed after a 2025 template update Monthly distribution monitoring added
Explainability Feature contributions available per referral Surfaced to coordinators from v2.1
Security Prompt injection not applicable; access controlled Standard controls

4. Human oversight

Question Answer
Who reviews the output? Referral coordinator (band 5), before the queue is worked
What information do they see? Rank, score, top three contributing factors, and a low-confidence flag
Can they realistically override? Yes — drag to reorder, reason required
How long do they have per decision? ~25 seconds per referral; ~180 referrals per shift
How would we know if they were rubber-stamping? Override rate is monitored
What training have they had? Two-hour session; refresher annually

Oversight was failing in practice

The override rate was 0.4% — roughly one referral per coordinator per shift. Interviews found coordinators believed they needed a clinical reason to override and did not feel qualified to second-guess the score. Oversight existed in the interface and not in reality.

Action taken: the interface now shows the score after the coordinator forms an initial view, low-confidence referrals are presented unranked, and the override rate is reported to the committee monthly. It rose to 6.2% over the following quarter.

5. Transparency

  • Patients are informed that referrals are prioritised with algorithmic support — added to the referral acknowledgement letter
  • Clinicians are told when they are viewing a ranked queue
  • Route to contest a ranking is documented but not yet staffed — open action, owner R. Okafor, due 2026-09-30
  • Explanation available on request

6. Residual risk and decision

Residual rating Justification Accepted by Authority Date
Medium (9) Bias gap mitigated by mandatory review for the affected cohort; oversight redesigned and evidenced; contest route outstanding Governance Committee Per decision rights — high-risk deployment 2026-05-14

Decision: Proceed with conditions.

  1. Mandatory human review for all interpreter-flagged referrals — in place
  2. Monthly subgroup performance reporting to committee — in place
  3. Contest route staffed and published — due 2026-09-30, open
  4. Retrain on multi-region data before any expansion — blocking condition

What to take from this

  • Aggregate accuracy hides concentrated harm. Meridian's 94% looked fine until someone tested the subgroups.
  • A 0.4% override rate is not a sign the model is excellent. Measure it, and treat a very low number as a red flag.
  • "Proceed with conditions" is a legitimate outcome — provided the conditions have owners and dates, and someone chases them.

Use the blank AI Risk Assessment

Not legal advice

These templates are a head start, not a substitute for professional judgement. Adapt them to your jurisdiction, sector, and risk appetite, and have qualified counsel review anything material before you rely on it.