RootCause MCP - Clinical Causality & Teaching Design MCP Server

🏥 AI-guided causal analysis, feedback-loop modeling, and teaching-case construction for healthcare quality improvement

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🎯 Vision

Enable AI Agents to move in both directions of causality:

• from clinical incidents → structured, traceable root cause analysis
• from root causes → learner-ready lesson plans for medical education

RootCause MCP supports three categories of analysis models through Domain Cartridges:

┌─────────────────────────────────────────────────────────────────┐
│                      RootCause MCP                              │
├─────────────────────────────────────────────────────────────────┤
│  ┌─────────────┐  ┌─────────────┐  ┌─────────────┐             │
│  │ PROSPECTIVE │  │RETROSPECTIVE│  │   SYSTEMIC  │             │
│  │  Proactive  │  │Investigation│  │  Complexity │             │
│  ├─────────────┤  ├─────────────┤  ├─────────────┤             │
│  │ • HFMEA     │  │ • HFACS  ✅ │  │ • STAMP/STPA│             │
│  │ • HVA       │  │ • 5-Whys ✅ │  │ • FRAM      │             │
│  │ • Bowtie    │  │ • Fishbone✅│  │ • AcciMap   │             │
│  └─────────────┘  └─────────────┘  └─────────────┘             │
│                          ▼                                      │
│              ┌───────────────────────┐                          │
│              │   Unified Graph API   │                          │
│              │    (21 MCP Tools)     │                          │
│              └───────────────────────┘                          │
└─────────────────────────────────────────────────────────────────┘

✨ Core Features

Retrospective Cartridge (Implemented ✅)

Feature	Description	Status
🐟 Fishbone (6M)	Healthcare-specialized Ishikawa diagram	✅ 4 tools
🔍 5-Why Analysis	Deep cause exploration with Proximate/Ultimate classification	✅ 4 tools
🔁 Bidirectional Causality	Cross-links, escalation loops, and feedback cycle modeling	✅ 1 tool
🎓 Teaching Case Builder	Convert RCA chains into medical student lesson plans	✅ 1 tool
📊 HFACS-MES	Human Factors Analysis auto-suggestion (5-level, 25 categories)	✅ 6 tools
✅ Causation Verify	Bradford Hill criteria-based verification	✅ 1 tool
🔗 6M-HFACS Mapping	Cross-reference between taxonomies	✅ 1 tool
💾 Session Management	Persistent analysis sessions	✅ 4 tools

Prospective Cartridge (Planned 📋)

• HFMEA - Healthcare Failure Mode and Effect Analysis
• HVA - Hazard Vulnerability Analysis
• Bowtie - Threat and consequence analysis

Systemic Cartridge (Planned 📋)

• STAMP/STPA - Control loop analysis
• FRAM - Functional Resonance Analysis Method

🔧 Available Tools

HFACS Tools (6)

Tool	Description
rc_suggest_hfacs	Auto-suggest HFACS codes from cause description
rc_confirm_classification	Confirm or override HFACS classification
rc_get_hfacs_framework	Get full HFACS-MES framework structure
rc_list_learned_rules	List learned classification rules
rc_reload_rules	Hot-reload YAML rules
rc_get_6m_hfacs_mapping	Get 6M-HFACS cross-reference table

Session Tools (4)

Tool	Description
rc_start_session	Create new RCA session
rc_get_session	Get session details
rc_list_sessions	List all sessions
rc_archive_session	Archive completed session

Fishbone Tools (4)

Tool	Description
rc_init_fishbone	Initialize fishbone diagram
rc_add_cause	Add cause to 6M category
rc_get_fishbone	Get fishbone structure
rc_export_fishbone	Export as Mermaid/Markdown/JSON

Why Tree Tools (6)

Tool	Description
rc_ask_why	Progressive 5-Why questioning
rc_get_why_tree	Get Why tree structure
rc_mark_root_cause	Mark node as root cause
rc_export_why_tree	Export as Mermaid/Markdown/JSON
rc_add_causal_link	Add feedback loops and bidirectional causal links
rc_build_teaching_case	Build a teaching-ready lesson plan from an RCA chain

Verification Tools (1)

Tool	Description
rc_verify_causation	Verify causation with 4-criteria test

🚀 Quick Start

# Install with uv (recommended)
uv pip install -e .

# Or development mode
uv pip install -e ".[dev]"

# Run MCP Server
python -m rootcause_mcp.interface.server

VS Code Integration

Add to your .vscode/mcp.json:

{
  "servers": {
    "rootcause-mcp": {
      "type": "stdio",
      "command": "uv",
      "args": ["run", "python", "-m", "rootcause_mcp.interface.server"],
      "cwd": "${workspaceFolder}"
    }
  }
}

📁 Project Structure

rootcause-mcp/
├── src/rootcause_mcp/
│   ├── domain/           # Domain Layer (DDD)
│   │   ├── entities/     # Session, Cause, Fishbone, WhyNode
│   │   ├── value_objects/# HFACSCode, Scores, Identifiers
│   │   ├── repositories/ # Repository interfaces
│   │   └── services/     # HFACSSuggester, CausationValidator
│   ├── application/      # Application Layer
│   │   ├── session_progress_tracker.py
│   │   └── guided_response_builder.py
│   ├── infrastructure/   # Infrastructure Layer
│   │   └── persistence/  # SQLite + SQLModel
│   └── interface/        # Interface Layer
│       ├── tools/        # MCP Tool definitions
│       ├── handlers/     # Tool handlers
│       └── server.py     # MCP Server entry
├── config/hfacs/         # YAML configurations
│   ├── hfacs_mes.yaml    # HFACS-MES framework
│   ├── fishbone_6m.yaml  # Healthcare 6M categories
│   └── keyword_rules.yaml# Classification rules
├── tests/                # Test suites
├── docs/                 # Documentation
│   └── spec_v2.md        # Full specification v2.5.0
└── memory-bank/          # Project memory (for AI)

🔗 Related MCPs

MCP	Purpose	Integration
asset-aware-mcp	Data decomposition & table refactoring	Pre-processing
HHRAG MCP	Knowledge graph retrieval	Context enrichment
CGU MCP	Creative divergent thinking	Cause brainstorming

📚 Documentation

• Full Specification - v2.5.0 (3700+ lines)
• Architecture - DDD layers
• Roadmap - Cartridge expansion plan
• Literature Review - HFACS-MES research

🔧 Development

# Run tests
pytest tests/ -v

# Code linting
ruff check src tests
mypy src --strict

# Security scan
bandit -r src

# Dead code detection
vulture src

🤝 Contributing

Contributions welcome! Please see CONTRIBUTING.md.

📄 License

Apache 2.0 License - See LICENSE

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