Utah Steps into Autonomous AI Medicine with Prescription Renewal Pilot Program
Utah Steps into Autonomous AI Medicine with Prescription Renewal Pilot Program
In this JAMA Health Forum commentary, SHP's Michelle Mello discusses the potential pros and cons of a new pilot project in Utah, which is testing an AI agent to renew prescriptions.
Utah launched a novel pilot program earlier this year which permits an autonomous AI agent to renew prescriptions for 192 drugs treating chronic conditions, such as hypertension, diabetes, and depression.
In this commentary published in JAMA Health Forum, SHP’s Michelle Mello, JD, PhD, looks at the merits and potential drawbacks of the pilot program.
The state initiative, using an AI platform developed by Doctronic, addresses structural challenges that patients may encounter getting prescriptions renewed, including provider shortages and cost barriers.
Mello, a professor of health policy and of law, notes the pilot incorporates meaningful safeguards: human physicians will review the AI's output for the first 250 patients in real time and the next 1,000 retrospectively, an automatic escalation protocol refers complex cases to clinicians, and Doctronic is contractually prohibited from using patient data for other purposes. Participants must also be informed they are interacting with AI.
The pilot aims to address access-to-care barriers in prescription renewals, such as provider shortages in rural areas. “Given these realities, the Utah pilot program deserves thoughtful analysis—not dismissal out of hand,” writes Mello.
However, important questions remain. There is little information about how well the system performs and no plans for an independent evaluation after its deployment.
There are also concerns, Mello notes, about accountability for errors, since Doctronic's terms of service disclaim liability for harms caused by its products. Additionally, moving away from physician visits for prescription renewals means losing a crucial opportunity for patients to receive preventive care.
While the Doctronic program may offer a promising model for improving medication access and using autonomous AI for primary care functions, robust oversight, transparent reporting, and a clear accountability framework will be essential moving forward.
“If Utah’s pilot program is the proverbial camel’s nose in the tent, it will be important for someone to be firmly holding the reins when the camel emerges,” Mello concludes.
