A prescription refill program recently initiated in Utah has ignited significant debate regarding the readiness of artificial intelligence to assume responsibilities traditionally held by healthcare professionals, reports BritPanorama.
Known as Doctronic, the program allows Utah residents to bypass in-person consultations by using an AI chatbot to renew their prescriptions online. While positioning itself as a convenience for both patients and medical practitioners, the initiative raises complex questions about the role of AI in medicine, including its regulation and the necessity for human oversight.
Critics, including physicians and legal experts, warn about the implications of using AI in clinical settings without established guidelines. They highlight concerns regarding how such systems should be monitored, whether healthcare professionals should retain the authority to override AI decisions, and what safeguards must be in place to ensure patient safety.
Central to the issue are existing state and federal laws that restrict prescription authority to licensed medical personnel. Advocates suggest updating these regulations to accommodate AI technologies, which have entered the healthcare landscape.
Dr. Eric Bressman of the University of Pennsylvania remarked, “We have crossed a threshold in terms of giving something that is not human a medical license, whether or not we want to call it that.”
AI cannot practice medicine under current laws
Bressman and other experts support integrating AI into prescribing but stress that such systems must adhere to rigorous standards similar to those human doctors must meet. In Utah, Doctronic was able to commence operations through a “regulatory sandbox” established for promising innovation in technology.
The program operates under the guidance of a five-member board composed solely of AI specialists who assert that extensive safety measures have been implemented. Initially, all prescription refill requests processed by Doctronic were reviewed by human physicians. The transition to fully automated refills is anticipated soon.
The head of the state’s medical licensing board, Dr. Alan Smith, expressed concern that board members only became aware of the initiative following its media coverage at launch. In a letter sent after the program’s inauguration, 11 board members requested an immediate halt due to risks associated with the automatic renewal of prescriptions that may involve serious side effects or drug interactions.
Smith noted, “We were essentially told: ‘Yes this is going on. And no, you don’t have a say in it.’” This scenario underscores the necessity for clarity in regulatory jurisdiction, as federal authority typically oversees medical technologies, while licensure and practice are managed at the state level.
Doctronic’s leaders maintain that their AI system operates within state medical practice regulations. However, the federal Food and Drug Administration is responsible for overseeing technologies that significantly impact medical decision-making, a distinction some experts argue Doctronic may have breached.
Some states are clearing the way for AI in healthcare
When questioned, Doctronic executives declined to specify whether they have sought permission from the FDA. Dr. Adam Oskowitz, co-founder of the company, stated, “Our goal here is really just to meet patients where they need healthcare.”
In Utah, users authenticate their identity on Doctronic’s website where the AI chatbot collects information on their prescriptions and medical history, checking validity against a national pharmacy database. If all criteria are met, the AI can arrange for a refill, or, if required, transfer users to a human physician within Doctronic’s telehealth system.
Oskowitz envisions an evolving landscape where routine medical tasks could be streamlined through Doctronic, potentially enabling physicians to manage a much larger patient volume than currently feasible.
Other states, including Texas and Wyoming, are also adjusting regulations to facilitate AI’s integration into healthcare. Moreover, legislative efforts are underway in Iowa and Idaho to formalize the licensing of AI medical services, drawing upon templates from pro-AI think tanks.
Pushback against AI in healthcare primarily arises from economic concerns reflecting the potential job implications for the medical workforce, as highlighted by Cicero Institute’s director for health policy. “Whoever goes first is going to take the slings and arrows because there’s economic interests, concerns about the workforce and what that’s going to mean for jobs,” stated Adam Meier.
Doctors see potential risks to AI prescription refills
Concerns from healthcare professionals, including Dr. Smith, underscore the tangible risks present with AI-driven prescriptions. He emphasizes that many of the medications eligible for renewal, such as blood thinners, pose heightened risks if patients’ conditions evolve over time.
“Many times when I see people after six months, I find that their medical history or situation has changed,” Smith noted. He cautioned against the assumption that a previously prescribed medication remains appropriate indefinitely.
The American Medical Association has echoed these apprehensions, asserting that “prescription renewals aren’t routine checkboxes.” In response to safety concerns, Doctronic has already excluded certain high-risk medications from its refill list.
Zach Boyd, head of Utah’s AI office, commented that Doctronic has been overly cautious, often escalating non-controversial decisions for human review. Initial statistics from the program have been released, and Doctronic plans to publish peer-reviewed research in the coming months, though the firm’s earlier findings have not undergone independent verification.
The initial research indicated that Doctronic’s accuracy in diagnosing medical conditions based on telehealth consultations matched that of human doctors 80% of the time.
The FDA is taking a hands-off approach
Bressman criticized Utah for not demanding comprehensive data from Doctronic prior to its launch, arguing that the state should have insisted on this accountability from the outset.
He stated, “Mostly they’re accepting the company’s word on good faith that they’re up to the task.” This hands-off FDA approach parallels the disorganized medical standards prevalent in the early 20th century, which lacked robust national benchmarks for training and licensing.
Although national guidance for medical technology would typically be provided by the FDA, the agency has signaled a preference for a less intrusive role under the current administration. An FDA spokesperson stated that, while no AI chatbots have received approval, the agency is dedicated to fostering medical innovation while prioritizing patient safety.
As a result, Doctronic and similar entities are expected to continue expanding across various states, each adopting distinct regulatory measures. “Companies may benefit in the short term by expanding their business models and kind of having the technology go beyond the evidence,” warned Daniel Aaron of the University of Utah’s law school. “But in the long term, I think they risk compromising public trust and fueling backlash.”
