Health Care

Utah's AI Prescription Experiment Faces Resistance From the Medical Establishment

AI doctors are bringing affordable medical care to Utah. Skeptics are now trying to slow it down.

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Artificial intelligence is rapidly transforming Utah's healthcare industry, bringing accessible and affordable medical care to patients around the state. Rather than welcoming the change, doctors and public health officials are resisting it.

Over the past few years, Utah has passed several laws and initiatives to spur the adoption of AI in healthcare, including a novel pilot program launched earlier this year to allow AI chatbots to fill prescriptions. Administered by the state's Commerce Department but powered by AI startup Doctronic, the project authorizes AI to fill birth control prescriptions and medication for asthma, diabetes, and other common health conditions. Patients still need to visit a doctor for new prescriptions before using the platform.

"Doctronic's AI will strive to automate routine, guideline-based prescription renewals—the kind of administrative work that often slows down clinics," according to Utah's Office of Artificial Intelligence Policy. "By safely delegating these repetitive tasks to AI, the system could lighten clinician workload, improve refill continuity, and expand patient access—all while maintaining the same safety and quality standards patients expect."

Despite these promises, the pilot project has generated criticism from the medical sector at large, which has characterized it as an unvetted and dangerous system. 

"People can have life and death reactions to medications," Alan Smith, a family physician, told The Wall Street Journal last week. "And then I worry about liability. Who is actually liable for problems that may occur because of a refill of a medication?" Smith, also the chair of the Utah Medical Licensing Board, told the Journal that his opinions were his own, not the board's, but it does appear that the board shares his apprehension.

In April, board members submitted a letter to the Office of Artificial Intelligence Policy housed in the Commerce Department, urging the immediate suspension of the program. Instead, the agency asserted that it could continue the pilot under its statutory authority and pointed to its broader effort to tighten safeguards for AI-partnered programs, including its prior agreement with Legion Health, an online platform that uses AI to process low-level mental health medication refills and provide mental health treatment. The agency tells Reason that it is also "exploring the role of third-party auditors to help develop a standardized auditing process that includes transparent reporting and increased trust."

Still, critics, particularly those in the medical field, contend that AI cannot replicate the nuanced clinical judgment required for mental health treatment.

"It's really a concern about a slippery slope. Do we start here with prescriptions, then all of a sudden, is it going to lead to diagnostic tests?" John Whyte, chief executive of the American Medical Association, told The Wall Street Journal. "Medical decisions are complicated, they're nuanced, and it's the fundamental component of the physician-patient relationship." 

Medical decisions are complicated, but Doctronic says its platform is guided by the opinions of board-certified physicians who design the system, review opinions, and continuously update the AI's medical guidelines to ensure every recommendation reflects real clinical reasoning. One clinical study found "the top diagnosis of Doctronic and clinician matched in 81% of cases, and the treatment plan aligned in 99.2% of cases." As for privacy concerns, the company maintains that its policy is based on prior consent and is anonymous by default, with sharing Doctronic medical recommendations to a physician being completely optional.

"Doctronic is HIPAA [Health Insurance Portability and Accountability Act] compliant and private by design," Doctronic outlines on its website. "Your information is only accessed as needed to safely process your refill. We never sell your data, and we never use it to train AI models."

Thus far, the Doctronic pilot has yielded fairly impressive results. STAT reported in May that the chatbot has refilled prescriptions 72 percent of the time "without escalating to physician for reasons like missing lab work." Meanwhile, physicians agreed with the program in 91 percent of cases where the chatbot granted a renewal. 

Still, there are reasons to be cautiously optimistic about the future of AI in Utah healthcare. As STAT points out, "it's not clear an AI bot can legally renew prescriptions without Food and Drug Administration [FDA] authorization." The FDA currently regulates technology if it's considered a medical device, and the agency has not provided clear regulations on AI. If it decides chatbots like Doctronic fall within its domain, it could inhibit AI platforms like this from entering the industry. As the Cato Institute points out, it can take years and millions of dollars for a complex medical device to receive FDA approval and be allowed to enter the market. In the case of Doctronic, this would mean preventing patients from using AI that can handle routine prescription renewals without sacrificing quality or safety. 

Utah is taking positive steps to incorporate AI into healthcare (even if the effort is more likely to be successful if it's private sector-led). Still, no matter how forward-looking the pilot program is, regulations and the medical establishment could slow it down and undermine a revolutionary tool with the potential to reduce costs and increase care for patients.