The Utah Medical Licensing Board has called for the immediate suspension of the state’s first-in-the-nation AI-prescription refill program. A suggestion that the Utah Department of Commerce has rejected, saying the program will continue.
The unique trial program has received national attention, and legal and medical experts across the country have raised questions and concerns.
An April 20 letter, signed by a majority of the medical board, said that oversight of “prescription refills is a task reserved for properly licensed medical practitioners for critical safety and clinical reasons.”
“Proceeding with this agreement without consulting the Medical Board potentially places Utah
citizens at risk and remains a major concern of the board,” the letter continued. “We must not allow AI or other financial motivations to override this obligation, yet that is precisely what occurred here.”
The private company running the program, Doctronic, signed an agreement with the state’s Office of Artificial Intelligence Policy, which opened in 2024 and is housed in the Department of Commerce. The office can remove or relax regulatory barriers for companies using AI, which it did for Doctronic.
The pilot, rolled out earlier this year, uses AI to process refills for certain prescriptions originally written by a licensed physician. In phase one, every AI-generated decision is reviewed by a licensed physician before it is submitted to a pharmacy. If the program proceeds to phase two, physicians would review prescribing decisions after the fact.
The Utah Medical Licensing Board says it wasn’t consulted before the pilot was implemented. And its letter came after the director of the AI office, Zach Boyd, attended the board’s March meeting, where members made their frustrations evident and aired their concerns.
Several said they were concerned that the company was refilling prescriptions without seeing the patient, and called the pilot essentially practicing medicine without a license.
Doctronic described the program’s routine refill of prescriptions as a “lower risk patient encounter,” and that higher-risk prescriptions have been excluded. But some board members had concerns about specific medications on the list.
The board is also worried about liability if something goes wrong. When asked, Boyd told the board that individual physicians couldn’t opt out of the program as it was up to the patient to decide, saying it was a “direct-to-consumer offering.”
During the March meeting, Dr. Alan Smith, chair of the Medical Licensing Board, worried about patient safety.
“I’m just very afraid that nothing's going to happen until we have some deaths,” Smith said.
Boyd and the director of the state’s Division of Professional Licensing, Mark Steinagel, responded to the board’s letter with one of their own. They wrote that “the pilot involving Doctronic was rigorously reviewed by several medical professionals prior to launch. This evaluation process generated a large number of suggested substantive adjustments and guardrails, many of which were integrated into the pilot.”
Those experts' overall conclusions were not stated in the letter, and the Department of Commerce did not immediately respond to KUER’s questions about them.
“Because the pilot is currently in Phase One—where a licensed physician reviews every refill decision, ensuring the program is already operating safely at the standard of care—we will not be suspending the pilot at this time,” the Department of Commerce said in its letter.
Moving forward, the letter said they welcome the board’s feedback and invited them to review the data as it comes out.
In a separate statement to KUER, the department dismissed the board’s concerns as appearing to be “rooted in misperceptions that do not align with the reality of the pilot’s operations.”
“Our sole focus is regulatory oversight and patient safety while fostering responsible innovation,” the department said. It added that state law didn’t require the board to be consulted.
University of Utah Law associate professor Daniel Aaron, who holds a law degree and a medical degree, recently co-authored a journal article on the program. He said the board has “a lot of valid concerns.”
The federal government regulates medical devices, Aaron noted, and the AI prescriber falls under that definition. But recently, he said the U.S. Food and Drug Administration has signaled a hands-off approach to AI.
Additionally, Aaron said states regulate the practice of medicine. Utah’s Office of AI Policy has temporarily waived certain regulations for Doctronic’s pilot.
“This program has moved forward without the normal legal checks and guardrails, and that's extremely concerning,” Aaron said. “Neither the federal nor state checks that are protecting us, the consumers, are even being used. And that’s problematic.”
It also concerns him that experts, like the medical board, have been sidelined. The prescription of medicines, even renewals, “can be very complicated.”
From what Aaron knows about how Doctronic collects data, he sees flaws. And if there is a bad methodology, he said, you won’t get reliable data. For him, that raises worries about whether profit motives are outweighing other concerns.
“It's not clear that either patient safety or the collection of data have been prioritized or really thought through by either the government here or by the company,” Aaron said. “And so it's possible we're going to get both poor data that doesn't help us in the future, and patients are harmed.”
The question is not whether AI should be used in healthcare, something that is already happening. The question, Aaron said, is how to make sure AI is adopted in a way that is safe for patients and generates usable long-term information. He thinks the program should be suspended and redesigned to address concerns.
When technology is rolled out too quickly, that can harm public trust, Aaron said. And rolling out AI programs like this one too quickly could contribute to backlash against AI, which has already started in the U.S.
The company’s statement in response to the medical board said, “We are participating in the process as designed, with defined safeguards, physician oversight of every prescription in the first phase of the program, and continued physician involvement throughout. We remain focused on demonstrating safe, evidence-based expansion of routine care access.”
Editor’s note: KUER is a licensee of the University of Utah but operates as an editorially independent news organization.
