The state of Utah is allowing artificial intelligence to prescribe medication refills to patients without direct human oversight in a pilot program public advocates call “dangerous.”
The program is through the state’s “regulatory sandbox” framework, which allows businesses to trial “innovative” products or services with state regulations temporarily waived. The Utah Department of Commerce partnered with Doctronic, a telehealth startup with an AI chatbot.
Doctronic offers a nationwide service that allows patients to chat with its “AI doctor” for free, then, for $39, book a virtual appointment with a real doctor licensed in their state. But patients must go through the AI chatbot first to get an appointment.
According to a non-peer-reviewed preprint article from Doctronic, which looked at 500 telehealth cases in its service, the company claims its AI’s diagnosis matched the diagnosis made by a real clinician in 81 percent of cases. The AI’s treatment plan was “consistent” with that of a doctor’s in 99 percent of the cases.
Now, for patients in Utah, Doctronic’s chatbot can refill a prescription without a doctor, for a $4 service fee . After a patient signs in and verifies state residency, the AI chatbot can pull up the patient’s prescription history and offer a list of prescription medications eligible for a refill. According to Politico, the chatbot will only be able to renew prescriptions for 190 common medications for chronic conditions, with key exclusions, such as medications for pain and ADHD, and those that are injected.
Caution
The first 250 renewals for each drug class will be reviewed by real doctors, but after that, the AI chatbot will be on its own. Adam Oskowitz, Doctronic co-founder and a professor at the University of California, San Francisco, told Politico that the AI chatbot is designed to err on the side of safety and escalate any case with uncertainty to a real doctor.
“Utah’s approach to regulatory mitigation strikes a vital balance between fostering innovation and ensuring consumer safety,” Margaret Woolley Busse, executive director of the Utah Department of Commerce, said in a statement.
For now, it’s unclear if the Food and Drug Administration will step in to regulate AI prescribing. On the one hand, prescription renewals are a matter of practicing medicine, which falls under state governance. However, Politico notes that the FDA has said that it has the authority to regulate medical devices used to diagnose, treat, or prevent disease.
In a statement, Robert Steinbrook, health research group director at watchdog Public Citizen, blasted Doctronic’s program and the lack of oversight. “AI should not be autonomously refilling prescriptions, nor identifying itself as an ‘AI doctor,'” Steinbrook said.
“Although the thoughtful application of AI can help to improve aspects of medical care, the Utah pilot program is a dangerous first step toward more autonomous medical practice,” he said."The FDA and other federal regulatory agencies cannot look the other way when AI applications undermine the essential human clinician role in prescribing and renewing medications.”
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