An artificial intelligence prescribing system is now being trialled to treat patients with psychiatric disorders in Utah.
The AI’s prescribing scope will be limited to “renewals” and 15 medications selected by the state, which are deemed lower risk.
These include medications such as fluoxetine, mirtazapine and sertraline.
Patients will also only be allowed to renew prescriptions that were “previously prescribed by a licensed health care provider”.
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Patients who have had “recent dose changes” or “recent psychiatric hospitalisation or acute safety escalation signals within one year” are not allowed to use the AI system.
Medications requiring “new labs” or an “ECG” for “safe renewal” are not allowed.
Drugs such as benzodiazepines, antipsychotics and controlled substances are also forbidden.
The chatbot is run by Legion Health AI and can be accessed through a $19 a month subscription.
Verification process
A patient using the system will have to “complete identity verification”, by using “government ID” and “biometric” verification or uploading a “selfie”.
The software then does a “prescription verification” against “electronic prescription history”, which patients can help with by submitting “photographic evidence” of their previous medication.
If discrepancies are found this is escalated to a “Utah-licensed clinician”.
Once the previous prescription has been verified, the AI follows several decision pathways.
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These include either “approval”, “automated escalation”, “patient-initated escalation”, “pharmacist-initated escalation” or “escalation SLA” which prompts a “provider review”.
Approval will only be granted if the medicine is within the “scope” of the scheme and there is no “risk” or “ambiguity” detected during the process.
The process is stopped immediately if certain factors are shown in the screening such as “positive suicidality”, a “pregnancy status change”, “worsening symptoms” or a mismatch between the request and the “medication ground truth”.
Once the prescriptions have been approved “pharmacists are clearly informed [that] the renewal originated from an AI system”.
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The scheme is testing the AI system in “a controlled, 12-month environment”.
The purpose of the pilot is to attempt to solve issues with the “access crisis” for mental health support.
The state said it may help “reduce bottlenecks” with “high volume” and “high friction” prescriptions.
It also hopes it will free up “human clinicians” allowing them to “focus their time on more complex, higher-risk patient needs”.
Legion Health AI said “the goal” is to “facilitate the safe deployment of novel AI applications by removing regulatory barriers temporarily, while closely monitoring the results to safeguard public safety.”
In January, Utah state partnered with Doctronic AI to pilot a similar AI prescription renewal programme for some conditions, such as medications for high blood pressure and birth control.
These medications could also only be renewed if they had “already been prescribed by a licensed provider”.
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It also comes after Healthera in January launched an AI platform to help pharmacists with “fully automated” prescription tracking.
Healthera orbit is “integrated with the NHS electronic prescription service (EPS)” and gets rid of the need for pharmacies to “manually update prescription statuses or notify patients when prescriptions are ready”.
