Utah has become the first state in the country to authorize an autonomous artificial intelligence system to legally participate in medical prescription renewals, marking a significant step in the integration of AI into clinical decision-making. The initiative, announced January 6 by the Utah Department of Commerce’s Office of Artificial Intelligence Policy, is being launched in partnership with Doctronic, an AI-native health platform.
Under the agreement, Doctronic’s system will autonomously review and approve renewals for routine medications used to treat chronic conditions. The pilot will operate in Utah’s regulatory sandbox framework, which allows the state to temporarily relax certain regulatory barriers while closely monitoring safety, patient experience, and economic outcomes.
State officials say the goal is to reduce delays that lead to medication lapses, a persistent problem with major health and financial consequences. Medication noncompliance has been tied to more than $100 billion in avoidable medical spending each year, according to Doctronic Co-founder and physician Adam Oskowitz. Renewals account for roughly 80 percent of all prescription activity, suggesting that automation could significantly improve adherence and reduce preventable emergency room visits.
“This is a major milestone to demonstrate how AI can improve access to care and health outcomes,” said Doctronic Co-CEO Matt Pavelle, who added that automation is intended to support rather than replace clinicians.
Utah officials emphasized that the pilot keeps physicians and pharmacists “at the center of care” while testing whether autonomous systems can ease administrative burdens and reduce costs. The program will publicly report metrics including adherence, refill timeliness, patient satisfaction, safety, workflow efficiency, and spending.
The initiative reflects Utah’s broader push to use regulatory mitigation agreements to enable real-world testing of AI in high-stakes environments. The state has previously launched sandbox pilots with ElizaChat and Dentacor, and other states — including Arizona, Texas, and Wyoming — are exploring similar paths.
Sen. Kirk Cullimore, who sponsored the legislation enabling the program, framed the effort as an attempt to simplify healthcare and lower prescription drug costs. “This partnership reinforces the principle of ‘doctor, not device,’ ensuring automation supports, rather than replaces, human judgment,” he said.
If successful, Utah’s model could influence federal and state approaches to healthcare AI regulation, offering a test case for how autonomous medical systems might be safely deployed at scale.
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