Despite courting controversy, Utah is doubling down on its autonomous artificial intelligence experiments in healthcare, approving pilots that will eventually enable prescriptions to be issued and refilled without a clinician reviewing it.
On Friday, Utah's Office of Artificial Intelligence Policy approved a slate of new pilots, including one with Nolla Health, developer of a dermatology app that assesses acne from patients' photographs. The pilot will test whether the app can prescribe initial medications and refills from a short list of topical drugs to adults in Utah with mild-to-moderate acne. At first, two physicians will review every prescription before it is sent, but in later stages, they’ll only review the prescriptions after the fact.
They’re the latest healthcare AI experiments to be approved by regulators in Utah in spite of pushback from doctors and other stakeholders. Earlier this year, regulators launched a pilot that would allow an AI system developed by Doctronic to renew medications without clinician oversight.
Other pilots approved on Friday include those from companies like August AI, which will have an AI system renew prescriptions for people with chronic conditions. Another pilot from Expect Fitness will offer virtual pelvic floor therapy for women in the state to help with urinary incontinence, pelvic pain and postpartum pelvic floor problems.
In all three pilots, the companies will need written approval from regulators before moving into the later phases that could include less human oversight. None of the pilots have yet launched.
Utah’s Artificial Intelligence Learning Laboratory, also known as the AI sandbox, was established by state law in 2024. Lawmakers said the AI laboratory would establish consumer protections while encouraging innovation by providing a supervised environment to test and evaluate AI-based tools and approaches before they’re scaled. Private companies that want to test their products can sign an agreement with the state, which defines boundaries, safeguards and reporting requirements.
But some of those pilots have faced ire from doctors in the state, including when Doctronic’s pilot was launched last year. The state’s medical licensing board asked that the pilot be suspended, saying they had not been informed of the pilot before its launch. The doctors also raised concerns that the AI pilot lacked necessary clinical judgment from a human, and that patients could risk taking outdated medication.
Still, regulators refused to pause the pilot, arguing that clinicians supervise AI systems during the program’s initial stages.
Other experts have raised concerns about the AI pilots, which they say carry risk for patients even when tasked with more innocuous seeming jobs like prescription renewals. In a JAMA Health Forum commentary, Michelle Mello, a professor of law and health policy at Stanford University, argued that Doctronic’s contract is murky about who bears responsibility for potential AI-based prescribing errors that injure patients.
Those concerns haven’t stopped regulators in Utah from exploring additional pilots. Last month, the Office of Artificial Intelligence Policy also signed master agreements with the University of Utah Health and Intermountain Health. Master agreements are not pilots, but they set the terms under which the office can later approve pilots.
