Richard Dalyai: Can AI Safely Refill Medications?
Richard Dalyai, Cerebrovascular Neurosurgeon and the Surgical Director of Stroke at Vidant Medical Center in Greenville, North Carolina, shared a post on X:
“Utah has authorized AI to renew prescriptions without a physician signing each order.
The list includes some medications I commonly prescribe like Eliquis, Xarelto, Plavix and Brilinta.
As a vascular neurosurgeon, I see the paradox: interrupting these medications can cause a stroke or stent thrombosis.
Continuing them in the wrong patient can cause a significant hemorrhage.
With patients lost to follow up, we’ve seen both sides of this problem.
But ‘routine refill’ can become a clinical decision with consequences.
In my treatment area area which is relatively rural this is particularly poignant issue.
Delayed renewals, rural physician shortages in our area and medication interruptions work against our care.
We should have a prospective, medication-specific evidence measuring missed contraindications, bleeding, thrombosis, inappropriate renewals and failures to escalate.
AI should earn autonomy one clinical task at a time, but this could be an area where AI improves our healthcare system workflows and performs low-value administrative work.
Utah may be designing an important experiment but physicians need to be part of the workflow to ensure it operates safely and effectively.”

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