AI Prescribing Pilot Places Pharmacists as Final Link in Care

Pharmacists are expected to be the final step in the care chain as artificial intelligence (AI) begins writing first-time acne prescriptions in Utah, according to Zaid Fadul, MD, FS, FAAFP, chief medical advisor with Nolla Health and overseeing physician for its Nolla Derm application.

“Utah residents can download the Nolla Derm app and opt in at a discounted $4.99/month,” according to a Nolla Health news release.¹ “Each patient verifies their identity, goes through informed consent, a short intake questionnaire, and a quick 5-angle face scan. In about 10–15 minutes, this generates a personalized treatment plan and, if appropriate, an initial prescription.”

Fadul explains that the intake process gathers comprehensive patient history regarding past over-the-counter (OTC) and prescription medications alongside medical background and diagnostic evolution. Following the 5-angle facial scan, the software formulates a daily treatment algorithm for morning and evening care that incorporates essential OTC products such as moisturizers and sunscreens.

During the initial pilot phase, these recommendations sit directly with overseeing physicians like Fadul who evaluate each case. If the doctors agree with the decision, they certify the prescription; if they disagree, they adjust the drug strength before releasing the order to the dispensing pharmacist.

READ MORE: American Pharmacists Month: Technology’s Role in Expanding Pharmacist Scope

Multistage Physician Oversight and Clinical Guardrails

To establish regulatory trust, Nolla Health collaborated for months with the Utah Office of Artificial Intelligence Policy and the Utah Medical Board to design a structured governance model. During the first stage, 2 licensed physicians independently evaluate and approve every single AI-generated prescription before it reaches a patient.^1,2

As the pilot advances to subsequent stages, oversight shifts to daily retrospective reviews for up to 500 patients and eventually weekly sampling of at least 10% of cases, provided the app maintains a 95% clinical agreement rate with zero serious adverse events. The software operates strictly within predefined, physician-approved protocols without free-text interfaces, preventing the algorithm from improvising. Patients presenting with severe acne, pregnancy, or complex symptoms fall outside these guardrails and are immediately redirected to licensed human clinicians.

This clinical framework aligns closely with established evidence-based practices in dermatology.

The American Academy of Dermatology guidelines for acne vulgaris state that effective management relies on multimodal topical therapies that combine complementary mechanisms of action. Recommended first-line agents include topical retinoids, benzoyl peroxide, and topical antibiotics, while systemic antibiotics like oral doxycycline are recommended alongside topical benzoyl peroxide to prevent antibiotic resistance.³

By embedding these clinical standards into automated algorithms, Nolla Health aims to address severe health care shortages in Utah, where 100,000 residents suffer from active acne while facing average wait times of 61 days and an absence of dermatologists in 11 counties.^1,2

Pharmacist Roles and Broader Regulatory Perspectives

Community pharmacists occupy an indispensable role as the final safeguard in this evolving clinical care chain. Fadul highlights that when patients receive their prescriptions, questions frequently arise regarding application techniques, product interactions, or supplemental skin care choices.

Pharmacists possess unique point-of-care advantages, including the ability to review total medication records, monitor patient vital signs, and conduct face-to-face clinical evaluations that automated applications cannot perform. Consequently, pharmacy consultations remain vital for ensuring patient comprehension and therapeutic adherence as digital health tools expand.⁴

Utah has become a central laboratory for digital health policy, simultaneously overseeing automated renewal initiatives like the Doctronic platform under agreements with state licensing authorities.^4,5

National medical organizations, including the American Psychiatric Association, emphasize that automated systems must function as augmented tools rather than replacements for human clinical judgment, urging policymakers to mandate independent clinical validation, transparent data audits, and clear legal liability rules.⁶

Health care experts note that while AI tools aim to ease administrative burdens, preserving human clinical touchpoints and supporting pharmacist-led care models are essential to maintaining patient safety across all prescribing innovations.^4,5

READ MORE: Technology and Data Resource Center

REFERENCES

1. Nolla Health launches the nation's first AI-powered prescriptions, starting in Utah. Nolla Health. News Release. October 5, 2026. Accessed November 2, 2026. https://www.nollahealth.com/blog/ai-prescriptions-utah

2. AI prescribing gets a state-supervised test in Utah. Chief Healthcare Executive. October 6, 2026. Accessed November 2, 2026. https://www.chiefhealthcareexecutive.com/view/ai-prescribing-gets-a-state-supervised-test-in-utah

3. Reynolds RV, Yeung H, Cheng CE, et al. Guidelines of care for the management of acne vulgaris. JAAD. 2024;90(5):1006.e1-1006.e30. doi:10.1016/j.jaad.2023.12.017

4. Utah launches pilot program for AI chatbot to renew prescriptions. Drug Topics. April 23, 2026. Accessed November 2, 2026. https://www.drugtopics.com/view/utah-launches-pilot-program-for-ai-chatbot-to-renew-prescriptions

5. Mello MM. Utah’s experiment with AI-driven prescription renewals. JAMA Health Forum. 2026;7(3):e261001. doi:10.1001/jamahealthforum.2026.1001

6. AI prescribing blog: innovation, risk, and the need for guardrails. American Psychiatric Association. March 26, 2026. Accessed November 2, 2026. https://www.psychiatry.org/psychiatrists/practice/artificial-intelligence/ai-prescribing/