The AI-powered pharmacist: full practice authority and the future of care
The first installment in a multi-part series on the AI revolution in pharmacy: a new era of productivity and practice.
Throughout this series, I will cover the concepts and implications of full practice authority, standard of care, and provider status as explained in the Cicero Institute Toward Pharmacist Full Practice Authority by Tim Frost and Jonathan Wolfson. The series will also draw on my interview of Dr. Frost at the RxRoundtable Hot Topics session on March 12, 2025. Each concept needs to be thoroughly understood to interpret how state Boards of Pharmacy, the federal government, and ultimately payors, grapple with the evolving role of pharmacists. I will also be presenting a few of the practice scenarios and show how full practice authority can help solve the crisis of poor access to primary care in America.
The time is coming when pharmacists and their staff will be freed from the burden of endless administrative tasks required to fill prescriptions. Pharmacists have always wanted more time. “Be careful what you wish for,” may quickly become the watchword for the profession.
AI is the tool that will create more time for pharmacists and for all of us. I am not sure when it will happen, but if it follows the model of other tech innovations, it will happen slowly, and then fast.
Are we ready?
AI is fundamentally transforming the work of various professions and job classes. I have written about the experience of IKEA using AI to upskill 8,500 customer service agents. Dario Amodei, CEO of Anthropic, a leading AI frontier model developer believes that within six months AI will be able to perform 90% of the tasks currently done by software programmers. Why do we believe that the practice of pharmacy will not experience the same positive productive impact? How will we adjust to a world where pharmacists are five times, or possibly ten times, more productive?
Go West, young pharmacist!
Idaho, Montana, and Colorado may show us the way. In the well-researched and thoughtful white paper, Toward Pharmacist Full Practice Authority, by Tim Frost, PharmD and Jonathan Wolfson, Esq. for the Cicero Institute, the authors describe how these states have completely rewritten their pharmacy regulations using a standard of care regulatory model linked to a full practice authority model.
The three concepts
Standard of Care is the regulatory benchmark used to measure the actions of healthcare providers and ensure they are performing their duties to prevent patient harm. The primary regulatory framework that was developed in the 1980s for medicine and nursing.(1)
Full Practice Authority is best defined by Dr. Ross Tsyuki: Full-scope pharmacist services include all proactive and comprehensive interventions that prevent or manage illness and are within an individual’s competency to perform independently.(2) In adopting Full Practice Authority, the states reject the concept of collaborative practice agreements in favor of collaborative practice.
Provider Status refers to the status conferred upon various healthcare providers by the various payor entities, be they state (Medicaid), federal (CMS) or commercial. In July 2022, the FDA issued an emergency use authorization for Paxlovid that demonstrated the concept of federal preemption allowing pharmacists to prescribe, dispense, and get paid for Paxlovid.(3)
We may be facing a generational shift in how pharmacists view their work and role in the US healthcare system. In her widely-acclaimed book Generations, Jean Twenge, PhD, argues that technology shapes how generations think and act. Today’s young pharmacists are entering the profession at the same time AI is changing the entire work paradigm. AI may provide the technological catalyst coupled with the regulatory reform of full practice authority to finally allow the profession to achieve its most productive place in the US healthcare system.
Pharmacists, young and old (or maybe “all of us”) need to learn the regulatory language that has been proven successful in these three states. We need to be able to confidently talk about Full Practice Authority and Standard of Care regulations. We need to make these terms part of our conversations with our friends either on the board of pharmacy or in pharmacy leadership positions if we are to reach the goal of Provider Status.
Citations
Kinney, Eleanor D., “The Origins and Promise of Medical Standards of Care.” Virtual Mentor 6, no. 12 (2004): 574-576. 10.1001/
virtualmentor.2004.6.12.mhst1-0412.
Tsuyuki, Houle, and Okada, “Time to Give up on Expanded Scope of Practice,” August 17, 2018.
Adams, Alex J., and Deeb D. Eid. “Federal Pharmacist Paxlovid Prescribing Authority: A Model Policy or Impediment to Optimal Care?” Exploratory Research in Clinical and Social Pharmacy 9 (March 1, 2023): 100244. https://doi.org/10.1016/j.rcsop.2023.100244.
