Artificial intelligence is gaining traction across hospital pharmacy operations, but many health systems struggle to move beyond small pilot programs.
According to Bickkie Solomon, PharmD, director of pharmacy at HCA Florida North Florida Hospital, part of Nashville, Tenn.-based HCA Healthcare, who is also an assistant professor of pharmacy at Irvine, Calif.-based West Coast University and founder and president of Stat Rx, the difference often comes down to how organizations approach implementation.
In pharmacy, AI can affect multiple areas at once, including clinical decision-making, pharmacy operations, patient safety, compliance, supply chain and workforce workflows. When organizations approach it narrowly as an IT project, the broader operational and governance implications can be overlooked, causing pilots to stall.
“Organizations that successfully scale AI treat it as an enterprise change-management and leadership initiative, not simply a technology pilot,” Dr. Solomon said.
Dr. Solomon said two of the most common failure points are organizational readiness and leadership accountability. She compared the transition to earlier EHR rollouts, which also required significant workflow adjustments and cultural change across health systems. Similar disruption and resistance can emerge as organizations introduce AI into pharmacy operations, making leadership engagement and transparency critical during implementation.
Successful organizations establish a clearly accountable executive owner, defined decision rights and cross-functional governance involving pharmacy leadership, clinical operations, informatics, IT, compliance, legal and data science, Dr. Solomon said.
In terms of AI investments, Dr. Solomon said organizations should evaluate them the same way they would any major operational initiative: through clear objectives, defined metrics and governance oversight.
Rather than pursuing AI as a standalone innovation project, she recommended focusing on specific operational challenges, such as medication safety monitoring, sterile compounding compliance, controlled substance diversion detection, drug shortage and inventory management, supply chain resilience, smart infusion pump safety, transitions of care and prior authorization workflows.
“In healthcare, some of the most meaningful value comes from risk mitigation and compliance oversight,” she said.
She added that properly governed AI tools can support continuous monitoring, strengthen traceability and improve inspection readiness across complex pharmacy operations.
At the same time, Dr. Solomon said technical sophistication alone is not enough. Adoption by front-line pharmacists and technicians remains essential, particularly because those teams interact with the systems every day and can identify operational blind spots.
“If the teams expected to use the tools do not adopt them or see value in them, the initiative will not deliver meaningful impact regardless of technical sophistication,” she said.
Dr. Solomon added that framing AI primarily around headcount reduction or cost savings is another common mistake.
Instead, she said AI should be positioned as a tool that removes repetitive work so clinicians can focus on higher-value responsibilities, including complex decision-making, expanded patient care responsibilities and new service lines.
She also said large health systems should balance standardization and flexibility when implementing advanced technologies. Foundational elements such as documentation standards, validation protocols and audit controls should remain consistent across the enterprise, while local sites retain flexibility to adapt workflows based on service lines, patient populations and staffing models.
Looking ahead, Dr. Solomon said the greatest opportunity for AI may be in decision intelligence for pharmacy leadership. She pointed to predictive insights across medication safety, sterile compounding oversight, operational bottlenecks, drug shortage forecasting and supply chain planning, as well as opportunities in prior authorization, medication reconciliation and transitions of care.
Still, she emphasized that AI should support, not replace, clinical expertise.
“Clinicians will not be replaced by AI, but clinicians who learn to work with AI will outpace those who do not,” she said.
The post AI in pharmacy: Why pilots stall at hospitals appeared first on Becker's Hospital Review | Healthcare News & Analysis.
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