Blogs

Pharmacy General Intelligence: Q1 2026 Update

By Ben Michaels posted 14 days ago
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Building on our Q4 2025 update, welcome to the first quarter review of 2026 tracking the evolution of artificial intelligence through the lens of Pharmacy General Intelligence (PGI). As a reminder, PGI focuses on AI's potential to perform at or beyond the level of a pharmacist, paving the way for autonomous agents to handle medication verification, dose adjustments, and direct patient care. If last year was about proof-of-concept, early 2026 is defined by integration and systemic restructuring. 1 AI is shifting from a new technology into expected, invisible infrastructure. Continuing our pattern here is a breakdown of the industry trends, technological advancements, ...
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Faster than I expected - Final rule for the 12-digit NDC

By Dennis Tribble posted 03-09-2026
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Last Thursday (3/5/2026), The FDA published its final rule on revising the National Drug Format and Drug Label Barcode Requirements . Last September I published an analysis of the impact of this change . I did not expect the change to be formalized this quickly. I should note one error in the article, which is that, in a non-NDC GTIN-14 barcode, the check-digit is the last character of the 14-digit GTIN as opposed to being an additional character after the GTIN. Specifically, this effects Figures 4 and 5, but does not otherwise change their meaning. The short story is: Industry will no longer be able to use the GTIN-12 (aka UPC) 12-digit format ...
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An iPhone moment...

By Dennis Tribble posted 03-05-2026
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On January 6, 2026, Eli Lilly and Nvidia announced collaboration for an innovation lab for drug discovery . Mon Monday, March 2, 2026, Keith Kohl, a publisher on technology markets and investing, announced on Monday that the AI system had been built and went live this week. I won't quote it here; you should read it for yourself and I urge you to do do. What this presages is a new world in which drug development that once took decades to reach human testing, with a 90% failure rate will now take months with with wet lab analysis and clinical trials limited to those that pass the "dry lab" analysis of AI. How will this affect human studies? How will ...
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Paying It Forward: How Mentorship Became Central to My Professional Identity

By Mariah Bobo posted 02-27-2026
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Mentorship has consistently been at the heart of my professional journey, forming the foundation of who I am as I prepare to enter the pharmacy profession in just a few short months. Throughout my training, mentors showed up for me in ways that went far beyond academic guidance. They saw my potential before I fully recognized it myself, offered encouragement during moments of uncertainty, and helped me navigate spaces that often felt unfamiliar or intimidating across various settings. These relationships shaped not only my career path, but also my confidence and sense of belonging within the profession. My background has deeply shaped why mentorship ...
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The Illusion of Accuracy - Part 2

By Dennis Tribble posted 02-16-2026
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I have recently spent some time in the Hazardous Drug space and have encountered another instance in which it seems to me that we pretend to achieve levels of precision which seem unlikely. Specifically, I have looked at dosing per square meter of Body Surface Area (BSA). There is a BSA Calculator that shows my BSA (ok... I'm old... and a bit overweight) from 8 different formulas that range between 1.93 m 2 and 2.1 m 2 . That doesn't seem like much until you start looking at the dosing. If you take the standard dosing for Fluorouracil (2400 mg/m 2 ), that means that a dose for me ranges somewhere between 4,632 mg and 5,040 mg (over 400 mg difference) depending ...
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Failure is an Option: How Pharmacists Learn, Adapt, and Lead in an AI-Augmented Workforce

By Susan Flaker posted 02-06-2026
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When we were in pharmacy school the perils of a medication error were drilled into our head. We are taught that it is the role of the pharmacist to catch these errors and prevent them from getting to the patient. We are trained to be meticulous in everything we do; we are trained to be perfect. In the world of Artificial Intelligence, perfection is no longer an option. It is through our failures that we learn our greatest lessons and are able to grow and develop our skills more than we can when using books or theoretical case studies. I had never felt this was more prevalent than when I realized that a project I was working on failed. We were ...
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Q4 2025 Update: Charting the Course Towards Pharmacy General Intelligence (PGI)

By Ben Michaels posted 01-06-2026
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Pharmacy General Intelligence: Q4 2025 Update Welcome to the last update for 2025 tracking the evolution of AI through the lens of Pharmacy General Intelligence (PGI). As a reminder, PGI focuses specifically on AI's potential to perform at or beyond the level of a pharmacist, which could lead to AI agents integrating into pharmacy workflows for tasks like medication verification, dose adjustments, and patient counseling notes. Q4 2025 was filled with policy, industry, and technology shifts and additionally, Q4 will be remembered as the time that AI started to get political. Maybe driven by the elections in November or other factors, for ...
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An interesting technology that might blur the line between compounding and manufacturing

By Dennis Tribble posted 12-19-2025
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One of the more interesting technologies on display in the MCM exhibit hall was a compounding system for personalized medication doses that looked a lot like a 3-D printer but was not. Rather, it consumes a mixture of drug and compounding base and extrudes the required amount of the mixture into formed cups that produce individual doses of drug. The base that was used at the show produced a gummy. Learn more about the device at curitylabs.com . Their approach appears to presume that the pharmacy has access to active pharmaceutical ingredient (API) that it can mix with the appropriate base to produce a mixture from which individual doses can be molded into ...
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Where gravimetrics fits

By Dennis Tribble posted 12-12-2025
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I read with some interest the article by Greszler et al regarding recommendations for implementation of gravimetric systems. Among the authors of this article are individuals I have known for a long time and whom I greatly admire. Their recommendations regarding the implementation of gravimetric systems are a step forward. It was gratifying to have my blog on the illusion of accuracy quoted. That blog contains other information that I think is important to consider when talking about what gravimetrics can, and cannot address. Gravimetrics only works if you positively know what drug preparation you are measuring . One cannot know the density by which ...
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AI Pharmacist verification is a data problem…..not an AI problem.

By Ben Michaels posted 12-03-2025
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Last year, at the 2024 ASHP Conference for Pharmacy Leaders in Chicago, I recall receiving a particular question following our second presentation. During the Q&A session, an audience member asked, "When will there be an AI pharmacist verification product?" What was particularly interesting about this question is that the question was not “if”, but “when” will this product exist. Until that point, I had only been asked if it was possible. At the time, I responded within the next 5 years and with recent developments, the possibility of AI verification built into our EMRs seems more realistic now than it was a year ago. Before we dive into the specifics ...
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Who will bell the cat?

By Dennis Tribble posted 11-17-2025
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I have read with some interest recent publications about the application of AI in pharmacy practice. Ben Michaels' Update describes a number of issues that need to be addressed before the plethora of EMR data can be used to try to drive pharmacy API models that might be useful, chief among which is the poor quality of such data and the wide variety of (or complete lack of ) standards by which concepts in that data are expressed. I also noted Scott Nelson's report on which also calls out the need for both data stewardship and participation of pharmacists in the development of such models. You will need a valid login to AJHP's website to get a copy. It is ...
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The Network Effect: How Every Experience Shapes Your Pharmacy Path

By Kate Luong posted 10-17-2025
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Networking is one of the most important yet often overlooked parts of a pharmacy student’s journey. It’s more than collecting contacts; it’s about building genuine relationships that can help you learn, grow, and discover new opportunities. From getting involved in research to joining student organizations, volunteering in your community, connecting with professionals during APPE rotations, or meeting peers and mentors at national conferences, each experience contributes to your personal and professional development. The connections you make today can shape the kind of pharmacist you become tomorrow. In this blog, several students share how networking ...
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Pharmacy General Intelligence: Q3 2025 Update

By Ben Michaels posted 09-29-2025
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Pharmacy General Intelligence: Q3 2025 Update Welcome to the third in a series of quarterly updates tracking the evolution of AI through the lens of Pharmacy General Intelligence (PGI). As a reminder, PGI focuses specifically on AI's potential to perform at or beyond the level of a pharmacist, which could lead to AI agents integrating into pharmacy workflows for tasks like medication verification, dose adjustments, and patient counseling notes. My goal is to provide a clear overview of the AI landscape, highlighting both the advancements propelling us towards PGI and the remaining hurdles. Expect insights into policy changes, industry trends, and technological ...
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Walk Away From Pharmacy Burnout

By Danielle Beltz posted 07-25-2025
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On Behalf of the ASHP Section of Specialty Pharmacy Practitioners Section Advisory Group on Operational and Workforce Development Breaks Are Essential – Take a walk during your break for improvements in mood, cognition, and overall health Pharmaci es are notoriously overloaded with time-sensitive orders. Breaks are often sacrificed by those hoping to catch up or stay current with their assignments and workloads. This can increase levels of stress, loss of focus, job dissatisfaction, the possibility of burnout, and even the development of physical and/or mental health issues. In addition, working long shifts without breaks can increase ...
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Healthcare provider shortages - the numbers don't add up.

By Dennis Tribble posted 07-01-2025
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I viewed an article in Becker's this morning about healthcare provide shortage entitled Healthcare’s broken math: 11 signs the numbers don’t add up . it is an interesting read. The short story appears to be that the upcoming supply of primary care healthcare providers is unlikely to meet demand by a significant margin and those who are entering practice are disproportionately locating to urban areas and more lucrative specialties. Interestingly, the article did not mention pharmacists as primary care providers. What if we could step into that role? How would we do that? Where would we locate our practices so that we provided good access? What would we need ...
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Human vs Generative AI

By Dennis Tribble posted 06-26-2025
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I saw an interesting graphic today displaying the time required to perform certain tasks with and without Generative AI. I freely admit that I have little basis on which to judge these numbers. But, even if they are only half-true, it would appear that generative AI should make a huge impact on routine clerical and administrative work. Take a look at the tasks described and consider what this might mean for where we place generative AI in the tasks we really don't want to do, mostly related to administrative/clerical work and, maybe, dispensing. I would love to hear what you think. Dennis A. Tribble, PharmD, FASHP Retired Ormond Beach, FL t ...
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Q2 2025 Update: Charting the Course Towards Pharmacy General Intelligence (PGI)

By Ben Michaels posted 06-23-2025
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Pharmacy General Intelligence: Q2 2025 Update Welcome to the second in a series of quarterly updates tracking the evolution of AI through the lens of Pharmacy General Intelligence (PGI). As a reminder, PGI focuses specifically on AI's potential to perform at or beyond the level of a pharmacist, envisioning AI agents seamlessly integrated into pharmacy workflows for tasks like medication verification, dose adjustments, and patient counseling notes. My goal is to provide a clear overview of the AI landscape, highlighting both the advancements propelling us towards PGI and the remaining hurdles. Expect insights into policy changes, industry trends, and technological ...
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Wallpaper

By Dennis Tribble posted 05-29-2025
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Having been involved in acute care medication management and the impact of a few disruptive technologies over the last 50 years, I have had a lot of time to think about what it takes for a disruptive technology to succeed within our practice. We are, after all, a cautious bunch. IV workflow was first presented at an ASHP Midyear Clinical Meeting in 2007; it took another 10 years to become commonplace. I have come to the conclusion that it is not just our caution that stands in the way of disruptive innovation, but rather that the problems that really need be solved are so large, and have seemed to be insoluble for so long, that we just don't see them any more. ...
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What does the next phase of medication distribution look like?

By Dennis Tribble posted 05-23-2025
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Today I was cleaning out my hard drive and ran across a draft document that never seemed to have gone anywhere entitled "Rethinking Medication Distribution in the Acute Care Setting". It is probably a couple of years old now, but I think it raises some questions that we need to answer as a profession. My interest was piqued by the article by Flynn et al entitled "The Autonomous Pharmacy" 1 , which did an excellent job of describing a 50,000 foot view of the problem but lacked details, as a vision statement should. It also reminded me of a classic video of a lecture by Russ Ackoff (that I recommend to your viewing) wherein he describes the process by which ...
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Exploring the Current State of Robotic Sterile Compounding – Part 2

By Leigh Miley posted 05-21-2025
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Exploring the Current State of Robotic Sterile Compounding – Part 2 Authors: Stacy Carson , PharmD, BCPS, FISMP; Darren S Ferer , BS Pharm, CPHIMS ; James Fiebert, PharmD, CPHIMS; Leigh Ann Miley, PharmD, BCPS, BCSCP; Destiny Riddle, PharmD; Audrey Ruotolo, PharmD, BCPS; Chris topher Urbanski, BS Pharm , MS, FASHP SAG: Operations and Automation In part 1 of this blog, the current state of the industry in sterile compounding robotics is explored , including an overview of available solutions, benefits and challenges of implementation, and strategies for success. ...
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