Healthcare organizations are increasingly turning to automation and AI to address rising administrative workloads—particularly in high-volume, repetitive clinical processes. One particular use case that is becoming increasingly popular is medication refills. As health systems experiment with automation, the central question is no longer whether AI can increase efficiency, but how far it should go without compromising patient safety and clinical judgment. At Endeavor Health, that question has shaped the design of Jarvis, a purpose-built smart automation platform that streamlines medication refills while keeping clinicians firmly in control through a human-in-the-lead model.
Becker’s Hospital Review recently highlighted a health system in Utah that launched a fully automated medication refill program with no human review. While this approach demonstrates the technical potential of automation, it also brings forward a critical tension facing healthcare leaders today: how to realize meaningful efficiency gains without removing the safeguards that protect both patients and clinicians.
At Endeavor Health, the third largest health system in Illinois, serving around 1.5 million patients, that effort is taking shape through Jarvis, designed not to replace clinical oversight, but to support it—using automation to handle routine protocol-driven work while ensuring that humans remain accountable for clinical decisions.
Jarvis works by independently performing a chart review based on Endeavor Health’s medication refill protocols and then creates a standardized note within the Epic Electronic Health Record, pulling required information directly from the patient chart. The system flags whether a refill passes or fails protocol and documents the reason for any failure. From there, the refill is routed to a centralized pool within Epic where medication technicians perform a double check and final review of Jarvis’s work. Any medication that does not pass the protocols or review from both Jarvis and the medication technician is sent back to the prescribing clinician for further review.
This model ensures that automation accelerates work without removing clinical judgment from the process.
This approach became essential as the volume of medication refills grew, placing increasing demands on clinical staff. At scale, Endeavor Health’s centralized Medication Prior Authorization and Refill (MPAR) teams process nearly half a million refill requests annually. With each refill taking roughly one minute of technician time, this equates to more than 8,000 hours of skilled clinical effort each year.
While refill workflows were already governed by Epic protocols to enhance the process, the scale of the work required a new approach to help teams be successful and ensure timely refills for patients.
Jarvis launched with a small pilot at four clinical office sites. During the initial test period, the system was able to perform hundreds of refills per day with an average processing time of about 22 seconds. Following a successful pilot, Jarvis expanded to support 26 medication protocols, including anti-hypertensives, cholesterol medications, thyroid therapies, diuretics, proton pump inhibitors (PPIs), and H2 blockers. Clinic coverage has grown from four sites to nine, encompassing 63 clinicians, with plans to scale across the broader health system.
As Jarvis has grown more advanced with additional protocols and features, the latest time studies show that it allows a skilled medication technician to perform an average of 208 refills per day from a baseline average of 90; a 131% improvement. Since launching in mid-2025, Jarvis has processed more than 36,000 refills. And as a result of the time saved, the centralized MPAR team has been able to expand and take on more of the refill workload, allowing in-office clinical teams to focus more of their time on direct patient care.
Automation and AI are incredibly powerful tools that can provide much needed relief to clinical teams facing high workloads while also improving the patient experience. At the same time, these tools remain imperfect, and the risk of error persists. As health systems push toward greater efficiency, patient safety must remain the non-negotiable priority.
At first glance, a human-in-the lead model may appear less efficient than full automation. Endeavor Health’s early experience with Jarvis suggests the opposite. By combining automation’s speed with human clinical review, the system has delivered substantial productivity gains while preserving accountability and trust, demonstrating that efficiency and safety are not mutually exclusive.
Progress does not require removing humans from the loop. Thoughtfully designed, protocol-driven automation can reduce burden at scale while reinforcing, not replacing, clinical judgment and patient-centered care.
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