Artificial intelligence-based expert systems are increasingly used in smart hospitals to improve medication safety, inventory efficiency, and pharmaceutical decision-making. This study aimed to evaluate the role of an integrated AI expert system in optimizing clinical and logistical pharmacy management. A multi-site mixed-methods quasi-experimental design was conducted in four smart hospitals, with two intervention hospitals and two comparison hospitals observed across six-month baseline and intervention periods. Quantitative data included 122,480 prescriptions, 1,186 pharmaceutical products, stockout records, expired medicines, emergency purchases, medication errors, and processing times, while qualitative data were obtained from surveys, interviews, and focus groups involving healthcare professionals. Results showed that AI implementation reduced stockouts by 48.24%, decreased medication errors from 3.82% to 2.06%, shortened prescription-processing time from 13.60 to 8.90 minutes, and lowered expired medicine value and emergency purchasing. The study concludes that AI-based expert systems can optimize pharmaceutical management by integrating predictive analytics, patient-specific safety rules, and human oversight within coordinated smart-hospital workflows, while preserving accountability, transparency, and professional judgment across diverse clinical and operational settings.
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