A Medication Intelligence Command Centre for Coordinating Risk, Workload, and Escalation

Medication-related risk is produced across prescribing, verification, dispensing, administration, monitoring, transitions of care, and patient communication, whereas responsibility for recognizing and responding to that risk is distributed across professions, technologies, locations, and time. Existing dashboards, alerts, prediction models, prioritization tools, and operational command centres address parts of this problem but do not provide a unified mechanism for coordinating medication risk, patient urgency, workload, assignment, and escalation. This article proposes a Medication Intelligence Command-Centre Architecture as an original non-empirical sociotechnical synthesis. The architecture separates data provenance, medication-risk signals, patient urgency, uncertainty, workload and capacity, queue state, orchestration, professional adjudication, escalation, closure, and lifecycle governance. It treats model outputs as inputs to bounded coordination rather than medication decisions and preserves professional authority for clinical interpretation and action. A multidimensional orchestration process is proposed to determine whether work should be assigned, checked, monitored, deferred, escalated, or redirected through a fallback pathway. Evaluation is organized across data quality, technical validity, medication-task performance, safety, throughput, work redistribution, human–AI interaction, equity, implementation, and temporal stability. Advancement toward operational use would require local validation, prospective workflow evaluation, subgroup analysis, incident monitoring, change control, and evidence that apparent efficiency does not conceal missed risk or displaced work. The proposed architecture does not establish clinical effectiveness, regulatory acceptance, universal applicability, or deployment readiness. Its original contribution is to frame medication intelligence as a governed coordination function in which risk, urgency, workload, and authority remain distinguishable but operationally connected.