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I was a retail pharmacist for 5 years. Independent pharmacies are getting squeezed by PBMs and thin margins, and owners drown in manual work: chasing prior authorizations, re-checking claims for underpayments, calling patients who never picked up. Most of it is repetitive and rules-based, so I automate it. What gets installed: - A Command Center — a local dashboard staff open: today's fills, aged will-call, margin alerts, PA queue. - The AIOS underneath — scheduled automations that ingest the pharmacy's data, run the tools (margin recovery, PA autopilot, patient win-back), and push reports. Nobody has to click anything. The Hardware: Each pharmacy gets a Mac Mini in the back office. I set it up at home, then drop it in. It runs the automations on a schedule and holds all data + dashboards locally, encrypted (FileVault). BestRx is the first pharmacy management system we're working with (Windows-only, can't run on a Mac), so the two machines stay separate. The only thing that crosses is an exported CSV of prescription/claims data: manual export to a watched folder on day one, then BestRx's built-in Scheduled Reports auto-delivers it. BestRx also has an API integration program we're pursuing, so the plan is to move off the manual drag-and-drop CSV entirely and pull the data directly. And before that, if the Playwright CLI can drive BestRx's export screen, we'll try that first to kill the manual step with zero dependency on their side. I run and update every box remotely over Tailscale (WireGuard VPN) — SSH in, deploy a new automation, no site visit. Locked down so only my device reaches any box. Where Claude runs. Claude can't run on the Mini (cloud-only), so I call it through AWS Bedrock under a BAA, billed per token (~$30–150/mo per pharmacy). Two BAAs gate everything: pharmacy↔me, and me↔AWS (so PHI can legally touch Bedrock). The consumer Claude plan is excluded from BAAs, so it never touches patient data. How I stay HIPAA compliant: - PHI stays on the box. The only PHI that leaves goes to Bedrock, legal under the AWS BAA. - Tailscale carries me and my code, never bulk patient files. WireGuard is end-to-end encrypted; Tailscale can't read the stream (the HIPAA "conduit" position). Fallback if needed: self-hosted Headscale. - Human-in-the-loop. The AI reads docs, auto-fills forms, and flags issues. It never submits. A prior auth still needs pharmacist review and prescriber attestation under their NPI. The tool prepares, a licensed human decides. - Claude builds and tests on synthetic data; only fixed, tested code runs on real PHI. No live AI improvising on patient data in production. - Plus audit log, encrypted off-site backups, retention floors.