Pharmacy Services at CVS Essay Sample
The case illustrates the power of the enterprise technologies, as well as the depth to which they transform companies that successfully put them in place. Customer Value Store faced increasing customer complaints that prevented the company from stronger growth. This problem was initially perceived to be due to poor customer service; however by historical data and customer interviews, Pharmacy Service Initiative (PSI) including “operations executives and managers”, “pharmacy supervisors, top pharmacists and consultants from the Boston Consulting Group” found that it was issues in the fulfillment process that resulted in customer dissatisfaction. The team was eager and enthusiastic to make “initiative” changes to solve the problem without compromising “customer safety”. The remaining part of this case study analysis is discussing about key issues found in the fulfillment process and recommend action steps to solve them. Key Issues:
1. Lack of management of customers’ expectation
Due to the following reasons, the customers couldn’t get what they were expecting while they found fulfillment process too long. a) Unauthorized refills. Customers often didn’t keep “track of how many refills were allowed” and therefore submitted ineligible scripts. In addition, it normally took a day on average to get a response from a doctor to whether a refill was approved. This caused customers impatient and especially upset when refills were not allowed. b) Scripts rejected for payment by insurance. That the payers wanted to control their costs by delivering log rules about drugs, refilling time and payment conditions truly complicated pharmacy employees work and lengthened wait time for a refill. c) DUR hard stop problem. As the information was sometimes incorrectly recorded due to written scripts, a DUR hard stop was generated and pharmacy employees had to call doctors to help them out.
2. Problems arose in almost every part of the fulfillment process Problems in the fulfillment process:
There are problems in almost every part of the fulfillment process – Drop Off – Staff asked for name, address, birth date, time of pick-up; then put script in slotted box (sectioned by hours of the day) in slot for one hour earlier than pick-up time. Potential Drop Off Problem: No one manning drop-off station
Data Entry – At each hour, tech took scripts from that hour’s slot and entered all required data into pharmacy info system (so no one looked at script until 1 hour before pickup) Hard Stop is good for patient safety but it’s bad for slowing down process, lowering efficiency Insurance check was done after DUR.
Potential Data Entry Problems: Tech couldn’t read handwriting on script, No refills allowed on script (6%), DUR hard stop (20%), and Insurance problems (17%). Production – Scripts were filled by pharmacy technicians
Potential Production Problem: Insufficient inventory – patient wouldn’t find out until pick-up that drug wasn’t available Quality Assurance – Pharmacist reviewed each script to make sure it was filled correctly. First priority is customer safety! Potential Quality Assurance Problem: None identified
Pickup – Bags stored in pickup area in alphabetical order until customer came for pickup. Potential Pickup Problems: Many, including staff couldn’t find script, unauthorized refill, script not covered by insurance – customer asked to pay full price, script not ready (waiting for doctor or insurance call-back or queue backed-up). Recommendation for CVS’s existing pharmacy fulfillment process:- I would suggest implementing a system that focuses on the day’s procedures and alters the drop-off, data entry, and production steps, therefore ideally reducing the number of problems that occur and must be resolved during the pick-up stage at CVS. The following represents the day-to-day operations of the plans which I would suggest for CVS Pharmacy – Day-to-Day Operations:-
* Gather/check customer information
* Constantly monitor drop-off station
* Update customer information in the system
* Refill online and over telephone
* Drug Utilization Review(DUR)
* Insurance Check & Revisions
* Continuous Data Entry
* Make necessary phone calls
* Technician counts and verifies prescription
* Record status of script
* Pharmacist Review
* File finished prescriptions in alphabetical order
* Verify names and birthdates
* “Quick Pay” option
* At Home Delivery
1a. Gather/Check Customer Information – In order to keep our system as organized as possible we want to make sure our customer information database is continually updated. This ensures accuracy and also allows our daily operations to run smoothly. By quickly looking up and collecting some customer information upon the drop-off of a prescription, a tech may be able to find and solve problems while the customer is in the store. This will reduce the problems that must be dealt with during busy pick-up times and may even keep some customers from having to make unnecessary trips to the pharmacy.
1b. Constantly Monitoring the Drop-Off Station – In the past, CVS has noted that there has been a problem keeping an available employee at the drop-off window of its pharmacies. Our new operation plans include a strong focus on the drop-off stage of filling prescriptions, and the first step to making this happen is to ensure that a technician is available to help customers when they first approach the pharmacy. 1c. Refill Options – Over the Phone and Online – First, the current telephone system asks the customer to input their prescription number, confirm the first three letters of his or her last name, and select a pick-up time. This is quick for the customer, and still collects enough information for the pharmacy to fill the prescription. We would like to add one step to this process, asking for the phone number at which the customer can best be reached during the filling process.
2. Data Entry
2a. Drug Utilization Review – Our computer system automatically checks to make sure the prescriptions being filled do not have a harmful interaction with other medications the customer might be taking. At this point the drug is also checked to make sure it is safe for the customer based on his or her age, gender, and other demographic data stored in the system4. If a conflict does arise, the system comes to an immediate stop and cannot proceed without the authorization of the pharmacist5. The drug interaction check dates back one year, which we feel is an appropriate period of time to examine in order to ensure customer safety.
2b. Insurance Check & Revisions – When the prescription is scanned into our system, the prescription is sent electronically to the specific customer’s insurance company. The insurance company then responds back to our technician with either an authorization to fill the prescription or a rejection due to refilling too soon, needing prior authorization, or that the drug might not be covered under their plan. 2c. Continuous Data Entry – Instead of waiting until the hour before the script is to be finished to begin the filling process, the techs will move to the next timeslot when each one is completed. For example, if the tech has completed the data entry for the prescriptions in the slot labeled ―3 p.m. before 4 p.m., then he or she will begin data entry for the 4 p.m. slot. This way, if problems arise and the drug utilization review and/or insurance checks create problems and lengthen the data entry process, the pharmacist has more time before the desired pick-up time to review and correct the issues.
2d. Updating Customers on Script Status – With the current system in place, many customers do not find out there are problems with their scripts until they come into the pharmacy and pick them up. This, therefore, causes much of our customers’ frustrations. This problem can be alleviated by informing customers of this before they return to the pharmacy. One solution to this problem is to implement an automated telephone system that can be used throughout the filling process in order to update our customers on the status of their prescriptions.
3a. Implement Partial Refill System – One problem we encounter during our production stage in operations is discovering we are out of stock or low on inventory of a particular script. This is obviously not only frustrating for pharmacy staff but for the customers as well. One way to aid this problem is to implement a system that allows us to fill part of the prescription for the patient so they can start talking the prescribed medicine. The following outlines the process and benefits of the system – * Give the patient enough medication for at least five (Initial Partial Fill) days just in case we encounter a problem when ordering inventory * Try to have the rest of the prescription filled in 1-2 days * Once the rest of the prescription arrives, notify customer (Final Partial Fill) * Helps eliminate unhappy customers
* Allows them to have at least part of their prescription rather than nothing * Reduces inconveniences for customers
3b. Record Status of Script – With the implementation of this new system, it is imperative that we are organized when we enter data into our computer. If we have to fill only part of the prescription we will indicate this as – Initial Partial Fill. This notifies techs and pharmacists that the prescription is not complete. As soon as more inventories arrive and the customer has returned to pick up the remainder of their prescription, it will be indicated as – Final Partial Fill. 4. Pick Up
If a customer’s prescription is not available when they come to pick it up, we are encouraging our technicians to explain to the customer why it is not ready. We feel that if customers are given explanations, customers will be less likely to get angry, 4a. Quick Pay Option – This is another option our customers will have to pay for their prescriptions. On our website our customers can click on the – “Quick Pay” tab. In order to do this, the customer must develop a username and password. After they have completed this, they will provide necessary information for billing (credit card number, billing name and address, etc). Their information will be secure and stored in our system. When their prescriptions are ready, they will automatically be billed and the only step they need to complete is to pick their prescriptions up from our pharmacy. 4b. At-Home-Delivery – In order to offer another option for customer convenience, we want to implement an at-home delivery service. The process would be simple and hassle-free and would eliminate the customer ever needing to set foot in our store. By visiting our website, our customers can enter the appropriate prescription information. We can fill new scripts, re-fills, and even prescriptions that have been transferred to our store.