CVS Pharmacy Case Study

CVS Pharmacy Case Study

Workflow Management SystemBy: Anit Thapaliya

Department of Computer Science Kyonggi Univeristy

Suwon, South Korea

30th March 2016 | SELAB

CVS Pharmacy : Customers Activities Initial

• Customers drop off prescription in the front counter • Customers can request their order filled immediately.

– Need to wait 15minutes to 1 hour as per workload.• Most of the customer pick the order later point during the

day (typically 5pm-6pm)

CVS Pharmacy : Technicians Activities

• Ask customers pick up time and labeled the prescription accordingly (i.e. 1 hour before the customers pick up time).

• Enter the details of the every prescription (Doctor details, patient details, medication details) into the CVS system.

CVS Pharmacy : System Activities

• Performs automated check called DUR (Drugs Utilization Review) – This check reflects any drugs that is incompatible with other drugs

that had been dispensed to the same customers before.– Or the drugs maybe inappropriate for the patient as per the patient

history maintained in the system before (i.e. Age). – Then, the system raised alarms if there is any problem.

CVS Pharmacy : Pharmacist Activities

• Pharmacist address the issue over the alarms and in some case he even call doctor in order to confirm the prescription.

CVS Pharmacy : System Activities

• Again after DUR check system performs the Insurance check: – In order to find out whether the customers insurance policy pay partial or full cost

of the drugs.– Mostly, the insurance company would pay the certain amount and the customer

has to pay rest of it (Co-payment). – And it is very complicated to find out that how much insurance company ..? It is

based on the company rules.– Normally insurance company doesn’t cover one or more drugs from the

prescription. In this case, the pharmacist consult both the doctor and the patient for the drugs replacement. The replaced drugs cost is under the insurance policies.

CVS Pharmacy : Technician Activities

• After insurance checking – Technician collects the drugs from the shelves and packed it on a bag with the

prescription stapled within it. – The bag is then forwarded to the pharmacist

CVS Pharmacy : Pharmacist Final Activities

• Pharmacist double check the prescription correctly. After this quality check the pharmacist seals the bag and put it in the pick-up area.

CVS Pharmacy : Customer/Technician Final Activities

• When the customer arrives to pick up the drugs. A technician retrieves the prescription and asked the customer to pay in

case the drugs in the prescription is not completely covered by the insurance policy.

Customer

System

PharmacistTechnician

CVS Pharmacy Work Flow

Questions • Type of process.?

– Procure to pay • Who are the actors

– Customer, Technician, Pharmacist, Doctor• What value does the process deliver to the customers..?

– Proper examination of the prescription and proper support from pharmacy automated DUR system

– Notify incompatible case to the pharmacist and sometimes pharmacist consults doctor for the necessary steps in case of incompatible cases.

– Process also provide the insurance for the customer based on some criteria.

Questions • What are the possible outcome of the process.– Effective business process – Customer retention – Payment – Drug release to customer

Questions • Taking the perspective of the customer, what performance

measures can be attached to this process?– Insurance checking before DUR

• Because pharmacy can suggest the proper replacement of the d

– Production/ Inventory • Information must be circulated to the customer if the drugs is not available in

the pharmacy.

– Data Entry• Technician only check the prescription just an hour before the pick up time.• In case of workload, it is impossible to address the all the process and inform

customer that the drugs is not available.

Questions • What potential issues do you foresee this process might

have? What information would you need to collect in order to analyze these issues?– Drop Off (If none of the technician available to recollect the

prescription).– Data Entry (just one hour before is insufficient to handle every

process, patient contact info is missing)– Poor communication channel to customer

• No way to inform Drugs shortage • Insurance checking is done while customer wasn’t available• In case of high amount of bill if the insurance doesn’t cover, no way to inform

customer whether they accept it or not

– Service Issue • Script not ready (waiting for doctor)• Improper insurance call-back or queue

Questions

• What possible changes do you think could be made to this process in order to address the above issues?– Drop off, data entry and insurance change must be done while

customer is present at the pharmacy – DUR & Quality Assurance must be performed in the single step

after the technicians prescription is filled – Communication channel must be strong in order to inform

customer about the process being carried out or the problem being faced during the process

Another Case Study company having 800 employees

• Employee initiate the purchase request. – Purchase request (good to be purchased, its costs, quantity and

vendors etcs)– Employee often request quotation form vendor for the goods to be

purchased– This requested is singed by two different supervisors one for

financial approval and others for approval of the necessity of the goods

– Rejected request is returned to the employee who issue the purchase request

– Approve purchased request is then forwarded for the next steps

Approved purchase request

• The employee then forward the request to the purchasing department. – This department checks the request and feedback the employee if

anything incomplete on request Or – Department clerk enters the details of request into the company’s

Enterprise System. – Clerk then check if the vendor is specified by the employee or not,

select one vendor from the Master vendor list available in the system

– Based on the different value of the quotation (in terms of costs) the clerk can update the vendor list with the flexible new vendor or the registered one

When the vendor is selected

• Purchase order is automatically generated by the system and send a fax to the vendor.

• A copy of order is send to the Accounts Payable Office (Under the Financial Department)

• This department uses an accounting system that is not integrated with the enterprise system.

• The goods received from the vendor goes to the Goods Receipt Department – Clerk at this department checks the goods following the purchase order

from the enterprise system and verify the goods, quantity and quality.– Then clerk generate the goods received form and send it to the

requesting employee as well as the account payable department.

When Goods is received

• The vendor sends the invoice directly to the account section.– Clerk at account section checks the invoice and compare it to the

purchased order and goods received form by using the three way matching.

– Then a bank transfer is made if everything is fine with the purchasing goods.

Questions • Type of process.? – Procure to pay

• Who are the actors – Employee, Vendor, Financial Department Clerk,

Account Clerk, Supervisors • Who is/are the customers..?– Employee of the organization

Questions • What value does the process deliver to the customers..?– Authorization of purchased request.– Provide the required goods to the customer.– Helps to select vendor in order to suitable cost matching

between the different available quotation.– Quantity and quality assurance.– Effective payment using three way matching. – Give each employee the opportunity to create his own

requisition and order any item

Questions • What are the possible outcomes of the process..?– Purchased request verification.– Selection of vendor.– Received Goods.– Quality and Quantity Check for verifying the goods.– Payment through three way matching.

Questions • What performance measures can be added to the

process..?– Inventory Section is missing in the case study.– Internal requisition before purchase request in order to reduce the

duplicate purchase request.• Goods maybe available in other department maybe.

Questions • Potential issues & Possible Changes ?

– Lack of inventory system.• Before purchasing they should at least check the available resources

– Internal Requisition • In order to minimize the possibilities of having the duplicate purchase order

from many employees.

– Week Vendor monitoring • Vender performance is vital for company so we must select vendor effectively.

– Based on Availability – Based on Reliability – Based on cost flexibility

– Proper tracking mechanism of the process • Timely procurement in correct quantities as per desired quality

Thank You