- 1. SIX SIGMA LEAN PRESENTATION JERRY ABRAMS July 2012
2. Introduction.. TRC-CC PBSs goal is to drive prescriptions
into the business by means of telephone outreach to current ESI
members. Outreach includes reviewing members medications and costs
involved at the retail pharmacy, then comparing them to the savings
built into their plan if the member selects to utilize their full
benefits and receive their meds from the ESI pharmacy. Once the
member agrees to take advantage of their plan, and utilize the ESI
Pharmacy, then the agent, with the members approval launches a fax
prescription request directly to the members prescriber. 3. Problem
Statement.. Over the past 3 years the ESI TRC-CC Prescriber update
process has been cumbersome, and costly. Prescriber information in
eSD is inaccurate thus resulting in an agent not being able to
launch his prescription request, resulting in an estimated $3.9
million dollars in lost or reduced revenue, which incurs increased
costs passed onto our clients and delayed and poor services
delivered to our members. 4. Introduction.. Overview Data
Collection Voice of the customer What is Analyzed Making the change
5. Overview.. Prescriber updates is a process to review, validate
and activate a prescriber within eSD. PBS agents require active
prescribers within eSD to process and launch faxes. Updates require
verbal communication between ESI and the prescribers office. Agent
is required to log off J-Phone and conduct prescriber validation on
an individual basis. Business units growth opportunity potential
was estimated Business data was captured over a 7 month period
Benefits were realized Actionable results realized benefits for
business unit TRC-CC PBS 6. Scope.. Data Control &
Analysis-Currently no form of prescriber data collection or
analysis is in place. Evaluation Spreadsheets Evaluation Methods
Customer Requirements (Internal & External) Quality Control 7.
Data Collection.. The data collected over the past 7 months is used
to :- Measure the VOC -Recognize growth and development
opportunities -Provide factual data stating whether the process
improvement is effective or not. 8. Data Control.. What is our
overall start total? Utilize data gathered over the past 7 months
to measure total weekly prescriber updates and revenue generated. -
How many departments were monitored - How many agents per
departmentCreate a process to consolidate prescriber updates and
monitor quality -Variations in agent submissions are monitored 9.
Data Control, cont.. Measure current submission levels.-How many
prescriber updates are being submitted by agents per week? -Create
a reporting system to validate submissions -What is the estimated
revenue generated per week? -Create a flow chart to track ebbs and
tides of revenue generation on a daily basis. 10. Voice of the
Customer CustomerInputVOC ToolProcess StatementRequestes
medications to be ESI MemberOrder placementeSDProcess
RequirementVerbal approval for ESI Agent to contact
prescriberdelivered to their home from thevia fax.ESI Pharmacy
Active prescribers within Agent must be able to
toggleeSD.Designated prescriber to launch PBS AgentMembers
CalledeSDPrescription request fax. Verbal out-reach to prescriber.
Validation of secured fax. TRC must receive a valid excelSubmission
to TRC forrequest to have a prescriber updated TRCPrescriber
updateeSD/ Excelprescriber activation in eSD.within eSDto PBS
Agent.Activation email delivered 11. Measuring Time Management
Average Process Time Variables In The Mix Forms
Research-Departmental RequirementsSearch Times-Systems Issues Best
Practices Organization-Quality Control-Time ManagementProcess Flow
12. Presenting Data.. Pareto Chart
300098.14%98.89%99.61%99.84%100.00%93.95%1 0.925000.8#
Observations0.7 2000 0.6 0.515000.4 10000.3 0.25000.1 00 Non Secure
FaxNew AddressPrescriber Not in System GroupNo Telephone NumberNot
updated in sysytemWrong Address 13. Presenting Data cont.
CountPrescriber Not in System Non Secure FaxNew Address No
Telephone Number Not updated in sysytem Wrong Address 14. Data
Analysis.. Once data is collected, how is it translated? Optimizing
the Failure Mode Effects Analysis Process we can easily identify:
Process Functions Process Failures Effects of potential failures
Clearly evaluate process controls Recommend achievable actions to
secure positive results 15. Analyze.. Simple math.. Average 72.4
prescriptions per day 145 days (29 weeks) * 72.4 prescriptions per
day= 10,498 prescriptions Weekly average = 362 prescriptions per
week Agents per team=30 * 7 minutes per call (average) = 210
minutes 210 minutes/60 (minutes /Hr) = 3.5 hrs per day on the phone
3.5 Hours * 3 teams = 10.5 hours 16. Additional analysis
ProcessPotentialFunctionFailurePotentialSuggested(Failure Mode
Analysis)ResponsibilityActions Taken12/1/11 flow chartRedesign
prescriberPotential actionEffects causes of failureAgent logs off
dialer to call prescribers for updated informationInability to take
new calls and gain conversionsLoss ofOne agent eSD not initiate
allmeds accurateupdate process and monitored12/10/11 encrptedvalue
of capture, time savedprescriberspread sheet beta testingthrough
having only one personcalls for entire dept12/15/12 Launch ofoff
the dialer and making outreaches to prescribers, thus keepingnew
prescriber updatebalance of agents focusedprocesson receiving
additional calls. 17. Whats the problem? The complexity of the
current process has intensified whereas in some cases Agents are
not properly validating a prescriber and are simply pushing it
through Thus causing IHI and HIPAA violations. (Prescription
requests are being faxed to wrong prescribers) Too many agents are
off the dialers at any given time thus not taking calls. There are
no safe-guards in place to monitor the process and validation of
data Received by the agent to update eSD.Inadequate or no
standardization in current process (extreme chaos) 18. Actionable
items for improvement.. Determine, isolate & reduce all
variables. Calculate value added Determine and establish best
practices (none currently Exist) Develop agent accountability
standards and quality Levels. 19. Isolation, reduction &
variable elimination Create a standardization process whereas all
agents are Compliant and remain on the dialer throughout the Day
and not calling prescribers for updates.Standardize process flow
implementing and adhered To by all agents Standardized submission
forms 20. Adherence Improvement. New process improves adherence by
allowing agents to Hit the Green Light faster! Allows for improved
accuracy with prescriber updates And for a reduction in IHA &
HIPAA violations. 21. Recommendation... Identify areas of
opportunity & report data collected Prescriber updates (3,900
requests) Captured value ($860,000.00) Time saved. (Cumulative
total 10.5 hrs per day) 22. Data Validation.. Established a
baseline using requests made each day,by each agent and the number
of meds associated to the request. Averaged baseline and multiplied
by the est. value of each med. Factored in the est. time and hourly
wage by 80 agents. Validated with TRC Management to ensure accurate
results and proper estimates. 23. Productivity.. Create
standardized process for requests and monitor accuracy and
validity. Originally each agent was responsible for out-reach to
prescriber. Management received requests each night Management sent
excel sheet to ESI (un validated or verified for accuracy)
Eventually ESI would confirm that eSD had Been updated Management
was responsible to notify agents requests were completed. 24.
Productivity cont.. Now. All prescriber requests are electronically
submitted by the agent to a specified specialists who conducts
outreaches to each prescriber to verify and validate address and a
secure fax number. (one specialist reduces IHI and HIPAA violations
and agents remain on the phone) Specialist reports directly to ESI
for prescriber updates in real time. Agents receive their updates
in a one hour turn around thus allowing increased production. 25.
Time in motion.. Continue to monitor and evaluate process Train
other locations as they utilize the prescriberupdate process Use
new and existing evaluations to plan additionalprocess flow
improvements 26. Performance Metrics.. Streamline system to monitor
and trend further individual requests: Production Completion rate
Denial rate RPh Verbal completion rate RPh Verbal denial rate
Incomplete rate 27. Performance Metrics cont. Added value: Value
gained per med Value lost per med Value gained by agent remaining
on the dialer Value lost by agent doing individual out-reaches 28.
5/1/20124/26/20124/23/20124/18/20124/13/20124/10/20124/5/20124/2/20123/28/20123/23/20123/20/20123/15/20123/12/20123/7/20123/2/20122/28/20122/23/20122/20/20122/15/20122/10/20122/7/20122/2/20121/30/20121/25/20121/20/20121/17/20121/12/20121/9/2012Current
financial Performance..
$25,000.00$20,000.00$15,000.00Series1$10,000.00$5,000.00$0.00 29.
Time to Implement.. Use current resources to begin gathering
historicaldata Use data to calculate results Present results to
customers(TRC-CC Management) Modify current Request forms Update
forms to reflect additional information Perform tracking and
validity of information Make impact with results 30. Conclusion..
2011-2012 Direct benefits 3,900 Prescriber update requests made
3,500 Prescriber update requests completed 10,498 Prescriptions
gained 1000 Prescriptions lost
