Villanova School of Business
VSB 1002- Business Dynamics II
Pharmacy Service Improvement at CVS (A)
Harvard Business School Case 9-605-015
(Rev. October 20, 2006)
Case Study Assignment
Problems arose in almost every part of the fulfillment process, as explained below:
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
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)
Info logged in:
Patient contact info
Doctor contact info
Third party payor info – insurance companies, employers
Number of doses
Number of refills
System performed an automated Drug Utilization Review:
Automated check of script against all other prescriptions in CVS database for patient; looking for harmful drug interactions and appropriateness of drug for patient given age, weight, gender, etc.
Hard Stop = fulfillment process cannot proceed until DUR reviewed by pharmacist if automated review reveals any potential problems
Hard Stop Good for patient safety
Hard Stop Bad for slowing down process, lowering efficiency
Insurance check was done after DUR.
Checking to make sure insurance still valid, script matches drugs on formulary, customer not trying to refill too soon, etc. In most cases, script would still be filled even if there was a problem with insurance - customer would simply be told to pay full amount at pickup.
Potential Data Entry Problems: Tech couldn’t read handwriting on script, No refills allowed on script (6%), DUR hard stop (20%), Insurance problems (17%)
Scripts were filled by pharmacy technicians
Potential Production Problem: Insufficient inventory – patient wouldn’t find out until pick-up that drug wasn’t available
Pharmacist reviewed each script to make sure it was filled correctly. First priority is customer safety!
Potential Quality Assurance Problem : None identified
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). Worst between 5-7 p.m. – long lines of angry customers – hard to get staff to work that shift.
6. How can IT help with streamlining the process at CVS pharmacies?
Get Teams to come up with a solution to problems in fulfillment process keeping 3 goals in mind:
1) Doesn’t degrade safety at all
2) Decreases waiting time
3) Improves customer satisfaction
What CVS did to improve fulfillment process:
1) Drop off, data entry, insurance check – all done while customer is present.
Data entry completed at drop-off while customer was still there – made it easier to verify customer insurance information. Insurance check is now done with customer present. Used to be they’d just make sure your name, address, and birth date were on prescription and let you go. At local CVS, there is a “new” drop-off window away from cash register where pick-ups are done. Clerks enter data into computer while you are still there. CVS was missing the opportunity to identify and resolve problems early in the process, when the customer is still present. Under old system, no one would look at script until 1 hour before pick-up – not enough time to resolve any problems. Clerk asks for best number to reach customer in case of a problem, which is a change from the past.
Staff can also inform customer about insufficient inventory at drop off instead of customer finding out when they come back for pick-up. Automated...
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