Pharmacy Service Improvement at Cvs (a)

Pharmacy Service Improvement at CVS (A) [HBR case #606015]

CVS's retail pharmacy operations are functioning poorly and dissatisfying customers. Many customers are defecting as a result. A pharmacy service improvement team has documented the current prescription fulfillment process, its exception rates, and the problems generated by exceptions. The company must now decide how to change this process, and what information system changes to make in support of the redesigned process.

What changes do you recommend to CVS’s existing pharmacy fulfillment process? The greatest problems are occurring at the pickup, but it is not the actual pickup process that is inherently flawed. Looking earlier into the process it was thought that “nothing happened” at drop off. Change that thought and use this time to eliminate problems from occurring at pickup. At the drop off do the initial data entry, verify customer information is correct, screen out any “no refill allowed” issues, and perform the insurance check. This extra attention at drop off would allow the customer to know upfront if there are any issues that need to be addressed and be notified of the timetable for closing out the issue.  The majority of the pickups occur after work but the drop-offs occur all throughout the day. Even if the drop off took more time than currently this would not increase lines because it would be occurring mostly during not peak times and would reduce the lines during peak times through eliminating those that would try to pickup their prescription during peak times only to find out an issue needs to be resolved. The new process must be able to identify customers that have multiple scripts to be filled and group them together for ease of pickup.

What IT changes, if any, are required to implement your changes? The IT system must increase the speed of the initial data entry and verification of customer information. If the IT system could perform a check of insurance this would allow for the customer to be notified upfront of the cost and eliminate cost surprises at pickup. The pharmacist largely resolves DUR hardstops, an IT system could use the same criteria to provide solutions. This would allow the pharmacist more time to complete other task. A system that could notify the customer when their prescription was ready for pickup either through text message, automated phone call, or email would eliminate the problem of misquoting and guessing of times by technicians. Instead of the pharmacist and technicians moving the scripts through boxes a system that will organize the number of scripts to be filled, the order they need to be filled, and provide a priority list for fulfillment.

How can you be sure that the new process you propose will be an improvement over the existing one? Each piece of the new procedure needs to be evaluated in terms of how it will benefit each person and the customer issues that it will eliminate. The staff needs to see how it helps them specifically. Identify specific problems that occur and then note where the new process eliminates or reduces such problems.

How can you be sure that it won’t make things worse? The new process needs to be tested at some pilot locations to ensure that the changes create the efficiencies sought after. Review the changes and review the largest complaints.  Are the changes addressing those complaints specifically and is it a noticeable change to the customer?