1.What changes do you recommend to CVSs existing pharmacy fulfillment process?

What IT changes, if any, are

required to implement your changes?

2. How can you be sure that the new process you propose will be an improvement over the
existing one? How can you be sure that it wont make things worse?

3. What groups, if any, are likely to have problems with your proposed solution? How will you
deal with their objections?

4. How will you ensure that theres no backslidingthat there wont still be wooden boxes in
use six months from now? How can technology be used to prevent or inhibit backsliding?

5. Does PSI represent a significant opportunity for CVS? Would improving customer service be of significant
financial benefit to the company?

6. What percent of pharmacy defectors from CVS in 2000 were light versus heavy users?




Consumer Value Store (CVS) Case Study
A non-IT related suggestion to improve the process would be to require the customers to fill up a short
questionnaire including details that will lessen the time some steps may consume such as a change in employment or
insurance company. Furthermore, the store may put up a poster, near the drop-off station, explaining to the
customers of delays they may possibly encounter such as a no refill situation. However, some customers may not
be inclined to read the poster, and if so, the store may choose to inform the customers beforehand. Also, customers
must be advised at the drop-off station that the specifications of the third party payer may limit their sponsored
payment. Since there exists the possibility of a prolonged fulfillment process during DUR, the schedule of attending
to the orders should be changed to at least an hour and a half (or two hours) before its pickup time.

The questionnaires that will be required for customers should be given out as they enter the store so that
they will have the time to list down any change they have undergone. If the customer chooses to leave the
questionnaire blank, CVS will merely have to go through the same process as before: checking up on the customers
current third party payer. However, if they do comply, the process will be shortened as they will have already
obtained the information beforehand. Informing the customers of other concerns will lessen customer complaint as
well since they will be aware of the possible complications that may be encountered. The proposed amount of time
(attending to the orders) will help the staff in handling potential complications and as such the waiting time of the
customer will be lessened greatly, and this in turn, will produce satisfied customers as long as they have their
requested drugs in time.

If CVS has the financial capacity, it can put up kiosks in its pharmacies instead of providing questionnaires
for its customers. These kiosks will be individual computer terminals that will contain an application software
displaying a window itemizing the questions that customers will need to answer. This has the benefit of having
explanations as captions or hover options and eliminates the need for paper. This IT method also lessens the need for
pharmacy employees to review every questionnaire as the customers answers will be available for perusal instantly
in the employee computer terminals which is linked to the kiosks. Due to its on-hand capability, the schedule of
attending to the orders can be lessened because the employee in-charge does not need to individually input customer
information and instead only add important data such as the drug-drug interaction. These kiosks can also include
drop-off chambers for the actual prescriptions much like an ATM drop-off chute.

Advisable IT changes to the process would be improving the system handling the data entry. The hard stops
that occur during DUR can be lessened by creating another system that is interconnected to the Data Entry System,
only this other system will be handled by the pharmacists. Instead of having the employees enter the data and wait
for the safety indication of DUR, they will firstly encode all customer information and their orders that is scheduled
for the hour. The orders that are deemed safe for the customer will move on to the insurance check, once again
handled by the employee. On the other hand, orders with warnings are inspected by the pharmacist once the data
is transferred from the data entry system. The systems handled by the pharmacists should be designed so that
efficiency is ensured; the variables that may affect the drug intake must be encoded as well as the least amount of
time that is safe between two different drugs. If no problem occurs, the orders may proceed to the insurance
checking of the employees, after transferring data about its safety or the alternative drug that is proposed to be taken.
Issues regarding the third party payer announced to the customer possibly through sending a SMS to said customer
and inquiring his decision with regards to it. An additional employee (or more) may be required as a helper(s) in
informing the customers of these, and also calling up the third party payers for affirmation. Additionally, the
helper(s) may be of assistance to others during peak hours.

The implementation of another IT system for the pharmacists will most likely take time before it can be
fully maximized, as the drug to drug interaction is a serious case. As a cautious step, the IT system should be
implemented in few stores before spreading it out if its effectiveness and efficiency is proved. Pharmacists will have
to be trained in using the system and they will initially have to double, triple check the results of their own DUR
system in order to ensure the safety of the customers. Otherwise, the system will backfire and as a result, will affect
the reputation of CVS, their sales, and customer base.

The employees will definitely have a harder time in managing the tasks as they are more complicated:
reading the questionnaires of the customers and quite possibly receiving ones that are illegible, having to constantly
inform the customers of the reminders and problems that may occur, entertaining customers that may not fully
understand these. Moreover, the proposed IT system imply that the pharmacists are required to learn of the system
and to coordinate with the programmer for the drug-drug interaction, all of which may be regarded to as
inconvenience. Due to the employee turnover, it is advisable for the company to invest in fostering a supportive and
homely environment to increase employee attachment to the company. Creating reward systems for the employees is
also an appropriate course of action to encourage the employees. Employee bonuses can be modified to that of a
bonus package such as being given a discount or an increased bonus for a certain number of shifts during peak
hours in a month. Adding their employee benefits can also improve the turnover rate of employees in CVS. The
possible need for an increase in staff, as well accommodating the employees with increased bonuses and benefits,
will, however, affect the Human Resources department.

Aside from the employees, the customers are also affected in that instead of simply dropping off their
prescriptions, they will need to fill in the questionnaires. The questionnaire might take a long time for some, if they
cannot completely understand some questions. The customers might complain about this, and a better way to
address this is to open up another booth to entertain drop offs wherein a pharmacy personnel will always be
available for questions on the questionnaire. The presence of kiosks still needs this personnel availability as the
hover option or the caption on the questions as explanation does not guarantee complete clarity on the part of the
customer. Another option for entertaining questions if the kiosk option is implemented is a chat box in the kiosk
where an employee will be available to answer in their own computer terminal. This allows the employee to
entertain more than one customer asking a question via multiple chat messages in the same chat functionality
provided by the application software in their computer.

Conclusion

The aforementioned analysis takes into consideration the Pharmacy Service Initiatives (PSI) concerns of
maintaining safety in fulfilling prescriptions, decreasing customer waiting time, and improving customer satisfaction.
To ensure that the new process implemented is an improvement over the current one, continuous reviewing of the
implemented changes in the process and the IT softwares they will use must be executed. This assures that methods
work as they should be, and if not, analysis can be done once again and an appropriate action to remedy them can be
executed. Repeated testing of the softwares they intend to use will also help ensure that what they are using are up-
to-date and are delivering the functions they want from it. These continuous improvement of the new process will
make certain that the past mistakes and problems will not be repeated.

With all of these recommendations, chances of backsliding is not out of the question however. What the
company can do to minimize backsliding and its consequences, is to ensure that employees undergo appropriate
training to create and maintain a satisfactory service to the customers. The IT system implemented in CVS also
suggests that the employees should develop sufficient knowledge (or receive training as well) about the system for
ease and flexibility. With employee training as part of the companys continuous improvement, chances of
backsliding can be minimized.

PSIs combination of a proactive and reactive approach to problem solving is a best practice that makes
CVS process more efficient, making them a significant opportunity for CVS. With the help of our
recommendations and PSIs best practices, the fulfillment process will surely undergo changes that can only make it
for the better.