Pharmacy Service

Improvement at
CVS
Background
What is CVS?
Founded in 1963 (Lowell, Massachusetts)
One of Americas largest retail drugstores
4,000 stores
$24.2 Billion in revenue

Pharmacy Service Initiative (PSI)
Over two-thirds of revenue generated by pharmacies
Pharmacies currently have 29.5M customers each year
High customer turnover in spite of increasing revenue
Loss of potential profit/revenue through customer retention (loss of 7.2M customers and a gain
of 8.5M customers in 2000)
Customers that switch take with them $2.5 Billion in revenue
Customers are not receiving a pleasant experience

The Current Pharmacy Process
Drop-Off (Tech)
Customer drops off prescription to tech
Tech puts script into slot corresponding to the hour before desired
pick up time.
Busiest drop-off times: before work, lunchtime, after work
Drop-Off Data Entry Production
Quality
Assurance
Pick-up
The Current Pharmacy Process
Data Entry (Tech)
Each hour, tech takes that hours scripts from the box
Required data entered into pharmacy information system
DUR checks current script against all previous scripts, patients
age, gender, and other demographics for potential problems
Hard stops MUST be reviewed by pharmacist before fulfillment (PH)
Insurance Check
90% of customers use insurance
Errors: Drug not on formulary or refill too soon
Process continues even if rule is violated

Drop-Off Data Entry Production
Quality
Assurance
Pick-up
The Current Pharmacy Process

Production (Tech)
Drugs to fill script are counted and verified
Quality Assurance (Pharmacist)
Pharmacist reviews script for quantity and other details
Five minute process from data entry to QA
Pickup (Tech)
Prescriptions sealed and stored in alphabetical order
Tech at pick up window finds script, verifies identity, and takes
payment
Drop-Off Data Entry Production
Quality
Assurance
Pick-up
Customer Complaints
Why the hell is this four hundred dollars?
Im not moving from this spot until we get this cleared up!
You lost my prescription!
Where are my other scripts?!
Im not sure how many scripts I have.
What do you mean you cant find my order?!
I talked to someone four days ago to make sure my order would
be ready!
Problems
Drop-Off (Tech)
Nobody available/extended wait before initial greeting
Tech fails to retrieve proper information from customer
Failure to properly prioritize scripts
Drop-Off Data Entry Production
Quality
Assurance
Pick-up
Problems
Data Entry (Tech)
DUR and Insurance Check
Customer not notified of third-party issues
No refills allowed
Cannot read handwriting
Drug not on formulary or refill too soon
No standard form for faxing providers
Process continues even if rule is violated
One hour time frame

Drop-Off Data Entry Production
Quality
Assurance
Pick-up
Problems



Production (Tech)
Partial or complete stock shortages
Quality Assurance (Pharmacist)
Prescriptions filled incorrectly
Pharmacist falls behind at QA
Pickup (Tech)
Script/groups of scripts cannot be found
Tech at pick-up window not qualified to answer questions

Drop-Off Data Entry Production
Quality
Assurance
Pick-up
The New Pharmacy Process
Drop-Off (Tech)
First time customers have information downloaded onto a CVS card
Create a kiosk for return customers
Customer scans card with personal information
Customer enters desired pickup time
Customer is asked if insurance information has changed
Customer selects preferred contact method
Displays information for confirmation
Kiosk prints receipt with pick-up time
New prescription prioritizing software

Drop-Off Data Entry
Issue
Resolution
Production
Quality
Assurance
Pick-up
The New Pharmacy Process
Data Entry (Tech)
Software selects next script in line to eliminate one hour time frame
problem
Sorting boxes are replaced with on-screen displays of next script
Tech enters data from script
Legible scripts that pass automated insurance check are verified against existing
inventories and go on to production
Insurance issues and illegible scripts are printed on a standard form displaying script
and are faxed to doctor
DUR hard stop issues are forwarded to pharmacist
Issues not resolved within a certain time frame from data entry are
communicated to customers via chosen contact method

Drop-Off Data Entry
Issue
Resolution
Production
Quality
Assurance
Pick-up
The New Pharmacy Process
Issue Resolution (Pharmacist)
Legitimate hard stops in the DUR and unresolved insurance issues are
communicated to customers via telephone by a qualified person
Production (Tech)
Software keeps track of inventories and is linked to other pharmacies
Pharmacists are notified to order additional inventory when thresholds
are reached
Customers are notified of new availability date or alternate pick-up
location for prescriptions not in inventory

Drop-Off Data Entry
Issue
Resolution
Production
Quality
Assurance
Pick-up
The New Pharmacy Process

Quality Assurance (Pharmacist)
Automated processes allow for pharmacists to spend more time
conducting QA
Pickup (Tech)
Customers card is scanned to display all pending prescriptions
Unresolved issues flagged at card scanning are resolved by the
pharmacist

Drop-Off Data Entry
Issue
Resolution
Production
Quality
Assurance
Pick-up
Conclusion
Personnel concerns
Technicians will require training for new software
Pharmacists will need to be more interactive with customers
Process integration concerns
Automated system will be the only means of completing duties (destroy
wooden boxes)
Regional managers will follow-up
Financial Benefits
Customers that switch take with them $2.5 Billion in revenue
13% of light users and 44% of heavy users switch due to service
60% - 90% of these can be retained through our new process
$600 $900M in additional revenue (Assumption: 40% of all users switch
due to service)
Questions?