Question

1. Consider the pharmacy prescription fulfillment process described below. Identify the steps in this process and classify them into value-adding, business value-adding, and non valueadding. Customers drop off their prescriptions either in the drive-through counter or in the front counter of the pharmacy. Customers can request that their prescription be filled immediately. In this case, they have to wait between 15 minutes and one hour depending on the current workload. Most customers are not willing to wait that long, so they opt to nominate a pickup time at a later point during the day. Generally, customers drop their prescriptions in the morning before going to work (or at lunchtime) and they come back to pick up the drugs after work, typically between 5pm and 6pm.When dropping their prescription, a technician asks the customer for the pick-up time and puts the prescription in a box labeled with the hour preceding the pick-up time. For example, if the customer asks to have the prescription be ready at 5pm, the technician will drop it in the box with the label 4pm (there is one box for each hour of the day). Every hour, one of the pharmacy technicians picks up the prescriptions due to be filled in the current hour. The technician then enters the details of each prescription (e.g. doctor details, patient details and medication details) into the pharmacy system. As soon as the details of a prescription are entered, the pharmacy system performs an automated check called Drug Utilization Review (DUR). This check is meant to determine if the prescription contains any drugs that may be incompatible with other drugs that had been dispensed to the same customer in the past, or drugs that may be inappropriate for the customer taking into account the customer data maintained in the system (e.g. age). Any alarms raised during the automated DUR are reviewed by a pharmacist who performs a more thorough check. In some cases, the pharmacist even has to call the doctor who issued the prescription in order to confirm it. After the DUR, the system performs an insurance check in order to determine whether the customer’s insurance policy will pay for part or for the whole cost of the drugs. In most cases, the output of this check is that the insurance company would pay for a certain percentage of the costs, while the customer has to pay for the remaining part (also called the co-payment). The rules for determining how much the insurance company will pay and how much the customer has to pay are very complicated. Every insurance company has different rules. In some cases, the insurance policy does not cover one or several drugs in a prescription, but the drug in question can be replaced by another drug that is covered by the insurance policy. When such cases are detected, the pharmacist generally calls the doctor and/or the patient to determine if it is possible to perform the drug replacement. Once the prescription passes the insurance check, it is assigned to a technician who collects the drugs from the shelves and puts them in a bag with the prescription stapled to it. After the technician has filled a given prescription, the bag is passed to the pharmacist who doublechecks that the prescription has been filled correctly. After this quality check, the pharmacist seals the bag and puts it in the pick-up area. When a customer arrives to pick up a prescription, a technician retrieves the prescription and asks the customer for payment in case the drugs in the prescription are not (fully) covered by the customer’s insurance.

Answer 1

This case is all about pharmacy prescription fulfillment process. There are three types of activities that we have to sagreegate namely value-adding,business value-adding and non-value adding.

Activities Classification

Value Adding Business Value-Adding Non Value-Adding Request by customer for immediate delivery of prescription. Dropping of prescription either in drive-through counter or front counter of pharmacy. Asking to customer by technician for pick up time inspite of awareness that it is usually between 5 to 6 P.M after office hours. Drug Utilization Review(DUR) performed by pharmacist regarding customer with refrence to his/her previous database. Dropping of prescription in a box labeled with the hour preceding the pick up time by technician as per process. Double checking of prescription by pharmacist after technician has filled a given prescription,this can be performed by technician. Thorough checking by pharmacist in case of any alarm raised up during DUR of a particular customer. Pickng of prescription every hour due to be filled in current hour by technician. Sealing of bag by pharmacist and putting it into pick up area,this can also be performed by technician. Calling to doctor by pharmacist in case of any alarm raised by pharmacy system during DUR. Checking up by pharmacy system in order to determine whether the insurance policy of a customer will pay full or part of the drug cost. Retrieving of the prescription by technician on arrival of a customer for pick up and asking for payment(full or part) in case the drugs in the prescription are not(fully or partly)covered. Collection of drugs by technician from the shelves after completion of insurance check and putting it into bag with prescription stapled to it. Calling to doctor and customer by pharmacist regarding the replacement(substitution) of drugs in case prescribed drugs are not covered under insurance policy of a particular customer.

Regards.