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:
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Drop Off

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
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Data Entry

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
Drug name
Dosage
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%)
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Production

Scripts were