Case Write-up #1: Pharmacy Service Improvement at CVS

After reading the two articles by Ramias and Wilkins on Performance Metrics, what metrics, if any would you identify that are essential to managing the prescription fulfillment process at CVS.
Ramias and Wilkens’ state that the starting point in developing metrics is to understand the expectation of the customer. Upon review of the data compiled by the PSI team, customers expect accuracy and timeliness. Therefore, most of the metrics developed below focus on measuring the two expectations and, I believe, are essential to managing the prescription fulfillment process at CVS. 1. Processing time – prescriptions filled per unit of time. A major customer complaint was time – either waiting too long in line, waiting for their prescription after the pick-up time, etc. 2. Number of prescriptions filled per day and median processing time. Again, this metric will help identify peak time periods, staffing needs, and eliminate waiting times by customers. This would also help to measure accuracy. If prescriptions are constantly wrong and the customer has to wait to correct them, the processing time will be higher than expected. 3. Hourly volume and median processing time. This metric would measure the volume of prescriptions filled per hour, the percentage of prescriptions filled in under the target number of minutes, and the median time to fill them per hour. Because heavy users cited service as their number one reason for switching pharmacies, and time is such a huge part of the customer’s expectations, metrics should be focused to measure timeliness of prescription fulfillment. 4. Weekly prescriptions processed on time. 5. Labor cost per prescription sold. This is an extremely important metric, as it will help scheduling and staffing levels. The metric should be graphed by day and hour. 6. Percentage of prescriptions with insurance problems to total prescriptions. This metric could help to identify problems in this process and allow the team to identify specifics. This also leads to a delay in the time spent processing a prescription. 7. Percentage of refills handled by the automated system that allows customer to phone in refills. This could be a helpful metric in determining staffing and the effectiveness of the IVR. 8. New/refill prescription ratio. This could be useful in determining customer retention and improve revenue growth. 9. Pharmacy performance rankings. This metric would measure individual CVS pharmacies against other CVS pharmacies. This metric would be helpful in determining best practices. 10. Ramias and Wilkins’ state that the starting point in developing metrics is to understand the expectations of your customer. Customer satisfaction surveys should be given and analyzed on a regular basis. The results would then be tracked and measured against previous surveys and by individual pharmacy, as well as the total company results. 11. Number of customer complaints. This could be an important metric to determining if customer complaints are decreasing or increasing over time. 12. A metric that is not wholly based on the prescription fulfillment process is the number of over the counter sales per prescription. CVS is currently 1/3 over the counter, and 2/3 prescriptions. A metric that tracks this percentage could be useful in determining how the non-prescription side of the business is performing.
At this time, I would not do anything with the drug utilization review. The article states, “Everyone at CVS felt that the DUR was an essential part of good pharmacy operations and customer service and that the automated review should be a very careful and conservative one.”