ITECH 5404 BUSINESS PROCESS ANALYTICS AND CHANGE

Tutorial 1
Topic
Introduction to Business Process Management

Questions

Consider the following process at a pharmacy.

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
labelled 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 double-checks 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.

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 Work on the following questions. Note that you may have to do some additional reading or research in
order to be able to answer some of these questions fully, but you should be able to start thinking about
these answers and coming up with meaningful ideas even if you don’t yet know all of the terminology
involved. You can also look at the other exercises in Chapter 1 of the textbook where solutions are
provided to get an idea of BPM as a whole.

1. What type of process is the above one: order-to-cash, procure-to-pay or issue-to resolution? Why?
Order to cash: It is also called O2C or OTC, refers to the set of business procedures in which
customer orders for goods and services are received and processed and payment is made.
procure-to-pay: The process for the requested, purchased, received, paid for and accounted
for goods and services is the procure-to-pay t process. It derives its name from the ordered
procurement sequence and financial processes, starting with the first steps in procurement or
service in terms of the final stages of payment.
issue-to resolution: An Issue register – where the project team and the end user or customer
record all the questions raised and exchange them. Communication For Issues Resolution –
emails, teleconferences, video conferences and face-to-face meetings will contribute to the
resolution of issues besides the Issue Register.
Order to cash is the case when customers buy pharmaceutical medicines, thus,
pharmacy receives a prescription and the processing order of sales to be paid in cash.

2. Who are the actors in this process?

Human: Customer, Technician, Pharmacist, Doctor.
Physical Objects: Prescription, Drug, Drive Through counter, Front counter, shelves, Bag,
pickup area.
Immaterial objects: pharmacy system, insurance policy
3. What are the tasks of this process?
Technician collects the prescription
Customers drop off their prescriptions
The technician enters into the system the details of each prescription.
An automated check called Drug Utilization Review (DUR) is carried out by the pharmacy
system.
Review DUR alarm
Check insurance (not automated at this stage)
Resolve insurance issue (call doctor if needed)
Collect drugs
Check drugs
Deliver drugs (check payment if required)
4. What value does the process deliver to its customer(s)?
Value: which is held in regard, the importance, worth, or usefulness
Value to customer:
o Drug deliver on pickup time agreed

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 o Successful insurance check
o Pickup or drop off facility offered by the pharmacy (No waiting time)
o Pharmacist calm insurance at the point of purchase (Not need for patient contact insurance company
depending of insurance policy)
o Need to make only co payment for the difference if required
5. What are the possible outcomes of this process?
Negative:
o Prescription not ready when customer came to pick up (customer dissatisfaction) due to the delay
in the process
o Customer do not agree with the co payment and withdraw the prescription
o Drug bot available
o DUR fails
o Insurance check fails
Positive:
Customer satisfaction:
o prescription ready when customer pickup on time
o drug available
o success of insurance check
o success of quality check
Result: accurate drug will be delivered on time and the customer agree with co-payment

6. Taking the perspective of the customer, what performance measures can be attached to this process?
Performance measurement is generally defined as regular measurement of outcomes and
result, which generate reliable data on the effectiveness and efficiency of programs. Input
resource (human resources, employee time funding) used to conduct activities and services.
Performance measure: timing script is filled (1 hour before pickup)
Most effective drugs dispensed
Drug utilisation review system
% of cases where drugs are available and delivered at the agreed time
% cases customer agrees to pay the co payment
%of cases where prescriptions are fulfilled accurately

7. What potential issues do you foresee this process might have? What information would you need to collect
in order to analyse these issues?
Performance measurement is generally defined as regular measurement of outcomes and
result, which generate reliable data on the effectiveness and efficiency of programs. Input
resource (human resources, employee time funding) used to conduct activities and services
Performance measures:
Drugs are not available at pick up therefore count of these cases and reasons for delays
should be made

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 Customer does not agree to pay co-payment. therefore, count of these cases and reasons for
discrepancies should be made
Pharmacy reject too many prescriptions during quality check % count and reasons should be
documented
Pharmacist need to deal with too many automated DUR alerts% count of false positivr among
drug alerts is needed categorised by reasons

8. What possible changes do you think could be made to this process in order to address the above issues?

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