Green belt presentation jerry abrams
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The current prescriber update process at TRC-CC PBS is cumbersome and costly, resulting in $3.9 million in lost revenue annually. A Six Sigma project was conducted to analyze the process, collect data, and identify areas for improvement. Key findings included inaccurate prescriber data in eSD, agents spending too much time off phone calls to update prescribers, and a lack of process standardization and monitoring. Recommendations included designating specialists to validate prescriber updates instead of individual agents, electronically submitting requests, and establishing performance metrics to track outcomes. Implementing these changes improved adherence and reduced errors while allowing agents to focus on calls, capturing an estimated $860,000 in additional value annually.
Green belt presentation jerry abrams
- 1. SIX SIGMA LEAN PRESENTATION JERRY ABRAMS July 2012
- 2. Introduction….. TRC-CC PBS’s goal is to drive prescriptions into the business by means of telephone outreach to current ESI members. Outreach includes reviewing members medications and costs involved at the retail pharmacy, then comparing them to the savings built into their plan if the member selects to utilize their full benefits and receive their meds from the ESI pharmacy. Once the member agrees to take advantage of their plan, and utilize the ESI Pharmacy, then the agent, with the members approval launches a fax prescription request directly to the members prescriber.
- 3. Problem Statement….. Over the past 3 years the ESI TRC-CC Prescriber update process has been cumbersome, and costly. Prescriber information in eSD is inaccurate thus resulting in an agent not being able to launch his prescription request, resulting in an estimated $3.9 million dollars in lost or reduced revenue, which incurs increased costs passed onto our clients and delayed and poor services delivered to our members.
- 4. Introduction….. Overview Data Collection Voice of the customer What is Analyzed Making the change
- 5. Overview….. Prescriber updates is a process to review, validate and activate a prescriber within eSD. PBS agents require active prescribers within eSD to process and launch faxes. Updates require verbal communication between ESI and the prescribers office. Agent is required to log off J-Phone and conduct prescriber validation on an individual basis. Business unit’s growth opportunity potential was estimated Business data was captured over a 7 month period Benefits were realized Actionable results realized benefits for business unit TRC-CC PBS
- 6. Scope….. Data Control & Analysis -Currently no form of prescriber data collection or analysis is in place. Evaluation Spreadsheets Evaluation Methods Customer Requirements (Internal & External) Quality Control
- 7. Data Collection….. The data collected over the past 7 months is used to : - Measure the VOC -Recognize growth and development opportunities -Provide factual data stating whether the process improvement is effective or not.
- 8. Data Control….. What is our overall start total? Utilize data gathered over the past 7 months to measure total weekly prescriber updates and revenue generated. - How many departments were monitored - How many agents per department Create a process to consolidate prescriber updates and monitor quality -Variations in agent submissions are monitored
- 9. Data Control, cont….. Measure current submission levels. -How many prescriber updates are being submitted by agents per week? -Create a reporting system to validate submissions -What is the estimated revenue generated per week? -Create a flow chart to track ebbs and tides of revenue generation on a daily basis.
- 10. Voice of the Customer Customer Input VOC Tool Process Statement Requestes medications to be ESI Member Order placement eSD Process Requirement Verbal approval for ESI Agent to contact prescriber delivered to their home from the via fax. ESI Pharmacy Active prescribers within Agent must be able to toggle eSD. Designated prescriber to launch PBS Agent Members Called eSD Prescription request fax. Verbal out-reach to prescriber. Validation of secured fax. TRC must receive a valid excel Submission to TRC for request to have a prescriber updated TRC Prescriber update eSD/ Excel prescriber activation in eSD. within eSD to PBS Agent. Activation email delivered
- 11. Measuring…… Time Management Average Process Time Variables In The Mix Forms –Research-Departmental RequirementsSearch Times-Systems Issues Best Practices Organization-Quality Control-Time ManagementProcess Flow
- 12. Presenting Data….. Pareto Chart 3000 98.14% 98.89% 99.61% 99.84% 100.00% 93.95% 1 0.9 2500 0.8 # Observations 0.7 2000 0.6 0.5 1500 0.4 1000 0.3 0.2 500 0.1 0 0 Non Secure Fax New Address Prescriber Not in System Group No Telephone Number Not updated in sysytem Wrong Address
- 13. Presenting Data cont…. Count Prescriber Not in System Non Secure Fax New Address No Telephone Number Not updated in sysytem Wrong Address
- 14. Data Analysis….. Once data is collected, how is it translated? Optimizing the Failure Mode Effects Analysis Process we can easily identify: Process Functions Process Failures Effects of potential failures Clearly evaluate process controls Recommend achievable actions to secure positive results
- 15. Analyze….. Simple math….. Average 72.4 prescriptions per day 145 days (29 weeks) * 72.4 prescriptions per day= 10,498 prescriptions Weekly average = 362 prescriptions per week Agents per team=30 * 7 minutes per call (average) = 210 minutes 210 minutes/60 (minutes /Hr) = 3.5 hrs per day on the phone 3.5 Hours * 3 teams = 10.5 hours
- 16. Additional analysis Process Potential Function Failure Potential Suggested (Failure Mode Analysis) Responsibility Actions Taken 12/1/11 flow chart Redesign prescriber Potential action Effects causes of failure Agent logs off dialer to call prescribers for updated information Inability to take new calls and gain conversions Loss of One agent eSD not initiate all meds accurate update process and monitored 12/10/11 encrpted value of capture, time saved prescriber spread sheet beta testing through having only one person calls for entire dept 12/15/12 Launch of off the dialer and making outreaches to prescribers, thus keeping new prescriber update balance of agents focused process on receiving additional calls.
- 17. What’s the problem? The complexity of the current process has intensified whereas in some cases Agents are not properly validating a prescriber and are simply pushing it through Thus causing IHI and HIPAA violations. (Prescription requests are being faxed to wrong prescribers) Too many agents are off the dialers at any given time thus not taking calls. There are no safe-guards in place to monitor the process and validation of data Received by the agent to update eSD. Inadequate or no standardization in current process (extreme chaos)
- 18. Actionable items for improvement….. Determine, isolate & reduce all variables. Calculate value added Determine and establish best practices (none currently Exist) Develop agent accountability standards and quality Levels.
- 19. Isolation, reduction & variable elimination Create a standardization process whereas all agents are Compliant and remain on the dialer throughout the Day and not calling prescribers for updates. Standardize process flow implementing and adhered To by all agents Standardized submission forms
- 20. Adherence Improvement…. New process improves adherence by allowing agents to “Hit the Green Light” faster! Allows for improved accuracy with prescriber updates And for a reduction in IHA & HIPAA violations.
- 21. Recommendation…... Identify areas of opportunity & report data collected Prescriber updates (3,900 requests) Captured value ($860,000.00) Time saved. (Cumulative total 10.5 hrs per day)
- 22. Data Validation….. Established a baseline using requests made each day, by each agent and the number of meds associated to the request. Averaged baseline and multiplied by the est. value of each med. Factored in the est. time and hourly wage by 80 agents. Validated with TRC Management to ensure accurate results and proper estimates.
- 23. Productivity….. Create standardized process for requests and monitor accuracy and validity. Originally each agent was responsible for out-reach to prescriber. Management received requests each night Management sent excel sheet to ESI (un validated or verified for accuracy) Eventually ESI would confirm that eSD had Been updated Management was responsible to notify agents requests were completed.
- 24. Productivity cont….. Now…. All prescriber requests are electronically submitted by the agent to a specified specialists who conducts outreaches to each prescriber to verify and validate address and a secure fax number. (one specialist reduces IHI and HIPAA violations and agents remain on the phone) Specialist reports directly to ESI for prescriber updates in real time. Agents receive their updates in a one hour turn around thus allowing increased production.
- 25. Time in motion….. Continue to monitor and evaluate process Train other locations as they utilize the prescriber update process Use new and existing evaluations to plan additional process flow improvements
- 26. Performance Metrics….. Streamline system to monitor and trend further individual requests: Production Completion rate Denial rate RPh Verbal completion rate RPh Verbal denial rate Incomplete rate
- 27. Performance Metrics cont. Added value: Value gained per med Value lost per med Value gained by agent remaining on the dialer Value lost by agent doing individual out-reaches
- 29. Time to Implement….. Use current resources to begin gathering historical data Use data to calculate results Present results to customers(TRC-CC Management) Modify current Request forms Update forms to reflect additional information Perform tracking and validity of information Make impact with results
- 30. Conclusion….. 2011-2012 Direct benefits 3,900 Prescriber update requests made 3,500 Prescriber update requests completed 10,498 Prescriptions gained 1000 Prescriptions lost