System and Methods of Providing Pharmacy Services

• US 20100256987A1
• Filed: 06/11/2010
• Published: 10/07/2010
• Est. Priority Date: 03/31/2004
• Status: Active Grant

• Current Assignee: CVS Pharmacy Incorporated (CVS Health Corporation)
• Original Assignee: CVS Pharmacy Incorporated (CVS Health Corporation)
• Inventors: Roberts, Jonathan C., Betses, Dimitri G.
• Granted Patent: US 8,554,581 B2
• Time in Patent Office: Days
• US Class Current: 705/2
• CPC Class Codes: G06Q 10/10 Office automation; Time management
• CPC Class Codes: G16H 20/10 relating to drugs or medications, e.g. for ensuring correct administration to patients
• CPC Class Codes: G16H 40/20 for the management or administration of healthcare resources or facilities, e.g. managing hospital staff or surgery rooms

Abstract

System and methods for processing a drug prescription transaction are configured to identify and resolve any issue or problem associated with the transaction during one or more early stages of processing. System and methods of processing the transaction handle prescription and customer data entry, pharmacy inventory check, prescription refill authorization check and/or insurance adjudication review well in advance of production and quality assurance stages by identifying and resolving any issue or problem. Prescription fulfillment is prioritized and estimated prescription pick-up times are predicted based on one or more outcomes of such early stage processing. Customers can be provided with realistic and relatively accurate prescription pick up times that a pharmacy can efficiently and consistently meet as a result of fulfillment prioritization. Further, system and methods for determining a staffing schedule for a workflow process requiring different skill levels during different operation times is provided.

Claims

1-84. -84. (canceled)

85. A workflow management method for processing a drug prescription in a pharmacy, the method being performed by execution of a computer readable program by a computer system, the method comprising:

entering data related to a drug prescription transaction including one or more prescriptions into the computer system to initiate the drug prescription transaction;

estimating and recording in the computer system an estimated date and a time by which the drug prescription transaction will be fulfilled and available to a customer for pick up, the estimated pick up time being determined relative to an estimated pick up time for one or more of a plurality of other prescription transactions requiring fulfillment and arranged in at least one work queue stored in the computer system in accordance with their pick up times;

if necessary, resetting in the computer the estimated pick up time of the prescription transaction in response to receiving data related to at least one of;

(i) drug inventory for fulfillment of the one or more prescriptions, (ii) a third party insurance adjudication review or refill authorization of the prescription transaction, and (iii) a number of prescription transactions in the work queue, and recording a reset estimated pick up time of the prescription transaction in the computer system;

entering the prescription transaction in the work queue for fulfillment; and

prioritizing in real time the position of the prescription transaction in the work queue in accordance with its estimated pick up or reset estimated pick up time relative to the pick up times of the other prescription transactions in the work queue.

86. The workflow management method of claim 85 further comprising relaying the prescription transaction pick up time to the customer.

87. The workflow management method of claim 85 wherein initiating the prescription transaction includes initiating the prescription transaction while in communication with the customer and reporting an outcome of initiating the prescription transaction to the customer.

89. The workflow management method of claim 85 further comprising receiving data related to the third party insurance adjudication review or refill authorization of the prescription transaction.

90. The workflow management method of claim 85 wherein resetting the estimated pick up time of the drug prescription transaction includes resetting the estimated time to accommodate an estimated time to resolve at least one of:

(i) insufficient pharmacy drug inventory for fulfillment of the one or more prescriptions in the prescription transaction and (ii) problems associated with the third party insurance adjudication review or refill authorization of the prescription transaction,

and further comprising prioritizing in real time the position of the prescription transaction in the work queue in accordance with the reset estimated pick up time.

91. The workflow management method of claim 85 further comprising entering data related to at least one of:

(i) insufficient drug inventory for fulfillment of one or more prescription transactions and (ii) problems associated with the insurance adjudication review or refill authorization, into at least one of;

(i) the computer system and (ii) an action note configured to initiate resolution of at least one of the aforementioned.

92. The workflow management method of claim 91 wherein the action note is further configured to include data related to a history of the resolution.

93. The workflow management method of claim 92 wherein the history of the resolution includes at least one of:

(i) one or more of a description of the one or more problems, (ii) one or more steps taken toward the resolution of the one or more problems, (iii) an outcome of one or more steps taken toward the resolution of the one or more problems, (iv) a record of one or more efforts to contact the customer regarding the one or more problems, and (v) the reset estimated pick up time.

94. The workflow management method of claim 85 further comprising prioritizing in real time a position of the drug prescription transaction in the work queue based on whether the customer will wait for the drug prescription transaction to be fulfilled.

95. The workflow management method of claim 94 further comprising prioritizing in real time a position of the drug prescription transaction for fulfillment among a plurality of prescription transactions in the work queue designated as transactions that customers will wait to be fulfilled based on the estimated pick up time or the reset estimated pick up time of each prescription transaction.

96. The workflow management method of claim 85 further comprising entering into the computer system a default pick up time, wherein the default pick up time includes a given period of time executed by the computer program.

97. The workflow management method of claim 85 wherein the estimated pick up time or the reset estimated pick up time includes a time less than a maximum period of time identified by the computer system.

98. The workflow management method of claim 97 wherein the estimated pick up time, the reset estimated pick up time, or a default pick up time includes a time less than the maximum period of time.

88. The workflow management method of clam 85 further comprising checking the pharmacy drug inventory to confirm sufficient inventory to fulfill the one or more prescriptions of the prescription transaction.

99. A computer readable memory having a computer program configured for execution by a computer system to implement a method of controlling processing a drug prescription transaction in a pharmacy, the computer program comprising program instructions for:

recording in the computer system an initial estimated pick up time by which the drug prescription transaction will be fulfilled and available to a customer after receipt of the drug prescription transaction by the pharmacy, wherein the prescription transaction includes one or more prescriptions;

entering prescription transaction data into at least one work queue stored in the computer system to position the prescription transaction into the work queue, the work queue including data related to a plurality of other prescription transactions for fulfillment including a pick up time for each transaction;

prioritizing in real time a position of the prescription transaction in the work queue relative to the initial estimated pick up time or a computed reset estimated pick up time, wherein computing the reset estimated pick up time is in response to receiving data related to at least one of;

(i) drug inventory for fulfillment of the one or more prescriptions, (ii) a third party insurance adjudication review or the refill authorization of the prescription transaction, and (iii) a number of prescription transactions in the work queue; and

recording the reset estimated pick up time, when computed, in the computer system.

100. The computer program of claim 99 wherein computing the reset estimated pick up time of the drug prescription transaction includes resetting the initial estimated pick up time based on an outcome of at least one of:

(i) checking the pharmacy drug inventory and (ii) obtaining insurance adjudication review or refill authorization,

and further comprising prioritizing in real time the position of the prescription transaction in the work queue in accordance with the reset estimated pick up time.

101. The computer program of claim 99 wherein computing the reset estimated pick up time of the drug prescription transaction includes resetting the initial estimated pick up time to accommodate an estimated time to resolve at least one of:

(i) insufficient pharmacy inventory for fulfillment of the one or more prescriptions in the prescription transaction and (ii) problems associated with the insurance adjudication review or the refill authorization,

and further comprising prioritizing in real time the position of the prescription transaction in the work queue in accordance with the reset estimated pick up time.

102. The computer program of claim 99 further comprising entering data related to at least one of:

(i) insufficient inventory for fulfillment of one or more prescription transactions and (ii) problems associated with the insurance adjudication review or the refill authorization, into at least one of;

(i) the computer system and (ii) an action note configured to initiate resolution of at least one of the aforementioned.

103. The computer program of claim 99 comprising instructions for:

prioritizing in real time a position of the prescription transaction in the work queue by identifying the transaction as a waiter prescription transaction and placing the waiter prescription transaction in the work queue in a priority position for fulfillment relative to at least the positions of the plurality of other prescription transactions in the work queue,

wherein the waiter prescription transaction includes one or more prescriptions being processed for fulfillment while a customer waits for processing and fulfillment of such waiter prescription transaction.

104. The computer program of claim 103 comprising instructions for:

prioritizing in real time a position of the waiter prescription transaction in the work queue among a plurality of other waiter prescription transactions in the work queue relative to the initial estimated pick up time or the computed reset estimated pick up time of the waiter prescription transaction.

105. The computer program of claim 99 wherein the drug prescription transaction includes a waiter prescription transaction including one or more prescriptions being processed for fulfillment while the customer waits for processing and fulfillment of such waiter prescription transaction.

106. The computer program of claim 105 comprising instructions for:

computing the initial estimated pick up time of the waiter prescription transaction including;

determining a total number of prescriptions in the waiter prescription transaction;

determining a total number of waiter prescriptions in the work queue within a first given period of time and identify the first given period of time as a first pick up time;

adding a percentage of a total number of non-waiter prescriptions in the work queue to the total number of waiter prescriptions in the work queue to determine a total number of prescriptions within a second period of time and identifying the second period of time as a second pick up time, wherein the non-waiter prescriptions include prescriptions being processed for fulfillment without customers waiting for the processing and fulfillment of the prescription transactions;

comparing the first pick up time and the second pickup time with a default pick up time, the default pick up time being a programmed maximum wait time stored in the computer system for a waiter prescription transaction, wherein

if the first pick up time is less than the default pick up time, recording the first pick up time as the initial estimated pick up time, or

if the first pick up time is less than the default pick up time and the second pick up time is more than the default pick up time, recording the default pick up time as the initial estimated pick up time, or

if the first and the second pick up times are less than the default pick up time, recording the second pick up time as the initial estimated pick up time.