Model the following prescription fulfillment process. Use
subprocesses where required, and nest them appropriately: (Hint- there
are 4 subprocesses: Receive Prescription, Enter and Check
Prescription,…., ….. . Also, you will need temporal events and error
events in a subprocess).
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 labeled 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
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.
Consider the pharmacy prescription fulfillment process described
above. Identify the steps in this process and classify them into
value-adding, business value-adding, and non value-adding.