Model the business process described below using Bonita BPM software. Answer

all the questions at the end. You can assume that communication with customers,

doctors, and insurance companies is done by telephone. This means that you do

not need separate pools; focus on the process within the pharmacy. You should

make reasonable/sensible assumptions about the information on prescriptions,

information about insurance, and information about drugs. Include what you

think is necessary for a realistic process.

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 pick-up 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 5 pm and 6 pm. 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 5 pm, the technician will drop it in the box with

the label 4 pm (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 customers 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 customers insurance.

With respect to the above process, consider the following questions:

1. What type of process is the above one: order-to-cash, procure-to-pay or issue-

to-resolution?

2. Who are the actors in this process? Who are the customers?

3. What are the tasks of this process?

4. What value does the process deliver to its customers?

5. What are the possible outcomes of this process?

6. Taking the perspective of the customer, what performance measures can be

attached to this process?

7. What potential issues do you foresee this process might have? What

information would you need to collect in order to analyze these issues?

8. What possible changes do you think could be made to this process in order to

address the above issues?