A Performance Of Health Maintenance Organizations

Case Study Your Name Subject and Section Professor’s Name August 1, 2019 Introduction Just like any other services in the market, the performance of Health Maintenance Organizations should always be accurate, efficient, and dynamic. It must be able to respond with any issues that arise from its day-to-day operations and be able to propose and adapt a solution that would ensure its clients of an above-par service. In the case at hand, Ben Davis faces a problem that includes accuracy and efficiency of an HMO service. It was stated that there are two main issues that he must resolve, namely (1) improve the performance of an HMO using business statistics and (2) to resolve problems when it comes to inaccurate prescriptions given to patients. In the succeeding section of this article, a process map about the prescription filing process in the pharmacy would be developed in order to address the issues posed above. All in all, the author believes that by streamlining the process with the help of statistics and automation, the HMO would benefit as it improves its performance and decreases risks. Process Map In order to maintain an efficient filing system, a linear process should be adapted from every stakeholder from the prescriber to the patient themselves. The process starts from the healthcare provider writing prescriptions for the patient. These prescriptions should then be given to the pharmacy that is affiliated with the HMO in order to standardized the process. As the pharmacy receives it (e.g., Ben Davis’ workplace) the details would then be entered into the system including everything from the patient’s personal information, medical history, and prescription given that the client gives his consent. As the system counterchecks the patient’s insurance status, it automatically approves the release of the prescription. However, the pharmacist should again consult and educate the patient in order to make sure that the patient is receiving the right medicine and knows how to take it. Going back to the case, this process model presents a very efficient solution to the problems that Juan is facing. In a study conducted by the World Health Organization (2016), one of the common causes of medication errors is the lack of communication between pharmacists and the doctors who prescribe the patient’s medicines. Specifically, the study found that medication error rates amount to about “3% at the dispensing stage and failure to review repeat medications at least once at every sixth request in 72% of cases” CITATION Wor16 \l 1033 (World Health Organization, 2016). Thus, in order to address these problems, phamacists at HMOs should be given more information based on both the patient’s records from treatment as well as the patient’s responses during followup interv...