- KPI's and goals are too superficial and do not identify higher leverage cost saving opportunities.
Focusing so much on reducing touch time leads to increasing pressure on pharmacists who have to review cases that could otherwise be approved by reps, if reps had more time. It also invariably leads to an overall increase in denials relative to baseline. This actually makes the department *lose* money because the rate of second attempts and appeals increase.
- Massive tech debt and tools rolled out without consulting end user needs.
Many of the tools and updates being released lately are half-baked, and there are large portions of the software that are slow and not performant. System outages put strain on all employees as the queues pile up.
- Management is not equipped with proper education or training on tools or have relevant pharmacy experience.
Example: It was once recommended to use ABBYY FineReader for every single attachment. This is not feasible. The built in OCR (Optical Character Recognition) model takes several minutes to transcribe images into text, even for a small 5-10 page document. If you're not aware of this, you will run through attachments and not find the pertinent information, which could lead to incorrect outcomes.
Some supervisors can not pronounce drug names, and do not know their drug class or indication. Even for the most basic drugs. While not entirely pertinent to the role, it is a little concerning.
