Slide 1
National Immunization Conference 
McKesson Specialty
Conference Goal
“The goals of the Conference are to provide information that will help participants provide comprehensive immunization coverage for all age groups and explore innovative strategies for developing programs, policy, and research to promote immunization coverage for all age groups.”

McKesson Specialty’s Objective:
To communicate the results we have achieved to date as well as our continued commitment to ensure you are able to execute on promoting immunization coverage for all age groups.

Slide 2
Quality Performance - DC

January 2008
88,361 lines shipped
26,688 packages shipped
218 returns

February 2008
88,181 lines shipped
23,087 packages shipped
35 returns

March 2008 
22,831 lines shipped
6,253 packages shipped
4 returns

As many of you have heard, there has been a problem with some vaccine shipments arriving frozen.  In January, 71 of 20,166 boxes arrived with the temperature monitor indicating "frozen."  This compared with 25 of 16,721 boxes in December, a change from 0.015% to 0.035% of shipment boxes.  The increase in cold chain problems happened on Sunday shipments.
 
McKesson traced the problem to a difference in the handoff of packed vaccine from McKesson to Federal Express on Sundays compared with weekdays.  On Sundays, the packed boxes were outside of the controlled environment of McKesson's warehouse for a longer period of time than on weekdays.  The colder temperatures in January, therefore, exposed the packed boxes to temperatures they were not designed to handle.  The temperature probe picked up this temperature excursion, preventing frozen vaccine from being used.

McKesson has suspended Sunday shipments temporarily until they can establish a cold chain between their warehouse and Federal Express that assures ambient temperatures in the range that the boxes can handle.  Once this procedure is established, McKesson will resume their Sunday shipments.

Slide 3
Cold Monitor Instances

December 2007
16,721 packages
25 Monitor instances
Accuracy rate of 99.84451 percent

January 2008*
20,166 packages
71 Monitor instances
Accuracy rate of 99.64793 percent
*Estimated point in time

Slide 4
Customer Service Calls
Total Monday Calls

January 7, 2008
Approximately 3 calls
Approximately 5 percent

January 14, 2008
Approximately 6 calls
Approximately 8 percent

January 21, 2008
Approximately 7 calls
Approximately 10 percent

January 21 and 22, 2008
Approximately 28 calls
Approximately 40%
Combined January 21 and 22 due to Martin Luther King Holiday

Total Monday Calls 
Approximately 37 calls
Approximately 55 percent

Slide 5
Instances by Ship Date

January 2, 2008 had 8 
January 3, 2008 had 1
January 4, 2008 had 0
January 5, 2008 had 0
January 6, 2008 had 10 - confirmed pick up on Sunday.
January 7, 2008 had 1
January 8, 2008 had 2
January 9, 2008 had 3
January 10, 2008 had 2
January 11, 2008 had 0
January 12, 2008 had 0
January 13, 2008 had 0
January 14, 2008 had 19 – confirmed pick up on Sunday
January 15, 2008 had 3
January 16, 2008 had 2
January 17, 2008 had 3
January 18, 2008 had 0
January 19, 2008 had 0
January 20, 2008 had 17 – confirmed pick up on Sunday

No longer ship via FedEx on Sundays to avoid delay such as those experienced in January.  Temperature scanners added to verify temperature range on orders and ice.  
Refrigerated storage added for each pack station to ensure proper handling of product and monitors.

Slide 6
Quality Measures - DC

Cold chain quality measures went from 99.92 percent to 99.98 percent to 99.97 percent with average of 99.75 percent

Order quality measures went from 99.98 percent to 99.92 percent to 99.86 percent with an average of 99 percent.  These were all responsibility all error types.

Slide 7
48 hour rescue product process

The objective of this process is to save as much vaccine for the program as possible
•	Proactively track delivery status of every order
•	At the 48 hour mark, intercept product and bring safely home (re-route to DC)
•	Follow up with outbound call to Grantee communicating events
•	Place replacement order, remove delivery challenge and get viable vaccine to provider

Slide 8
Over $750K in rescued product
October rescued approximately $50,000
November rescued approximately $250,000
December rescued approximately $150,000
January rescued approximately $300,000

Slide 9
New Packing List

There is a blurred image of a packing list which can not be read.  Items emphasized are:
Provider PIN number
Number of containers
Product presentation
Container numbers
Manufacturer
Ship date
Lot number
Doses by presentation
Vaccine Price

Slide 10
Sacramento Update

•	Live with second distribution center
•	Orders – 1,241
•	Containers – 1,282
•	Doses – 267,073
•	Boxes/Order – 1.03
•	Comprehensive transition schedule

Sacramento Service – AK, AZ, CA, HI, ID, KS, MN, MT, NE, NM, NV, OK, OR, TX, UT, WA, WY, Pacific Islands

Slide 11
Customer Operations Overview

“Customer Service is the ability of an organization to constantly and consistently exceed the customer’s expectations”
Slide 12
Where have we been?

Project Ambassadors:
•	Designed and implemented as administrative staff to track and escalate the disposition of packages en route.
•	Take Phone calls, voice mail and email and escalate to DC for resolution
No single point of contact (SPOC)
No clear escalation path
Lack of responsiveness
Little to no follow up

Slide 13
Verbatim Experience Quotes 

“I have sent 3 previous requests to have their wasted vaccine picked up.  Clinic is upset that it has been sitting in their office waiting for pick up since early Sept.”

“We need to be notified of these types of instances immediately.  It is a poor reflection on all of us, when basically the only reason we find out about the lack of stock is because a provider called McKesson and found out--or because I've called McKesson due to the provider calls I am receiving and that's how I find out.  This situation has to change.”

“I have not received a response regarding this shipment.  Is there a time frame that I can expect a response within?  I sent this Wednesday and then again Thursday. “
“Vaccine delivery service to our state has not been going well.”

Slide 14
Where are we now?

Customer Service:
−	Empowered with tools, SOP’s and authority to resolve issues for Grantees on the very first telephone call when possible
−	Training our agents to act as the advocate for the Grantee and Provider, owning issues from inception to resolution

Slide 15
Customer Operations Key Developments – Technology and Customer Service Alignment

Technology
•	All Calls logged in Storm as of Mid-December
•	Capable of Delivering Key Customer Operations Metrics by November 5th
−	Issues by Category; by CSR; by Project; Created over Date Range
•	Escalation Tracking; Time to Resolution; 1st Call Resolution; Re-Open Rate; Temp Monitor Reporting
Internet Protocol Call Center Manager 
−	Average Wait Time
−	Abandon Rate
−	Speed of Answer
−	Talk Time

Slide 16
Key Metrics

Capture Rate
Greater than or equal to 96 percent of total Telephone Calls and Emails
December 70 percent
January 83 percent
February 85 percent

Answer Rate
Greater than or equal to 95 percent of calls answered
December 83 percent
January 73 percent
February 72 percent

Time to Resolution
Issues not resolved on first call
December 1.52D
January 2D
February 0.9D

First call Resolution
Greater than or equal to 98 percent of total tickets logged
December 60 percent
January 63 percent
February 66 percent

Service Level - Average Speed of Answer
Greater than or equal to 80 percent of calls answered in 30 seconds or less
December 85 percent
January 83 percent
February 81 percent

Total Call Volume (email and telephone)
December 822
January 1, 099
February 822

Slide 17
Verbatim Experience Quotes

“Yes, it has been an excruciating month for us, and I am sure you are tired of seeing the daily e-mail’s from me, and I know that those of you I talked to in customer service got tired of hearing my croaky, laryngitis stricken voice.  I am very thankful and appreciative of all of your hard work.  You truly have been partners with us during this challenging time.”

“I hope you know you are helping us a great deal by moving these on through.  It saves us a great deal of time and energy.  Thanks for doing such a good job.”

“Thank you for your help, you are doing a great job for (our) providers, and we appreciate it...”

“Thank you, thank you!!! I have contacted the Provider they are willing and ready to accept the delivery tomorrow!!  All three of my concerns have been resolved by you and I appreciate it so very much!!!”

Slide 18
Issue Escalation
Escalation Path
How to escalate:   
 In the event you are not getting timely resolution to your reported issue, escalate as follows:
1.	Send an email to our Team Lead, or call 877-822-7746
2.	In your email subject line type “Escalation: PINxyz, PROVIDERNAMEabc, PPOC tel 123-456-7890,”  or when your phone call is answered say “I am escalating an issue and need to speak with your team lead”
3.	If the team lead is not available, follow the escalation path up until you are connected to a person that can handle your escalation

Start Here:
McKesson:	Kristina Cliff   Kristina.Cliff@McKesson.com     Team Lead
McKesson:	Jennifer Boss   Jennifer.Boss@McKesson.com   Customer Care Manager
McKesson:	Jake Frost   Jake.Frost@McKesson.com   Client Executive
McKesson:	Tom Hart   Tom.Hart@McKesson.com   Sr. Director Customer Operations
CDC:	Your POB Project Officer
	Sally Somerfeldt: zfe0@cdc.gov   
Julie Orta: jio7@cdc.gov  
Brad Prescott: bap3@cdc.gov  

Slide 19
Customer Experience Advisory Board
Picture of people in lab coats – two women and three men.

Slide 20
Objective

Form and cultivate an organization that includes McKesson, CDC and Grantees focused on sustainable solutions that bring value to VMBIP empowering all of us to meet or exceed the expectations of providers

Slide 21
Charter

General function
•	The function of the VMBIP Customer Experience Advisory Board will be to advise and make non-binding recommendations to the VMBIP Leadership team

Membership
•	The VMBIP Customer Experience Advisory Board will be co-chaired by Tom Hart, MCK and Brad Prescott, CDC
•	Members will contain 3 CDC members, 3 MCK members and 15 Grantees

Mode of operation
•	The VMBIP Customer Experience Advisory Board will meet 4 times a year (1 time each quarter)
•	The VMBIP Customer Experience Advisory Board will communicate updates to all grantees following each meeting
•	A member of the VMBIP Customer Experience Advisory Board will provide a progress report at group conferences such as AIM or NIC

Slide 22
Process to engage
Membership:
•	Selection and notification will be provided to the advisory board as to those participating, via AIM

Time Frame:
•	All members should be selected by May 15th

Kick off meeting
•	Location TBD
•	Date: June 3rd, 2008

Slide 23
Rules of Engagement

Real life examples
•	Though anecdotal information abounds us, it is critical that those participating in the board collect detailed examples of those issues driving challenges for all

Be part of the solution
•	As an active member of the board, we will be looking to you to provide solutions and positively engage in communicating results

Voice of the customer
•	Come as a voice for those you represent.  We all should be advocates and remember why the program was created:

Many parents can't afford to pay for vaccines on their own. When large groups of children go without vaccines, it leaves them unprotected and disease outbreaks can happen. This program allows everyone to stay healthy by getting his or her vaccines on time. 
(Ref: Mar. 10th, http://www.cdc.gov/vaccines/programs/vfc/providers/faq-parents.htm   )

Slide 24
Thank you

This document can be found on the CDC website at:
http://www.cdc.gov/vaccines/programs/vmbip/downloads/nic/08-nic-mvk-final.rtf