Uncovering Smart Solutions

By James Yothment, CPP

Medco Health Solutions—now part of Express Scripts—had an escalating, but mysterious problem. Some customers of the mail-order prescription service were returning their shipments, fearing that the package holding the medication had been tampered with. The cost of replacing such orders for customers was more than $500,000 annually. Senior executives turned to security to fix the problem, improve the customer experience, and save money. The security team turned to Six Sigma.

The security team had previously been trained on Six Sigma, a process improvement method developed in the 1980s that continues to be used by Fortune 500 companies. It provides a method for improving any process, including making it quicker or more productive, while increasing quality and cutting costs.

Six Sigma offers a focused approach to process improvement through a method known as DMAIC. This stands for Define, Measure, Analyze, Improve, and Control. In each phase of the DMAIC process, specific tools are used to advance the process improvement. Following is a discussion of each of these tools and how they were used to solve Medco’s product tampering issue.


The first step in the DMAIC process is to accurately define the problem. Here, the project team identifies the customers served by the process, determines customer requirements, and plans how to complete the project. This usually requires some research and initial data collection. The team then prepares problem and goal statements for the project and records this information in a project charter document.

In defining Medco’s problem, the security team understood that customers requested replacement orders for a variety of reasons. The package might have been damaged when received. Items could be missing from the order. The package could appear as if tampering had occurred. An order could get lost and never arrive at the patient’s address. Any of these reasons could result in a replacement order, costing the company significant funds in employee time, postage, packaging, and the replacement medication.

The security team investigated the reasons behind the replacement requests and found that suspected tampering was an overwhelming reason given by customers. A goal was set to reduce shipment replacements due to suspected tampering.



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