This research proposes an integration of service blueprint, value stream mapping and FMEA to enhance the effectiveness and efficiency of service improvement. The integration tool is named “Integration Service Stream Value Risk Analysis; IS2VRA” IS2VRA is a visualized and systematic tool, according process improvement logic IS2VRA have fourteen steps. This study describes step by step IS2VRA and case study in Health examination. After the application, health examination process total time has been reduced 7 minutes and customer satisfaction has been promoted 52%. It has successfully proved that IS2VRA is feasibility and effectiveness.